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Dec

29

2014

The Spike In Our Veins

Heroin Epidemic in Mountain Towns

[Editor’s Note: On May 1, 2015, the Western Publishing Association recognized this feature from Mountain‘s Early Winter 2014 issue with the 2015 MAGGIE Award for Best News Story in a consumer publication. For 64 years, the WPA MAGGIE Awards have honored excellence among media publications in the Western United States. See a complete list of 2015 finalists here.]

Injury, prescription painkillers, opiate addiction, death. Gordy Megroz reports on the growing heroin epidemic in mountain towns. Photograph by Chris Milliman.

I don’t know just where I’m going / But I’m gonna try for the kingdom, if I can 

‘Cause it makes me feel like I’m a man / When I put a spike into my vein

Then I tell you, things aren’t quite the same / When I’m rushing on my run

And I feel just like Jesus’ son / And I guess that I just don’t know

And I guess that I just don’t know —Lou Reed/The Velvet Underground

“Get your feet off the table! Did you do your chores?” Brennan Dekeersgieter shouts at a friend, playfully imitating an authority figure they know. At six feet, three inches tall and athletic, Brennan’s imposing enough to command respect when barking orders. But his kind blue eyes and goofy demeanor invite the dinner table to erupt in laughter. With a grin, Brennan wraps an arm around his younger sister Caitlin and hugs her.

It’s Thanksgiving 2012, and the Dekeersgieter family has come to Portland, Maine to celebrate the holiday with Brennan, known to friends as Bo. There’s cause for joy. The 26-year-old has been clean for 10 weeks, a notable stretch after a five-year prescription opiate habit compounded by more than a year of heroin addiction. Divorced now, his mother, Margery Keasler, an acupuncturist, and father Robert, a furniture maker, have traveled from Burlington, Vermont to support Brennan. Caitlin, 18, arrived from the University of New Hampshire, and Brennan’s brother Colin, 23, made the trip from the City University of New York. The family brought a 25-pound turkey for the occasion—big enough to share with the other young men that live in Skip Murphy’s sober house.

After dinner, Margery offers Brennan and his housemates acupuncture. “Make sure you put on the good yoga music for Dominic,” he jokes, and Margery smiles. The drugs made Brennan “really pissy,” she says. But this was the demonstrative, compassionate son she knew. Brennan was back. There was hope.

If you’re of a certain age, you might think of heroin addiction as an affliction of ’70s rockers, but opiate abuse in the United States is once again an epidemic. According to the Centers for Disease Control (CDC), about 17,000 people die from prescription painkiller overdoses annually. And as the medical world has moved to curtail the misuse of such legal painkillers, heroin, a cheaper, staggeringly dangerous, and highly illegal opiate, has filled the void in the market. Nearly 670,000 people reported they used heroin in the past 12 months—that’s about double the users counted by the CDC as recently as 2007.

Despite rampant headline catching heroin use in cities, there’s often a presumption that mountain towns are safe from the scourge. These healthy-lifestyle populations eschew hard drugs for the natural rush of skiing, biking, or climbing—or so the thinking goes. Here’s how it actually works, as recounted anonymously by a recreational cyclist, businessman, and father from Boulder, Colorado. The cyclist’s daughter was a star swimmer in high school, but an overuse injury in her junior year forced her off the squad. Prescription painkillers were prescribed. When they ran out, classmates from low-income neighborhoods offered her a few pills for free. Her grades dropped, as did her ambition. Within 18 months, those same students introduced the recent high school graduate to heroin. Now hooked and dangerously close to overdosing, her father found her in a run-down apartment in the gleaming university district. He rushed her to rehab.

Such is the stark contrast of heroin addiction in beautiful places. Pastoral and liberal Vermont is home to 19 ski areas, burgeoning networks of singletrack, and an archipelago of picturesque mountain towns. But Rolling Stone recently dubbed it the “new face of heroin.” In January 2014, Vermont Governor Peter Shumlin boldy faced the issue head-on in his annual address: “What started as an OxyContin and prescription drug addiction problem in Vermont has now grown into a full-blown heroin crisis.”

In Colorado, police busts don’t nab just a few baggies of weed anymore. This past January, Grand Junction cops apprehended a man transporting five pounds of heroin. A scan of the obits reveals recent overdose deaths in Aspen, Durango, Crested Butte, and Steamboat Springs. Tom Warnick, a rising star freeskier who appeared in Stept Productions ski films and appeared destined for life-long pro skier fame, overdosed and died in Boulder in November 2013.

The pattern holds throughout the West. Local authorities report a 30 percent increase in heroin-related seizures over the past year in Tahoe. That figure is on par with British Columbia’s rise in trafficking and possession cases in 2012. “Smack is Back,” announced an August headline in Wyoming’s Jackson Hole News & Guide. The article detailed three heroin-related arrests that month. Last year, a local physician reported the first heroin overdose he’d seen in 30 years. Tellingly, nearly half the people in Brennan Dekeersgieter and Tom Warnick’s age group who use heroin abused prescription drugs first.

 “We play hard. We get hurt. We take drugs,” says Ed Wigg, director of the Curran-Seeley Foundation rehab facility in Jackson. “The lifestyle tends to breed abuse. Your feet and knees are killing you, but you don’t want to miss a powder day. So you pop some Oxies and head for the hill. And if heroin is cheaper, that works too.”

Most people don’t know Brennan Dekeersgieter the junkie. Most people know Bo the snowboarder with big dreams.

Brennan first tried the sport when he was 11, on a vacation with a friend’s family to Bariloche, Argentina. The surfy powder at the Cerro Catedral resort wooed him, but adrenaline rushes from big air made him a devotee. Back home in decidedly non-alpine Key Biscayne, Florida, he grew his hair long and immersed himself in snowboard culture. Up went posters of pro snowboarders. He picked up the lingo, the image, the baggy clothes. When he was 14, Margery and Robert moved the family to Burlington, both to escape South Florida’s drug and alcohol problems and to cultivate their eldest son’s passion.

In Vermont, Brennan refined his snowboarding at Smugglers’ Notch and Stowe. After graduating high school, he enrolled at Sierra Nevada College (SNC) to study business in 2006. The school’s Nevada campus sits in the shade of lofty Ponderosa pines just two blocks from the north shore of Lake Tahoe. The college takes its name from the granite mountains that rise nearly 4,000 feet above the expanse of impossibly blue water. Seven major ski resorts call the area home. Brennan came for those mountains. He snowboarded every day. And he was good at it.

“He had the most natural style of any snowboarder out there,” says Sean Hartel, a friend. “He could ride any gnarly line with the best pros. But he didn’t want to be the best—he just wanted to have the most fun. He always had a huge grin on his face. It rubbed off on everybody.” 

At the end of his first semester in Lake Tahoe, Brennan hit a jump, landed weird, and tore the ACL in his left knee. He returned to Vermont for surgery and rehab, and doctors prescribed the opiate Dilaudid for pain relief. As the weeks went by, Margery realized something was wrong. The prescriptions had run out, but Margery thought Brennan was still taking drugs. “He was itching and he would isolate himself in his room,” says Margery, whose brother was once addicted to opiates. Then she overheard a conversation. Brennan was buying pills from a friend. “When I’d confront him about it, he’d argue with me and tell me I was crazy.” 

Finally, about five months after surgery, Brennan sat down in Margery’s office, and admitted she was right. “I have a problem,” he said.

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Brennan spent 30 days at Maple Leaf Treatment Center, a rehab facility near Burlington, and then headed back to Tahoe where he took online classes, worked in a ski shop, and delivered pizzas. Along with Hartel and three more friends, Brennan rented a Tahoe ski palace complete with a hot tub. Healthy again, he continued snowboarding. Hartel says Brennan was not using drugs at that time. “He didn’t need to,” says Hartel. “We were having too much fun. We’d mountain bike, go four-wheeling, camp, sail, hang out at the hot springs. We had a saying: Our ordinary day is better than anybody else’s best day.”

For the next few years, Brennan spent winters in Tahoe and summers in Vermont. Back home, he’d relapse, then stop using when he returned to Tahoe. Margery says Brennan had learned to hide his habit. “He was ashamed,” she says. “He never wanted his friends to know he used drugs.”

In March 2010, Brennan was snowboarding at Alpine Meadows. He dropped a 20-foot cliff and landed on exposed rocks. The impact caused trauma to his lungs, pelvis, and right wrist, as well as bleeding in his brain. Doctors placed him in a medically induced coma and removed half his skull until the brain swelling subsided. Brennan spent seven weeks in intensive care with a traumatic brain injury. Doctors feared he would never speak again. 

Once more, Brennan returned to Vermont to live with his mother and rebuild his body. Margery made sure Brennan left the hospital without any opiates that might entice him to use again. Thanks to grants from the High Fives Foundation, a Tahoe nonprofit that helps injured athletes defray medical costs, Brennan received craniosacral massage, neuropathic massage, and other treatments that High Fives founder Roy Tuscany says “helped connect his body to his brain.” Within six months, Brennan had made a near complete recovery. “His doctors were shocked,” says Margery. “They said he must have a very special brain to heal like that.”

But by autumn, she could tell Brennan’s drug problem had returned. “I told him if he was using, he had to leave my house,” says Margery. Her son would crash at a friend’s place for four or five days, then check into drug rehab, then return to Margery’s home, only to repeat the cycle. He hid the turmoil from High Fives. “Brennan was always checking in with us,” says Tuscany. “He would give us updates on his progress and ask how he could give back. I can’t say that any of the 65 athletes we’ve worked with has ever had a drug problem, and it never crossed my mind that Brennan did either.”

Science can help explain why Brennan and active mountain types like him could be predisposed to heroin addiction. The drug supplies a rush of dopamine, the hormone produced by our brains responsible for feelings of reward. The brain gets the same surge during outdoor sports. “People who are addicted to opiates are often people who like extreme sports,” says Dr. Theodore Friedman, chairman of internal medicine at Charles R. Drew University of Medicine and Science. As the theory goes, those with naturally low dopamine levels are drawn to sports like skiing or whitewater kayaking that supply a dopamine boost. “Heroin does the same thing,” says Friedman. “It’s easy to see why those people could become addicted.”

As Brennan’s addiction progressed, he’d get a job waiting tables and then get fired. He moved in with his father. One day, Robert discovered a spoon, lighter, and a syringe. Was his son using heroin? Confronted by his parents, Brennan broke down. “He was crushed, ashamed, and angry,” says Margery. All three were in tears.

“Yes, I did it,” Brennan said. Then he quickly got in his car and drove away.

Heroin is cheap today. Most of the stuff sold in the United States now originates in Mexico and Columbia—as opposed to Southeast Asia, which historically dominated the global market. In 1995, a kilogram of heroin cost upwards of $250,000. But in 2007, a Mexican cartel run by Carlos Ramon Castro-Rocha began growing poppies. The flower’s oils contain opium, a narcotic used by humans since the Neolithic age and the raw material for heroin. The switch to poppies and heroin, and away from marijuana, may be linked to the decriminalization of pot in the U.S. Legalized grow ops mean less demand for smuggled cannabis. But the distribution channels are the same: “Heroin’s cheaper now because it’s easier to obtain,” says DEA agent Matt Barden. “It passes through less hands.” Street value for a kilogram of heroin now dips as low as $24,000. A serious junkie can buy a week’s supply for $350.

From Mexico, the supply chain runs through major cities like New York, Boston, Montreal, Los Angeles, and Denver. But then it moves to the suburbs and eventually mountain towns where it garners higher prices. A point—a bag holding one-tenth a gram of heroin—can sell for $6 in Boston and $30 in Vermont. It’s a significant markup, but still far cheaper than the prescription painkiller equivalent, which can run $60 on the street. “A lot of people travel through Vermont, so it’s easy to traffic,” says Barbara Cimaglio with the Vermont Department of Health. 

Even the progression from popping prescription pills to injecting heroin has lost its stigma. Today’s prescription opiate abusers often grind their pills to a fine powder to snort or inject. By the time they sink to heroin the delivery method is familiar. And it’s worth pointing out that Millennials missed the drug culture and ensuing war on drugs of decades past. “Kids today aren’t raised in a world where heroin is a scary drug,” says Wigg, the Jackson addiction counselor.  

Brennan’s parents, however, were terrified. After he admitted using heroin and drove off distraught, they sent him to another rehab facility. He spent a month at the Plymouth House in New Hampshire before Margery took him straight to Skip Murphy’s sober house. 

At Murphy’s, Brennan was assigned chores, required to attend meetings, and kept a mandated journal. “He hated the rules,” says Margery. “But he felt that’s what he needed to get better.” He got another job waiting tables—and held onto it. After the OK from doctors, he began snowboarding again. Then, shortly after that Thanksgiving dinner with his family, he ate somebody else’s food in the sober house and missed curfew after a day of snowboarding. The rule violations got him kicked out of Skip Murphy’s.

Another sober living house on the same block admitted him, but after more infractions he moved into a less supervised sober apartment with a roommate. In early 2013, he visited Margery in Vermont. When they said goodbye at the bus station, she could tell something wasn’t right. “I was trying to let go a little, to not be so invasive,” she says. “I just told him how much I loved him.”

Two weeks later, Margery was visiting Brennan’s brother Colin in New York City. At   6 A.M. on March 2, Margery’s phone rang. The caller ID revealed it was Brennan’s roommate in Portland. 

“What’s up? Is Brennan OK?”

The roommate had found Brennan in his bedroom, slumped over in a chair, a syringe nearby. “Brennan is dead,” he said.

Margery threw her phone against the wall and wailed.

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Colin delivered his brother’s eulogy to 350 mourners in Burlington. “Brennan owned every single room he walked into,” he said. “When he was on the mountain, the mountain was his. But his immensity came at a price: He had to hold up the world. He had to bear all its beauty, its aches and pains, its hate, its anger, and its love. He took it all in, letting out only the light and burying the dark, deep into a place I never understood because his pride would not reveal it.”

The description fits many heroin addicts in mountain communities: Big personalities racked by a secret, torturous battle. “Coming off heroin feels like having the worst flu ever, times ten,” says Brad Osborn, a private addiction counselor in Basalt, Colorado. “A lot of addicts here are otherwise successful in life. Lack of control is terrifying. And the whole time they’re thinking, ‘One little hit can stop this.’”

Ironically, drugs can help. Buprenorphine blocks opiate cravings, and it can ease withdrawal. Same goes for methadone, a less potent opiate that doctors administer to manage addiction and wean patients off heroin. But eventually addicts must withdraw from those supplemental drugs. The process can take years. Inpatient rehab coupled with a lifetime of outpatient therapy seems to work best. Addicts who do 30 days of inpatient treatment have a 30 percent success rate; that jumps to 70 percent for 90 days of treatment. Insurance often covers treatment, but when it doesn’t, the cost of medication can run upwards of $400 a day. And there are other expenses. Brennan’s parents paid $950 a month for sober housing. 

For its part, the federal government targets the source, tracking cartel movements and making clandestine stings that often don’t appear in the news. But Vermont has shifted policy. In August, Governor Shumlin announced that people caught using or possessing heroin can avoid prosecution by enrolling in treatment. Vermont addicts have improved access to medications to help them quit. As Shumlin pointed out, treating an addict costs the state $136 a week, compared to $1,138 a week for prison.

As the medical community unravels what causes heroin addiction, professionals are managing prescribed drugs more closely. Patients typically become hooked after 90 days on opiates. So doctors are finally employing different pain management techniques—from less addictive drugs to acupuncture—and attempting to take their patients off opiates before addiction sets in.

To help find some good in Brennan’s death, Margery now heads up the Vermont chapter of Grief Recovery After a Substance Passing (GRASP). The organization supports bereaved families, advocates for better drug education, and provides information for parents of addicts. The family also set up the Brennan Dekeersgieter Fund to introduce underprivileged kids to the fundamentally healthy pursuit of snowboarding. “Brennan would want that,” says Margery.

These days Margery visits Brennan’s memorial four days a week. The bench in Burlington’s Oakledge Park overlooks Lake Champlain. An inscribed plaque reads “Ride Infinite Powder.” 

There are few answers. “I cry,” Margery says. “I cry a lot these days.”

From the Early Winter 2014 issue. Please visit grasphelp.org for more information.

9 Responses to “The Spike In Our Veins”

  1. Alora Goodkind

    i LOVE you Margery. May your painful journey help others. My daughter is an opiate addict so I know the painful struggle to understand. Please care for yourself.

    Reply
  2. Vickie

    What an amazing story. Brennan will be missed every minute of every day, but his life has touched so many,, so deeply. Those who knew him should be grateful. HIs light was brighter than most. Always thinking of you and your family. XO

    Reply
  3. Sarah Jarvis

    Thanks for sharing. I am an avid snowboarder from Burlington VT as well and always have a season pass to smuggs… I have experienced many friends and loved ones going through addiction and am writing a fiction novel about drug (specifically heroin) addiction. If it ends up getting published and being profitable I would like to donate a portion of the profit to either drug treatment facilities or something like the Brennan Dekeersgieter Fund.

    Reply
  4. Bob Campbell

    Gordy has written some great pieces. This may well be his best. . With all we know about drugs it just doesn’t make sense.

    Reply
  5. Mara

    This is powerful and spot on. I lost my younger brother in October and it has destroyed our lives. Not just his death, but all that led up to losing him. This is an epidemic gaining full steam throughout our nation and there are no answers. Only knowledge can bring power and I am grateful Gordy and others are ending the silence.

    Reply

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