By Michael Booth
The Denver Post
MADISON, WIS.: Thirty-six hours on a bus numbs the body, but it can focus the mind on increasingly unpleasant facts. What else to do, through hundreds of look-alike miles of Nebraska and Iowa, but count the minutes since your last shot of heroin? Angel had thinned out and stretched out her doses to make them last the long bus trip.
By a late August afternoon near Eau Claire, Angel's stomach hurt, she was too irritable to talk, and her nose was running. Her teeth now ached, too — the constant opiates had masked the pain of decay.Hours later, she was home.Waiting at a curbside drop-off in Madison were her mom, her older sister, her uncle and her grandfather. Angel pulled back her hoodie and descended from the bus with two goals in mind: "Finding a stable dose of methadone that works for me," and, "making amends with my family."Yet when she embraced her mother, it looked like she was hugging a cactus. Her family rallied around her in August when she finally accepted her dad's offer of a bus ticket home. But in the past, her family has been as much problem as solution. Among them, Angel's immediate family has more than 50 entries in the Wisconsin judicial database. "My family keeps telling me they'll help me with whatever they can so I can get through it," Angel said.But in the next breath, she adds: "My dad takes pills, but he only takes them for pain when he has to. My mom is on methadone, and she drinks a lot now. My sister, from what she says, is on the straight and narrow and doesn't do any drugs."The day after arriving on the bus, Angel stayed at her grandparents', the most stable home in the family. She took her last Denver dose of heroin that morning, and by evening, it was wearing off. Angel alternated between lying on the couch and watching television, holding her stomach, and coming outside to the shaded patio of the trailer home to smoke and listen to family stories.Lynne, Angel's mother, found a framed photo of the family posed in sweaters and smiles for a formal Christmas portrait, when Angel was about 9 years old. Angel looked at it, then looked away with a sad smirk. "We were happy then," she said. Lynne shushes her, saying they can be happy now, too.
She sees Angel carry out a yogurt drink from the kitchen and fusses over her, saying she knows how hard it is to wean off drugs. "Those are good for you. Suck it up, buttercup," she said.Then Lynne talked about the growing homeless and drug-addiction problem in Madison and surrounding rural counties. "I'm a softie; I get taken by the same (liars) every time, holding their signs," she said. Angel listened to this, bent over with a cigarette and then went indoors. Lynne suddenly realizes her daughter held such a sign just three days ago to raise drug money for the trip home. "I try to be sensitive to what she's been through," Lynne said, then turned her anger on Joe, in prison. "I had her boyfriend on this porch last July say, 'Your daughter can make $80 to $100 a day!' That's not the dream I had for my daughter."
Joe, 90 miles away behind barbed wire and concrete, said that's not his dream for Angel anymore either. His dream is for her to kick heroin without using methadone as a crutch, the same way he did after getting arrested in Denver at the beginning of the year. She's more than tough enough to pull it off, he said."I think if she just suffered ... she's already suffered a lot in life, and I would never want to see her suffer, but three weeks. That one day when she woke up and didn't feel that sickness anymore. Then she'd know," he said. "She's stronger than me, a million times."As beholden as she's been to his opinions in the past, Angel felt her body wasn't strong enough to try it his way. Her mom was overcoming her opioid-painkiller habit through Suboxone and methadone, and Angel wanted to get into the same clinic. They had tried the day after she arrived home. First the clinic wanted a Wisconsin ID, which would take Angel another day to get. Then they said the next appointment she could get with a prescribing doctor would be the following Wednesday, six days away. Lynne and Angel got on the phone. Striking up again with friends who deal is one of the most dangerous things a struggling junkie can do, treatment experts say. Yet those same risky acquaintances can fill the craving gaps. This is the very reason clinics handle addicted clients with frustrating restrictions: There is a black market for any prescription drug.
The rules and the laws are just obstacles to getting what you need to stay functional, Lynne believes. She doesn't see it as a moral minefield. Drinking has hurt just as many people in her family as opiates have. "Every substance is a drug," she said. "It's just different degrees of it."While Angel struggles to get off opiates, the temptations around her in south-central Wisconsin are only growing worse. Heroin-overdose deaths in young people ages 15-24 jumped from 198 nationwide in 1999 to 510 a decade later, according to federal statistics.
In Dane County, around Madison, and in Columbia County, where Angel went to high school, sheriffs report sharp increases in burglaries, thefts and pawn-shop traffic as the newly addicted work the margins to pay for their habits.
Joe Kaiser, with prison time to reflect on it, sees his friends taking to pain pills the way young people used to sneak 3.2 beer. "From my generation down, it's an epidemic that's just unreal," he said. "Thousands and thousands of kids addicted to the stuff around here. Since I've been incarcerated, I've lost six people I grew up with who died" from opiate problems, he said. Lt. Brian Ackeret of the Dane County drug task force hopes doctors get the message. He knows they try to save struggling patients money on co-pays by writing larger prescriptions at one time, but many of those pills end up in other hands.On a purely emergency level, Ackeret said, he'd like to see the overdose-reversing drug Narcan widely available. Saving lives is the first priority. "On the other hand, we now have people who have had multiple Narcan rescues," he said. "So clearly, death is not always a deterrent."Counselors and drug-treatment experts said the one word Angel should be thinking about now is "replacement."Replace the heroin with something more stable, recommended by a doctor. Trade the sleeping bag on the street for a bedroom in a safe place. Keep busy instead of flying a sign all day. Substitute a job for the boredom. Exchange the dopamine of opiates for an accumulation of small, natural highs.
"Come up with a plan," said Denver addiction counselor Chris Christner. "I'm more interested in where you want to be, rather than where you have been."Angel has replaced heroin, for now, with Suboxone. She's living with her father, her sister and her sister's kids in a residence near the office of the pet-food-rendering plant. Her dad paid the $240 for the doctor's visit after she got off the bus and is financing the $120 a week she needs for the Suboxone prescription. She's taking two Suboxone doses a day but thinks it should be three or four to fully fight off the withdrawal. Her father can't afford three or four, so she's putting up with hot and cold flashes, cravings and a constant runny nose. She thinks that in a few months she can join a drug manufacturer's program to subsidize the cost. "I will have to deal with it for a while," she said.Studies have shown forms of Suboxone can keep more than 65 percent of users off illicit opiates. But long-term studies of heroin users show high early death rates and "heavy odds against permanent abstinence."
Angel is replacing the boredom by playing with her niece and nephew, and catching up with her grandparents. In October, she thinks, if she's still clean, she'll be able to get her old janitor job back at the John Deere building.She feels good about herself for making a change, but it's a battle. "All I can do is think about getting high," she said. "It's a struggle, that's for sure."Some of her street acquaintances in Denver appear to be tiring of the life too. Alice and Iris said they will leave for home in Missouri when Iris' mom forwards money from an insurance settlement. They have dealer troubles, and Iris' veins are so far gone that Alice lately has had to hit him in the neck.
"It's getting really old. We're sick of it," he said.The night before leaving Denver, Angel sat on a curb outside a laundromat where her street clothes were spinning dry. Joe's letter urging her to come home and get clean was in her backpack, but she said she had also been spending a lot of time thinking about her parents getting older. "And I don't want to be here while I can be there with them, and enjoy my life, and they can enjoy theirs knowing that I'm safe and happy" she said.Her mom had just told her on the phone that she'd "sell her assets" to help Angel pay for a treatment clinic. Even if she had no assets to sell. It was time to put Denver behind her as a vacation gone terribly wrong."Being a heroin addict, the only good times you have are when you have enough money to get what you want and need," she said. "Other than that, you're pissed off or grumpy because you don't have the means to do that. So I wouldn't say there's good memories. It was fun with Joe, coming here and discovering a new place. But after we got kicked out and had to live on the streets? No."