Southern Indiana's Sudden HIV and Drug Epidemic: One Woman's Story
Susan*, now 26, grew up in Austin and Scottsburg, Indiana and graduated from a local high school. Her parents separated when she was 3 or 4 years old, and Susan and her siblings lived with her mother and step-father, both of whom were alcoholics. Susan says that her mother was never around, gone to bars or fighting with Susan's step-father, giving the kids, “free roam and no punishment. We'd take her vehicles before we had a license and she didn't even care. She was off doing her own thing. The more we stayed away from her, the better it was for her, so she didn't have to be bothered with it.” Susan even confessed that she would, “steal $300 or $400 from her [mother] every night and we'd go get wild. It's a small town. It's what everybody does. They either drink or get high, one of the two.”
By the time she turned 13, Susan, who admits to growing up around drugs, was already smoking marijuana and abusing pills, such as Loratab and Xanax, partying and, “doing weekend stuff.” When she turned 21, Susan started a relationship with a drug dealer, and found that the pain killers she was accustomed to taking were not getting her, “high enough, so I moved on to something bigger.” That “something bigger” was Opana, an Oxymorphone narcotic used to relieve pain. At first, Susan was snorting Opana, but in 2012, the makers of the opioid re-formulated the drug to make it less addictive, so, in 2013, she began to shoot it up for a better effect.
Noticing that her Opana addiction was getting out of control, Susan began outpatient treatment by going to a methodone clinic, a place which provides opioid addicts with methodone in an effort to eliminate or reduce their dependency on pain killers. After going to the facility for 1 year and 8 months, Susan's new boyfriend, a drug dealer, told her he no longer wanted her to take methodone, so she stopped going to the institution. Since she no longer had methodone to help with her pill problem, Susan fell into using meth because, she says, “meth will help you get off pain pills. [It] doesn't make the withdrawals as bad.”
Susan attempted to seek care for her drug addiction two more times, both as an inpatient, attending a rehabilitation center in Kentucky from June 22, 2014 until August 2014, and from September 2014 until October 2014, when she left treatment altogether. She has tried both medical and non-medical detox, but neither one has helped. According to The Addiction Recovery Guide, medical detox is “a controlled and medically supervised withdrawal from addicting drugs, usually under the care of a physician.” Michael's House, a nationally recognized treatment center, describes non-medical detox as one which, “excludes medication except for the purpose of diminishing opiate withdrawal symptoms.” The latter option is more uncomfortable for the addict, but it means that the patient moves more quickly from being drug-dependent to being drug-free.” In Susan's opinion, however, “it doesn't really make a difference. If you wanna get high, you're gonna get high, regardless if you do medical or non-medical.” She thinks that the reason both of her tries at staying clean have failed is because drugs are “all I know, all I've ever done, so it's normal for me. It's just the lifestyle, it's just normal and such a small town, there's not much to do. All your friends do it, you can't go 3 houses in a row and in one of those 3 houses, someone's not getting high. It's everywhere.”
When asked to speculate whether her addiction to weed and pills started right away, Susan replies, “I wouldn't say I was addicted physically, but mentally, yeah. It's just a way to escape any of the problems or anything. Something to take your mind off sh--.” Even now that she is addicted to heroin, Susan says that, “with shooting up, [you have the] ritual of getting it ready, routine of how you do it every day and you get addicted to that.” She acknowledges that prior to being on drugs, she, “never understood people...saying you get addicted to poking yourself with a needle, but you really do. I always said the reason I shoot up is because it's the only way to do Opanas, but, now that I do heroin, you can snort it. I could snort it if I want to, but it's not the same. I choose to shoot it up. I don't have to, I choose to.”
Even though in all her years as an addict, Susan was in relationships with men who sold drugs, at the beginning of her addiction, she was a regular girl, employed and making enough money to buy her dope. As time went on, however, she began to solely depend on her boyfriends for the drugs. “I've prostituted whenever I didn't have a way to get it. That's just part of it. Drug dealers around here, that's kinda their MO. They pay girls to have sex with them and get them high. That's how this town works,” she says. “You can see the girls walking up and down the roads, that's what they're doing.” Drug dealers, “local people [who have] been here their whole lives,” as Susan points out, have a set amount they charge for their product, and one prostitution trick is enough to pay for one hit. 1/10th of heroin, sufficient for one fix, is $40 and stays in the system longer than ¼, or 10 mg, of an Opana, also $40; so, “you don't get sick as fast.” Two hours after snorting or shooting up 10 mg of Opana, Susan says she goes through withdrawal, but with heroin she can go as many as 4 hours before shooting up again. That's why, in Susan's opinion, heroin is the drug of choice in Austin: it's cheaper than Opana with a longer lasting high.
But if there's a shortage of heroin, addicts in this southern Indiana town resort to meth in order to circumvent their withdrawal symptoms, which range from vomiting, cold sweats, insomnia to leg cramps. Prior to shooting up, Susan's “withdrawals weren't as bad as they are now, I didn't throw up or get diarrhea; but, now, I throw up. It's a whole lot worse now. You can go 6 days without sleeping because you're withdrawing so bad.” Before an addict can get a fix, though, the needle has to go directly into the vein. “There are days I have to poke myself 10, 15 times to hit. When you miss, it swells and you have to go to the hospital to get it lanced open. Big rashes. I got big knots. Big, huge bumps and it really hurts,” Susan explains. While pointing to her index and middle fingers on the left hand, she says, “I was going right here in my wrist, and I actually hit a nerve and these fingers right here, I can't bend them back. I've done it before, it'll go away.”
The trackmarks from shooting up, blown veins on her inner arms and withdrawal symptoms are not the only side effects Susan has of her years as a drug addict. This March, Susan was hospitalized for pneumonia and other breathing problems which she often suffers because of a lung disease, and she disclosed to the hospital staff that she was an intravenous drug user. Susan was then asked if she, “wanted to be tested,” for Hepatitis and HIV. “I told them, 'yeah,'” she recollects, “and they did all the tests.” She says that she “pretty much knew she had,” Hepatitis C, but a couple of weeks after being discharged, “two people from the Health Department showed up at my mom's house.” Susan was not at her mother's at the time, but her mom took a number from the officials, which Susan called and made an appointment to meet them at a nearby gas station. “They said, 'we got your results and you're HIV positive,'” she remembers.
The damning news, “makes me want to change my ways, but then again, it's like, 'f--- it.' Anything bad that can happen has already happened. Why stop now? It's already over,” she laments. While the Scott County Health Department gave her a number to a human infectious disease doctor who will give her medicine for the disease, Susan has not called the doctor or sought treatment for her condition; nonetheless, she plans on doing so within two weeks as a stipulation of her probation. “If I get treatment for it, it can lay dormant and I can be okay,” she hopes.
Susan's family is aware of her condition and most of them have stuck by her side, except for an older relative who has no contact with her and she is not allowed to see his kids. “I understand it,” she says, “I can't say that if I was in that situation, I wouldn't be the same way.” She divulges that there is still a stigma that comes with having HIV because, “people think you can get it from shaking somebody's hand, and it's nothing like that, but you can't help how other people think.” When Susan found out that she had the virus, the Health Department gave her a document to sign which states that before she has sex or shares a needle with anyone, she has to disclose to them that she is HIV positive. Failure to comply with this policy can result in criminal charges, but Susan says she has adhered to the rule because she, “would never put anybody in that position. Ever. It's not their fault I f---ed up.”
Following some evaluation, Susan believes that she contracted both Hepatitis C and HIV by sharing needles, “when you use needles, you know the risks, but it's not a reality. You think, 'that'll never happen to me. It's nothing for 4 or 5 people sitting around, getting high, and your needle clogs up or you don't have one, and you just say, 'hey, can I use your needle?' It's not a big deal around here at all. Everybody shares needles with everybody. And, it's such a small town. Everybody knows everybody. So, 'I've known you my whole life, f--- it, I'll use your needle.' That's how people look at it.”
“When I was shooting up, I thought, 'I could get Hepatitis from this. I could get HIV from this;' but, at that moment in time, you don't care. You think, 'I'm gonna do what I have to do right now to make myself feel better. F--- what happens in six months. I'll deal with it then. I'm just trying to feel better right now.'”
She says that even though she was aware of the chances she was taking when she shared needles, “when you're sick and you need something to make you feel better, you don't care. You just don't. It's the short term thing. It's making you feel better right now, who gives a f--- about what happens 6 months down the road when you're dying from it?”
In order to curb the needle sharing problem Scott County is facing, Indiana Governor Mike Pence overrode state law banning needle exchanges and set up a needle exchange program in the southeastern county. Addicts are encouraged to bring dirty needles to the exchange centers where they are given clean needles in return. Will Susan use the free incentive to get clean needles for herself? “Nope. I know they're not watching everybody that goes in there and gets stuff and I know everybody knows what I do, but I don't like to put it out there for everybody to see. I try to keep it a little bit hidden,” she answers, adding, “why worry about it?” getting clean needles while she's already infected with Hepatitis and HIV, “this is pretty much the worst scenario.”
A day in the life of an addict is undoubtedly different from a day in the life of a well person. Susan says she wakes up at a time that, “depends on whether [she] had anything the night before,” that may be at 11:00AM or 1:00PM or even, “6 o'clock in the morning that I'll be up running around, trying to find something. Whenever I can get something is the only time I'll be able to go to sleep. I can't sleep if I don't.” When she does wake up, she is sick “anytime you fall asleep, you wake up, you're sick,” so as soon as she wakes, she calls around to locate some heroin, or boy, as the locals refer to it. Susan says that there are a couple of main houses that provide her with boy, but, “if one person doesn't have it, somebody else does. There's 10 or 12 people I can call right now and get whatever. From meth to Opana, to heroin. Whatever.” She likes to get high 5 to 6 times a day, “as many as I can,” but at least 4 times: “once when I wake up, couple during the day and once right before I go to bed. Now, it's to the point, really, where I can't really get high. It's just doing enough to not be sick.”
Currently, Susan resides with an ex-boyfriend and his family, while she dates someone else who deals in drugs. Although her living arrangement seems strange to some, “that's just normal life for people around here. They don't know any different,” she explains. Susan says that the home in which she lives is, “a nice place...yeah,” however, she is quick to add that, “the reality of it is, all of Austin is pretty bad. There's not any awesome places around here, setting wise. Most of the places are Section 8 [government housing] because nobody works and everything is government-paid-for around here.” And the fact that the city is in the midst of a health crisis does not seem to affect its constituents, according to Susan, “people are like, 'f--- it, whatever.' They don't give a f---.”
Even with the media spotlight shining brightly on her town, drugs are not hard to come by. Susan says that things, “haven't changed at all. At all,” and despite the fact that the Austin Police Department is trying to crack down on the problem, “there's only so much you can do There's always gonna be people in the town that have it. As soon as one person goes to jail for it, 3 more pop up that are selling it. They're [police] overwhelmed. They can't do it all.” One boon of the police trying to downsize the drug problem is that, “you have to know somebody up here to be able to get anything,” a dealer cannot be simply approached by an unknown person because, “they'd think you're a cop, for sure.”
As far as any future for her, Susan says that she “really [doesn't] think about it, I just go day by day. My only goal right now is to try and keep myself not sick. It's really all I focus on. It's all you focus on. It's all you worry about.”
*Name has been changed to protect identity.
*This content is copyrighted and may be used only with permission.
WOW. Great story !
ReplyDeleteThere are still many law abiding, hard working and SOBER people in Austin. Not everyone is a user. Sorry but I am getting sick of all the media coverage in MY HomeTown!
ReplyDeleteWhat a pathetic life...
ReplyDelete