Heroin cuts a wide swath of addiction and anguish
Heroin was not among the problems the grandparents who raised Ashley Sims, above, were prepared for, and they have since come to believe that it is a silent epidemic among young people.
Karen Sims and Paula Sayword unfold the quilt made from Ashley Sims’ clothing, which they put together as a way to grieve for their granddaughter, who died at 22 of an accidental heroin overdose on her grandmother’s birthday.
Discarded hypodermic needles, seen here across the street from Greenfield District Court, are commonly discovered in public, and called in to police for safe disposal.
Heroin bags, sealed as evidence, are stamped, in one case with a none-too-subtle but perhaps prophetic message, a skull and crossbones
First in a series
As far as her grandmothers can piece together, Ashley Sims began using heroin less than a year before it killed her.
From conversations with Ashley between her two stays in detox facilities and with friends after her death, they believe she was introduced to the drug at a party in April 2012 and was addicted by the time they learned she had a problem that October.
Ashley was 22 and lived with her grandmothers, but she was an adult and wasn’t always home ... and neither were they.
What’s more, they had no reason to suspect heroin.
Ashley grew up with her grandmothers in Leyden, living with them from the age of 9. The dirt road by their house is lined with sugar maples. Ashley’s cat, “Kitty Bear,” oversees the kitchen from a chair near the entrance and the wood stove.
Ashley loved animals and children, riding horses at a local farm when she was younger and spending a year after high school as a City Year Corps member in a Boston third grade classroom. The nonprofit service program targets urban schools with high dropout rates, with the motto “give a year, change the world.”
“This is a child we raised,” grandmother Karen Sims said. “She had a lot of opportunities and this was a decent kid.”
It wasn’t until late last year that they knew for certain something was wrong. It was the way she came downstairs one evening: sideways and slowly.
Confronted about her odd behavior, Ashley admitted she was using heroin.
They took her to the emergency room and from there she checked into a detox facility in Brookline for a five- to seven-day stay, the usual period permitted by health insurance. During that stay, a bed opened up in a long-term rehab facility, but she hesitated because she didn’t want to lose her home care job and when she changed her mind minutes later, the bed was gone.
Grandmother Paula Sayword said the program then let her stay for another five days.
“She just knew she couldn’t come back out; she just totally freaked out that she was going to have to come back to her Franklin County life, and how was she not going to use again?” Sayword recalled.
“There were no (long-term) beds; they searched for the next five days.”
Back home, she in fact did begin using again, within a month, and again checked into detox in early December, this time for a shorter stay in a Worcester facility.
Between and during those stays, she was unable to find the longer-term treatment Sims and Sayword believed she needed.
Not knowing what to do and afraid she would die at home, they helped her get her own apartment in Greenfield.
There she died of an apparent heroin overdose on Dec. 11.
Ashley was lost
During her high school years, Ashley participated in Model Congress, attended Stoneleigh-Burnham School’s summer debate camp and rode horses.
After graduation from Pioneer Valley Regional School, she briefly attended Greenfield Community College, completed her City Year and worked as a personal care assistant and at Applebee’s. Her grandmothers say she was interested in law and medicine and thought about finding a career combining these things, but she was at loose ends.
She left the area a few times but always came back to Franklin County, where, like her remaining high school friends, she wasn’t making much money and had few job prospects. The end of a relationship eventually stirred in a little depression.
“Franklin County is hard in that it’s a poor county with not a lot of job opportunities. It’s really hard for young people to find a niche,” Sims said.
“The bottom line is Ashley was lost, like a lot of her generation,” Sayword added.
As Ashley described it, heroin “took her sad away,” Sayword said.
Ashley had just begun visiting a psychiatrist for the depression that her grandmothers believe she had suffered for years, but they are adamant she did not take her own life.
The night she died she was about 12 days out of her second stint in rehab and freshly moved out of her grandmothers’ Leyden home and into a Greenfield efficiency, where she had spent the evening preparing food for Sims’ 61st birthday the next day. Her grandmothers say she was learning to live on her own, cooking things like grilled cheese and tacos.
She didn’t wake up
She had immediate plans: her grandmother’s birthday dinner and an appointment to have her windshield replaced the next day. In the long term she wanted to find a career combining health care and law, and she had just begun working nights at the Buckley HealthCare Center so she could resume her interrupted studies at Greenfield Community College.
The grandmothers believe she shot up after her friend went to sleep ... and didn’t wake up.
Sims and Sayword contend that Ashley died because she was trapped in a county toxic for people of her generation, because she wasn’t sufficiently educated regarding a drug that has largely slipped off the common radar since the 1970s, and because she fell through the cracks of an inadequate addiction treatment system.
The couple, legally married in Massachusetts, originally didn’t put their finger on the cause of Ashley’s occasionally odd behavior earlier last fall, they believe, partly because they never would have suspected heroin.
Sayword worked in public housing for 25 years and Sims is semi-retired from a career in health care — she spent 20 years as a high school nurse and is now working in an area hospital’s mental health unit.
Despite this life experience, heroin was not among the problems they were prepared for, and they have since come to believe that it is a silent epidemic among young people.
“People aren’t talking about it,” Sims said.
“People think it’s a drug that lowlifes, street people use. Young kids don’t realize it’s not something you can mess around with; it turns around to bite you,” agreed Sayword. “It’s everywhere. It’s not just a city problem, it’s all across the country.”
“People do think of it as a city drug and really it’s more prevalent in rural areas,” Sims said.
Hoping to raise awareness, they chose to publish Ashley’s cause of death in her obituary, and as a result they have heard of other deaths, including two in the Pioneer Valley in December.
Based on anecdotal evidence, heroin seems rampant in the county. Statistically, however, the presence of heroin and other opiates in a small population is difficult to quantify.
Conversations with area law enforcement and health care professionals suggest heroin has been a growing presence in the Franklin County area for the past five years, a presence intertwined with prescription drug abuse.
Prescription opiates, whether prescribed to the user, found in a home medicine cabinet or purchased illegally, share with heroin a common pharmacological ancestor and common effects when abused.
“(Opiates are the) number-one cause of death in Massachusetts under the age of 45,” said local physician Dr. Ruth Potee.
“It used to be car accidents; that’s why we have cars with airbags and seat belts we ask people to use, and we put kids in car seats trying to keep people alive, but overdose from opiates surpassed motor vehicle deaths in Mass. a couple years ago, and that’s old data from before people started using so much.”
Potee, a family physician practicing at the Valley Medical Group’s Greenfield Health Center, practiced in Boston before moving to Franklin County, where she is now one of only two general practitioners locally treating patients for opiate addiction with the drug Suboxone.
Potee estimates heavy heroin use hit the area within the past four years.
“Franklin County and the North Quabbin area is not alone. In fact, if anything, it hit us a little bit later, it came up from New York and it sort of stopped in the normal cities, Bridgeport and New Haven, Springfield — Holyoke is certainly the epicenter down here — then it sort of blew by Greenfield for a few years and headed up toward Vermont,” Potee said.
“Now it’s sort of everywhere, it’s just sort of a wide swath of abuse.”
Montague Police Narcotics Detective Leon Laster estimates heroin has been on the rise locally within the past five years.
“Heroin is very, very prevalent in this area. It is easier to get a bag of heroin than it is to buy a dime bag of pot these days,” Laster said. “It’s unfortunate because we’re finding our users are a lot younger now because they don’t mainline it like the days of old, meaning the preferred method now is not so much injecting it as it is snorting it.”
Laster and others say prescription pill abuse has helped contribute to a heroin renaissance, with many heroin addicts beginning with painkillers, whether through a legitimate prescription or otherwise, and transitioning into heroin when they discover it is cheaper and often easier to come by.
“It’s global. It’s not just a problem here in Turners Falls, Greenfield, Massachusetts, Holyoke, Springfield; it’s a problem nationwide, worldwide,” Laster said. “We’re not the only ones to have it, but for the population of our area it’s devastating. If we have one or two heroin overdoses a year that’s too many for us.”
“It’s too small of an area to have such a big problem, and it affects everyone: rich, poor, black, white, Hispanic, Asian. It doesn’t matter, it doesn’t discriminate,” Laster said. “It’s rampant, it really is.”
Great need for help
Dr. Amanda Wilson, president and CEO of CleanSlate Addiction Treatment Centers, offers a similar assessment. Wilson opened one of her offices — which specialize in addiction treatment with Suboxone, a methadone alternative — in Greenfield less than four years ago.
“We opened here because we heard the need was really great and it’s really proven to be true,” said Wilson, who opened offices in Greenfield and West Springfield simultaneously before expanding to locations in Springfield, Holyoke, New Bedford and Quincy.
“In Greenfield currently we probably have about 500 patients in treatment for opioid dependency,” Wilson said, with some travelling from outside the county and numbers split about half-and-half between heroin and pill dependence.
In the Greenfield area, “it’s a pretty serious issue; there are lots of people up there who unfortunately have long-standing dependencies,” Wilson said. It is not uncommon to see networks of friends or family who use.
“We end up treating whole families up there quite a bit; we’re treating the wife and husband and sometimes his brother or her sister too,” she said. “At the Greenfield office, considering what the population is, for us to have 500 patients, it’s a lot.”
Orange, Athol and the hilltowns are among the areas hardest hit, according to Wilson.
“We expected it to be an urban issue and it’s really very much a suburban and rural issue,” she said.
Assistant District Attorney Jeremy Bucci heads the Northwestern District Attorney’s Office drug prosecution unit and identifies heroin addiction as the driving factor behind much of the county’s recent crime. Dealers of heroin and other opiates will therefore be among the first targets of the DA’s new anti-crime task force.
Bucci said much of the information needed to grasp the extent of the problem will not be available until investigations begin, arrests are made, suspects interviewed and search warrants executed.
“I would say by June we should have some arrests made and at least begin to understand the scope of our problem,” Bucci said.
People’s lives go to hell