HOPE AFTER HARDSHIP
Emerging from darkness:
People who have struggled with drug abuse talk about their trials and triumphs
By Susan Baldrige
Photography by Dan Marschka
(This series is best viewed in landscape mode on your smartphone)
Life was pretty rough for Mary after two years of heroin addiction.
Raised in Lancaster’s affluent suburbs, she had resorted to living in a car — homeless, broke and sick.
She had contracted hepatitis and developed an abscess on her arm from sharing dirty needles.
She was on the brink of death.
But Mary survived.
She survived her near-fatal health problems.
And she survived the intense cravings for a substance that is killing record numbers of people across Lancaster County, Pennsylvania and the nation.
"There is hope."
But Mary did not break free of heroin’s grip alone.
She had a plan, she had support, she had counselors, and she had access to medication that helped her kick the physical addiction.
On her own, she had built the type of program now being advocated by government researchers and private addiction specialists.
Her message for other addicts and their families now is simple.
"There is hope," said Mary, who is now 23, working full-time and taking college courses.
Mary started shooting up heroin six years ago, before opiate use in Lancaster County had grown into the full-fledged epidemic it is now.
You can find the stories of the latest overdose victims on the obituary pages of LNP on almost any given day. The number of overdose deaths from heroin this year is certain to surpass that of any other year on record, Lancaster County Coroner Dr. Stephen G. Diamantoni has said.
They are people like Mary. Some are older. Many are younger.
"I knew nothing about heroin except it was bad," said Mary, who LNP is not identifying because of concerns she will lose her job if details about her past become public.
"My boyfriend at the time had been doing it. I tried it to see what the big deal was."
She understood pretty quickly.
The drug took away her anxiety and made her feel carefree, an escape from all the awful things she had gone through in her youth. Mary is a survivor of child sexual abuse, and of parents who introduced her to drugs when she was a teenager.
"It wasn’t but a few days of using and I was already hooked," Mary said. "I wanted it. I felt sad without it. Heroin is the only thing that feels that good and that bad."
Soon Mary and her boyfriend were living in a car, panhandling and getting arrested. At one point, she ended up in the hospital with an infection — and had a friend sneak heroin to her to satisfy her cravings.
She overdosed in the bathroom, and nearly died.
Mary had hit rock bottom.
"It wasn’t but a few days of using and I was already hooked."
Leah, a local businesswoman, described her 13-year-old son’s escape to heroin after being the victim of sexual assault.
"I was a wreck for years. I wanted to go to bed, pull the covers over my head and never get up," she said in an interview with LNP. "I was absolutely panic-stricken every day, wondering how my life got this horrible."
The newspaper is not using Leah’s last name because it would disclose the identity of her son, a victim of sexual assault.
Though the abuser had been jailed, Leah's husband had started drinking to cope with the stress.
At one point, she came home to find her husband passed out on the floor after drinking too much, and her son overdosing on heroin.
Leah had to call two ambulances.
Her family had hit rock bottom.
But like Mary, they climbed back.
Mary didn’t trust herself to stay clean, even after stays at two separate rehabs. She knew from experience that heroin is one of the toughest addictions to beat.
Relapse is common.
So she built a plan. One that included medication to ease the biological cravings for heroin, the support of a church group, meetings with a 12-step group and intensive counseling.
"I absolutely need all those things to stay on track," said Mary, who went to Manheim Township High School as a teen.
She said the medication — in this case methadone — made her feel normal again. “For once I felt that I could actually beat the addiction," she said.
The use of such medication coupled with support and counseling make up the kinds of programs now being advocated by the government and private addiction specialists.
"She was ahead of her time," said Dr. Joseph Garbely, medical director at at Caron Treatment Centers in Wernersville, Berks County, after hearing about the program Mary put together for herself.
Dr. Mary Jeanne Kreek, a professor at Rockefeller University who has been studying the effect of drugs on the brain for more than 50 years, agrees that such programs are crucial to overcoming addiction.
"The brain changes, and it doesn't recover when you just stop the drug because the brain has been actually changed," she said in a published report.
"It's hard to find a person who has completely normal brain function after a long cycle of opiate addiction, not without specific medication treatment," she wrote.
"It's time for everyone to wake up and accept that abstinence-based treatment only works in under 10 percent of opiate addicts," Kreek said.
Practice guidelines published by the American Journal of Addictive Medicine now include recommendations for the treatment of opioid use using methadone, buprenorphine, naltrexone, and/or naloxone.
"We believe recovery is a journey of the body, mind, spirit."
-Dr. Joseph Garbely
And this year the federal government increased access to medication-assisted therapy as part of what they called "a well-rounded treatment program."
Caron and many other facilities that treat opiate addiction embrace the kind of multidimensional program that has kept Mary clean for almost three years, which includes medication.
Almost 60 percent of patients enrolled in a Caron Treatment Center monitoring program were tested free of drugs one year later.
"We believe recovery is a journey of the body, mind, spirit," Garbely said.
Caron also offers group and individual therapy to address underlying psychological trauma and other issues that may have turned someone to heroin in the first place.
It offers a spiritual approach to recovery and supports a 12-step program for addicts.
It also emphasized the education of family members of addicts.
"It's really important to address the whole family," Garbely said.
Dr. Joseph Garbely sits in Chit Chat Auditorium at Caron Treatment Centers in Wernersville. Dr. Garbely lectures there periodically about the medical aspects of addiction to families and patients while they are in treatment.
Leah, too, discovered that support is key. And not just for addicts, but for their families.
"I was sick, too," she said. “I had to learn to say I am not living like this."
After 10 years of living with the addictions of her husband and son, she walked out.
She found hope in Al-Anon, a nationwide network of groups for friends and families of addicts. There are several chapters in Lancaster County.
"What's so cool about the meetings is that you are loved unconditionally," she said, "no matter where you are in your journey."
She said she learned from those meetings that addicts don't get better when someone is doing their work. Indeed, the two addicts in her family started to do things for themselves — including getting help - after she left.
"Once I got clean, I realized I’m on this earth for a purpose."
Mary is now healthy, working full time, going to college and supporting herself and her two rescue dogs.
"Before heroin, I was too lazy to figure out what I believed in. Once I got clean, I realized I’m on this earth for a purpose," she said in a recent interview.
She works as a nursing aide, tending to elderly patients. She sees a counselor regularly.
"I keep a journal, writing thoughts and feelings," she said.
She's working to achieve another dream — becoming a registered nurse. Although she's struggling financially to do it, she's already completed one semester at the Pennsylvania College of Health Sciences. She has to take off for a semester so she can save up money for more schooling.
But she takes this setback like she does many others in life, with gratitude for what she has.
"I have no family. I have no money, but I'm free and working toward my goals," she said.
“There's a better life out there, but sobriety is not just about staying off heroin,” she said. “It's about your whole life, the rest of your life."