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Category: Chasing Dark

Jamieson says doctors turning around opioid prescription issue

Dr. Jay Jamieson of WVP Keizer Clinic. (KEIZERTIMES/Craig Murphy)
Dr. Jay Jamieson of WVP Keizer Clinic. (KEIZERTIMES/Craig Murphy)

Of the Keizertimes

The numbers are staggering.

Dr. Jay Jamieson has faith things will get better.

According to the Centers for Disease Control and Prevention (CDC) National Vital Statistics System mortality data, 44 people die each day in the United States as a result of prescription opioid overdose.

The data shows there were 43,982 drug overdose deaths in this country in 2013. Of those, 51.8 percent (22,767) were related to prescription drugs. Statistics show drug overdose to be the leading cause of injury death in the U.S. in 2013.

The numbers for 2014 were even worse, according to data posted in December in Morbidity and Mortality Weekly Report: 47,055 drug overdose deaths in the U.S. Rates of opioid overdose deaths increased 14 percent in the one year.

Opioids include drugs like heroin, which has been a key focus of the ongoing Chasing Dark series in the Keizertimes. Prescription opioids include hydrocodone (Vicodin), oxycodone (OxyContin), oxymorphone (Opana) and methadone, as well as benzodiazepine.

In the series of stories, several people interviewed pointed the finger at the medical community for prescribing opiate painkillers, an addiction studies have shown can easily lead to a heroin addiction. Jamieson, who has been a doctor for 36 years and came to Keizer Klinic – now known as WVP Keizer Clinic – in 1987, said fewer prescriptions are being given out by the medical community these days.

“A large amount of people in power are well aware of the problem now,” Jamieson said. “The number of deaths should be reduced in the upcoming years. It takes time to turn the ship around, but over the next five years we will start seeing a trend where those numbers go down.”

While in medical school and during his residency, Jamieson said caution was expressed in terms of prescribing opiates.

“When I started, our understanding of opiates was they are addicting,” he said. “They are to be used very carefully and sparingly. We were taught you need to get patients off that medication as soon as possible.”

By the time Jamieson came to Oregon to practice in 1983, it was made clear to doctors such as himself the Oregon Medical Board carefully monitored prescriptions, especially of narcotics.

“If there was over prescription, you would be called in before the board,” Jamieson said. “I understood it and most other doctors did as well.”

Jamieson said things changed in the 1990s when Purdue Pharma pushed the belief that its OxyContin product was not addictive.

“It was foisted upon the U.S. medical community, state by state, so that state medical boards started accepting it and penalized doctors for under prescribing,” Jamieson said. “We were told we had to be a pain manager, so we could use the products.”

Jamieson recalls coming back from training about pain management with co-worker Dr. Greg Thomas.

“We asked each other, ‘When did opiates become not addictive?’” Jamieson said. “We prescribed it, but not for a large number of people.”

By the 2000s, the tide started to turn and lawsuits started being filed against Purdue. In 2007, current and former company executives pleaded guilty to misleading the public about the risk of addiction of OxyContin. The company was hit with more than $600 million in fines.

Jamieson said in the last few years the pendulum has been swinging the other direction.

“The Oregon Medical Board is aware of what’s happening and they’re taking steps to get us back to the correct norm,” he said. “They are closely watching prescription habits. People do have pain we need to treat, but we have to be careful what road we’re taking them down.”

Jamieson said he has a handful of patients with chronic pain that he prescribes a modest amount of narcotics to. The dosage is closely monitored to make sure the use doesn’t become habitual or an addiction.

“We want to help, but we have to be careful,” Jamieson said. “We don’t want to hurt them but we also want to not get into trouble. I’ll prescribe a short-term narcotic, but for long-term I want something safer that’s non-addicting. My patients appreciate that.”

Jamieson said there are some who hop from doctor to doctor, seeking prescription opiates.

“The real problem is the drug seeker,” he said. “You don’t know if they’re addicted and just using me as the portal to a prescription, or turning around and selling it.”

Jamieson emphasized his clinic never bought into the push from Purdue.

“This clinic did not buy into the theory of opiates not being addictive,” he said. “We held out all along.”

Helping doctors across the state is a new registry system.

“If you get a narcotic from a doctor, within a day you’re on the list,” Jamieson said. “If I look you up and see you hit up five doctors up and down the I-5 corridor for a prescription, I’ll know about it. As doctors, we can all do this. We can look and see what’s going on.”

According to Jamieson, Salem Hospital’s announcement a few years ago of no longer refilling prescriptions for narcotics was helpful as well.

While the medical community as a whole has been paying closer attention to painkillers, Jamieson said patients can do their part as well.

“Families can help by being very careful,” Jamieson said. “If you had a prescription, make sure it’s locked and away from kids. When you’re done with them, there is a system where you can hand in used prescriptions. Get rid of them. That’s how kids get started, by finding them in medicine cabinets. They’re not thinking about the long-term consequences. You have to protect them.”

Jamieson said narcotics are used because when a patient has intense pain, there’s nothing quite like a narcotic. Tylenol can be used on the low-end of the pain spectrum, followed by anti-inflammatory relief like Aleve or Motrin, which can be used with a muscle relaxant for issues such as back pain. Then there is Tramadol before narcotics are used.

“With chronic pain, there are people who legitimately need a dose or two of a narcotic,” Jamieson said. “You have to make sure use is not accelerated. Most of the time we will have a pain contract. We sit down and talk about limits, I’m the only person to prescribe it, what the potential side effects and risk of using it are and that you only go to one pharmacy. If there’s any breakdown in that system, they are not your patient anymore.”

In one of the Chasing Dark stories from last fall, members of the Keizer Police Department’s Community Response Unit talked about how addictions to heroin often start.

“A lot of times it is an injury,” officer James Young said. “When people can’t get more (painkillers) from the doctor but they are hooked on the opiate, they turn to street level heroin. A lot of times it will be after an injury or just experimenting. Sometimes it is a familial connection. Sometimes you’ll see the drug use going on in your house growing up, so you wind up using it yourself.”

Sgt. Bob Trump noted the addiction to opiates at first seems harmless.

“It often comes from the doctor, so it’s seen as being safe,” Trump said. “Then (the prescription) dries up, but by now you are addicted.”

The KPD has a drug turn-in receptacle in the police department’s lobby for old prescriptions.

Jamieson believes doctors are now helping to turn the problem around.

“We got ourselves into trouble as the medical community,” he said. “We were misled by a large medical company. But the pendulum has been switched the other way. Systems now more closely monitor (opiate) usage. We are being encouraged to reduce the number of pills prescribed.”

This story is from the February 2016 Salem-Keizer Health and Wellness Magazine, which came in the Feb. 19 issue of the Keizertimes.

Heroin: A devious liar with a powerful pull

Samantha Nixon (right) and her mother Elizabeth Smith. (Submitted Photo)
Samantha Nixon (right) and her mother Elizabeth Smith. (Submitted Photo). Chasing Dark is an ongoing series looking at heroin abuse in Keizer. For past stories, please visit

For the Keizertimes

Editor’s Note: In a recent Chasing Dark story, Elizabeth Smith talked about her daughter Sam Nixon’s struggles with heroin. This is Sam’s first person tale of what she went through and what she wants others to know about heroin.

I’m sure people who have never tried heroin think, “Why would anyone ever want to?”

We hear stories about overdoses, arrests and beautiful souls’ transformations into unrecognizable individuals all the time.

We’re in the midst of an epidemic, and I want to say first and foremost: heroin does not discriminate.

Some of us are more susceptible to becoming enslaved in the throes of addiction due to a complex combination of genetics, circumstances, mental illnesses and social factors. But heroin does not care about the superficial differences that trick us into believing the lie that we or our loved ones are immune to her reach.

Heroin is a liar. She lies to families.

She tells them, “It won’t happen to my family.” “My child/mother/father/sibling/friend would never do something like that.” “I have to give them money or they’ll die.” “I’m keeping them alive by providing somewhere for them to live.” “If I set boundaries, they will hate me forever.” “It hurts me too much to see them in pain, so I’ll enable them to continue to use.”

She also lies to the person using.

She says things like, “I’m not as bad as them.” “I can control this.” “I’ll only try it once.” “I can’t live without it.” “I deserve to live like this.” “Nobody understands what I’m going through.” “I can’t live without it.”

Heroin lied to me. Heroin lied to my friends and my family. I can only speak from experience, so here is my story of becoming a prisoner and, thankfully, breaking free.

So why try it?

At first it was a test, a sample, a “who cares, why not?” moment based on a belief that dependency and addiction couldn’t happen to me.

Besides, why worry about your life, consequences and eventual, long-term effects when you don’t really care about yourself anyway?

I was not lacking knowledge. I was not lacking support. I was not lacking a plethora of accomplishments, academic achievements and superficial successes.

I came from a good family.

I was lucky enough to live in a nice house, in the nice part of town, with a family who loved me and provided more than I needed. We had a boat. We had a cabin. We had a hot tub and a fire pit and a gigantic TV. I had a collection of designer clothes and pretty little things. I was not lacking anything on the surface.

So what was I lacking?

I was lacking the ability to think ahead, to weigh the decisions I made against the consequences. But most importantly, I was lacking self-esteem, self-awareness and self-worth.

I didn’t know who I was. I didn’t understand the underlying issues that were contributing to my perpetual feelings of gut-wrenching agony and unhappiness.

I wasn’t lacking self-centered thinking and a desperate desire to escape my reality.

Inside I was dying, and what’s worse, I didn’t know why. I needed to find a fix; I needed to find a cure for the pain.

She finds me

When I was introduced to heroin, I found a way to self-medicate that had the potential side effect of death, which was honestly my passive intention. I found a slow way to kill myself – an easier, softer way to go away.

But initially, the decision to try it was impulsive and without much thought.

I thought, I can try it once. I’ll be fine.

Upon my first ingestion I was catapulted into an alternate universe where all of the sudden, everything was going to be okay.

My body was flooded with warmth and contentment. Nothing scared me anymore. All my fears disappeared and my worries and cares and feelings were completely eliminated.

I was numb to everything, which was exactly what I wanted.

I thought, I want to do that again.

And thus, the imprisonment began. I was tied to Her, a beautiful seductress who whispered in my ear: “You need me. I take away your pain. You want me. Come visit me again.”

And I did. Again. Again. Again. Again. Again… Again…. Again…

The destruction of things worthwhile

I shattered my family’s trust. I shattered what was left of my identity. I lost everything superficial, everything worthwhile, everything I loved and my interest in basic needs like food, shelter and water.

My family decided, very intelligently, to stop enabling me and kicked me out of their house. They refused to support me as I killed myself.

I didn’t care. I rode my bike around with my belongings on my back, caring about only one thing that consumed my mind completely, obscuring my sight, creating tunnel vision that led to one thing:


I ran out of money. I overdosed. I lost everything I’d worked so hard for – college, transportation, financial security and, above all, my relationships. I lost it all. Her power made none of it matter.

My solution stops working

Soon, heroin’s “healing” magic lost its power. I needed more and I didn’t have a way to get it. Fortunately, I didn’t have to resort to means that many people who are trapped in Her sickening cycle of self-destruction and complete dependence have to do to stay well.

But only by the grace of something bigger was I spared, because I was no better and no different than them. I would have gotten there quickly, because I would have done anything for Her. But I was spared. I received help; I was given another chance.

Saving grace

By the grace of whatever power is out there, my family (bless them) intervened and I was removed from Her clutches. I am proud to say I haven’t used heroin in 1,292 days and I never plan to do so again. I escaped Her power and found another as of July 8, 2012.

In the time between then and today, I have seen countless other people who were bound by addiction recover. I have also seen beautiful, kind, joyful, hilarious, sweet, dear souls lose the battle and move on to whatever is waiting for us on the other side.

I want everyone to know that it is not impossible to stop. Heroin is a liar. Don’t believe her. Don’t get involved with her. And if you already are, I promise, I promise, freedom is out there. You can be freed.

I was freed. People with more difficult circumstances and less advantages than me have been freed.

It doesn’t have to be your demise. It doesn’t have to be the end.

To families: I am so sorry for the pain that comes with battling a loved one’s addiction. There is support out there for you, too. There is always hope.

To everyone: Stop believing heroin’s lies. You are worth much more than anything she could ever offer. Hope is not lost. Help is out there.

Getting a new perspective

Chasing Dark is an ongoing series looking at heroin and other types of drug abuse in Keizer.

Of the Keizertimes

Eric Peterson certainly had preconceived notions in his mind and figured they would be proven right.

A few days after 22-year-old Brandon Crist of Keizer – the nephew of Peterson’s longtime significant other – died of a heroin overdose in late September, Peterson heard some of Crist’s friends would be gathering at a park in Salem to remember him.

“My intention was to go there and hang in the background, scope people out, embed myself, prove my preconceived notions,” Peterson said. “What actually happened was one of the most moving experiences of my life.”

As Peterson approached the park, he found a group of Crist’s friends. He also saw police lights, since neighbors had complained about noise and a sheriff’s deputy was waiting for more people to enter the scene.

Peterson approached the deputy, explained what was going on and asked for the police lights to be turned off.

“I asked the deputy if I could diffuse the gathering, make sure nobody was drinking and driving and get them out of there without him getting involved,” Peterson said. “He approved and turned off his lights as a group of kids started shuffling out of the woods. The deputy backed up his patrol car to the other side of the parking lot while I approached the kids.”

With law enforcement backing off, Peterson approached the group.

“I tried to corral them and let them know that the cop wasn’t there for them, but that I was there for them,” Peterson said. “I wanted to see Brandon’s friends celebrating his life, I wanted to see what they looked like, I wanted to see if they had tears in their eyes or just an excuse to party. Some of them scattered but most stayed, asking me how the family was doing, what the police are doing, are they allowed at the funeral, etc. We talked for a couple minutes and at one point they all mobbed me with hugs, one right after another like after a football game pile on. It was very surreal.

“I made sure they were cool to drive, told them to keep talking about Brandon on social media because it means a lot to the family and that’s how they will find out about his memorial,” he added. “Another larger group came out of the woods shortly thereafter and the whole scenario was repeated with the mass hug and all.”

In a matter of moments, Peterson found his stereotypes shattered.

“My preconceived notion is that these are a bunch of kids that look like they are never going to make it if they don’t play the game, the same advice I gave Brandon many times,” Peterson said. “I think that after meeting them and seeing their hearts instead of their messed up hair and piercings and tattoos that I am the one who is never going to make it unless I play the game. I’ve become more tolerant to people and life in general in just the short time since his death and I attribute it to that night.

“These weren’t the friends Brandon was doing heroin with,” he added. “I assumed every single person in his life was a junkie and every minute of his day was spent chasing that fix. I’ve come to learn that his friends loved him more than anything. He helped out people constantly with the most menial things like changing tires for people in need and picking stuff up at the store for friends and countless stories of him being a shoulder to cry on when life was kicking them down. I’ve learned that he was a talented artist, a beautiful writer and practiced a Polynesian form of fire art and dance that blows my mind away. I never got to know that side of him, never even knew it existed.”

Unfortunately, Peterson did know the drug side existed. It was an all too familiar story for Peterson. His immediate family members have been decimated by drug addictions, though Crist was the first to die of a drug overdose.

“I probably only knew addict Brandon after the age of 13,” Peterson said. “I tried to foster sort of a mentor/protege relationship with him: I would give him life lessons, he would seem receptive and we had mutual interests in music and culture. I would tell him my feelings on drugs and alcohol when he would ask, which are pretty liberal but still have no place in adolescence. And he seemed to respect that.”

Before Crist started doing drugs, Peterson said he warned him about the perils.

“I explained that the smart move is to just stay away from it until you are an adult because there is no advantage to it,” Peterson said. “You don’t pour heavy duty weed killer or fertilizer on a baby plant and expect good things to happen. I explained to him many times that the key to being a kid is playing the game. You can dress how you want and act how you want if you can trump it with your productivity. I told him no parent ever yelled at a straight-A student for having an earring.”

Once Crist started getting into trouble, he turned to Peterson for advice.

“I laid out a foundation for how the next five years of his life should go if he wanted to get through the next 60 years,” Peterson said. “It was pretty simple: get away from Salem/Keizer and get your head and body right. He didn’t or couldn’t listen.”

But Peterson doesn’t put all the blame on Crist.

“I set such a high bar for an addict to be in my life,” Peterson said. “I was way too tough on too weak of a kid because I thought that my path to his sobriety was the correct one. When he disappointed me, he knew it and our relationship was fractured. I wish I would have been more realistic and less principled.”

On the other hand, Peterson doesn’t know how much difference it would have made.

“If I did do things differently, not giving him the silent treatment when he was using, trying to keep letting him know I wasn’t judging him, being the pseudo-cool uncle – the response would have been the same,” Peterson said. “He would have lied and been dodgy and told me what I wanted to hear, just like he did with everybody else. I thought he knew he had an ally in me and in hindsight either I didn’t make it obvious enough or he didn’t believe me.”

Chasing Dark: Signs, tips and resources


In recent weeks, the Keizertimes has run a Chasing Dark series, looking at the growing heroin epidemic in Keizer.

Links to full stories will be in a special section of the Keizertimes website (www.keizertimes.com this weekend.

Throughout the series of stories, parents and law enforcement personnel alike have shared advice, tips and resources to help families. Here is a recap of some of that information:

Signs your child could be doing heroin

• Bottles disappearing from the medicine cabinet

• Items around the house suddenly disappearing or money missing from purses/wallets

• A sudden withdrawal socially from the family

• Messages on social media about drugs. The problem is most of the times the messages will be private.

• Those going through withdrawals will be extremely weak and unable to keep food down.

• Excessive drowsiness

• Losing track of time

• Excessive use of cotton swabs

• Pick marks around the face

• Weight loss

• Dark circles under the eyes

• Lack of smiling

• Dirtiness, especially under the fingernails

• Parents and authorities alike agreed those who are caught in an addiction need to feel free to talk openly about what they are going through, without feeling judged. Building trust is critical.

• Jeff and Hollie Crist, whose son Brandon died of a heroin overdose in September, said if parents suspect something is going on, trust that instinct.

What to do

• Benton County offers a needle exchange program; such a program isn’t offered in Marion County. Information about the Benton County program and other harm reduction programs:

• Bottles of old medications can be turned in at the turn-in receptacle at the Keizer Police Department, no questions asked.

• Sometimes drug court programs are utilized, forcing users to stop doing drugs. The problem, many involved in the series agree, is users need to make the decision themselves to kick the habit. Forcing someone to go through treatment before they’re ready to face up to the problem typically leads to the problem continuing.

• A Washington-based website has information:

• There are several treatment facilities. For example, ADAPT Oregon has several locations around the state, mostly in the Roseburg area. More information is available at

For Elizabeth Smith, she found Balboa Horizons in California ( helped her daughter. Other options include the Hazelden Treatment Center in Newberg (, Astoria Pointe (, facilities in Eugene ( or Klamath Falls (

Reports/other media

• In July, the Centers for Disease Control and Prevention posted a briefing about the heroin epidemic. That briefing can be found here:

• In 2014 the Oregon Health Authority published a report about drug overdoses:

• In November, the Drug Enforcement Administration published a study about the increase in drug use. A summary can be found here: The full report can be found here:

• In the summer of 2013, Oregonian investigations editor Les Zaitz wrote an in-depth story about drug cartels in Oregon:

• In August 2011, NBC News did a story about addictions being a brain disorder:

• This fall, a link was shared by KGW with Alicia Cook writing about losing her cousin to a drug overdose:

• The police department in Gloucester, Mass. has a program designed to combat opiate overdoses.

• In July, Seattle Weekly did a story about heroin:

Heroin: an issue that needs light


As we enter into the holiday season, we have been running a Chasing Dark series of stories here in the Keizertimes about drugs.

Pretty crappy timing, no?

Actually, no.

Brandon Crist was just 22 years old when he overdosed on heroin in late September. His death was a key factor in doing this series. We had been discussing doing some story about drugs, using an excellent piece from August in Seattle Weekly by Casey Jaywork titled “The Spike: What Lies Behind the New Heroin Epidemic?” as a starting point. That story can be found here:

We were told there might be someone locally willing to talk about what it’s like to be a heroin addict. But that didn’t go anywhere until Brandon’s tragic death. We were told people in the heroin community were shaken up by Brandon’s death and would now be willing to talk. That led to the first story in the series, about heroin addict Spencer and how his family is dealing with his addiction.

Counting this week’s story about resources and suggestions, the series has now spanned 10 stories. More could be on the horizon. A new tab will be added to our website with full versions of all the stories, plus any additional stories in the series will be added there in the future.

I want to extend a huge thank you to those willing to share their stories, insights and suggestions. I can’t even begin to imagine how tough it must have been for parents to talk about losing their children to drug addictions, both because of the pain involved and because of the stigma that goes with drugs, which I’ll address in a moment.

So what was the intent of the series? Simple: to shed light on the growing problem – yes, it is fair to call this an epidemic – of heroin addiction. Put simply, this crap is killing our youth at an alarming rate. We need to have open, frank discussions about what the drugs does, signs to look for that your child may be addicted and to let families know they are not alone.

Jeff and Hollie Crist never imagined their son would die of a heroin overdose. Even after Brandon became addicted, it seemed like his life was back on track. He was going to be a drug counselor, using his story to share with teens and to warn them what not to do. But then he slipped off track.

Elizabeth Smith didn’t even recognize her daughter along River Road after a near-fatal heroin overdose. She never imagined having to find where to send Samantha to get clean. But she fought like hell, learning some awful, dark truths along the way. Now Sam is helping others and Elizabeth was adamant their story be shared.

Sue was frustrated about what happened with Peggy and saw her daughter never hitting rock bottom.

Going back to the stigma: the stereotype out there is drug addicts are from questionable families, often low income. Sometimes that is the case. But in the three examples mentioned above, it’s just the opposite.

That’s the scary thing – or one of the scariest things – about heroin: it’s an addiction that can latch onto anyone, regardless of factors like family life and economic status.

Let me be blunt for a moment: If you think your child couldn’t possibly become an addict because such behavior is somehow beneath you or your family, your head is buried in the sand.

And if you think it’s only an isolated problem with some people in town, you’re sadly mistaken. This is a problem that extends well beyond the seven square miles of Keizer. It’s everywhere.

Elizabeth and Sam would love to have a community meeting to talk about heroin. I would love to see that happen and I hope the meeting draws a standing room-only crowd.

But that should only be one step along the way. We need the topic to stay in the light. We need the story to be shared with friends and family outside of Keizer. We need media organizations in other areas to help by doing stories.

Why? So that other parents don’t have to answer that knock on the door, which only confirms the sickening feeling deep in the pit of the mom’s stomach.

Why? So that youth like Brandon and Peggy didn’t die in vain, and so families that have gone through this hell didn’t do it in vain.

Why? So that this growing epidemic can be stopped.

To say this isn’t the “right” time to talk about this issue because of the holidays is to say there never is a right time. We can’t just push it off and say let’s talk about it tomorrow, because there will always be an excuse to push if off. This is a topic that needs to be addressed.

Right now.

After all, for people like Brandon Crist, there are no more tomorrows.

(Craig Murphy is news editor of the Keizertimes).

Drug use, deaths on rise


Of the Keizertimes

Drug overdoses cause more deaths each year than car crashes and guns.

That was one of several sobering details in the recently released 2015 National Drug Threat Assessment Summary. The summary was produced by the Drug Enforcement Administration and written by acting administrator Chuck Rosenberg.

“The trafficking and abuse of illicit drugs pose a monumental danger to our citizens and a significant challenge for our law enforcement agencies and health care systems,” Rosenberg wrote in part. “The Centers for Disease Control and Prevention reported that 46,471 of our citizens died of a drug overdose in 2013, the most recent year for which this information is available. Drug overdose deaths have become the leading cause of injury death in the United States, surpassing the number of deaths by motor vehicles and by firearms every year since 2008. Overdose deaths, particularly from prescription drugs and heroin, have reached epidemic levels.”

Rosenberg added that the most significant drug trafficking organizations in this country are the “dangerous and highly sophisticated Mexican transnational criminal organizations” that continue to be the principal suppliers of cocaine, heroin, methamphetamine and marijuana.

“Domestically, affiliated and violent gangs are increasingly a threat to the safety and security of our communities,” Rosenberg wrote. “They profit primarily by putting drugs on the street and have become crucial to the Mexican cartels.”

Those conclusions match what investigators with the Keizer Police Department have found, as referenced in previous stories of the ongoing Chasing Dark series in the Keizertimes.

According to the report, more than 120 people die each day in the United States from a drug overdose.

Many of the Chasing Dark stories have focused on heroin use locally. The DEA report supports that by showing the increased heroin use in recent years.

For example, one chart shows the greatest drug threats and lists cocaine, meth, marijuana, heroin and controlled prescription drugs (CPDs). In 2007 heroin was fourth on the list, with about 8 percent of respondents reporting it to be the biggest threat. By 2009 heroin was up to third with about 13 percent. That number jumped to 25 percent in 2013 and 29 percent in 2014. In 2015, heroin surpassed meth as the biggest threat, at 38 percent.

“The threat posed by heroin in the United States is serious and has increased since 2007,” the report states. “Heroin is available in larger quantities, used by a larger number of people, and is causing an increasing number of overdose deaths. Increased demand for, and use of, heroin is being driven by both increasing availability of heroin in the U.S. market and by some opioid CPD abusers using heroin. CPD abusers who begin using heroin do so chiefly because of price differences, but also because of availability, and the reformulation of OxyContin, a commonly abused prescription opioid.

“Heroin overdose deaths are increasing in many cities and counties across the United States, particularly in the Northeast, as well as areas of the Midwest,” the report adds, listing possible reasons for the increased overdose death of heroin users as an overall increase in heroin users, high purity batches of heroin, more new users who are young and inexperienced with the drug and the use of highly toxic heroin adulterants such as fentanyl.

“Further, heroin users who have stopped using heroin for a period of time (due to treatment programs, incarceration, etc.) and subsequently return to using heroin are particularly susceptible to overdose, because their tolerance for the drug has decreased,” the report states.

According to the survey, 53 percent of respondents this year said heroin availability was high or moderate in their area, with 65 percent saying heroin availability was increasing and 64 percent saying heroin demand was increasing.

Of the DEA’s 21 field divisions, 10 reported heroin availability was high in the first half of 2014.

According to National Seizure System data, heroin seizures in the U.S. increased 81 percent over a five-year period, from 2,763 kilograms in 2010 to 5,014 kilograms in 2014.

The average size of a heroin seizure more than doubled during that time period, from .86 kilograms in 2010 to 1.74 kilograms in 2014.

Data from the National Survey on Drug Use and Health shows an 80 percent increase in heroin users from 2007 to 2012, increasing from 161,000 users in 2007 to 335,000 in 2012.

In addition, the survey found a 26 percent increase in users who reported lifetime heroin usage.

Between 2007 and 2013, the number of heroin-related overdose deaths in the U.S. increased from 2,402 in 2007 to 8,257 in 2013. More alarming, there were approximately 3,000 such deaths in 2010, meaning a significant uptick in just three years.

Worse yet, it’s believed the number of heroin deaths are underreported.

“Heroin deaths are often undercounted because of variations in state reporting procedures, and because heroin metabolizes into morphine very quickly in the body, making it difficult to determine the presence of heroin,” the report states.

Relief isn’t expected anytime soon.

“Heroin use and overdose deaths are likely to continue to increase in the near term,” according to the report. “Mexican traffickers are making a concerted effort to increase heroin availability in the U.S. market. The drug’s increased availability and relatively low cost make it attractive to the large number of opioid abusers (both prescription opioid and heroin) in the United States.”

The full report can be found online at

‘It’s a gift she’s still here’

Elizabeth Smith and her daughter, Samantha. (Photo courtesy Elizabeth Smith)
Elizabeth Smith and her daughter, Samantha. (Photo courtesy Elizabeth Smith)

Of the Keizertimes

Most of the time, Elizabeth Smith is a strong woman.

Part of that strength comes from fighting for her daughter, Samantha Nixon, who nearly died of a heroin overdose in July 2012, to get clean.

In order to help her daughter, Elizabeth had to learn dark truths and be exposed to friends of her daughter who were also fighting drug addiction.

Some of those friends have died of heroin overdoses. Samantha was a lucky one.


During a two-hour conversation with the Keizertimes for this latest Chasing Dark story, Elizabeth broke down once: when asked why her daughter survived her overdose when others didn’t.

“I don’t know,” Elizabeth whispered, breaking into tears. “I don’t know. It’s a gift she’s still here. You can’t just take that for granted. Everything happens for a reason. Samantha and I have discussed this many times. You feel really guilty as a survivor. As a parent, you always worry you’re going to join the club; the club of parents that have buried their children who have lost their battle to drug addiction. It’s a club you never want to be a part of. At the same time, fighting addiction can consume you and ruin you, or you can harness this hell and make it something powerful. I’m not going to let it ruin me, I am going to fight it. I owe it to them. That is why we made the decision to tell our story.”

Elizabeth estimates the problems for Samantha, now 22, started when she was 12 years old, after her parents divorced. She started drinking and smoking weed. When Samantha was 16, she started doing methamphetamine.

Samantha was sent to the Deer Creek Adolescent Treatment Center in Roseburg. It wasn’t long until she bolted, just as Elizabeth had predicted.

“They told her she couldn’t leave,” Elizabeth said. “She laughed and said, ‘I’m not here because I have to be by law. So, good luck with that’ and she walked out.”

A furious Elizabeth got the call, went into mama bear mode and got in her car.

“I had never driven down I-5 so fast before,” Elizabeth said of her trip to find her wayward daughter. “I was driving to Roseburg at 100 mph. I got there in two hours, praying the whole time I didn’t get pulled over.”

Fortunately, Samantha ran into a lady at a store who recognized immediately she was an addict running away from the treatment facility, having been in the same position herself before. She took Samantha in until Elizabeth got there.

Elizabeth removed Samantha from McNary High School and sent her to Chemeketa Community College’s Early High School College. Medicines were removed from cabinets and there was no alcohol in the house. When not in school, Samantha had to sit in Elizabeth’s office.

“She wasn’t allowed to be by herself,” Elizabeth said. “I think she hated me during that time, but I didn’t care. You’re just fighting all the time.”

Samantha finished her high school diploma and received enough credits to transfer to Linfield College in the fall of 2011. For a while, things weren’t so bad.

But then a series of events happened that triggered a downward spiral for Samantha. Her grandfather died in November 2011, causing her anxiety to spike. It brought back things she had not dealt with during her initial addiction battle and with the death of her best friend the year before.

“Burying emotions and pain eventually played into her addiction, as she was now dealing with things she had not dealt with before,” Elizabeth said of Sam. “There’s a lot of emotions there.”

Samantha hit her bottom in July 2012. She had received a prescription for Xanax to fight her anxiety while in school, triggering the addictive cycle all over again. She dropped out of college and wasn’t allowed to move in with her mom, who knew her daughter needed inpatient help. So Samantha moved in with her dad. When he came home on the 4th of July weekend, he kicked her out of the house.

“It was disastrous,” Elizabeth said. “Bottles and weed were everywhere. Her dad kicked her out and called me. Her Facebook page was on the computer and it was open to messages about getting heroin. She had shot up on heroin. That was the night she almost died.”

Samantha had gone to a house with other users, shot up and passed out. When she stopped breathing, no one knew what to do.

“The next day, I found her on River Road, walking with a friend,” Elizabeth said, noting Samantha believes her best friend and grandpa saved her. “I drove past her. She was so bloated and dirty, I didn’t recognize her at first. I flipped a u-turn and stopped. They were both high on heroin. I asked her to get in my car. Once she did, after she looked at me like a zombie, I told her I knew everything and I would do anything to get her help. She asked, ‘Why? Why do you care?’ If she only could have understood.”

Elizabeth got her daughter a sandwich and made her take a shower before taking her to the emergency room.

“I was terrified,” Elizabeth said. “I had no idea what heroin does or possible reactions. When I brought her home, my husband and my other daughter Erica just sat there. No one really knew what to do or say to someone who was clearly high and out of her mind. You sure don’t read that in a parenting book.”

Things only got worse from there.

“She yelled at Erica,” Elizabeth recalled. “Erica went into her room and cried. Erica was 16 at the time and didn’t understand why Sam was making these choices. Sam was all strung out, but she felt bad about she’d done to her sister. Erica told her, ‘You’ve always been my hero and promised you would be there for me. You’re breaking my heart and killing yourself.’”

That ended up being Samantha’s turning point. Breaking her sister’s heart was the worst feeling in the world for her, so Samantha agreed to get help.

Elizabeth took Samantha to the ER, then brought her home and stayed with her for three days and nights as her daughter went through severe withdrawals from heroin.

“Watching someone withdrawal off of heroin is awful,” Elizabeth said. “She couldn’t even walk to the bathroom. I had to help her to the bathroom. She couldn’t keep food down. I shut down into emergency crisis mode.”

As if seeing her daughter nearly die of a heroin overdose wasn’t bad enough, the next step was just as tough in a different way: trying to find a way to help Samantha.

“The hardest part is finding help,” Elizabeth said. “There was not a list of names or a website with names out there. I never imagined I would find myself in this world.”

Elizabeth found out about Hazelden Treatment Center in Newberg, with her mom paying the co-pay to get Samantha in. Three weeks later Samantha was kicked out, with the recommendation to check out Balboa Horizons in Southern California, a 90-day rehab program. Insurance picked up the bill and Samantha was on her road to recovery.

While Samantha was at Balboa, Elizabeth and Erica went down for family week, where family members are taught about the addiction. Elizabeth had the stereotypical image of drug addicts coming from trashy-looking families in mind.

“We walked in and I thought it would be all these drug addicts,” she said. “But it was families that looked just like us. I started crying, just broke down. It was so good to know I wasn’t alone.”

Elizabeth, who is still friends with some of the families she met that week, said Jim, the class instructor, taught about enabling. For example, often parents of addicts will make conditions such as buying the addict a car if they get clean.

“You have to empower your loved one to believe in themselves and to fight for their sobriety,” Elizabeth said. “If not, you’re crippling them.”

In another example, Jim had a parent sit in a chair while he portrayed an addict struggling to cross the room to sobriety. The parent wasn’t able to get out of the chair to help, meaning Jim had to fight to get himself across the room.

“A lot of parents were angry when we got down there,” Elizabeth said. “Erica and I were. We did an emotional check-in every day. Throughout the week, the anger was lessened because you start to understand what you are dealing with. When you don’t understand, the fear overwhelms you. It’s usually because you’re scared to death.”

Among other things, Elizabeth learned that when youth become addicted to drugs at a young age, the frontal cortex of the brain’s growth is stunted, leading to obsessive behavior and allowing impulses to take over. In other words, things aren’t firing correctly in the addict’s brain.

“The drugs stop their maturity,” Elizabeth said. “They don’t have the necessary logic or the stop zone, because the control center hasn’t kicked in yet.”

For Samantha, Balboa Horizons was an answer to prayers as it put her on the road to recovery. In May 2013, she did a video for Balboa, telling about her story.

“It was really cool, because like most people I’ve talked to here, I haven’t really had the close relationships with women,” Samantha said in the video. “Coming to Balboa, in an all-girl’s facility, we really formed a sisterhood. Everyone could really relate to each other and you could get just completely open and honest about everything going on. It was like family support.”

After her time at Balboa, Samantha moved into a sober living house with several friends she made at Balboa. They had to stay clean, do random urine tests three times a week and went through a 12-step AA process. Samantha and two others then moved into a condo, followed the same rules and went to work at rehab facilities.

“The biggest thing is to have a lot of people around you who understand, who’ve been through the same battles,” Elizabeth said. “I’d love for her to be at home, but Orange County is the largest area for rehab and sober living. Plus it’s sunny around there, which is so nice for addicts with depression. She needs to have a sober support group of people her age. That is lacking in the Salem/Keizer area. The people she’s with down there, she can’t bullshit them. An addict can spot an addict faster than anyone and is so quick to call you on it. They’ve all been through it.”

By contrast, Elizabeth said there’s a lack of awareness of the issue in Keizer.

“This town needs to wake up,” she said. “People assume it will never happen to them. We want to bring awareness to Keizer. We’ve got to talk about it and have these conversations. When one more kid gets buried, that breaks my heart. We live in a nice neighborhood and look like the typical American family. Don’t ever think it can’t happen to your child.”

After Samantha was on the road to recovery, Elizabeth reached out to the young man that was with her daughter shortly after her overdose.

“He came from a good Christian family, in a nice Keizer neighborhood,” Elizabeth said. “His parents both worked during the day and he did heroin while they worked. He said he didn’t think his parents would listen. I told him, ‘You’d be amazed. It’s a lot better for them to learn it now than to find out after you’re dead.’ Sam said he got his life together and is married now.”

Elizabeth would like to have a public meeting in Keizer to talk about the issue and would like to see more treatment options and facilities locally.

“We need to develop a website of resources,” she said. “Oregon is lacking the resources. I had to go out of state to save my daughter. That needs to be addressed. Balboa needs to open a place up here. We have people dying left and right. You need to get them around people who’ve been there because they speak their language. I don’t speak it, but they do. There are no things like narcotics anonymous for young people up here.”

Elizabeth has suggestions for parents.

“Watch your pain pills,” she said. “Watch your medicine cabinet, your prescriptions, your kids. It’s just way too easy for them to get their hands on the pills. Don’t bring pain meds into your house. It’s so important that we talk about it. We’re losing an entire generation to prescription medications. A lot of kids are dying because they got into heroin more than they thought they would.”

Even though her daughter is doing better, Elizabeth battles living in fear.

“The risk of relapse is real,” she said. “It’s always going to be a threat. A relapse can always happen. I am always on edge. I sleep with my phone next to the bed, just waiting for that call. I pray it never comes. I’m more afraid of that knock on the door in the middle of the night.”

Elizabeth put the struggle into simple terms.

“It’s like staring down the devil,” she said. “I’m not going to blink.”

The whole experience has left Elizabeth infuriated, especially in regards to how dealers get youth started.

“They give it away at parties just to hook them,” said Elizabeth, who has shared all the information and contact information from Facebook messages with police to help their efforts. “You know how we tell our kids don’t take candy from a stranger? It’s the same with drugs. If you knew taking that one hit, to give you that high, could end up like Sam that next day, unable to walk, throwing up because every muscle in her body hurt, you’d realize it’s not worth it. It’s horrifying. Plus it could kill you the first time.”

Having watched her friends Jeff and Hollie Crist bury their son Brandon, who died at the age of 22 in September due to a heroin overdose, Elizabeth knew she had to publicly share her family’s story. She posted about it recently on Facebook and willingly shared the story with this paper in the hopes of making people aware of the dangers.

“The one person who was going to call 9-1-1 to save Samantha’s life that night was Brandon Crist. I don’t believe we’ve gone through this to just be quiet about it,” Elizabeth said. “We would miss the whole point.”

Meet Brandon Crist (1993-2015)

Jeff and Hollie Crist hold a picture of their son Brandon, who died of a heroin overdose in late September. (KEIZERTIMES/Craig Murphy)
Jeff and Hollie Crist hold a picture of their son Brandon, who died of a heroin overdose in late September. (KEIZERTIMES/Craig Murphy)

Of the Keizertimes

Brandon Crist’s parents were going to kick him out of the house.

The 22-year-old had once again been caught doing drugs. Though they loved him dearly, Jeff and Hollie Crist couldn’t let him live under their roof anymore.

They never had the chance to kick him out.

Two days after Brandon didn’t show up at home, Hollie’s motherly instincts proved to be sadly correct when the officer knocked on the door.

Brandon had been found dead in his van after a heroin overdose.


The death has been jarring to many who knew Brandon, some of whom thought he had finally kicked the drug habit that had plagued him for so long. Brandon’s death was a key factor behind the Chasing Dark series of stories in the Keizertimes.

The death has been most jarring to Brandon’s parents.

“Both Jeff and I were so devastated that he was all by himself for two-and-a-half days in his van,” Hollie said last week. “Then I wanted to say goodbye and kiss him one last time and was told at the funeral home they suggested I not see him. So we never got to say goodbye.”

In Brandon’s last year, he had moved back home to Keizer. His parents thought he was clean, only to find out he wasn’t. Instead of using suboxone, an opiate blocker that is designed to help block the craving for heroin, Brandon was selling suboxone pills to pay for heroin.

As far as Jeff was concerned, when he came from work Monday, Sept. 28, he was kicking his son out of the home.

“I’d had enough,” Jeff said. “I was done. Putting me through it, that’s fine. But his mom is emotional, with all the ups and downs this puts her through. It wasn’t fair to her. Considering all the things we’d done in the last eight months, we spent a lot of money, fixing cars, buying stuff.”

When Hollie got home on Sept. 28, she noticed Brandon had left his Facebook page open on a laptop in the house.

“I saw his private messages,” Hollie said. “I called his last phone numbers he’d called. Anyone he contacted, I texted them. He was selling suboxone. I was frantic. I put a Facebook post out to his friends about him being missing. He didn’t want us to see anything. He just randomly left the computer open that day. I felt this was a God thing, because I was able to reach out to his friends.”

Hollie knew something was wrong at that point.

“When I looked out Tuesday, his van wasn’t there,” she said. “He would always call or text if he didn’t come home. I called all the hospitals, jails, rehab centers. I knew. I started worrying Tuesday morning when he didn’t come home.”

Jeff wasn’t as concerned initially.

“I just thought he would come back and I would kick him out,” he said. “I was done. I didn’t want to see him again.”

Jeff then turned to Hollie.

“You said, ‘You know he’s not coming home,’” Jeff said.

Hollie looked at her husband and nodded.

“You said, ‘He is too,’” she said. “That Wednesday at about 8:45 p.m. we got the knock we’d feared for five years.”

It was a Keizer Police Department officer knocking on the door.

“He said, ‘Is Hollie here?’” Jeff recalled. “I said yes. Then I said, ‘So you found him?’ He wouldn’t say until he could talk to Hollie.”

When Hollie came to the door, the officer explained Brandon’s body had been found in his van in Salem.

As with other addicts, there were two Brandons.

“He’s outgoing,” Hollie said when asked to describe her only son. “He was always smiling when not using drugs. Anyone who met him liked him. Any rehab place we took him to, they said he was awesome. He had a great heart. He was a good kid.”

Jeff said Brandon’s charm was apparent to all who got to know him.

“All of our friends liked him,” Jeff said.

Troubles started in eighth grade. After going to a private Christian school in Salem previously, Brandon decided to start attending Whiteaker Middle School.

“In eighth grade it started with alcohol and pot,” Hollie said. “He didn’t feel like he fit in. He didn’t have a group to gravitate to. The kids who were experimenting (with drugs), he was gravitating to them.”

Police reports obtained by the Keizertimes show a history of a young man in trouble with the law, mainly for drugs and behavioral issues, dating back to when Brandon was 13.

Things progressed when Brandon entered McNary High School. He started running away and doing other drugs like ecstasy. At age 15 the Crists sent Brandon to a boarding school in Costa Rica.

“He was skipping school, running away, being defiant,” Hollie said. “It was good for a while when he came back. Then it went downhill again. He lied about who he was seeing. He probably started doing heroin at 17.”

Hollie said Brandon eventually admitted to doing heroin, cocaine and speedballs, a mixture of the two.

“He and his friends wanted to try all the drugs,” Hollie said. “Heroin was the one that hooked him.”

Over the course of several years, Brandon was in and out of detox centers. He went to one in Portland three separate times – two weeks each time – but didn’t finish the third time. There was a week spent in a Eugene detox center. He got a diploma for completing 45 days at a detox center in Klamath Falls.

“He was just a troubled kid,” Jeff said. “I don’t know what to think. He was a good boy before all of this. You never think it will happen to you, or to your kid.”

In July 2013 Brandon was arrested by Detective Chris Nelson of the KPD for unlawful possession and delivery of heroin.

“Brandon said when Chris Nelson pulled the gun on him and he went to jail for the first time, that’s when he decided to get clean,” Hollie said. “The arrest was the best thing that happened to him. We had him back for a year.”

As mentioned in a previous Chasing Dark story, Brandon entered a detox center and then transitioned to a long-term rehab center. He talked with Nelson about once a month.

“He showed interest when he got out of the treatment center about talking to kids about the dangers of drug use, particularly heroin, and the devastation it hails on individuals and families,” Nelson said. “Brandon fought hard against the dark and evil addiction to heroin. He gave himself a glimpse of freedom and you could hear energy and excitement in his voice when he was drug-free. Unfortunately, he relapsed after treatment and the addiction to heroin ended his life.”

Hollie also noted the change in her son.

“He was clean for 11 months,” she said. “He was pumped about it. He was happy. He was going to be a drug and alcohol counselor. He found a friend in Bend. He was going to live in a youth shelter, then a Sober Living house in Bend.”

In an Oxford House, recovering addicts live together in transitional housing, support each other and go to Narcotics Anonymous meetings together. In short, it’s a large support group.

“He was always going to meetings,” Jeff said. “He knew exactly how many days he’d been clean.”

Suddenly, things fell apart.

“We’re not really sure what happened,” Hollie said. “He called, crying and said he was going to move out. He said he was going to have a drink. He was struggling with step four of the recovery, which is coming to terms with who you’ve hurt. He moved out but didn’t have a place to live. I think it was to use heroin. I have no idea what happened, no clue. I thought he was doing fine.”

Brandon came back to Keizer, but continued using drugs. He didn’t want to go to Narcotics Anonymous meetings, since he wanted to go to bars with friends.

Hollie said it became clear when Brandon was on heroin.

“He was negative when using,” Hollie said. “The poor pitiful me thing. Everyone was out to get him. He wasn’t nice. He didn’t smile a lot and was always unhappy. When he was clean he was smiling, happy, outgoing, family oriented. But he missed my birthday and Mother’s Day five years in a row.”

In addition, Brandon would come home late, constantly be tired and nodding off.

“He alienated himself,” Hollie said. “He was definitely nodding off with the heroin. He looked bad. He was very thin, had lost a lot of weight, had dark circles under the eyes. He wouldn’t shower. His nails would be dirty. He used black tar heroin, which would be under his fingernails. He was washing his clothes all the time. There was a real personality change. They’ll get very defensive when you confront them.”

Jeff said parents suspecting drug use need to trust their instincts.

“If you think there’s something wrong, there’s something wrong,” Jeff said. “Don’t doubt it.”

Hollie said nothing else could have been done to help Brandon.

“We tried everything,” she said. “We did everything. He had every opportunity to get clean. The times he went to detox, he just did it for us. It’s an internal thing. It has always been his choice (to get clean). We loved him to death and would have done anything, but it had to be his choice to get clean.”

After bouncing between Keizer and the Bend area, Brandon came back to Keizer in October 2014. He had trouble finding work due to his felony history, but in September – just two weeks before his passing – Brandon got a job at a call center.

“He told them before being hired about the felony,” Hollie said. “I do human resources, so I told him to tell them right off the bat. They knew about it and they hired him. He was so excited about it. Three days in, he got a tap on the shoulder and was terminated. He was devastated. I wonder if that’s the excuse for what set him over.”

Hollie still feels anger.

“I get mad at Brandon for doing it again and for leaving me,” she said. “I know he wouldn’t want me to see him using. I’m mad at myself for not catching it. I’m mad at myself and at him.”

Hollie said her son didn’t want to be remembered for his addiction.

“He never wanted to be known as a junkie,” Hollie said. “He would hate that. But that’s how people are remembering him. He would just be devastated. He had a lot of shame and guilt in being an addict.

“He was the addict,” she added later. “He chose to do it. He couldn’t get out of it. It’s a disease. People don’t choose to get cancer, but he chose to do drugs. I don’t think he knew what he was getting himself into.”

The pain can be felt in Brandon’s obituary, which includes this line: “Brandon put up a good fight with his addiction, but sadly lost the battle. He is finally at peace and will be deeply missed.”

Hollie recalled one Christmas gift from Brandon.

“He had stolen our camera,” Hollie said. “So he brought us a camera, which he’d probably stolen from someone. It was just a box and a camera, nothing else. I know he had guilt about stealing. He wasn’t stealing, it was the drugs. He would rather sell drugs than get money from stealing things.”

Now it’s Jeff and Hollie thinking about their son’s life being stolen away.

“A lot of friends have helped us through it,” Jeff said. “I think about it every day. I’ll drive somewhere and I’ll remember Brandon. It could be places we would go, or I’ll see a white van. I think about it every day, all the time.”

Hollie still hasn’t completely processed the loss of her son.

“I’m more numb still,” she said. “I sleep with his coat. We haven’t touched anything in his room. He was the love of my life. I just adored him. I told him I would lay down in the road and die for him in order for him to be clean. That drug just got him really bad. It’s just the most awful thing ever.”

At Brandon’s memorial service, a mom wrote in the service book her son was going down the same path Brandon had. She asked for Hollie to call her.

Hollie tearfully said last week she hasn’t made the call yet.

“Right now I don’t know how to help somebody,” Hollie said. “I didn’t even know how to help my own son. We did everything we possibly could. I hope this story helps one kid. That’s what Brandon would have wanted. His message would have been don’t ever start.”

Ideally, Hollie would love for more than one addict to be saved after hearing Brandon’s story. But even if that happened, it wouldn’t replace the hole in her life.

“It would feel good, but it wouldn’t make his death any easier,” she said.

Harm reduction offers hope in increments


Of the Keizertimes

Chris Gray is in the business of starting conversations with injection drug users.

“Once someone engages you and says, ‘I want to use a clean needle,’ that’s the beginning of some sort of contemplation,” said Gray, harm reduction outreach specialist for the Benton County Health Department.

The Benton County harm reduction program is one of the nearest harm reduction and needle exchange programs to Keizer. Marion County offers no such service and calls and e-mails for comment on the current status of the local conversation went unreturned.

However, such programs are proven in their effectiveness when it comes to not only weaning drug abusers off their habits, but containing outbreaks of potentially lethal diseases such as Hepatitis C and HIV. Earlier this year, Austin, Indiana, was the epicenter of one such outbreak – nearly 150 cases of HIV were diagnosed in a short span of time  after widespread needle-sharing was uncovered.

Benton County’s program offers a 24/7 needle drop box, a decentralized network of secondary needle exchange nodes, rapid HIV and Hep C testing, access to Hepatitis A and B vaccinations and can even hook up users with detoxification centers and provide transport. All of it is free of cost to those in need and the supplies only set the county general fund back about $38,000 per year.

“There’s additional outreach prevention time, but that’s what it is for materials and supplies,” said Charlie Fautin, deputy director of Benton County Health Department.

In return, more than 50,000 needles are kept off the street and out of landfills each year.

Getting started

When Benton County began looking at the possibility of offering a harm reduction program in 2002, officials started by talking with anyone who might have a stake in the issues surrounding injection drug use.

They started by surveying as many active injection drug users as they could find, about 150.

“About 53 percent of the users surveyed said they frequently, often or always shared needles,” said Fautin. “But we also surveyed them as to what services they would use to help them get off drugs.”

Fautin said officials spent the better part of a year in community conversations with local leaders about the science behind harm reduction programs and attempted to allay fears about what such programs represent.  Harm reduction programs often spark two polarizing views. They are either cast as “enabling abusers” or “saving lives,” and Fautin said Benton County met with both types of individuals.

“The compelling arguments were preventing infection and preventing health care costs, but the enablement argument comes up all the time. There are those who believe that zero-tolerance is the only approach, but there is consistent research that shows harm reduction programs deter the transmission of blood-borne diseases,” Fautin said.

Washington state was an early adopter of syringe exchange to curb transmission of HIV and hepatitis among drug injectors. Now, its rate of cumulative AIDS cases attributable to injecting drug use is the fifth lowest in the nation.  One study found every $1 invested in syringe exchange saves $3 to $7 in HIV treatment costs.

Fautin said some of the harm reduction program’s biggest supporters are now law enforcement and solid waste disposal suppliers.

“We get quite a bit of support from law enforcement because they don’t want to pat someone down and find needles. We’ve also gotten support from the solid waste disposal folks because they don’t want their employees in danger while carting away a trash can filled with sharps,” Fautin said.

When budgets are tight, the program usually ends up in the crosshairs, but the science-founded arguments have kept Benton County’s harm reduction program going.

Establishing harm reduction programs at the local level is also easier now than it was in 2002. The North American Syringe Exchange Network offers start-up kits for new needle exchanges, $1,200 gets the organization credit with the Buyers’ Club and is equal to about 14,000 syringes or a combination of syringes and other supplies. There is currently a ban on using federal funds to establish and operate harm reduction/needle exchange programs.

How it works

While Benton County offers the drop box for round-the-clock disposal, county officials rely on a decentralized network of distribution partners to get most of the used needles off the streets.

“One of the basic principles is reducing harm to the self and others,” said Gray. “The way we operate now is we make contact with leaders in local communities and they can be someone in a homeless camp or a trailer park or just someone in their own home. Most of them have Hep C or HIV and they have a vested interest in reducing harm to others.”

Those individuals are selected to operate secondary exchange sites and given supplies of needles to exchange for used ones and sharps containers to collect used needles being turned in. Gray and the county operate the secondary exchanges on the honor system. Sometimes secondary exchangers don’t even need to give their full name.

“We’ve been very lucky to have low turnover in Chris’s position and that’s given us a lot of street credibility to make the right contacts with people in a position to help us,” Fautin said.

Gray also offers rapid HIV and Hep C testing that he performs out in the community away from the spaces – county health clinics – where some might fear “an ambush” by government employees.

A solution in stages

While harm reduction programs are by no means an end-all solution to injection drug abuse, Gray said keeping the focus on incremental improvement shows their effectiveness.

“Seeing someone go through the stages of harm reduction is the most powerful thing. They’ll move from using and sharing needles to not sharing to using less to deciding to go into rehab to asking if I can get them a bed in a detox center,” Gray said.

Fautin said buying into such programs requires doing the legwork of starting community conversations, but also fundamentally shifting perceptions of drug abusers.

“People tend to think of addicts and users as totally irresponsible. It increases impulses and reduces inhibition, but there are people dealing with HIV or Hep C and they want to protect their friends and acquaintences who are at risk,” he said.

Fautin has been surprised in recent years to see the number of requests for needle drop boxes grow, even within the more rural areas of Benton County.

“We go out and talk with some of the local town councils and pretty soon someone asks if they can get a drop box in their area,” he said.

While law enforcement can stem, at least temporarily, the tide of drugs available, Gray said the real resolutions come from seeing an addict not just as an addict but as a person.

“Addicts are not going to go away, they are our brothers  our sisters, our mothers, our fathers. We can choose to ignore them or choose to engage them,” Gray said.

‘She did not want to die’


Of the Keizertimes

If need be, Sue doesn’t mind being blunt when it comes to drugs.

“If you gave people a loaded gun and told them to put it to their head, they wouldn’t do it,” Sue said. “But that’s what they do with heroin. It’s the same thing.”

Unfortunately, Sue has some experience with the topic. Her daughter, Peggy (both names have been changed for this Chasing Dark story), died this summer after an infection from needles. Peggy had heart issues and used drugs for years, in particular heroin.

In last week’s Chasing Dark story with members of the Keizer Police Department’s Community Response Unit (CRU), there was an emphasis on how addicts have to be willing to make the choice to get clean before any change can be seen.

“If you’re an adult, are you ready to stop? You can tell me ‘I’m a drug user,’ but if you don’t say ‘I’m done with this,’ you are not ready for treatment,” CRU member James Young said. “Until they’re ready, they’re not going to go.”

Rehabilitation is also seen as a key way to help addicts, especially once they express a desire to get better. Sue questions the part about waiting for addicts like Peggy to indicate a desire for change.

“Rehab is a complete joke with heroin addicts,” Sue said. “I know for a fact she scammed her way through rehab with her meth addiction. She would have her kids pee in a cup to pass the UA (urine analysis). She was good at that.

“In rehab, they say you have to hit your bottom,” she added. “Peggy didn’t have a bottom. We were sure she would reach the point where she would do the work (to get better). Losing her children wasn’t her bottom. Having open heart surgery wasn’t her bottom. Knowing she would die from this addiction was not her bottom. Waiting for them to ask for help isn’t the answer. Being she was dying in the hospital, we said goodbye to her three times. That wasn’t enough to keep her clean. That wasn’t enough.”

Peggy’s addiction got so bad, the state stepped in and removed her children from her home.

“When her kids were taken away because of the heroin, Peggy had a year to get clean,” Sue said. “It took her months to even get in the game to schedule the first visitation, because she wasn’t ready. That was the heroin talking. She was the most devoted mother when she was clean. She was mother of the year material. But with heroin, you can’t feel. That’s not the answer, waiting for a heroin addict to say, ‘I’m ready.’”

Even as her daughter struggled with various drug addictions for years, Sue kept the lines of communication open. In last week’s story, Young pointed to that as a key.

“The biggest thing is be involved,” Young said. “Users are distancing themselves with the drug. When you see them spending time alone, bring them into the family unit again, especially with juveniles. They are using that as a replacement for something lacking, which is often family. You have to make sure you’re all together mentally.”

Sue had the same approach.

“Building trust and respect early on is a huge thing,” she said. “Peggy could talk to me about anything. Making sure the kids feel respected so that they don’t feel they’re being judged, that’s a big thing in our house. I don’t agree with the notion about not being your kid’s friend. You need to treat them with respect, like any other human being. That worked with my other four kids. They can tell me anything. It worked. The drill sergeant thing just breeds hiding and lying. Then the parents are the opposition.”

Sue knows Peggy smoked weed in high school and then moved on to meth before turning to heroin. But in the midst of that, mom was there.

“I made her talk to me every day,” Sue said. “Through all of this, I always made sure she stayed connected. I listened without judgement. When she did meth, I called the police and she was in jail for a month. I made her tell me what was happening, not that it was okay, but I made sure she stayed connected to me. I listened because I needed to know and I needed her to know she could talk to me about it. There was a lot I didn’t want to know.”

And yet, even with that communication, even being there for her daughter, Sue still had to deal with the pain of losing her daughter to drugs. In some ways, it made her question the approach.

“That’s what I felt was right, but it didn’t change anything. The outcome was still the same,” Sue said quietly. “Of course you want to be there for your kid and not be judgmental. It’s not because she was a bad person. She didn’t grow up on the streets or in a bad situation. She was raised in a suburban upper class home. In the end, heroin is such a bad drug, there’s nothing that my being there could change. She was locked in.”

Though she isn’t certain, Sue believes her daughter’s first experience with drugs fueled a habit that caused escalating destruction.

“The ritual of escaping, that opens the door to all the rest of it,” she said. “Then your mind is open to the next thing. You give yourself permission to do the next thing. There’s nobody who did heroin who didn’t do weed first.

“The solution is keeping people from doing it the first time,” Sue added. “Once you’ve done it the first time, it’s too late. It’s supposed to be the best high ever. I don’t want to know. It’s just a culture as far as escapism. There’s got to be a better way to cope with whatever it is.”

Over time, Sue picked up on cues that indicated when Peggy was on heroin.

“The first thing I can remember in figuring out she was doing something was that she had no concept of time,” Sue said, remembering one holiday season. “She would bring the kids over and would be four hours late. With school, her kids were not getting there on time. She completely lost track of time. A lot of naps and sleeping are involved. They steal Q-tips and lighters. You will see a lot of Q-tips around your bathroom. And there are a lot of pick marks. It was mainly her face. If she picked, I knew.”

There were also the eyes: dilated pupils meant Peggy was on methamphetamine, while pinpointed eyes meant an opiate (heroin is an opiate).

Sue, who called anti-drug efforts like DARE (Drug Abuse Resistance Education) “worthless,” said Peggy told her she got bacteria from a dirty needle.

“She said she had a bladder infection that got into the kidney and the blood stream,” Sue said. “If she was not doing heroin, it wouldn’t have happened.”

In Peggy’s final year, she was in and out of the hospital. A week before Peggy’s death, Sue discovered used needles in her closet and realized her daughter was using again.

“I didn’t know the infection had come back,” Sue said. “I didn’t know she was sick again. So a week before she died, I kicked her out of the house. Knowing that she would die, she still used. It was basically suicide. It was the air she breathed. She couldn’t kick the habit. You just get this tunnel vision and you don’t see anything else that’s going on.”

After Peggy’s passing, the family went to the funeral home and got a rude surprise.

“They said they needed to do special handling of the body due to Hepatitis B,” Sue said. “Never had we heard about that. I wonder if she got that in the last week.”

That put the exclamation point on a sad ending, which leaves bad memories for the family.

“The last year of her life was so traumatic,” Sue said. “That’s what you’re left with, it’s just yuck when you see someone so unhealthy. The Peggy we knew the last couple of years was a train wreck.”

Peggy’s passing brought out anger in her mom.

“I was mad at Peggy,” Sue said. “When the doctor said there was 0 percent chance she would make it, I went straight to anger. I was mad for a good month, just fuming. That wasn’t the Peggy I know. The Peggy I know, I’m not mad at her.”

Sue said her daughter was an amazing woman who was great with crafts – when clean.

“Her kids were everything to her,” Sue said. “She was always all about doing craft projects with them. She was very creative and so crafty. It was terrible to take her to a place like Michael’s, because you couldn’t get her out of there. A card from her wasn’t just a card. When she did birthday cards, she would do 3-D pop out things. It would be like a cityscape. She would sit there and make signs and cards for other people.

“Everything she did, she would do 110 percent,” the mom added. “She was always about helping everyone and taking care of everyone else. She was a really good person when she was not clouded up by her demons.”

Sue is sure the Peggy not clouded by the demons didn’t want a tragic ending.

“She did not want to die,” Sue said. “She wouldn’t have put a gun to her head.”