An attempt to understand the recent rise of dangerous drug use
Bodies are accumulating. A populace is scared. Poison flows in the streets with impunity. It is almost as if a deadly plague were spreading through our homes and backyards. An infestation that crosses social, racial and ethnic barriers. An epidemic that has claimed dozens of lives in Southern New England in mere weeks. Instead of a flesh eating bacterium or violently elegant viral strain, this plague is an addiction to the powerful and long misunderstood drug heroin.
In the past two months, public awareness of the heroin epidemic, boosted by Governor Shumlin’s State of the State address in Vermont and the death of beloved actor Philip Seymour Hoffman, has skyrocketed. But with the exposure, questions have risen. Why now, in 2014, is heroin, long associated with 1970s post-Vietnam urban drug decay, a deadly threat in the Ocean State and New England as a whole? Why now, in a time when marijuana has taken the failed War on Drugs public spotlight, is a drug like heroin such an extreme threat to the lives of our citizens?
The answers to these questions are simple and impossible at the same time. The American obsession with the chemicals that alter our thoughts and feelings is a fascinating and terrifying field of higher thought and a social commentary on our way of life. Drug overdose has become so common that there exists a national debate as to whether police, firemen and other first responders should carry medicine to counter the overdose and save lives. Why are we so prone to dangerous drug use? Is it backlash from the evolving understanding that the American Dream was a bill of goods sold to several generations that turned up far short of our expectations? The public battlegrounds of the War on Drugs have been ever-evolving. Weed and LSD in the ’60s turned to heroin in the ’70s turned to crack in the ’80s turned to meth and ecstasy in the late ’90s turned to prescription pills in the pre-teens turned back into a full fledged heroin resurgence. Are we doomed to repeat the vicious cycle claiming the lives and health of our neighbors, crippled by our own ignorance of the disease of addiction and criminal versus public health driven approaches to it?
For the heroin addict in RI, these questions are far from their minds. Political rhetoric, intellectual addiction think tanks and dry congressional hearings are far removed from the heroin addict’s daily pain and anguish. Like a nightmare they can’t wake from, the heroin addict sees reality deteriorate in front of their eyes and feels powerless to stop it. For those who don’t imbibe, it is easy to cast judgement. Many have been burned by the destructive actions of addict friends or family members and have no further capacity for sympathy. “Why even start?” they say. “Just another junkie, good riddance!” is a popular sentiment on social media when a headline announces the overdose death of another local or celebrity. We look down on addicts as a thieving criminal class of lower citizens, but how many do we truly understand?
It was this desire for understanding that compelled me to travel to an undisclosed inpatient women’s rehabilitation facility in Rhode Island to talk to Kristen S., a 23-year-old local currently undergoing her second round of treatment for heroin addiction. I sat down with her over coffee and we discussed what it means to be addicted to one of the most dangerous drugs on the planet.
Adam Schirling: Hello Kristen. Thank you so very much for sitting down with me. Where are we right now?
Kristen S.: This is a women’s residential alcohol and addict treatment program. It was originally long term, like 6 months to a year program, but recently due to insurance issues, it’s cutting down to a 3 to 6 month top program, which is unfortunate for me because long term is definitely more effective than just a 30 day ‘spin dry’ sort of thing, you know?
AS: How long have you been here?
KS: I’ve been here… Well, the first time I came here was November 14, 2012. I stayed 10 months, and graduated August 26 2013. I moved next door into the sober house, and I ended up relapsing like 2 months into it for about three months, which brought me back here New Year’s Eve of this year.
AS: What made you come in on New Year’s Eve? It seems like an unusual time for someone to seek help. For most people it’s a time for partying and they’ll get better the next day…
KS: I was just to that point, you know, where I needed help again. It was very quick. The progression of the disease is really quick, no matter how much clean time you have it’s still right there. Luckily it happened in a pretty good way because I came New Year’s Eve and January 1 was the start of the whole insurance change (ACA). I wouldn’t have been able to claim a 6 month bed like I am now, just by coming a day beforehand, so that turned out to be something good. But it was just the day, where I was mentally. It didn’t matter what day it was, you know? New Year’s Eve or Christmas or just a regular day. It was just the day that I needed to get help.
AS: When you checked in, what substances were you here for?
AS: Strictly heroin or anything else?
KS: Strictly heroin.
AS: How long have you been taking heroin?
KS: I started with Oxy when I was 17, which gradually turned into heroin within two months. So I’ve been using since I was 17 and I’m 23 now.
AS: What made you try the heroin after you had been on Oxy for a while?
KS: I couldn’t get a hold of Oxy at the time, and they were expensive. My body… when I had first taken Oxy, I didn’t realize my body was going to be hooked on it. I thought it was like a Vicodin … not so heavy. My boss was giving them to me. I had a lot of back pain, sciatic pain. I took them to help my physical pain and it just got out of control. I met some people, I guess, who were somewhat in my group of friends, who were selling cocaine and heroin. I just ended up trying it and… it was a wrap. Honestly, I wouldn’t blame that on my disease of addiction, because I was definitely using uppers like cocaine, and ecstasy was my thing from when I was 13, until I was 17. I got into opiates for my back pain. So, you know, I already had those tendencies in me, but I never was into downers, or heroin, or pills. I just liked uppers…
AS: So it was easier to find the heroin than it was the Oxy at that point?
KS: Oh yea, absolutely. Especially when they changed the Oxycotin to the new formula where you couldn’t crush them … the time release.
KS: They seemed a bit weaker, but I didn’t even honestly end up trying the new Oxy just from what I heard. I just ended up trying heroin and I was hooked right off the bat.
AS: Is heroin easy to find in Rhode Island?
AS: All over the spectrum of Rhode Island or is it centralized more to the Providence area?
KS: I would say everywhere. From Mass to RI… I’d know many many towns, West Warwick, Providence, Fall River… that’s mainly where I got it from.
AS: Tell me about the first time you tried heroin. What was your first high like?
KS: I snorted it that first few times. I snorted it for like a month. In my head I thought… Well for one I never thought I would be doing heroin and I never thought I would shoot anything. That was kind of like a drawn line just for me in general, due to my stepmother having that same addiction and just witnessing how she lived her life and what it did to her. But i snorted it the first time and I threw up, but even though I threw up i immediately wanted more, and the moment I was done puking I felt like Superman. I just felt amazing and everything was just… everything was ok.. everything in the world was ok.
AS: So have you been using continuously from age 17 to 23?
KS: Well, the first time I stopped and realized I needed help for addiction in general was November 14, 2012.
AS: How hard was it the first time you came in to the facility to get help? What did it feel like?
KS: Well, I did a cold turkey detox because I didn’t want my body to be chained to suboxin or methadone and the detox was horrible, physically and mentally. Once the physical sickness was over, the mental was just as horrible. I couldn’t sit still. My thoughts were all over the place. I felt completely alone, uncomfortable, uneasy. Every negative feeling in the human condition was possible and was just there. All the negativity just was overwhelming me.
AS: Now when you were clean for 10 months, did that feeling ever subside?
KS: It did. After a few months, it became easier and easier. I did have a couple slips, you know, where I used one night and then told on myself, and they gave me another chance because of how honest I was. And I did truly want help, you know. I just didn’t know how at that point. you know? Like right off the bat I put the drugs down and was kind of just soaking up all this negative and I didn’t know what else to do. I couldn’t handle it so I just used again. I say 4 months in, I remember standing in the backyard and I was smoking a cigarette. I remember it was getting a little nice out. It was cold but the sun was out, and it was the first moment in my life that I felt… not alone in the world… and it wasn’t the people, it was just this feeling like…. I’ve always believe in a higher power, but i felt like my higher power finally saw me, you know? I was standing outside and I felt everything was going to be ok. I had never felt that way before unless it was drug induced.
AS: So that was the first time you ever felt that euphoria sober?
KS: Yes. That was the first time I felt that in my life that was genuine, you know it wasn’t drug induced. I had such comfort inside of me that I knew everything was going to be ok as long as I stay on this path and not use.
AS: How has the heroin use affected your work or personal relationships?
KS: Before getting into treatment? I worked hard to get into the union because I love painting and construction and I finally got in in 2010. It was awesome. It was great pay, benefits, security, but I had to lay myself off on October 2, 2013, a month before I came back into treatment, because I became a safety hazard. I was nodding off, falling down, I was driving a lift and nodding off and I’d bang into walls and have to patch it up real quick before my boss would see it. I was just a mess, and everyone knew. They would just keep asking me if I was ok. I was wicked underweight, falling asleep everywhere.
AS: Did a supervisor ever approach you or did anyone suspect?
KS: I heard from a couple people that they thought I was on pills or something. No one guessed it was heroin until I told them when it had gotten to the point that I realized I needed help. I went to the office after work one day and told my head boss, you gotta lay me off I need treatment. I loved my job, but i was not loving my job anymore. It had become something where I had no passion in it. I wasn’t doing the things I needed to do and I was becoming a safety hazard. Toward the end, I was in debt even though I was getting paid well because all of the money went up my arm, and days that I couldn’t get dope and I was sick, I would literally go up to the top of the building and curl up in the fetal position and just cry.
AS: Can we backtrack for a minute? I remember when you said you first started you were snorting heroin. What made you switch to shooting since you said you had this mental barrier that you didn’t want to cross that line? What made you switch?
KS: The funny thing is, it was in the summertime and for some reason my bag of powdered heroin that was snortable was in my pocket. I don’t know if it was due to the humidity or what, but it became really moist and clumpy and it was like an $80 bag, like 2 half grams, and I just happened to be in a room with people who were shooting Adderall and Percocet for some reason, and they had clean needles. I wasn’t going to waste my $80 bag at that point, and I ended up taking a needle and shooting it and I fell in love. I never snorted again. I never saw a point in snorting it anymore.
AS: What was the difference in the feeling between injecting and snorting?
KS: It was extremely instant. You literally feel it go throughout your whole body and just the mental euphoria as well as the physical is just a lot better than snorting it.
AS: I’ve heard a lot of heroin users say that after that first injection, they never had a high like that first time they injected it. Was it like that for you?
KS: No. I loved shooting it, loved the setup and everything about it. I’m probably addicted to the needle itself. The feeling was the same until it turned on me. Each high was just as good and toward the end, right before i realized i needed help, you know when your tolerance matches up, that’s when you say, ok I’m never going to feel the same high.
AS: And how long did it take for you to reach that point?
KS: I’d say like 2012. A few years.
AS: Even when you’re sober like you are now, what does your craving feel like? Is it gone or still there? Do you think about it?
KS: Since I’ve been back, since New Year’s, almost 3 months now, is the first time I haven’t had a desire to use. But the last stay, when I was here for 10 months, every couple of weeks I would envision it. The desire. It wasn’t there fully, but it was always on my mind in some way. There were times where I slipped, like I said..
AS: Does it come at different times during the day? Does it happen in the mornings or more at night? Is there anything that triggers your cravings? A thought, smell, or memory?
KS: I think feelings are what triggered a lot of mine. When i was really trying my best to stop, it was the moments where I was overwhelmed or extremely anxious and fearful. Those are the moments I would go to using again. But the desire itself, it could be a good day, a bad day, morning, night, didn’t matter, you know?
AS: How did you feel about yourself when you used? Not during the actual high, but after the high wore off. How did you feel?
KS: I didn’t feel anything until I came to the realization that I needed help, which would be around October/November 2012. I would actually have to spend days sick because I was in so much debt to my dealer. I was selling everything I owned, I was ready to steal from my family. Those days that I spent sick, the physical effect was so bad, that it would bring me to do things that I would never do on a normal day, you know? To get more and not be sick.
AS: Anything particular you want to mention?
KS: Well, my best friend and her mom, they took me in when I was 14. They are my family. They aren’t blood related, but they’re my family. They’re the people who love me unconditionally. I bought them iPod touches and xboxes and stuff and when it came to the point when I was in their house and ready to pawn those, that’s when I knew I needed help. I called my best friend and I was in her house and I was like, “You need to come get me. I’m about to rob the shit out of you,” and I was crying. I knew I was gone and the insides of me were gone and all my values and morals were out the window. There were times I would sell my own things. xboxes, pawn them, buy them back, pawn them again, pawn my cell phone. The real desperate times, I would do sexual things with my dealer, and you know… I don’t normally do sexual things with men at all. Those times hit me. Those were shameful times and disgusting to myself, but all I needed to do to make that go away was get high.
AS: Let’s scale back for a second. What’s your opinion on the heroin use in New England skyrocketing in the past couple years?
KS: I think that since the Oxy situation … I don’t know exactly what happened, but it’s a lot harder to get Oxy around here. So I think people were hooked on that and because their bodies are so physically addicted to that, they needed something to replace it when they couldn’t get the Oxy anymore. The cheaper, more potent thing next to Oxy is heroin. And because it’s cheaper, I think a lot of people switched over. I have no idea why there is so much heroin here. I had never known there was heroin here before because I was into ecstasy and cocaine, but it’s everywhere.
AS: Did you ever reach the point where you wondered what was the end game? How much longer could you maintain?
KS: Honestly, those thoughts weren’t there. Because I had maintained for so long, I just was going through the motions and I guess I settled. I am such a fearful, nervous person, I always believed I needed to be high to function in society. I had that liquid courage and that was the cure-all. I was very much so not present, though. I would go through the motions and go to work and thought I was happy. I thought I was in the right relationship and thought I was doing the right thing by finally getting into the union, my dream job, and you know, buying a car, and all that stuff. I never took the time to stop. And honestly, the years flew by. I thought I was only using heroin for maybe a year and a half when I came into recovery. I didn’t even realize how long I was using it until I went back into my myspace messages and started reading really old messages. That’s when I realized that I had been using since 17. It just felt like it hadn’t been that long. Like the days ran together. One day turned into three days. There were times I had mini overdoses and I’d wake up three days later and have no idea when I even fell out.
AS: Have you ever had any legal troubles because of your addiction?
KS: I got into a car accident, a bad one, toward the end. I was in a lot of debt even though I was making a lot of money and I had let my insurance drop. I let all my bills drop. So I’m driving my truck to and from work with no insurance, and I was coming back from Springfield, Mass., one day and I nodded off at the wheel two blocks from my house in Providence. I was about to smash into a car that was at a stop light, about to turn left. and right as I woke up, I swerved left, tapped the car that was in front of me and knocked their tail light out and swerved into oncoming traffic and totaled that car. That was with no insurance, and I owe $42,000 to the insurance companies. No one was hurt, which I’m blessed for because I don’t think I would have been able to live with that. I walked home, got high, called my boss and said, “I don’t have a vehicle. Can we carpoo?” I ended up completely dismissing what I had just done like it hadn’t happened.
AS: After 10 months of being sober before, what made you want to start using again?
KS: I honestly didn’t want to, but i had back surgery a month before i graduated, in July 2013. I had a lumbar fusion, which caused more pain, and due to the pain and the fear of having to go back and have another surgery, well, instead of facing it, I ran from it, like I run from everything in my life. I chose to use, so I could go and be somewhat productive and it was a conscious choice. Before I came into recovery, it wasn’t a conscious choice. I started so young and that was just what life was. I had this belief that without drugs I couldn’t function in this world. That’s something I had to learn in recovery. I learned it’s not a lack of will power or self knowledge. I learned the tools to not use again that 10 months. I learned what I needed that 10 months. I learned how to go to a sober house and function with a little bit more freedom. It wasn’t an accident, you know? I consciously made that choice. I was lying in bed and thinking, “Should I take that pain without painkillers because i am a heroin addict, or should I just say fuck it and say, ‘I tried my best,’ and just get high and go back to work. I tried that. And it only lasted those three months and that first month, honestly, I was so lonely and depressed, and those feelings I felt right before I came into treatment, that desperation was right there. I ended up doing everything I could to get back into here and thankfully I did because, I couldn’t do it alone.
AS: After you left the 10 months sober, during your relapse, were you thinking you were going to be able to control it more?
KS: I don’t think so. I learned that there is no such thing as control. I know there is no such thing as a “social IV heroin user,” you know? I have two people inside of my brain. There is the disease part of my brain that says, “Yes you can use one more time.” And I learned a way to face that voice and not really block it out but to tell it you know, “No. There is no way I can ever use in safety. One is too many and one thousand isn’t enough.” Or I will be in that place where I feel that desperation, where you are ready to end your life and that’s when your human instincts kick in and you decide to fight.
AS: Sober now, how do you feel mentally?
KS: I feel guilty and shameful that I chose to run from my problem again and that I couldn’t face the fact that I have a physically disabling condition right now, with the surgery going bad, and I could have just faced it at that time instead of running from it. Had I faced it right away, I probably would have had the surgery by now and I would be on my feet and getting better.
AS: Do you have any other friends or relatives who are involved in heroin in RI?
KS: Just my stepmother. We aren’t connected anymore, though. I just remember growing up and seeing her with marks and and burnt spoons and nodding out…
AS: You said you were 17 when you first started getting high and you said even then it was easy for you to obtain heroin in Rhode Island.
KS: Oh yeah. I wasn’t in school and none of my friends used heroin except for my dealer, and there was this kid I knew who was using heroin. He introduced me to his dealer and I started going through him. And then he would give me a number to another person if he wasn’t around and then another and it was like the shake of the tree and it spread like that.
AS: Like a network?
KS: Yeah. At any point for a majority of the time that I was using I went through at least six dealers. I would never go without. Unless I had no money.
AS: What is the cost of heroin compared to Oxy?
KS: Say an 80 mg Oxy is like 80 bucks a pop and you can get a 1/2 gram of heroin for like $40, wich will get you further than the Oxy would. It’s half the price and more potent.
AS: Now that it’s in the public light, what would you want the average person reading this, someone who has no experience or knowledge of the world of heroin use, to know about what it’s like to be a heroin addict in RI?
KS: I would have to say, heroin is the only drug that has grabbed me, you know? It’s taken hold and just literally my whole life went downhill. I fell apart in a matter of five years. I was so sick of using and so sick of that chase. I didn’t know how to stop, though. I didn’t think I could. And a lot of people never do. Heroin addicts stay heroin addicts until they die. I know it is the most evil drug out there. I know because I’ve tried them all, you know? And nothing, nothing grabbed me like heroin did. It killed my spirit, everything that made me alive, a person, it killed me, and I didn’t care. I know it’s all over. I have Facebook and I’ll put up or post inspirational things about addiction and people from high school will contact me about how they need help, but then they will disappear and I don’t hear from them again. And it’s sad. A lot of people are dying. A lot of people very young. It’s very sad.
AS: One of the biggest news stories lately has been a rash of heroin deaths because of heroin laced with fentanyl, a powerful opiate. If you were still a daily user and you saw that there were these fentanyl laced deaths in Rhode Island, would that keep a heroin addict such as yourself from wanting to use?
KS: I wish I could say yes, but I know that when I’m in active addiction, that nothing will stop me. No human being. On heroin I feel like someone could take anything I had, my home, if I had kids, my kids, I would give up anything and nothing would stop me.
AS: How do you feel about your future now?
KS: I have hope. If I didn’t have hope I wouldn’t be here. It’s scary. I know that if I continue on this path, and choose to stay in recovery, I will be rewarded. That a more fulfilling and honest life, a life that is genuine, will be there. As much as it’s hard to be hopeful, I have it inside me. Thank God for this place. I can recover, and my plan is to go back to work and even if I end up in a wheelchair, I would become a substance abuse counselor. But I have learned that I am not in control, they taught me that here. But I feel hopeful. I tested it out with my last relapse, but with what I know, I know there is not point in going back again. I have never felt truly alive. It was synthetic, until now.
AS: Do you have any last things you want to say about heroin?
KS: I know there is controversy, I know some people don’t see this as a disease. If you were to ask me when my addiction started, I know that it was way before I picked up a drug. Probably when I was 5 or 6 years old I felt those first feelings of not being good enough or that nervousness, and I was such a fearful person. I always had this belief that me being able to function in this world was only possible if I had drugs. The first time I did a drug I was 13. And I knew I felt comfortable. I could talk anyone, I could go to a job interview and talk to someone and that was alright. That fear was paralyzing and the drugs were feeding that belief for a long time. It went to the point that I was living when I was using the drugs. I believed those were actual feelings and emotions, but I was completely empty inside. And eventually it got to the point that I didn’t want to live anymore. It does turn on you.
Heroin will turn on you. It will never be the same.