Heroin addiction is growing nationwide, and eastern Iowa is no exception with more than 61 non-fatal overdoses and 21 deaths in 2015. The Cedar Rapids Gazette’s healthcare reporter Chelsea Keenan and public safety reporter Lee Hermiston took an in-depth look at the epidemic in their June 2016 series, “Heroin’s Hold In Iowa.”
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Read The Gazette Series:
First In The Series: Heroin’s hold: How Iowans struggle — and sometimes succeed — in overcoming opioid addiction
Part Two: Heroin’s Hold: For some, heroin is ‘love at first sight’
Part Three: Heroin’s hold: For pregnant women battling opioid addiction, more at stake than just breaking the habit
Part Four: Heroin’s Hold: Authorities take varied approaches to addressing opiate epidemic
A national study from the Center for Disease Control and Prevention shows the rates of fatal heroin overdoses quadrupled from 2002 to 2013. Heroin and opioid addiction is not reserved for the stereotypical lowlife junkie, Hermiston said. Rather, it finds the young mother who first tried heroin at 17 and the man who became addicted to painkillers after a wisdom teeth removal surgery.
In an interview with IowaWatch, Keenan and Hermiston talked through their reporting process and the sensitive nature of writing about the intimate details of a source’s life. They faced obstacles of corroborating stories and sources seeking anonymity, but said they accomplished their initial goal: to bring awareness to the growing epidemic of heroin and opioid addiction both nationally and at home in eastern Iowa.
Brittany Robb: So first off, why this story?
Lee Hermiston: I think it started several months ago with a study from the CDC that looked at I think both heroin and opioid use or abuse amongst certain demographics and we saw that it was rising across the board. And it kind of started with a question between Chelsea and I, if more women and especially more young women are abusing heroin and opioids does that mean more children are being born addicted to opiates? And that was kind of the initial question we had in the beginning of our reporting.
Chelsea Keenan: Yeah, because I think obviously heroin pops up in my beat and Lee’s beat often, whether it’s someone getting arrested for it, whether it’s the city of Cedar Rapids hiring an officer to focus specifically on heroin, whether it’s, you know, a methadone clinic opening in Cedar Rapids. There’s just a lot of things that have been popping up. The CDC just announced a bunch of guidelines on how physicians should properly prescribe painkillers to try to cut down on this and so it was something we were kind of paying attention to kind of closely. And yeah, we kind of had that conversation and it started with me just reaching out to a couple different sources to start gathering data. So we talked with the Iowa Hospital Association, I talked with DHS (Iowa Department of Human Services) and we started collecting data, like Lee said, specifically about the number of babies born who had I think it’s an noxious influence and they tested positive for it. And we really went from there. And I think there was a lot of pre-reporting beforehand without even knowing what the stories were going to be. So Lee and I started reaching out to sources whether they were hospitals or police officers or district attorneys and just started kind of talking to them about a lot of different things they’re seeing with heroin and just kind of came back and realized we had a lot of stuff, and we had a lot more stuff than for just that original article idea which was specifically about women and babies.
Hermiston: Right. The initial focus was really a narrow look, women, children. What happens to a child that is born to an opiate-addicted mother? What is the process? How is DHS involved? How are the foster care system involved? What happens to the mother? And in researching that we discovered that there was going to be a drug-endangered children conference in Des Moines and our editors were kind enough to let us spend the day there. And that’s really when I think we realized there was so much more to this story and that drug-endangered children was really just one part of it. We both came away with half a dozen story ideas each and we sat down with one of our editors I think maybe a week later and said, “this is everything we have, these are the questions that need answered, this is how everything relates.” And we mapped it all out and that’s when it went from being kind of one very specific story to a series of stories which ultimately came of our reporting.
Robb: So that CDC report that came out, do you know when that came out?
Keenan: I think it was in 2015.
Hermiston: Late in 2015, or early 2016.
Keenan: Yeah because we started talking, you and I started talking about the drug-endangered children – without knowing that was the term – around the first of the year.
Hermiston: Right, that’s really when we started kicking that around. That’s when we really started either late 2015 or early 2016. And that was a national report. I probably localized it, call some folks here, probably DHS or ASAC (Area Substance Abuse Council), someone like that, and saying, “Is this reflected in Linn County, Johnson County?” what have you. And we found that it was. So we knew that this wasn’t just a problem out on the East Coast, it was a problem that really had started there but was working its way through the Midwest and that Iowa was kind of in the crosshairs in a way.
Keenan: Especially eastern Iowa. We’re kind of getting hit harder before the rest of the state.
Hermiston: And we had both done heroin stories last summer, unrelated to them. We had had a number of overdose deaths in our area and I wrote about just the high number of overdoses both fatal and non-fatal and the impact fentanyl had been having in Iowa, especially eastern Iowa; Johnson County, Linn County, Black Hawk, Scott and Dubuque Counties. All eastern Iowa counties were just getting slammed so much harder than say Polk, Woodbury, western Iowa. Chelsea, at the same time, what, you were writing about…
Keenan: I was writing about treatment so I talked to the hospitals about how they dealt with overdoses. I talked with ASAC about if they had seen an increase in their residential units and with people coming in with heroin addiction. And they had – both the hospitals, ER rooms and ASAC. That was right about the time the methadone clinic had opened so we talked a little bit with them methadone clinic about why they had come to Cedar Rapids and what they’d seen. I think they had been open about six months. And so, yeah, we did do a couple stories last summer but one thing both those stories were missing were the people. You had a lot of those officials talking about the problems and the issue but we were missing the people. And I think that was what really set these set of stories apart that we did this summer was really finding the individuals who are experiencing this and are dealing with this and are trying to overcome it.
Robb: So kind of on that, did you go to Heart of Iowa and the Cedar Rapids treatment center, was that your next step? Or how did that kind of progress to get you to those people?
Keenan: Yeah, so Lee and I no problem finding the data and finding the official sources to talk about how this is a problem. But finding the people to talk about it was a little bit harder. Since I was trying to talk about women and children I reached out specifically to the Heart of Iowa because they deal with women and children. I talked with the executive director for quite a while about the stories and what we were kind of hoping to do. I just said to her,” I’m looking for someone who is overcoming either a heroin or an opioid addiction and if that person would be comfortable with talking with me and sharing their story I would love to talk to that person.” And the director said, “Well, I will go into group and kind of tell them what’s going on and if anyone raises their hand and says they’re interested we’ll hook you up.” And that led me to Abby, who was the woman who was featured in the first story that kind of kicked off the series. She was originally going to be just a part of the third story which was about women and babies, but after sitting with Abby for more than a few hours and hearing her story it became very clear very quickly that Abby deserved more time and attention because her story was a very powerful one. As far as the individuals that we found through the methadone clinic, that was just, Lee and I both talked with Jackie Scott who’s the director over there and she’s just a helpful, passionate individual who really just wants these people to overcome these addictions and she wants to help them do that. She knows these people, they come in every day. They talk, they chat and I think she kind of just asked and reached out and we were both looking for kind of specific things. I was looking for women who were pregnant. Lee was trying to find some men to talk to because I was focusing more on the women and children aspect of it. And Jackie came through in a very big way.
Hermiston: I think Jackie and everyone else that we spoke with understand the importance of putting a face on these stories and how it’s helping the public understand that heroin abuse is not the homeless junkie on the street that’s been shooting up for 20 years. That’s the old stereotype. The reality now is it runs the gambit. It’s young men and women; it’s mothers, fathers, virtually anyone, it cuts across all demographics. And that’s really what we wanted to show in our reporting and our sources, I believe, understood the importance of that. Like Chelsea said, they really came through in finding us people, real people with real stories to tell that were willing to speak with us.
Keenan: Right, because they all had powerful stories. I think all the data was interesting and all the things we had hospitals and police officers tell us was very interesting. Everyone has a really new outlook on the best way to treat and deal with this problem but I think every person Lee and I talked to, we would just come back from these interviews and have to share them with one another because they were so interesting and so powerful and the stories were so unbelievable and we were just so happy that people trusted us with those stories, too.
Robb: What do you think helped them feel that trust and how did you guys work on building that trust to get those more intimate interviews?
Keenan: Especially with Abby, that was something, we met several times. The photographer who worked on this with us, Rebecca Miller, she really put in a lot of time and effort and energy into this project as well and she was there with us to try and gain these people’s trust. And with Abby especially it started off with one conversation, then we went back and asked a couple more questions, then we went back and talked to her some more. And along the way Lee and I both were like, “If you have any questions, let us know. If you have any concerns, let us know.” It was really kind of trying to meet them halfway and making sure that they understood we weren’t just going to take their story and turn them, make them look like some demonized heroin junkie. We wanted to treat them with respect because these are people who are experiencing really hard times and are really trying to make their lives better. I think a lot of times when they realized that we weren’t out to just try to make them look like a strung-out junkie it really kind of helped build that trust. And I think it was just having conversations. Like, you (Hermiston) were on the phone with those guys a couple times trying to figure out photos or asking about follow-up questions or calling them and just saying, “Hey, do you have any questions? Do you need any information from me?” And I think that really helped them feel like they could trust us.
Robb: Still on the note of the people you were speaking with, how did the decision of using first names – I know there was a note in every story and I can see it from an editorial and reporting side, but how did that decision come about when you’re thinking about the reader.
Hermiston: That was difficult. That was maybe the hardest part of this series, coming to a conclusion on that. We didn’t go into any of these interviews telling folks that you’re going to get complete anonymity. In fact, Abby was the first person we spoke with and up until…
Keenan: I mean, she was comfortable with using first and last name, but because of various circumstances that both Abby and her boyfriend – who was mentioned in the story who is also a recovering addict involved with ASAC’s treatment program – there were some concerns through them, ASAC, various people that we were trying to juggle and deal with, and it was a little bit of a back and forth. And that’s obviously, that was not a decision we took lightly. There were lots of very long painful conversations about how we needed to handle this and what we needed to do. And all of their concerns, we felt, were legitimate. These people are trying to find jobs. Some of these people have jobs and are managers at their companies that they are working for. Some of these people are trying to find housing or trying to get their lives back together. And Lee and I felt that because we could look at jail logs or we could double-check various facts with the treatment centers – Lee went as far as checking with the Sheriff to double check a story that one of the individuals talked with him about. So there was a lot of double checking whatever we could substantiate from their stories. We felt that because we went to such lengths that there was – and because they’d told us so much of their stories that involved things that put them in jail and that involved things that they were very ashamed of and were not proud of, that there had to be some kind of trade-off for them. It’s one thing to put on your job application that you were arrested, right? It’s another thing for your employer to be able to Google your name and have an 80-inch article pop up that talks about and details everything that you’ve ever done that you’re still ashamed of to this day. We were trying to be cognizant of that because we want these people to succeed in their recovery and we didn’t want to do something that might jeopardize that as well. So there was lots of balancing acts, lots of conversations. It was the part that we ran into the most trouble with in everything.
Hermiston: And we were having those conversations the week before the first story was supposed to run. So it’s kind of a high-stress time anyway and our editors had a lot of good points. This is not something that we typically do, that our reputations and our integrity could be at stake and both sides were very – it was an emotional time and we were all pretty charged up about it because Chelsea and I had put several months into our reporting. Ultimately what I think we ended up doing, we did just the best case scenario, the best outcome we could have had for that. I thank all of our editors and everyone here on the staff. It was a show of faith, I think, in Chelsea and I that we were able to do that for four stories. Not naming them. That’s a big thing to do. I think it showed that we did our homework on these guys. We corroborated as much as we could. I did more background on my two interviews with our anonymous sources than I’ve probably ever done on any other person I’ve interviewed in my life. Like I said, I think that really led our editors to trust us and let us go forward with this. But it was not an easy decision to reach at all.
Robb: What it an all or nothing, was it everyone is anonymous or no one is anonymous? Or was there any conversation of maybe just letting Abby or any one person?
Keenan: You know, we tried – before the story with Abby ran and Abby had already made her feelings clear that she only wanted to only use her first name, they did ask me to go back and talk with her again about it and talk about the things we just talked about with you, the reasoning behind why last names are so important. And I did and she kind of stood her ground with what she wanted and that’s a delicate balance too because you don’t want to scare the source away and you don’t want her to decide to pull out at the last minute. So we did have that conversation. I don’t think there was necessarily a conversation with some of the others, but Lee and I knew the last names of every person we interviewed. These people obviously were in treatment and referred to us by whatever program they’re in receiving treatment, so there was kind of the backing of these organizations that are well respected in their respective fields for offering this type of treatment. That kind of helped it as well. And yeah, I mean when Abby pushed back and said she didn’t want to use her last name, I think that kind of stopped the conversation and we kind of just went forward with what we had and the efforts we had made to double check everything that we could double check that our sources gave us.
Hermiston: And it was consistent across the board then. I think that was important. In an ideal world, we would’ve had first and last names for everybody, but I think if it had been first and last name in this story but not in this story then do you trust this story more than this story, is this person more credible than the others? I think the consistency ultimately helped. It wasn’t ideal but again it was the best thing we could hope for in this situation. We really had to balance reporting versus not doing any more harm to these folks by airing all their dirty laundry in a sense.
Robb: Have you had any reactions from readers either with this issue or just from the story in general? How’s the feedback been?
Keenan: We had a lot of positive reaction. I got plenty of emails and phone calls talking about it. People who are dealing with this in their families, those people were the most likely to kind of speak out and respond. A father emailed me right after Abby’s story ran telling me about a situation that he and his wife are dealing with with their teenage son and how reading Abby’s story made him realize how big of an issue this is and how they need to work really hard to get their son the treatment he needs. We had plenty of people come and talk to us about that. I think we had really positive reactions on social media as well. We posted videos and the stories online and on Facebook and the people who commented were rooting for these people. THey wanted them to get better and to succeed. I don’t think I received any negative feedback. Did you? (to Hermiston)
Hermiston: No. I think I heard more from sources just by — my more kind of official sources, the U.S. Attorney’s Office, police — just by virtue of that being probably 90 percent of my reporting. I think they were glad that we achieved what we told them we were setting out to do, which was put a human face on this and it’s not just, “Well, cops say this is bad and attorneys say this is bad so you should say it’s bad.” We said, “Look, this could be your son or daughter. This could be your mother. This could be your coworker. This could be anyone in your life. And that’s why awareness of this issue is so important.” And I think that’s what we did. We raised awareness about this issue and showed people how pervasive it is and how quickly your life can spiral out of control. I mean one of my guys started off with having his wisdom teeth removed and then a couple years later he’s shooting up heroin. I’ve had my wisdom teeth pulled! It could literally happen to anyone and I think that’s what we tried to convey. Not to try to scare people. It wasn’t a fear mongering story. It was, we need to be aware of this and we need to look out for each other and look for the warning signs. Because anyone could go about their lives and you wouldn’t know any better, so how do you help these folks and how do you get them off this cycle of addiction? And I think that’s the big question right now. What are we going to do about it?
Keenan: Right, I mean that’s something the country is looking at. President Obama and Congress are discussing this exact issue and the best way to deal with it and to equip our communities to deal with it. Hospitals and police stations and community services they are all trying to figure out how to deal with this issue and that was what we were trying to highlight.
Robb: Have you had any follow-up with any of your sources or had conversations beyond when it was printed?
Keenan: I spoke with Abby after it was printed. We did a wrap-up at the end of the series because she graduated from ASAC. We talked to her a little bit, just because – especially since her story was so large and it set the tone for everything else. When she saw it in print, she was a little overwhelmed, understandably. If I told someone my deepest darkest secrets and they wrote a gigantic story and it ran on the front page of a Sunday newspaper I’d probably be – she described it as being in a funk all day. So we definitely had a conversation after that first story ran just about how it’s okay to feel that way and that how her story definitely helped people and it definitely reached people and they were thinking of things differently. I think that made her feel better. But yeah, she was kind of the only one I talked to after. Both of the other women I spoke with – obviously both their stories were impactful and powerful – but because there were two of them in one story and it wasn’t just one story solely focused on them I think they weren’t necessarily as impacted by it as Abby was.
Hermiston: Casey reached out to me the day the story ran and basically just said thanks. I think for him – especially being a little bit older than Derek and having been on this road a little bit longer – I think it was cathartic to share that story. He’s close to graduating and getting a degree so he’s really at a turning point in his life. It was helpful for him to get that story out there, even anonymously, and kind of exorcise those demons a little bit. He said similar things to Abby that you do feel a little exposed like, “Oh, my gosh, that’s my life.” And while we didn’t use last names, certainly there are folks who can probably read that and say, “I know exactly who that is.” So he did put that out there, but I think ultimately it was a good experience for him.