Andrew Nelson, an 18-year-old senior at Mills E. Godwin High School, spends his free time playing soccer and writing music.
On the surface, he is like any other teenager, but, behind his fun-loving personality, there is a struggle. This struggle is known to many Virginians, and that is the struggle of addiction.
According to The National Institute on Drug Abuse, drug addiction is "a chronic, relapsing brain disease that is characterized by compulsive drug seeking and use, despite harmful consequences."
Growing up in Henrico County, Va., Nelson—a white male—is recovering from Benzodiazepine (benzos) and opiate addiction, and his path is an increasingly familiar story.
When Nelson was eight years old, his parents divorced. Feeling that it was his fault, he began to act out and constantly sought attention from his peers.
"I would do anything to make myself feel better," said Nelson. "Whether it was being the class clown or doing something dumb just to get laughs out of people. After a while I was just trying to get to the next thing that would make me feel better."
As time went on Nelson began exploring other avenues to make himself feel better, including drugs and alcohol. At 12, he began drinking but as he says, "never really topped off on it," and as a result, he began smoking weed and taking pills at the age of 13.
"I started out with just painkillers," said Nelson. "And I increased my way up to cocaine and LSD, any drug that I could get my hands on."
Around ninth grade, Nelson's use advanced even further and he began to isolate himself.
"I wasn't me anymore," said Nelson. "I quit travel soccer which I had been playing for a long time and I stopped playing the guitar. I didn't have any hobbies anymore; my hobbies were getting drunk or getting high with friends or alone."
As his ninth grade year went on Nelson's drug use soon progressed to the point where not even others wanted to use with him. He would either get angry and act out, or become "ridiculous." Soon his friends became so uncomfortable with how much he was using that, when he got high, it was often alone.
During his sophomore year he began to use oxycodone.
"I lost 30 pounds in about a two-month period," said Nelson. "I went into withdrawal that August, and got off of it for a little bit, but just about the time of junior year I overdosed."
The Role of Race in a Growing Epidemic
Nelson's story of addiction, and overdose is not uncommon. But he is one of the lucky ones. Many other stories end in death.
According to the Office of the Attorney General, heroin deaths due to overdose in Virginia have nearly doubled from 2011 to 2013. In Northern Virginia, there has been a 164 percent increase in heroin related deaths, while in the Richmond Metro Area there has been a 50 percent increase.
Additionally, in a recent report by the Center for Disease Control (CDC) from 2011 to 2013 "heroin-involved deaths due to overdose nearly doubled, with more than 8,200 people dying in 2013 alone. Of this number, 45 percent of those surveyed were also addicted to prescription painkillers."
The abuse of painkillers isn't new and its correlation to heroin isn't either. As documented in the same CDC report, those who abuse prescription drugs are 40 percent more likely to try and abuse heroin.
Since the 1980s lawmakers have endorsed harsh punishments and mandatory sentencing around the country for those who use and abuse drugs.
"How we choose to respond to these problems was always an open question," said Marc Mauer, Executive Director of the Sentencing Project, a non-profit that examines racial issues in the criminal justice system. "The options we choose have many considerations. We want to look at evidence of what is effective, we want to think about what are the compassionate ways to deal with it, and we want to think of cost effectiveness."
“But it seems over time one of the key factors determining our response has to do with our racial perceptions of those who have a drug problem.”
Three decades ago, the focus was on cocaine and how it affected lower-income communities, mostly consisting of African Americans. However, today, the focus is on the predominately-white middle and upper classes. As a result, how society approaches drug and drug addiction has changed.
"In short, when the perception is of a black drug user or seller then the policy choices become much more constrained, much more punitive," said Mauer. "But when the public perception is of a white person then we become more compassionate."
This gentler approach that Mauer speaks of, consists of states — such as New Hampshire — beginning to enact laws that focus more on treatment and prevention rather than incarceration.
Virginia has also began to alter its approach to this epidemic, seeking to educate the public on the dangers of heroin through a variety of means.
Working in partnership with Virginia State University, the Office of the Attorney General approached Jesse Vaughan, director of VSU’s Advance Creative Services Group, to direct a documentary entitled Heroin: The Hardest Hit, which details the high cost of the drug within the state of Virginia.
"The price of doing heroin is death," said Vaughan. "And death doesn't always mean physical death. It can mean death in terms of relationships with family members and friends, death can be in regards to your financial life. It is a devastating drug."
The Road to Recovery
Stas Novitsky, 26, knows all too well the pull of addiction and the "death" Vaughan speaks of. Currently the Director of Youth and Family Development at the McShin Foundation in Richmond, Va., Novitsky is "in recovery" from heroin abuse.
According to the Substance Abuse and Mental Health Administration (SAMHSA) to be "in recovery," is defined as, " the process of change through which an individual achieves abstinence and improved health, wellness and quality of life.”
Founded in 2004 by John Shinholser and Carol McDaid, the McShin Foundation is a non-profit, full-service Recovery Community Organization (RCO) that works to provide recovering individuals with the tools they need to create a positive lifestyle for themselves and their families.
"Addiction is like a black hole," said Novitsky. "Where the person who is addicted just attracts all this negative energy around themselves and they're not producing anything in the world they're just consuming and taking and manipulating and stealing."
"These are character traits that these people have and they're not necessarily bad people, they are just in an unfortunate situation because of drugs and addiction."
The program's foundation is that of a Peer-to-Peer Recovery Support Services (PPRSS) model which employs those in recovery from alcohol and substance abuse to mentor, educate and advocate to those new to sobriety.
"Our main program is our recovery residential program," said Honesty Liller, McShin Foundation CEO. Liller, 35, is in recovery from drug abuse, and like Novitisky was a former participant in the McShin Foundation program. "We have 75 beds that are in different houses or apartments for men and women.”
Many people have come through the doors of the McShin Foundation since its conception, including Nelson who is a current participant in the residential program.
Nelson first heard about McShin through a school guidance counselor who out of concern provided him a list of resources after his overdose.
Before coming to the program, Nelson had been in and out of different treatment facilities and programs for his addiction with mixed results.
He participated in an intensive outpatient program for adolescents through the FCCR in 2014, but the program was ineffective because he never truly stopped using during that time.
"I would cheat the drug test," said Nelson. "I would drink and use other drugs that wouldn't show up like LSD or I'd use pills and time it a couple days before the drug test so I could get away with it."
After going to rehab for 37 days and attending Alcoholics Anonymous (AA) meetings, Nelson began to rebuild his relationships with friends and family and stayed clean for eight months.
However, in September 2015, he relapsed and began using more heavily than ever before.
It was on Oct. 5, 2015, that he went into detox at Tucker Psychiatric Hospital in Richmond, Va.
"I stayed there for about a week," said Nelson. "I then went to rehab at Cumberland Heights in Tennessee for 56 days and from there I moved straight into the McShin Foundation.”
Having been at the McShin Foundation since late December, Nelson was 175 days sober as of April 4, 2016. He was moved into a Step Up House on Jan. 14, 2016.
Being moved into a Step Up House is a big accomplishment for those in recovery. The move means that they are doing well on their journey and are allowed to once again have cellphone privileges, work, attend after school activities if they are a student, and other such privileges.
"This program has been instrumental to my recovery," said Nelson. "Everyone who works at McShin is recovering so I can automatically relate to anyone."
While there are many different types of treatment methods, including inpatient and outpatient programs, such as the McShin Foundation, that cater to a variety of ages and demographics. All treatment begins with detoxification and medically managed withdrawal.
"For people that are on heroin they give you a medicine called Methadone," said Eddie Smith, clinic director and family physician at Eagle Harbor Medical Associates in Carrollton, VA. "What we do most of the time is to put people into an inpatient setting because once you start weaning off of the drug, especially something like heroin, you get hallucinations, you get heart problems, and you get sweating."
"Once they get through the acute phase of heart palpitations, sweating and the hallucinations go away then you can switch to more of an outpatient, or going to a clinic type setting.”
Smith, who has 32 years experience in the medical field, also notes that innovations in medication may also be able to assist in combating this growing epidemic.
"Another thing is that they can give you medicine, so that if you decide to take one of the drugs, your body would reject it," said Smith. "Let's say that you have an addiction to heroin or cocaine, we can give you a medicine that if you slip up, you will get no effects from it."
The drug that Smith speaks of is called Naltrexone.
Along with its residential program, the McShin Foundation also provides other services in their 15,000 square foot recovery center. These programs range from outpatient services and meetings to religious services, youth and family development, and judicial services that work to help those who are incarcerated with their recovery.
"There are different pathways to recovery," said Novitsky. "There's state based, there's Twelve Step, there's many different paths one can take, but the best path to recovery is the path that works for you as an individual."