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In Heroin's Heartland - Pacific Standard
As the opioid epidemic spins out of control, a grassroots network of activists is fighting it at the source.

"I've been arrested 18 times, incarcerated 496 days, and spent 2,556 days addicted to heroin," Nicole Walmsley says before about 70 people at an event center in Lodi, Ohio.

It's April of 2017, and Nicole has been sober for over four years. The better part of her recovery was spent in what she calls fight mode, driving all across Ohio to save addicts in the midst of the state's rising opioid epidemic. Since 2015, when the state's opioid epidemic hit record numbers, Nicole has been a major figure in a loosely connected coalition of treatment coordinators, police liaisons, and 12-Step program leaders convinced that the only way to remedy Ohio's public-health emergency is to take action on their own.

Gathered around Nicole at the Family Day Center is her aunt, Alice Eckley, along with Nicole's 20-something clients and partners-in-recovery. Next to Nicole stands her 12-year-old daughter Haley. "I got clean when she was seven," Nicole says. "One time we were watching The Walking Dead and Haley said: 'Mom! Do you remember when you looked like one of those?'" Haley smiles, embarrassed. "Here I am thinking I looked good in my addiction, and the whole time my daughter says I looked like a zombie."

Born in April of 1985, and genetically predisposed to addiction, Nicole grew up in Rootstown, an Ohio township of 7,000. When she was 11, a counselor diagnosed her with attention-deficit/hyperactivity disorder, and prescribed her sleep medication. When she was 19, Nicole ended up pregnant with her daughter, which left her with endometriosis that required back-to-back surgeries. For abdominal pain, her doctor prescribed Vicodin, a pill made from opioids. Nicole obliged, needing relief.

"I became addicted," she says. "They didn't take me off properly and I got bad." In 2007, a dealer who had been selling Nicole Oxycodones, a different opioid pain pill, hinted at something cheaper: heroin. She was sick; this was remedial. Months after, cognizant of her self-decline, Nicole gave up custody of Haley to her parents after her first trafficking charge. "It's not that I didn't love her," she says. "I was just gone."

For roughly a decade, Nicole owned the life of a wandering addict. She worked odd jobs in landscaping, lived with dealer boyfriends, would claim up to 15 phone numbers and addresses—from rural townships to trailer parks—to escape piling up warrants. She lived a life of close calls, she says: "Car crashes, overdoses, guns to the head."

Nicole once was sent to jail for trafficking heroin outside her old high school. In a Days Inn outside of Ravenna, an officer caught her with a stolen wallet and two hypodermic syringes tucked under a mattress. Another time, in Tallmadge, she was busted lifting a cell phone charger at a Walmart, found in her purse alongside two needles. "That's one thing we didn't leave home without," a friend of Nicole's tells me, "our needles and our cell phones."In the spring of 2013, after being released from a jail sentence on her second felony, Nicole fled to a tiny village an hour outside of Youngstown to care for horses. She was broke, estranged from her family, and now fitted with an ankle bracelet. The year before, she attempted to study become a paralegal—"to live a life of normalcy"—but that only lasted three semesters. She had a clean spell, took prescription Suboxone, a narcotic used for withdrawal, but relapsed after missing a dose. Now, she was on house arrest, alone, and 61 miles away from her daughter.

On the night of March 14th, 2013, Nicole relapsed. She decided to drive "all over God's creation" to scout for heroin. The officers assigned to keeping tabs of her whereabouts were baffled. Nicole got lucky. Sitting on the edge of her bed, she injected what turned out to be fentanyl, a substance used to sedate horses. She blacked out. EMS from nearby Springfield Township rushed over. "When I came to," she recalls, "everyone looked scared. I had blood and foam coming out of my mouth. My chest hurt. They thought I was dead."

Revived, Nicole turned herself in to authorities the next day. She begged the Mahoning County judge to keep her locked up for longer. Convicted of a second felony of the fifth degree, Nicole was ordered to a Youngstown corrections facility without visitation rights—though Haley saw her once—until October. She would, after months, return home anew.

Around her, Ohio's epidemic was worsening. Police were arresting drug users, but relapses were expected. In about a year, morgues in Summit and Montgomery County would fill up to capacity. Fentanyl would explode around the state, upping fatalities 20 percent, taking many of Nicole's friends. She asked herself: "Why was my life spared, and not theirs? And what can I do to save the next?"

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Pockmarked in and around opioid-stricken Ohio towns, a 2015 state emergency was met by a grassroots effort by recovering addicts torn by the epidemic. Some are full-on non-profit group meet-ups in the vein of 12-Step remedies, like Akron's Rebel Recovery; others are traveling centers for opiate awareness, like Choose Freedom or the Fuck Heroin Foundation. Others are groups of treatment coordinators—many who've saved one another in the past—operating solo or en masse with a detailed network of nearby clinics and patients-in-progress (some have at dozen "clients" at any given period of time). But all operate under the same pretense: recovering addicts foregoing the law to get users treatment themselves. And doing it fast.

Before soldiers like Nicole began driving to users' houses with clinic scholarships, addicts would follow a rigid path toward recovery: Register for treatment at a rehabilitation clinic, if there's one close by and he or she is qualified. Addicts arrested can pray their possession charge warrants a trip to a Florida sober campus, not residency in the county jail. But with meager half-measures, only 13.9 percent of Ohioans who needed treatment received it in 2014, according to the Centers for Disease Control and Prevention, all while 18 were dying per week from opioids. As a result, clinics can't keep up with patient demand; and addicts in rural towns may not even own a car, let alone the will, to drive hours for Vivitrol (a drug used to combat opioid dependence). Even Ohio police became skeptics of their own system—police were not used to reprimanding and jailing this many drug offenders. One police chief tells me that, up until 2015, the ins-and-outs of heroin arrestees were "pretty much a revolving door."

"If you put an addict in jail, they're actually more susceptible to relapsing," says Lieutenant Rick Edwards of the Akron Police Department. Edwards blames how ineffective drug arrests are on outdated police policies. "They may sober up, for four or five more days. But it's bogging down the criminal justice system, and it's inciting a vicious cycle. Putting addicts in jail is not treatment."

At about three years clean, Nicole saved her first life. She had been out of the Youngstown correctional facility since October 25th, 2013, and had moved to Medina to contemplate a second life. One day, after a rally in Youngstown, Nicole caught wind of a guy who couldn't beat his opioid addiction. "He told me, 'I don't really want to live like this anymore,'" she says. "I had to do something."

After a year or two of speaking at rallies and high schools, Nicole came across a Boston-based opiate pushback called the Police Assisted Addiction Recovery Initiative, which was started by a man named Leonard Campanello. An experienced narcotics officer, Campanello was fed up with seeing addicts criminalized. Nicole knew this was her in. She had no resources, but PAARI did. In October of 2015, she emailed PAARI director Allie McDade to see if a partnership was viable. McDade wrote back with glowing news: They could offer Nicole's friend a rehab scholarship.

"One time we were watching The Walking Dead and Haley said: 'Mom! Do you remember when you looked like one of those?'"

In early January of 2016, Nicole put on "We Do Recover" hoodie and jeans and walked into Chief Dave Keough's office in the Lodi Police Department to talk to him and eight officers about adopting PAARI's "Begin Again" philosophy into a revitalized offender policy. Fentanyl had exploded in Lodi, and Keough had agreed two months earlier to formulate a workable strategy. "Up to that point we weren't doing things right," he says. "We were basically just arresting people. That was it."

The PAARI solution seemed to fit on paper: Don't threaten non-offending users with jail time. Permit them to turn themselves in. Send them to detox in the small window they're sober. Follow up biweekly to stave off relapsing. Lodi's department was enamored. Officers now had the ability to revive addicts with state-funded Narcan—a type of spray naxolene used in emergencies to revive opioid overdosers—instead of just administering CPR. Nicole's efforts paid off. Lodi would place 111 addicts in detox over a year and a half with her help.

After her success in Lodi, Nicole took the PAARI model to 50 other police departments around Ohio. Most complied. Some, like Akron's, put up a stiff hand, refusing her advances under the belief that Narcan enabled further drug use. Nicole had only won over small departments, and hesitant big-city officers remained cynical.

"All the time I hear people say: 'Why don't you just let them die? They did this to themselves!'" Edwards says. "I reverse the role, and say: 'What about diabetics? Or cancer patients? Should we also let them die? Are their lives worth saving?' At some point we have to decide: Is this a criminal offense or this an addiction."

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At 8 a.m. on March 15th, 2017, Nicole and eight other addicts-in-recovery in her circle, including a Norton police officer named Heather Bauer, speed down I-71 South to Portsmouth, Ohio, to participate in the largest heroin rally in the country. I ride with Chris Carter, a high-on-life coordinator with specks of silver hairs who tells me he carried a Snub-Nose .38 revolver during drug runs, and once sold his BMW for $1,500 worth of heroin. "I was like a Jerry Springer episode," he says.

Our caravan down to Portsmouth is, in a way, the movement in a nutshell. As Nicole ramped up support for PAARI in 2016 around Ohio, she enlisted the help of "disciples helping disciples" under the title of "liaison." Samantha Burkhartt, the founder of Rebel Recovery, introduced her help to the church group in Cheston, and vice versa; she and Carter swipe clients via text message for the sake of immediacy. Bauer, a friend of Nicole's since Nicole sold Norton police on their own PAARI-like program, has administered would-be convicts to rehab since their partnership formed. It's the only way the pushback works: via a tight-knit method of fast-to-respond communication.

At the rally, 500-plus people gather in Spartan Stadium to talk to fellow battlers from as far as Del Ray, Florida. Groups of teenagers wear matching shirts that read "RIP MOM & JAKE" or "THE OPPOSITE OF ADDICTION IS CONNECTION." Grassroots groups like Recovery Mafia or the Wounded Warriors Project hand out recovery literature and sell self-published memoirs while a rapper named TeeLow sings: "I'm afraid to be alone / 'cause I'm scared of me." Without the posters and stark PSA-style adverts, accidental guests might think they walked into a medicinal flea market, not a rally against opioid addiction.

As Nicole chats with other treatment coordinators—trading contacts, business cards, patient info—a 29-year-old machinist named Randy Pierpoint walks the stadium's track in aviators and a Harley Davidson hat. He says that he went through "13 years of straight alcohol and drug abuse," and lived in denial up until a family intervention last year. His mom caught wind of Nicole, and called her. They met, and Nicole spent a month persuading a "selfish" Pierpoint of his delusions.

"She told me her story when I first met her," Pierpoint says. "I knew that she got it. [But] I still thought I was different. I'm not like these people. I've never robbed anybody. She doesn't know where I'm coming from." He looks around at passersby, lowers his cap bill, and tells me he got clean after Nicole got him a scholarship to a treatment center in Florida. Seven months later, in July, Pierpoint would start his own program. "Nicole had nothing to benefit from spending time with me to get me treatment. Just the faith that she knew I could do better. That's it, that's all it was to her."

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Since January of 2015, Nicole has helped place over 180 addicts in treatment across the state of Ohio with police help. There are 15 departments with pending partnerships, five in Cuyahoga County and three in Summit County (Akron's been on board since last July), along with plans to extend her reach to towns in West Virginia. As a whole, she's seen a 70 percent success rate, with 20 relapses so far, and three deaths. And her daughter, she says, will be following a path in her image.

"She wants to become a police officer," Nicole says, smiling, "so that she can arrest the same people who sold me drugs in the first place."

At Family Day in April, after Nicole tells her story for the umpteenth time, her aunt, Alice Eckley, walks up in a forest green sweater and gold-rim specs to read a letter she had kept in her purse since Nicole's recovery. Nicole listens as Alice reads from a half-folded piece of notebook paper, telling the story of the day Nicole approached her family to apologize for years of suffering.

"By taking the road less traveled, she has not only helped others, but reinforced them not to backslide," she reads. "Her eyes have now been open to see life and reality."

Nicole walks up to Alice with tears running. They hug. Around the room, everyone claps.

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