That patient’s continued recovery, Wells added, “speaks to the fact that MAT works. And that patients will go to any length not to relapse. They know what they need!”
But the divide between MAT opponents and proponents only deepened as I followed the travails of the Hope Initiative and users like Tess. While treatment providers, police, and family members were arguing about the best way forward, lives hung perilously in the balance.
*
It was hard being Tess. After four NA meetings, she stopped wanting to go, often texting me just as I was leaving to pick her up. The baby was sleeping, or she was too tired because he’d kept her awake the night before. His father was in jail after an alcohol-related arrest. And though his mother stepped in often to babysit, she was planning to move to North Carolina and hinted that she wanted to take her grandson with her.
Having grown up in an alcoholic household, I knew what it felt like to live on the periphery of addiction—the potential danger of being neglected, taken advantage of, or even raged against. And being with Tess sometimes brought up memories of a much darker time. I worried about her son and felt sorry for him. There were instances when journalistic boundaries blurred, such as the night Tess texted me from an unknown location:
Can yoi please come gwt me.
I was in the middle of organizing taxes, with the help of my spreadsheet-whiz niece, and didn’t see the text immediately. An hour later, I weighed what to do, talked to my husband, and ultimately forwarded Tess’s plea to both Patricia and Jamie Waldrop, who was Tess’s Hope volunteer. The next time I saw Tess, neither of us brought it up.
It was February 2016, and Patricia believed Tess was using again—items from the house started vanishing, including a laptop, and she discovered empty heroin baggies in her bathroom trash—but Tess vehemently denied it.
Family stress was high. Tess’s parents had different opinions about the best course of treatment, and Tess believed her siblings looked down on her as the black sheep. Her dad, Dr. Alan Henry, begged her to enroll in a twelve-month residential recovery program at the faith-based Roanoke rescue mission, but the mission banned stimulants of all kinds, from cigarettes to MAT, and Tess was not only still on buprenorphine and a heavy smoker, she was also a proud atheist. “The one thing that becomes clear is, there is misunderstanding with the siblings and with me on the distinction between helping and enabling that remains very murky,” Alan Henry told me later, suggesting that whereas he and Tess’s siblings preferred a tough-love approach, Patricia and her father were too easily manipulated by Tess, he thought.
Tess’s older sister, an AA proponent, begged Tess to adopt the Twelve Steps as she had done, arguing that the program emphasized spirituality over religion. “I told her, ‘Use Koda [Tess’s dog] as your higher power, for all it matters; just pray to something.’” But Tess laughed and said, “That’s ridiculous.” Soon after, a dopesick Tess asked her for money to buy buprenorphine, and her sister, believing Tess would spend it on heroin, offered her a ride to a meeting instead.
“I’m not trying to go sit in an AA meeting and listen to that bullshit,” Tess told her. “And you’re not my sister.” They stopped speaking.
When Patricia proposed that Tess consider other long-term treatment programs, MAT or not, she refused, turning argumentative and sharp. Her mom had a full-time hospital job with irregular hours; her shifts often ran longer than twelve hours, leaving Tess home alone with her son. Patricia had a security system installed in her home. But two cameras weren’t nearly enough.
In March, Patricia arrived home to find Tess stumbling around the house, seemingly high, and clothes from one of the bedrooms vanished—pawned, presumably, for drugs. “I’m meeting with my attorney,” Patricia told me, shortly after this incident. “I can’t just kick her out because she’s been here awhile.” A guardian ad litem would be appointed by the court to weigh in on what was best for Tess’s son.
“Everything’s such a mess, and in the middle of it is this gorgeous, beautiful boy,” Patricia said. Now seven months old, he was ahead of developmental schedule and before long he would babble his first word: Mama.
*
Tess maintained she was not using, but evidence to the contrary kept presenting itself. Patricia sometimes arrived home from work to find her security cameras turned to the side. Once, awakened by the baby’s cry in the middle of the night, she found him on the couch, “only he could barely sit up, and he’s leaning over, and he’s crying. He had a piece of a bottle, a plastic tube, and he could have choked.”
And where was Tess? “She was in the bathroom putting on makeup! She was superhigh,” with her baby about to tip onto the floor. “It is so embarrassing and so painful, trying to make this work,” Patricia said. “Your giving starts to give out.”
The guardian ad litem saw what was happening, and by late March, Tess lost custody of her son. A judge awarded shared custody to the grandmothers, and Tess was no longer permitted to live at Patricia’s, though she could visit her son when Patricia was home.
That spring Tess moved into a cheap motel, a known haven for drug users and dealers, with no car. To regain custody, she had until July 18 to find a job and a place to live, and prove her sobriety. She was mad at her dad for not loaning her money for an apartment down payment and furious about being unfairly painted as an unfit mother in court. “Even if I did take a Xanax when I was with [my son], I’ve never been fucked up. I’ve never not changed his diaper,” Tess insisted. Asked if it was difficult to stay away from other heroin users, Tess said, “When I’m angry and I have nothing, it’s really hard.”
She was trying to switch to a Suboxone doctor who accepted Medicaid, which she was now enrolled in, but that physician had long ago reached his federally mandated cap (then a hundred patients). A hundred dollars in debt to her Blacksburg psychiatrist and cash-only MAT provider, Tess had to pay the balance before she could be seen again, and meanwhile she was down to just a week’s supply of MAT. She’d tested positive for marijuana on her last doctor’s visit: “I was having really bad anxiety, and I thought pot would be better because at least it’s herbal,” she said.
*
By May, Tess was couch-surfing in low-rent apartments in southeast Roanoke and using heroin daily. She posted a cry for help on her Facebook page, ending with a quote from a Lil Wayne/Eminem song: “Been to hell and back / I can show you vouchers.” She went by the street name Sweet T.
Though the Hope Initiative was still months from opening its doors, Jamie reached out to Tess on Facebook: “Call me if you need help. I might just know of something right up your alley, Girl. Much love.”
Tess called immediately. She wanted to hear how Jamie’s older son, whom Tess had once dated, had gotten sober. They made plans to meet the next day, but Tess canceled at the last minute.
By early June her son’s dad was out of jail. They squabbled, it turned violent, and Tess went deeper underground.
Patricia and Jamie worked their contacts to find her. Jamie’s son showed her where they’d once done drugs together while Patricia, worried that Tess was seriously hurt, filed a missing-persons report.
They distributed flyers across the region and on Facebook with a smiling picture of Tess and her description: “Last seen June 11, 2016. Brownish/red hair, green eyes, 5' 7", 130 lbs. Tree of Life tattoo on left shoulder blade.” Two days later, police received a report that Tess had stolen a car and a credit card—she’d been sent out for groceries by a woman she was staying with and never returned. Police found and arrested Tess later that day.