Alaska News

After a daughter's heroin overdose, an Alaska mother's grief

It has been two months since the January afternoon when Jared Smallwood got a strange feeling while eating a bowl of cereal in the Arctic Boulevard trailer he shared with his older sister.

He hadn't heard anything from the bedroom for a while. He wondered what she was doing.

Inside, he found Summer Myers slumped over on a bed strewn with clothing, a needle next to her. A tourniquet sat on the bedside table, along with an overflowing ashtray, prescription pill bottles and a bottle of chocolate milk.

He lifted her up. She was stiff. Her face was contracted as if she'd had a seizure.

The 19-year-old tried to resuscitate his sister as he called 911.

When medics arrived, they dragged her into the kitchen and declared her dead.

Police descended on the scene to take photographs and compile reports.

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Later, they gave the investigation files to Myers' mother, Jackie Smallwood.

The pictures taken by police are hard to look at: a young woman's lifeless body, crumpled on the linoleum floor. She wears a polka-dot sundress, her skin blotched purple and white.

Don't turn away, Smallwood says: See what heroin did to my child.

A killer of the young

Summer Myers is one of six people who have died in Alaska this year from overdoses involving heroin, according to the state medical examiner's office. But heroin was not the only drug in Myers' body when she was found. The final autopsy report attributed her death to "acute combined opiate (heroin), hydromorphone, amphetamine and clonazepam intoxication."

Heroin and prescription drug abuse are rising killers in Alaska and the rest of the country.

The Centers for Disease Control and Prevention said in January that overdose deaths linked to heroin nationwide jumped 39 percent from 2012 to 2013, the most recent data available.

In Alaska, about a quarter of fatal drug overdoses in the past few years involved heroin, said Dr. Gary Zientek, who as the state medical examiner is charged with performing autopsies.

Last year, only one of the roughly 25 to 30 people who died of heroin-related overdoses was found with only that drug in their body, Zientek said. Far more often, people die from a toxic combination of heroin and amphetamines, known as a speedball, or from mixing heroin and alcohol, two powerful depressants.

Deaths that involve a mix of heroin and prescription drugs, like Myers', account for a fraction of the total, maybe 3-4 percent, Zientek said.

Though law enforcement officials say heroin is increasingly being sold in rural Alaska, the majority of the people Zientek sees who have died with heroin in their bodies lived in the state's cities.

Like Myers, who would have turned 26 this month, most are young.

A fresh start

Jackie Smallwood brought her family to Alaska hoping for a fresh start.

Smallwood, a fierce, matter-of-fact licensed practical nurse, comes from New Philadelphia, Ohio, a town off an interstate highway 70 miles south of Cleveland.

"They got a Walmart. They have a mall. But really, if you want to get anywhere you have to leave," is how she describes the place. "All you have (for work) is the restaurants, the stores. There's nothing special at all about it."

When Smallwood was growing up there, cocaine, marijuana and amphetamine pills were the main drugs in town. She's not sure when heroin crept in from cities like Pittsburgh and Detroit. In the past decade, the drug has become a serious problem in Tuscarawas County: More than a few of the playmates her children grew up with there are dead from addiction, she said.

Growing up, Smallwood thought of Myers, her youngest daughter, as her "delicate flower."

She was an anxious child, prone to hiding in her room upstairs when her cousins came over to play, aggrieved by slights and teasing. By high school, she had asked to be homeschooled. She finished the required coursework online in less than a year, Smallwood said. By 16, she was studying at the local campus of Kent State University, studying psychology. She switched to online classes and came within striking distance of an associate's degree at the University of Phoenix.

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When she was around 18, Myers met a local guy on MySpace who went by the name "Johnny Bitchface." Smallwood believes he introduced her daughter to heroin. Soon, she was stealing money from her mother. Then a camera. A DVD player.

"She became a completely different person," Smallwood said.

She says she tried her best to help her daughter. But Myers was legally an adult. Before long, she was convicted of a drug felony.

Jared Smallwood says his sister was entranced with a Hollywood-esque image of drugs from the time she was young -- an idealized lifestyle in which hedonism went hand in hand with unbridled creativity.

"She was into the whole heroin chic thing," Jared Smallwood says.

At the time she died, Myers' Facebook page banner was a drawing of writer and famed drug connoisseur Hunter S. Thompson with the phrase "Too Weird to Live, Too Rare to Die."

Myers told her brother she liked the full-body rush of heroin.

Soon, she was owned by it, her mother says.

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"My daughter did things she would never, ever have done if she wasn't on that drug," she said.

To earn a living, Smallwood became a licensed practical nurse. Options were slim locally, so she left Ohio for long stretches to work nursing gigs in Kotzebue and Nome, eventually moving to Anchorage.

For a while, she worked at Clitheroe Center, the city's main inpatient addiction treatment facility.

Meanwhile, her daughter went to jail for drugs in Ohio and begged for bail money. Smallwood said no. She felt secretly relieved that Myers was in jail because it seemed safer.

In 2011, Smallwood moved Myers and her son to Alaska. A fresh start.

In Anchorage, Myers met people on a social networking app called MeetMe who helped reacquaint her with heroin, her mother said. Myers' boyfriend from Ohio, also an addict, moved up to be with her, the four of them crammed in the little trailer on Arctic Boulevard.

Her mother slept on the couch with a bag of prescribed pills hidden under her in the cushions. Myers managed to take them anyway.

But it was heroin that was devouring her, Smallwood says.

In 2013, Myers took Xanax, Klonopin and other drugs in a half-hearted attempt to die.

"At this point she doesn't appear acutely suicidal, though without treatment of depression and abstinence from drugs this is likely to become an issue again," read her discharge paperwork from the Alaska Psychiatric Institute, where she'd spent the night.

Slipping away

In Anchorage, there were stretches of relative stability. Myers worked at Applebee's and PartyCraft, but didn't hold down jobs for long.

Smallwood felt her daughter slipping away.

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Myers had tried DMT, a hallucinogenic drug known for its use in religious ceremonies in South America. While on the drug, she'd gone to a place of light, peace and calm, she told her family. She said she wanted to go back there.

Smallwood says rehab was never really an option for her daughter. The few times when Myers expressed a willingness to go, programs either had a wait list or were out of reach financially, Smallwood said.

"They don't take Medicaid. I didn't have insurance," she said. "Or 'there's no beds, sorry about your luck.'"

In theory, Myers should have been able to get into at least detox, said Stacy Toner, the deputy director of the Department of Health and Social Services Division of Behavioral Health.

"Anybody who needs to get into detox should have access to it," she said. "(Over the past eight months,) the capacity of Anchorage is not full. They are running at just about 80 percent."

That's not to say there isn't a wait list on any given day, Toner said.

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Ability to pay shouldn't be a barrier, either. Programs get subsidies to treat people who don't have insurance, so Myers should have been able to get some kind of help on a sliding scale or without paying.

In Anchorage, a methadone clinic, the Narcotic Drug Treatment Center, "prioritizes women who are injecting," Toner said.

The center currently has a wait list of 30 days, according to a receptionist.

Are wait lists for opiate addiction treatment common? Toner said she wasn't sure.

"Our wait list reporting is broken in our system at this point. There probably are but we don't know. We're working to fix it."

The confusion illustrates a gap between what professionals say is available to help people kick opiate addictions and the experiences of families who say they have tried to navigate the system and failed.

"I don't know why the dots didn't connect for this family," Toner said. "I'm sorry that they didn't."

At one point, Myers did enroll in one Eagle River program, where Smallwood said Myers was given Suboxone, a substitute opioid used to treat addiction and a drug The New York Times described as a "blockbuster drug most people have never heard of."

"She just got fed Suboxone and the guy was pushing his vitamins," Smallwood said. "That did not work."

Eventually, she says, her own insurance would not longer pay for the treatment.

Last fall, Smallwood began staying at her fiance's house in Wasilla. When she returned for daily checks on Myers and her brother, she saw the home devolving into a mire of unwashed dishes and countertops strewn with debris.

This, too, is part of the reality of addiction, Smallwood said.

"They don't do nothing but get high," Smallwood said.

She felt like tough love was needed. Her now-grown children had to be able to live successfully on their own. What would her kids do when she was gone?

"I said, 'You guys are adults. I want you to know what it's like to live on your own,'" she said.

On Oct. 6, Myers nearly overdosed on heroin.

A police report from the day notes that Smallwood "expressed her frustration with Myers' condition and lack of treatment options."

On that day, she was revived with Narcan, a powerful drug used in emergency medicine to counteract drug intoxication.

When Myers woke up, "boy, was she mad," Smallwood said. "She said, 'I'm writing a living will. I do not want to be resuscitated.'"

Too bad, her mother told her.

"As long as I'm here, I will reach into death and grab you back," Smallwood told her daughter. "I will not let you go."

Grief into words

Myers died on Jan. 4, less than two months later.

Smallwood worries about her son. He feels guilty and haunted by what he saw.

"I found out from the police report that she had shot up 20 minutes before I went back and found her," Jared Smallwood said. "I mean, I ate a bowl of cereal. If I went back to see her first, I might have been able to revive her and she could have lived."

That's not true, his mother tells him: Myers took so much of each drug she thinks it must have been purposeful.

Smallwood has scarcely returned to the green and white trailer.

The house was in such shambles that walking inside sapped her energy. It took her weeks to empty the sink of dishes. She forced herself to return the other day to tackle the mess. She flipped up the mattress Myers died on because she couldn't stand to look at it.

Now, Smallwood is picking through the things her daughter left behind: shamanism and tarot books. Sundresses and a tie-dyed shawl. A jewelry box. They remind her of the person Myers was outside of drugs.

Since Myers died, Smallwood's urge has been to launch her grief into the world as a bulwark against the possibility that her daughter's struggle will be forgotten.

She has called newspaper editors and television stations. She has written about Myers on Facebook and posted flyers on coffee shops with her picture on them, asking for money to take her body home to Ohio. She wants to write a book about heroin addiction. "Summer's Story," it would be called.

She wants people to see the graphic photos of her daughter's body. She hopes they will be printed in the newspaper.

She wants the image of her pretty, raven-haired daughter dead on the floor of a filthy trailer to sear itself into people's minds.

Smallwood realizes this is a strange wish for a mother. But she wants people to be repelled.

She wants someone to do what she couldn't -- save their child. Or save themselves.

Michelle Theriault Boots

Michelle Theriault Boots is a longtime reporter for the Anchorage Daily News. She focuses on in-depth stories about the intersection of public policy and Alaskans' lives. Before joining the ADN in 2012, she worked at daily newspapers up and down the West Coast and earned a master's degree from the University of Oregon.

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