ELKHART — One moment, he was out, dying.
The next, with the plunge of a syringe, he spasmed awake, angry and zombie-like as his brain coped with being yanked back to life, bewildered by who forced him off his heroin high.
Stefanie Bailey, his girlfriend and partner in shooting-up, watched the situation unfold in horror — her man overdosing on heroin, emergency responders sticking him with naloxone to bully the heroin out of his system, his shocked return to consciousness and sobriety.
That was the last time, Bailey swore. That was the last time she would use and be with a user.
“It was just terrifying. I kind of realized in that moment too that I didn’t want to do that anymore,” Bailey said. “If I was going to be in a situation with someone where I was calling 9-1-1 and having somebody administer Narcan that I would — I couldn’t continue to put myself in that situation. It was terrifying, and if this guy would’ve died, and I would have had to live with that, I would rather be alone for the rest of my life than ever have to do that again.”
Bailey, a recovering addict, now lives and works in Elkhart. She got help, got clean by committing to an intense treatment program through Spa Women’s Ministry Homes in Elkhart.
While Bailey’s addiction is unique to her experience, she is one of millions of Americans who became locked in a cycle of addiction to opioids — drugs from prescription painkillers to heroin.
Her now-ex-boyfriend, when they were together in Michigan, was one of thousands pulled from the brink of death by naloxone, an overdose-reversal medication.
Naloxone, also known by its brand name Narcan, only affects opioids and targets those substances by kicking them off of and blocking them from a patient’s brain receptors during an overdose. The result is typically an immediate and painful revival to sobriety.
As the opioid epidemic grew, the administration of naloxone also climbed.
The drug was used close to 400 times to thwart overdoses in Indiana in 2012, said Dr. Michael Kaufmann, Indiana’s EMS medical director. In 2017, naloxone usage ballooned to approximately 7,500 uses, and is up to approximately 5,700 uses so far this year.
MAPPING THE USE
To provide a glimpse at the scope of emergency calls to opioid overdoses in the state, the Indiana Commission to Combat Drug Abuse launched an online heat map on Aug. 23, the Indiana Homeland Security Department said.
The interactive public map shows locations in Indiana where naloxone was administered during emergency medical services calls. Dense clusters of incidents appear in yellow and red. Users can zoom from the state-level down to local neighborhoods with date options ranging from 2014 to the present. Exact locations aren’t listed to protect patient confidentiality.
Approximately 20 points appeared in and around Goshen on the heat map in a 2018 year-to-date look on Friday. The Elkhart area showed a larger amount of occurrences of naloxone use. A few incidents also appeared in Middlebury, Wakarusa, Nappanee and Milford.
Kaufmann called the map, which took about six months to develop, a first in the nation at making such information public.
“Being able to see it on a map really puts it in perspective,” Kaufmann said of viewing the opioid epidemic progression through naloxone use.
He expects the information could help state officials better identify at-risk populations and improve responses with naloxone. Another goal, he said, is to stir more residents to take action through grassroots activities to help reduce overdoses in their neighborhoods.
Data for the map comes from reports of naloxone administrations EMS providers submitted to Indiana Homeland Security. Situations where naloxone was used privately are also probably folded into the information.
PUBLIC CAN HELP
“Aaron’s Law,” which Indiana passed in 2015, loosened restrictions and allowed the public to obtain the medication as a precaution if someone they know is at risk of overdosing. Since residents are supposed to call 9-1-1 after giving someone naloxone, such incidents would be included in the EMS reports, Kaufmann said. He acknowledged there are probably rare situations where 9-1-1 isn’t called.
The map is still a work-in-progress, Kaufmann cautioned, so some reports can be delayed depending on when they’re submitted.
The agency recently updated rules to have providers submit naloxone reports within 24 hours of the instances. About half of the providers are now doing that, Kaufmann said.
The more timely the information, the quicker the state can adapt to changing overdose trends.
“Now we can engage law enforcement on a more real-time basis,” Kaufmann said.
Elkhart County has seen about six deaths as a result of opioid overdoses so far this year, according to provisional state data. There were approximately 21 such deaths in 2017, up from 12 deaths in 2016, and 9 deaths in 2015.
Meanwhile, the number of overdose patients arriving at local hospitals nearly tripled from 2011 to 2016. There were about 66 non-fatal emergency room visits for opioid ODs in Elkhart County in 2016, compared to 45 in 2015 and 23 in 2011, state data shows. Non-fatal hospitalizations as a result of opioids in Elkhart County grew from 36 in 2015 to 45 in 2016.
LEAVING THE LIFE
Bailey was never given naloxone while she was in the thrall of her addictions. She had situations that made her vomit, she said, but not to an extent that put her in the hospital. Her ex-boyfriend, on the other hand, was given naloxone three times, she said.
The 39-year-old didn’t get into drugs for fun or the sake of social deviancy. Like many opioid addicts, she fell hard to circumstances.
Bailey worked as a nurse at a hospital in Kalamazoo. She injured her back on the job one day and was prescribed Vicodin, she said. She was also trapped in an abusive marriage.
The combination of physical pain and the struggle in her personal life helped push her into a downward spiral.
“I would say that I pretty much got addicted to them really, really quickly. They kind of woke me up. They numbed me out because I was in this abusive marriage, and I felt like I could keep this mask that I was forced to wear in place — you know, I could keep everybody at arm’s length,” Bailey said, calling herself a functioning addict.
“I was getting high to, like, stop the bleeding on the inside,” she said. “I needed to function. I was crying, and I was lying, and I was trying to put on this façade that everything was OK, and it wasn’t. So, drugs kind of helped me keep that lie in place, turned my feelings off.”
Over time, Bailey’s tolerance to the drug increased, and she needed more to dull the physical and emotional pain. She started abusing stronger painkillers, including Percocet and Dilaudid.
She finally divorced her husband and gravitated to a high school friend, a recovering addict in Centreville, Michigan, she said. He offered protection from the ex who continued to harass her.
But the new boyfriend fell off the wagon, and their addictions intensified. Bailey moved from pills to using heroin with him.
“It got really ugly really fast,” she said.
August 2016, when Bailey’s boyfriend needed his third naloxone dose, was about where she hit rock bottom.
Overdosing, the boyfriend didn’t realize he was half-dead, as she put it. EMTs arrived and administered naloxone. The medication did its thing, hauling him back to awareness.
“He woke up raging mad,” Bailey recalled, describing him as briefly confused and disoriented. “He settled down … the shock of it, the shock to his system from, like, being high and kind of half-asleep/half-dead to … The drugs are immediately out of your system, and — I think it was more fear and not knowing where he was.”
Bailey was arrested for drug possession after the incident. She spent two months in the St. Joseph County, Michigan Jail, where she decided she was done with drugs and needed help.
She re-entered Spa in Elkhart, which she participated in once before but didn’t fully embrace. The second time, she committed to the faith-based intensive year-long inpatient program.
“You have to make the decision to let go a lot of things that you’re holding on to,” she said.
Bailey graduated in 2017 and moved to Elkhart to start fresh, avoid the people, situations and behaviors that could draw her back into drugs, she said.
She now works as a professional for a recreational vehicle company and recently joined the Spa board, where she’ll take over the mentorship program.
The shadows of Bailey’s addiction still linger. Cravings still pull at her at times, or she has bad dreams. But she has a better foundation for staying clean.
“I think the biggest thing is staying in touch and staying purposeful,” she said.
She relies on family, friends, Spa members and her Christian faith as a support network to keep moving forward.