GONE NORTH:

THE FRONT LINES
OF OHIO'S 
OPIOID CRISIS

Wheat fields, country roads, and even Amish buggies aren’t quaint details so much as the background features in an otherwise terrifying story about addiction in America.

“We’re just stopping by to see if Chelsea’s alive,” Dave shrugs. “It’s a favor for someone.”

It’s explained to me like it’s something to tick off a grocery list, or the thumbnail plot of a movie we’re about to see. There’s no mention of who the favor is actually for. Worried boyfriend? Sick-to-death mother? Hell, maybe it’s all a lie and we’re just here to collect money. Anything is possible as we stand on the wet, sagging porch of a rotted duplex in Mansfield, Ohio. I barely even know Dave—the tall, hollow-eyed friend of a friend of a friend from an AA meeting I don’t attend all that regularly. He’s two decades younger than me, but he has that hardened, weary, no-bullshit expression where most young addicts’ faces rest. While reconnaissance isn’t really my thing (Netflix’s Stranger Things is), I’m way too fascinated. I wanted a first-hand glimpse at the opioid epidemic, so I offered to drive. Now, I keep thinking of excuses to get back into my car.

The story goes that Chelsea was a smart, athletic high-school junior in one of the countless well-heeled suburbs that dot Columbus, Ohio. Cross-country, track, swim. Something about a sports injury. Torn ACL, maybe. OxyContin. Anyway, you know the drill: it’s the typical trajectory you read about in the news. One thing leads to another, and it never leads anywhere good. Still, by all accounts, her parents were blindsided by the painkillers. The tractor beam of heroin yanked Chelsea, just like Dave and so many other unsuspecting high schoolers, from the Interstate 270 loop around Columbus, up to Mansfield. These days, it’s not surprising to hear how kids—teenagers, really—would just vanish up there. Gone north, people say. Earlier this summer, there were 11 overdoses there in one day.

Mansfield itself is a hilly wasteland of sorts, zigzagged with railroad tracks, shuttered storefronts, sleepy family restaurants, and dead manufacturing plants with vast tangles of rusted pipework and shattered windows. It’s an unseasonably cold day in July: concrete-gray sky, slight chill undercutting everything, oddly humid. The entire city is pitched at a 30-degree angle—as though the people here are conditioned to fight uphill. To me, it seems like the city’s been hollowed out. The skyline is modest, if not slouched—careful not to draw too much attention. There are enough unkempt yards on Main Street to tell me that most people don’t care. The owner of a coffee shop calls Mansfield a “shell game”: all the drug-out criminals, he says, keep trading the same stolen electronics and lawnmowers over and over again. There’s a penitentiary that’s just a stone’s throw from downtown—a glaring, razor-wire reminder of what happens to drug offenders. Hell, the iconic Ohio State Reformatory—Shawshank fucking Prison—is just a mile away, too. And yet, Mansfield is just like any other town in Central Ohio: it’s blighted by a problem that the CDC has officially called an epidemic.

Despite a merry-go-round, Mansfield doesn’t seem all that happy to be alive. It’s haunted—and so am I, studying the patio as Dave knocks on the door for the fourth time: trash bags, ancient board games, a fat Zenith TV, a gas grill with spiderwebbed knobs. Everything is soaked from morning rain.

Finally, the door opens.

A skeletal girl winces back. Vague recognition flashes in her blue eyes when she sees Dave.

Chelsea.

There aren’t any hugs or handshakes. Chelsea just steps back and lets us in. To call her “wiry” is to say she actually has something of a body, which wouldn’t really be telling the truth. She’s a ghost, shrouded in a men’s Superman T-shirt several sizes too big for her. It’s splotched, stained, and wrinkled—the “S” logo is faded and flaking. Maybe she could have filled out the shirt when she was a high school junior a couple of years ago, but no longer. All told, she’s my height: just under six feet—and doesn’t look fazed that a total stranger (me) is standing there.

I don’t want to step inside. This isn’t what I signed up for. We just had to see if she was alive. That’s it. But inside I go. I’m 40, married father of three, and I don’t belong here. But my brain is already scrabbling through every single detail: Where did all the furniture go? Who pays the rent? Is she squatting here? Will the cops be busting in at any second? Heroin use is like a cartoon in my head: it’s all people wildly running around with needles and spoons, as if they’re all my grandmother’s greatest nightmare about people running with scissors come alive. I’m afraid that if I touch anything, I’ll get hooked on heroin, like catching my toe on a rusty nail will give me instant tetanus.

“Don’t mind this,” Chelsea says, uprighting a chair that’s off to the side. I don’t know what she’s referring to. There’s really no other furniture in the duplex—just an epic stretch of stained carpet and the fresh reek of cat piss. There’s a nice flat-screen TV, though, sitting atop some cinder blocks and moving boxes. An Xbox is there too, with controllers snaking out. The video-game system is clearly a shrine, but whose shrine? Is Chelsea secretly skilled at Zelda? Everything else has probably been pawned or sold or stolen, I tell myself.

There’s an acrid, unfamiliar smell here, though. Some people are in a bedroom back to the left, but all I can hear are murmurs and shuffling. Mild, half-hearted arguing. Vague signs of life.

Heroin is nowhere to be seen here and yet—it’s everywhere.

For me, it’s enough that Chelsea is alive. Mission accomplished. I don’t need to hear about her exhausting schedule for the rest of her Sunday, as she details all the places she’s going to “check out” with some friends. It amounts to a list of streets on the west side where, when most people are out, she can root around, jostle doorknobs, and scour unlocked cars for loose change. She’s just trying to keep her addiction alive which, like Mansfield itself, seems to be hanging on by a thin thread.

They say goodbye. Chelsea never once acknowledges me. When we leave, though, Dave seems oddly satisfied and asks if I want to hit Taco Bell. That’s where his brain goes: 7-layer burritos and Chalupas. Me? My brain starts working through everything I’m surrounded by. The doom-and-gloom of it all catches up with me. The stories are right, I realize. All of them. Chelsea is just one of a zillion sad endings. There’s no hope. Heroin is winning. Addiction is bleeding across the map. There aren’t enough treatment programs in the world to undo the damage that surrounds us on every street corner here.

It’s over.

“Look, man,” Dave shakes his head, sensing I’m bothered.

 

“Chelsea’s not sober. And we can’t get her sober. But if I’m sober, something’s working.”

A lot of Internet bandwidth has been burned on the opioid addiction in Central Ohio. If you’ve heard “Ohio” and “addiction” in the same sentence, it’s probably in one of the countless news stories that paint the Buckeye State as Ground Zero for opioids. Here, overdoses are at historic highs. Coroners don’t even have enough room for all the bodies and they call funeral homes directly. Oxycodone, fentanyl, hydromorphone, hydrocodone and heroin flood virtually every corner of the state. Wheat fields, country roads, and even Amish buggies aren’t innocent, quaint details so much as the background features in an otherwise terrifying story about addiction in America. To show someone a map of Ohio is to show them an anatomical map of addiction: arteries of drug transportation, clustered nerve-endings of trailer parks ravaged by a bad batch, fevers of crime waves.

Opioid addiction feels less like an epidemic here and more like a guarantee—it’s always going to be here, thrumming in the background like insidious white noise. What’s even clearer is that no one program has the answer—there’s no magic frequency out there that will shatter the addiction crystal.

 

“Heroin caught us all off-guard,” admits Berlin Heights police officer Joseph Bernard. “We only got trained in using the Narcan spray in the last two years.”

He also admitted to not knowing the specifics of his department’s current drug awareness programs—a familiar refrain among law enforcement across all of the state, given that they’re constantly changing and evolving their strategies, throwing anything and everything at the problem, trying to see what sticks. And while Officer Bernard works in a village of less than 1,000 people, it doesn’t make these postage-stamp towns any less impacted by the opioid crisis. In fact, it makes it all the more apparent that opioids strike anywhere. Heroin addiction often lives in secret and shadow, which is why when it emerges in a small town, it means it’s actually everywhere. In Berlin Heights, over July 4th weekend, he says it took seven sprays of Narcan to revive a woman who’d overdosed.

“It’s ridiculous how exponentially [heroin] has grown. It touches everyone,” Bernard says, observing that it’s pretty much the only game in his sleepy town. “I don’t even hear about pills. It’s just heroin, heroin, heroin. I’m genuinely surprised by how prevalent it is and how many people it affects. We have people who drive through and they just physically crash out. Next thing you know, squads are on the way.”

In fact, heroin in small towns isn’t even shocking. What shocks most professionals isn’t that it exists at all—it’s that it took so long to get noticed. “I remember my cousin who lived in a suburb of Columbus telling me about her classmates using pills and heroin around 2007,” says Rikki Grace, a mental health specialist in Westerville, Ohio. She claims she didn’t see a newspaper story on the crisis for another seven years, when she was working in an inpatient treatment facility. And yet, opioid addiction was festering long before it hit newspaper covers and made feature stories.

Have opioids always been here in Ohio, or has supply finally satisfied a demand that’s always been percolating in the dark?

I graduated from Edison High School in 1995, a 6,000-square-foot “L” hemmed in by cornfields on every side. Lake Erie is just ten minutes to the north. Growing up in Milan, Ohio, the birthplace of Thomas Edison, we were pretty much always under the shadow of greatness. The man left Milan at the age of three, yet elementary schools still tour his brick birthplace with reverence. After all, we’re the “Edison Chargers.” And yet, for everything Edison famously foresaw, he certainly couldn’t have anticipated the pall of addiction darkening the doorsteps of his village. Truth be told: I was pretty blind to drugs in high school. For a kid obsessed with Star Trek: The Next Generation and James Bond movies, it’s entirely possible that I just wasn’t plugged into any of it. Maybe the Borg had blinded me to a world not unlike that goofy scene in Wet Hot American Summer where a five-minute run to town turns into a nightmare straight out of Trainspotting. I asked my best friend “Big Neal” Doerner for a reality check.

“The hardest drug I ever saw in high school,” Big Neal reveals to me, “was a Triple Whopper with Bacon at Burger King.”

Yep. I had to dig deeper.

Marijuana and booze seemed to be as ubiquitous as the barnhouse parties they appeared at. I remember friends getting the occasional few days’ suspension for a bag of weed here and there, but nothing remarkable. “Prescriptions and over-the-counter stimulants [were] huge,” one friend from high school told me via Facebook. “I recall Friday afternoon trips to Drug Mart to grab No-Doz.” Beyond that, he explains that codeine was as popular as nitrous “whippits.” Still, “cocaine was present, but people I knew rarely messed with it.” (Ironically, this friend is now a drug and alcohol prevention counselor—something I didn’t know before reaching out to him.)

This was more like it, though. This sounded like the backwater Ohio I remembered. What’s more is that the more responses I received from people about our shared high school years, the more at home I felt. I may have been lost in a world of steel-toothed henchmen, but my nose for reality wasn’t completely gone.

So, what happened? Urban legends abound that the “T” of the east-west Ohio Turnpike and the north-south I-71 make for a perfect drug delivery network. Shipments get quietly (and efficiently) distributed along the highways and byways of Ohio, targeting tiny towns and upper-class suburbs alike. Cities like Chelsea’s.

Adam disagrees with the media. He’s a tall, fit young man in his mid-twenties, with an easy, kind smile and close-cropped hair. Adam’s the type of guy you want standing next to you in a bar fight: there’s a quietness to his strength. Even relaxed, though, his posture tells you he’s ready for anything. He’s married, has a good job, goes to school and, according to him, has an insane household with two babies running around in it. And not that long ago, heroin had him in its grip. “I don’t care if Mexican gangs decided to change the game and deliver it to upper-class kids in Central Ohio,” he says. “Whether someone was going to deliver it to me or not didn’t matter. I was going to find it.”

Heroin ended up taking Adam places never thought he’d go to see things he never thought he’d see. But he didn’t start off on the hard stuff. His story paints a portrait of Ohio drug addiction that falls more in line with today’s newspaper headlines and notifications. While weed was everywhere in high school, the young father recalled, so too were prescription pills. “Adderall, Vyvanse, Xanax,” he counts them off with his fingers. “You could also easily find lower-dose opiates: OxyContin and Vicodin. But it really came down to whoever has the prescription. Someone might have one at the beginning of the month, but not by the end. So you had to live through these dry periods followed by a ton of pills.”

Adam was a high-school football player beset with several injuries. “The locker room is where I really first saw opiates,” he said. “Players would just be sharing opiate painkillers before and after every game.” And before he knew it, Adam was a high school junior completely addicted to painkillers, which led him to start looking outside school for a harder fix.

“No one gets into heroin loving needles,” Mike, another former heroin user in his mid-twenties tells me. “It’s a fear you get over, though—and you get over it almost immediately.”

I’d met Mike in a treatment center years before, and this version of Mike is light years past the wafer-thin, sunken-cheeked one I’d encountered in 2013. Mike now wears thin-rimmed spectacles and a confident smile wherever he goes. He has muscle mass and a sense of humor now. When he talks, it’s almost as if he’s in disbelief that he made it out of hell alive. “You’ve gotta remember, I went to treatment 14 times,” he shakes his head, which he says is less about the power of heroin than it is about his eventual willingness to surrender to his troubles completely. With a full-time job, a library of books lining one wall, and workout equipment tucked into his modest, meticulously clean apartment, he’s a well-read, well-spoken advocate for recovery who’s also mindful that his addiction that isn’t even five years in the rearview mirror yet.

In fact, his first encounters with heroin weren’t all that impressive, according to Mike. “20 dollars of heroin snorted wasn’t going to get me the same high as 100 dollars worth of OxyContin,” he admitted. But soon enough, life spiraled out from underneath him. He recounts shooting up in McDonald’s bathroom stalls minutes after getting out of jail—a memory that doesn’t carry any sense of wistfulness, like someone remembering a bachelor party that got a little out of hand. “I was shooting up with career heroin addicts. The youngest one was in his mid-30s. We’d hang out at different houses in foreclosure with cat shit and black mold and I was just this teenager.” He even describes a moment where he thought he’d shot himself into a vegetative state.

Like Mike, Adam feels lucky—but not blessed. He knows he’s just on the winning side of some terribly dark math—and he’s carrying that exact message into a men’s AA meeting he and Mike put together. In fact, he’s just minutes away from setting foot into the church basement of that very meeting.

“It’s so surreal that I was even part of the epidemic,” Adam says. “A lot of it comes down to me feeling invincible when I was 17 and 18. Most 17 and 18-year-olds do. The thought of me going to AA at 26 because of the things I was doing at 17 would’ve blown my mind. Now, looking back, heroin affected my life in such a brutal, unrelenting way that it blows my mind that anyone is still using.”

When I ask Adam for specifics about his first experiences and how much a bag of heroin cost, the details get murky. He either doesn’t remember or doesn’t care—which speaks to a larger point when it comes to opioid addiction: the details don’t matter.

“Of the three people I started using heroin with,” Adam says, “two of them are dead and one of them just got out of prison. A lot of us died.”

Just because Ohio is one of the worst-ranked states for opioid addiction, it doesn’t necessarily make it the least-prepared or ill-informed. Quite the contrary. Countless treatment centers, prevention programs and awareness efforts are working overtime across the state—all shapes, sizes, flavors, and approaches—but it amounts to a matter of time to reveal what actually works. Many experts believe that we have to make sure we have the best interests of the people struggling with addiction in mind. “I would like to say I am surprised by our societal tendency to want to put a Band-Aid on the problem rather than work toward real solutions, but I'm too cynical to say such a thing,” therapist Rikki Grace says. “There are people who want to make a difference. There are also people who make a lot of money from the revolving rehab doors.”

That’s where the real work begins. The Ohio State University, for its part, isn’t ignoring the opioid epidemic in its backyard. It’s thrown top-notch tools and resources to help, not to mention putting together an entire department to combat the problem. According to the school, “OSU Extension” is a landmark department that’s “uniquely positioned to address the prevention of opioid abuse statewide,” having engaged everyone from the Governor’s Office to a raft of local mental health organizations; they're also smartly partnering with the colleges of Public Health, Social Work, Nursing and Medicine. OSU is also spearheading several other innovative programs, including drug-education task forces in hard-hit counties throughout the state. “Opioid addiction is a community and family problem, and because OSU Extension works directly with communities and families as part of our outreach mission, we are positioned to help people understand how they can contribute to helping take on this challenge," said its chair, Ken Martin.

Adam, whose Tuesday-night AA group helps dozens of men sustain sobriety, argues that the opioid addiction finds its greatest “success” in American youth. “I have an entire theory about why young people are hit harder by addiction than older people,” he says, tossing out a broad sketch about frontal-lobe development and an anecdote about his older friends not touching drugs because of biology. Turns out: he’s absolutely right. “I think the amount of dopamine that opioids provide creates a perfect storm with the developing brains of teenagers and young adults. The messages young people receive about opioids are different from the messages a couple of decades ago,” Grace says. “I was taught that heroin was one of two drugs (cocaine being the other—methamphetamine wasn't as popular then) that you absolutely did not do, because you would be hooked as soon as you tried it and you would probably die. Now, I think American youth are still exposed to that message, but it is offset with experience. They see people using these drugs, and they may not see those severe consequences initially.”

Unfortunately, like many things, it takes a sledgehammer to get some of these messages across. I immediately think of Chelsea, shuddering and pale in that shitbox duplex up in Mansfield. I wonder how quickly the bottom had fallen out of her life: one minute shopping at Easton, sizing up shoes at FrontRunner, bringing in personal-best cross-country records in front of proud parents; the next minute, shooting heroin and committing petty crimes. Certainly, she had to have seen or heard the warning signs of heroin beforehand. Then again, it’s not important what her specific trigger was. To me, the question is why wasn’t the message enough?

“I think awareness programs and education are crucial. I think working to reduce the stigma toward addiction and addicts is crucial. I think letting go of the belief that addiction is caused by some moral failing of the addict, and recognizing we're all human and we all struggle at times is crucial,” Grace nods, taking all of my questions in stride. “I think [Narcan] is conceptually great, but we do not have the structures in place that would make it the most effective it can be,” she says, noting that the drug is oftentimes administered to the same people over and over.

“If we truly want to effectively treat not only this crisis, but addiction in general, we have to create a culture that treats people like human beings, and we have to invest in the practices that work.” Of course, this might mean lots more long-term community building than we’re doing already. In fact, it simply means more doing than talking. As Rikki Grace suggests, we need to push for “readily available and affordable treatment options that provide long-term support, connection, and healing for not only addicts, but also their families, friends, and communities.” It’s a tall order, experts agree, but it’s as possible as it is necessary. Ohio may be the most ravaged by opioid addiction, but it doesn’t mean it’s weak. It just means the current conditions are right. And similarly, the opioid crisis has conditioned everyone—families, lawmakers, people struggling with addiction—in a way that other states haven’t seen yet. We may not have been prepared, but we’re quickly adjusting.

There’s no use in looking at the numbers. Nothing good comes from seeing doomsday headlines, day in and day out. We’re not going to change those trends. No, the real salvation comes in finding the people who’ve beaten the odds to not only survive, but who have inexplicably decided to go the extra mile and carry messages of recovery to others. They’re the silver linings everyone’s so desperate to find in the thundercloud-dark stories that lumber across our news feeds about Central Ohio. We have to treat them with white gloves, ask them questions, take their humble advice. After all, we may be failing when it comes to the spread of addiction, but we’re succeeding in ways we can’t even begin to understand through the people who survive it. Nature shows us that pressure creates diamonds and it’s true, too, in recovery: those same forces continue to forge incredible people at the front lines of opioid recovery. People in recovery are the one true key to cracking the opioid epidemic once and for all. In the end, they’re the only people who know both the way into hell—and the way back out.

This piece was originally published at The Fix.