Forced to Fight: Addicts long for life beyond heroin

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Forced to Fight: Addicts long for life beyond heroin

Heroin addict Daphne Laurel administers the shot of Suboxone that will prevent her from going into withdrawal, at least for the day. Cory Vaillancourt photo

Editor’s note: Names have been changed to protect the identity of those interviewed for this story.

Five miles down an Appalachian dirt road 45 minutes from nowhere is where Daphne Laurel was raised, right in the heart of the sparsely populated mountainous region hit hardest by the ongoing opioid crisis.

“I was kind of rebellious,” she said. “I wish I had known better.”

Now 27, Daphne is actively attempting to combat a heroin addiction that she picked up after she began using meth and pills almost a decade ago.

“To begin with, yeah, it was fun,” she said of her first forays into opiates. “But there’s a difference between having fun and having to have it to get up every day. I’m not going to say it doesn’t feel good every time you get high, because of course it does. But when it gets to being a ‘need’ from being a ‘want,’ it sucks. You would never sign up for this.”

Daphne’s need now consumes her life. Paying for the Suboxone she needs to stay off heroin is a constant challenge and resisting the powerful urge to relapse is a daily struggle she doesn’t always win.

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But she’s trying. Sitting on the front porch of the small, nondescript bungalow she shares with her husband Paul in a rural Western North Carolina county, cigarette dangling precariously from her pursed lips, she’s trying to remember her life before heroin — because the life of an addict isn’t much of a life at all.

“I miss my daughter. I miss having a job. I miss normal things, like going to the movies or just hanging out with people,” she said. “I miss my life.”

No cellphone. No makeup. No dating. Daphne grew up in a strict household and once had dreams of becoming a lawyer because she wanted to send bad people to jail and help good people stay out of jail.

Intelligent and relatively self-sufficient from a young age, Daphne was also the victim of childhood physical and sexual abuse, which likely contributed to her legal aspirations as much as her drug addiction that began one evening when the 17-year-old was employed at a fast food restaurant.

“I worked the night shift, and there was this girl outside, cooing at the birds,” she said. “She was high. She was talking to the birds. I don’t know why, but I said, ‘I want to do whatever that is.’”

“That” was meth, and it wasn’t hard to find. Last week, retired DEA Agent Joel Reece told The Smoky Mountain News that methamphetamines had just begun to make an impact east of the Mississippi River around that time, and when they hit, they hit hard.

It also taught a generation of drug users how to use needles; although the crystalline white powder can be snorted, it’s much more fast-acting when administered intravenously.

Daphne’s meth use led to prescription opiates like hydrocodone and oxycodone, and before she knew it, she was injecting those, too. At the time pills were cheap and easy to come by, as chronicled in a Washington Post report based on a pain pill database that tracked every single hydro and oxy pill manufactured in the United States from 2006 through 2012.

During those years, the distribution of those two opioids alone grew more than 50 percent to almost 13 billion pills a year in 2012, according to The Post. All in all, more than 76 billion pills were distributed across the country, enough to supply every man, woman and child in America with 33 pills per person, per year.

More than 2.5 billion of those pills ended up in North Carolina, placing this state of 10 million residents slightly above the national average with about 35 pills per person, per year. Western counties, like the one Daphne grew up in, saw pill totals far higher than the state average.

Not long after beginning her descent into full-blown dependency, Daphne became pregnant. She used drugs throughout her pregnancy, until the local social services department intervened.

“At the end I had to stay clean for a month and I did,” she said. “I was ready to kill myself at the end of those 30 days, but we had some tweakers at the house and I made the mistake of getting high.”

After a court battle, Daphne was able to keep her baby. Meanwhile, DEA Agent Joel Reece, who was deputy director of the Appalachian High Intensity Drug Trafficking Area (HIDTA) at the time, was focusing substantial resources on an educational campaign targeting NAS, or neonatal abstinence syndrome.

Babies born after exposure to drugs in utero can suffer a variety of horrific and debilitating conditions including agonizing withdrawal symptoms and developmental disabilities that last a lifetime.

“He’s perfect,” Daphne said of her son. “I’m really lucky that nothing happened to him. I know so many horror stories. They come out deformed or mentally incapable or whatever. We’re so lucky that there’s nothing wrong with him.”

That was perhaps the last stroke of good fortune Daphne would see for quite some time; her baby’s father will remain incarcerated for several more years as a habitual drug offender, and when her own addiction worsened she gave up her son to his parents, who live in an upscale residential community in the region.

“I had to take a step back. He doesn’t have either one of us right now, but he’s taken care of, and he’s loved,” Daphne said. “I try not to be in and out of his life, because it’s unstable. It’s not good for him.”

Daphne’s son is just one of thousands of children now being raised by grandparents — an unanticipated consequence of the opioid crisis that’s left many young parents deceased, debilitated or incarcerated.

According to a July 10 report published in Carolina Demography by demographic analyst Jessica Stanford of UNC-Chapel Hill’s Population Center, the share of children being raised by their grandparents is “often higher in states with higher opioid prescribing rates.”

Stanford’s report says the national rate is around 1.3 percent, with Mississippi, Arkansas, Louisiana and Alabama being among the highest, logging numbers approaching double the national average. North Carolina is closer to the national average at 1.6 percent, but of the state’s highest counties — Anson (5.4 percent), Clay (4.6) and Graham (3.9) — two of them are in Western North Carolina, and those two, Clay and Graham, have opioid pill distribution rates nearly 50 percent higher than the state average.

As the opioid crisis continued to ravage both the nation and the state, increasing legislative scrutiny was placed on the millions of illicit pills making their way from manufacturers to street dealers each year.

North Carolina’s STOP Act, passed in 2017, was designed to keep those pills off the streets and out of the hands of Daphne and people like her — people like Haywood County native Clayton Suggs, who became addicted after a routine surgery in 2011.

The STOP Act’s prescription restrictions revealed yet another unanticipated consequence of the opioid crisis, in that it is subject to the same economic market forces as any other commodity — supply and demand.

“Pills got too damn expensive. I started using heroin because it was cheaper,” Daphne said, like Suggs had said a few years before his fatal heroin overdose last year.

With a hat-tip to Steven Levitt’s groundbreaking 2005 book Freakonomics — in which the University of Chicago-trained and self-proclaimed “rogue economist” explores the economics of crack dealing — here’s a quick and grim lesson on the current state of tweakonomics in Western North Carolina:

Daphne was spending $200 a day on pills, but could achieve the same result with $60 worth of heroin. Now, she can barely afford her $13 daily Suboxone doses but a night in the county jail costs taxpayers around $75, and an eternity in the ground costs them nothing.

Back on that idyllic front porch, still smoking that cigarette, Daphne is beckoned inside by her husband Paul because she has an active bench warrant.

Paul took a different route than Daphne, but both ended up in the same place — the WNC native earned a bachelor’s degree in construction management and made good money working in the field until he hurt his back and ended up with a bad heroin addiction he described as “being in a boat on a lake with only one paddle.”

He’s also in recovery, perhaps a few steps ahead of his wife — he recently started a new job for the first time since 2015, and is saving up for a car.

Inside, on a worn brown couch, Daphne — who’d only just awakened from a rare night of sleep — prepared her daily dose of Suboxone on a faded wooden coffee table.

“If I didn’t have Suboxone, I’d be on heroin,” she said, mashing up the pill in a large metal soupspoon with the butt end of a brand new disposable syringe. “Suboxone saved my life. I’ve probably died 20-something times. I don’t know why I’m still here. I really don’t.”

Even with wider availability and a fair amount of subsidies, Suboxone is still hard to afford for an unemployed addict. She says hers costs $400 a month through a local diversion program, same as her husband’s.

When family support or other financial difficulties ensue, the consequences can be disastrous. Earlier this year, want of Suboxone caused Daphne to relapse.

SEE ALSO: Coverage: Opioids in WNC

“I kinda went crazy and ran off for about a month,” she said, pouring some tap water from a small rocks glass into the spoon and muddling it about until it became a uniform chalky white color.

Daphne’s story of living as a heroin addict on the streets of Asheville, the region’s largest city, offers several sad and poignant insights into a lifestyle that she says policymakers and the general public probably can’t fathom.

“We’d be out in dumpsters,” she said. “Over there, they’re big on dumpster diving. It’s crazy what you can find and take to the stores around Asheville and resell. They have these vintage shops. You take clothes, little knick-knacks, you find pieces of furniture that people throw away — it’s insane.”

Although she notes that it’s still technically illegal, dumpster diving is a better alternative than attempting to acquire money by other means.

“I’ve always been really big about not trying to steal from people, just because I’ve been there and done that, so if I do have to do something like that, I try to go out and get it from a store, like Walmart,” she said, drawing the mixture from the spoon into the syringe and then squirting some out onto the couch, to purge air bubbles. “It doesn’t make it right, I know. But you go in there, you’re going to jail if you get caught.”

Once she eventually converted her goods to cash, she’d seek out the drugs she needed.

“It’s fairly easy to find,” she said. “In Asheville it’s easy because everything’s right next to each other. Here [in a more rural county] you can go two minutes down the road. It’s not like you’ve got to hunt it.”

From there, Daphne’s concern would shift to finding a discreet place to inject.

“Most of the time I would do it right when I got it. You’ve got to think about riding or walking around with it, and if you’re not good at hitting yourself, you need to find a place to sit down, like you and I are right now,” she said, tying a cord around her thin, pale left arm, high up toward the shoulder. “Personally, I can hit really quickly so long as I can sit still, just for a second. I can be in a car, or at my dealer’s house. When I couldn’t hit myself very good, you can’t sit there and try to poke yourself 15 million times.”

Finding a thick vein up near her bicep, Daphne deftly guided the needle to it, forced it in, pulled it out just a little, and depressed the plunger, delivering the Suboxone.

That same action would mark the completion of her heroin acquisition cycle — a cycle that would then immediately begin again.

“Not even the next day,” she said. “It’s a couple times a day.”

Suboxone, or heroin, are no longer merely “wants” for Daphne. They’re now needs, because without one or the other, it wouldn’t take long for her to enter withdrawal.

“A day, day and a half. Two days maybe. You start hurtin’. It’s a physical hurt. You’ve got your colds and your sweats and you can live through that, but it’s when your legs get to hurtin’, and you start puking,” she said. “With heroin, and Suboxone, you’re not just sick for a day or two days. You’re sick for a week, or two weeks.”

The extent of withdrawal depends on how much and for how long one has been using.

“I know it’s not a long time in the spectrum of things, but when you’re sitting there curled up in a ball for two, three weeks at a time and your stomach hurts and your back’s killing you and your legs, you can’t get up, you can’t eat, you can’t sleep, you can’t go to the bathroom,” she said. “You just want to die.”

Day to day and hour to hour, Daphne and Paul must now ensure that nobody runs out of Suboxone.

“I always call this place 9/11,” she said. “We’re constantly in war mode. You can’t live a normal life like that.”

For Daphne and Paul, normalcy now means needles and cords, spoons and Suboxone, and sometimes even a little naloxone.

“This used to be what they call a ‘trap house.’ We had tweakers coming out the windows,” she said. “There’s so many people that do drugs that don’t have anywhere to go. If you’re out in public, there’s a hundred percent chance you’re going to get the law involved, but we still see heroin addicts because they knew us from back in the day. We’ve had people stop and given them naloxone I don’t know how many times, just because they know we keep it here.”

Although there’s been some controversy over the supply programs that provide Daphne and Paul with overdose reversal drug naloxone, sharps containers and recently-legalized test strips that reveal the presence of deadly fentanyl, Daphne called the arguments against the measures “archaic.”

“Everybody I know has Hep C,” she said of the blood-borne Hepatitis virus that inflames the liver. “I can specifically remember the day I got it.”

Daphne said she had no choice, or rather, the choice between being sick and not being sick.

“He had the only clean needle,” she said. “He went first and fixed his shot, and then I did mine, and I was like, ‘Wait, you’ve got Hep C?’ and he was like, ‘Yeah.’”

The lack of clean, new, straight, sharp needles isn’t a deterrent at all.

“Either way,” Daphne said, “we’d get it done.”

Clean needles can reduce the spread of disease, just as the sturdy plastic sharps containers can reduce the spread of the needles themselves; a 2018 Smoky Mountain News story about a local needle cleanup effort notes that a handful of volunteers found three syringes and several other discarded tools of the trade in just an hour or two of searching.

If things continue as they are for Daphne and Paul Laurel, they just might avoid being conscripted into what retired DEA Agent Joel Reece said was a generation the better part of which had been lost to addiction.

“My ultimate goal is to get a job,” she said. “That is not the case with everybody I know. A lot of the people I know are OK with living off the government, but my ultimate goal is to get a job so I can help repay society, because I really have taken my share of government help. And when you’re taking from the government, you’re taking from your fellow Americans, because they’re the ones paying taxes.”

Prodded by Paul and fading memories of her life before heroin, Daphne entertains the thought of rehab.

“He’s been really wanting me to go. I’ve never been. What I hope to do is get a job and see my son,” she said. “I’m to the point in my life, where, yes … but what makes me apprehensive about it is coming home. I’m going to be in the same situation. You’re around it 24-7.”

Daphne also tries to imagine a life beyond heroin, after years of being forced to fight for wants that became needs and a son that’s become a stranger.

“I’ve been clean one time in my life,” she said. “He is the only thing … I’ve never been able to do it for myself.”

Delve into the data

The Washington Post’s searchable database of prescription pill distribution information is available online. Although it can be accessed with a free trial account, purchasing a subscription helps support ambitious journalistic endeavors like those of The Post, which led to a federal court’s release of the data cited in this story.

www.washingtonpost.com/graphics/2019/investigations/dea-pain-pill-database

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