Editor’s note: The name of the heroin addict described in the following story has been changed.
Shirley, a 56-year-old woman living in Haines, is broken.
When she was 21, her husband fired a bullet into her gut. He also threw her down a flight of stairs, breaking nearly every bone on the left side of her body. He kicked her teeth out.
Shirley’s mind also is broken. Besides the pain associated with spending three decades in an abusive relationship, she is an addict who prostituted herself and shared needles to get high.
In May, Shirley overdosed on heroin twice in one week. Local emergency medical responders saved her life both times by administering Narcan, a nasal spray that revives overdose patients.
She woke up in the SEARHC clinic. The last thing she remembered was injecting heroin. She was angry because EMTs “took my high away.” Within hours of waking up, she went home without resources or a plan to get sober.
The local medical clinic isn’t designed to offer in-patient addiction treatment, said SEARHC administrator Pat Hefley. Before his job in Haines, Hefley was the director of SEARHC’s behavioral health program. He spent a lot of time researching addiction.
“The clinic is both an out-patient and emergency stabilization facility,” Hefley said.
“We’re not a hospital. In an emergency, we either stabilize and medevac patients or we stabilize and discharge…or recommend follow-up work including seeking additional care.”
For doctors to offer help, an addict has to show willingness to seek treatment, Hefley said. Depending on the severity and length of the addiction, addicts often need a residential program offered only in communities larger than Haines.
Individuals ready for addiction treatment should tell clinic staff, and they can work with Lynn Canal Counseling to get them the appropriate level of care, Hefley said.
Shirley started taking heroin while tending bar in Juneau in the late 1980s.
“I didn’t start doing opiates because I wanted to get high,” she said. “That was never me. I did it because I was hurt. My husband shot me. It felt like I was on fire.”
Her addiction started after she was prescribed painkillers for her bullet wound. She drank every day, abused pain medication and snorted coke.
Shirley moved to Haines about seven years ago to escape her abusive husband. She was prescribed methadone – a synthetic opiate – for about 20 years but turned to heroin when her access to methadone ended about five years ago.
“Even if I went a day without something not hurting on my body, which doesn’t happen now, I’d still take heroin because I couldn’t calm the demons up there,” Shirley said, pointing to her head.
Abuse and its associated trauma often walk hand-in-hand with addiction, Hefley said.
“There’s a change in the brain in people who have trauma and they process things differently,” Hefley said. “You have to create another network of thought processes that overshadows their normal patterns of behavior and thinking and understanding the world. It doesn’t happen overnight. It perpetuates itself. Some people never recover. Some people do.”
Shirley became sober for three years while living in Haines, and received support from fellow addicts at AA meetings. Like many addicts, she relapsed.
“Since I was a child, I’ve never been as happy as I was when I went to AA four times a week and stayed sober for three years,” Shirley said. “I haven’t been going over a year now.”
Shirley’s done a lot of things she’s not proud of. She’s sold her body for drug money and smuggled drugs into Alaska to sell at a huge profit to buy more.
Perhaps what shamed her most, after relapsing, is her perceived alienation from the connections she made during her time at AA. It’s a reason why she won’t go back.
“How can I go around all them when I’m f–king up, as usual,” Shirley said.
“I’m always a f–k up, it seems like. We (addicts) all have that same story though, so I don’t know why I feel that way. The self-hatred is off the charts. It’s pure self-hatred. Put a needle in your arm and share a needle with someone who has HIV and Hepatitis C and I don’t care. I wanted heroin and that’s all that mattered.”
The only thing stopping Shirley from using heroin is the possibility that she could overdose and die.
Heroin is easy to get, she said, and it obliterates her pain. She would take opioids in pill form, she said, if she knew where to get them. “The physical pain is there all the time,” Shirley said. “And the psychological pain. I don’t know which is worse. It’s hard not to drive yourself nuts.”
During the interview for this story, Shirley smiled and laughed. She spoke objectively about her life and addiction. She knows how she got where she is, but she agrees with “broken” as a description of her condition.
“Oh yeah. You got that. No doubt about that,” she said.
Haines doesn’t have the resources to provide a rehabilitation clinic, Hefley said. The population of addicts is relatively low and even if there was a clinic, only a fraction of addicts would likely be willing to walk through the doors of a rehab center.
“We don’t have 200 people who need this service in this town as far as I can tell,” Hefley said. “If we were to have 200, maybe 10 or 15 people might be ready. We don’t have a program that’s residential with 24-hour coverage, medical availability for that size of a population. That’s not appropriate for Haines.”
Shirley does have friends who care about her. Recovering addict Jayme Dozier, 49, has made it her mission to support Shirley and other addicts wanting help.
Dozier has suffered her own story of addiction. She had to leave her son in Haines to turn herself in to police in Arizona, where she served a three-year prison sentence for a meth charge.
Dozier said the same community members who supported her, who raised her son in Haines while she was locked up, saved her life.
“Haines was my savior,” Dozier said. “Haines has been amazing. It was really hard coming back after three years. That saying ‘It takes a village to raise a child,’ this whole town helped raise my son for three years while I was gone.”
Dozier grew up in Arizona with abusive parents. She ran away from home when she was 14. She has used heroin as well, but meth was her drug of choice.
In prison, she completed a year-long sobriety program and came back to Haines, and to her son, with the fresh start she was looking for.
After years sober, Dozier relapsed last October after hanging around someone who started smoking meth.
“That was it,” Dozier said. “Addict. Over. I was off and running for three days.”
She told her son about her relapse because in AA, the program teaches addicts to be accountable. Dozier said staying clean is a daily, moment-to-moment struggle.
“When I see somebody high, my mouth waters,” Dozier said. “The hair on my arms stands up because I know that they’re high. And just for a split second my brain goes, ‘Jeez, I wonder if they’ve got anything.’ I’m an addict for life.”
“We (addicts) have to have support,” Dozier said. “We have to have resources. I just turned 49 and I’m just now learning how to be an adult, how to handle emotions. I got to really, really work hard to stay in check in the moment.”
Addicts come from all walks of life, Hefley said, but they share some common experiences.
“People in addictions tend to be isolated,” Hefley said. “They tend to not feel acceptance. They tend to feel shame and they’re not easy to reach. People often don’t know how to reach them.”
The Haines clinic may soon begin prescribing Suboxone, a medication used to treat addiction and the pain of withdrawal, Hefley said. Although it helps treat acute symptoms, it’s only the beginning of a long process of addiction recovery and is used in tandem with therapy and other programs, Hefley said.
Shirley spends much of her time at home watching television, taking her dog for walks, and collecting disability checks. Her rent was just raised by $200 a month and she said she has less than $50 to live on, after the bills are paid.
Asked what she would do without heroin or pain medications, Shirley shrugged her shoulders. “I just have to live with it,” she said. “It’s hard. I’m very depressed now. Very depressed.”
Two days after this interview, Shirley said she was on her way to an AA meeting.