Opioid abuse is a crisis gripping the nation and one that doesn't discriminate.

Opioids kill 115 people every day in the United States.

Pennsylvania, New Jersey and Delaware combine for nearly 20 of those deaths.

But the impact of the crisis spreads far beyond those who are battling an addiction.

Family members, friends and first responders are also on the front lines of this epidemic.

Here are some of their stories.


From the outside, Ronnie Powell seemed to have it all.

"Everything he touched, every sport he did he excelled in. He was a very athletic, very smart, very funny and very kind person. He was very much for the underdog," said his mother, Justina McIntyre.

"He went to sleep and never woke up that night."

"His love, his passion, was football," she said. "Ronnie caught the eye of the Tennessee Tigers coaches. They loved his speed."

"They offered him a complete ride scholarship, and that was an exciting day to sign that paper," McIntyre said.

But she later found out Ronnie was also struggling with addiction. During high school, he started smoking marijuana and then experimenting with opioids.

"It was all pills from other people giving it to him or selling it," McIntyre said. "From my knowledge it did not get to heroin yet, it was a lot of Oxy though," she said.

Ronnie lost his scholarship to Tennessee State University. He moved home and was hoping to get a fresh start.

He died October 13, 2008 from a drug overdose.

"He went to sleep and never woke up that night," McIntyre said. "Ronnie started abusing pills at 15 and he died at 19. That was four short years," McIntyre said.

"I miss the fact that my door would just fly open and he would yell, 'Mom, I'm home!'"

Ronnie's daughter was born four months after he died.

"Her name is Angel, and she is an Angel," said McIntyre. "So Angel knows that her daddy is in heaven, not looking for any more chemicals and he's healed from his addiction."

But despite the passage of time and the love of her granddaughter, the pain remains.

"A lot of people say it gets better with time. I wouldn't say it gets better... It's that you learn how to make it work," she said.


Ground Zero of our local heroin epidemic lies in the heart of Philadelphia's Kensington section, where drug users line the streets in makeshift tents throughout the neighborhood.

Until a few months ago, the homeless population here lived on a stretch of railroad known as "The Tracks." But in September, Conrail purged the area of all remnants of the drug users, pushing hundreds of homeless onto Kensington's streets...

"Never in my entire life would [I] think that I would be living under a tunnel."

To an area called Emerald City.

The encampment, spread out under three bridges in Kensington, shares nothing with the famous fantasyland in Oz but a name. This is the harsh reality of life as an addict on Philadelphia's streets.

"It's really bad. It's not like back in the day when you'd be able to go down to the tracks and you didn't have to worry about getting robbed or dying," said Melissa Finley.

This is now what the 34-year-old woman, formerly of Delaware County, calls home.

"Never in my entire life would [I] think that I would be living under a tunnel."

This Emerald City is at the Corner of Emerald and Lehigh Streets. It's a place where dreams for a future, and countless addicts, die.

"I was stupid enough to think I was smarter than them..."

One user, who asked us to call her Kelly, had just gotten high before we talked to her.

But the former college student and athlete says it doesn't stop the pain of remembering what she's lost.

"I was stupid enough to think I was smarter, smarter than them, so to speak, and that I just wouldn't end up out here," said Kelly.

But there are people like Samuel Santiago who are out there trying to help.

"We don't want people to die. They are too young. They still have their whole life ahead," he said. Santiago has been working outreach in Kensington for 19 years.

"These people, all they are thinking about is 'when am I going to get high?" he said.

His team from Project Home walks these streets every day, hoping there is one person who will go into treatment.

"We don't want people to die. They are too young. They still have their whole life ahead."

"That is all you can hope for. The one thing you cannot do is give up, because that is somebody's daughter, that is somebody's son," he said.

On a five degree day a few weeks later, we run back into Kelly, still living on the streets.

"It's not much better. Actually worse, a whole lot worse, with the cold. It's brutal," she said.

This time, the police arrived with the Streets Department for a weekly cleanup.

"Human feces, any other trash, needles, anything else that is underneath this bridge to make it unsafe, we make it safe again," said Inspector Ray Convery of the Philadelphia Police Department.

The officers aren't here to arrest anyone. The "residents" are allowed to take what they want, and the rest is thrown away. But shortly after the cleanup is completed, the users take their spots under the bridge, and the cycle starts all over.

Police say the much larger issue is stopping the addiction. Both the day we were out with police and with outreach teams, they were successful in getting someone to go to a shelter.

They say this is not hopeless, but the problem is too big for them to solve alone.


Elizabeth Lopez took a familiar path to addiction. She was offered, and took, Oxycontin without any idea how addictive it can be.

From there she not only had to overcome her addiction, but also to find a way to manage the pain from surgery without the use of opioids.

Lopez, of Conshohocken, Pa., says her substance abuse took off her freshman year in college, after taking a seemingly harmless pill at a party.

"I didn't know Oxycontin was extremely addictive."

"It kind of took away all my troubles and worries, and gave me a way to escape," she said.

But, she admits, she had no idea what she was in for.

"I didn't know that Oxycontin was extremely addictive," she said.

She was not only hooked on painkillers, but for a time she took heroin as well. Finally, after graduating college, she eventually overcame her addition.

Little did she know that another major challenge was coming her way. It began when she ruptured her Achilles tendon during a pickup basketball game.

'My first thought was, 'What am I going to do? I'm an opiate addict and I'm going to have to have surgery,'" Lopez said.

Opioids are often used in orthopedic treatments, especially after major surgery, such as joint replacements.

Lopez has been clean and sober for four years. So, she told her surgeon at the Rothman Institute bluntly: no narcotics.

"I'm an opiate addict and I'm going to have to have surgery."

"She looked at me and said, 'That's totally possible.' And I can't tell you how that changed my perspective," she said.

Lopez found out that the Rothman Institute - the area's largest orthopedic practice - now has a comprehensive program to scale back the use of opioids.

Dr. Asif Ilyas says Rothman uses a multi-prong strategy to keep patients' pain in check, while also reducing the use of opioids.

There's a detailed discussion of the risks and benefits in a brochure, a video discussing the opioid epidemic, and an explanation about to manage their pain after surgery.

"Recommendation number one is to try to use non-opioid medications," said Dr. Ilyas.

During surgery, non-opioid medications are emphasized, such as nerve blocks, intravenous Tylenol, and medications that prevent nerve pain.

Doctor Ilyas says studies show it works.

"Just formally educating patients on the risks and benefits of opioids and their safe use can decrease consumption by half to two-thirds," Ilyas said.

Lopez says her pain never got above five on a scale of one to 10. She's thankful for Rothman's cautious approach, and wishes more doctors followed it.

"I've had friends that had to have surgery because they had an injury, and that's not the message they received from their doctor," she said.

So what can you do to reduce your risk of dependency? Here are some suggestions from the Pennsylvania Orthopedic Society:

-Try non-opioids, like ibuprofen or Tylenol, first. You'll want to take these ahead of the pain.

-Add in alternatives such as using ice or elevation.

-If you do take opioids, take the minimum amount and for the shortest time.

-Never drink alcohol or take anxiety or sleep medications when taking opioids.


One of the more contentious solutions being considered to decrease the number of lives lost to the opioid epidemic is the use of safe injection facilities.

It's an idea that may seem unthinkable, but the magnitude of this heroin crisis has public health officials and law enforcement grasping for ideas, and exploring highly contentious solutions.

"I totally understand people being uncomfortable with it," said Philadelphia Health Commissioner Dr. Tom Farley. "Creating facilities where drug users can inject themselves with illegal drugs, seemingly with the permission of local municipalities."

"We know from other centers that they save lives. But it is complicated from a community perspective and it is complicated from a legal perspective," Farley said.

"I totally understand people being uncomfortable with it."

Farley, and other local officials, took a trip to Canada to investigate a safe injection program there.

"People can come in, they can sit down in a little booth, they have access to syringes and other sterile equipment, they inject drugs," Farley said.

In Vancouver, the injection sites are based in neighborhoods already plagued by the drug epidemic. The idea is to keep users off the streets.

They are supervised by staff who can give them Narcan if they overdose, and who can talk addicts into a recovery program just a few feet away.

"There is evidence that these facilities do increase the number of people who go into drug treatment," said Farley.

"We are not only paying in dollars, we are paying in our lives."

Critics say it allows people to engage in illegal activity in facilities funded by taxpayers. Farley argues the public is already paying a high price.

"The public is paying a lot for this crisis right now with all of the consequences and we are not only paying in dollars, we are paying in our lives," said Farley.

Some local law enforcement officials are on board with the idea. Supporters include Philadelphia District Attorney Larry Krasner and Atlantic County Prosecutor Damon Tyner.

"I will not enforce against safe injection sites that are properly run," said Krasner.

"People and attitudes are starting to change towards how we are going to treat this epidemic," said Tyner.

Some public health officials say the crisis needs to be approached as a public health issue and illness, not a crime.

"If this were your son or daughter... you would at least want to keep them alive."

"I don't think users should be put in jail. Absolutely not. These people have a health problem, they can be helped and they can recover," said Farley.

Farley says there is evidence safe injection sites reduced the number of people injecting themselves in public, the number of needles on the ground, and public disorder related to drug use.

"If this were your son or daughter and if you did everything you could to get them into treatment, you would at least want to keep them alive until they were ready," Farley said.

Image from Upcoming Documentary: "Where's My Needle"

Brandon Novak was hooked on heroin and other drugs for more than two decades, but he is now clean and sober and telling others it's never too late to get help.

You could say Brandon has always lived life in the fast lane. He got his first skateboard at age seven, and he turned pro when he was just a teenager.

"It was like God had come down and handed me the Holy Grail in the form of a skateboard," Novak said.

"God, please cure him, kill him, or kill me because I can't take it anymore."

At a young age, he was traveling the world, skateboarding, and also making infamous blockbuster movies.

He gradually fell into drinking, smoking... then pills, cocaine and heroin.

Brandon was at death's door.

"By that time it had me almost wrapped in its grips, I was almost unsalvageable," he said.

He spent 21 years addicted.

He was in and out of treatment programs, and he said he and his mother went to church with one last prayer.

He remembers his mother saying, "God, please cure him, kill him, or kill me because I can't take it anymore."

Photo credit: Jason Chapman

By the time Brandon walked into his 13th recovery center, with almost nothing left, he admitted he was powerless against addiction.

He was desperate to get clean.

Brandon spent 90 days in-patient and then lived in a sober house in Bucks County for a year.

"The disease of addiction is not a death sentence."

Today, he's been drug and alcohol free for three years. He still takes it day by day, but also shares his story to save others.

"The disease of addiction is not a death sentence. As long as you are breathing, it is never too late and your history does not have to dictate your future," he said.

"I believe people need to see there is life after drugs and alcohol," he said.



WEBSITE: RecoveryCentersOfAmerica.com


Pa. Get Help Now

WEBSITE: Pa. Get Help Now

WEBSITE: Opioid Epidemic Guide

MORE INFORMATION: Opioid Epidemic Guide


Resources by county:

WEBSITE: Pa. Get Help Now County Services




Get rid of unused drugs

WEBSITE: Pa. Get Help Now Pill Drop



WEBSITE: ReachNJ.gov

PHONE NUMBER 844-732-2465 (844-REACHNJ)

NJ Division of Mental Health and Addiction Services

WEBSITE: NJ.gov/Helath/IntegratedHealth/DMHAS







Substance abuse coverage under Affordable Care Act

WEBSITE: Healthcare.gov Mental Health and Substance Abuse Coverage

National Institute on Drug Abuse

WEBSITE: DrugAbuse.gov

Substance Abuse and Mental Health Services Administration