It began, as heroin addiction today typically does, with physician-prescribed medication for pain. In John’s case, the problem was a high school football injury suffered more than a decade ago.
“I broke a rib playing quarterback,” the North Texas resident remembered. “The doctor prescribed hydrocodone, and that is the path to destruction. I went from that to OxyContin, and when the price at the pharmacy got to $600, I couldn’t afford to pick it up.”
But chronic pain from football and a subsequent car wreck wasn’t the only issue. John’s body craved the legally obtained opiates from virtually the first prescribed dose. And when the pharmacy was no longer an option, a much cheaper alternative was readily at hand.
John, now 29 and identified in this story by a pseudonym, began to inject heroin about eight years ago, getting high at least twice a day. He struggled to hold down a job and was in and out of rehab and Alcoholics Anonymous and Narcotics Anonymous.
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When he tried to quit the drug, the force of the cravings would sometimes send him into seizures.
Such is an increasingly common anguish, tragic dramas that had been playing out in the shadows of American life, at least until last weekend. The recent death of actor Cory Monteith from an overdose of champagne and heroin passed relatively quickly from the headlines.
But last Sunday, when the body of acclaimed actor Philip Seymour Hoffman was found in a New York apartment, a syringe in his arm and packets of heroin everywhere, story after national story began to document heroin’s dark new era.
The drug’s surging popularity, authorities say, is an unintended consequence of a crackdown on prescription drug abuse in the past decade. When the black-market costs of opiates such as hydrocodone and OxyContin surged, addicts turned to a cheaper, even more potent high.
“It’s the tightening-down on opiates, all the pain medication,” said Flower Mound’s Kathy O’Keefe, whose 18-year-old son, Brett, died from a heroin overdose in 2010. “You’ve got heroin right behind it. You can get high for 10 bucks. You can die from $15. That’s pretty cheap. That’s cheaper than beer.”
Although methamphetamine remains the drug of choice for the largest percentage of addicts, heroin dependence across the nation has doubled in a decade, authorities and drug experts say. Drug cartels in Mexico, the source of most Texas heroin, quickly responded to the increased demand.
“When you see our border seizures up 232 percent between 2008 and 2012, it’s a real good predictor of where heroin is heading,” said Dan Salter, special agent in charge of the Drug Enforcement Administration’s Dallas field office. “We predicted a little over two years ago that people are going to shift to heroin, and unfortunately that’s becoming a reality.
“It took the unfortunate deaths of a couple of actors for people to realize that this is nothing new,” he said. “There is a mom and dad in southern Tarrant County and a mother and dad in northern Tarrant County grieving the loss of a loved one because of heroin. They’re in just as much pain as the parents of these actors.”
So the scourge intensifies and the tragic dramas play out. John’s heroin story, it turns out, might be among the more hopeful.
Just last Wednesday, he woke up and decided he had had enough. He shot up for what he hoped would be the last time, borrowed gas money from his mother, persuaded his sister to drive him and showed up at the door of the Recovery Resource Council on Airport Freeway in Fort Worth.
“He had come to our door once before and walked away,” said longtime substance abuse counselor Paula Shockey. “Sometimes, the hardest step is walking through our door and saying, ‘I need help.’ ”
John walked through this time. He wept when Shockey told him that a Dallas rehab center would have a bed available the next morning.
“Praise the Lord for them to get me in as soon as they did,” John said. “I’m tired of chasing the dragon’s tail, is what they would call it back in the day. This is the hardest thing I’ve ever come across, the hardest thing I’ve ever had to do. I will beat it. It will not take me down. My mom prays too hard for anything like that to ever go on.”
On Thursday morning, Shockey followed up with the Dallas rehab center. John had made it. He was there.
‘He didn’t want to be an addict’
Kathy O’Keefe, 57, grew up in Chicago at a time when heroin addicts shot up in seedy places where most people did not go.
“For my generation, heroin was a bad drug,” she said. “You didn’t drive in that area. It was icky. They were junkies. But kids don’t look at heroin like that anymore. It’s kind of like how they think about pot.”
Brett, the younger of her two sons, struggled in school and was diagnosed with severe attention-deficit disorder. His self-esteem was very low. When Brett was 14, Kathy O’Keefe and her husband, Ben, found out through the family doctor that their son was using drugs.
“I hung up with the doctor and said to my husband, ‘Our suspicions were right. He’s smoking pot,’ ” O’Keefe recalled last week. “In reality, he was already into prescription drugs, so again we were kind of behind. You have that denial.
“We still didn’t have a clue about the heroin, but we found out real quick because he overdosed at our house,” she said. “We kind of knew that one of the kids he was hanging out with was using heroin, but there was that denial. Brett wouldn’t do that.”
After the first overdose, in spring 2009, Brett’s parents sent him to rehab. When he got out, he told his parents that his heroin use was a big mistake, that he had just been experimenting, that he would never do it again.
“He was telling us what we wanted to hear, and we believed him,” O’Keefe said. “I tell parents now, ‘Don’t buy into that story.’ It may be true, but don’t assume that it is.”
Six months later, Brett suffered another overdose, followed by a longer period in rehab and intensive outpatient therapy.
“It’s hell,” Kathy O’Keefe said. “Living with an addict, it’s like having Satan take over your child, because everything is amok. They lie. The mouth was real abusive, because it’s all about the drugs. So he’s either feeling sick and he’s crabby, or he’s high and nodded-out, or he’s sleeping. Those are the only things you do. You’re chasing the drug, doing the drug or sleeping the drug off.”
After the second overdose, Brett seemed to have turned the corner.
“He looked good. He felt good,” his mother said. “He didn’t want to be an addict.”
One March weekend in 2010, Brett’s parents were on a quick trip to San Antonio. Their son had apparently been clean for months. He said he planned to hang out with friends at the family’s Flower Mound home.
“I told him, ‘Don’t make a mess in the house,’ ” Kathy O’Keefe said. “We planned to talk on Sunday morning.”
On Saturday night, a friend called paramedics after Brett fell unconscious. He had been mixing heroin and Xanax.
“At 9 o’clock on Sunday morning, I got a call from the Lewisville hospital indicating that he had died,” Kathy O’Keefe said. “We came back home and planned a funeral.
“After we got home from San Antonio, people were coming by, kids were coming by,” she said. “The kids were all freaking out. Their friend had just died, and we’re sitting there looking at this, going, ‘They are all high, too.’ We finally could look past Brett and see the bigger picture.”
During her son’s visitation, a rainstorm kept Brett’s friends from leaving the funeral home.
“I called them into the big room where Brett was, closed the door and had a guy from Narcotics Anonymous talk to them,” Kathy O’Keefe said. “So we kind of started immediately, because this has to stop. I was saying that over and over: ‘This has to stop.’ ”
‘Come cry. That’s OK’
Shortly after her son’s death, O’Keefe formed an organization called WTF-Winning the Fight. She tells her family’s story wherever she can, particularly to young people, but they are only part of the focus.
“It started with us trying to help the kids, but in reality it’s turning into helping the parents,” she said. “With us, we were isolated. There was nobody to call and say, ‘Gosh, my son’s a heroin addict.’ So I vowed that nobody has to go through this alone. You shouldn’t be embarrassed because your son is sick with addiction.
“Sometimes our support is just, ‘Let me give you a hug. Come cry. That’s OK,’ ” she said. “I had a mother come by yesterday, and she just sat in my living room and cried. She also left with a drug test, which is good, too.”
Authorities and counselors also say the scourge has not spared older addicts. Counselors at the Recovery Resource Council have seen heroin addicts in their 60s.
“I was talking to a woman the other day. Her mother literally has surgeries, then researches how to have problems so she can get more pain prescription meds,” O’Keefe said. “A lot of people think it’s only kids, and it’s not. There are mothers and fathers.”
In November, the DEA created a heroin task force that includes state and local law enforcement agencies across North Texas.
“We are into a large-scale investigation in that area, dealing with these sources of supply,” the DEA’s Salter said. “Unfortunately, the death or overdose of a person provides more intelligence for us. We try to learn the people the young man or young woman associated with. Who was his source of supply? That’s what we’re targeting.
“We can do a lot, but we can only do so much as investigators,” he said. “We have to get our educators and our parents involved. Parents need to sit down and talk to their kids about drugs from the very early ages.”
‘I’m scared, yes’
Last Sunday, John learned about Hoffman’s death through an alert on his cellphone. He wasn’t surprised.
“I guarantee you, he just got out of rehab and he picked up where he left off,” John said. “That’s what stopped his heart.”
But the actor’s overdose was not behind John’s decision to enter rehab.
“No. I’m making this for me,” he said. “There are two options. If I continue to use, my parents will be picking out a tombstone and burying me. Or I could make the decision I made this morning. I went and I got help and I cried my eyes out and I was honest.”
Given his motivation, family support and experience with drug treatment programs, Shockey said, John has a good chance to make it this time, maybe 3 in 4, to stay clean for good.
“I’m scared, yes, but I will overcome this,” John said Wednesday. “This will be nothing but a chapter in my life that I can share with others. Hopefully, I can change one person’s life with my experience, with what I’ve gone through.”