Stats show opiate overdoses kill 78 a day, but the toll is really much higher
Elizabeth Blunt could play the guitar, flute and piano. She excelled in soccer and volleyball at Wheaton Academy, a high school in West Chicago. She was known as Beth, and at 22, she was dead.
Her family explained her life and death in an obituary similar to nearly 100 others published in U.S. newspapers during the past six months that blame addiction to heroin or other opiates as the cause of death.
Families wrote time and again that the addiction is a demon, a battle or an epidemic.
But obituaries don't reflect the stunning number of people dying in big cities, small towns and rural communities because of their addictions. An estimated 435,000 Americans use heroin, according to 2014 figures from the U.S. Drug Enforcement Administration, nearly triple the number who used in 2007.
Every day, 78 people in the United States die from an opiate overdose — 29 of them from heroin alone, according to the U.S. Centers for Disease Control and Prevention. That's more than 10,500 deaths a year attributed to heroin and more than 28,000 deaths due to opiate overdoses.
By comparison, more than 35,000 people were killed on U.S. roads last year.
But the overdose numbers don't fully reflect heroin’s hold on us.
The April death notice for Travis Colton, 29, of Russellton, Pennsylvania, personified his heroin addiction as a woman who made him "feel inspiration for only a brief moment in time and then she was gone."
It took the family of Seth Marshall Pettengill two years to overcome their grief before writing his obituary. He died on July 4, 2014, "alone and in a musty, windowless basement bedroom from a heroin overdose."
Pettengill, of Spokane, Washington, was one of 10,574 people claimed by heroin in 2014, according to the CDC.
'One tool in the battle'
The true extent of heroin abuse is not entirely known because of gaps in data collection. For example, the federal government does not track the number of people seeking treatment for a heroin or other opiate addiction in 21 states, including some of the most populated — Florida, Illinois and Ohio.
And yet, Illinois and Ohio are states that the CDC has identified as hot spots for overdose deaths.
In Ohio, overall drug overdose deaths tallied 3,050 in 2015. That’s an uptick from the 2,531 deaths in 2014, according to the Ohio Department of Health.
In 2013, Ohio Attorney General Mike DeWine started his office’s Heroin Unit to battle heroin and opiate traffickers and to coordinate with communities impacted by related deaths and crime. The unit includes Ohio Organized Crime Investigations Commission, the Bureau of Criminal Investigation, the Special Prosecutions Section and drug-abuse outreach specialists.
One method used to treat heroin addicts is placing them in a drug court, which are special treatment courts focussed on treating addicts through intervention instead of incarceration. Drug courts have been a growing trend since 1989 with now over 3,000 of the special courts treating adults, juveniles and families gripped by heroin or opiates.
DeWine, who has visited drug courts in Ohio, said he thinks they're "a great idea."
"It’s one tool in the battle against the opiate problem," he said. "What really is required for these drug courts is the judge and the staff to be tied into the treatment community, as well as the mental health resources in the community. That’s just very important."
DeWine also said education prevention should be taught to school-aged children from kindergarten through high school, making heroin and opiate avoidance part of the curriculum.
Because available data from the federal Substance Abuse and Mental Health Services Administration (SAMHSA) lags by anywhere from a couple of years to several years, it is impossible to know the current and full effects of America’s fast-growing addiction on families, emergency departments, treatment centers and coroners’ offices.
Nor does any single agency track outcomes after treatment, and counselors know that it often takes several, if not many trips to a rehab center to get an addict on a clear path to sobriety.
That's why Beth Blunt's parents opened up about their daughter's addiction.
"We decided to be upfront about what really happened," her mother Lisa Blunt said from her Carol Stream, Illinois, home, about 35 miles west of Chicago.
Beth Blunt died on May 25 in Sycamore, Illinois, just a month shy of her 23rd birthday.
Her mother said that she learned after Beth's death that she started taking prescription pills in high school. Beth attended Wheaton Academy in West Chicago and later graduated with honors in 2011 from Glenbard North High School in Carol Stream.
Blunt said that during Beth's second semester of college at Asbury University, in Wilmore, Kentucky, Beth received a letter about her academic performance that she shared with her family. Although Beth denied ever doing heroin, Blunt said that the letter about her daughter's dropping grades is her best guess about when the addiction started.
Beth dreamed of working in international relations for a company that had dealings in both the U.S. and China, her mother said. Learning another language was easy for Beth, who admired the Chinese language and wanted to travel.
But Beth did things that made Blunt and her husband, Terry Blunt, suspicious of Beth's drug use.
After living with a friend and later with her grandfather in Iowa in 2014, Beth returned home to Carol Stream with out-of-control anxiety, Lisa Blunt said. Beth sought counseling for anxiety and depression, but the counseling centers she attended also treated substance abuse, her mother noted.
"We just suspected something," Blunt said.
When Blunt confronted Beth a year later, Beth still denied drug use.
That happened in July 2015 after Blunt noticed some of her jewelry was missing. If the death numbers don't exactly tell the story of opiate addiction, missing rings from parents' jewelry boxes and stolen change from unlocked cars help give the bigger picture. Across the U.S., as in Beth's case, addicts desperate for a fix are stealing to support their habits.
A rise in thefts in any community often is an indicator of rising drug abuse.
In Utica, New York, Police Lt. Bryan Coromato said drug-related break-ins are hitting a high.
"With the spike in the usage of heroin out there, it's safe to say, definitely, there's going to be a spike in the amount of burglaries that have occurred that are drug-related," Coromato said. "It doesn't necessarily mean more burglaries, but probably the people committing them are using it to fuel drug addiction."
Coromato said he’s seen break-ins peak and fall with drug trends, but he has never seen it as bad as right now. It’s because of the increase in heroin use, he said.
It’s also why, in sleepy Southborough, Massachusetts, where the median household income is nearly $150,000, police began warning residents in 2014 to take extra precautions. A rash of break-ins in the region was rooted in drug addiction, police said.
When Beth Blunt's parents caught her stealing, they gave her two options: Get treatment or leave their house.
Beth chose treatment and went to a Stonybrook Center, a methadone clinic in Winfield, Illinois, in August 2015. She received therapy for six months.
Many choose treatment whether or not they want it. As a result, Dr. Kimberly Johnson, director of SAMHSA's Center for Substance Abuse Treatment, said that treatment programs across the country can't keep up with the demand.
That is causing delays for those who want and need to enter treatment. U.S. Drug Czar Michael Botticelli told reporters during a telephone news conference in July that only 12 percent of addicts get treatment, a problem that Johnson said is compounded by wait lists and obstacles, such as a lack of adequate insurance coverage for many who need it.
For some, though, getting help is even more complicated.
Faces of addiction
Many addicts don't fit the stereotype of the drug abuser many of us have in our minds, nor are all treatment programs designed to serve those who need them most.
Between 2005 and 2014, the number of women dying from drug overdoses has at least tripled in eight states: West Virginia, Delaware, Alabama, Wyoming, Minnesota, New York, New Hampshire and Idaho, according to a GateHouse Media analysis of CDC data. These include all types of drugs and are not specific to heroin.
Overall, across the U.S., drug overdoses are claiming a higher percentage of women than men.
Although data show that treatment centers for women and men are in similar proportions to users, women who need specialized care face an uphill battle, according to Johnson, particularly when it comes to child care.
Doctors say there just aren’t enough spots for women and their children to meet the demand. For many women, the question of where their children will go if they can’t get into one of these centers is scary. That’s why some women who desperately need help won’t seek it, Johnson said.
And it's a very real concern. In Ohio, for example, about 14,000 children are in custody of the child-welfare system. That's an increase of nearly 13 percent since the end of 2012.
"I think there are two barriers that affect both men and women, but probably affect women more. One is the whole issue of child care and being a parent," Johnson said. "The potential ramifications of having it be known that you have a substance-abuse disorder, whether it's child welfare or, in general, your family's perspective of you, and the whole physical aspect of caring for children and being able to do that while getting treatment" are barriers to getting help.
Elizabeth Celorier needed treatment for her heroin addiction, but focusing on getting sober was difficult when authorities took her newborn twins and placed them in foster care. Desperate to get her kids back, Celorier said a treatment center that would allow her children to live with her was her only option. She entered a program in Massachusetts that accepted her with her twins and she got sober.
As of 2014, only 480 of the 3,473 residential treatment centers in the country allowed women to take their children. That, Celorier and Johnson agreed, acts as a barrier for many women. Because they don't see options for safe havens for their children while they get help, so many of those women choose not to get help.
"As a woman, as a mother, I think we wait the longest to get help because it's so scary, because we have so many responsibilities," Celorier said. "Saying we need help, yes, someone could come in and take our kids, and what happens to our kids if we go get the help?"
That fear is also one reason more women with substance abuse disorder end up in prison, said Ohio Department of Rehabilitation and Correction director Gary Mohr. If there were more treatment options on the outside, particularly in Ohio, where opiate addiction is a rapidly growing plague, Mohr said he believes fewer women would end up in prison because of drug addiction.
Since 2010, the number of women in prison has been increasing rapidly, comprising the fastest growing population in prison. In 2013, there were 111,287 women in state and federal prisons, up 2.3 percent from the year before according to numbers from the U.S. Bureau of Justice Statistics. Mohr, however, said locking up people for addictions won't quell the problem. Treatment will.
"What is it that keeps our community safe? How do we keep our houses from being broken into?" Mohr said. "I think everybody should be concerned about that"
When hope ends
The last time Beth Blunt spoke with her mother, Beth admitted doing heroin once. But at her funeral, Beth’s arms were hidden to mask the many needle and track marks the coroner reported seeing.
"She was a really heavy user," Lisa Blunt said. "She was a 'functional' addict. She only held minimum-wage jobs, but could hold down a job. And not that she was really functioning all that well, but drug addicts can't keep jobs, so her addiction was harder to spot."
Blunt warned parents against enabling their addicted children by letting them live at home. She said that causes them not to worry about paying rent, for example, but about how they'll pay for their next drug deal. Living away from home, they have other things to worry about, such as paying bills and having a job.
She also urged parents to pay close attention and take action if they see behavior changes. Blunt said her daughter may have done other drugs, including alcohol, but she was oblivious.
"She never came home drunk, didn't show signs of drug abuse," she said. "She used to be the sweetest girl. I don't know what happened."
On May 18, Beth showed up at her parents' house at 6:45 a.m. in a panic, asking for $25. Beth explained that she needed it to get into a rehab clinic in Naperville, Illinois. Blunt reluctantly gave her daughter the money.
A week later, the Blunts' doorbell rang at 11:30 p.m. on May 25.
"When I saw them, I knew it was about Beth, but I thought they were going to tell me she was in jail or the hospital," Blunt said.
Beth was dead — killed by an overdose of heroin laced with fentanyl, a cheap, powerful and deadly synthetic opiate that is increasingly mixed with heroin by dealers and users.
It is a story told more than 78 times a day in the United States.
Data analysis by Jill Riepenhoff of The Columbus Dispatch.