The New Face of Heroin

The explosion of drugs like OxyContin has given way to a heroin epidemic ravaging the least likely corners of America - like bucolic Vermont, which has just woken up to a full-blown crisis

April 3, 2014 9:00 AM ET
The New Face of Heroin
Photography by Fredrik Broden; Painting by David M. Brinley, Lettering by Jon Valk

Eve Rivait rode her first horse when she was five, too small to get her feet through the stirrups, let alone give the animal a kick that registered. Yet even then, bouncing in the saddle, she was aware that being on the back of a horse provided relief from the boredom and isolation that, for her, were a more dominant part of growing up in Vermont than the snowcapped mountains and autumn foliage that draw millions of tourists to the state each year. As Eve got older, she began spending afternoons exercising the herd at Missy Ann Stables, not far from her home in Milton, a working-class town of about 10,000 located along Lake Champlain, some 30 minutes north of Burlington. Before she could drive a car, Eve was training horses at various barns in the area where seasoned farmhands asked about her knack for taming those with the wildest of temperaments. "Oh, I don't know," Eve would say, a sly grin forming on her round face, her lip piercing clicking against the bottom row of her teeth. "I guess they remind me of me."

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Away from the stables, she attracted the attention of adults in other ways. Skipping school. Clashing with teachers. Running away from a home where the disintegration of her parents' marriage – her mother worked for Homeland Security, her father as a project manager in construction – had created an environment more toxic than nurturing. In 2004, when Eve was 12, she discovered what seemed an easier way to rein in a mind that felt hard-wired to pinball from one extreme to the other. Her grandfather had just died of brain cancer, leaving behind a medicine cabinet stocked with the powerful opiate OxyContin, a substance Eve understood was prescribed by doctors to "make pain go away." She swallowed one. The sensation it produced was more seductive than any she had ever felt: Home, she thought. This is home. "I could be alone with myself," she says, "and not freak out."

Though it was a private solution to private pain, Eve was far from alone in discovering the pleasures of opiates. By the time she was 18, the same kids who once talked about the thrill of smoking pot were now praising the joys of "oxys," not to mention "vikes" and "perc-30s," the street names for Vicodin and the pale-blue 30-milligram tablets of oxycodone. Eve was out of high school, renting a room on the outskirts of Middlebury, a picturesque college town an hour south of Milton, when she started dating a boy who taught her that grinding and snorting the pills produced a more potent high. This led to a daily habit, though she never entertained the idea that she was developing a problem. An addict wouldn't be able to keep jobs at multiple stables. An addict couldn't make her rent and car payments on time. An addict didn't rescue a horse from a racetrack, as Eve did.

By the time Eve's relationship ended, six months later, another opiate was making a comeback. She had been dating her next boyfriend for only a few weeks when she came home to find him preparing to inject a needle filled with heroin into his arm – a sight so jarring it felt like a hallucination. Junkies, she thought, were people in places like the Bronx or Baltimore, not the middle of Vermont. But soon more people she knew were shooting up, and Eve's shock morphed into curiosity, heroin's corrosive reputation diminished by the fact that everyone compared it to a drug she'd already tried: "It's like oxys," she kept hearing, "only cheaper." So one evening, in the fall of 2010, distraught after her boyfriend stormed out in the wake of an argument, Eve took his stash from the bedside table. From her experience medicating horses she knew how to use a syringe; how much heroin to put in it, however, was a mystery. She opted for what she thought was a tiny amount – three small baggies of the beige powder. Moments after injecting it into her arm, Eve was on the bathroom floor, semi­conscious and unable to move.

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On the afternoon of January 8th, Peter Shumlin, the governor of Vermont, entered Representatives Hall in the Vermont State House, in the capital, Montpelier, to deliver his annual State of the State address. With its famed dome capped in gold leaf, the building is as synonymous with Vermont in the popular imagination as maple-syrup refineries, ski resorts, the rugged ingenuity of Ethan Allen and the earnest marketing of Ben & Jerry's. As Shumlin began his speech, however, it became clear that he was less interested in extolling Vermont's pastoral reputation, as he had in the previous year's address, than in framing the experience of a resident like Eve Rivait within a larger, more ominous context. "In every corner of our state, heroin and opiate-drug addiction threatens us," he said, devoting the entirety of the speech – a startling gesture reflective of his maverick streak – to discussing the issue in a tone of blunt urgency: "What started as an OxyContin and prescription-drug-addiction problem in Vermont has now grown into a full-blown heroin crisis."

The portrait of the governor's native state that emerged was severe, conjuring up images more commonly associated with blighted inner cities than a state with the nation's fifth-lowest unemployment rate and a populace that is 95 percent white. Since 2000, Shumlin noted, Vermont has seen an eightfold increase in those seeking treatment for opiate use, with an almost 40 percent spike in the past year for heroin alone, and every day hundreds are languishing on waiting lists for understaffed clinics. Deaths from overdoses in 2013 had nearly doubled from 2012; property crimes and home invasions were on the rise; and close to 80 percent of the state's inmates "are either addicted or in prison because of their addiction." The same major highways where tourists routinely pull over to take photos of rustic vistas had, in the governor's description, become pipelines of heroin distribution, with organized gangs setting up outposts across the state, where a six-dollar bag of heroin in their home cities can fetch as much as $30. As a result, an estimated $2 million worth of opiates were now being trafficked into Vermont each week – a staggering amount for a state that, with only 626,000 residents, is the second-least-populated in the country, after Wyoming.

Within Vermont, where reports of heroin's rise had become fixtures in local papers for more than a year, Shumlin was applauded for turning up the volume on an alarm that had already been sounded; nationally, the attention his address garnered was filtered through a lens of morbid curiosity. HOW DID IDYLLIC VERMONT BECOME AMERICA'S HEROIN CAPITAL? read the headline on the website Politico, reinforcing the idea that what Shumlin was confronting was an aberration – an urban scourge freakishly resurfacing in the least likely of rural sanctuaries. Two weeks after Shumlin stepped down from the podium, however, 22 people died in Pennsylvania in a single week from injecting heroin laced with fentanyl, a narcotic that can be 100 times more potent than morphine. A few days later, four died from a similar mixture in Flint, Michigan, a city long defined by economic hardship, while authorities in Maryland, the richest state in the country, reported 37 similar deaths since last September. Then, on February 2nd, the actor Philip Seymour Hoffman was found dead, a needle still in his arm, after which reports of heroin outbreaks became so ubiquitous it seemed you could throw a dart at a map of the U.S. and land on its heroin capital. Northern Kentucky, central Florida, western Massachusetts and northwestern Indiana were all under siege, to say nothing of Ohio, Delaware and Wisconsin. President Obama's "drug czar," R. Gil Kerlikowske, weighed in, warning the nation that "there is no question we're seeing a resurgence of heroin."

With its sparse population spread throughout towns less populated than single blocks in major cities, Vermont stands out as a state where, perhaps more than any in the nation, the complexity and consequences of heroin's current rise come into grim focus. Unlike residents of New York City, who may be surprised to learn that fatal overdoses there increased 84 percent between 2010 and 2012 – a spike diluted among a population of 8.3 million – rare is the Vermonter who does not have a heroin story to share. The CEO whose daughter died of an overdose. The counselor at the treatment clinic robbed in broad daylight. The neighborhood coalitions in quaint hamlets trying, and failing, to keep their blocks from becoming open-air drug markets. The nearly 700 bags seized in Westminster from under the car seat of a five-year-old girl. Not long ago, in Burlington, a 29-year-old former user sits inside a coffee shop on a busy thoroughfare lined with outdoorsy boutiques, yoga studios and craft breweries, telling his own story of addiction and recovery. He stops himself midsentence and nods at the two people next to him who are in the process of conducting a deal. "See that?" he says. "The shit is everywhere."

Vermont is one of the most forward-thinking states in the nation, with a history of taking pioneering, unorthodox approaches to complex issues. It was the first to create civil unions for same-sex couples, in 2000, and last year, under Shumlin, announced single-payer health insurance and decriminalized marijuana. In February, six weeks after delivering his State of the State, Gov. Shumlin sits in his office, the panoramic view from the wraparound windows obscured by snow flurries, where he makes it clear that he wants his approach to heroin to be an extension of this pragmatism. "The theory has been that if we just arrest users and put them away, then we're going to make progress," says the 58-year-old Shumlin, who, with his chiseled jaw and shock of salt-and-pepper hair, personifies the self-reliant, affably renegade spirit of the state he presides over. "Public policymakers have refused to say not only that this has failed, but that it's failing miserably." He is a passionate man, but also a practical one, and he has made it his priority to reframe the issue in terms of public health: understanding addiction as a disease, bolstering treatment infrastructures and creating a culture where the collective empathy felt toward an addicted Oscar winner can extend to anonymous addicts before they arrive at the morgue. By March, Eric Holder, the U.S. attorney general, was advocating Shumlin's approach on a national stage, deeming heroin "an urgent public-health crisis," calling for reduced mandatory minimums for minor drug charges, and making it clear that the situation in Vermont is all the more disturbing and relevant when understood not as an anomaly but as a microcosm of a pandemic that extends far beyond its bucolic borders.

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