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Reporter’s notebook: Understanding opioid addiction through one woman’s life

Liz Casper struggled with a problem shared by millions of Americans who are hooked on opioids

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A woman with a shaved head, red shirt and blue scarf looks at the camera.
Liz Casper waits before a chemotherapy appointment in St. Louis Park on Jan. 13, 2017.
Evan Frost | MPR News

The opioid epidemic now claims about 30,000 lives each year in the United States. The deaths dominate the headlines. But many more people live every day dependent on opioids — both painkillers and illicit drugs like heroin.

Until her death earlier this month, Liz Casper, 37, of Minneapolis, was one of the more than 2 million Americans addicted to opioids. She died Oct. 18 of complications from cancer. But she struggled with her addiction for two decades.

I’m writing about Liz because she is one face of America’s opioid epidemic. Like millions of others, she found herself pressed between the illness of addiction, the black market for illicit drugs and the medical system. No one, including Liz, is blameless.

She died as an active heroin user who repeatedly tried to quit. But as people in her life told me at her memorial, that doesn’t mean she failed.

Liz had been stuck in a loop of addiction her entire adult life. She’d get deep into heroin, clean up at treatment, stay sober for a bit, then relapse. And repeat.

In 2016 when I met her, Liz was sober. She’d been to treatment 17 times. Here’s how she described what it was like when she relapsed: "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,” she said. “I don't know. Something."

But almost always, Liz had hope of changing her life. She’d lost custody of her son due to her heroin use. More than anything, she wanted him back. "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," Liz said. "I want what everybody else has."

I met Liz Casper more than three years ago. I’d been looking for people who represented different angles of the opioid epidemic, and as a former heroin user now in recovery, Liz embodied the challenges people faced in getting off opioids.

We met in the basement of a church in downtown Minneapolis, where her AA group met. Liz’s first instinct was to show me her world.

As her best friend, Jeff Jordan said on that first day, he often told her that she shared too much and she shouldn’t be so open. But until Liz died earlier this month, she continued to share her journey with me, and also with my colleague, photojournalist Evan Frost.

We checked in with Liz when she was struggling to qualify for the conditions required to get her now 9-year-old son in her life, which was her foremost desire. We talked to her as she worried over a breast cancer diagnosis, prepared for a double mastectomy and then relapsed with heroin after doctors prescribed her opioids for the pain. We were with her when she finally got approved for a sober apartment, but she never moved in because she was too high to find the keys.

We kept in touch on Facebook. Whenever we could wrangle her in person, she at times didn’t show up. We met at a church basement where volunteers serve free soup or at a coffee shop. She walked us over to the dollar store in summer so she could get frozen Popsicles to make her overheated apartment more bearable.

Liz’s addiction interfered, and she eventually drifted from cancer treatment. And without active treatment the cancer spread through her body.

Liz’s mother Dede Casper said it was hard to watch.

“She was so sick, and yet she wasn’t taking care of herself, and that was so frustrating for everyone in the family. We just wanted her to stop it. Get herself clean and sober and just move on,” Dede said. “So, that was the hardest part for everyone in the family — to see her suffer so bad.”

A woman reaches up to the face of another with both hands.
Liz Casper's mother, Dede Casper, embraces Carrie Stanton as she arrives at Liz's funeral. Stanton called Liz a "part of our family since '92," and would frequently call her to talk about recovery during the last months of her life. Stanton had been sober 103 days on the day of the funeral.
Evan Frost | MPR News

Liz, who went by the nickname Lizzo, told us she was so afraid of dying and of leaving her son behind. She said this wasn't supposed to be her life. But at times she started to accept it.

"I heard someone say, a long time ago, ‘Why not me?’” Liz told me from her hospital bed in February. “I say, ‘Why me? Why me?’ And well, Lizzo, ‘Why not you?’ I'm not exempt."

As journalists, Evan Frost and I normally try to stay out of the story. But we got to know Liz well over the years, and we cared deeply about what happened to her. We would text one another messages Liz sent us, social media posts and goofy selfies. We wanted her to be happy with her life. It was heartbreaking to watch her time run out.

We don’t normally get years to follow the subjects of our stories. And even though we didn’t know what story MPR News could tell about her life, we both felt like we owed Liz to follow her all the way to the conclusion.

Up until the very end, Liz had hope. She made plans to be with her son, to travel across the country in an RV to see a band play. The last time we saw each other, I was on my bike, and I spotted her walking across Lake Street in Minneapolis. She told me she wanted to get clean. She didn't have time right then. Maybe she'd have time next week, she said.

We leaned against a fence in front of a bank and talked and laughed.

That was this summer. Liz died a few months later, after checking into the hospital because she had trouble breathing.

On Saturday, friends and family packed into the main room at Sandberg Funeral Home on North St. Paul’s main drag. Alcoholics wore AA medallions around their necks to mark their sobriety. They sat alongside people who still wake up and chase heroin down every day.

So many people showed up for her funeral that staff set up folding chairs in two overflow rooms. Songs by The Beatles and Whitney Houston piped out of white speakers in the ceiling.

Some at Liz’s memorial warned of addiction. Some spoke about recovery. But most talked about Liz’s generous spirit, how she made a room shine, and the way she was sometimes joyfully drawn to trouble.

Family friend Dean Stanton said the world will be less fun without Liz, but he believes she’s gone to heaven.

“I would send her to heaven despite everything she struggled with, and God loved her more than I do,” Stanton said. “So, I’m not worried about Liz. But I am worried about God.”

Liz’s friend Jeff Jordan spent almost every day with her for the last five years.

“I learned a lot from her. I didn’t have anything when I met her. I was homeless and depressed, it didn’t matter to her. She didn’t care,” Jordan said. “Even her passing like this is just another lesson.”

Carrie Stanton knew Liz was using heroin again. But despite her own challenges, Liz talked her through giving up alcohol. Stanton is now more than 100 days sober.

A portrait of a woman sits next to flowers.
A portrait of Liz Casper sits next flowers and an urn containing her ashes at her funeral on Saturday.
Evan Frost | MPR News

Liz’s mother Dede says she wants her daughter to be remembered as a caring person, who struggled so hard and so long, and unknowingly inspired so many others.

“It gave me peace. And tranquility,” Dede Casper said of stories people told at Liz’s memorial. “Just relaxed me, relaxed my soul, just knowing that she touched all these people.”

In lieu of memorials, the family asked for donations to Liz's 9-year-old son, who is living with her sister.