Lieutenant Kevin Walruff, 49, is a big, clean-shaven man wearing a light blue button-down and a Santa Claus and reindeer tie. I follow him down a hallway and into a conference room in the nondescript building of florescent lighting and concrete blocks that currently houses the Medford Police Department. I notice that he has handcuffs clipped to his pants and .40-caliber Glock holstered at his waist. Walruff is the commander of MADGE, the Medford Area Drug and Gang Enforcement, a multi-agency task force comprised of investigators from the Medford Police, the Ashland Police, the Jackson County Sheriff’s Office, the Jackson County Community Justice, the Oregon State Police and the FBI. MADGE works with several federal agencies, including the Department of Homeland Security, to stop illegal drug use in Jackson County.
From reading the newspaper and talking to friends, I already knew there was a growing problem with heroin abuse in Oregon—a problem that mirrors a disturbing national trend—but I had no idea of the scope of the local problem until I sat down with Walruff.
In the last four years, Walruff tells me, the amount of heroin MADGE has seized has quadrupled.
“The availability of and demand for heroin is continuing to increase,” Walruff explains. He turns on his computer to access MADGE’s most recent statistics and turns the screen towards me so I can look at the numbers with him as he talks.
“In 2013 you were as likely to die of a heroin overdose as you were to die in a traffic accident,” he says, pointing to the screen, “that’s according to a Jackson County Medical Examiner’s Annual Report.”
Tracey Helton, 44, a former heroin addict who now works in public health in the San Francisco Bay Area, agrees that heroin is more widespread and available in California and Oregon than ever before. “Twenty years ago there wasn’t heroin like there is now,” says Helton. She tried heroin for first time when she 20 years old, was high for twelve hours and spent the entire night vomiting. But she could not wait to try it again. “Back then it was difficult to obtain.”
“It was very easy to get heroin in Ashland,” Diana Cooper, 26, who has been clean for 20 months, tells me.
Heroin is a naturally occurring substance extracted from the seedpods of Asian opium poppy plants. It can be injected intravenously, snorted or sniffed, or smoked in a pipe. Walruff says that a younger crowd is starting to smoke gunpowder heroin, a substance that has the consistency and color of cocoa powder. It is readily available to buy illegally on the streets and only a little more expensive than the black tar heroin that is usually used intravenously.
Young people convince themselves smoking heroin is not so bad, Walruff explains. “‘If I’m not sticking a needle in my arm, I’m not a user,’ is what they tell themselves.” But it’s just as dangerous, Walruff insists, and just as easy to get hooked on.
The local rise in heroin brings a whole new level of worry to raising teenagers. But the most surprising thing that Walruff and others tell me about heroin addiction here in Southern Oregon is that they encounter heroin and opiate prescription drug addicts from all walks of life: A surgical nurse with a good job at the hospital, a mom of four who serves on the PTO, a competitive triathlete, a well-respected official in a high-level state government job, a small business owner.
Two months after meeting with Walruff, I walk by a young woman with blonde hair and sores on her face who is sitting on a slip of cardboard in front of a line of food wagons in Portland’s Pearl District. Her cardboard sign reads, “Kindness is contagious.” Her face is puffy and pale, her head bowed. I stop to talk to her.
Tiffany tells me she is 25 years old and that she looks so bad because she has been crying. She is back on the streets for the first time after a year and a half. Before that she successfully kicked her heroin addiction, but then got hooked on methadone, a less dangerous opioid medication that is sometimes prescribed to addicts to help taper them off heroin.
Tiffany fits the stereotype of the strung-out dope addict living on the streets or one step away from being homeless. But many others are active members of society, successfully hiding an addiction that is secretly destroying their lives.
“I never in a million years believed I would get hooked,” says Tracey Helton, who grew up in an upper middle class family in Cincinnati, Ohio. Helton’s father was an engineer and her mother was an executive secretary. She went to an elite private high school. Though her father was an alcoholic and she had an eating disorder and cut herself as a teen, Helton never thought she could become a heroin addict. “That’s for people who you see downtown, who didn’t have the kind of life I had,” she explains. “But there were 126 girls in my graduating class and two of us became junkies.”
“You see it in all levels of society,” Walruff insists.
Experts say that many factors are contributing to the rise of heroin use in the United States in general and Oregon in particular: highly organized Mexican drug cartels that are ready to sell H wherever they find a demand, the fact that Interstate 5 is a drug trafficking corridor providing easy access to California and Oregon’s cities, budget cuts that have decreased national and local funding for drug enforcement officers to go after dealers and drug lords.
But others argue that there is an even bigger reason we are seeing spikes in heroin use. They blame the pharmaceutical industry and America’s medical doctors. They claim that it is the medical community that has been irresponsibly prescribing highly addictive medication and creating a whole new category of drug addicts.
“Doctors have actually created addiction to heroin,” argues Joshua Graner, the director of Kolpia Counseling Services, a non-profit based in Ashland, which provides psychological counseling and other health services—including medically supervised drug tapering, yoga therapy, and nutritionally counseling—to addicts.
“Big Pharma said opiates are safe and not addictive to prescribe,” Graner explains. A muscular, soft-spoken man with a neatly trimmed beard and curly brown hair, Graner is sitting on a yoga ball in his downstairs office. The air smells of lemongrass and lavender, essential oils that are being defused into the air via a machine that hums softly. “For over 90 percent of the people I treat, the addiction is iatrogenic—related to a prescription they were given.”
Graner uses a hypothetical to explain. You get into an accident of some kind, say a car crash, which results in debilitating back pain. A doctor then prescribes you an opiate to combat the pain. These opiate painkillers, which consist of a surprisingly long list of widely prescribed drugs, include many with familiar names: codeine, methadone, hydrocodone (Lorcet, Lortab, Narco, Vicodin), and oxycodone (OxyContin, Oxyfast, Percocet, Roxicodone). Because you are in pain, you take the highly addictive prescription drug given to you by your doctor and paid for by insurance for several months. At first your insurance company pays for the pain relief but after a certain amount of time, usually three to six months, the insurance stops paying for them and your doctor refuses to prescribe you more. By this time, whether the reason you started to take them in the first place has been resolved or not, you have become inadvertently addicted to the painkillers themselves. As unlikely as this may seem to someone who has never experienced it, you then find out that you can buy heroin illegally to feed what has now become an addiction. The heroin is not only cheaper than paying out of pocket for the prescription pain medications that you no longer have easy access to, it is relatively easy to buy on the black market.
In some ways that is what happened to Diana Cooper, a mother of four who lives in Medford with her family. Cooper tried heroin for the first time in December 2012, just a few weeks after her youngest son was born. The young mom had been taking narcotic pain medication for seven years, which was prescribed to her after a bout with meningitis when she was 18. She had been using prescription drugs ostensibly for migraine pain—both legally and illegally—ever since. Cooper and her husband both became heroin addicts.
Cooper says she grew up middle class, like Tracey Helton. Addiction runs in her family, and she started smoking pot as a teenager. She knew she liked how the pain meds made her feel but she was never willing to admit to herself that she was addicted to them. After all, they were legal, and prescribed by a doctor.
Even after she started buying extra quantities of the prescription drugs, including methadone, off the streets, she refused to think of herself as an addict. So she felt sure she would be able to try heroin, too, without becoming addicted. Cooper called her sister late one night and casually mentioned heroin.
She tried not to let on how excited she was to try it.
The Incredible, Deadly Euphoria
Kristine’s (who asked her last name not be used) heroin addiction was not the result of a doctor’s prescription. When she was in her 20s, Kristine moved from Bend, Oregon to the Bay Area to attend the Art Institute of San Francisco. She says she was living a “normal college lifestyle,” studying hard and partying on the weekends. But one night with her roommate Kristine was so drunk on red wine that she tried shooting it up her arm. She did not like it when she first tried it, but got drunk a few days later and tried it again. Kristine’s biological father was an alcoholic, her brother had a contentious relationship with their stepdad, she had been date raped when she was 15, and also had an eating disorder, which made her feel ashamed.
“It takes away all those anxieties and it makes you more comfortable with yourself,” Kristine, 35, and a mom of two, tells me when I reach her by phone at her home in Bend. She talks so fast and has so much to say that I have trouble keeping up. “It totally mellows you out.”
Tracey Helton loved the Vicodin she was prescribed for dental work she had done when she was 17 and thought “it would be cool” to try heroin. Though she kept her heroin use under control for the first two years, she ended up moving to California and becoming a full-blown addict, turning to prostitution and panhandling to fund her need for smack.
“The euphoria is incredible,” Helton, who has been drug-free for sixteen years now, remembers. “It’s a hard experience to describe.”
After she tried heroin for the first time, Diana Cooper knew she would never go back to taking pills. She, too, loved the feeling of being high.
“Your heart is racing, you get a rush,” Cooper remembers. “You get a lot of endorphins … I wouldn’t go out and pick a fight with some 300-pound guy, but you feel invincible to the point where, ‘I can do everything I need to do. Nothing’s going to hold me back, no little pain, no illness, nothing.’” Overwhelmed with taking care of four small children, she says heroin gave her more energy and she felt at the time like it made her a better mom.
When heroin gets into the brain it is converted into morphine, which has a chemical structure that is very similar to endorphins, the “feel good” hormones your body synthesizes during things like exercise and sex. Endorphins are the body’s natural analgesics, relieving pain and creating a feeling of well-being. Because of its similar structure, morphine binds with the specialized receptor cells in the brain usually reserved for the body’s own endorphins. The high you experience is nearly instantaneous. But there’s a catch. The more heroin you take, the more your body builds up a tolerance to it and the more heroin you need to get high.
The euphoria was so enticing, and the need to use so overwhelming, that Cooper overlooked the negative aspects of taking the drug. She ignored the fact that she would sometimes fall asleep while cooking dinner, that she started putting off everything else she needed to do in order to get a bag. Even her sense of time became distorted. “You say, ‘I’ll be gone for five minutes,’ and you come back the next day. It’s that bad. I don’t know how I didn’t see that, other than that I was really deep into addiction.”
Every day in the United States, 120 people die of drug overdoses and another 6,748 people are treated in hospital emergency rooms around the country for drug abuse. In 2012, drug overdose was the leading cause of injury death for people ages 25 to 64, according to the Centers for Disease Control and Prevention. Although nationwide twice as many people died from prescription opioid overdoses in 2012 than from heroin overdoses, deaths from heroin increased sharply. In Jackson County, the threat of heroin comes in a close second after methamphetamines.
If you’ve never tried heroin before, a dose of between 200 and 500 milligrams can be lethal. But if you are a constant drug user, your body can tolerate many times that much, surviving doses of over 1800 milligrams. The built-up tolerance for heroin is one of the reasons for overdoses. It is impossible to know how much heroin is in a bag that you buy illegally off the streets, since drug dealers sometimes cut their products with other substances to increase their profits. These realities, combined with the fact that many heroin users often drink alcohol or take sedatives at the same time they are smoking or shooting up dope, make it devastatingly easy to overdose.
How Do We Fix The Problem?
Kristine has quit using heroin twice. The first time was when she was 25 years old and had a falling out with her friend and roommate who first gave it to her. Kristine’s new boyfriend didn’t know she was a heroin addict and she wanted to keep it that way. Coming off the drug was so excruciating that she stayed drunk for two weeks. For eight days she was in so much pain that she could not sleep. Her body shook, her bones ached, and she could do little more than lay in bed … and drink. Though she stayed off heroin for two and a half years after that, she was still drinking and using cocaine. When her son was a year and a half old, she started shooting up again.
At that point Kristine used heroin as discretely as she could, successfully hiding her addiction from her “normal” friends and from her son’s father. She shot up two or three times during her second pregnancy. She lied to her family and friends, stopped spending time with the people who were partying, and went to church. But one day after her daughter was born, her children’s father (they had since split up) found drug paraphernalia in the bathroom and yelled at her to stop. Things got worse from there and the addiction spun out of control. Kristine let a drug dealer rent a room in her home and allowed another friend, who had a warrant for his arrest, crash at her house for a week. The police raided her house and arrested all three of them.
For Kristine it was actually a relief to get busted. She spent 45 days in jail, which is how she got clean the second time. The threat of losing custody of her children, the relief she felt at admitting she had been lying, and the desire to go back to a normal life and find herself have helped her stay away from heroin. She has been off it for almost two years. But, she tells me, she would be lying if she said she did not still crave heroin. She does. Every single day.
Diana Cooper and her husband have a more unusual story. They were completely down and out. The family was virtually homeless: They had been living in their van in the Walmart parking lot in Talent, taking turns going in to clean up in the bathroom, then at Jackson Wellsprings, and then with Cooper’s sister, a well-to-do cocaine dealer who lived in an upscale house in Ashland. Her husband was on the streets because Cooper’s sister’s boyfriend did not want him in their house. He went in person to the Department of Human Services, told them that he and his wife were using drugs and that they had no place to go. He also told them he and Diana were a danger to their children, and asked them for help.
A few days later DHS put the family in supervised state-funded crisis housing where they could all be together. “Medford is the only city in the country that has a treatment facility equipped to take children as well,” says Cooper, who has been clean for 20 months, now volunteers for the Southern Oregon Early Learning Service, and is studying child development at Rogue Community College. “We’re very lucky to live here.”
For Cooper the biggest factor in getting clean was the threat of losing her children. Three days after she moved into supervised housing and stopped using, which she was reluctant to do, she heard a former addict talk about having a baby while homeless, losing her for five days, and realizing when she got her baby back that her need to be a mom was stronger than her need to use drugs. That was a moment of awakening for Cooper: it helped her realize that she did not have to use anymore, even when she wanted to, and that there was a better way to be. The help from DHS, support of the people around her, and role modeling from former addicts have been invaluable to her.
“It’s a big issue problem,” says Lieutenant Walruff. “It’s going to take a lot to fix it, not just the drug part.”
Joshua Graner agrees. He believes that we cannot talk about heroin addiction in Southern Oregon without talking about the problem of homelessness. Addicts and alcoholics have nowhere to turn, he explains, because we have no “wet housing” in Southern Oregon. If you test positive for drugs or alcohol you cannot qualify for certain subsidized housing. Unless the temperature drops below zero, addicts are even barred from homeless shelters. But not having a place to live makes an addict’s life that much more difficult and creates a vicious circle, driving them to use even more.
More than 40 years ago, Bruce Alexander, an emeritus professor of Psychology at Simon Fraser University in Vancouver, British Columbia, wondered if the problem with drug addiction was not the addictive nature of the drugs themselves but the social and cultural context that leads to addiction. In the 1970s Alexander conducted a fascinating experiment on rats. He built what he called “Rat Park,” the Cadillac of rat habitats, with great food, plenty of tunnels to explore, and good rat friends. Into Rat Park he put two bottles: one with water and one with cocaine.
Alexander’s theory was that if the rats were in a safe and stimulating environment and had a good life to begin with, they might not become addicted to cocaine. Though his research was buried at the time because it did not dovetail with the thinking in the 1970s, Alexander’s experiment showed that his hypothesis was correct: the Rat Park rats tried the cocaine but did not drink it often. No rat overdosed. In contrast, the rats in isolated cages, bored, alone, and presumably unhappy, became cocaine addicts.
What is the take-away message for Southern Oregon from Alexander’s experiments? Heroin addiction does not happen in a vacuum. It’s a societal problem as much as an individual one. And it will take all of us working together to support each other and create a healthier society—whether or not we are personally affected by drug addiction—to keep young people, mothers and fathers, sons and daughters off drugs.
Jennifer Margulis, Ph.D., is an award-winning journalist, Fulbright grantee, and a champion of children’s health and wellbeing. A sought-after speaker, she has been researching and writing about issues related to health for over a decade. She is the author/editor of five books, including Your Baby, Your Way (Scribner), finalist for a Books For a Better Life Award. Her articles have appeared in the New York Times, the Washington Post, and on the cover of Smithsonian magazine. She has taught literature in inner city Atlanta; appeared live on prime-time TV in France; and worked on a child survival campaign in Niger, West Africa. A frequent contributor to the Jefferson Monthly, she lives in Southern Oregon with her husband and four children.