Tonya Yates, pictured here with mother Tammy, has brighter days ahead and doesn’t define herself by her past drug use.
In recent years, the entire country has seen a rise in heroin abuse, and Alabama is no exception.
Written by Tom Gordon
Heroin, be the death of me
Heroin, it’s my wife and it’s my life
-Lou Reed, “Heroin”
When he was elected to the Alabama House of Representatives in 2006, Allen Treadaway’s top legislative priorities did not include giving more people the authority to administer a drug known as Naloxone to bring someone back from a possibly fatal overdose of heroin. But when the Legislature convenes next March, the Jefferson County Republican plans to push a bill that will do just that and for a very simple reason. “With what we’re seeing, the increase in the use of heroin, I think we’ve got to get this out there,” Treadaway says.
Heroin has been around long enough so that the very word seems lethally loaded with menace. And as a menace, it is making a comeback. When the acclaimed actor Philip Seymour Hoffman died in February from a toxic combination of drugs that included heroin, the news prompted more than a few parents to have a talk with their children about the dangers of drugs. In Jefferson County, authorities noted that the number of heroin overdose deaths had reached 58 for the second consecutive year in 2013, compared to just 12 in 2010. By April of this year, according to the U.S. Attorney’s office in Birmingham, the heroin overdose death total was already at 36.
Statewide, health officials said overdoses from heroin have contributed to an alarming jump in accidental poisoning deaths, from 233 in 2005 to 482 in 2012. “A lot of these are young adults, in their most productive years,” says Albert Woolbright, director of the division of statistical analysis at the Alabama Department of Public Health. Of the 482 who died in 2012, 60 percent ranged from age 15 to age 44. “We could have 800 seven years from now,” Woolbright says.
Highly addictive, heroin is listed by the U.S. Drug Enforcement Administration as a “Schedule 1″ controlled substance, which means it has “no currently accepted medical use in the United States, a lack of accepted safety for use under medical supervision, and a high potential for abuse,” the DEA states. Heroin is an opiate, “processed” from morphine, the painkiller that is a natural part of the opium poppy. It is snorted and injected. It has lots of nicknames. One former user, Jasper native Joseph Upton, refers to it as “boy.” “Anyone that had done it and says they didn’t love it is a liar,” Upton says. “That’s why it is so horrible.”
Heroin is cheaper and often more potent than it was decades ago. Dr. Mark E. Wilson, Jefferson County health officer, says the potency can vary from one amount to another and that’s why taking it can be like playing Russian roulette. “It doesn’t come with reliability labels or anything,” Wilson says. Nationally and locally, heroin’s lethal return to veins and nasal passages has been the subject of special government reports. It has been the focus of public meetings such as Pills to Needles: The Pathway to Rising Heroin Deaths held last June at UAB. Participants included physicians, educators, prosecutors, judges, first responders, psychiatrists, former users who are still alive, and loved ones of users who are not. A follow-up meeting took place in August at Canterbury United Methodist Church where working groups were set up to develop what U.S. Attorney Joyce White Vance called a strategic plan to “address the myriad ways opiate abuse affects our families, our lives, and our society.”
As long as heroin has been around, people have died from abusing it. Cops have never stopped making heroin cases, but in recent decades, they were making more cases involving stimulants like cocaine. That pattern has been changing dramatically in the past few years. Emergency room physicians are seeing it, too. “Seven or eight years ago, we might have made about two heroin cases a year,” says Lt. J.M. Davis, commander of the narcotics unit at the Jefferson County Sheriff’s Department. “Now, heroin cases make up about 60 percent of our caseload.” Dr. David Pigott, a professor of emergency medicine at UAB who works about a dozen emergency room shifts a month at UAB Hospital, says, “We’re definitely seeing a significant amount of heroin use and heroin overdoses.
“I’m not sure that I would say this year is worse than last year,” Pigott says. “But in the last five years, it’s definitely increased.” Davis and Pigott’s comments would bring a knowing nod from Allen Treadaway, who is also a captain with the Birmingham Police Department.
U.S. Attorney Joyce White Vance was worked to help create a strategic plan to “address the myriad ways opiate abuse affects our families, our lives, and our society.
“I’ve been in law enforcement 25 years, and crack has been king,” Treadaway says. “But heroin is rapidly taking over as the number one choice of hard drug out here, and consequently, folks are dying. Good people are dying…
“When you use heroin, your body builds a tolerance up and you go into rehab—many, many struggle to overcome this addiction—and they go back to the drug and what happens is when they’re off it, even just for a few weeks, the body’s tolerance drops, and then they go back using the same dosage that they were using and they’re dying of accidental overdosing on heroin,” he explains. “The purity of what we’re finding out here on the street is as high as it’s ever been. It’s cheap now. Where…kids addicted to Oxycontin and things like that were paying upward of $80 a pill, you can now, for $20, get a hit of heroin, so you’re paying a fourth or less for heroin than you were paying for the other stuff that was out there.”
Conversations with users, analysts, and law enforcement professionals suggest there’s not a one-size-fits-all answer to the increased use of heroin. For some, it may have started with the troubled economy and the steps some took to cope with the continued lack of a job with pay and benefits matching what they had before the Great Recession. For others, heroin was a new wrinkle in their thrill-seeking, rebellion-against-authority lifestyle. For still others, it started when they got a prescription for a narcotic pain reliever like Oxycontin and they became addicted. Over time, they moved to heroin because it was cheaper, easier to get, and easier to take. And when that first heroin high hits, your aches, pains, and problems seem to just drift away like a vapor trail, but only for a while. Here’s an account from former heroin addict Danny Molloy, a program support specialist for the Birmingham-based Addiction Prevention Coalition: “Imagine that all of life’s problems, pains, and stress go away for a brief time. Every cell inside your brain is flooded with dopamine and serotonin [brain chemicals linked to feelings of happiness]. The feeling that moves throughout your body is that of ecstasy. Some liken this feeling [as] close to a sexual experience. For that brief moment, you are everything you ever wanted to be and have compassion, good feelings, love, and the like.
“As the drug moves throughout your system, after injecting, a warm and fuzzy feeling encompasses your being. It starts at your head and moves throughout your body down to your toes and feels like a cosmic bath in bliss. All of your cells tingle and are super alive for, what seems like, the first time,” Molloy explains. “After this initial rush, the high is very numbing and is referred to as being ‘jammed.’ As all of the problems return, you are just numb to the consequences and in the cycle of addiction and begin to chase the next high.”
Addicts soon realize they need to take heroin not only to get the high, but also to avoid the pain and sickness symptoms that are a result of not having the drug. “If the addiction cycle has already been started, then more often than not, you are dope sick and have to get high just to not be sick,” Molloy says. “The sickness that comes from not having heroin/opiates is like the worst nightmare you have ever experienced along with the worst flu you have ever had. The physiological torment that comes with addiction is unbearable. You know that just one hit will make this all go away, and it does, until tomorrow and thus, you have entered the cycle of addiction. Only God can stop the madness.”
The descent into the throes of heroin addiction is rarely a solitary undertaking. Willingly or unwillingly, friends or loved ones are usually along for the ride. The consequences for them can sometimes be addiction themselves or a drain on their emotional and financial resources that leave them estranged from the person with whom they stayed out of love or loyalty. Tonya Yates of Brookside can talk about that. She and her older sister Misty both became heroin users. Misty died three summers ago, at age 28, of an overdose, and Yates had to identify her lifeless body on a hotel bed. Yates, who is 27, has been clean for more than a year, but her journey to this point has seen its share of backward spirals. She’s seen jail and prison, done speedballs of heroin and cocaine, sold hits of heroin to make money to support her addiction. She did things she never thought she’d do—there wasn’t much she wouldn’t do to get her fix.Two years ago, while staying with her grandmother, the mother of three shot heroin in the bathroom and became disoriented, and her mother made her pack up her things in a black garbage bag and leave. “Oh, man, I spent so much money on heroin, it’s just ridiculous,” Yates says. “I was probably up to $200 a day.”
Misty, to whom Yates was “attached at the hip,” led a reckless life that Yates followed in many respects. But she says she has no one to blame but herself. “I think a lot of it had to do with just, you know, staying in the wrong crowd and being rebellious and doing what I wanted to do,” she says. “And you know, I can’t blame my mistakes on [Misty] or anybody else because the first time I used heroin, I wasn’t with her.”
And while drugs were obviously a setback in Yates’s life, she knows that they don’t define her. “God has a purpose for everybody,” she says. “I don’t think my purpose was for me to use drugs. But I did, and now that I’m 27 years old, I look back on everything that I have done [and] I’m glad I have done everything I’ve done in my lifetime because of the fact that you see people that are…older and are trying the drug for the first time, and they have houses, vehicles, and everything, and once they use the drug, they end up losing everything. So I’m kind of glad that everything happened to me at such an early age to where I have learned my lessons and I know the consequences of using drugs.”
As David Pigott puts it, heroin “crosses all boundaries.” So let’s travel due south from Tonya Yates’s residence in northwest Jefferson County and head over the mountain. A 45-year-old man, heavily tattooed and cowboy handsome, sits at a dining room table in his mother’s home. He does not want his name published because he is concerned about keeping his job, but he has no reluctance to talk about the impact heroin has had on his life since he and his younger brother first snorted it 20 years ago when they were living in New York. “Back then, heroin was like this total taboo, mysterious, you know like…the last step, the baddest drug you could ever do,” he says. “I’d always been curious about it.” He, his younger brother, and a friend each chipped in about $8 to buy a bag of the stuff. When he saw how small his share was, he wanted his money back. But then he snorted it and found that he liked it. “That little bit knocked me on my ass for 12 hours,” he says. For about two months, he and his brother designated Saturday as heroin day. But then they started using it on weekdays, and he started using it in the amount that he, his brother, and their friend chipped in to buy when they took it for the first time. And if he couldn’t get it, the withdrawal would hit him “like the flu on steroids.”
Scott Sands is in a better place now and rarely thinks about heroin these days. He says his first thought each morning is usually about coffee.
“A twitchiness, diarrhea, nausea. Your skin crawls—It’s like your skin hurts,” he says. “And then, you know, your organs hurt, no appetite. There’s a huge mental aspect to that, too. Depression, like a lack of hope or whatever. It just feels like…you’re gonna die, you know. It’s awful, and the fact that it’s so easy to make yourself feel better again…it’s next to impossible to go through the withdrawal unsupervised, by yourself. Very few people that I know could do it.” The man is clean now, as is his brother, but in the summer of last year, he overdosed in his mother’s home while she was away. That close call came after he had spent the past five years without a hit of the stuff. “Just got the itch to do it again,” he says. “I did it because it feels good…for the same reason that you take a warm shower.”
Now he is thinking about declaring bankruptcy because his return to heroin left him with a mound of debt. He has a whopping bill from the hospital stay that followed his overdose, but there’s debt from other things, like the payday loans he took out to get heroin money after he started using it again. And that last overdose nearly took his life. “If [my] mom hadn’t come home and gotten me to the hospital, I probably would have…it’s a miracle I even survived for the six or eight hours I was on the floor in the bathroom,” he says.
He also says that his ultimate survival may depend on him getting access to another drug, called Suboxone, which suppresses heroin withdrawal symptoms and curbs the craving for the drug. His mom has reservations about it, he says, “But it may save my life, and so I’m all for it.”
As the longtime director of UAB’s Treatment Alternatives for Safer Communities (TASC), founded in the 1970s as a case management program for felony offenders with drug problems, Foster Cook has seen, time and again, the human consequences of drug abuse. You can’t talk about a heroin problem in Alabama without talking about the state leading the nation in prescriptions of painkillers, and Cook says “there’s a large amount of overlap between people that are using opiates and people that actually have legitimate medical issues.”
People wanting relief from severe pain are “prescribed legitimate medications,” Cook says, “and they use them over a period of time and the secondary benefits they get in terms of the way it makes them feel and relate to their environment over and above the pain is something that is desirable for them for one reason or another, whether it’s you know, an emotional need or whatever it is.” When the prescriptions run out and can’t be refilled, “for certain people, they figure out that there’s access out there somewhere to heroin.”
Scott Sands, a TASC client, could not get a prescription for the heroin he used, starting for the first time about 10 years ago. The 38-year-old Hoover High grad got it from dealers throughout the area, and some of them were tough characters in tough neighborhoods. At one place, Sands says he watched as the dealer smashed a guy’s head with a baseball bat. At the house of another, who also was a pimp, Sands said he “got jumped” and “got my ass kicked.” But heroin was really what was kicking his ass, getting him arrested, landing him in drug court, costing him a job, and nearly killing him. He remembers awakening in a hospital room after overdosing on one bag of heroin and immediately wondering where his other two bags were. “That’s how screwed you are,” he says. “That’s pretty sick and disturbing.” He spent two years at a Sober Living America center and attended Heroin Anonymous meetings in Southside, where many of those on hand were 17- to 25-year-olds from Over the Mountain communities.
Like other users he has come to know over his years of treatment and counseling, Sands had dabbled in other drugs before he made his bed with heroin. The cycle of first-high euphoria, the need to take more dope to get that feeling back, and the wrenching withdrawals are all familiar to him. But what he also came to realize was that heroin was his way of avoiding life in all of its glories and imperfections. “It became my solution and my coping mechanism for all the stresses in life,” he says. Now, he says, he is making an effort to cope without chemicals. “It’s new to actually deal and feel and experience the stresses of everyday life, but it’s kind of beautiful,” Sands says. “My world had become so small as a heroin addict. This opens up a whole world of possibilities, you know what I mean? Every day is new because I have another fighting chance at life. You know, when I’m sitting there, nodding in and out of consciousness, I’m not living in reality…. You’ve got to go out there and live your life, embrace the pain, the struggle, all of that.”
Sands says he is in a good place now, with a job as a waiter and a supportive girlfriend, and he is working to avoid an accumulation of stressors that, in the wrong circumstances, might make him think about needles, dark brown liquid cooked in a spoon, cotton filters, and syringes. But he says he rarely thinks about all that now. In fact, he says his first thought each morning is usually about coffee. “That’s definite progress for me, you know,” Sands says.