'It's like you're grieving a death that hasn't happened yet': Harsh realities of the opioid crisis
The opioid crisis in Kentucky and Indiana through the eyes of addicts, their loved ones and the people hoping to help.
Author: Shay McAlister, Heather Fountaine, John Charlton, Chris Williams, Brooke Hasch, Andrea Ash, Lisa Hutson, Lena Duncan, Taylor Weiter
Published: 5:24 PM EDT June 27, 2019
Updated: 12:47 PM EDT July 2, 2019
FOCUS 6 Articles

The stories shared both online and on-air may be difficult for some to watch and read.

Opioid addiction affects every single person. For some, every day is spent trying to find a clean needle or quick buck to satisfy an addiction. For others, every waking minute is spent trying to help loved ones overcome their addiction. And for those who have not personally dealt with addiction, every state effort to fight the ongoing crisis takes from taxpayers’ money.

While those struggling with addiction are often judged or looked down upon, they were the first to admit that their lives and the lives of their loved ones are not lives any person would openly choose. Instead, many said their current situations are a result of one decision – often made from desire or need.

One decision that changed millions of lives, that turned a businessman to the street or a mother to support groups. One decision that turned into a lifetime of struggle.


'It's like you're grieving a death that hasn't happened yet': Harsh realities of the opioid crisis

Chapter 1

A Life on the Streets

One woman's mission to help Louisville's homeless

Christen 'Tiny' Herron Markwell has been surrounded by addiction for most of her life. Her father, a preacher, worked at a small church in Old Louisville. Though the congregation was small, Markwell said the doors were always open – bringing people from all walks of life into each pew.

“From a really early age I learned what addiction was and what prostitution was, but I was taught to love them and not shun them,” Markwell said.

Seeing how desperate people were for help, Markwell put her father’s teachings into action, founding The Forgotten Louisville in 2005. The nonprofit is dedicated to helping Louisville’s addicted and homeless residents.

"I called it The Forgotten Louisville because we are a city full of resources – we have lots of resources for the homeless, we have lots of resources for substance use disorder, but for whatever reason they don't get tapped into like they should,” Markwell said.

Every week, Markwell and a group of volunteers hit the streets, talking to people – providing help if needed. They go to the corners of town with horrible reputations, getting to know each person for who they are, not what they do.

"We’ve really just tried to come out here and hang out, get to know the folks, know their names and their stories and how we can help them,” Markwell said.

Some do not want help – doing anything they want to get what they need to satisfy their addiction.

"I ain't gonna lie, I spend probably $40 to $45 a day on it. How I get my money? I panhandle, fly a sign, however I can,” one spice addict said. "We're addicts, you know what I'm saying?"

But when they do need help, Markwell and her team are there, taking people to detox, finding sober living solutions and following them through the process.

"What I'm doing now is I'm digging a hole so damn deep man,” one addict said, “but I'm crawling up out of it slowly."

All volunteers carry Narcan as overdoses have become more prevalent now than when the nonprofit first began. Louisville EMS reported 17 overdose calls a day in 2019, with first responders administering 1,086 doses through the end of May. The numbers, though large, are down from previous years.

Volunteers also practice “harm reduction,” supporting a needle exchange program and promoting the notion that addicts use together with access and ability to administer Narcan, something Markwell said many people may not agree with.

"Harm reduction…does not mean I'm saying go get high. That is me saying I accept you as you are, you've shared with me what your struggles are, let me give you some tips on at least how to be safe if you choose to do this,” Markwell said.

Several of the nonprofit’s volunteers are recovering addicts, with stories of how dirty needles or near-death experience brought them back to a reality Markwell helps them through.

"You've got a very fine window and with that window we want to be there and be able to respond right now,” Markwell said. “You are not forgotten. You are loved.”

Chapter 2

Suffering in Jail Cells

The use of Methadone in Metro Corrections

As Markwell’s team works the streets of Louisville, Metro Corrections is working to aid addicts in jail. Once placed in a cell, unable to feed their growing addiction, many users face horrifying withdrawal symptoms: vomiting, cramps and headaches.

James Sweasy, a recovering addict, faced those symptoms after he crashed his truck in 2000. Struggling with an opioid addiction, Sweasy spent 72 painstaking hours in jail – each hour worse than the one before.

“I wasn't able to take anything, and the withdrawal symptoms kicked in,” Sweasy said. “Can you imagine the worst flu you've ever had? Where you’re lying in bed and your brain tells you you should be up doing something, cleaning the house, going to work, whatever.”

Sweasy’s story is not unusual. Metro Corrections Assistant Director Steve Durham said that nearly 10,000 of the jail’s 30,000 inmates went straight to detox in 2017.

“Any given day, between 40, 60, 80 sometimes even 120 individuals are going through withdrawal here in Metro Corrections,” Durham said.

In an effort to assist with recovery, the jail is now trying to take away the pain so many inmates feel with methadone, a red liquid that helps reduce severe withdrawal symptoms. The jail already administers methadone to pregnant women, but a recently announced program would extend the treatment to other inmates as well – something Durham said could help the community immensely.

“This is a pathway for us,” Durham said. “Individuals [are] coming to us as a captured audience and we have an opportunity to offer them an opportunity to change the way their life is going.”

An opioid itself, the medication is considered controversial – with several recovering addicts concerned about how it will affect inmates. Sweasy, who has tried the treatment, said that while the medication can wean people off heroin, the withdrawals from methadone can be even worse than withdrawals from other opioids. Additionally, Sweasy said its high cost, $12 per dose at local clinic, can cause issues.

“I think it can be a good thing, but they're playing with fire,” Sweasy said. “What happens when their feet hits the streets? Where is the off ramp?”

Henry Lucas, a therapist who has worked with thousands in recovery, said the medication cannot be the only treatment that brings addicts into recovery.

“It's going to decrease, and maybe bring some progress to the physical symptoms, but it's not the end all be all,” Lucas said.

Lori Caloia with the Department of Public Health and Wellness said behavioral therapy and other treatments should coincide with the use of methadone, saying each person should be treated based on their specific case. For some, like Sweasy, abstinence is the goal. For others, though, abstinence may not work.

“Every individual is a unique person and has their own unique factors that played into their disease and they'll need their own treatment plan as well,” Caloia said. “…I know our goal is when we treat patients at our methadone clinic that ideally we have people on the least amount of medication that they need…working towards trying to reduce how much they need.”

Durham said the jail hopes to find out how to best address different problems during their program, saying the gold standard is to use methadone along with counseling to help lead inmates towards recovery.

“This is a vulnerable population and we're going to try to start with the most vulnerable individuals in jail who are transitioning into our community and start finding ways to do the best approach for medication assisted treatment, behavioral planning and recovery services int he community,” Durham said.

RELATED: Louisville selected to take part in national program to expand opioid treatment in jails

RELATED: US awards $350M in research funds to fight opioid epidemic

Chapter 3

The Struggles of Recovery

The pricey cost of treatment

There’s no quick fix for opioid addiction, especially as more time passes. Michael Walsh knows that all too well.

After 13 years of using painkillers and heroin, Walsh was one of the lucky ones. A judge gave him the option: enter a transitional living facility or head straight to prison. The Beacon House gave Walsh a chance to start again, to begin recovery.

But before he was given a new lease on life, he tried to get help on his own. He checked into a 28-day program on his own dime, but the costs were too much to bear.

“The first time I went I got to stay for seven days and my insurance…that's all they allowed me to stay,” Walsh said. “It was supposed to be like a 28-day program, so I only got to stay 7 days and I was back out after that.”

Without insurance, inpatient rehab can cost $500 to $700 per day. Not all 32 facilities in Louisville responded to requests about cost, but FOCUS did find a wide range of expenses for different services. Where one center is $290 per outpatient visit, another costs $20 per group session. Two years of counseling can cost $9,000, and the anti-relapse drug Vivitrol is provided for $1,300 a dose at another center.

Kentucky Health Commissioner Jeffrey Howard said he understands how much the opioid crisis affects people across the state. Kentucky and Indiana have two of the highest opioid prescription rates in the county despite major decreases, with providers writing 86.8 opioid prescriptions for every 100 persons in Kentucky and Indiana providers writing 74.2 prescriptions per every 100. The national average is 58.7 prescriptions.

“No Kentuckian is more than once removed from substance abuse disorder and its far-reaching effects, and I'm no different,” Howard said. “I grew up in very rural Appalachia…my mother and step-father, both were addicted to drugs, particularly the infamous drug, Oxycontin.”

Howard said that with a state match of up to $30 million, there must and will be more of an emphasis on transitional help.

“We have to support the post recovery, post inpatient treatment aspect of care to the utmost,” Howard said.

One facility understands the need for cheaper treatment. With the help of donations and Metro Corrections funding, addicts can stay at the three Healing Place locations for free.

“The Healing Place is a six to nine-month recovery model-based behavior modification,” program manager Shannon Gray said, “to put them in the best possible position for long term recovery because that's our job.”

After a recent expansion, The Healing Place has almost 800 beds across three campuses, taking people from Kentucky and Indiana. Since opening a bed center in Campbellsville, Gray said the facility has not had to turn anyone away.

Walsh has now been sober for over two years, working as a shuttle driver for James Collins Downtown Ford dealership. He said his time at The Beacon House was necessary in making the transition back into workforce.

“I know what it's like to be out there and be miserable and alone and just not have anywhere to go and not have any hope,” Walsh said. “It's hard at first, but you have to come to terms with, ‘I made those decisions, I did those things, I can't change my past,’” Walsh said.

Now, Walsh said he visits the facility often, mentoring many of the people going through what he went through – knowing there is still hope.

“I think if people were educated and we're aware of all the different avenues and help that's out there, they would be a lot more willing and ready to try to go get that help,” Walsh said.

RELATED: Healing Place ready to help more battle addiction

RELATED: Report: Indiana sees opioid prescription decrease

RELATED: Kentucky businesses awarded grant to fight opioid epidemic

Chapter 4

Overcoming the Shame

How families advocate in their loved ones' honor

In the process of helping people she did not know through The Forgotten Louisville, Markwell was also personally affected by the opioid crisis. After five years of sobriety, her husband, Todd, died from a fentanyl overdose in December 2018.

Markwell said he was sent home with prescription drugs to address his back pain earlier in the year. Though hyperaware of his addiction, she said she had gotten comfortable with his sobriety as he was often a driving force behind helping addicts find recovery.

"I wasn't ignorant to the fact that it could happen. I lived on high alert,” Markwell said, “but I had just gotten very comfortable thinking you know we've got five years under our belt, he's in the professional world, working within this field, working with this population.”

Todd relapsed after receiving the prescriptions, taking a “test shot” of heroin while Markwell was on her way to visit her family. He died three days before Christmas, an autopsy showing the “test shot” was all fentanyl.

"His funeral was probably the most beautiful funeral I've ever seen or attended,” Markwell said. “You had so many people from the community who came out and shared stories with how he made a difference in their life, he was there for them, he showed them a way out."

While his death was a result of his struggle with addiction, Markwell said she never felt ashamed to share her husband’s story.

"I'm not embarrassed of him, his life, his death,” Markwell said. “There is so much shame and guilt with the stigma of addiction that people are afraid to talk about it. And I didn't dare want my husband's life or legacy to be tarnished that way.”

RELATED: Fentanyl most common drug in deadly overdoses, CDC says

Chapter 5

Finding Support

Loved ones rediscover joy despite the despair

The pain of losing a loved one – physically or emotionally – to addiction can be difficult to address alone. Feeling like they are losing themselves to save another, many let their loved ones consume their every thought, minute and even dollar.

“You forget about the things that are enjoyable and the things in life you deserve," one member said. "That's the insanity a lot of us live."

Like Markwell, some may exercise their pain through advocacy. Others find their joy through support. Nar-Anon, an anonymous 12-step support group for families and friends of addicts, provides the support so many people need as they witness the ones they love struggle every day.

“There are so many emotions, so many disappointments, so many hopes that disappear,” Ed, a member for 15 years, said. “I just can't do it. But inside these rooms, every single person knows what it's like.”

Ed said within 15 minutes of his first meeting, he knew the group was what he needed: a place to vent to people who understand his pain.

"People like us do not mind sitting in a room with people who do understand,” Ed said.

While their stories may differ, their feelings are the same: no one can imagine what it’s like until they have lived it.

"It's like you're grieving a death that hasn't happened yet," Janaya said, having come to the support group for two years.

Many of the parents and spouses in the room said they try to soak in the moments when their loved ones are sober, fearing the days they use. Nar-Anon helps them cope.

“It's a nightmare for the person using and it's a nightmare for the people around them,” one member said. "You have to learn how to love your addicted loved one but detach from their corrosive behaviors."

Like Al-Anon, there is no advice given or pressure put on any member of Nar-Anon. No one is forced to speak or go to every meeting, each person sharing their story to get support from the only people who understand their pain.

"The first night was unbelievable,” Jean, a member for over three years, said. “It was like a weight lifted off of my shoulders.”

Like so many other members, Jean said working through the 12 steps has allowed her to release the addict she loves, helping her realize she can't control or cure the addiction."

The realization brings her serenity, and It’s something the users help pass down to new members.

"All of a sudden, my loved one is the one living down under that bridge everyone's talking about," Cindy, a five-year member, said. "I was obsessed with trying to save her but realized I couldn't. I needed the wisdom of other people in these meetings, who'd experienced this before, to help me find out how to survive it."

In a difficult life filled with difficult moments, Nar-Anon helps its members find their peace.

"Sometimes if you're dealing with active addiction, it's an hour you look forward to out of the whole week, because you can smile,” one member said. “You can talk. You can listen. You can learn.”

If there is a breath, there is a hope – and with support, there is joy.

RELATED: More than 1,000 Kentucky babies born with opioid dependency each year

RELATED: Opioid orphans: A crisis affecting the Kentucky's foster care system

RELATED: Brett Favre, Robert Downey Jr. just a few celebrities who struggled with opioid addiction

Chapter 6

Getting Help

A list of resources for addicts and their families

People struggling with opioid addiction can find treatment centers throughout Kentucky. The Kentucky Help Call Center provides referrals for public and private centers via the toll free hotline at 1-833-8KY-HELP. 

You can also:

Juvenile-specific treatment centers in Kentucky include but are not limited to:

Indiana residents struggling with addiction can call the state's hotline at 1-800-662-HELP, or chat live with a representative of Indiana's Division of Mental Health and Addiction online.

Opioid treatment centers in Indiana include but are not limited to:

Nar-Anon Family Groups meet four times a week in Louisville, and different times in other cities. Louisville locations are listed below:

  • Stepping Through Recovery at Immanuel United Church of Christ
  • Saturday: 9:45 - 11 a.m.
  • Thursday Night Nar-Anon at Beargrass Christian Church
  • Thursday: 6:15 - 6:45 p.m. (Beginners) or 7 - 8 p.m. (Regulars)
  • Mosaic UMC Nar-Anon at Mosaic United Methodist Church
  • Monday: 8 p.m.
  • Hope for the Heart at Trinity Chapel Assembly of God
  • Tuesday: 7 p.m.

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