For all the devastation and death connected with the opioid epidemic, this is also true: There is hope.
People can and do work their way into recovery. It is hard, and far from inevitable, but it does happen. For some, in-patient treatment, medication-assisted treatment, a 12-step program, or all three together, repeatedly, prove pivotal.
Others find their drive to recover in the love of their family and children, the death of someone close, the intervention of someone who believes in them, their faith in a power greater than themselves.
Here are the stories of four people in the Philadelphia area working every day to maintain recovery. They are sharing their stories in hopes of helping others seek their own roads to recovery.
Rachel Krauser Carpenter
Lives in: Royersford
Beginnings: Raised in Malvern in "a nice Jewish family" with two siblings, a doctor father and a teacher mother. In Great Valley High School, she had friends, but "I always lived in a fantasy world. I was always looking to escape. I was looking to be anyone other than me."
The first taste: "I was 9. I was at a wedding. I remember drinking the champagne, and the shyness – poof! – just disappeared. All the years of my active addiction, I chased that feeling."
Introduction to opioids: In high school and college, she drank and smoked pot. In 1991, as a student at Penn State, she had a boyfriend who sold drugs, including heroin. "The first time I did it, I remember it filled that hole inside of me so perfectly. I thought everyone feels this way: At peace. At peace with who they are, at peace in their own body."
Chasing the dragon: Between ages 23 and 30, she estimates, she went into treatment "probably around 20" times. She shoplifted to finance her habit. "My life got smaller, smaller, until it was just me and the drugs."
A respite, then relapse: At 30, she achieved recovery long enough to get married and have two children, now ages 10 and 13. But in time, she stopped going to 12-step meetings and keeping in touch with recovery friends. Her marriage was faltering. "I think I was really unhappy, and I forgot who I am, what I am. I'm an addict. I can't just have a drink. I can't just smoke weed." At age 37, she relapsed hard. "It was ugly and awful." She went to Kensington to score heroin and was held up at gunpoint. But that didn't stop her.
What made the difference: By spring 2014, Carpenter yearned for a way out. She heard of a University of Pennsylvania program testing Vivitrol, a monthly injection of the recovery drug naltrexone, which blocks the brain's opioid receptors and lessens cravings. That, plus getting back to 12-step meetings, helped her put down the heroin. But she was still using cocaine. Her parents gave her an ultimatum: Get clean, or they would help her estranged husband get permanent custody of their children. "That was a consequence I was not willing to live with," she said. That day, she entered Malvern Institute.
Recovery: Carpenter spent about a month at Malvern. After discharge, she went to at least one 12-step meeting a day for the next 90 days, and paid follow-up visits to Penn as part of the Vivitrol trial. Now three years clean and sober, she is engaged to a man also in recovery; he had helped her into Malvern. They live in Royersford and operate recovery homes for people trying to stay sober. She and her ex-husband have joint custody of the children. She is in a graduate program to become a recovery counselor.
Parting thoughts: "We're not bad people. We're sick people. When we get well, we get better. Through recovery. I started to learn to be a better version of me, and that's something I continue to work on every single day."
Lives in: Philadelphia's Mayfair section
Beginnings: Figueroa-Vargas was 7 when his family moved from Puerto Rico to Philadelphia. His brother Luis, about 15 years his senior, became addicted to crack cocaine and landed in prison. After his release, on New Year's Day 2002, his family found Luis dead after he had overdosed on a speedball – cocaine and heroin mixed.
Introduction to opioids: "I didn't think much of drugs, especially watching what my brother went through," said Figueroa-Vargas. "I never picked up marijuana, cigarettes, caffeine, any of that." But at 25, he was in a motorcycle accident and was prescribed an opioid pain medication, Percocet. Then living with a girlfriend and their child, he was devastated when they left. The pills helped take the edge off, but he needed more and more to get the same effect. He thought he was OK because "the doctor was giving them to me."
Addiction: Soon, the doctor would not renew the prescription, but withdrawal symptoms were so bad that Figueroa-Vargas bought pills on the street, and added anti-anxiety pills to intensify the good feeling. He worked up to 50 Percocets a day and was arrested for driving under the influence. He lost his job, started losing friends. He sold drugs to pay for his habit. He started dabbling in heroin — cheaper, stronger, and exactly what he thought he never would use.
Redemption: Five years after he started on Percocet, Figueroa-Vargas was arrested for retail theft. His parents went to court hearings, pleaded for him to be sent to drug treatment. His mother prayed for him.
In 2011, he was alone in a prison cell, sick from withdrawal. "I remember feeling the presence of something greater than me, which to me was the spirit of God, the Holy Spirit — something telling me I was going to overcome this. I remember immediately after that being able to hear the birds chirping outside. I remember smelling grass being cut. My senses came back to me." Invited to be the prison chaplain's translator, he studied the Bible. He was released to an in-patient drug treatment program, Nuestra Clinica Residencial in Lancaster. From there, he went to outpatient treatment. He joined his counselor's church. "I've been there ever since."
Sober life: After earning his G.E.D., he earned degrees from Community College of Philadelphia and Eastern University. He married a woman who stood by him while he pursued his recovery. They have a new son. He works as a program manager with the Mental Health Association of Southeastern Pennsylvania, helping the homeless, including those struggling with substance abuse.
When he meets people in the Kensington area's notorious heroin encampment, he tells them: "Things could be a lot worse, even if it seems to be the end of the world. Look at my brother. He doesn't have the option to seek recovery. Folks still here have the option to make some different decisions."
Parting thoughts: "I believe there are many pathways to recovery. Faith has been my pathway to recovery. You have to have will. You have to want to change things. Recovery is possible."
Lives in: West Philadelphia
Beginnings: Raised in Cape May Court House, an only child, by a single mother. She was sexually abused by a male relative between the ages of 2 and 4; the abuse ended when her mother found out about it. "My mother worked a lot, so I was always by myself," she recalled. "I rebelled against anybody who tried to order me around. I had a lot of personal issues from the time that [abuse] happened that never got dealt with."
In high school, she gave birth to a daughter. After she graduated, her mother moved to Hawaii and took the child. Staley stayed behind, living on public assistance.
The first taste: "I was 12 when I took my first drink and smoked my first blunt. It made everything go away."
Addiction: She progressed quickly to pills: tranquilizers, stimulants, opioid painkillers. "Anything that would take me away from how I felt." She got drugs from people she knew and went to doctors complaining of made-up injuries to get prescriptions. By 18, she was snorting heroin and smoking PCP, but heroin was "better than anything I'd ever done. Heroin was my best friend."
The life: She had a second baby, who was sent to live with a relative. After she lost her public assistance because she didn't follow program rules, she got a job, briefly, at a strip club in South Philadelphia. "I started smoking crack cocaine, and that's what basically took me all the way down."
For the next two years, she was homeless. She slept under I-95 or behind a South Philadelphia Walmart. She panhandled along Columbus Boulevard to get money for heroin. She ate only when people gave her food, and dwindled to 82 pounds. She tried to kill herself by overdosing.
Sam Santiago, an outreach worker with Project HOME, brought her food, urged her to get help. Staley feared going into withdrawal. Now she realizes she also feared "all the emotions I'd buried for so long that I'd never dealt with, and knowing that when I became sober, it was all going to come out, and how was I going to be able to handle it because, before, I always handled it with drugs."
What made the difference: "Having someone to believe in me and see the good through all the bad. Sam was that believer."
Getting clean: In late September 2016, Staley finally told Santiago she was ready. He got her a drug treatment bed at the Girard Medical Center of the North Philadelphia Health System, where she detoxed for five days on methadone. It made the pain bearable. She went to Womanspace, a nonprofit shelter in Germantown for women with substance-abuse and mental-health problems. She found support, stability and counseling to deal with the pain of her past. "It was a joy to wake up and not have to depend on something. It felt like freedom."
Life now: Recently, Staley marked seven months clean and sober. She goes to 12-step meetings and has a sponsor. She works at a grocery store, and just moved into her own apartment. Her next goals: become a medical assistant and get her children back.
Parting thoughts: "If you really want the help, you can get it. People don't want to ask for help. People may enjoy getting high, but it only leads to death, jails, and institutions. There's no happy ending."
Lives in: Penn Wynne
Beginnings: Raised in and around Wynnewood, with some years in South Jersey and South Florida and back north again as his parents divorced and remarried. Except for some relatively stable years with grandparents, his childhood was marked by abuse, neglect and abandonment. "I was scared more than anything," he said. "It was just an unhealthy childhood."
First high: "I used my first drugs when I was 8 years old, smoking pot with my father. ... That was kind of a normal thing. That hippie time." About three years later, he said, he did his first line of cocaine with a stepmother.
Introduction to opioids: When Salop was 19, he was plagued by persistent earaches. A family member gave him a few Percocets, an opioid painkiller. "In 10 minutes, my life changed," he said. "That fear, that uncomfortableness in my own skin turned into, 'I'm OK.' And that was a big lie. I chased that feeling for 30 years."
Addiction: When Salop was still a young adult, his mother, then a South Florida real estate agent, went to prison for several years on federal cocaine charges. An aunt and uncle offered to pay Salop's way through restaurant school, introducing him to a trade that took him to France and some well-regarded restaurants. Like his father, he also worked in the car business. While he was desperately afraid of needles, he tried all kinds of drugs. "But opiates and alcohol were the ones in the end that really tore me apart. Brought me to my knees."
The turning: In the final days of 2013, he was facing felony drug charges and potential prison time. His aunt and uncle stepped in again, this time asking him whether he wanted to get into treatment. He had not tried that before. He said yes.
After 30 days as an in-patient at Caron Treatment Center at Wernersville, Pa., he managed to get an additional four months through its Extended Care program. From there, he went to the Retreat in Minnesota for 30 days of treatment and a year in one of the Retreat's sober living recovery houses. He says long-term treatment was crucial to his recovery. "I needed to learn how to live."
Salop participated in Caron's My First Year, which helps alumni stay in touch and accountable by telephone. He also takes part in a 12-step fellowship. He said he is working to make amends for the wrong he has done and to forgive those who have hurt him.
He stayed out of prison and now works as a chef and house manager for a treatment program. He says he prizes his sobriety above all else.
Parting words: "It's been a real gift.