Nicholas DiCillo vividly recalls the day he fell in love with heroin. It's at once a story that binds every moment in his life since then, seven years ago, and yet a story that he feels shouldn't define who he is. This is not an easy line to draw in Northeast Ohio these days.
"That was the beginning of the end," he says from inside his counselor's white-walled office at Community Assessment Treatment Services (CATS) in Slavic Village. It's April 18, nearly two months after he voluntarily checked in for another spin through rehab. He wanted to stay for three months, but funding is scarce for opiate addiction treatment across the nation, and that fact is no different in Cuyahoga County. There's local money for court-ordered clients at rehab facilities, but the cash flow for voluntary clients is paltry. DiCillo is riding the dime of the Alcohol, Drug Addiction and Mental Health Services Board of Cuyahoga County. "They stripped me of those extra 30 days," he says. He'd be checking out by the end of the month.
As DiCillo describes that first tryst with heroin, his voice is bold and confident. He's wearing a T-shirt and gym shorts, leaning forward in a swiveling office chair, one leg resting across the other's thigh. Back in 2009, he says, he was working at a downtown bar on West Sixth Street, and one of his friends told him that she was going to go buy some heroin. Would he like to try it?
DiCillo, 28, had a long track record of experimenting with drugs by that point. For years, even through the full-ride scholarship that took him to Northwestern University, he had been dabbling with just about anything that crossed his path. "You lay it on the table, and I wanted to try it," he says.
He snorted his first dose of heroin and eyed his friend as she stuck a needle in her arm. "I watched her mainline it and watched this sort of metamorphosis and transition — from lucid to what looked like heaven," DiCillo says. "I had a weird curiosity and fascination with that. So the next day I started IVing the drug."
It was new to DiCillo in the moment but familiar territory in some ways. His father overdosed on heroin and died when DiCillo was just a few years old. His mother, Celeste, overdosed on a combination of heroin and benzodiazepines and died this past January. They had been supportive of one another, him and his mom, both in that unconditional sense of familial love but also in a codependent sense of trying to get by in a world where addiction drives every action.
For her, that story ended at her home in Cleveland, where DiCillo found her unresponsive body.
For him, that story became a sinking, deep depression. But he used the cataclysm of his mother's fatal overdose to push him toward his own rehabilitation, toward life. "I had just enough hope and just enough strength and courage to pull myself out of the gutter and do something different," DiCillo says. "Dare I say it, I think my mom had to die for me to live. That's a really tough cross to bear, but I'm certainly going to honor her — but live for me — in my sobriety."
Like many addicts approaching recovery, he tried going cold-turkey solo at first. When that didn't work, he landed back at CATS, the treatment center on Broadway Avenue in Slavic Village, in February. He'd already been through those doors before, in 2012, and he needed that familiar setting to attempt to rebuild his life.
The opiate plague has ticked across America and hit every demographic without prejudice — urban, suburban; white, black, Hispanic, Asian; rich, poor; male, female — and it's impossible to listen to the stories of addicts without being overwhelmed by a sense of how unsuspecting it all is. Each story is different, but they're all the same. DiCillo, as he spins his life's yarn in a plain room with four white walls, motivational posters breaking the visual static, sounds very much like you or someone you know. He was a college student once. A musician in his mid-20s. When he'd see an open swing set at a park, hell, he'd hit the swings for a spell and relive the childhood he never had. And then there were the drugs.
"Whether or not they were gateway drugs is almost inconsequential," DiCillo says. He tells Scene that when he fell in love with heroin, the high felt like a "hug from God," but then ... "The fact of the matter is heroin took me to the depths of hell and beyond."***
It's a narrative that no longer rests below the surface of Northeast Ohio. You can't turn on the news without hearing a reporter lay out the latest overdose statistics. According to the coroner's office, about 1.5 people die each day of opiate-related overdoses in Cuyahoga County. "Epidemic" is the word we use, for lack of a better term. It captures the scope, but not the complexities. Still, the body count is stunning and the brute force of the data is, at the very least, a conduit in beginning to describe the public health emergency.
The Cuyahoga County Medical Examiner's office, for instance, began publishing spreadsheet-style press releases, alerting the community to the ongoing death toll. Eight people overdosed and died between March 16 and March 20. Twelve people overdosed and died between March 30 and April 4. And so on. White female, 26, Parma Heights. White male, 46, Cleveland. Hispanic male, 53, Cleveland.
String them together and, during the first four months of 2016 alone, 150 people in Cuyahoga County fatally overdosed on heroin, fentanyl or a combination of the two.
If that trend continues — getting worse before it gets better, as many predict — the county will end up with around 450 overdose deaths by year's end. That's compared to 194 in 2015, 198 in 2014, and 194 in 2013, according to the medical examiner's data. In other words, more than twice as many deaths than last year. More than the last two years combined.
Cleveland's problem is bad — horrible — but certainly not unique. Mid-sized markets like Cleveland and Columbus and Dayton grew desirable in the eyes of traffickers as doctors across the country built a culture of overzealous opiate prescriptions through the 1990s and 2000s. Heroin, as DiCillo puts it, is easy and cheap as hell to buy. Much easier than tracking down OxyContin in a pinch. The numbers only begin to tell the story. The real picture is a modern twist on a Norman Rockwell painting, the disease of addiction running rampant in America.
Aaron Marks works with the Heroin and Opioid Task Force led by the U.S. Attorney's Office in the Northern District of Ohio. He survived his own bout with heroin addiction more than a decade ago, and he's not optimistic about the region's prospects these days.
"I think we're still at a point where this is going to continue to get worse before it gets better," he tells Scene in an Ohio City cafe one morning. "I don't want to sound defeated, but we've been working on it for three years and you see these numbers and it's tough. I don't think people realize how much is going on. You see the numbers and it's kind of shocking, but once you take a step back and look at the scope of the problem, this is the public health crisis of the next generation. It's the No. 1 cause of accidental death in the United States of America."
Marks can't help but zoom out for the aerial shot. This is bigger than imaginable, he says. Last month, the U.S. Congress passed the Comprehensive Addiction and Recovery Act, which President Barack Obama is expected to sign into law. The bill would shift federal drug policy away from punishment and toward treatment. The hope is that this is a bellwether for states and local governments' handling of addicts. This, Marks says, is the tone that this country needs right now.
In Ohio, for instance, drug offenders comprise 27 percent of the state's rising prison population. That image of the addict-inmate is a perpetual problem for folks like Marks and countless others who are trying to reroute public perception of the addiction problem in the U.S. Simply put, this isn't being treated as a public health crisis. It's something to be hidden, mocked, reduced to base criminal behavior.
Here's a moment you'll remember: Video footage of a man overdosing in a Fairview Park McDonald's hit the local news networks in April. The woman he was with came over to his side of the table and applied a shot of naloxone up his nose. (Naloxone – brand name, Narcan – reverses overdoses and is available over the counter in Ohio.) The woman went on to overdose herself within an hour back at home. She lived. But the tone of the reports and their online comments — the simple framing of a moment in the life of a heroin addict in Northeast Ohio — further etched the narrative that addicts are criminals destined for jail or worse. That sort of fear isn't helping the county's case at this most harrowing juncture.
"This is the crisis of the generation. People don't realize it, but it's going to wipe us out," Marks says. "It's touching every aspect of society, and it's going to wipe out an entire generation of people."
Marks pauses a beat for emphasis before finishing his thought: "It's going to kill so many people."***
These things don't happen in a vacuum. Addiction touches all corners of a person's life, including all the people who revolve around him or her. Karyn Faranda met DiCillo five or six years ago. He had wandered into her social circles, bringing with him a curiosity and a burgeoning heroin habit. The two of them knitted a fast friendship.
"You kind of couch-flop wherever somebody will let you," Faranda says of the social flow in the junkie circuit. "He struck me as a very beautiful soul: very kind, very intelligent. That's something I didn't get a lot of while I was out there. People aren't talking about the evolution of time and space and, you know, the meaning of life while shooting heroin. But Nick and I did."
They were honest with each other about the nature of their addictions.
"We never fit in," Faranda says over coffee on a recent Saturday afternoon. She speaks from behind big brown eyes heavy with stories, earrings dangling amid black locks and a blue patterned headband. "We had that need to want to see the world, to see more than shitty-ass Cleveland, Ohio. We were meant for better things, and we always knew it. However, we also knew our limitations because of what we were doing. And we shared in our sorrow of that — that there seemed no way out at that point."
DiCillo was studying at Northwestern University before he returned to Cleveland in 2009. He describes a fairly typical college lifestyle: the rites of passage of beer-soaked parties by night, the ambitious classload by day. He was on a full-ride scholarship for music; DiCillo was an accomplished flautist. He offset his creativity with the rigors of the university's acclaimed journalism program. He kept busy.
For all the opportunity and open paths ahead, he didn't feel the sort of optimism and pride one might expect. He'd suffered from depression for years. And while prescription painkillers are one path to heroin, depression can be too.
"I went from cosmopolitan cultured collegiate — you like that alliteration? — to gutter junkie," DiCillo says with a slight laugh. "When I moved here I bought a car for the first time and I moved out on my own. I had a great job. I freely gave it all away. Nothing was taken from me, you know what I mean? I gave it all away. I gave every bit of it away. But today I'm re-empowered to a certain degree, and I'm able to take ownership of my life again and slowly and surely rebuild and re-attain all of those things I so freely gave away."
It took a few months after his first hit before DiCillo started getting dopesick. That's the word for the physiological nightmare of heroin withdrawal, those creeping moments when you need the drug but don't have any (or won't give your body any). The symptoms are brutal: nausea, headaches, restlessness, sleeplessness, diarrhea, cold sweats, hot flashes, seizures, hallucinations, suicidal thoughts.
When you start getting dopesick, that's when life takes a darker turn inward. The addiction is real and unrepentant at that point. And whether it's a loving family, a good job or a nice house, heroin dwarfs the things that give life its structure. Nothing is taken, but everything is lost.***
To hear the stories, it's a very simple matter to pick up a bag of heroin in Cleveland. DiCillo and his friend, Bryan Stadtler, from the confines of a rehab clinic in Slavic Village, recount to Scene horrific stories of their respective addictions in Cleveland. It's a simple process, yes, but this is not an easy path to walk. "It's amazing how intricate it really is and how much ingenuity is required [to sustain a heroin habit]," DiCillo says.