coming up with the $12,000 she still needed for treatment, less the last bit of her college fund. She considered asking her eighty-five-year-old father for an early release of the inheritance he planned to leave for Tess, knowing the money would be no good to her dead.
Patricia had visited Tess at the hospital the night before, taking her grandson with her, and Tess beamed at the sight of her boy. It was the first time she had seen him in ten months.
But she had a methamphetamine rash on her face, and track marks extended from her biceps to her wrists. She was newly diagnosed, too, with hepatitis C, her weight down to ninety pounds. When Tess got on the hospital floor to crawl around with her son, Patricia saw abscesses on the back of her head. “She’s the sickest I’ve ever seen her, but she has no idea how sick she is!” Patricia told me.
After the forum, Tess’s onetime track coach walked up as we were talking and told Patricia he was stunned by her remarks. “She was such a good kid, I mean…Tess was just an awesome kid.”
*
The latest research on substance use disorder from Harvard Medical School shows it takes the typical opioid-addicted user eight years—and four to five treatment attempts—to achieve remission for just a single year. And yet only about 10 percent of the addicted population manages to get access to care and treatment for a disease that has roughly the same incidence rate as diabetes.
But Patricia wasn’t giving up on her father’s generosity, and she wasn’t giving up on Tess. Neither was Jamie. “We all knew that if we didn’t actually have a car waiting to take her to the airport from the hospital, she’d never go,” Jamie said.
Tess had lost her ID, and Patricia persuaded a kindly hospital employee who happened to be a notary public to create a new, makeshift one for her so she could get on the plane. Hope volunteer Terrence Engles, in recovery for five years, coordinated the transfer between the hospital and the cab that ferried Tess to the airport on February 26, 2017. The Nevada treatment center did not accept patients on MAT. Tess had quit Suboxone months earlier—she’d lost her Medicaid coverage when her son was removed from her care—and was mostly now using crack and heroin.
Tess would end up being the Hope Initiative’s fifth person to be funneled into residential treatment, though only time would tell if the Nevada attempt would be her last. “I feel like a spectator watching a movie and just hoping and praying it ends well,” Jamie said.
Patricia compared the precariousness of the situation to a balloon with a pin poised a millimeter from the edge. “It’s like, dear God, please please do not pop this balloon,” she said. “Because there is no love you can throw on them, no hug big enough that will change the power of that drug; it is just beyond imagination how controlling and destructive it is.”
After an initial hiccup—Tess transferred in her second week to a smaller women’s facility nearby called the We Care House, saying the first place wasn’t a good fit—Patricia said she was “doing great” a month in, and would soon transition to aftercare. Her granddad had stepped in with her early inheritance, putting $12,000 toward her treatment.
Jamie Waldrop and I both sent cards of encouragement, and I included a copy of Mitchell’s Big Fix: Hope After Heroin because it offered the clearest framework for getting sober that I had read. The author, in recovery for nearly two decades, was not opposed to MAT (even though replacement medication had not been her ultimate path), and her book was full of hopeful data like this:
If Tess could remain sober for a year, she had a 50 percent chance of relapsing. If she stayed sober five years, her chance of relapse was less than 15 percent.
*
At the Hope Initiative, triaging Tess now shifted to triaging her friend Joey Gilbert. The two had couch-surfed together in southeast Roanoke, trading intermittent texts about dopesickness, Xanax, and crystal meth. Joey had arrived at Hope with her mom in early 2017. She tried going cold turkey during a brief stint at the abstinence-only rescue mission program—and didn’t last twenty-four hours before fleeing, telling Jamie she was too sick and couldn’t handle it. “She told me, ‘As long as I can use the Suboxone, I can wean myself down,’” Jamie said. Her goal was to become someone who helps other