Deaths from opioid drug overdoses have hit epidemic proportions nationwide. In Minnesota, the struggle with addiction to prescription painkillers and illegal opioid drugs has left families, friends and communities across the state grieving deaths that could have been prevented.
Liz Casper has been through drug treatment 17 times, by her count. At 34, she has spent more than a third of her life as a heroin addict, rotating between treatment programs and the streets of Minneapolis where she's gotten the drug. She's hoping a new medication she's now taking might help her kick heroin for good.
People don't understand how she got this deep into addiction, said Liz, who has been clean for four months now. They think she should have done things differently. She agrees.
"This disease is so upsetting, and I'm so angry with it because it's taken so much," Liz said. "I gave up my life for this disease that is killing us. It is killing us."
'Getting money and getting drugs'
Substance abuse has always been a problem for Liz. Raised in White Bear Lake, she started drinking at 11. As a young adult, she would go out to bars and clubs almost every night, mixing with a pack of friends and fellow partiers.
In 2002, at 20, she went into a treatment program to try to kick a cocaine habit. It was there that she met an older man who was a heroin user.
"He was one of the old school," Liz said. "When I first met him, I was actually really scared of him, because I had this picture in my mind of what a heroin user was. And, eventually, I became that person."
She still remembers the first time her boyfriend shot her up with heroin. She was sitting in a wicker chair in her mother's kitchen.
"He just called up his people, and it was history from then on," Liz said.
Within a year, the heroin was running her life. And every day was about avoiding the pain and nausea that goes along with opioid withdrawal.
"We'd have to get up really early in the morning because we were sick and call up the dope man. And if he was open, he was open. If not, we'd have to keep calling and calling and calling," Liz said. "It wasn't really that fun. It was all about getting money and getting drugs and getting high."
She had a couple jobs during those years. But mostly she got money to buy heroin any way she could.
"I mean, there was definitely some different exchanges, I guess. I'm not really proud of that, but that's part of my story. I did do some prostitution here and there," Liz said. "Or else I had boyfriends who would boost stuff, steal from different stores, and they would return them and get money."
Liz had an apartment on a rough stretch of Portland Avenue in south Minneapolis for a bit, but mostly she just bounced around or stayed with boyfriends. She chose to be homeless in Minneapolis rather than move in with family in the suburbs so she could be close to her drug supplies.
"There would be times that I would be driving to the dope man and I'd be bawling because I knew that I was worth more and there was something out there that was better," Liz said. "Yet I was sick, and I wanted drugs, and I was going to get what I wanted. I went to any length to get it."
Liz stopped seeing her friends, spending most of her time with other drug users. She backed off from her family.
"I felt horrible that my mom and everybody was super worried," Liz said. "But at the same time, in the back of my mind, I really didn't care. I was kind of like, 'Whatever, it just isn't that big of a deal.'"
Eight years ago, Liz stormed out of a halfway house after staff told her she wasn't allowed to leave. She met up with a boyfriend in downtown Minneapolis, stopped by a liquor store and then went back to the garage of his mother's house and used heroin. She overdosed.
"What I remember is it being orange and dark. And I think that's just because it was candlelit," Liz said. "The last thing I remember is I had a spoon of my drug of choice, and instead of setting it down, in my mind I thought it was going to spill, and I didn't want to waste that, so I ate it."
Her boyfriend called 911 and performed CPR until paramedics arrived. Police arrested him, Liz said, and threatened to charge him with manslaughter if she died. If that had happened today, he wouldn't have been arrested — a Good Samaritan law passed in 2014 gives limited immunity to people who call 911 to report an overdose.
She woke up with hearing loss in both ears and a brain injury from the oxygen deprivation she suffered during her overdose. All she remembers is seeing the Summer Olympics playing on the television of her hospital room when she woke up.
'He was one of the best things that happened to me'
After the overdose, Liz went straight from the emergency room to a hospital, to assess the damage to her brain, and then directly into a locked treatment facility. This time, she was ready to be clean.
"I was just done. There was something in me, it just kind of clicked and I was just willing to do stuff differently," she said. "I've seen recovery in other people, and I just followed what they did."
After she left treatment, Liz got into a relationship with a man she met through sobriety support meetings, with whom she conceived her son, Donovan.
"I had Donovan when I was eighteen months sober," she said. "He was my little AA baby — he was one of the best things that happened to me."
Liz and Donovan got an apartment with the help of a group that supports the homeless. She stayed sober and said the next three and a half years were among the best times of her life.
But then a doctor offered her opioid pain pills. She was having a procedure done to treat the Hepatitis C that she had contracted from sharing needles when she was 20.
• Explained: Minnesota's opioid epidemic
"When I was in the recovery room, basically, I lied and said I needed medication that I didn't," she said.
Liz regained her footing after that slip-up, but the alcohol and heroin crept back into her life. In 2014, she overdosed in her apartment while Donovan was there. Her best friend found her, unresponsive.
Because she was using drugs, she lost the apartment. And the county put Donovan in the custody of her sister, imposing a number of requirements for her to get her son back.
"I had to do different things. Treatment and other stuff. And I just wasn't able to do it," she said. "I can't even sit here and tell you why. I love my son so much. And I just couldn't do it."
'Good people with a bad disease'
Eventually, Liz granted custody to Donovan's father so she could take the time to get clean. She thinks her little boy understands. She has a tattoo of the 6-year-old's name across her shoulders. She still wishes she had more time with him.
"He's affected by it," she said. "He wants his mom, but he's definitely very loved by the family household that he's in, and by my family as well."
Liz was clean for a few months, but relapsed again last August. It's like she's been on autopilot during these relapses, she said.
"The urge was physical, it was mental. I just got this feeling inside, like it was almost like anxiety, like I had to do it, like I needed something. I don't know. Something," she said. "There was absolutely no stopping me."
After a relapse, she said, there is only one thought: "'I can not believe I did this.'"
Just this January, Liz got sober again. This time she chose to take regular shots of a medication called Vivitrol, which can assist with opioid dependency. Vivitrol is one of a number of medications that are becoming more widespread as treatment programs change tactics to try to help opioid addicts. Even if Liz used heroin, the medication would negate any effect.
Now, she's going to support group meetings. She sees a counselor and is trying to understand why addiction knocked her life off course.
"I feel like I was kind of at a standstill. Here I am sitting, and my life is going on around me, and I'm not doing anything," she said. "Everybody else is doing something, and I'm just here. Not progressing." In treatment, counselors ask her where she'd like to be in five years. It's a tough question, she said, because she sometimes has doubted whether she even has a future. But now she has an answer.
"I want to be a mom. I want to be sober. I want to be a person of society. I want to contribute something different," she said. "I want what everybody else has."
Liz recently got a job at a group home for mentally handicapped adults. She's staying with sober friends now, but wants to get her own apartment.
She wants others who've struggled with addiction to know they shouldn't ever give up.
"We are definitely important people. We do bad things, but that doesn't mean that we're bad people," she said. "We're good people with a bad disease."