Heroin's Tragic Toll, Part 1 of 4

HONOR STUDENT LOSES HOPELESS STRUGGLE

For seven weeks a heroin needle pointed 19-year-old Elizabeth Gohn toward
death. It killed her June 23.

An infected needle, rather than heroin itself, caused the death. Now
Elizabeth's survivors wants other people not to be ashamed to admit
addiction. It saves life.

"Talk with other parents. You network about everything, but not about
drugs. Why not?" asked Elizabeth's mother, Elaine.

Elizabeth was among 43 people to die from heroin in Allegheny County thus
far this year, according to the county coroner's office.

Elizabeth of Harrison was a member of the Highlands High School Class of
2001. Two other classmates, who died in August and October, were among the
120 who died from heroin in 2001.

From Mother's Day until June 23 doctors and nurses struggled to save
Elizabeth's life.

Their foe was a raging drug-resistant infection that was unforgiving and
relentless.

Elizabeth had started in an outpatient hospital program to kick heroin.

Still, she didn't feel well.

Five days before Mother's Day it hurt to breathe and there was a persistent
headache.

"She got rid of heroin, but it didn't let go of her," Elaine said.

Frightfully, the infection damaged a heart valve and soon both lungs were
infected, too.

On May 13 Elizabeth's blood pressure plummeted and the deathly ill
Elizabeth was rushed to a Pittsburgh hospital for specialized, last- hope
care one day later.

Soon the heart valve damage sent clumps of infected tissue into her
bloodstream to cause two strokes.

Doctors broke the sad news to her family: prepare for the death of the
Highlands honors graduate. Get ready to say goodbye to their lovely and
bright daughter and granddaughter, sister and niece, their Liz.

"What we saw was numbing. The doctor told us that if we hadn't brought her
to the hospital on that Sunday that she'd be dead on Monday and maybe she'd
be anyway," Elaine said.

So Liz's family shook off the shock and horror, prayed, and signed a "do
not resuscitate order" that would allow Liz to die without any special
medical intervention.

The doctors promised to keep her as comfortable as possible and nothing else.

Then the family bought a cemetery plot, made funeral arrangements, prayed
again and waited.

For them the seven weeks were full of hope and horror, ups and downs and,
finally, death.

A final goodbye

Liz was buried June 28. Her friends knew she loved butterflies,
particularly yellow ones, so they sent dozens of plastic butterfly
replicas, and Liz's favorite stargazer lillies, to the funeral home. At
least 300 people visited the funeral home.

Amid the butterflies and flowers, Liz's family voiced one burning wish:
that no other family has to turn a hospital room into their whole world
because of heroin.

Liz's family remembers the Class of 2001's Ashley Elder when Ashley and Liz
attended the same elementary classes in Fawn. The girls went their own ways
in junior high school. Last October Liz's family was saddened to hear that
Ashley had died from heroin. The family also knows of another classmate who
died from an overdose last August.

During her addiction treatment, Liz lived in her mother's Natrona Heights
home. Her mother, Elaine, said there was plenty of time for her to talk.

Based on what she said then, it appears that Liz was using about about $120
worth of stamp bags per day by the time she was hooked in November.

A stamp bag is the common way for heroin to be sold. The clear bag, which
might hold stamps, usually has a brand name, such as "Mambo King," and
"Brain damage" and others. White powder heroin and other types of heroin
almost always weigh less than the bag.

Liz drove to Pittsburgh to buy it because the drug is cheaper, and usually
riskier, to obtain there, said Elaine's stepfather, Rick Shumaker.

After about seven months of getting a heroin rush, Liz decided to kick the
habit.

'Still an addict'

Somehow Liz didn't overdose when she started to snort, then inject, heroin.
The needle was a shock to her family because Liz always had been afraid of
needles.

"She held my hand in a death grip when she had immunizations or a blood
test at 15," Elaine remembers.

During Easter week, Liz tried to quit heroin "cold turkey" and stayed in
her family's house for three days.

Liz told her mother she "never had a bad time on heroin," Elaine said. "She
also told us you just don't know how addictive this stuff is and that she
couldn't stop without help," she added.

Liz agreed to get drug treatment at St. Francis Hospital, Pittsburgh, but
only on an out-patient basis. She refused to be admitted and said she was
ashamed of her addiction.

"When I called the insurance company before we went, she got so mad at me.
I told her that you may not have taken it for two days, but you're still an
addict," Elaine said.

Elaine remembers a Narcotics Anonymous meeting that she attended with Liz.

She was surprised to see how far heroin's hooks had sunk into the
community. Some of the meeting attendees wore ties and others wore T- shirts.

"There were Mercedes (cars) and rust buckets in the lot. This is affecting
all types of people," Elaine said.

Some of the ex-addicts were embarrassed; others were not. Elaine now thinks
being ashamed only takes time and delays treatment. It's something they
wish someone would have told them.

Unbearable headaches

About five days before Mother's Day, Liz was suffering from shortness of
breath and severe headaches when she was taken to a Valley hospital.

Doctors weren't told about her heroin habit or using a needle and there was
no sign of addiction.

The headaches became unbearable. So on May 12 Liz's mother and brother,
Andy, drove Liz to the hospital. This time doctors were told about Liz and
heroin.

The doctor immediately ordered other tests.

"Maybe if we had told the doctors the first visit, it might have made a
difference. If I had known about the infection, I would have said let's get
a physical in April when she was quitting heroin. All addicts should do
that - get a physical when they quit - but we didn't know that," Elaine said.

"Don't be ashamed to admit that your kid has a problem and tell them not to
be ashamed. Just get help," Rick said.

"Tell the doctors right away that they are an ex-heroin user or ex- cocaine
user or ex-whatever. It makes a difference," Elaine said.

Heroin users don't know what is mixed with the drug to stretch it to make
more money for the seller. Users also can get sick from infected needles or
needles shared by someone with an infection they might not be aware of.

"They really don't know what they're putting into their arms. It could be
dust, talcum powder or dirt," said an exasperated Rick.

"Infections of this type may be akin to toxic shock syndrome," Fred
Fochtman, the Allegheny County coroner office's toxicologist. "This type of
death used to be more prevalent than it is today. It's not totally rare,
but it happens," he said.

Addiction 101

Rick and Elaine said they have learned much during the six weeks of
torment, worry, hope and surrender.

There were signs about Liz needing money, but no one paid attention because
she was an honors student and had never been in trouble. She always had
managed her money and was known to be responsible.

After all, Liz was working and going to school and succeeding at both. She
had good grades and was getting bonuses for her sales at a department store.

Then it started. She asked Elaine and Rick to give her $20, then $100 until
payday or for money to fill up the gas tank of the car Liz bought.

"If you have questions about your child doing drugs, don't give them
money," Elaine said. "If they need gas money, fill up the tank for them. It
took us a while to learn that," Elaine said.

"Yeah, if they ask you for money to pay a bill, you pay it. Don't give them
the money," Rick said. "The last time she asked for cash, we gave it to her
and she didn't say anything. She just went out to her boyfriend who was
waiting in the car. We should have known," he said.

"No matter how old your son or daughter gets, they still need you to watch
out for them," Elaine said.

Turn for the worst

Liz's health was precarious on May 13.

She was put on a machine to breathe for her, and was paralyzed on one side.
Soon she slipped into a coma.

Once surgeons operated on her leg to remove a life-threatening blood clot.
The strokes robbed her of the use of one side. Her family prayed that it
was temporary, but each day reality stared at them and they knew they had
to prepare for Liz's death.

Still, from the start, even when most people thought Liz would die right
away, there were hopeful moments. Elaine maintained that there was "focus
in one eye when she looked at us" although doctors said CT and other tests
showed major brain damage.

Yet about two weeks after the clot was removed, Liz was grasping other
people's hands. It was hard for the family to believe that it was simply a
reflex and that the Liz they knew was no more.

"To know that she knew what she was doing, we needed her to release the
hand. Grabbing is one thing. Releasing is another," Rick said.

"And she did that," he said, still not believing what he saw.

Glimmers of hope

When the time came for Elaine to tell her daughter that it was OK to let
go, to move on, Rick switched from being practical. He too had seen
something, a flicker of hope, almost against hope.

"One time a nurse Liz didn't like moved her a little bit. Liz scrunched up
her nose. The nurse said, 'Well, if you're mad, stick your tongue out at
me.' And she did. She really did," Elaine said, still relishing that brief
moment of joy.

The family thinks the nurse too jumped for joy, secretly, outside in the
hallway.

Several Fridays ago Liz started to cry. Elaine moved the bedrail and
blankets to make her more comfortable.

Then it happened.

As Elaine focused on the task, Liz slowly moved her one good hand to reach
around her mother. "She rubbed my back," a jubilant Elaine said.

"I just don't know if she knew it was me, her mother, or if it's just the
woman who has been here for weeks. We just don't know."

But the damage was done and the infection couldn't be controlled.

She was having trouble breathing five days before she died.

"She died the day after Andy's graduation party. I think she knew and she
just hung on. We know Liz fought hard and that she suffered. She was itchy
from one of the antibiotics," Elaine said.

To celebrate Liz's life, the family released more than two dozen
butterflies at the cemetery.

"Butterflies are free and now so is she," Elaine said.

Part 2: http://www.mapinc.org/drugnews/v02/n1257/a09.html