Include a byline with the reporter’s name and Direct Relief in the following format: "Author Name, Direct Relief." If attribution in that format is not possible, include the following language at the top of the story: "This story was originally published by Direct Relief."
If publishing online, please link to the original URL of the story.
Maintain any tagline at the bottom of the story.
With Direct Relief's permission, news publications can make changes such as localizing the content for a particular area, using a different headline, or shortening story text. To confirm edits are acceptable, please check with Direct Relief by clicking this link.
If new content is added to the original story — for example, a comment from a local official — a note with language to the effect of the following must be included: "Additional reporting by [reporter and organization]."
If republished stories are shared on social media, Direct Relief appreciates being tagged in the posts:
Unless stated otherwise, images shot by Direct Relief may be republished for non-commercial purposes with proper attribution, given the republisher complies with the requirements identified below.
Maintain correct caption information.
Credit the photographer and Direct Relief in the caption. For example: "First and Last Name / Direct Relief."
Do not digitally alter images.
Direct Relief often contracts with freelance photographers who usually, but not always, allow their work to be published by Direct Relief’s media partners. Contact Direct Relief for permission to use images in which Direct Relief is not credited in the caption by clicking here.
Do not state or imply that donations to any third-party organization support Direct Relief's work.
Republishers may not sell Direct Relief's content.
Direct Relief's work is prohibited from populating web pages designed to improve rankings on search engines or solely to gain revenue from network-based advertisements.
Advance permission is required to translate Direct Relief's stories into a language different from the original language of publication. To inquire, contact us here.
If Direct Relief requests a change to or removal of republished Direct Relief content from a site or on-air, the republisher must comply.
For any additional questions about republishing Direct Relief content, please email the team here.
Editor’s note: This story is the first in a series on the opioid epidemic in America
The teenager told her mother she had the flu.
The 16-year-old locked herself in her New Rochelle, New York, bedroom and spent days vomiting, shaking and sweating.
These were flu-like symptoms, but the health condition was a lie to cover what would turn into a life-long struggle. Her life didn’t start out that way.
Janice Shea was an intelligent child. She was enrolled in an academically gifted program which placed her in classrooms with students two and three years older than herself. Shea was the kind of kid who loved to write existentialist plays and wear dark clothing. She loved drama club and afterschool sports. It was at school, with a friend who had brought it from home, that she first tried a substance to “enhance their creative edge.”
Though Shea did well in class, if it weren’t for extracurricular activities, she may not have gone to school at all. But she didn’t want to go home either.
Her second-grade teacher, Mrs. Eilbert, recognized there was an issue at home and looked after Shea as often as she could. The young girl knew she would have to leave home before becoming an adult, but New York law required her to stay in school until age 16. Shea waited for her 16th birthday, self-medicating and avoiding the abusive household her mother had created.
Because Shea knew she wouldn’t be able to afford to live away from home in her condition, the teenager decided to detox from her four-year heroin addiction, alone in her bedroom, before leaving for good.
“Heroin was home to me,” Shea said. “…When I found heroin it took all the pain away and it made life tolerable, and I was home, and I stayed there.”
Shea, now 64 years old, has not used heroin in 33 years. She used 12-step meeting methods in her recovery, which is no easy task. It’s part of the reason she supports medically assisted treatment programs and the use of the overdose-reversing drug, naloxone.
Dr. Charles Camillo Fenzi, of the Santa Barbara Neighborhood Clinics’ Goleta Neighborhood Clinic, hired Shea to help with the clinic’s MAT program. The clinic also uses a naloxone donation from Pfizer and Direct Relief in their emergency kits, specifically for patients before they even enter the treatment program.
Fenzi said Shea’s success is highly unusual.
“This person may be a champion of recovery,” Fenzi said.
Shea’s the current behavioral health care coordinator at the Goleta Neighborhood Clinic, where she helps patients overcome substance use disorders. Her past experience with addiction has made her essential to the practice because she can connect with patients at a genuine level.
Shea’s early introduction and addiction to opioid drugs is not uncommon. From 2007 to 2012, there was an upward trend among persons aged 12 and older in the United States who had used heroin in the past month.
Though Shea was given heroin directly, others are introduced initially to opioid prescription painkillers by their doctors, or by taking painkillers that were prescribed to parents, relatives or siblings. The rate of opiate prescription painkiller use began to rise in 2000. Opiate prescription drugs like hydrocodone, codeine and fentanyl are highly addictive and can cause users to overdose and die if not taken with caution.
“The misuse of prescription opioids started increasing in about 2000 and it peaked around 2012,” said Kimberly Johnson of the Substance Abuse and Mental Health Services Administration.
Johnson, the director of the Center for Substance Abuse Treatment at SAMHSA, said opioid overdose death rates have increased due to the introduction of fentanyl and carfentanil (previously used as an elephant tranquilizer) which is 10,000 times more powerful than morphine and can be mixed with street drugs like heroin, many times with deadly consequences.
In an effort to save lives, healthcare providers began requesting two specific drugs—naloxone, an overdose reversal drug, and suboxone, a supplemental detox treatment.
SAMHSA recommends medically assisted treatment with behavioral therapy for substance addiction treatment; however, holistic treatment wasn’t popular when Shea needed it most.
Shea has seen five friends die from overdoses after using opiate drugs. She’s overdosed too. Sometimes others were around to pack her body in ice to keep her alive, others considered places to dump her body if she didn’t wake up. Sometimes, she awoke days later, alone and in a pool of her own vomit.
“I’ve had more overdoses than I can count,” Shea said. “I have no idea why I’m still breathing while others are not.”
Many of those overdoses were in Northern Vermont, where she continued to use heroin daily throughout her 20s. But she was a functional addict, the kind who contributed to society, working with the New England court system to set up group homes for children and teenagers.
It wasn’t until Shea was 29 years old and pregnant with her first child that she realized she couldn’t stop. She failed, repeatedly, until her ex-husband offered her help in Los Angeles.
“I didn’t believe addicts who claimed to be clean — they were lying,” Shea said.
Shea had trouble finding a treatment center in California that would accept her. She was malnourished, pregnant, poor, and didn’t know she had insurance at the time.
“I didn’t believe I could stay clean if I didn’t get locked up,” Shea said. “But I couldn’t get any treatment plans to take me because I looked like a walking malpractice suit.”
Insurance is key to whether a person can afford drug treatment or not. Almost 20 percent of people under 65 in California lacked insurance in 2017, according to County Health Rankings and Roadmaps. Additionally, just having insurance doesn’t guarantee affordability.
Although Shea was insured, she couldn’t afford the co-pay for treatment.
The alternative was a 12-step program, an anonymous network of support for addicts. Before and after the birth of her only child, Shea went to three and four meetings a day. She relied on other substance users who were seeking help and kept a small social circle of understanding and helpful people.
Support is part of the reason the Goleta clinic is trying to build its treatment program. Though patients are given medication to assist the pain from withdrawal, Fenzi said it’s important for patients to receive behavioral health help simultaneously.
Due to her experience, Shea’s presence in the clinic has been beneficial to the practice.
“Anyone who walks in the door and kind of starts with an aggressive approach … [Shea] always kind of jumps in and de-escalates the situation for us,” said Angie Perez, clinic manager at the Goleta clinic.