The roots of rising heroin abuse and what it means for Boulder County

Mark Goodman

Ashley is 32. She looks 52. A 20-year addiction to heroin has changed her. She sits in Boulder County detox, nine months sober, and talks about the most traumatic experience she’s had in her life. It lingers more than giving up two children, than walking away from a nursing job, and from injecting $300 of heroin into her body almost every day for two decades.

“He would show up every now and then,” Ashley says. “He’d come find me if he needed something. He lived in Longmont. He would come to Boulder just to get drugs. He had a house. He ran a business. So, I mean, he had a lot going for him, and it was just really sad.”

Ashley is one of at least 750 Boulder County residents who injected illegal drugs last year. She talks about being a part of one of last year’s 13 heroin-related deaths in the county, the acquaintance from Longmont, as the lowest point in her addiction.

“I was actually at a friend’s house. We’d been staying there because it was cold outside because of the snow. It was really late in the year for snow, which was really weird. I get a knock on the door and it’s this kid and I tell him, ‘No, we don’t have nothing.’ Me and my husband go out a little bit later, and we went and got ours for the day.

“I came back and right as I was coming back, I hadn’t even opened the door yet, and this kid came back and was like, ‘Got anything yet?’ And I’m like, ‘Ah, fuck.’ So I’m like ‘Yeah, I guess so.’

“So I sold him like a 20 bag of my personal stuff. He was sick. I could obviously see he was sick. His nose was running, his eyes were watering, he was shaking. We knew he was sick. We go inside, and I didn’t know he had been doing benzo’s, and the guy we were staying with was doing meth, so while I was breaking up the dope to give to him, he went and got meth from the guy so he mixed the two, which I didn’t know because I was also getting high at the same time. He was in the living room, I was in the bathroom, my husband was in the bedroom, and I heard him say something to me like ‘Ashley, something’s not right’ and I walk in, and I’m like, ‘Shit. Fuck.’”

Ashley says she doesn’t recall too many memories over the last 20 years, but she speaks clearly, lucidly. She leans forward spontaneously, scratching at her arms reflexively. She is wearing an oversized red hoodie and a graphic T-shirt. She has short blond hair and sun damage. She has white teeth. Her pace quickens.

“So I go and grab my Narcan, hit him once. And he still doesn’t come out of it,” she says. Narcan is an emergency drug that reverses the effects of heroin. Boulder County offers free Narcan training and supplies monthly, and Ashley says she’s seen at least 10 overdosed bodies in Boulder because she was the only user in her circle to take Narcan training. People called her when someone overdosed.

“I start doing CPR, he doesn’t come out of it. Hit him again with Narcan, still doesn’t bring him out of it. So I start banging on the door, screaming at my husband, ‘You need to get out and help me now. I have felony warrants out on me.’

“So I’m like, ‘Fuck, we need to call the paramedics. There’s nothing we can do.’ I’m pulling up another shot of Narcan as we were speaking, and I’m like, ‘You know, I’m kind of afraid to give it to him because basically it’s not working,’ and I couldn’t understand why it wasn’t working.

“And then I looked in his backpack ’cause it was open ’cause he was getting high so all his crap was laying on the floor, and I hadn’t paid attention to it before but the spoon was still there. The rig was still half full, like he didn’t even do the whole shot that he mixed up so I can’t even imagine what shape he would’ve been in if he would’ve done the whole shot. And I look, and I see a whole bunch of Xanax and I’m like, ‘Ah, shit.’

“So my husband is doing CPR, I’m getting dressed, putting on my shoes, grabbing all the dope, grabbing all the money, and I take off, but by the time I took off, he was already dead. He was no longer breathing. There was no more death gurgle. There was nothing.

“I should’ve been able to stop it and I couldn’t, you know? It’s just… there was nothing I could fucking do. No, there was nothing I could do. It was really traumatic. I’ve seen people die, and this one was really the worst one.

“And I really didn’t even like the kid.”

Yet witnessing that death wasn’t a turning point for Ashley. Not even the birth of her second child last June was enough to get her to quit heroin. In jail from a prior offense, she was transferred to a hospital to give birth. When her daughter was born, the state took the baby, and Ashley returned to the streets. She smoked meth for four days before she was arrested again.

Now, sitting in detox, Ashley is part of a work release program, hopes to find housing when she leaves the facility in March (or else return to jail), and reunite with her daughter in August. She thinks about how she might one day tell her infant and her 7-year-old daughter who lives with Ashley’s ex-husband in Louisville about her addiction.

She might start at the beginning. Ashley grew up in Philadelphia and loved training horses. At 12, she says she fell off a horse and was prescribed painkillers. Ashley, who says she “doesn’t blame anyone for [her] choices,” had moved onto heroin by 14, encouraged by older friends who had been selling her pills once doctors stopped writing prescriptions, and who said heroin was cheaper and stronger than the pills she had become addicted to. She hadn’t hit puberty yet and was addicted to opiates.

That addiction trajectory for opiates is common, especially in Boulder County, says Widd Medford, program manager at Boulder County Addiction Recovery Center, the county’s detox facility.

“Heroin addicts … started out probably taking painkillers, hurt their shoulder playing football in high school, starting taking Vicodin or Percocet. After a period of time, they start feeling like, ‘Hey, I kind of like the pill, and all of a sudden they can’t get the pills because they burned all the docs, and then they go to heroin.”

Medford says the brain changes with prolonged opiate use. At first, painkillers reduce pain and elicit euphoria. But slowly the chemicals that produce pleasure and joy naturally in the brain shut off due to the increase in synthetic chemicals that produce those same feelings. Eventually, the euphoria goes away, Medford says, and what’s left is dependence. Addicts need to get high just to feel normal.

“The heroin groups that are shooting up half a gram or a gram a day are the saddest group of people you will ever see,” Medford says. “It’s because the normal things in life — you have sex with your partner, you get a raise at work — there’s this great release of chemicals in your brain. The brain doesn’t do that when someone’s on heroin; so they lose that normal joy of life that all of us experience because we’re not using it.”

11344Wikimedia Commons

Cody Gardner, director of operations for Northstar Transitions, a Boulder drug abuse rehabilitation facility, says he hears the story of heroin addiction starting with prescription pain management pills “probably once a week.”

“We’re seeing people saying it started with prescription pills, where they had legitimate medical needs for medication, and that medication turned into addiction pretty quickly,” Gardner says. “I think the typical story is, ‘I was in a skiing accident, I was in an automobile accident, and they gave me Percocet, and after a period of time, the Percocet stopped treating the pain.’”

The jump from prescription painkillers, even if bought illegally on the street, to heroin abuse still seems like a drastic jump, to the layman at least. But Medford says most heroin users think that at the beginning, too.

“Most everybody can relate to a time when they either went to a dentist or a doctor … and they were given muscle relaxers or painkillers. And they work. That’s what’s great about them. They work,” Medford says. “So when you begin taking them, everyone I’ve ever talked to that has begun taking them, there was a part in [their] recovery where [they] began looking forward to the next pill.

“It catches people because they think, ‘Well a pill’s OK because a doctor gave it to me.’ Then they get hooked. Then once they get hooked and addicted and are dependent on that medication, all reason goes out the window. Most people say, ‘Oh, heroin? No way,’ ‘Needles? No way,’ but if you’re craving it and you can’t get it, and you’re going to go into this terrible withdrawal if you don’t get it, the pattern for us has been pills, can’t get them anymore, then they’ll buy them off the street, they’re too expensive, [then] they’ll buy heroin and smoke it, and then pretty soon tolerance develops, and they’re told, ‘Hey, you can use a lot less with a needle and get the same high,’ and that’s when they go to the needle.”

Ashley says that she had built up such a tolerance to heroin that she had to use three times a day just to function and feel relatively normal. She also says that she couldn’t go back to painkillers after using heroin so extensively, saying that when she was at the height of her addiction, she could “eat a whole prescription of morphine and still not feel well.”

Medford laments a medical system that isn’t doing all it can to prevent opiate abuse. For instance, he says, the average medical student spends no more than six hours on addiction, and doctors often won’t screen for abuse potential.

“If you’re sitting there in a practice and you walk in there clean cut, say, ‘My knee’s killing me,’ he says ‘You know what, I’m going to give you a referral to physical therapy, and I’ll give you some pills just to get you through. Give me a call if you run out.’ And he’s on to the next patient. Is he going to say, ‘Have you had an addiction issue? Do you ever bang heroin?’ They just don’t ask those questions.”

Medford says instead of prescribing 60 Percocet or Vicodin, doctors should prescribe about a dozen at a time, so there aren’t 40 pills lying around after the initial necessity for them has subsided.

“And then you’ve got kids,” Medford continues, “that now think with the onset of medical marijuana who think if it’s medical it’s OK, and if it’s in a prescription bottle then it’s OK, and so they take it. ‘It’s not heroin, no way, but it’s a painkiller my dad had for his back, it seems OK, I’ll just have one of those,’ and so they go down that path.”

And the “kids” who are starting to abuse opiates in Boulder County are getting younger.

The county’s Works Program, which provides intravenous drug users free and clean injection supplies, tracks the numbers and demographics of users in the county. Though data of intravenous drug users is not limited to heroin, “by and large most of it is heroin,” Medford says.

The number of people 24 and under in Boulder County who came in for injection supplies increased from less than 20 people in 2010 to more than 160 last year. That rate of increase is similar for users age 25-34.

It’s also estimated that supplies from one person’s visit to the exchange program are shared with three users who don’t come in, so those numbers could be far greater.

Ashley, Medford and Gardner all say they’ve personally seen heroin use in Boulder County skew younger.

“I’ve noticed it’s more high school kids nowadays,” Ashley says. “[They’re] 15, 16, 17 years old. I wouldn’t even give them a cigarette if they asked they look so young. They’re walking to the park from Boulder High on their lunch break.

“They keep getting younger and younger and younger, and they’re all from Boulder. Like, what are you doing? You need to go home.”

Medford adds, “A lot of college kids will take a painkiller to just relax socially in a situation they’re new to, like a Xanax or a benzodiazepine. That social pressure leads a lot of kids down that road, where like, ‘When I took that pill I was able to relax. I was able to talk to people. My defenses were down. I felt great.’”

Medford adds that many kids are able to stay in school and keep jobs with an opiate addiction. Ashley, for instance, was able to earn a nursing degree and hold a job at a medical facility in Louisville before walking away from the job because, “Fuck it all, I’m going back to the street.” She added that it was, “the worst mistake I ever made.”

Statistics show that overall heroin abuse in Boulder County is also on the rise. Overdose death rates in Boulder County rose 600 percent from 1990 to 2012. Heroin deaths, often caused by mixing drugs or after relapsing, in Boulder County went from six in 2011 and 2012, to 15 in 2013, and 13 (a preliminary number from the coroner’s office) in 2014.

In 2010, heroin represented less than 2 percent of all Boulder County detox admissions. It now represents more than 6.5 percent.

So where is the heroin coming from, who is using and selling it, and why are more young people using it?

What’s on the street in Boulder County is called Mexican tar, Ashley says. It’s brought up from Mexico and Honduras. It runs about $70 a gram, which would get an average user high about four times, Ashley says. It’s a different form of heroin from China White, Ashley says, which is available on the East Coast, and is much purer — a $10 bag of China White will get you high four times, by comparison.

Ashley says because Mexican tar is black and shiny, thrifty dealers will melt tootsie rolls or cook Coca-Cola into the heroin so as to cut the total quantity sold. When you do get high on it, withdrawals are stronger than those with China White.

“Out here, your stomach’s horrible, you’re throwing up, you can’t sleep. The last time I withdrew … it took me a good two and half months before I was done. It progressively gets worse. Every withdrawal gets harder every time,” Ashley says, adding that she once feared withdrawal so much that instead of going to jail for four days on a minor crime, she evaded police and earned herself a felony charge that’s still being sorted out.

Boulder County dealers are often “white kids” in their late 20s who grew up here, Ashley says. Local dealers will go to Denver and buy large quantities from a typically Mexican supplier. She says the Mexican dealers are “too scared” to deal in Boulder County because of the concentration of police. Ashley says she financed her addiction by transporting heroin from Denver to Boulder starting in 2004.

Once the substances get up to Boulder County, though, it’s not necessarily easy for people to find a dealer.

“Up here you actually have to know somebody. You can’t just go look for it. You have to know somebody or know some person who knows a person,” Ashley says, adding that’s it’s equally hard for police to catch a user in the act.

“You can only pretty much smoke [heroin] or shoot it here. It’s just so dirty,” Ashley says. “So most people hide out. There’s cops everywhere. When I first got here [we used drugs on] Pearl Street, then we moved to the library, then we moved to Central Park, then we moved to the horseshoe, then we moved to Canyon Park, then we moved back to the horseshoe. They just keep chasing us around, and so we hide and come out when we’re done.”

Ashley says that she knows of about five heroin dealers in Boulder, about 10 cocaine dealers, but that those numbers don’t include dealers who sell to college students, which she says is a different scene entirely. Still, new users are evidently finding ways into the market, even if locations are not concrete. (A recent bust of a Longmont heroin ring by the police and FBI revealed deals were occurring in front of a preschool.)

Looking broadly at the increase in heroin use, Commander Scot Williams of the Boulder County Drug Task Force says the legalization of marijuana has had an effect.

“I think what they’re seeing down in Mexico is the cartels are replacing their marijuana crops with poppies in order to seize demand of the opiates in America,” Williams says. “The supply of heroin is increasing due to the loss in revenue from marijuana by those who are providing it out of Mexico.”

To that end, nearly everyone with knowledge on the subject thinks the heroin problem is going to get worse in Boulder County.

The county is working to curb the issue though, via the syringe exchange program and innovative rehab therapies and facilities. That includes providing rehab drugs like suboxone, which would cost about $1,000 at a doctor, Medford says, to users for free in Boulder County. Medford says there’s at least one support group for drug abusers to attend in the county every day. The syringe exchange program also provides the opportunity to let the drug user hear about treatment. Early data shows positive signs for the efficacy of local treatment.

And so that’s where we leave Ashley: in treatment. She says she wants to stay clean — and nine months is the longest she’s been sober since age 11 — and reunite with her daughters. She says she likes working (even if she doesn’t exactly love the work) and living at the detox facility. She says she wants to start training horses again. She says she’s “leery about it,” because even though she loves it, it “kind of put me in this position to begin with.”

But like other addicts, there are a lot of things out of Ashley’s control. She can’t control what the state will decide on her child, she can’t control what her children will say about her addiction if she is alive to have that conversation, and she’s scared that she won’t be able to control her addiction once she’s back on the street.

“Even if I’m sober for a long time, and I have that conversation with my daughter … that’s going to bring up feelings from her that I really do not want to hear because then I have to face what I’ve done. Like if she has a bad reaction, am I going to go use because that’s what I’ve always done in the past?

“If I lose my infant to the state, am I going to go use and say, ‘Fuck it all,’ and not give a shit anymore? It’s a high possibility because, I don’t know, heroin’s been my life for 20 years. That’s more than half my lifetime. It’s ridiculous.

“I don’t know if I lose my kids and go back to using or something happens, I don’t know if I can do another 20 years. I really don’t think I’ve got it in me. It’s just ridiculous.”

If you or someone you know in Boulder County is struggling with addiction, call Mental Health Partners at 303-443- 8500.

  • Tarzan58

    Better off dead than shooting heroin in your veins.