by Jordan Green
There are different doors, different introductions to the drug, different reasons people make the acquaintance of heroin. Personal trauma, mental illness, physical pain or simply idle curiosity. With a sly glance, casual and flirting at first, the suitor initiates the dance. But the user tires of the party the very moment she realizes she has become a prisoner.
Heroin takes all the existential pain of life — whatever the particulars, from one person to the next — and in a flash it is resolved in a brilliant jolt of pleasure and wellbeing. The high becomes the North Star, an all-consuming focal point.
There’s a downside, of course. The sickness of withdrawal is so intense and tormenting that getting the next high becomes imperative. And then chasing the high is almost completely an exercise in avoiding dope sickness.
Whether heroin is a death certificate or a manageable hazard turns out to be incredibly controversial. So too is the matter of whether the personal wreckage surrounding addiction is a direct result of the drug or a byproduct of criminalization and social stigma. Does the drug destroy the lives of every person it touches, or it possible for some to soldier on? There are different narratives and treatises that addicts adopt to make sense of their experience and illuminate a path out of the darkness.
Some people who have used heroin don’t even like the term addict.
“Let’s use scientific language,” said Louise Vincent, a 38-year-old Greensboro native who began using heroin in her twenties. “My brain chemistry is changed. My reward system has been hijacked.”
In any case, the way out is a crooked path, choked with thorns, full of false turns and beset by unsuspected perils.
Heroin use has been on the rise in recent years, spurred by a crackdown on the abuse of prescription pain medication that has dried up supply and driven up prices, forcing addicts to turn to the cheaper alternative. As the demand for heroin accelerated, the scourge has focused on High Point, a traditional pipeline for the northern Piedmont region strategically located on Interstate 85.
Opioid pain medications still account for the majority of overdose deaths in North Carolina — more than heroin and cocaine combined, according to data collected by the NC State Center for Health Statistics. But beginning in 2011, overdose deaths from prescription pain medication began to taper off as deaths from heroin overdoses showed a marked uptick. The number of heroin deaths in North Carolina increased from 38 in 2010 to 170 a few years later in 2013. And the number of people who have used treatment services for heroin in the state has steadily risen since the late 1990s, from 1,816 in 1997 to 3,560 in 2013.
“We have seen success across the country in curbing the abuse of prescription medication, with monitoring, educating the medical community, running patient names and making sure they’re not getting multiple medications from multiple doctors,” said Jackie Butler, director of client services at Alcohol & Drug Services in High Point. “There’s been more attention because we know that prescription pain medication has been abused. We’ve found that with people who were already addicted and already in trouble, if they can’t get their prescription medication, it was an awful storm waiting to happen because there was a dealer on the street waiting to feed their addiction.”
A rash of overdoses — more than 100, including 14 deaths — in High Point last year prompted a multi-agency investigation that concluded in December with more than 15 arrests, dismantling a network that law enforcement officials said was trafficking roughly 100 grams of heroin into the city every single day.
“High Point has always been a pipeline where heroin comes in,” Butler said. “I think you see that it’s a place where people come to get it from other cities. It’s just the center of where drugs come through from Mexico to the United States.”
Getting drug dealers off the street is only part of the solution, Butler said. Unfortunately, the acceleration of the heroin crisis dovetailed with the recession, when state legislators reduced mental-health funding that had supported treatment services. On a brighter note, advocates and outreach workers have stepped up efforts to distribute the drug naloxone, which can reverse heroin overdoses, to emergency medical technicians and family members of addicts.
The NC Harm Reduction Coalition has seen some of its greatest successes in Guilford County. The coalition reports reversals of as many as 251 overdoses across the state through its distribution of naloxone kits, and that’s only counting addicts, friends and family who went to the trouble to report back to the agency. By far, the largest share of reversals has been reported in Greensboro and High Point — 66 and 47 respectively. That compares to 21 in Charlotte, five in Raleigh, seven in Durham and 15 in Winston-Salem.
At the very least, naloxone can keep addicts alive until they’re ready to seek treatment. Advocates are also heartened by the recent passage of the 911 Good Samaritan Law in North Carolina, which guarantees that a person who calls 911 to report a drug overdose won’t be prosecuted for possession of small amounts of drugs or paraphernalia.
Meanwhile, Butler and others are trying to educate people about heroin to reduce the stigma, so that addicts are not discouraged from seeking help.
“A number of people have chronic pain or suffer from some type of chronic-pain illness,” she said. “They’re taking prescription pain medicine for relief, but they get in trouble and use the drug as a reward. That’s a real challenge — handling pain appropriately. That could happen to any of us. We could be in an automobile accident where we’re in pain, and we could become addicted to the prescription pills, and then make the switch to heroin.”
Louise Vincent was 13 years old when her bipolar disorder started to manifest. The daughter of a respected English professor at UNCG and a Greensboro School Board member, she had experienced a happy childhood until her interior world inexplicably crashed into darkness.
“It was right around 6th grade,” she recalled. “I just wanted to die. I wasn’t allowed to watch TV, so I didn’t even know what suicide was. I almost believe that drugs saved my life. I think if I hadn’t found them I couldn’t have coped. There was so much chaos in my brain I had to find a way out.”
Although she said she used “heavy drugs” beginning at the age of 13, she didn’t try heroin until she was in her twenties. Someone gave her a pain pill to help cope with a traumatic event. She liked it, and took more. It didn’t take her long to move on to heroin, which was cheaper.
“Pain pills have always been too expensive,” Vincent said. “I’m not an upscale user. There’s a hierarchy in the drug world. People pay a premium for pain pills to not have the stigma [of heroin]. And people who use heroin look down on people who use crack. It’s that ridiculous. With pain pills, people say, ‘It comes from a doctor; it’s better.’ But it’s not your doctor. And did your doctor give you seven prescriptions?”
Amy Catherine Dean grew up in Kernersville. She ran away from home at the age of 14. Years later her mother would learn that an older boy, perhaps 19 or 20 years old, forced her at gunpoint to perform sex acts.
Dean attended Glenn High School in Kernersville. She was the school mascot and played soccer. She was playing soccer when she was injured, leading to a prescription for pain medication. Her parents were separated, and she started taking un-prescribed pain pills while she was staying with her father, her mother said.
Misty Sanders and Stacy West attended Trinity High School together outside of High Point in Randolph County. West, who graduated in 2002, was a year behind Sanders, who dropped out before graduating. They were friendly with each other but not especially close. Drugs were not really part of their high school scene.
“A few people smoked pot,” Sanders said. “I didn’t know anyone in school that did any hard drugs. When we all got out of school, we went our separate ways, and some of us went down the wrong path.”
The two “went from friends to family,” as Sanders put it, when West married Sanders’ cousin. Sanders and her boyfriend at the time stayed with West and her husband in their apartment in Archdale for a while. At the time, both of them were abusing prescription pain medication. They used pain pills together, but heroin was still an unforeseen cloud on their horizon.