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Man: Lyle! Get up, Lyle!

Get up.

Man: Facebook Live, he found her passed out, man.

He found her passed out on her face... (indistinct).

I don't know. But he might be dead, bro. Hold on, bro.

(woman speaking indistinctly) Yeah, hold on, fool.

He might-- might be dead, jack.

Alan Spanos: We doctors were wrong in thinking

that opioids can't be used long-term.

They can be and they should be.

We used to think they'd stop working

or that patients would become addicts

or that they'd be sedated into inactivity.

Spanos: We now find that these medicines are much safer,

much more powerful, much more versatile than we used to think,

and we feel that they should be used much more liberally

for people with all sorts of chronic pain.

Man: Some patients may be afraid of taking opioids

because they're perceived as too strong, or addictive...

but that is far from actual fact.

Less than one percent of patients taking opioids

actually become addicted.

Man: She's making noises.

She's making noises. Yo!

Woman: She's breathing. She's-- Come on, baby.

Man: Breathing? Woman: Yeah. She's...

She's trying to-- Come on, girl.

Come on, Jerry, wake up.

Jerry, wake up! Look at me.

Look at me, Jerry.

Officer: Jerry, look at me! Come on!

Man: Wake up, girl! There you are! Man 2: Woo-hoo!

Stay with us. Hang on. Stay with us.

High five, you're alive. You're fine. You're okay.

Man: You all right? You with us?

You doing okay?

Hey, stay with me, man. Stay with me.

Man: Can you wake up? Woman: Are you gonna be okay?

Is she okay?

Man: Yo, she's overdosing. Like, what the fuck, man?

Man: Wake up! Man 2: Hey!

Man: Wake up, wake up!

Wake up, boy!

Get water, get water, get water!

Man 2: Pour water on her first.

Man: Want him too? Man 2: Fuck it, man, 'cause...

Man: I know. Man 2: Anything could've happened.

(child crying) Mommy... Mommy!

Man: Oh my God.

Mommy! (crying)

Mommy!

Newsman: Law enforcement says they have never seen abuse

of a prescription drug mushroom out of control so fast.

Newsman 2: These drugs all belong to a family of drugs called opioids.

Woman: And prescription painkillers lead to heroin.

Newswoman: It is a narcotic, closely related to heroin and morphine

with the same potential for addiction.

Stephany Gay: If somebody'd told me six years ago

that I was going to be a heroin addict,

I would have thought that they were crazy.

Never in a million years.

I didn't hang out with bad kids.

I didn't get in trouble.

I-I just would have never ever thought that it could happen to me.

When I was about 16,

I started getting kidney stones,

and they would give me pain medication for it,

because that's pretty much all that they could do.

Kathy Kelly: The X-rays would show the kidney stones.

There was no faking it, nothing.

I mean, here is a child, 15, 16...

that was about the age she started getting 'em,

um, and she's getting 'em every-- few times a year.

Stephany: They gave me a shot of Dilaudid,

which is a very strong painkiller.

And then I remember them sending me home,

with a prescription of Oxycontin

and a prescription of Vicodin.

Kelly: And I remember thinking at that time,

"Wow, those are kind of high-powered medications for such a young person,"

but I trusted the doctors.

Stephany: In the beginning, I would just take my Vicodin

as prescribed when I was in pain,

but it, like, gradually got worse over time.

It numbed my feelings and made me feel like...

okay about everything.

You know, "I'm fine. I'm-- I'm good."

You know, I would take an extra one here or there,

and then, if I ran out, I would just pretend

like I didn't know what was wrong with me, so that I could get more.

You know, faking pain to go to the hospital to get painkillers.

I mean, it would be anything from Oxycontin,

to Vicodin to Norcos.

Then it went from taking the prescribed dose

of like one every six hours

to taking, like, 20 Norcos a day.

I'm going through a month prescription in two days.

And I called my mom crying, and I was like, "I don't know what's wrong with me."

"Mom... I can't stop taking these,

'cause when I stop taking them, I don't feel good."

I said, "Well, we need to talk to your doctor."

And he wrote me another prescription for Percocets,

which was stronger than the Norcos that I had been taking.

My sister, Ashley...

she was the closest person to me in this whole world.

We did everything together.

I would get painkillers, and I'd, like, you know,

when I started getting bad with them

she was curious, because what I did, she did.

So, to go to sleep, she'd be like, "Let me get one of your pills.

Let me get one of your painkillers to go to sleep. Let me get a Vicodin."

And I'd give her one, you know,

and she'd be like, "Oh my gosh, I love this."

Kelly: They would share 'em with each other.

"Oh, I have a headache." "Oh, well, here, you can take one of my pills."

Um... menstrual cramps.

One sister sharing medication with another sister.

Stephany: We'd never been exposed to drugs like that.

We didn't know what could happen, you know?

We just thought, like,

"Well, our doctor started giving us the, you know,

these painkillers, so it can't be that bad."

Well, then he cut her off on 'em,

and then she didn't feel good.

Her friends say, "Oh, well, here, I'll give you-- Take mine."

But they became expensive to buy privately from friends,

and the doctors would not give 'em to her anymore.

So, this friend gave her a little bag,

and said, "Just sniff this.

"It'll do the same thing as the pills do,

"only thing, you don't need to take five pills.

"Just take this little bag, sniff it,

and you'll feel better."

And it worked!

She took it and it worked.

I remember thinking, like, "Wow. This is the best feeling in the world."

It was really, like...

I had, like, not a care in the world.

It made me feel like I could do anything.

I felt like Super Woman.

It's a lot cheaper than...

buying 15 Norcos a day at five dollars apiece.

You know, "Here's a ten-dollar bag of heroin,

and it'll last you three days."

I didn't have anxiety or I didn't feel depressed.

I felt happy, I felt warm.

I felt like it loved me, and I loved it back.

It felt like I was in, like, a relationship with it,

like, I felt like I had a relationship with heroin.

It was just the best feeling in the world.

I snorted heroin for about a year.

Me and Ashley both did.

Kelly: They did not know

the scope of the addiction that they were up against,

like a tidal wave.

You know, you're standing on a beach, and you've got this...

50-foot wave coming at you.

And I remember Ashley saying,

"It's not like we're sticking needles in our arms, Mom."

Stephany: "That's for real junkies.

"You know, I'll never do that.

"I'll never touch a needle.

That's disgusting, that's gross."

And somewhere... along that time,

somebody introduced the needle to them.

Stephany: You only have to do a little tiny bit,

and you get, you know, ten times as high,

and it lasts ten times as long,

but then, it, like, gets so out of control so fast.

If I was lucky, you know,

it would only take me ten minutes to hit a vein,

and then I could go lay back down.

I had no veins left.

I mean, in my neck, and the side of my face,

palms of my hands, my fingers,

I mean, like, on my chest,

and I'd be covered in blood.

I would just sleep all day,

till I woke up from being sick again,

and then I'd have to go through it all over again.

When I started using...

I had my own three-bedroom, two-story house.

I was a stay-at-home Mom with my two-year-old daughter.

Me and my daughter's father,

we each had our own new cars.

We had a pool in our backyard, we had two dogs.

I had, like, the perfect life.

By the time I started injecting heroin,

I had lost my house.

We'd sold both of our cars,

and I lost custody of my daughter.

Kelly: I remember Ashley saying,

"I don't want to do this anymore."

It was no longer a party,

and she was a slave to it.

Stephany: She got into a fight with her fiancé,

and she went and got a motel.

I was clean at the time, and I...

I didn't think that she was using.

Kelly: Ashley had been in treatment.

She had stayed in just long enough

to get through the withdrawal period,

and she felt fine,

and then she walked out of treatment early.

That's when it can take 'em because they think

that they can use what they were using before.

They say, "Well, I did this much,"

um, "so I can handle it," and they can't.

Their body is back to what it was.

And when I would tell my daughter,

"I'm so worried about you, Ashley,"

she would say,

"Mom, I'm-- I'm too young, and pretty to die.

I'll be fine. I'm gonna beat this."

Stephany: I think that maybe she thought

she could just do it one more time

and get that really good high,

and then not do it anymore.

And it's like... that one time, you never know.

Stephany: Her fiancé called me, and he was at the motel,

and she wasn't answering her phone.

Stephany: He called me and he was, like, hysterical.

Stephany: He started banging on the doors.

He called 911, and told the operator,

"My girlfriend is a heroin addict.

"She's not answering her phone.

"I know she's in trouble.

Please come to this hotel and help me."

Stephany: I remember where I was at.

I was at the Taco Bell drive thru.

I remember seeing the police station's number come up on my phone.

And I remember picking up the phone,

and it being a man's voice.

He was like, "I'm sorry for your loss."

And I was just like...

I was like, "What are you talking about?"

And, um, he's like,

"I need you to come into the police station."

And I just-- I knew.

And...

It was like my whole world just, like, stopped.

It was the worst nightmare that anybody could have.

I miss her every day.

From morning till night, it's an all-day thing.

Stephany: I was suicidal when I lost my sister.

I would just do massive amounts,

$200 worth of drugs,

in an hour, in a sitting.

Just praying, like,

"Please don't let me wake up.

I don't want to live anymore."

Stephany: She was like a second mom to Audrey.

She acted like Audrey was her daughter.

You know, she would--

She would take over when I would get stressed or...

Kelly: You two were inseparable.

Stephany: I can never imagine going back to...

living like I was.

I could never imagine going back to...

sticking myself with needles,

15 times a day for hours at a time.

I've been clean for long enough to where...

it scares me, the thought of using,

because I know one time could kill me.

This is a crucial time--

now that you, you have clean time.

She had that, that clean time,

and then she used...

and I feel like you're...

you're right there, and it's so scary.

Anytime I get a call in the middle of the night,

I-I get that gut feeling.

Everything tightens up.

I couldn't imagine...

putting you through losing another... child.

Britt Doyle: That picture...

was taken when I was, I think, six years old.

I sort of remember that day, like a little bit,

but I remember that that photo was...

in her room always, 'cause she said it was her favorite photo of us,

and I really like it too. (giggles)

This cross...

she gave to me when my parents split up,

because I told--

I was really sad one day, and I was like...

"Mom, I'm not gonna be able to see you anymore.

I'm not gonna live with you,"

and she was like,

"I have the same necklace.

"I'm gonna give you this one,

"and if you wear it, then we're gonna--

"just know that we're together,

and just know that I'm thinking of you."

"Dear Preston,

"I've enjoyed every minute of our time in Tahoe.

"You're this amazing young man

that makes me proud every day,

"and more every year.

"There are incredible things that await you in your future.

"You're a success in life...

"and always will be, because you have that special spark

"to do and enjoy life to its fullest.

I love you. XO, Mom."

And I read that...

literally any time I have any sort of problem in my life,

because there's just the fact that she wrote that.

It just... I don't know,

just shows what kind of person I had by my side for all those years.

Here's a screenshot of a text she sent me.

And, uh, she did not mean to send that.

She, like...

was just probably high out of her mind.

(laughing) That mean picture.

I know, I'm sorry. This one's funny.

Wait. Britt: Whoa!

Britt: Get off! I'm ticklish, and I don't like being tickled.

Wynne: I wasn't tickling you. (Britt giggles)

I was trying to make a wish on your tummy, you big biddy.

Ow! Not happening!

Britt: And she wipes her nose with my hair.

Doyle: Each one of our three kids were C-sections,

but the third one was a particularly hard pregnancy,

so when Wynne got out of the hospital,

they gave her a lot of...

uh, prescriptions, I mean, in a row.

I had no idea

that she'd been given Oxycontin,

or Vicodin or any of the opiates that we all know about now.

We had no idea that there were any dangers.

About a month and a half after the baby was born,

Wynne was starting not to get out of bed.

And that's when I started finding

the pill bottles around the house.

All of a sudden, now there's pills all the time,

and there's more and more doctor visits,

and there's more and more trips to the pharmacy,

and she's getting less and less interested in anything.

She was hiding 'em,

and she was getting 'em from multiple doctors.

Different doctors that started showing up on pill bottles.

Doctors were just throwing pills at her.

And by the end of the year,

you know, she just was a totally different person.

Completely different.

It was like Jekyll and Hyde.

When we were dating,

I had never thought about any kind of addiction,

or alcohol, I mean, anything.

We went out a few times a week.

We'd go to restaurants and drink wine.

I mean, there was nothing.

I mean, I never saw anything.

She was driven, and fun to be around,

and it felt right.

We had a couple of kids, she was a great mom.

We were going on vacations.

We were visiting with family.

We had friends over all the time. We'd have dinner parties.

She was raised really well.

She was, like, a track star,

cross-country, the cheerleader, everyone loved her.

I just always looked up to her when I was little,

and being like, "That is the most beautiful woman, like, ever."

And I'd wear all of her clothes, all of her jewelery,

I would do makeup with her

ever since I was-- I could walk, I feel like. (chuckles)

Doyle: Christmas morning of 2000,

about five or six months after the baby was born,

I woke her up, and it had been a couple of days

since she'd been up,

and, uh, I got the kids out of bed,

and, you know, she didn't even realize it was Christmas.

I asked her if she would consider

going to a treatment facility,

and I had already talked to Betty Ford Clinic down in Palm Springs.

She stayed for three days and then went missing.

I went down and tried to find her.

She'd checked into a motel, and...

she was passed out.

I had just no idea what was going on.

She went to a second rehab facility,

and I figured, since I could afford it at the time,

maybe this place would be better 'cause it was three times as expensive.

When she checked out 28 days later,

she had a whole bunch of new pills...

and it happened all over again.

She would go around to different doctors,

telling them that she had pain.

You know, she'd do something to injure herself.

I watched her slam her hand in the car door one time

just so that she could go to the emergency room,

and the doctors would always give her something,

Vicodin or Oxy or something.

She shattered both her wrists,

and she had...

um, this-- I don't know how to...

she had like a cast on both of 'em,

and as soon as they were all healed up again,

she did something that shattered it again.

Repeatedly, like, the cycle was over, and over,

where she'd hurt herself,

and then get medication, and then she'd go off, and leave.

My dad always told me it was "cooking school."

Once we got older, we started to realize that, like,

she is going to rehab right now, but...

It's not-- ...it's not gonna-- it's not gonna work.

It got to the point where it was so common,

I was like, "Maybe she was really like that."

But then I could tell when she was clean,

how healthy and just amazing she looked,

but when she was high, it was like...

it was like she was sleepwalking,

like, she wasn't herself whatsoever.

Just, like, her eyes were different,

her speech was different,

the way she walked, everything about her was just really off.

Preston: When she was clean, she was an awesome human being,

and just the best mother,

and I'd trust her with my life when she was sober,

but I had to do things that most kids wouldn't have to.

It almost felt like I was the parent.

It's like the roles switched,

where I'd be searching her room for-- for drugs.

Whenever I'd open drawers, there would be pills hidden.

There would be pills in the bathroom counters.

You know, in her coat pockets, or in her shoes,

in her sock drawer,

I mean, in the back of the food pantry, or wherever.

They were everywhere.

Her family was ashamed.

Every Christmas was a disaster.

All of a sudden, we're losing friends,

people didn't want to be around us.

Doyle: I think at this point, the kids...

they were just starting to understand it.

The reason why I would keep them out in the evenings, you know,

and always filled their days with things, you know.

I mean, at one point, I had all three of 'em in Little League,

which was a disaster for me,

because I'm driving all over the place.

Two practices and a game for each one of 'em every week.

You know, we'd have dinner out all the time,

and movies, and you know.

It was exhausting.

I'm trying to keep them away

from wanting to go upstairs and see their mom in bed.

We knew there was a problem, but there was nothing that

we could say or do that was gonna change it,

so it just became part of our life.

Doyle: In 2008, like seven years into it,

a rehab facility in Malibu called and said,

"Are you not coming for family week?" And I said, "No, I've had it.

"You know, I'm not coming to anymore family weeks.

I've been to too many already."

And they said, um...

"Well, it sounds to me like you're done."

And I said, "I don't even know what that means."

He said...

"Well, if you're thinking about a divorce,

"we... we really ought to think about that while she's here,

"so that she doesn't come home to that

and not have a support group."

I mean, it was the first time anybody had ever said...

that I actually...

you know, could get out, so...

um, I...

I filed...

and moved the kids out.

When we divorced,

Wynne got half custody,

and started living in San Francisco.

The kids would visit her.

They're getting older.

They're starting to really develop

a relationship with their mom

that's separate from me.

Harry: The last house that we lived at with her

was in the South Market, and the Embarcadero.

And I used to skate on the Embarcadero at 10:30,

'cause she would allow me to, like, leave the house,

like, she gave us that much freedom.

It was just like my favorite feeling in the world.

This was her house, you see, with all these candles.

Man: Oh, that's cool, yeah.

Doyle: When the kids were with her,

I was always on edge.

Then it really just became about safety.

I became this hyper-vigilant sort of guy,

and she was fine,

but I knew it wasn't gonna last.

It just slowly deteriorated again.

I heard from the kids that she was going into the hospital

because she had a kidney stone that they had to remove.

She had been taking a lot of opiates,

and once she got to the hospital,

they were giving her what a normal person

would be getting as a dose when you have pain,

but it wasn't near the amount she'd been taking on her own.

So, there she is in a confined spot,

for four days going through withdrawals,

and it was just getting worse.

So, she left the hospital,

and they gave her a bunch of opiates on the way out.

Preston and Harry were staying with their mom.

Harry: Like, she had all these pills on the side of her bed.

"The hospital told me to take these," and I was just like,

just... please don't overdo this.

Like, there's a lot of pills here.

Eight bottles filled to the top,

and I was like, "Who gave you all of these?"

And she said, "Oh, my doctor did."

Like, "I'm still in a lot of pain from the kidneys."

And then, in the morning, she was just laying there

with her arms spread out, and her eyes were kind of open.

We said goodbye, and got no response,

and we thought that was odd.

Preston, like, pulled out his phone to, like,

take a video to just, like, show our father,

like, what was, like, going on.

And I told him, like,

"Put down the phone, like, right now."

And he's like, "Why?"

And like I, that was-- I was like grabbing her foot,

and it was just ice-cold.

And I called 911, they were telling me to do chest compressions on her.

I was just yelling at Preston to stop,

and he was just like, said, "We need to do everything we can."

and... it was, um...

I mean, that's when I had to call, like, my father.

And it just was surreal,

in having the conversation with Harry

as I can hear Preston in the background.

"Mom's dead. Like we-- we need to do something,"

and he just-- he didn't believe me, and I was just like,

"Just get to the city, like, right now."

And then hearing Preston screaming on the other--

You know, he's, um...

trying to give her compressions. (sniffles)

Doyle: By the end...

at the funeral, there were hardly any of her friends.

Britt: When I saw the pills on her bedside table,

when she had passed,

that was probably the most anger I could feel ever,

because she's been to that hospital

easily like 50 times.

They've seen her there, unconscious, had to, like, pump her stomach

so many times,

and yet, she comes in there,

and they leave her, like, with more?

Doyle: I firmly believe that there are so many people

that are being prescribed opiates

without any direction or support

that have no idea what they're getting into,

and then, once they can't get out of it

the shame and the inability to actually confront it

and talk about it with somebody... makes it worse,

because now, all of a sudden, they're an addict.

Do you like it so far?

I love it, I think it's beautiful.

I was thinking, maybe we would make one for your mommy.

That's what I would like to do when,

when I'm done with yours, if that's okay.

Let her know that we're thinking of her.

Kelly: I have adopted Audrey.

She needed stability, security,

and until my daughter could recover,

she just couldn't give her that.

Kelly: I'm trying to keep her a child.

I don't want her to grow up too fast.

But she's part of this,

and she's kind of my partner.

We have the Narcan,

and I dropped some off for her.

If something happened,

and I couldn't get over there,

do you remember what you would do?

Where-- where do I keep it?

In the top.

So I keep the Narcan right here.

This one is real easy access

for Audrey if she needs to.

I keep a couple of packs inside here.

Three, actually,

and it's two... two doses per box.

But this is really easy for her to reach.

I can get at it.

It's very visible in the red bag.

If she wasn't moving,

try to shake her? I would check if she was breathing.

Okay.

And, then, what's the next thing you would do?

Rub, rub the lips, try to stimulate her.

And then what would you do

if she didn't wake up?

Then I would take the... the Narcan...

Okay.

...and I would... and I would place it on her thigh,

her butt,

or right here. Yep.

Exactly. And then what do you do?

Then, call 911.

Right.

I'm gonna say a special prayer for your mommy today,

'cause she really needs it.

I know she's trying very hard,

and I know she misses you.

I'm gonna bring some to Stephany.

I don't know what she's doing...

but it's always good to have it there, just in case.

And also...

a lot of times, they don't use alone.

They're so pretty.

Gail Cole: When we found him,

the two of us pulled him off the bed.

I'll never forget the sound

of just the air coming out of his lungs.

For the longest time, I couldn't come in this room.

It's literally like the day he died.

It took me a year to come in

and throw his garbage out,

and I think I did that,

because I saw that the medical examiner

left the wrapper for the body bag in there.

I just-- I can't go through it.

I feel like it's like getting rid of him.

Brian Cole: Part of me takes great comfort in all of this stuff too.

Just reminds me of his personality, you know.

Brian: I did everything possible

to-- to create a perfect life for a family.

Brendan: Brothers get together!

Brian (in video): All the brothers, hold on.

Brian: To have this happen is just

not even conceivable to me.

Brian (in video): Come on, Connor.

Gail (in video): Here's Brendan!

Hey baby, I'm not four yet!

Brian (in video): Yeah, Brendan!

Brian: That's his calendar, he was marking off the days when he was first...

Gail: Sober? Brian: ...sober.

I just thought it would be important for him to be able to

look at the calendar at the end of every day,

and cross it off, and say, you know,

"There's another day, I've done it."

You know? I just wanted him to have

some type of way of measuring his success.

Gail: When he had come out of rehab,

he looked the best he had in years,

He looked so healthy and was so positive.

And he said, "Oh, can I borrow the car? I want to go to the mall."

And I said, "Sure."

And he's only gone 45 minutes.

He's texting Brian pictures of shoes, of all things.

And he came back.

He poked his head in, I said, "You know,"

I said, "It's so nice to have you back."

He goes, "Thanks, Mom, I love you. Thanks for giving me another chance."

And, with that, I look at his face

and I'm, like, "Wow! He's high."

And, you know, the yelling, the screaming, and...

we agreed tomorrow would be another day.

And, um, I went to sleep.

Brian fell asleep on the, on the couch,

and woke up at around one o'clock, by the grace of God.

He found him kind of laying at an odd angle on the bed.

He turned on the light and screamed.

His lips were turning blue.

He was unconscious. He was barely breathing.

And you were screaming, we're shaking him,

calling 911.

The police came, the ambulance came,

and then Mobile Intensive Care came

and they revived him with Narcan...

and he walked out the front door to the ambulance.

When we got into the emergency room,

nobody really talked about the withdrawal from the Narcan,

and there was no real game plan

for what to do after overdosing.

So, we got in the car and I drove him home,

and I could, could barely even speak to him.

I was just so furious.

He was, you know, sleeping in the front seat,

and we pulled in the garage and I said,

"Do me a favor, would you just take a shower and try to get yourself together?"

And he goes, "I can't."

And I didn't really understand,

but I've learned, after the fact,

that when you're going through withdrawal,

it hurts to shave, it hurts to shower, it hurts to brush your teeth.

He went up in his room.

The door was open.

We had his laptop, we had his cellphone.

We had taken all those away,

so he was, you know, kind of in lockdown.

That was at 1:30 in the afternoon.

And then about 2:30, Brian came up

and said to him, he goes,

you know, kind of tussled his hair, and said,

"You know... you got a second chance.

Not everyone gets a second chance."

He goes, "You better not waste that second chance."

And that was probably the last thing anyone said to him.

It was about quarter to three, and I came upstairs,

and he was kneeling with his hands on his head.

And, to this day, I wish I would have said something to him.

I wish I would have come over and said,

"You know, B, I love you. It's going to be okay."

Connor came home.

It was 20 after three, or so, and he said, "Where's B?"

I said, "I don't know. He's upstairs kneeling next to his bed."

And he went upstairs.

And he must've tried to...

move him and shake him, and he screamed.

And we called 911 immediately.

And everyone-- Connor's throwing up,

and everyone's screaming,

and Brian had run over and got our neighbor

who was a doctor.

It was a nightmare.

They, uh, made us leave the room.

And they tried to revive him again with the Narcan,

but it didn't work.

They had worked on him for about 40 minutes.

I knew. I just, I knew he was gone.

You know, you prayed, you hoped. You did everything, but...

And probably at about 4:20,

our neighbor pronounced him dead.

He had used heroin again.

We found this old stuffed animal

that had old baggies of heroin and a syringe in it.

I had the hardest time, and so did Brian,

wrapping our head around that.

Why would he have done that?

Like... he knew we loved him.

He knew we wanted to, you know,

send him back to rehab and get him help.

And what could you be thinking,

that, like, that love wasn't enough.

Brian: One of the things that's always a regret

is that you completely underestimate

how hard the battle of addiction is.

I mean, you think that, if you drop everything,

and, you know, you get the right help,

that you'll be able to see your way through this

and help somebody, but it's not quite that easy.

I mean, I thought I knew Brendan like the back of my hand,

but it's a different person once this addiction kicks in.

As a father, you have this,

this guilt that it, it happened on your watch.

And it's just, you know, you can explain it away all you want,

and other people can tell you, you know, you did everything you could.

But that always will linger in the back of your mind.

You taking that also? Yeah.

And this? Yep.

Gail: When Brendan overdosed,

we didn't know what happened.

Heroin? Like, you know, here we are, we're in...

we're in Allendale, we're in "Mayberry."

Heroin, you think a dark alley,

you think, you know, somebody on the streets,

not in towns like this.

Gail: Just sign in. Nice to see you.

Man: Good to see you too.

Yeah, just sign in, make a name tag.

Gail: We formed a group "Hope and Healing After an Addiction Death,"

and we meet twice a month,

and it's for people who have lost somebody

to the disease of addiction.

I thought we would start by sharing our stories,

um, and, if you have a picture, that would be great.

Um, you know, just,

share your story and, and talk about what you went through.

I have two pictures of Georgia.

This is my favorite.

Gail: That's Georgia. Group: Georgia, Georgia.

This is her. This is her.

She's just all energy.

All, like, "Yeah!"

You know? And that's how she was.

David (on tape): Georgia. Hey, Georgia.

Come here. What?

David: When Georgia was born,

I remember that I was in the delivery room with her,

and I started talking to her.

I didn't talk to her like she was a newborn baby.

I talked to her like she was somebody who...

we had been waiting for,

and that she had been waiting to arrive.

Who is that?

David: Within minutes, we had our first conversation.

It was one-sided, but...

but it was, uh...

Judy: But she was special,

she was the first grandchild, first niece. David: Yeah.

And we took a lot of pictures of her doing nothing.

We thought it was so exciting.

Judy: She was just very happy.

It was a very special, happy time of life.

David: I had a nickname for her, I called her "Soda Pop,"

because she was bubbly,

and she was, like, you know...

you didn't want to shake her before opening her.

David: It was just a constant amazement.

You know, watching her unfold

into an amazingly bright, young child.

She died, um, Thanksgiving Day a year ago.

She was 26.

It's like she never knew what hit her.

But the way she described it with me was,

that, um, she was working with a group

that ran several group homes,

and she was an assistant in these group homes,

and one day, she was taking a break.

She was on the porch, and this was in 2011,

and she fell through a guard rail,

or a hand rail, on the porch.

Took a fall and went down.

Hurt her back and her hip,

and went and got prescribed these,

you know, monster painkillers.

It could have been anything from Vicodin,

OxyCodone, I'm not sure.

I know it was one of the heavier ones just by the way she described it.

And they gave her enough

that, by the time the prescription ran out,

she needed more.

And, then, this one night,

I came up the stairs to go into the bathroom,

and Georgia was in the doorway of her room,

and she was upset about not being able to find something.

So I said, "Okay."

I went into the bathroom,

and as I shut the door, in the middle of the floor,

was a glasses case.

David: Right? So.

Somebody dropped their glasses case.

I picked it up to put it on the counter,

and it felt weird.

And I opened it up,

and there was six bags of heroin,

and a syringe, and a couple of other things in there, and I just went...

"Oh, no, no, no, no." You know?

And she said she didn't know where it came from.

"Oh, my God," you know, it was just the whole thing.

And, and... (sighs)

So this was probably a month before it happened.

On Thanksgiving morning,

Judy woke me up about five o'clock, I guess.

And she said, "Something's wrong with Georgia.

I can't wake her up, and she's really cold."

So I went into the living room,

and Georgia was sitting,

the television was on,

she was sitting between the couch

and the coffee table on the floor

with her feet out in front of her,

and her hands folded in her lap.

She had just leaned forward like this.

And we had this little carpet-covered stool thing, you know, right there.

There was a syringe laying right on top of it,

and it looked like she had just dozed off.

And I went over to her and I--

and I could-- as soon as I touched her...

I don't know, at that point, you're just in something that you can't even...

describe.

Well, all of you probably could.

So, I put my hand around her neck looking for a pulse,

and her skin was starting to get that

real stiff kind of, you know...

If you've ever had a dead pet

that you've had to pick up, you know that feeling,

and I knew I wasn't going to find a pulse,

and then I got around, you know, I had turned on the lights.

So I got around in front of her,

and I picked her head up,

and I looked--

David: I had called the police,

and they were on their way.

And whatever I said to Judy,

I let her know that Georgia was gone.

And we finally went outside

with our son, Eli, and

a man pulled up in a car,

parked across the street, and he got out with a camera,

a big camera in his hand,

and it was obvious that he was going to photograph the scene,

but as he was walking toward me,

we made eye contact,

and he said, "I'm sorry for your loss."

Pretty soon after that,

they were rolling her out of the front door on a gurney...

in a body bag. (sniffles)

That was the last time she was here.

This person that had been a part of my life

for more than 26 years...

(sniffles) would never be again.

I know she's, uh, she's here.

I feel her.

And I talk to her the same way I always have.

I miss her.

Kelly: The last time I was with her,

she seemed fine.

Her outlook on things was hopeful.

And then...

all of a sudden, nothing.

She's not answering the phone.

She's not answering the door.

She started this relapse around the time

of Ashley's birthday.

Stephany?

Kelly: And, when she's using, it's a very dark,

small, closed world.

Stephany?

Steph?

Kelly: What happened?

We were together.

We were making plans.

Kelly: Nobody's given up on you, please.

Please, honey.

You can't do it on your own, sweetie.

You tried, you gotta go in.

Kelly: Why don't you get up, and...

you come back to the house, take a nice hot shower.

You'll feel better. Get dressed.

Okay? You ready?

Yeah.

Kelly: Okay.

Oh, it feels a lot nicer in here.

Laura: Better than the majority of my clients.

I'm going to sit here.

Kelly: You want to try a little protein?

Whatever. Looks good.

Kelly: They're not chilled. I was drinking... (indistinct)

Laura: I can get some for you if you want--

Like ice tea, like this is really good.

Well, drink the ice tea. There's a, a pot of it in there, too.

If you want, I'll chill this, this is good for you.

All right. Kelly: I don't know how well you've been eating.

I haven't eaten in like two days.

I just need my clothes.

Kelly: Clothes? You've got them.

Laura: Mm-hmm.

I'm worried about that too.

Steph?

What are you doing? Stephany: I'm taking my medication!

You okay? Yes.

And I can't straighten it or close it.

Laura: This is the spoon of a heroin user.

She had it in her bag.

Stephany is feeling very anxious right now.

She's gonna be going into rehab.

She knows that she can't use.

The program that we started is called "A Way Out."

We have seven police departments

in our county that are participating,

and someone can walk into the police department and say,

"I need help."

No repercussions whatsoever.

Okay. (retches)

Okay.

Okay.

All right.

If you do have any sort of paraphernalia or drugs--

Stephany: I got-- gave it all to my mom.

Yeah, I've done her laundry before,

and I've asked her, "Is there anything in there that will poke me?"

Like how-- how many bags?

I just have, like, a backpack and, like, a carry bag

with clothes in it for when I go. Okay. So, what we'll do on, on our end,

is we'll go through it. Okay? Kelly: Yeah, that's...

just in case, she might-- It's part of the program,

so, whatever we find, it just gets disposed of.

Stephany: I definitely did not know that that one was there, Officer.

Just a little bit.

Kelly: What is it?

It's like really embarrassing. Officer: Okay.

It happens.

Hi, this is Officer Jake Anderson with the Mundelein Police Department.

I am calling with an "A Way Out" participant.

Hi.

Oh.

Sure.

Well, I have, I've suffered with kidney stones.

That's how I got addicted to opiates was

I had been getting kidney stones since I was sixteen,

but that's it.

Okay.

Stephany: Okay.

Kelly: I do blame prescription opioids

for my daughter's addiction.

I never pieced together

how does one become an I.V. drug user.

That was... that was the bridge right there.

Officer: Are you ready?

Yep. I'll help you carry some stuff here.

Kelly: She was still a teenager when she started with 'em...

these really high-powered pills.

And I trusted the doctors.

DANIEL EDNEY: I had been in pain for a good while.

The pain was basically a chronic, unrelenting

burning feeling in my neck,

and that would just through the day

just get worse and worse.

I could work a whole day with no pain,

and I just was able to rock along

very well for a couple years.

Then the doses escalated and it became compulsive using.

You move from Hydrocodone

to Oxycodone, which is one and a half times as strong.

And then you get to where that's not working

and you move to Oxycontin.

And then you get to where that's not working,

and you add, you know,

some Oxycodone short-acting for breakthrough.

And then that's not working,

and then you move to drugs like Fentanyl and Methadone.

MEL POHL: As I think back to Dr. Dan's case,

if he would have been willing to give up

his ability to practice medicine

in order to be able to take drugs to relieve pain,

that's pathological pursuit of relief.

POHL: Some deep breaths for me, please.

The conclusion of our team was

that he had the disease of addiction

driven by his chronic pain condition.

The only way I can bring good of this hell

is to help somebody else.

I had to find a way to treat folks with my illness,

but who couldn't afford to go to treatment for a month.

And I knew the only solution was to get them off

of the opioids.

When was your last dose of Oxy?

Um, about an hour and a half ago.

EDNEY: And I knew that I had to detox them

as an outpatient in an affordable fashion

where they could keep working.

And so I knew I had to use beprenorphine.

NURSE: Blood pressure good.

EDNEY: Beprenorphine makes the conversion off opioids

so much easier.

Their quality of life improves, they start eating again,

and they start functioning again,

they start thinking clearly again.

And the families have their loved ones back.

How are you today?

You're still getting pain relief with your beprenorphine?

-No, yes, sir. Yes, sir. -EDNEY: Okay.

It's worth a lot to me.

I mean, I can tell a big difference.

I'm doing normal stuff with my kids, uh,

going fishing.

You know, me and my wife went fishing last weekend.

And just, you know, do my meditation

and, you know, I do my stretches and my exercises.

I get my mind focused.

I mean, I understand now that I'm gonna have pain.

I mean, it's just a part of life.

In the midst of an epidemic,

where overdoses on opioids

are now a leading cause of death in the United States,

it's a no brainer that we should be making

an antidote for an opioid overdose

like Narcan or naloxone as available as possible.

NORA VOLKOW: What happens is you have your receptor,

you have your drug like heroin

or Fentanyl, say, for example.

Then the drug, morphine, Fentanyl,

are inhibiting the respiratory centers.

So there you give Narcan,

and Narcan comes in and pushes that drug out,

does not allow for the drug to come back in.

Therefore, the respiratory center

is no longer inhibited. That's how it works.

ANDREW KOLODNY: You inject the patient with naloxone.

MECHANICAL VOICE: Five, four, three...

KOLODNY: You squirt it up their nose,

it kicks the opioid off the receptor,

and the patient starts breathing again,

and their color comes back.

Our strategy has been to deliver products

that will make naloxone as widely available as possible.

We should see that it's in every household

where somebody might have opioid addition.

Hospitals, college dorms,

and maybe even high schools.

Any possible setting

where somebody might be opioid-addicted.

We are focusing on naloxone so heavily

because I would have loved to have had it

when my brother Alex were experiencing

what he was going through.

When we first decided to focus on naloxone,

people were literally like,

"So we're gonna enable people to keep using drugs?

That's what we're doing now?"

Well, maybe if we do revive them,

we have an opportunity to intervene.

Maybe they don't want to live that life anymore.

It's so important if you are doing a reversal of an overdose

to refer that patient to treatment

for their substance use disorders.

Intervening and linking to care is what we are promoting.

Recognizing that it is a very serious

and chronic disease,

where the likelihood of relapse is actually quite high.

Just because it doesn't happen the first time

doesn't mean it can't happen the fourth or the fifth time.

Because I have so many people in my life

who have been revived several times by naloxone,

and they're out there doing great things

with their lives.

GARY MENDELL: When he went to college the first year,

I suspect he may have been exposed to opiates.

And I think that's where it started, in college.

Brian went to eight different treatment programs.

In the eighth program he went to,

the psychiatrist called us after a couple days

and said, "I want to put Brian on Suboxone."

MENDELL: It was the only treatment program

that he ever called and said, "Dad, can I stay longer?"

He said, "They really get it."

And he had gone a year without using.

Then they recommended that he go out

to a halfway house,

and it was really hard to find a place

that would take someone on Suboxone.

We found a place in Venice Beach out in Los Angeles.

Brian was there two days, and I get a call from--

a frantic call from him.

He said, "Dad, I just met with a psychiatrist.

I walked in and he said,

'Oh, I see you're on Suboxone.

I don't believe in it. You have to get off.'"

Abstinence-based approaches

don't work very well for opioid addiction.

Most patients who are addicted to opioids

are going to need to be managed with a medicine

like buprenorphine, which is also called Suboxone.

There are three different types of medication assisted therapy.

The one that's most known for... to everyone is methadone.

Uh, second one is buprenorphine,

and a more recent development is extended release naltrexone.

Those treatments are unfortunately seen by some

as not really treatment.

That it's just substituting one drug for another.

It's a very common reaction to it, is you are changing

one drug for the other.

So how are you helping the patient?

Instead of heroin, now they are on buprenorphine.

Without an understanding that actually

the effects of buprenorphine or methadone

are different from the effects of heroin.

ANDREW KOLODNY: It's kind of like putting a nicotine patch

on a smoker. They're not thinking about

"when am I gonna have my next cigarette,"

because they're getting a little bit of nicotine

in their-- their bloodstream.

Somebody's who's opioid addicted and takes their buprenorphine

gets enough of a response from that drug

that their cravings are well controlled,

and they don't experience the physical withdrawal.

You have a situation where

middle class, working class families

have a loved one suffering from opioid addiction.

In some cases, they're emptying out their bank account

to send their family member to a 28-day rehab somewhere,

and then their family member comes back out of rehab

and within a week relapses.

I want families to know that addiction is a disease,

that it is a chronic disease,

which means that the changes in the brain produced by drugs

are very long lasting,

and actually last months or years

after the person stops taking the drug.

But I also want to tell the families

that addiction can be treated,

and that it will for success require continuity of treatment.

That it needs to be treated like a chronic disease

that it is.

And that recovery is possible if you institute treatment.

DANIEL EDNEY: I was taught in the mid to late eighties

that opiates and opioids were used for acute pain,

for acute injuries like a broken bone,

for postoperative pain which is acute and self-limited.

All the acute pain syndromes that you expect

to be under control within two weeks.

Opioids are the drug of choice.

They work wonderfully well. It's why they were designed.

I mean, I'm shaking.

JANE BALLANTYNE: We used opiates generously for people who are dying,

and very generously for people who had acute pain,

people who'd had surgery, people who'd had trauma.

We'd never used opiates at all for people with chronic pain.

EDNEY: Something big happened in the mid-nineties

with the release of Oxycontin.

Uh, we were re-educated,

and what we were taught in medical school

and residency was incorrect,

that the risk of addiction in the chronic pain population

was virtually zero as long as they had legitimate pain.

When Purdue Pharma launched Oxycontin,

it was interested in a blockbuster drug.

Some patients may be afraid of taking opioids

because they're perceived as too strong,

or addictive. But that is far from actual fact.

They launched a brilliant campaign that re-framed

all of these very good reasons for being cautious

with opioids as barriers to compassionate pain care.

The Joint Commission sets the rules for hospitals

in the United States that they have to follow,

and the Joint Commission was told that we're

under-treating pain, and then agreed to create

new rules so that every patient who comes to a hospital

would be asked about their pain.

The opioid crisis had really been caused

by the medical community writing too many

opioid prescriptions,

and we realized that opioids were being over-prescribed

because our colleagues had been badly misinformed,

and you're starting to see policy-makers ask

why every grandma's got painkillers

in her medicine chest.

You're starting to finally see recognition that

it's an addiction epidemic.

We can stop the initiation of inappropriate opiate use

in its tracks by following the new CDC guidelines,

by... using very little opioids, if any,

for acute pain.

So if you have a wisdom tooth extracted, or if you have

a sports injury, you go to the urgent care center

or your doctor, no more than three days or ten pills

of an opioid, of a short-acting opioid.

This is the worst man-made epidemic

in modern medical history, and it's up to all of us

as healthcare leaders and clinicians

to reverse this thing. We need to do it now.

We needed to do it ten years ago.

We have about ten to twelve million Americans

who have been put on long-term opioids.

The best available evidence is telling us that

they're not doing well.

Many have had a decline in their function

and their pain has not improved.

Maybe their pain has gotten worse.

So very, very high doses of opiates

can actually produce pain.

So instead of making pain better,

they actually make pain worse.

Most common chronic pain conditions that are currently

treated with opiates probably shouldn't be treated

with opiates at all, other than possibly

for three days of an acute attack.

So, for example, a back sprain injury.

Use opiates for three days, get moving again,

and then stop completely, just like the CDC recommends.

The question we're often asked...

"If not opioids, what then?"

And we need, as physicians, to have lots

of "what then" answers.

We know they do much better with simple things

like exercise.

Yoga and acupuncture and massage...

Behavioral, physical therapy.

Spiritual support for a person

to renavigate their life, uh, and to take control

over this sensation of pain.

You have to take care of a complex problem

with a complex solution, which is not gonna come

in the form of a pill.

DETECTIVE MICHAEL DILLON: Here in Northern New Jersey,

we've seen a spike in the number of accidental overdoses.

Tonight we're doing Operation Take Back,

so unwanted prescriptions can be anonymously disposed of.

When you put unwanted medications into the garbage,

you risk either having them stolen from their garbage

or taken by an individual who's in their house.

Could be a family member.

Somebody during a real estate open house.

Anonymously drop the medication,

and what we do is periodically collect it and bring it

through armed escort to a incinerator.

Where the medications are all incinerated and destroyed.

JOHN G. WAFFENSCHMIDT: When we started this program,

energy-from-waste, it was because

the pharmaceutical drugs were going into waterways.

Eighty percent of waterways have pharmaceutical agents in it.

It affects the fish.

So what we want to do is encourage people

not to flush them down the toilet.

Because once it's burned, there's no chance at all

for groundwater or surface water contamination.

OFFICER GARY MANKOWITZ: I'm very happy with our department

participating in this great program,

because we are saving lives.

Every time somebody dumps this into our mailbox

and we clean it out,

that's somebody who's protecting their children

from getting it. Their grandchildren.

Their sisters. Brothers. It could be anybody.

It's insane,

the amount of prescriptions that are out there,

and how easily they are prescribed to people.

This crisis, is in my view,

the single public health crisis we face as a country.

I worked with my legislature

to put in a number of different pieces of legislation

to stem this epidemic.

One in particular, which was a bit controversial at the time,

but we were successful in passing it,

was limiting the number of doses

that physicians can prescribe in the first instance for, uh...

prescription painkillers.

It shouldn't be the case that it's an automatic 30 days

of OxyContin, or an automatic 60 days. We said it should be...

five or six days.

And then check in with the physician and let the physician

have discretion to do what comes next.

Because we're really trying to cut down on...

a leftover half a bottle of pills, which goes to a friend.

That person gets hooked and that person winds up addicted.

We...provided funding to make sure that

all first responders in Rhode Island,

in every single city and town, have access to naloxone.

The colonel of the state police and I...

literally passed out in paper bags...

naloxone to every police chief.

Every single city and town in Rhode Island.

This is a disease. We know how to treat it.

We have a huge effort in Rhode Island,

and we're starting to see some success

training physicians...

to... know how to do the medical assisted treatment.

It costs money. And a lot of folks are on Medicaid.

If the federal government cuts off our Medicaid,

and reduces our ability to treat folks

with medical assisted treatment...

we will lose lives. It's that simple.

There's no more important thing that a governor could be working on than this.