AKRON, Ohio — There was a time when a shot of heroin was an important part of his morning routine.
In a way, it still is.
Larry Soper is a residential manager at the Interval Brotherhood Home in Coventry Township, Ohio, where many of the area’s heroin addicts go for residential treatment.
It’s a facility funded by taxpayers through the county Alcohol Drug and Mental Health board.
Soper oversees about 30 men, who live at the facility for several weeks. Nearly every client is opiate dependent. His counterpart — women’s house manager Nicole Cunningham — has about the same number of opiate-addicted females.
“Opiate users are younger and younger and younger,” Soper said. “Before, the users were older, late 20s to 50s. Look at the clients we have now, 19, 20 years old.”
Cunningham quickly agrees. Every day she works with young adults whose addictions started in the earlier teens. Streetwise herself after a prison stint, and five years sober, Cunningham seems amazed at the faces she sees.
“They’re full-blown heroin addicts by the time they’re 18 or 19 years old,” she said.
For the past decade or so, law enforcement and government officials have hammered away at the painkiller market. Drugs such as Vicodin, Percocet and Oxycontin were loosely guarded, opening the market to pill mills to distribute the medication and a black market to sell the goods.
America was viewed as the pain medicine capital of the world as millions of pills hit the market. Shady doctors prescribed them to patients who either wanted to abuse them or sell them.
So once the crackdown began, the cost rose while the availability dissipated. Also drastically changing the drug landscape was the government order that certain high-potency painkillers be uncrushable. This change prevents users from injecting the drug for greater effect.
“I think (the painkiller crackdown) has exasperated the heroin use,” Soper said.
As a result of the war on painkillers, heroin has risen dramatically in popularity. Once considered a skid-row drug, users today find the drug much cheaper than pain pills and far more intoxicating.
On the downside, heroin is far more addicting. A user’s tolerance to the drug grows quickly. At first, $20 worth of heroin could bring a new user a high for two days. Within weeks, that same user needs $100 of heroin just to feel normal and make it through the day.
Withdrawals are described as misery, full of body pain, cold sweats, vomiting and diarrhea. The fear of withdrawing is largely the main spark keeping users on the drug.
“What I’ve seen is an increase in suburban kids. I’ve seen an increase in socioeconomics and white middle to upper class becoming more and more of our addicted clientele,” Soper said. “We’re looking at kids today with high academic achievements, from good suburban families. That’s the back story of the opiate abuse.”
Cunningham said the goal in residential treatment goes beyond beating an addiction. In most cases, she said, there is an underlying mental health issue — depression, bipolar disease — at the root of the drug use and the need to self-medicate.
“We need to look at what the motive is for someone to make that jump from social recreational drug use to all of a sudden being involved in incredibly dangerous, high-risk use,” Soper said. “To change an element of their life, there’s a motivation there. It’s not just bad behavior. There’s always a driving force behind it.
“The real issue is what brings people to using in the first place and what issues haven’t they overcome.”
Treatment is not quick and easy. Providers say the aftercare following detox and rehab is vital. It is the physical pain of withdrawals that keep many using.
Dr. Gregory Johnson, medical director at Community Health Center, said patients are often put on a medication regimen to ease the pain. The center provides opioid addiction treatment.
Patients seeking to recover are sometimes prescribed methadone, a synthetic narcotic taken once a day “to stop withdrawal symptoms and reduce opiate cravings.” Some patients are put on suboxone to help their recovery.
CHC is treating more than 400 patients, many of whom make daily trips to the center for medication. The recovery from heroin addiction is long-term, said Rebecca Mason, CHC’s director of outpatient services. Some patients have been on methadone for 20-plus years.
“These patients are very sick,” Johnson said. “They can’t function. … Nobody dies from opiate withdrawals, but they wish they could.”
Oriana House serves addicts at facilities throughout Northeast Ohio. Sally Longstreth Fluck, the clinical director, said that 10 years ago opiate addicts were rare. Now, 65 percent of their clients are opiate dependent.
Oriana provides drug and alcohol recovery treatment. The program is outpatient, but intense: three hours a day, three days a week for six months followed by four months of aftercare.
“I think what makes it different is the intensity,” she said. “It’s a rapid and intense addiction. It’s cheaper. It’s more accessible and it’s more potent. But addiction is really a side effect to something else.”
Many overdose victims never see it coming. Often, their death follows a rehab effort or detoxification visit. Once users get out and seek a high, they often fail to correct their tolerance level.
“They’re an overdose waiting to happen because their tolerance went down,” Cunningham said.
Cunningham, 32, grew up in the Ohio’s Falls area. By the age of 12, she was abusing. In time, she’d have two children and serve four years in prison for selling meth. She was a heroin user for years.
She’s been five years sober and working at IBH for almost a year.
Soper’s story is similar. He said he was the spoiled suburban kid growing up in North Canton, Ohio. He worked as a journalist for years. He also used heroin, he said, every day for 15 years. Now, 43, he’s been clean for the past eight-plus years.
Those seeking help from IBH sometimes have to wait four months for a bed. Their success rate isn’t tracked.
“I don’t know,” Soper said. “I’d like to say in my heart that we’ve had a lot of success, but I know we don’t.”
The truth is, addiction is a life-long struggle. Aftercare is vital. Some succeed. Some don’t. Some die.
“Treatment itself is not a cure-all,” Soper said. “It takes years and years.”
Soper said when he came to IBH, he was the “poster child for that guy who isn’t going to make it.”
In time, he did.
“My job is to tell other addicts how I stay sober,” he said.
The lure of heroin is striking. Some start by snorting it through their nose. Others smoke it. Later, in order to squeeze out those fading effects that first drew the user’s lust, heroin is heated in a spoon, sucked into a syringe and expelled into a vein.
In the Internet years, many young adults grew up seeing their film or music stars rise in fame only to fall to drugs and rehab. Day after day, one celebrity after another announces a trip to rehab.
“I think there’s a very romantic idea that young people have about addiction,” Soper said. “I think they see this in movies and music. I think there’s this idea that heroin is an antiseptic, that it’s pain relief because a lot of our youth are in pain whether that mental health or emotional pain and that makes it a very attractive drug.
“You don’t need to go to the inner city,” Soper said.