Jose Cruz thought his luck had changed when a fellow inmate sprung him from Northampton County Prison during a massive jailbreak. But three months of freedom merely resurrected Cruz’s heroin habit.
Recaptured in Connecticut, he writhed in pain for three days as he withdrew cold turkey in a holding cell. For Cruz, 26 at the time and an addict since age 14, the experience was the final push he needed to give up heroin.
“I decided right then and there that I wanted a different life,” he said.
With the help of a merciful judge who offered him drug treatment instead of prison time, Cruz did change his life, morphing from a petty drug-dealer to an addiction counselor to a medical professional. He now works as a community health specialist for the city of Bethlehem and has been clean 34 years.
As a heroin epidemic rages across Pennsylvania and the nation, stories like Cruz’s show recovery is possible, though not easy. “For most, it’s a process” that requires help to get through, said Jay Youtz, an intervention specialist with Recovery Centers of America, a chain of for-profit addiction treatment centers headquartered in King of Prussia, Montgomery County.
Fueled by cheap and easy access to heroin and prescription opiates, drug overdoses have become the leading cause of accidental deaths in the United States, surpassing car accidents in 2015, according to the U.S. Department of Justice. The Lehigh Valley has not been spared . In the first 11 months of 2016, there were 127 drug-related deaths in Lehigh County, Coroner Scott Grim said. Toxicology tests are pending in some of the cases, but Grim estimated about 70 percent of those deaths could be attributed to heroin or opioid medication.
In Northampton, Coroner Zachary Lysek reported that the “majority” of the 79 drug-related deaths in 2016 were caused by heroin.
Picking up the needle
Cruz began using heroin as a teenager in the 1970s to dull the anger he said he felt over his family’s move from Puerto Rico to Bethlehem. Upset about changing schools and losing friends, he picked up the needle.
Cruz fed his habit by selling the drug, which could be bought in New York City for around $3 a bag and resold in the Lehigh Valley for $10, he said. Drug dealing led to several stints in jail, culminating with the 1981 escape from Northampton County Prison when inmates used a smuggled gun to hold guards at bay while one unlocked 70 to 80 cells — including Cruz’s.
Nicknamed Rabbit Foot by his older siblings because of his ability to run from trouble, Cruz was looking at a possible state prison term on the escape charge and parole violation when the judge offered him a fresh start.
His efforts caught the attention of the program’s director, and soon Cruz was hired to coordinate counseling at Hogar Crea sites in Puerto Rico before becoming an assistant director at the Bethlehem program.
“I found myself sitting at tables with the minister of health, with professional people, and I realized, I can function this way. I am cured,” he said.
Cruz rejects the “once an addict, always an addict” message that’s preached in many recovery communities. He believes adopting a new mind-set is the key.
A strong will definitely helps when trying to get clean, but it’s rarely enough, said Bart Rossi, a clinical psychologist in Florida, where heroin overdoses have quadrupled since 2014, according to the Florida Medical Examiners Commission.
“With opiate addiction, the high is so overwhelming that the need to use is extremely difficult to conquer by an individual alone,” Rossi said. “Addiction is not just about being tough and taking control. It’s about having the right treatment.”
Treatment doesn’t work for everyone. And even when it does, “relapsing to drug abuse at some point is not only possible, but likely,” according to the National Institute on Drug Abuse. The institute notes 40 to 60 percent of drug addicts relapse. For heroin users, that number is probably much higher, said Chris Jacob, a counselor at Keenan House in Allentown. Perhaps 85 to 95 percent, he said.
It took a lot of treatment — 13 stints in rehab — for Nicholas Labar, 24, to stop using heroin three years ago.
Labar last shot up while sitting at a picnic table along the Delaware River in Portland, where he was living at the time. He recalled spreading several bags of heroin on the tabletop. Below it sat items he had stolen from his father and planned to pawn. Labar said he realized then that he had to get out of Portland and stay away until he could get clean.
Like many heroin addictions today, Labar’s started in the medicine cabinet. At 15, he shattered his leg while sledding and was prescribed the opioid pain reliever Oxycontin. He quickly became addicted to the incredible high.
When the prescription ran out, Labar felt sick but didn’t realize he was experiencing withdrawal symptoms. When he complained to a neighbor about his aches and fever, the man invited Labar into his home and tossed him a bag of heroin.
“He thought nothing about giving a bag of heroin to a teenager,” Labar said.
The first snort remains etched in his mind. He loved the feeling of his body feeling numb and his mind free-falling into nothingness. It only took a few months for his addiction to take hold. He asked the same man who introduced him to heroin to inject him with the drug and soon Labar was shooting up on his own. At the height of his addiction, Labar said he was using 20 to 30 bags a day.
After numerous relapses, Labar has stayed clean.
Like Cruz, sobriety came after an epiphany. “I realized if I didn’t want to get better, nothing would work,” he said.
A poised public speaker, Labar shares his journey to recovery at events across the country and coaches recovering addicts at Discovery Institute, a detox facility in New Jersey.
While Labar and Cruz found success in traditional treatment programs, there is no single road to recovery. Each person has to sort through the options to find what works for them, said psychologist Sheila Shilati, who heads Seasons Recovery Centers in Malibu, Calif. Shilati teaches her clients to focus on maintenance, instead of chasing a cure for their disease.
“Recovery is not a straightforward diagnostic road map like treating diabetes or high blood pressure,” Shilati said. “For some heroin users, the commitment to lifelong recovery through active program participation is the only way. They may not want to hit the same rock bottom they once did, and the threat of feeling cured might just open them up to the potential of relapse.”
Labar said he’s glad to see the fight against heroin addiction going mainstream, but laments that so many people died before communities rallied to end the epidemic.
“And now parents are losing their kids, kids are losing their parents and other family members,” Labar said. “It’s not until people start dying that everyone realizes how bad the problem is.”
Stepping out on their own
On the second Sunday of each month for the past 30 years, alumni gather at Keenan House in Allentown for brunch and goodbyes.
Before dawn, residents of the treatment center that houses up to 95 men, chop strawberries to top waffles, scramble dozens of eggs and set up brunch for the public. The invitation allows the community to learn more about the facility, where residents find rehabilitative treatment and therapy as well as opportunities to get high-school equivalency diplomas and build self-esteem.
Recovery requires more than kicking the habit, said Jacob, a former Keenan House resident who credits the facility with saving him from cocaine addiction.
“The criminal justice system is ill-equipped to deal with addiction and there needs to be more thinking-outside-the-box alternatives like this,” Jacob said. “If abstinence worked, prisons would be the ideal environment to deal with addicts.”
At the brunch, alumni offer not just encouragement, but also guidance to those leaving Keenan House, helping them navigate the pitfalls and challenges of recovery.
“It’s a time of anxiety for many of these people who are getting ready to leave and have to learn how to live life again,” said Peggy Douglass, Keenan’s activities director. “It allows those alumni to help share what worked for them and provide support.”
Before brunch, there’s a meeting for soon-to-be-released residents and alumni, who are greeted with hugs and hellos.
Yampi Ramos, 40, arrived a few minutes into a recent meeting. After he introduced himself, someone lightheartedly pointed out that Ramos’ new shirt still had the size tag on the front.
“As you can see with the new shirt, I’m keeping it fresh,” Ramos quipped. He’s been clean from heroin for six months and is trying to rebuild his life, starting with his relationship with his mother, who hasn’t responded to the letters he has written.
“I burned some bridges on the way,” Ramos said to the group. “That’s what happens when you’re an addict.”
Ramos, who is living at a halfway house in Allentown, said he didn’t come into recovery easily. He reveled in “causing drama” for the counselors and staff and admitted he “basically fought them every step of the way.”
But like many addicts, he faced a reckoning: “I had a choice of either life or death, and I chose to live,” he said.
After the alumni meeting, the men headed downstairs to fill their plates with waffles, bacon and made-to-order omelets.
The diners included Tom Chrin of Allentown, cutting up pancakes for his 3-year-old daughter and sipping coffee with his wife, Amber. Both are in recovery.
Chrin said he’s been clean for more than eight years since leaving Keenan House. He works as a church custodian and can scarcely believe how far he’s come after using heroin and cocaine.
“The sad reality is no one can do this, do recovery, for you,” Chrin said. “You can be prayed over, beaten on and incarcerated and until an addict wants to stop, none of it helps.”
Nationwide: More than 265,000 people between 1999 and 2014.
Pennsylvania: 3,383 between 2014 and 2015 alone.
Lehigh County: Most of the 127 drug-related deaths in 2016 involved heroin or other opioid
Northampton County: Most of the 79 drug-related deaths in 2016 were caused by opioids.
Sources: Federal, state and county statistics
To find resources for overcoming addiction:
•Lehigh County Drug and Alcohol Administration: 610-782-3555
•Northampton County Drug and Alcohol Division: 610-829-4725; emergencies, 610-252-9060