“He talked about it as if he was talking about the love of his life. He even had a sparkle in his eye.”

Lori Au, a Licensed Chemical Dependency Counselor at the Ashland County Council Alcoholism and Drug Abuse Center, reminisces on one of her experiences speaking with a heroin addict. 

According to the Center for Disease Control and Prevention, the heroin epidemic and epidemic of overdoses in the United States has reached crisis levels in 2016. 

According to the 2016 Drug Report, 247 million people used drugs in the past year. 29 million suffer from drug use disorders, but only one in six people with drug use disorders is in treatment. 

Heroin-related overdose deaths have more than quadrupled since 2010 with Ohio leading the nation, one in nine heroin deaths across the U.S. happen in Ohio. 

In Cuyahoga County alone, there were 500 deaths due to drug related overdoses. In Ashland County, there were 52 overdose responses in the past year, 12 of which resulted in deaths.

Recovering addict Brittany Pry has been in and out of both jail and prison following her struggles with painkillers, which turned into an addiction to heroin. 

Much like Pry, a majority of drug addictions begin with the use of pain medications according to Au. In Pry’s case, and many others, users start off by taking painkillers as they are prescribed, and over time, they become addicted to them.

“The opium medications become a euphoria,” Au said. “Once people do not have a prescription for them, they will buy them off the street. Initially, it’s not too bad, but once your tolerance increases and you need to take more, it costs more money to buy the pills. Eventually they can’t afford it, so the next alternative is heroin, which is from the opiate family and it is much cheaper than the painkillers.”

According to Au, drug addiction has the ability to not only take over the life of an addict, by their family members and loved ones as well. Au explains that for the addict, figuring out where they are going to get their next batch not only becomes a 24/7 job, but also adds to the adrenaline and rush of doing the drug. 

“An active addiction means that while someone is using, they are already thinking about where they are going to get the money for their next batch,” Au said. “It is a 24-hour a day, seven day a week process. They go and buy just enough for the moment, but while they are using, they are already trying to figure out where they are going to get more.”

Throughout their process of searching for their next batch, Au said addicts are constantly searching for ways to intensify their drug, and the mystery of what the drug is cut with, is exciting to addicts and also adds to the rush of using.

“They will start off by snorting or smoking, but then they eventually will shoot it because they get a quicker and longer lasting buzz,” Au said. 

Despite the increase in deaths, many have begun to disassociate overdose with death because not everyone who overdoses dies. Au said, with Narcan now readily available, families can have it prescribed to use in the case of an accidental overdose in order to reverse the death of a loved one. 

“The word overdose does not have the impact that it used too,” Au said. “Narcan is out so we can bring people back from overdoses. They now have parties, where they have Narcan available and people are shooting up purposely to the point of overdosing, and someone is there who is not using that can gives these people Narcan to bring them back.”

Au says people who have never used before have difficulty understanding why people are still intrigued by this drug; especially knowing the dangers it can lead too including overdose and potential death. 

Many people try the drug because they are so infatuated with it. Au says some addicts have described the drug as something that is incomparable to anything else. Some claiming it gets them on a high they have never felt before where nothing else seems to matter.

Once they begin using heroin, Au says many addicts will not take a step back to using a less intense drug like marijuana. Therefore, they begin using heroin, and the pain of going through withdrawal is what causes them to never stop. 

“The withdrawal from it can be so painful,” Au said. “People become very sick when they go through withdrawal and as soon as they start feeling that discomfort, they know all they have to do is get some heroin and the pain will go away.”

The feelings one may go through during withdrawal are similar to the worst case of the flu Au said. The sickness begins about three days after the last use and can last up to five days.

“One would think, if someone had all this pain and was so sick going through withdrawal, once they were clean they would not go back knowing how sick they would get,” Au said. “But this is not the logic addicts think with.”

According to Au, in the mind of an addict, their pain can always be cured with heroin. Even after spending months in prison, they can return to reality and still possess the addiction for it.

“If you have been in a locked down place for a period of time, you have adapted to the seclusion,” Au said. “When you come out, you will endure a lot of feelings and emotions. They get out, they have good intentions, but it is not just the addiction to the substance, but the behaviors, people, places and things, and addicts start making connections.

Au says being released from prison and going back into the real world is like seeing an ex for the first time following a break up. For a large period of time, you feel fine, but the first time you see them, all the feelings and emotions, both good and bad come back and these memories trigger feelings inside someone’s mind. These feelings can remind addicts of times when they were using and can potentially cause them to relapse. 

When an addict returns from prison, there is just as much pressure on the family as there is on the addict to keep clean.

“As a part of the active addiction, addicts are lying, manipulative, they are masters at that, and as a family member, you do not want to enable them, but it gets tricky because if it seems like you do not trust them, they will make you feel guilty for not trusting them,” Au said. “Addicts use this as their defense mechanism.”

Au believes the best transition from prison is going to a rehab facility. Along with being a drug abuse counselor, Au also works with community linkage, which entails going out into the community jails and helping recovering addicts prepare for coming back to reality. 

“People need to take steps before going right back to reality after being released from jail,” Au said. “In those rehab centers, they are going to tell you the same stuff you have heard 50 times before in jail, but you are going from a restricted environment, to still restricted, but with some freedoms, so it is gradual. It is better than going from one extreme to total freedom.”

Despite helping people on their road to recovery everyday, not every recovering addict fully recovers.

“Every time a client dies, it rips my heart out,” Au said. “And you do think, I mean I do anyhow, is there something I could have done different? Why did I not see this coming? But then the reality sets in. I mean, I can provide tools and support and they know they can reach out to me. If they choose not to do that, I cannot take responsibility for the death.”

Addicts are not just numbers, and they all are able to create relationships with their counselors, Au said. The attachment she has with some of her clients is so strong and if they do die, as a counselor, she does not receive closure because she cannot show up at their funeral due to confidentiality purposes. 

“The purpose of doing what I do is to change someone’s life or maybe save someone’s life,” Au said. “It is not realistic to think that I am going to do that for everyone who walks into my office.”

Au believes the biggest way to put a stop to the heroin epidemic is to spread prevention, starting with younger kids in school. Being honest with younger children about the dangers of this drug can hopefully prevent them from using for the first time. 

“To have people who have been clean for a significant amount of time and have them thank me is an amazing feeling,” Au said. “It is exciting to know they made it, but I do not take credit for it. I provide the skills and they do the work. In my opinion, the strongest people in the world are addicts in recovery.”

This is Part 2 of a 3 part series

Look for Part 3 in the next edition on March 2