It’s been more than a month since 22-year-old Madison Marini died of a heroin-related overdose in the bathroom of the Taco Bell in King, where she worked. For her mother, Claudia, the struggle to make life go on without her daughter is just beginning.
“I wake up every morning and for a brief second I forget and I pray that it was a nightmare,” Claudia said. “Then I remember and then the rest of the day ends up being my nightmare.”
On Dec. 5, 2016, 24 days before Madison overdosed, she started a new journal.
“This journal is going to be all about my new, independent life and my timeline of me achieving everything I set my heart on,” Claudia read, from Madison’s entry. “I have a pending charge, no license or car. I’m not in school and still living at home. I work at Taco Bell. But, my goal is, by the end of this journal all of that will change.”
However, the first entry proved to be her last. Today, Madison rests, cremated, in a box in Claudia’s living room.
“Every morning I wake up, and I go over there and I just am so overwhelmed by the fact that my daughter is in a box,” Claudia said. “I wear her ashes, I have ashes in a locket, I wear her bracelet, I carry around her hair.”
But before the heroin made its way into Madison’s body, it had to get into the United States.
“I don’t know how they sell to these kids, take their money, and hand them over this drug, and walk away and know that there’s a 50/50 chance that they’ve just killed them,” Claudia said, of heroin dealers.
The Winston-Salem Police Department’s Special Investigations Division says heroin is made in Afghanistan, China and Mexico, with most of the heroin in the United States coming in from over our southern border.
“This is real people’s families. These are sons and daughters, moms and dads that are really dying from the poison, from the poison that these drug dealers are willing to profit off,” said Sgt. David Rose, of the Winston-Salem Police Department’s Special Investigations Division.
From the border, it’s sent to distribution points, to the dealers, then the users.
Somewhere along the way, they’re cutting the heroin, to make more money off of less of the drug; adding things like fentanyl – which is 100 times more powerful than morphine – and carfentanil, which is an elephant tranquilizer.
“Fentanyl, the airborne particles of fentanyl, have actually overcome police officers that were packaging and testing the stuff,” Rose said.
The Winston-Salem Police Department’s Special Investigations Division is home to their undercover operations.
“We’ve used undercover officers to buy drugs, we’ve used informants to buy drugs, we’ve executed search warrants, surveillance,” Rose detailed.
They run surveillance everywhere from your shopping centers, to your gas stations, to your neighborhoods. They’ll conduct operation with as few as eight officers and as many as 100.
“This is about as bad as we’ve seen it,” Rose said.
For the first time, overdoses have become the leading cause of accidental death in the United States.
“It’s passed car accidents, which has been the number one cause of death for decades,” Rose added.
In Forsyth County in January 2016, there were eight overdoses. In January of 2017, there were 23.
“When you’re looking at the lifeless body of a 20, or 21-year-old, laying on an asphalt parking lot, the gravity of what’s going on settles in quickly,” Rose said.
In addition to the fentanyl and carfentanil being added to the heroin, another major factor in the spike of overdose deaths happens when users relapse. They may not use for days or weeks at a time, but then they go back to it and use the same amount and their body can’t handle it.
“We’re going to go after the dealers and we want them to know that,” said Forsyth County District Attorney Jim O’Neill. “We’re coming after you.”
In the state of North Carolina, when someone overdoses, the dealer is just as guilty as the drug they deliver.
“To the drug dealers out there that continue to earn blood money on the souls of other people that are less fortunate than them, law enforcement will continue to come after you, and if we can prove that you delivered heroin that caused somebody else’s death, I can assure you, you’re going to be prosecuted to the fullest extent of the law,” O’Neill said. “We’re going to charge you with second-degree murder.”
When building a case, officers and attorneys have to decide how they want to charge the dealers; through the state, or the federal government.
“America is in the middle of a heroin epidemic,” O’Neill added.
O’Neill says 75 percent of heroin users started with legal opioids; prescription medications.
“Doctors back there were writing pills, just, crazy,” said Lance Ratliff, who last used heroin in October, speaking of his home state of Virginia.
At one point, Ratliff was crushing pills and laying them out on his bedside table, so he could consume the drug as soon as he woke up.
“I hear people tell me, so many times, ‘Oh it gets easier as time goes on,’ but it don’t seem like it’s getting easier for me,” said Ratliff, who is in the 90-day program at the Winston-Salem Rescue Mission.
From pills, Ratliff made the transition to heroin.
“Best way to describe it is it’s like hearing a train in your head,” he said, of the first time he used. “Just a roar.”
Following, Ratliff did what all users do, which is increase the amount of the drug they take in an attempt to get the same sensation.
“You’re always chasing that first high and it’ll never come,” he said.
As heroin usage increased, the Winston-Salem Police Department modified how they investigate it. In 2016, about two-thirds of their heroin-related arrests were for simple possession; mostly users. In January 2017, it became a 50/50 split, with half of their arrests being for crimes such as intent to sell and/or distribute and trafficking.
“I’ve you choose to poison the citizens of this city with heroin, we have chosen to make you our priority,” Rose said.
When Winston-Salem officers do encounter users, they give them an option; become part of the conspiracy, or help them go after the dealers, and seek treatment.
“I spent my professional career understanding and knowing this is a disease,” said Dr. Laura Veach, of Wake Forest Baptist Medical Center. “We still have a lot to learn about it and how it works, but yes it’s a disease.”
Classifying addiction as a disease provides some hope, Veach said.
“With other diseases that we’ve faced down, we’ve found ways to treat those more successfully and I believe with peoples’ awareness now and willingness to come together, we can do that with addiction as well,” she added.
Veach added that the medical community is changing its approach when it comes to preventing and treating addiction.
“Critically, urgently, this year, doctors are already changing the way they’ve been prescribing medications,” she said.
At Wake Forest Baptist Medical Center, they have started providing users with options for treatment when they’re most likely to have a moment of clarity; at the bedside.
“So many people who are affected by addiction have never seen help, gotten help, talked to anybody who’s a specialist,” she said.
Veach added that after six months, upwards of 70 percent of users who have sought treatment have made substantial changes.
“We’re not waiting for them to leave the hospital and make an appointment,” she added.
At the Forsyth County District Attorney’s Office, Jim O’Neill tells FOX8 he has appointed five full-time drug prosecutors on his staff, who primarily go after drug dealers.
“The education has to start earlier,” he said. “We have to make people aware that, they’re thinking that pills right now are not going to lead to a bigger problem, but it always does.”
The Winston-Salem Police Department wants to stress the importance of saving life with the Good Samaritan Law. The law means that anyone who calls 911 or notifies a first responder that someone is having an overdose, they cannot be prosecuted as long as they provide their real name, assuming the person acted in good faith when seeking medical assistance, they provided their own name to the 911 system or law enforcement officer and the person did not seek the medical assistance during the execution of an arrest warrant, search warrant or other lawful search.
In 2016, 76 people were revived using Naloxone in Forsyth County.
“That’s 76 times that somebody got a second chance,” Rose said.
It’s these experts’ hope that with more education, more care and more research, we can have fewer users, fewer crying mothers and fewer life stories left unwritten.
“I think sometimes about if I live a full life, 40, 50 years I have still,” Claudia said. “I have to do those 40, 50 years without her and it crushes me.”