The heroin and pain pill crisis is a full-blown epidemic in our community. But treatment for this addiction crisis is inadequate and the death toll continues to grow. This is the first of a series of columns examining a broken system. You can also watch our WCPO 9 On Your Side special, "Heroin: Fixing a Broken System" at 7 p.m. Thursday.
David Holthaus researched these stories for eight months, with help from WCPO's Heroin Advisory Board, a group of experts, parents and recovering addicts. Holthaus has been a Cincinnati journalist for more than 25 years and is currently managing editor, opinion and engagement for WCPO.com.
At the age of 26, Courtney Hasse has already endured a lifetime’s worth of pain.
Alcohol abuse led to cocaine, which led to pain pills, then to heroin addiction. At least a half a dozen attempts at rehab. Drug court. County jail. State prison. A felony record. A daughter born addicted.
Now, just weeks out of prison, she’s starting over. But Courtney, and so many other addicts in recovery, face long odds of restoring some semblance of a normal life after repeated bouts with addiction and jail.
Courtney has been off of drugs for one year, 11 months and one day, as of this publication. But she faces months of drug tests, court dates, classes and meetings with her probation officer. If she slips, she could be sent back to a prison cell.
“How is she not set up for immediate failure?” her mom, Katrina Sauerwein, wondered before Courtney’s release from Dayton Correctional Institution. “She has nowhere to go, no job, no car … we don’t know what’s going to happen with her.”
It's a common predicament for addicts who seek recovery. So many have been to jail and through the courts, and are so busy cleaning up the mistakes of the past, that building a future is hard to do. Probation, fines, court costs, arrest warrants, lack of employment and the unforgiving demands of the legal system can drag them back into the chaos of their old lives, and perhaps back to the escape of drugs again.
Staying straight in the face of those demands requires uncommon willpower. After years of a life in disarray, Courtney appears to have acquired it.
As difficult as finding treatment and successfully getting clean can be, there is hope. Sometimes addicts can turn their lives around.
And while 12-step programs like Alcoholics Anonymous don't work for some, they do work for some.
But the legal system makes that process difficult, too.
Courtney was sent to prison for a minor parole violation. Now, her list of demands from “the system” even includes mandating where she can live.
Because she’s under the supervision of the Butler County drug court, she’s required to live in that county. She would have preferred to live with her chief means of support, her mom, who has custody of her daughter. But they reside in Hamilton County, so Courtney is staying with her grandparents.
Here’s what she has to do, post-prison:
- Find and keep a full-time job
- Attend Alcoholics Anonymous or Narcotics Anonymous meetings at least three times a week
- Attend rehab classes twice a week
- Every morning, call in by 7 a.m. to see if she must take a drug test that day
- Download information twice a week from the alcohol monitor she’s required to wear around her ankle
- Meet with her probation officer once a month.
- Meet with a drug court clinician twice a month.
“When I’m done with this, I’m not going to know what to do,” she said.
It’s quite a change from the last eight or so years.
Descent Into Addiction
After graduating from Northwest High School in 2008, Courtney was working, and partying hard on the weekends, mostly with alcohol. That led to hanging with a crowd that was doing cocaine and other “party drugs,” crashing on friends’ couches, only occasionally checking in at home.
Her descent into heroin addiction began at the house of a friend whose brother dealt in black market pain pills. Presented with a tray of pills, “One night I said, ‘OK, I’ll do it.’”
That progressed “quickly and out of control.” Eventually, most of her paycheck was going to buy pain pills, which were getting more and more expensive as their abuse became widespread and demand grew.
In November 2011, she checked herself in to St. Elizabeth Healthcare’s seven-day detox program in Falmouth, Kentucky.
And that is where she learned about heroin.
“I was the only one who was in there for pills,” she said. “Everybody else was in for heroin. I was like, ’They’re crazy. I could never do that.’”
Relapse
After seven days at the Falmouth center, she returned home, but she was depressed, lacked the motivation to get out of bed, and was likely still suffering symptoms of opiate withdrawal.
She had no follow-up care, no nurse or doctor to supervise her post-detox, no treatment plan to maintain sobriety. Just seven days of medically supervised detox to get the drugs out of her system and then she was sent on her way.
It was the beginning of a firsthand education about the shortcomings of the addiction treatment system.
“I thought that’s all we had to do was send her somewhere for seven days and she’d come home and everything would be great. She’d be healed,” her mom said. But, “they just detoxed her for seven days then sent her home. Nothing was mentioned about inpatient or outpatient treatment ... ”
She stayed clean for 30 days. That, in her mind, warranted a celebration.
“I haven’t gotten high in 30 days,” she remembers thinking. “I haven’t done any pills in 30 days. Let’s get drunk. That’s how I celebrated my 30 days clean.”
First Taste of Heroin
That binge, which she thought would be one time only, sent her on a fast track back to drug abuse and to the overwhelming addiction of heroin.
Her first taste came when she and a friend were trying to score pain pills. By then, the 40-milligram Opanas she was taking cost $80 apiece, quite a bit of money to come up with for a daily habit.
Her friend had another option. “She said, ‘I got this, do you want to do it?’ I said, ’What is it?’”
It was heroin. And it was only $20.
“I was like, ‘I don’t know… OK.’ Just as quick as that.”
And just that quickly, she was addicted.
In and Out of Treatment
After her daughter was born, Courtney went into treatment again, but it didn’t last.
She’d go in, begin to go into withdrawal and then leave. She was in and out of treatment several times, sometimes staying only a few days. She left First Step Home in the middle of the night. At Chaney-Allen, she was caught shooting heroin with her boyfriend during a visit.
She made it through a 30-day program in Elizabethtown, Ky. But in June 2013, she was arrested for writing bogus prescriptions for narcotics, a felony. That began the journey into the legal system that she’s still winding through today.
After 10 months in prison, she possesses the resolve to rebuild her life from the rubble she left it in.
Courtney, her daughter, and her mother, Katrina.
“There’s a hundred different things I want to do,” she said. “But I know there’s one thing that I don’t want to do, and that’s get high. I really just want to do what I have to do to not only make it through, but to succeed and be happy.”
Her Will to Succeed
After so many setbacks, she radiates determination.
Getting high?
“It’s just not an option,” she said. “If I would make a conscious decision to do that, I might as well just walk myself to prison right now, because that’s where it’s going to end up. If I’m lucky … if I don’t die.”
She has a plan that revolves around the 12-step program of Alcoholics Anonymous. That involves going to meetings often, maybe arriving early and staying late to meet people who also want to stay sober.
“One of the first things you hear is you’ve got to change your people, places and things,” she said.
That means cutting off the old crowd, most of whom had one thing in common – drugs.
“Stick with the winners,” she said, echoing a reminder from the AA handbook.
For Courtney, the AA philosophy of going often to meetings and building a network of friends who are also sober is essential, and her she refers often to AA slogans in conversation.
“Meeting makers make it,” she said. “Nothing is better than going to a meeting on a Friday night and there’s a hundred people in a room who are just trying to better their life who aren’t at the bar, who aren’t chasing down their drug dealers to get one more.
“They say a grateful addict will not use. As long as I stay grateful," she said. "I get to go to work today, and that’s a blessing in itself because there was a point in time when I didn’t care about work.”
She now has a job as a server in a nice restaurant, and has completed another phase of her outpatient rehab. Those are milestones, but along the path of recovery, one also looks for small signs of success. Her mom got a sign of Courtney’s resolve in the fall, when her daughter volunteered for a chore she had until then avoided.
“The day she cut my in-laws’ grass, I knew, for once, she is winning this battle.”
MORE FROM THIS SERIES:
• The shadow system of treatment
• Heroin addicts: 'We can't just throw them out'
• Heroin drug saves lives, but it's hard to get
• 'Body brokers' profit from heroin addiction
