One week ago three hours after I left the all-male halfway house where I am a substance abuse counselor, one of my clients overdosed in the bathroom on the second floor of the house. At 6’3″ his body twisted into a space the size of a small closet. A really small closet.
Not being in recovery myself, I’m still learning how to spot the pinpoint pupils of a person high on heroin. My co-workers, all recovering addicts themselves, and the residents, the majority recovering heroin addicts, can spot this in a split-second. I can easily tell when one of them is smashed from drinking (usually a lot of crying and staggering not to mention the reeking of booze that can be smelled from feet away) but someone on heroin, other opiates, and some of the newer synthetic marijuana, not so easy for me. When I started all the guys who looked tired I generally thought were high. I would ask my co-workers if so-and-so looked high to them, they would go and take a look, and come back with a definitive assessment of “No. Not high.”
On my very first day of work, the house manager who has fifteen years clean, was staring at one of the guys who was picking over his food.
“He’s high,” he said.
I asked him how he could tell and he told me that he’s never seen him pick at his food before. He was given a quick-cup (an on-the-spot urine sample) tested positive, and was discharged from the house. I was amazed that that one subtle nuance tipped my co-worker off. I had a lot to learn.
Since then, I’ve been taught to pay attention to broken patterns. I had a client who came home from work every day at 2:00 on the dot. Every day. When one day he didn’t show up at this usual time, I called him in a slight panic. “Gayle, I’m fine. I had to go to the registry to renew my license. It’s all good.” Another day, when a guy didn’t show up for a mandatory house meeting the same co-worker said “He’s not coming back.” And he was right. He didn’t.
With the guy who overdosed, even I could tell he was high. He was wearing glasses for the first time. His speech was different. My other co-worker had seen him first and made a beeline to the three staff in the office and said “________ is high.” Three hours later, he was minutes from death in the bathroom.
When I came into work the next morning I heard the details from the other guys:
- A resident noticed that the water was running for a long time behind the locked bathroom door.
- He went into his room and said to his roommate “Is someone dead in the bathroom?”
- Roommate has a light bulb go off and runs to the door with a pen and tries to pick the lock.
- Lock is picked but the aforementioned 6’3″ body is sprawled in a way that his legs are blocking the door making it impossible for anyone to get in. A guy who had been there just one day turned into the Incredible Hulk and threw his body repeatedly against the door in an attempt to break it down.
- Somehow, the door opens just enough to allow the lankiest guy in the house to get in, see that my client has banged his head on the toilet and that blood is everywhere. He manages to lift the client just enough so that his legs are no longer blocking the door.
- In the meantime the other residents are running around grabbing Narcan that hangs in bags on every floor of the house. Lanky client doesn’t know how to use Narcan so another resident steps in and administers it, bringing the client out of his overdose. Client is mortified and ashamed, sobbing and apologizing to the other 29 guys.
- Ambulance arrives and the others walk him down with a leg and ankle injury sustained from the frantic pushing of the door. The other guys stand on the sidewalk and watch him get whisked away. From what I understand, this entire event unfolded in about three minutes.
The next morning I made sure to check-in with the men on my caseload and urged them to process what they were feeling. The alcoholics who had never seen anything like this were the most rattled. One said that it was the most terrifying thing he had ever seen. The other heroin addicts were either triggered by the sight of the needle or were grateful that it wasn’t them. The youngest on my caseload had an anxiety attack.
I called my client in the hospital the next day to see how he was doing. The first thing he did was apologize and to say how embarrassed he was. The next thing he said was that he had no idea where he was going to go next. He doesn’t want to get into the never ending cycle of detox, program, relapse, detox, etc. One of the other guys has said that he’s stopped texting and posting on Facebook. That’s a pretty tell-tale sign that he’s on a run, perhaps using on the streets, where unfortunately, there won’t be 29 other guys around to save his life.