Five years ago, fueled by heroin addiction, Kasandra Quednau pursued drugs the way a CEO chases a high-stakes business deal. The adrenaline flowed, and the thrill of the hunt had an aura of consequence and glamour to it. "As much as the drug itself, you also crave the lifestyle," says Quednau, 26. "It's fast, it's fun. You're getting in the car and going down to the city. You're always getting phone calls, there's action, there's money. And you're high, so you feel great." In moments like these, a healthy, normal life seemed boring, hardly something to aspire to. Yet other moments were far less glamorous—the broke and evicted moments, the vomiting-all-over moments, the crushed-by-despair moments. "When it was good it was good, but when it was bad it was just so so so bad," she intones. "The bad starts overshadowing the good." Quednau always suspected that with heroin she'd end up either dead or in jail. Lucky for her, it was the latter. After 18 months of incarceration, six of them in a military prison boot camp, she knew she'd never go back to the lifestyle, or the drug. "If it wasn't for that time in jail," she says, "I might never have shaken it."
White Picket Fences and Opioids
The fast pace of addict culture matches the breakneck speed at which opiate use is growing in this country. In 2014, more than 47,000 Americans died from drug overdoses, a 14 percent leap from the previous year. With the nation in the grip of a heroin epidemic imported mainly from the poppy fields of Afghanistan and shuttled through cartels in Mexico, we now have more deaths from overdoses than from car accidents. "Over the last five to 10 years we've seen a dramatic rise in the abuse of opiates," says Dean Scher, PhD, executive director at Catholic Charities Community Services of Orange County. Catholic Charities has eight locations, ranging from community residences with crisis units for detox to day rehab services and residences for people in recovery. In the past, Catholic Charities has mainly served urban areas such as Newburgh affected by heroin addiction; these days, the scourge is more widespread. "We're seeing it in all locations now," says Kristin Jensen, director of communications and development for Catholic Charities. "People used to see [heroin] as an inner-city problem, but it's not anymore. It's a very middle-class and suburban problem now. It's even in rural areas."
Communities locally and across the country are scrambling to catch up and get a handle on the crisis. They're tackling it from all sides as if fighting Godzilla, with a growing number of interventions—from urgent police task forces and community coalitions to support groups and prevention councils. Some states are putting a cap on the number of painkiller pills that doctors can prescribe. The Centers for Disease Control and Prevention issued tough new guidelines last month on the use of prescription opiates such as OxyContin, Vicodin, and Percocet, advising doctors to try nonnarcotic options for their patients' chronic pain. It's an important move, because heroin addiction often begins with a dependence on painkillers that can lead to their abuse, says Paul Arteta, the police lieutenant in charge of Orange County's drug task force. "A lot of people we've spoken to, most of them that had been arrested [on heroin-related charges], stated that they'd had a sports injury or car accident, or they went to a party and someone who'd had one of these injuries or accidents provided them with a pill. And it filled some kind of hole, something missing in their life."
Whatever the hole is, a feeling of euphoria fills it up instantly when the drugs are snorted or injected, and opiate molecules flood the brain in a chemical reaction that mimics endorphin, the feel-good hormone naturally produced by the body. With long-term use, tolerance builds and users require larger doses or more frequent injections to achieve the same results. In extreme cases Arteta has encountered addicts who shoot up heroin 100 times a day, spending $1,000 daily on the drug. "We're seeing a lot of research being done that shows people can be fully functional; they're using heroin and going to work," he says. For many hard-core users the euphoria begins to fade or vanishes completely. Yet they continue to take the drug to feel "normal" and avoid the onslaught of nausea, vomiting, shaking, and flu-like symptoms that are the hallmarks of the addict's worst nightmare: withdrawal.