WILMINGTON, NC (WECT) - While opioids, like heroin, are known to block physical pain in the body, addicts will tell you the drug can also erase emotional hurt.
That was just the fix Abby was looking for after her son tragically died.
"From the moment I knew my son was coming into the world, I spent ten years planning our life together," Abby said through tears. "And in a moments time it was taken from me."
Abby was the proverbial "soccer mom."
She was active in her son's school PTA and had a great job.
When her son was killed there was no amount of anything that could soothe the pain for months.
"I came really close to committing suicide," Abby recalled. "As soon as I would feel that pain I would just want to numb it. I started self-medicating."
Her doctor prescribed Xanax – and a lot of it, but she could't find a dosage that would lift the depression she had sunk into.
"A friend introduced me to a baggy with something in it," Abby remembered. "He said, 'Snort this. You'll feel better.'"
Inside the small white bag was heroin. Abby was hooked almost instantly.
"It just seemed to take me somewhere else where I wasn't constantly hurting inside," she cried. "I didn't know how to live. I did think it was my saving grace, and that it might even save my life."
Most heroin users share a similar story as to how their addiction began - by first abusing doctor-prescribed narcotic pain medication. Courtland Rogers is one of many who fell into the trap.
"I had gotten into a bad car wreck and was prescribed prescription pain pills," Rogers explained.
According to the National Institute on Drug Abuse, about 12 million people used prescription pain medications outside of doctor recommendations or for the feeling it created in 2010. Dependence quickly sets in and abuse leads to heroin.
Within ten years, the Institute says 1 in 15 people taking narcotic pain killers will try heroin.
In 1996 the American Pain Society labeled pain as the "fifth vital sign" which should be measured in patients along with all the others: body temperature, heart rate, breathing rate and blood pressure. Pain measurement on a 0 to 10 rating scale by a patient became standard practice.
An update to guidelines in 2004 allowed state medical boards to consider the undertreatment of pain by doctors a punishable offense.
In the years after, use of narcotic pain medication grew and so did the problems associated with them. Pharmaceutical drugs like oxycodone and hydrocode became household names.
"Pain was just hammered on everyone," said Dr. Bryan Durham, the Medical Director of New Hanover Regional Medical Center's emergency department. "This notion that we were falsely going to get their pain to a zero. And all of a sudden you have people coming in with a simple little ankle sprain and walking out with a week's supply of whatever opiate."
Americans, while making up just 4.6 percent of the world's population, now consume 80 percent of the global opioid supply and 99 percent of the global hydrocodone supply, according to The American Society of Interventional Pain Physicians.
It's an expensive addiction.
Addicts say the doctor-prescribed supply quickly runs out. On the street, narcotic pain pills can be as expensive as $60 per pill. That's when most turn to heroin. Same effect, a fraction of the price.
"They find quickly that there's a cheaper source, initially," said Dr. Bernard Gottschalk, the medical director of the Wilmington Treatment Center. "They can buy heroin for half the cost or a third of the cost than what their pills were. Then their tolerance goes up quite rapidly. They can't afford their heroin and they can't function because they're always dope sick."
Once a tolerance is built up, addicts say most users have to keep using just so that they don't go into withdrawal. The euphoria is harder and harder to reach.
"You feel like you are on top of the world," Rogers explained. "Like you are untouchable, nothing can hurt you."
To maintain his habit, Rogers got up to around 30 bags a day. It cost him about $1,400 a week.
"To use heroin on a regular basis, is a full-time job," said Kenny House, the Clinical Director at Coastal Horizons. It leaves little room for maintaining an actual full-time job, although some addicts are able to function in high-pressure jobs like medicine and law - at least for a while.
"You are going to lose everything you have," Abby warned. "Because you have to support your addiction every single day."
Theft, robbery and prostitution are the more common routes addicts go pay for their supply.
"They're pawning everything they have," Rogers explained. "Some people are stealing from their families. Girls, they have a different way of getting heroin. I won't go into specifics, but they don't have to go out and rob."
Without an easy way to replenish supply of dope, withdrawal symptoms begin within hours. Vomiting, sweating, diarrhea, fever and pain sometimes lasting for days.
"As an addict, 'normal' is the drug in your body and when you do not have it you are SICK," Abby said. "Sometimes it hurts so bad you can feel your hair hurting and you will not stop until you get that fix."
"The sickness is like almost wanna kill yourself if you don't have it," Rogers explained. "You feel like death."
Abby's addiction had a relatively short life.
"I was new to the game and thankfully never got old to the game," Abby laughed. "Thank God I got caught."
Abby sold drugs to an undercover drug agent. She served time and the North Carolina Corrections Facility for Women. After she was released, Abby relapsed almost immediately.
She was back in the game until she found out she was pregnant again. That was the last time she used heroin.
"That stopped the world," Abby remembered. "Literally, the world quit turning. Thank God for him."
Rogers has tried quitting six times.
"I was doing 12 step programs, then something would throw me off and you'll justify it to get high," Rogers explained. "It's got me three felonies on my record. It's got my family to where they don't know if I'm lying. It's destroyed everything I've ever had. It's taken everything from my life. And when I say that I mean everything."
Rogers said treatment centers are only as good as the level of commitment of those staying in them. He found support in sober living homes around Wilmington, but says there aren't nearly enough of them to meet the demand.
"Fortunately right now I'm sober and that's great but it's like, that could change in 5 minutes and that's the scary part," he said. "They say that your addiction is in the parking lot doing push-ups. That's not true. He's already in the parking lot and he's already done his push-ups."
Kenny House of Coastal Horizons says that kind of relapse cycle is usually linked to a desperation for help.
"It's important to realize this is not people having fun on some kind of rollercoaster," House explained. "It's a predictable, but very scary and painful process to become addicted to heroin."
Out-patient programs, crisis services and therapy are offered at a handful of other, smaller operations nearby.
None of these are currently at full capacity.
Still, addicts will tell you Wilmington needs more.
"I think that's an excuse," said Dr. Gottschald of Wilmington Treatment Center. "I think if a person wants treatment in Wilmington North Carolina they can get it. People don't want to quit using until consequences come about."
For perspective, self-pay (without insurance) at Wilmington Treatment Center starts at $9,000. Addicts say that bill can go above $20,000, especially if the cost is being subsidized with insurance.
"Making it easier for people of all ages, all races, all financial status to get into treatment would be a big boon for southeastern North Carolina," Gottschald said.
Users who either can't afford treatment, don't want treatment, are in withdrawal or who have overdosed typically end up in the same place - the emergency department.
"You know it's heroin because you see the track marks or whoever rolls them out of the car said, 'He was shooting heroin,'" said Ruth White, RN, Manager of NHRMC Emergency Department. "They peel off and you're left there with this blue, unresponsive person."
New Hanover Regional Medical Center is not a detox facility. At best, the emergency department staff can ease their symptoms.
"What that treatment would entail is basically room and board and what medical care we can provide while we are working to get that patient into a facility," White explained.
If a patient agrees to treatment, the hospital is tasked with finding them a bed in a program they can afford. This is typically within a state facility which can have a wait list.
"It can range from 24 hours to...we've had people boarding in the ED for weeks," White said. "And it's at a tremendous cost."
As addicts wait in the ED, precious bed space is taken up.
"It definitely contributes to the overcrowding problem and takes up treatment space that we would otherwise be able to use," White said. "And creates the problem of having people who have to wait for care."
"This is truly an epidemic that is out of control," Gottschalk said. "And we're doing very little to stop it as a country."