Voices of the Epidemic (originally featured in Folio Weekly Magazine)

story by ASHTON ELDER
photos by DENNIS HO

On a recent sweltering summer afternoon, a young man sat in the shade outside a Jacksonville Beach café. Handsome, clean-cut and preppy, his look brought to mind quaint golf outings with friends or shopping at J. Crew. But the attractive young man wasn’t fresh from the golf course or the mall. Two activities occupy the vast majority of his time: smoking crack and doing heroin.

“John,” as he asked to be called, is one of the many local faces of the nationwide heroin epidemic. John, 30, says he started experimenting with drugs — everything from cocaine to ecstasy — in high school.

After graduation, he played football at the University of North Carolina but left after only a year. (He implied, but didn’t say, that he dropped out due to drug use.) John moved back to Bradenton, where he’d grown up.

“Right about that time is when the roxy craze was really starting to hit, in about late ’05 and early ’06 and I got back down there and just started dealing them,” he said.

“Roxy” is a street name for Roxicodone, also known as oxycodone, a strong semi-synthetic opioid medication with effects similar to those of morphine and heroin. According to John, Roxicodone, along with similar prescription opioids such as Oxycontin, Percocet, Vicodin and Hydrocodone, were the main drugs people started using around the time he dropped out of college.

At that time, Florida was known for its “pill mills,” doctors’ offices that masqueraded as pain management clinics, prescribing large quantities of pain pills and other narcotics to anyone willing to pay a hefty cash fee. “My buddy came back from Boca Raton with about 10,000 of them every weekend,” he said.

The pill mills created a new generation of opiate addicts in Florida.

In 2010 and 2011, Florida passed legislation that significantly cracked down on the pill mills. Initially, that resulted in fewer deaths from overdoses, according to a study by Johns Hopkins Bloomberg School of Public Health.

However, the sudden decrease in the availability of pain pills caused the street value of the pills to rapidly increase. As the pills became harder to find and more expensive, many addicts like John turned to heroin.

“I stuck to Roxicodone and Oxycontin until about three years ago and by then the price had skyrocketed. That’s when I made the switch over to heroin,” he said.

By this time, John was living in Jacksonville, where, he said, heroin was cheap and easy to find all over the city and at the beaches.

“For me, whenever I would take roxies, they gave me a superman feeling and I felt like I could do anything … by the time I switched over to heroin, it didn’t take near as much for me to do to get the same feeling. With heroin, I had a very similar high but it would kind of keep phasing on. Now, every once in a while, I will try a few roxies but I [don’t] like it as much … it’s hard to go back.”

Unlike many addicts, John never injects heroin. Instead, he snorts and smokes it. “Honestly, I have a pretty good paying job and I always thought I would rather just spend a lot more money on it than shoot it … That’s why I have been able to do eight, nine, 10 [bags] a day.”

John says he has seen many local addicts make the switch to heroin. “It’s been growing for a while now,” he said. “Heroin is a lot cheaper … A chronic user will only spend anywhere between $100 and $200 a day on heroin, which is cheaper than the pills.”

Shortly after he turned to heroin, John started smoking crack, too, doing them together to get up and then come down.

“It’s not just heroin for me … one of the big things I have seen a lot of people doing now is crack and heroin,” he said. “I will go smoke crack in my car for hours … and then take heroin to come down.”

John says heroin users come in many varieties in Northeast Florida. “There is no set lifestyle for the drug scene in Jacksonville. I’ve worked in restaurants and I work at a financial institution now and I have found drug dealers at both places. I mean, really, in all walks of life, I have found dealers and users. It’s all types.”

Although able to hold down a job, for years John has supported his growing habit like many addicts: by doing business at pawn shops. After he pawned everything he owned, he says, he stole from his family and pawned their things. When we spoke, John said that the day before, he’d pawned a blender to pay for crack and heroin. He’s filed for bankruptcy — and the morning after our interview, he got kicked out of his home. John is now homeless.

Although John attends 12-step program meetings on a regular basis, he calls himself “a chronic relapser.” He has been in and out of five Florida treatment centers over the years. The longest time he has been able to remain clean and sober in the 11 years he has been using was 74 days. “That was three treatment centers ago,” he said.

He did not seem interested in getting treatment to help him detox; instead, he intends to continue using drugs.

John did praise the benefits of the 12-step program, however, and seemed to genuinely believe in the program’s principles, such as checking in with a sponsor every day.

He actually attended a meeting right before our interview, but explained he usually has to tell his sponsor he has relapsed again. “At least now, I’m being honest with someone about it,” he said. John said that every day, he wakes up and decides he will remain clean but “as soon as the addiction says ‘go use’ … my willpower goes away. I have become so well-versed in what is supposed to be done [in recovery] it’s just making that sacrifice. Honestly, I still think in a sense I hold on to the notion that I can control it in a way … that there is some way that I can do it. I’ll think: I am going to fight this myself,” he said.

John has a history of going to rehab, cutting back on his habit, then going down a path where his using quickly gets out of control. When we spoke, John said that he was doing fewer drugs but could see his habit getting out of control again. “This is how it starts: I start off small and eventually it goes into a full-blown binge.”

Rehab is out of the question for him right now, but he claims he is trying to work the 12 steps “the best I can.”

“I want to quit, yeah, I do want to quit.” He paused. “Let me rephrase that: I want to do drugs but I know that I can’t and that’s the way I feel every day after doing drugs until that restlessness comes up again and then I feel like, oh, I can just do it today and then do the right thing tomorrow.”

John is just one person within an epidemic of people who have become addicted to heroin since the pill mills closed. In 2015, the U.S. Centers for Disease Control & Prevention (CDC) reported that heroin use had increased 63 percent between 2002 and 2013, and that heroin-related overdose deaths had quadrupled during that same period.

All across the country, addicts like John are dying in greater numbers due to the addition of the potent synthetic opiate fentanyl into the heroin supply. In recent years, drug suppliers nationwide have been creating a stronger, cheaper drug by mixing heroin with Fentanyl, a drug that’s 50 times more potent. Some simply substitute Fentanyl for heroin; according to the Drug Enforcement Agency (DEA), this new drug is being sold to unsuspecting addicts as heroin. In 2015, the DEA issued this warning: “Fentanyl is commonly laced in heroin, causing significant problems across the country, particularly as heroin abuse has increased.”

The introduction of Fentanyl into the city’s drug supply has had deadly consequences.

It has fallen upon the Jacksonville Fire & Rescue Department (JFRD) to respond to the quickly increasing numbers of overdoses in the city.

JFRD Fire Chief of Rescue David Castleman said, “From a response standpoint, JFRD is on the front lines. Our units routinely respond to overdose victims; many who are drawing their last breath and some that aren’t so lucky. A number of overdose death victims have been found with the needle still in their arm.”

Castleman confirmed that the new Fentanyl-laced heroin has had a deadly impact on drug users in the area. “Fentanyl-related deaths and heroin overdoses are on the rise here in Jacksonville. In addition to the powder form of Fentanyl-laced heroin, there are also counterfeit oxycodone pills being sold on the street. These pills are also cut with Fentanyl and are producing a high percentage of deaths related to their use,” he said. “Oftentimes, drug users believe they are using heroin, when in fact they are using pure Fentanyl.”

“What the [Medical Examiner’s] office told me at that time was that the majority of its cases perceived to be caused by heroin [overdoses] were in fact, actually Fentanyl overdose deaths,” he continued.

The department uses the drug Narcan to counteract opiate overdoses. “Narcan, or naloxone as it is also known, is classified as a narcotic antagonist. It immediately blocks the suppressive effects of Fentanyl on the receptor sites of the brain that control respiration,” Castleman said. He said that over the past five years, JFRD has seen a 100 percent increase in Narcan administration.

The JFRD is working with the Jacksonville Sheriff’s Office (JSO) to address the new threat of Fentanyl in the city.

“With the growing number of overdose responses by JFRD, there is a direct correlation to the instances of Narcan administration. The JFRD is in the process of partnering with JSO to utilize cash seized from drug raids to purchase Narcan, which has nearly doubled in cost over the last six to eight years,” he said.

Castleman stressed that due to Fentanyl-laced drugs, the overdose problem has dramatically increased in recent months. “In the first quarter of 2016, the JFRD has seen a 278 percent increase in Narcan administration for overdoses. That spike in this year’s first quarter provides insight into the magnitude of this epidemic,” he said.

Though he was very clear that the department does not condone the use of illegal or illicit drugs because these drugs suppress brain activity, Castleman advised that addicts should never use alone. After an overdose, death is much more likely without immediate intervention. Narcan saves lives if it is administered in time.

John said that he remembered one dealer in particular who had so much Fentanyl in the heroin that it was basically pure Fentanyl.

But he isn’t concerned about overdosing.

“Surprisingly, no, I’m not worried,” he said with a shrug. “Tons of people have told me it is going to kill me one day. None of that fazes me … We all die some day.”

John had some insight about the opiate epidemic highlighted recently by the death of music legend Prince, who died of a Fentanyl overdose in May.

John believes there is a deep depression in today’s society, which is causing people to need drugs to cope.

“I think it’s what’s going on today that makes people want to do this stuff … as far as the epidemic goes, it is not a matter of controlling the drugs, they’re always going to be there … It is [a matter of] what we can do to help people not want to take the drugs,” he said.

After our interview, John’s family decided to cut all ties with him until he got clean. He shared a group message from his family, which read in part: “We are doing this out of complete desperation, and it’s killing all of us … we love you … we can not watch you self-destruct.”

Another local is living proof that there is hope for addicts like John.

After years of opiate abuse, Ashley Thornberg has won her battle with addiction.

Thornberg took a drag off a cigarette as she sat in the May sun outside a local Starbucks. “I think my addiction started when I was 15 and my stepdad died of a drug overdose and I didn’t know how to handle his death,” she said, exhaling a ribbon of smoke.

Like John, Thornberg started taking pain pills in high school and her drug use quickly escalated when the pain pill craze hit Florida. Now 28, Thornberg said that she started using heroin two years ago when pain pills became more expensive and difficult to find.

“I told myself I would never turn to heroin, but by that time, I really just didn’t care anymore,” she said.

After she switched to heroin, things quickly went downhill for Thornberg. It became a struggle to maintain a job. “I would either be dope sick and unable to come in or high at work and have a bad attitude and leave early,” she said.

Thornberg turned to stealing and pawning to get drugs and explained sometimes she would wake up in withdrawals so severe that she needed her dealer to front her just enough heroin to function so she could go out and get money for more drugs. Thornberg spoke of agonizing withdrawals during which she experienced pain that “seeped into her bones.” Many nights her sheets were completely drenched in sweat.

“It was just progressive and got worse and worse until I ended up in jail,” she said.

After her arrest in June 2015, Thornberg detoxed off heroin in jail. She said withdrawing cold-turkey was excruciatingly painful.

Upon her release last August, Thornberg became involved with the Duval County Adult Drug Court program aimed at helping offenders with addiction problems. “I know most definitely if the drug court program wasn’t offered to me, I would have most likely gone straight back to using when I got out of jail. That’s just because of the mental state that I was in … When I was in jail, I literally lost my mind. I was hearing voices … I drove myself insane in there,” she said. “So who knows what would have happened if I had used drugs right when I got out, on top of what I was already experiencing mentally?”

Thornberg has been personally affected by the Fentanyl that is flooding Jacksonville’s drug scene.

While Thornberg was in jail, she met another young mother named Christina. The two became close. “We would always talk about our kids when we were in jail and I didn’t really know that she had a drug problem.” After Thornberg’s release, she added Christina as a friend on Facebook. As their friendship deepened, Christina fixed Thornberg up with her brother. “I remember I saw a picture of her brother on her Facebook page and said, ‘Who is that? Introduce me!’” said Thornberg.

Shortly after she started dating Christina’s brother, Thornberg noticed her friend sliding back into drugs. “The three of us would hang out and I could tell she had been using. I knew that she was really trying [to stay clean] … She had so many positive things going on and had accomplished so much. She had her own place, a job, she was going to school and taking care of her son on her own,” she said.

Thornberg’s friend was not able to get — and stay — clean. Three months ago, Christina died after an overdose.

“She was just a great person. She would have given anyone the shirt off her back. That was just the kind of person she was,” Thornberg said.

Thornberg said the toxicology report found heroin, Fentanyl, cocaine and benzodiazepines were in Christina’s system when she died.

“She was one of the sweetest, most kind, nonjudgmental people and pretty much just loved everyone. It’s still really hard. I see her pictures on Facebook and I just think about her son and how he’s going to have to grow up without a mom and he is just three years old. In a few years, he’s probably not going to have any memory of her,” Thornberg said.

Thornberg has lost other friends to drugs; one had died of an overdose the day before we spoke. The gravity of losing friends to drugs is shaping Thornberg’s new outlook on life as she celebrates a year of sobriety.

“I think the greatest thing about getting sober, for me — well, pretty much everything is great about it — but it is having some trust back from my family. I can actually stay in my mom’s house and she can actually leave her purse out on the counter now without worrying about me rummaging through it, looking for drug money … And also being an accountable, dependable employee. Oh! And of course actually being a parent! I feel like I deserve to be called that word now,” she said.

Thornberg credits her 2-year-old daughter Gabby as the main reason she stays clean and sober. She said the type of mother she is now compared to when she was using drugs is night and day.

Thornberg said she tries not to think about the dangers she exposed her daughter to by raising her in the drug lifestyle. “We were living in a very unsafe environment … It was kind of like a flop house. Almost everyone there had just gotten out of jail … The girl I was staying with had three kids as well and it was just a really bad environment for all of them.” She shuddered. “It was a really dark period in my life.”

“When I was using, I couldn’t really care less about my child. I didn’t care if she ate. I didn’t care if she had a bath … When I was high, I wanted nothing to do with my daughter. I didn’t want her near me. I just wanted to enjoy my high … I didn’t care about anything else in this world.” Looking at the floor, brow furrowed in thought, she took one last puff of her cigarette and smashed the butt with her foot into the cement.

When she looked back up, the corners of her mouth pulled into a warm smile.

“Now my daughter is my number one motivator … Yeah, she’s two and she drives me crazy,” she said, “but, you know, I wouldn’t trade it for anything in the world.”

Thornberg said her daughter helps her withstand the temptation to relapse.

“Some days, when I do have thoughts of using and I’m not doing well emotionally, I just look at her … I don’t want her to be without a mom.”

Now that she has taken her life back, Thornberg feels that overcoming addiction has helped her truly value living.

“I feel like I live life now instead of just existing. I was suicidal and I felt like I had absolutely no purpose before, but now, even if my purpose is just to stay sober and take care of my daughter … I’m OK with that,” she said. “I’m just a mom.”

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Update: After our interview, John moved away from Jacksonville, hoping to get clean and rid himself of the temptation to do drugs.