When death came for Mark MacMillan, it was on the floor of the family bathroom, where the 18-year-old had retreated to shoot heroin a day after leaving rehab. It came with the familiar wave of euphoric tranquility, then a nod and a tumble to the floor. It came as his 83-year-old grandfather — who had been like a father to Mark, his male role model in a single-parent household — burst in, dragged him to his bedroom, and performed CPR. It came as Mark’s 14-year-old sister, Ginny, shielded their 11-year-old brother, who has autism, from the sight of the needle, the whirl of sirens, their older brother’s blue limbs, the grim scene playing out in their Allendale home. It came faster than Mark’s mother could drive home from her waitressing job, and despite her screams and prayers over her son’s lifeless body. It came when Susan MacMillan’s eldest son — who just months ago had tearfully begged her for help — lost his battle with heroin. It was a brief battle, and a quick death, but it came with warnings, and with lessons. Support groups tell parents of addicts that they have to set boundaries. But that refrain rings hollow to MacMillan. “There are no boundaries with heroin,” MacMillan said. “You can take their keys away. You can take their car away. You can take their money away. You can do everything. They will find a way. You cannot stop it. Love cannot stop it. Nothing can stop it. Only they can stop it themselves.”
Officials, counselors and families alike point to several overlapping causes behind the surge in heroin addiction in New Jersey: powerful prescription painkillers and doctors who over-prescribe them, inadequate resources for young addicts, an influx of high-quality heroin from South America, an ill-equipped criminal justice system. But they also point to parents, who often don’t acknowledge the presence of the drug in their communities or recognize the warning signs of a child in the grip of an addiction. And even if parents do spot the problem, how much they can do to break their child free of heroin’s grasp is debatable.
Parents say they face an impossible choice: to shelter and nurture a child through a cruel, all-consuming addiction — even as they lie, steal and become unrecognizable — or to cut them loose. Heroin may know no boundaries, but neither does parental love.
“How do you let go of a child? How?” MacMillan said, sitting in her back yard on a sunny spring morning. “You get to the point where you want to throw that child out, but then you get worried that one day, you’re going to get a phone call, and they’re going to be dead in the street. And you’re worried when they’re in the house, because they could hide anything anywhere. You just worry.”
Since the beginning of 2011, more than 50 people have died in Bergen County of heroin overdoses. In that span, more than 1,800 Bergen County residents have been admitted to hospitals and state-registered facilities for heroin- or opiate-related emergencies or treatment. More than 30 percent of those admitted have been under age 25.
There have been hundreds of non-fatal overdoses and drug-related crimes across Bergen County in the past two years, authorities said, many of which go unreported. Because of heroin’s chemical similarity to opiate painkillers such as oxycodone, public health data often group the two together.
Some parents knew nothing of their child’s drug abuse until an arrest or an overdose. Some ignored it; others became entangled: Police have seen some parents drive their children to Paterson to buy drugs or get clean syringes at the needle exchange. Some are unwilling to watch their kids go through withdrawal. Others have been manipulated into believing that the needles are for someone else.
A Montvale woman whose son died last August after battling a heroin addiction for six years described endless legal bills and court fees, theft, lies, costly rehabs, false hope, relapses.
“Did we enable him? Absolutely,” said Margaret, who asked to be identified only by her middle name because of the emotional impact on her family. “We didn’t give him drugs — we gave him another chance, another chance, another chance. According to tough love, you’re supposed to stop a million times before we did. But you can’t … as long as I really did have a son, I was never going to turn my back on him.”
Margaret and Susan MacMillan said they felt profoundly helpless as their sons, growing more sick and more ashamed, cycled in and out of rehab and the courts. The families grappled with insurance companies that would not cover the costs of medical care, and the paucity of affordable, effective treatment options. In communities that did not seem to want to acknowledge the presence of heroin, they felt alone.
“I have seen the depths of hell,” said Margaret, who spent the bulk of her retirement savings to rehabilitate her child.Many of the young adults who have died in Bergen County of heroin-related overdoses since the beginning of 2011 were living at home with their parents — as did many of the 90 charged with possession in recent months as part of a county investigation into the surge of heroin addiction among suburban youth.
Last week, the Bergen County Prosecutor’s Office announced the arrests of 115 people on heroin possession and distribution charges, the culmination of a four-month task force that aimed to stem demand for the drug and shed light on the regional heroin trade. One element of the task force was interventions with addicts and their parents.
“With parents whose children are addicted, if you’d spoken with them four years earlier, when their kids were dabbling in other drugs like pot or alcohol, they would say, ‘This is what kids do,’ ” said Ellen Elias, director of the Center for Alcohol and Drug Resources, in Hackensack. “For some kids, that’s where they stop. For other kids, it’s really not.”
Parents often cannot see the progression from casual drug use, specifically the non-medical use of prescription painkillers, to full-blown addiction, Elias said.
“It’s not until these parents are in a situation where they have to sleep with a wallet under their pillow, or all their jewelry is gone, that they realize their child has a problem,” Elias said.
Mark MacMillan was a restless kid who liked to catch frogs and fix up cars. “He was all boy,” his mother said.
As a teenager, he was prone to dark moods, and got into trouble with local police for “horsing around,” Susan MacMillan said. But in his senior year of high school, Mark’s behavior grew more erratic, and his depression deepened. His mother knew he was smoking cigarettes, drinking beer, using marijuana.
“I was viewing that, in a way, as pretty average for a 17-year-old boy,” MacMillan said. “I was not informed enough to realize that he entered a harsh arena.” She now suspects that Mark had discovered painkillers, and was transitioning to heroin.
Many signs of heroin or opiate addiction are remarkably similar to what might be described as typical teenage behavior: moodiness, casual deception, withdrawal from family, a loss of interest in old hobbies and friends, sleeping late, trouble in school.
“Then I started finding things,” MacMillan said: rubber bands, empty plastic bags, hypodermic needles stashed around in his bedroom. After she found an old tourniquet under Mark’s mattress, she confronted him — and he confessed to shooting heroin.
“It’s bad,” Mark told his mother, she said. “I can’t not shoot heroin.”
In the spring of 2011, Mark graduated from high school — his mother called it “the happiest day of my life.” But his addiction was escalating. He stole money, and sold car parts salvaged from scrap heaps to buy heroin in Paterson. MacMillan tried to get him on Suboxone, which is used to treat opiate addiction, but he refused.
In the end, the only way MacMillan got Mark to detox was by turning him over to the courts, she said. “He was getting in more and more trouble, which was putting a lot of pressure on him and actually making him more depressed, which was actually making him use more,” MacMillan said. “Part of me felt that the negative reinforcement was not helping him, it was making him worse.”
MacMillan secretly made arrangements to have Mark remanded to a rehab facility.
“I had to lie to my poor son,” MacMillan said.
But when they appeared in court for an evaluation, and the judge asked MacMillan if she could handle Mark at home for 72 hours while they found him a bed, she lost her nerve. “I could not say no in front of my son. He was crying — like a 3-year-old — hanging on to me.” MacMillan began to cry as she recalled his plea. “Ÿ‘Please, Mommy,’ that’s all he would say. So I finally said ‘Yes, I’ll take him home.’Ÿ”
But the judge read her body language, MacMillan said, and remanded Mark to jail. When they put him in holding, he began to go through withdrawal — he collapsed, and was taken to the hospital, where he got so sick he became dehydrated. He was shuffled between hospitals before authorities found him a bed at a rehab facility in Summit.
“The judge said he should remain there 21 to 28 days, followed by intensive outpatient rehab at Bergen Regional,” MacMillan said. He was released after only six days, a much shorter duration than ordered, something MacMillan suspects occurred because of insufficient health care coverage. MacMillan was sporadically employed at the time, with her children covered by New Jersey Family Care, which provides insurance for lower-income families.
On the way home from rehab, Mark told his mother about plans for the future — he wanted to go to technical school and community college, and open a custom auto shop.
“When I picked him up from rehab, he was my Mark again,” MacMillan said. “I was so happy.”
But hope quickly gave way to the reality of addiction.
That night, she said, he told her he was going to a Narcotics Anonymous meeting. Instead, he used heroin. The next day, August 26, Mark injected himself with the fatal dose.
“I drove home as fast as humanly possible,” MacMillan said. “I knew he was going. I just screamed, and screamed, and screamed — ‘Please wake up.’Ÿ”
Nearly two years later, MacMillan describes Mark’s death as a call to arms. A forceful and outspoken woman, she has dedicated herself to raising awareness of the addiction that killed her son.
She has started a foundation, Team MacMillan, that works to support addicts and their families, and she recently joined roughly 1,000 others in a “human chain” in Wanaque, an anti-heroin rally.
“Going to the rally in Wanaque showed me that I am not alone, and that all of us, every parent, needs to get together,” MacMillan said. “The ignorance has to stop.”
That ignorance, or denial, about the spread of heroin and its allure among teenagers troubles officials like Doug Collier, a special agent at the Drug Enforcement Administration in New Jersey. “I think that’s the biggest thing that stuck out to me as a DEA agent,” Collier said. “When I talk to parents, they are in denial. The three most dangerous words are, ‘Not my kid.’Ÿ”
Detective Brian Huth of Ramsey has spoken with parents of addicts who refuse to believe their kid is using heroin.
“Denial is a real enemy here, the parental attitude,” Huth said.
“Parents seem to be more permissive,” Huth said. “They are permissive with parties, kids partying in the basement while parents are upstairs. It all leads to the attitude that this stuff is OK. Parents seem to think they can quietly shuffle their kid off to rehab. Most of the time, they relapse.”
Collier, a member of a state task force on heroin and opiate addiction, has observed that parents struggle to admit a child has a problem even after an overdose.
“They don’t want to believe that it’s heroin,” Collier said. “It’s really difficult, for every parent.”
Part of the problem is stigma, Collier said: Many parents think of heroin as a dirty drug, used in dark alleys. “We have 18-, 19-year-olds that come from affluent families,” Collier said. “They don’t wake up and become heroin addicts. It doesn’t just happen that way. It crosses all boundaries. I’ve seen the richest of the rich, and the poorest of the poor.”
Another problem is shame.
“People don’t want to talk about it, because there’s this whole image of ‘I’m supposed to have it together,’Ÿ” Elias said. “Honestly, I think that a lot of people don’t see how it affects them, in their families and in their communities and schools. I don’t think people are aware of the fact that there is a problem. Those who are experiencing it aren’t really talking about it.”
The state task force, which is expected to release a report in the coming weeks, heard testimony from dozens of former addicts and parents who have lost children to heroin or opiate overdoses. Their stories have remarkable parallels — teenagers who experimented with pills, then turned to heroin. Some had conquered their addictions; others were lost.
Last July, Abby Boxman of Freehold testified about her son, Justin, a star football player who died of a heroin overdose in 2011 at age 21.
Boxman and her husband knew Justin drank alcohol and smoked marijuana, she told the panel, “as parents, you know, we brushed off things,” she said. In his senior year of high school, Justin began to change. He got suspended, lost interest in sports, and starting hanging out with a different group of kids.
He left for college with an addiction to opiates, failed most of his classes, and came home after a semester. Over the next two years, Boxman said, “we became involved with the chaotic life of addiction; you know, the stealing, accidents, tickets, lying, loss of friends, loss of jobs.” As Justin’s addiction progressed to heroin, the family fought with insurance companies that would only cover two days of rehab.
“He really tried to keep himself sober,” Boxman said. “But early in 2011 was when we really realized, my husband and I actually admitted to ourselves, that our son was an addict, and I think the worst part of this whole epidemic is really admitting that. Because, as a parent, you know, you do everything that you possibly can to protect your kid. You do everything.”
Boxman still struggled to use the word “heroin” in her testimony.
“The epidemic of opiates is stronger than the love that a mother has for a child,” Boxman said.
Margaret had only one child, but for six years, she lived with two different versions of her son. “There was Mr. Drugs, and there was my son,” Margaret said. “You mean nothing to Mr. Drugs. You are not his mother. You are in his way, or her way, to get drugs.”
Margaret’s son began using heroin at age 19, when he left college to recover from a traumatic injury. Margaret said it took months for her to realize that her son was using hard drugs.
“It sounds dumb, but I didn’t realize it was so bad,” Margaret said. “He was so freaking functional. He graduated from high school, he went off to college.”
Driven by his addiction, Margaret’s son used his father’s Social Security number, pulled money off family credit cards, sold his mother’s jewelry and household electronics. “They have phenomenal ways of raiding your bank account,” Margaret said. “You come in with the groceries, and the next thing you know, the money in your wallet is gone.”
Margaret and her husband burned through their savings, spending hundreds of thousands of dollars on rehab — all out of pocket, until the Affordable Care Act allowed them to put their adult son on their insurance. His body was covered in sores and scars. He overdosed 11 times; on three occasions, his father revived him. At his peak, he was shooting up to 15 bags of heroin a day in the basement apartment of the family home.
“There is a point in time when parents or loved ones don’t want to hear it anymore,” Margaret said. “We have been hurt too much.” Margaret said she stopped attending group therapy sessions and retreated to the horror of her household. “I really got to the point where I said, ‘This is not my problem. I didn’t cause it. I can’t cure it. I can’t change it.’Ÿ”
Last spring, Margaret’s son came home clean from his sixth stint in rehab — Mr. Drugs was gone. “This last time, he was his same wonderful self,” Margaret said. The family went on vacation together. “I had so much hope. I had no expectations. I had hope. We both said, ‘Our kid is back.’Ÿ”
Two months later, at age 25, he died in his bed. His death was never ruled a heroin overdose, but the years of abuse had taken their toll. Margaret suspects his heart gave out in his sleep.
“He tried so hard,” Margaret said. “He did not want to be what he was. Nobody wants to be an alcoholic or a drug addict. Nobody aspires to this.”
BY REBECCA D. O’BRIEN
STAFF WRITER | THE RECORD