Kate is 25 and began drinking, smoking and experimenting with prescription drugs when she was a teenager in Washington County.
“I started doing pills in high school, 15, I think. Something just happened in high school and I just was, you know, curious and then it just turned into doing it too much."
Her name has been changed to protect her privacy. When the pills that sustained her became too expensive, and she turned to heroin as a substitute. Kate said nothing about her upbringing lead to her addiction.
“I come from an amazing family," she said. "My parents were awesome; I was raised a Christian.”
Like many others addicted to opioids, Kate doesn’t fit neatly into a stereotype of a hard-core drug user.
“Twenty, thirty years ago in your mind you put heroin overdoses in certain demographics, certain parts of the city" said Allegheny County Coroner Karl Williams. "Not anymore.”
Williams has watched the number of opioid overdose deaths tick up for years in his jurisdiction, from 100 in 1995 to 307 in 2014. Nationally, opioid deaths from both prescriptions and heroin leapt from around 11,000 in 2001 to more than 31,000 in 2013, according to the Centers for Disease Control and Prevention.
Many attribute that jump to the proliferation of oxycodone, which laid bare a susceptibility to addiction. U.S. Attorney David Hickton said in 2012 doctors wrote 259 million prescriptions for opioids, enough for a bottle of pills for every American adult. Some people had a hard time weaning themselves off those painkillers, and heroin provided a cheaper high to opioid fiends. Hickton said addiction is often misunderstood.
“It’s the only illness where we pretend like it’s the fault of the person who’s sick,” Hickton said.
He and others aren't standing still, hoping the crisis will dissipate. Hickton is co-chairing a federal Heroin Task Force charged with gathering best practices for combating the opioid addiction epidemic. Though he's a prosecutor, Hickton said he knows this problem can’t be solved solely through the courts.
“We’re working on the supply side, but to fully and fulsomely deal with the problem, you have to work equally on the demand side to dry up the demand for these drugs,” he said.
In the short term, Hickton praised the passage of a Pennsylvania law equipping police and first responders with naloxone, a drug that can reverse the effects of an overdose and save lives.
Williams tallies the lives that are not saved. He said his open, online database Overdose Free PA can help stem the crisis through information.
“My role is to try make those statistics as open to the public as possible," Williams said. "The more people can see what the drugs are, where they’re coming from (and) what the ages are, the more that it’s obvious to the public and to the people in an open way what the problem is.”
Neil Capretto, medical director for Gateway Rehabilitation Center explained that rehabilitation and treatment programs need to approach addiction as a disease that requires constant vigilance. He said getting into treatment is only the first step.
“This is a chronic condition," Capretto said. "You have to work on it over the long term. When I lecture my patients, I say it’s like going up the down escalator. There’s really no such thing in early recovery as standing still. If you neglect it, it’s going to pull you down.”
Kate knows what it’s like to fight the down escalator. After stints in rehab in 2010, 2013 and again this year, she says this time is different.
“I’m pretty sure I’m done," she said. "I have a daughter I love more than anything, and it disgusts me when I think about the fact that I’m here again and I have her. I feel as though I’m done, and and I know how to go out there and what works for me and I know how to stay clean. That’s exactly what I’m going to do.”
Breaking the bonds of drug addiction is crucial said Attorney Hickton. It’s not just about reducing the number of lives lost, but the number of lives wasted.
The Heroin Task Force’s report is due to the attorney general, the president and Congress in December.