Substance Use, Mental Health & the Road to Recovery: ‘Like Juggling Explosives Blindfolded’

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Family photos courtesy of McKoon Funeral Home

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When Corey Roberts came out of prison, he hit the ground running.

In short order, he found a job at a chicken joint. He found a girlfriend. And at 21, after an 18-month stretch in Georgia correctional facilities, including nine months in a drug-rehabilitation program, he began the process of rebuilding a life within the legally constrained horizons of an ex-convict.

For more information about mental health and substance use, go to JJIE Resource Hub | Mental Health and Substance Use Disorders

But like a lot of people who struggle with drugs, depression and a criminal record, Roberts soon hit some setbacks.

He went through several jobs in the year after his August 2015 release. He lost his driver’s license when he got ticketed for speeding and failed to show up for his court date. Dating was difficult. He resumed an old habit of self-medicating with marijuana. And when that wasn’t cutting it any more, he turned to more potent drugs.

[Related: Convicted on Drug Charges, Georgia Youth Faces Life After Rehab]

Barely a year after walking out of prison, Roberts — who detailed his prison experience in Youth Today last January — was dead of a drug overdose at 22.

“I knew he’d been upset. He was going through a breakup. But I think it was more just really hitting him how difficult things were going to be,” said his mother, Doneen Mills.

Mills found her son unresponsive in their home in Newnan, Georgia, about 40 miles south of Atlanta, on Sept. 13. He died two days later at a nearby hospital.

But he left no note. She called his overdose a “cry for help” that went too far.

“He would never have killed himself in a million years knowing it was me who would find him," she said.


Overdoses common among ex-convicts

Roberts died from an accidental overdose of fentanyl, according to the Coweta County coroner’s office. Fentanyl is a powerful narcotic blamed for thousands of deaths around the United States in the past three years. In the hardest-hit states, deaths from fentanyl and other synthetic opioid painkillers have more than tripled among young men between 15 and 24.

Normally used to relieve the pain of people suffering from acute cancer, fentanyl is far more potent than heroin — and it has been turning up on the streets, either to cut heroin or, increasingly, on its own.

Drug overdoses are depressingly common among ex-convicts, in particular. One 2007 study found recently released inmates were more than three times as likely to die as other people in their first two years outside, with drug overdoses their No. 1 cause of death.

Mills said she knew her son had begun using marijuana again, but was unaware he was turning to harder drugs.

“At one point, on the advice of a counselor, I had kicked him out because he was doing the same things that got him put in jail the first time,” she said. “I kind of wanted him to hit bottom and agree to follow the rules, and offered counseling and things like that.

“He had just recently come home. We’d given up on trying to get him to stop smoking, because in the grand scheme of things, we couldn’t keep him out of jail, and he said it was helping him with his depression.”

Roberts had been treated for depression since he was a teenager, and his attempts to self-medicate were what led him to start smoking weed, he told Youth Today last January.

“Having a child like Corey was kind of like juggling explosives blindfolded,” Mills said. “You’re always afraid to look away, always afraid to drop the ball.”

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‘Weren’t we just here?’

Roberts was struggling against a tide that has washed over Georgia and other states for the past few years. The state is scrambling to fight a wave of problems related to the spread of opioid painkillers, like fentanyl, after it slashed funding for drug treatment and prevention programs during the last recession, said Neil Campbell, executive director of the Georgia Council on Substance Abuse.

“Georgia’s opiate deaths are rising, and they’re trying to get ahead of it so we’re not like Ohio,” Campbell said.  Authorities there say they’re recording an average of eight deaths per day from drug overdoses.

“There’s a lot we can do to get some funding back and get some attention, but we’ve got to do it now,” she added. “Kids are dying.”

And while Mills performed CPR in a bid to revive her son, she didn’t know this wasn’t his first overdose.

Roberts was taken to the emergency room on Sept. 11, while Mills was traveling. He was on the phone when he began slurring his words. The friend on the other end got worried and called an ambulance, Roberts told his high school buddy, Irvin Dunn, after getting out of the hospital. Dunn said Roberts seemed genuinely shaken by his close call.

“He was like, ‘Man, I’m not doing that shit again,’” Dunn said.

That day in September, paramedics took Roberts to the hospital, where he was treated for an overdose. Mills said a nurse later told her that he’d been urged to stay for 72 hours, but he refused and signed himself out.

According to text messages his family found after his death, Roberts did fentanyl only twice. The first time, it put him in the hospital. The second time, it killed him.

Roberts told Dunn about his ambulance ride the next day, spurring what his friend called “a coming-to-Jesus conversation.”

“I really got onto him,” Dunn said. ”I told him, ‘You’ve got to think about your mother; you’ve got to think about your father, your brothers and your sisters. It’s going to affect them if something happens to you. It’s going to hurt them.’”

Dunn said Roberts told him, “I’m not going to be doing that crazy shit again. I cheated death. I’m not doing that again.’”

That day, Dunn — an aspiring photographer — took Roberts with him to Kennesaw State University*, where he had a meeting. Roberts talked about wanting to become a sportswriter, and Dunn encouraged him to check out the college’s journalism program.

“I made a promise to him: I said if you get yourself together, I will do a branch on my website for sports, and you can be my sports journalist,” Dunn said. Roberts was upbeat when they got to the campus, on the northern outskirts of Atlanta — but when Dunn came out of his meeting, Roberts “had a different look. He was aggravated. He was irritated.”

When he encouraged Roberts to go to the admissions office to ask about applying, he said Roberts sounded discouraged because of his record. Dunn said he tried to assure Roberts that there were ways around a criminal conviction, and Roberts eventually went into the office and got some information about the program.

Mills had been overseas visiting her husband, whose job had taken him to Britain for an extended stretch. She returned that night, exhausted and facing the prospect of a funeral — that of her ailing stepfather. Her son had been distraught over a breakup in the days before her return, texting her frequently about his anguish. When she got back, he told her he wanted to see a counselor.

“He told me he wanted help, and I told him we’ll call a counselor tomorrow,” she said. “In retrospect, I feel like I should have paid more attention. I should have picked up things being worse than I even knew. I’ve always picked up on it in the past, but I was very tired.

“He gave me a hug. He said, ‘I love you.’ I said, ‘I love you too,’ and he went to bed.”

He didn’t mention his trip to the hospital the previous night. She learned about it when the paramedics arrived the next morning, when one of them asked another, “Weren’t we just here?”

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‘Somewhere, his heart is still beating’

Roberts was laid to rest three days after his death. Dunn delivered the eulogy for his friend, recounting their meeting in a high school French class and describing them as “a fraternity of two.”

His friend never quite recovered from his time in prison, he said.

“The reason Corey went from job to job to job to job was he just couldn’t stay stable,” Dunn said later. “He had so much going on in his life. He’d been through a traumatic experience for 18 months — boom boom boom, wake up; boom boom boom, lights out, every day. That changes you, being stuck in a box for the whole day. So your adjustment to reality is so different.”

Roberts ended up in prison during his sophomore year at Georgia Southern University. His periodic marijuana use in high school had become a daily habit in college. He and his friends turned to dealing to pay for their own weed. A beef with another dealer led to a beat-down that drew the attention of police. It was his second arrest, after a misdemeanor marijuana possession charge for which he was already on probation.

In the end, Roberts pleaded guilty to burglary, forgery and selling marijuana and got 15 months in prison, nine of them in a state drug-rehabilitation program for inmates. He was one of millions of Americans who served time in the decades-old war on drugs since the 1980s.

Roberts ended up spending 18 months behind bars because he needed to wait for an opening in the rehabilitation program, with the additional time taken off his post-release probation. As a middle-class kid who returned home to a supportive family, he knew he had advantages many of those who had been locked up with him didn’t. But he also came out of prison with fines and probation costs to pay — a monthly nut of about $130 — and student loans in default, while working at entry-level jobs.

"There were so many steps to take to dig him out of the hole he was in. I think he felt like he was never going to get out,” Mills said. “He couldn’t see a different life than he was living right now."

For those who do fall back on drugs, the spread of fentanyl has made it much easier for a high to turn deadly.

The drug killed more than 250 people in Georgia in 2015, either on its own or in combination with heroin, according to state and county statistics. The four counties at the heart of the metro-Atlanta area made up more than half of those deaths, medical examiners’ offices reported. Around the rest of the state, fentanyl claimed another 115 lives, according to figures from the Georgia Bureau of Investigation.

Nationwide, opioid overdoses killed nearly 29,000 people in 2014, according to a late-November report by the U.S. Surgeon General’s office.

In 2014, Georgia lawmakers voted to allow paramedics and police carry nalaxone, or Narcan, an anti-opioid drug that helps revive victims of a narcotic overdose. Paramedics in Coweta County, which includes Roberts’ hometown, used it 175 times between October 2015 and October 2016, said Jeff Denney, who leads the county Fire Department’s emergency medical service.

“Things are definitely on an upturn in terms of these types of calls,” Denney said. “Our numbers are proportional to what’s happening everywhere else.”

Denney wouldn’t discuss details of the calls to Roberts’ home, citing patient privacy laws. But he said nalaxone is a “wonder drug” that revives most patients who overdose — as long as their breathing hasn’t been so reduced for so long that the brain is dying. Some people his crews find are breathing as little as two to four times a minute, he said.

Denney said his service starting seeing a spike in overdoses about two years ago. While some of the calls involve cases where people have mistakenly doubled up on a powerful opioid painkiller prescription, the bulk of them involve drug abuse, he said.

“You hear the stories about people jumping into dumpsters behind nursing homes to get the fentanyl out of there, or about heroin and using fentanyl on top of that to have a synergistic effect for a better high,” he said. “I wouldn’t know how it breaks down percentage-wise, as far as which one is more common than the other, but none of them are uncommon.”

No best practices yet for recovery

The recent surgeon general’s report looked at a variety of strategies that can help people who are struggling with recovery. Twelve-step programs have been well supported by scientific evidence, the report noted, while other support programs based in schools or housing designated for recovering users are “promising.”

But the report found other methods “have been studied little or not at all.” Campbell called the report an important first step toward treating addiction as a public health problem, but she said there’s not yet an established list of best practices for recovery. Only about one person in 10 with a drug or alcohol problem gets into a treatment program, and about half of those don’t complete the program, she said.  A lack of openings and fear of social stigma or losing a job keep many from seeking help. Many insurers don’t treat addiction as a chronic problem needing long-term care, and some users have needs that aren’t addressed by their rehabilitation program, Campbell said.

“I just think it’s so important for families to be supportive, to stay connected to their loved one with a substance abuse disorder and to make sure that they continue to hold hope,” she said. “There is no one thing that works for all people, every time. But it’s like any other preventable, treatable chronic health condition that’s affected by lifestyle — think diabetes, heart disease, asthma. It is a deeply personal journey, and has to be managed over time.”

Wrappers for fentanyl patches, which are designed to deliver a dose of the drug through the skin, were found in Roberts’ bedroom. Not only was he using the drug, he was chewing the patches — which delivers the full punch of the drug rapidly.

“It gets in your system very quickly through ingestion, but it is so dangerous,” Campbell said. “You can't control the dosage or have any way of knowing how much of the drug is even embedded in the patch when you're chewing it.” But it’s become “a fairly common practice,” she said.

Mills is a graduate student in political science who has been involved in international human rights activism. In a letter from prison, Roberts once told her that she was his hero.

“I really want to be the person my son believed I am,” she said. But when and how she resumes that path, or takes another — justice reform, perhaps — is still up in the air as she deals with the fallout from her son’s death.

“I’m the optimist,” she said. “I’m the one in my family who’s always trying to look on the bright side. But right now, I just don’t have one.”

What little comfort she has comes from the fact that six of her son’s organs, including his heart, went to transplant patients.

"I guess the only thing that helps me is that somewhere his heart’s still beating," Mills said.

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* Youth Today and its sister publication, Juvenile Justice Information Exchange, are housed at Kennesaw State University.

This story has been updated.

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