By: Dalton M. Bright
Logan Carter stands on the bank of a lake in Holly Pond, Alabama, and digs through an old green tackle box. He sifts through layers of lures, hooks, line and bobbers before he pulls out a pair of needle-nose pliers. While the wind blows his long hair like a horse tail, he secures the weight around his line and clamps down with the pliers. Carter has been spending more of his days fishing since he took his last shot of heroin six months ago.
In a 2019 report released by the Drug Enforcement Agency, it was found that more than 2 billion pharmaceutical opioids were prescribed in Alabama between 2006 and 2014. The Alabama county with the highest opioid prescription rate was Walker County, with more than 66 million pills being distributed through legal prescriptions. That is about 140 pills per person, per year.
The overall rates of opioid prescription have steadily declined across the country since 2014, but the Center for Disease Control and Prevention found that Alabama still had the highest opioid prescription rates in the United States in 2020, with a dispensing rate of 80.4 per every 100 people.
In 2021, Alabama saw a 33 percent increase in deaths from drug overdoses. While
methamphetamine still remains the most widely used drug in Alabama, the CDC has indicated that prescription opioids and heroin account for most drug deaths.
In a 2021 article from CNHI news, Matt Gentry, sheriff of Cullman County, discussed the threat of opioids in the area. “Our community is like any other around the state. We see heroin or heroin with fentanyl overdoses throughout our community. Meth is still our most prevalent drug in Cullman County, but heroin is an issue," Gentry said.
“I took my first Percocet when I was 19,“ Carter says. “Me and my buddy started going to Birmingham and getting these Dilaudid for my mom, which is like pharmaceutical heroin. We would go there and also get like 15 or so Percocet because I’d take 10 at a time,” he says.
Carter’s first time doing heroin was in the backseat of his friend's Chevrolet truck. “My buddy had started doing it, and on the way back from Birmingham one night, he did a line. I told him to give me one and he refused. I kept begging and he finally gave me one around Warrior. It was the highest I had probably ever been,” Carter says.
“When I got home, Mom was doing some heroin, so I walked up to her and was like:
‘let me try some, let me try some,’ and she said
‘no, you’re never trying this’ and I said
‘what if I told you I already had? I did some today,’ and she said
‘well, you’re not doing anymore,’ but I begged and begged and got her to let me do it. I was probably 19 then. It just kind of went from there. I never stopped doing it after the first time. I did it daily,” he says.
He sits the pliers back inside his tacklebox. For nearly a year, Carter and his mother would share their stash of heroin together. They would split an eighth of an ounce, but Carter started doing bigger lines and wanting more. He talked his mom into giving him a shot of heroin in his muscle. “She’d give me one every once in a while, but I just started doing my own shots,” he says.
Carter says after shooting himself in the muscle for months, he learned how to do it in a vein from a group of people he would ride to Birmingham to get drugs with. These same people, over the course of six months, stole the computer he assembled himself as well as thousands of dollars. =
“We went down there to get some once. I had spent like $300 on gas, oil and a new tire for their car helping them to get down there. I also bought them and myself an eight ball, so it was damn near $1,000,” he says.
“They told me to hop out of their car and they would pop the trunk for me to get a bag of new rigs that were in there. They told me they’d give me a few, which excited me because I didn’t have any. I got out, popped the trunk and the next thing I see is the white lights on the tail lights. They slammed it in reverse and hit me. I broke several ribs,” Carter says. “The car sped away and left me at a gas station 30 miles from Cullman. I had nothing. I was lucky I had my phone and vape.”
Carter’s lifelong friend, C.J. Monk, looked at the U-Haul truck sitting in his driveway. His eyes followed the steel ramp that jutted out the back of the truck and laid against the curb. Accompanied by grunts, Carter’s boots beat out the same cadence each time he carried a cardboard box up the steel ramp. Boxes full of shoes, DVDs, drumsticks, magazines, tools, spice jars and pillows.
Monk remembered the nights he sat in this driveway, talking with friends until 2 a.m. He remembered when the lady at the end of the street yelled at him for climbing on the stones by the creek. He remembered learning to skateboard with Carter.
He watched as his best friend stacked cardboard boxes in the corner of the truck, as his home became just another house on the block. On the same day the Monk family headed westward from Cullman, his friend Carter shot up fentanyl for the first time.
“I grieved when he first told me,” Monk says on a video call from Cabot, Arkansas, remembering when Carter started injecting fentanyl. Monk recounts first seeing the track marks on Carter’s forearms and being scared of what would happen to him. “There was a point in time when I was terrified of getting a phone call.”
Dr. Marilyn Bulloch is an Associate Clinical Professor in the Department of Pharmacy Practice at the Auburn University Harrison School of Pharmacy. Bulloch specializes in critical care medicine and practices at the DCH Regional Medical Center in Tuscaloosa, Alabama.
“Fentanyl is a very potent opioid, nearly 80 to 100 times more potent than morphine. It was developed in the mid-20th century to fill a need for a quick acting, strong analgesic,” Bulloch notes.
“Because of its potency, very little physical amounts of the drug are needed to relieve pain, and it does not take much more beyond that to cause an overdose. Some of the overdoses caused by fentanyl are unintentional. We frequently hear of other drugs being laced with fentanyl without the user being aware of it. I think it is important to understand that not all of the overdoses due to fentanyl are due to use of FDA approved fentanyl products. In reality, the epidemic is being impacted more by illicit fentanyl and fentanyl analogs often being imported from other countries.”
Naloxone is a medication that can reverse an overdose by blocking the effects of drugs like heroin, fentanyl and prescription opioids. Naloxone, sometimes called by the name brand Narcan, is often given as a nasal spray and can restore normal breathing within two to three minutes in a person whose breath has slowed or stopped as a result of opioid overdose.
“Naloxone is a great tool to have, and certainly a wonderful way to help prevent opioid deaths when used appropriately. We currently have a standing order from the state where anyone can go into a pharmacy and receive naloxone,” Bulloch says.
She warns that while naloxone may be a great tool to help in emergencies, it should be used with discretion. “What we need to be cautious of is not to make people abusing opioids overly reliant and expectant with naloxone. It cannot and should not be promoted as anything that would make it seem like it could be a “crutch,” Bulloch adds.
In July 2019, the Alabama Department of Public Health published a report showcasing overdose statistics related to the state. The report stated that in 2017, 836 drug overdose-related deaths were reported and 50 percent of those involved opioids. The report concluded that fentanyl-related overdose deaths are increasing faster than any other illicit or prescribed drug.
“Our generation’s opioid epidemic is driven by agents such as fentanyl and oxycodone. In the 19th century, it was agents such as laudanum. The ‘reward’ the brain and body feel after taking an opioid, and the risks of addiction, are not new,” Bulloch says.
“What happened in the past few decades that is a little unique is that we were led to believe that not all opioids were addicting. The promotion of certain opioids, including oxycodone, as ‘safer’ analgesics has been one of the biggest influences on the opioid epidemic. There are a lot of people in this country and within Alabama who work long hours at physically demanding jobs, and after decades of this, their bodies hurt. The addiction issue with morphine is well known. When the healthcare community was presented with something that they thought would help relieve suffering in their patients without the risks of morphine, they understandably utilized it,” Bulloch adds.
“You also had a period of time when heroin was very popular, but it was illegal then as it is now. Many addicts realized that they could get the same impact from prescription opioids, with less legal risk, and for a while we saw a decline in heroin use. On top of all of that, there was a push to consider pain as the 5th vital sign – something that should be proactively addressed and not ignored,” Bulloch continues.
“Unfortunately, not only was the promotion of oxycodone as safer wrong. It turns out it can be even more addicting in some people. By the time this was identified, prescribing practices throughout the U.S. had changed and opioid prescribing was routine. We have put in place a lot of measures to educate providers on how to select between opioids and non-opioid pain medications. We also have made it more difficult to obtain high doses for pain, improved access for dispensers to know how many prescriptions a person is getting for controlled substances and increased efforts for rehabilitation.”
She believes many of these efforts are paying off, but in some areas, the control on prescription opioids has driven some people back to heroin or other opioid alternatives.
Carter says he first turned to shooting fentanyl because of the cheaper price. At first, he and his buddies would get an eighth of an ounce of heroin and a gram of fentanyl and mix it together. From there, it went half and half. Then, they cut out the heroin entirely and started shooting just fentanyl.
“It marked the lowest point of my life. We weren’t spending any money on groceries, and I was asking neighbors for $5 to get a two liter at the gas station,” he says. The debt they accrued by getting drugs fronted during this time left them without any money to eat and in a matter of months, Carter lost over 100 pounds.
He and his mom decided to detox cold turkey together. They both stopped on Oct. 25, 2021. “Withdrawal takes about 15 days and if you don’t medically detox, you feel like you are fucking dying. Being ‘dopesick’ feels like the flu times 50. You’re constantly throwing up, constantly shitting your guts out. You don’t want more, but you want the pain to stop,” he says.
Carter says he went through most of the withdrawal process curled up in his bed. He says the worst symptoms he had were sporadic changes in his body temperature, spine pain that left him weeping and restlessness so bad “you couldn’t sleep if you took 10 Xanax bars.”
On Halloween night, after five days of the worst symptoms behind him, Carter was listening to Young Thug’s new album in his room and drinking beers. About five deep, he decided to go grab another when he saw that his mother had fallen off the toilet and into the hallway.
“She had really bad Lyme disease. Sometimes it would make her a bit grouchy, so I asked her if she needed any help getting up, but she just yelled and refused to get in bed, so, I grabbed her a pillow and a blanket and she curled up right there,” he says. “I went back to my room, and I remember getting in bed and telling myself ‘if we can make it three more days, we’re good.’” Carter says he headed to his kitchen to grab another beer when he looked down at his mother sprawled out on the floor.
“She was ghost white and not moving. I got closer and saw bile draining out of her mouth. I stuck my hand in her throat and didn’t feel any pills. I called 911, put my phone on speaker and started doing chest compressions,” Carter says.
When first responders arrived, they injected her with rounds of adrenaline shots and left a chest compression machine running for 30 minutes, but to no avail. “No one may ever know what killed my mom, but I think it was a combination of the toll that withdrawals take on your body and the Lyme disease,” Carter says.
When the Cullman Police Department arrived at his house, through tears, Carter mentioned how he wished he was dead. They booked him on suicide watch and put him in the psychiatric ward for two days.
“When I got out, I still felt like I was withdrawing. I had to drink pretty much all day just to feel normal. Beer was the only thing that helped me. Nothing really helps the withdrawal symptoms, but beer does a good job,” he says.
Monk calls Carter formidable. Not only in regard to his ability to survive huge doses of drugs and alcohol, but also his will to keep trucking with a smile on his face.
“He will say things like ‘I feel like I’m just waiting to die,’ yet he still carries on, still has fun with his friends. He’s truly been able to find his way and stay sane. His fortitude is so much higher than anyone I’ve ever met,” Monk says.
“He is strong, but he is also incredibly intimate. He never really had the resources to give to his friends like he wanted to, but he does what he can. Every time we talk on the phone, right before he hangs up he will always say ‘bye, I love you,’ and he extends it fully,” Monk adds.
Monk blames a lot of the current state of the opioid epidemic on interlinking socioeconomic factors. He refers to the Rust Belt, the geographic region spanning from New York through the Midwest that was once known as a manufacturing hub.
"The Rust Belt is the heart of the opioid crisis in this country, and it is not by coincidence nor the 'personal failing' of the people there," Monk says. “It used to be that the main way to support yourself and your family was to work in a factory manufacturing goods. However, these jobs got shipped overseas, and there were suddenly a critical mass of people in these states whose only chance of employment was in the low-paying, no-benefits service economy," he says.
"Add in the over prescription of opiates at the time, and it inevitably became the perfect storm, a surge of 'diseases of despair' that is still continuing to this day. It really is a public health crisis. You can link drug addiction to socioeconomic changes. There may not always be causation, but they almost always correlate,” Monk says. “When people see they have no future, they’ll do just about anything to escape their present.”
Monk feels that in a small town like Cullman, it may be easy to be seen as an outsider if you are different. Monk says he hates seeing Carter being dehumanized more than anything, addding that the stigma that comes with drug addiction is difficult to combat. “People would call him ‘junkie.’ I fucking hate that word. Addiction is an illness, not a personal failing. No one asks to become an addict,” Monk says.
Monk says being friends with Carter has changed his entire perspective. “I had to ask why this happened to him, and his experience led me down a rabbit hole of researching how so many things interconnect. He had the most profound impact on how I perceive the world.”
More and more individuals are seeking treatment for heroin abuse in Alabama. According to the Alabama Department of Mental Health, 5,593 individuals sought treatment for heroin abuse in 2019.
Eric Smith is the director of health promotion and wellness services at Auburn University. He says his office works with students in various stages of recovery for things like substance use and eating concerns. They also offer intervention programs and referrals to larger rehabilitation centers in the area.
“I’ve been working with recovery pretty closely for ten years. I think the stigma is starting to change. When we first started talking about recovery here, there was definitely a stigma,” he says.
In 2015, Taylor Wesley was crowned Auburn University Miss Homecoming. She ran on a platform of increasing awareness for mental wellbeing and recovery from substance abuse. Smith feels like her candor was a pivotal moment in combating the stigma at Auburn University.
“She was on the 5- yard line, getting praised by the president [of Auburn] and hugged by her family members. I felt like that really turned the tide for us in terms of that stigma because Taylor physically represented an antithesis to that stigma,” Smith says.
“She was a young, attractive blonde woman who had battled addiction, put it all back together and was moving forward. It really set a different stage of what an addict looks like in many people's minds.”
Issac Samuels first met Carter and Monk in high school. Samuels is unemployed and rises anywhere from 8 a.m. to 3 p.m. Every morning he stumbles out of bed, over to a coffee maker and fills a mug to the top. He steps outside and pulls a pack of cigarettes from his pocket. He smokes three, finishes his black coffee and heads back inside, where he walks up the edge of a table and tosses a plastic baggie down.
“Once I wake up a good bit I usually snort a line of heroin or meth to get my day started, and I continue to do either from sunrise to sunset as needed to maintain a steady dosage of either drug,” Samuels says. “I usually spend my days cleaning this trailer to make it liveable. It's got a long way to go,” he says.
For months, he and his girlfriend have lived in a mobile home in Calhoun County with no running water or sewage system. After spending the money needed to fix both, the plumber informed them that the toilets, the kitchen sink and the shower in the trailer would all need to be replaced before being used.
“It’s a real shit show,” Samuels says. “I don't do much in my days, but I try to stay content. My biggest motivating factors in life are music, my girlfriend and the fact that this life could be the last thing I ever get to experience.”
Samuels had his first run in with drugs during a stint at a juvenile detention center when he was 14. “Everyone in juvenile was talking about how cool drugs were, so straight-edge me was intrigued. I got put on ADHD medicine and soon after started abusing them to harness their powers, and because I liked how productive they made me,” Samuels says.
“At 16, I abused Xanax for the first time after stealing my granddad's prescription. I got put in the hospital twice after my grandparents found me unconscious after taking handfuls of them. Sometime at this age I also abused Hydrocodone and Tramadol for the first time, thus beginning my journey with opiates,” he says.
In October of 2018, Samuels tried heroin for the first time. “I was 18. I binged it for a couple months, which resulted in me dropping out of college. The first time you do it might be fun, but after another few times, you’re hooked and feel like you can’t live without it. From ages 19 through 21, I was on heroin pretty bad, using every day and pawning my shit to feed my habits,” he says.
“In September of 2021, I was being sold what I thought was just really good heroin, but it turned out to be straight fentanyl. So, I got myself hooked on fentanyl by accident, which is way worse than being addicted to heroin. Last month, I quit cold turkey and haven't touched fentanyl since then. I did however buy a half gram of heroin last week, so you could say I relapsed, but I don't consider it to be a relapse since I plan on quitting after this runs out,” he says.
“I still regularly use meth and heroin, at least once a day. I know it's not the best choice, but it's much better than being addicted to fentanyl. Opioids have impacted my life drastically, as I’ve spent three years being addicted to them. I never expected them to kick my ass this hard. I sold most of my belongings to feed my habits except for my amp and guitar. I told myself no matter how bad I got that I would never sell those,” he says.
Music has played a key role in Samuels’ life. His uncle was a fan of heavy metal music and would play it around him when he was young. He began playing guitar when he was 12, learning to play along to some of the songs he and his uncle loved so much. Still, Samuels finds a sort of solace in music. He quotes artists like Alice in Chains, Queens of the Stone Age, Ufomammut and Eyehategod as some of his most influential artists.
Eyehategod is a band from New Orleans. They are known as the pioneers of the “sludge metal” genre. From their inception, they have combined an abrasive sound with nihilistic lyrics dealing with issues of the American South.
A very common trend in their music is drug addiction, with one of their most popular albums being titled ‘Dopesick.’ Samuels says their album ‘Take As Needed For Pain’ is one that is especially important to him, as the opening track of the album was the first song he chose to listen to the first time he did heroin.
“I relate to the imagery Eyehategod portrays about the South in their music. Birmingham is where my drugs are located, so I had to drive there about every other day to score, and let me tell you, that place is a shithole,” Samuels says.
“Almost everyone who lives there will disagree with you because it's the ‘big city,’ but the ‘big city’ has drugs, homelessness, crime of all kind, prostitution and much more, just like every other big city. And every small town in Alabama I've lived in looks like it was forgotten in the 60s, with no major progress being made since then. My hometown of Warrior used to be a big coal town, but they gave up on that in the 40s or so and haven't looked back,” he says.
Samuels plans to start a new job within the next month. He recently got hired as a meat cutter at an Oxford grocery story but hasn’t heard when his first shift will be. He says he is looking forward to it and wants to keep his nose to the grindstone. “After that, it's saving up money until I can afford the luxuries I so desire,” he says.
Carter shares the same sentiments as Samuels about the decay of the rural South. He says he believes over half of the population of Cullman has had their lives altered by drugs, whether it be heroin or meth. He thinks the slow living and lack of support in Cullman are some of the reasons people turn to drugs.
“If we had more stuff to do, like activities, I think less people would be doing drugs,” he says. “Not just for children in elementary school, but also like middle school to high school and even after high school. Even 20 and 30 year olds like having a place to go and do stuff other than Alcoholics Anonymous or church.” he says.
“You know, if we had more teams, like a community football team, just more activities, then I think there would be less people doing drugs. I only smoke weed and drink now, but that's one of the reasons I did it so much, because there's nothing else to do here in Cullman.”
Since January, Carter has been working at a local electrical company. He says within the next year he hopes to become a certified electrician so he can practice on his own. He holds his Zebco fishing rod in his left hand and reaches down with his right to grab a can of Busch from the top of his tacklebox. With one hand he holds the can and pops the top.
“I’ll always have some kind of job to fall back on if I’m certified,” he says. He enjoys working at the electric company, but he says his dream gig is to pursue rap music. In the coming months, he hopes to take some time off and work on recording an album. He names rap artists Lil Peep and Greydon Square as inspiration.
“I mostly just want to experiment. My goal is to try and create some sort of unique trap-like sound and mix that with lyrics to educate people. From drugs to the Kardashev Scale,” he says.
He takes a sip and sits the beer can back atop his tackle box. He clasps his hands around his reel, his left thumb holding the other like a hug. He brings his wrists up, pulls back and then out, casting his line into the lake. His red and white bobber splashes and leaves ripples bouncing outward. Carter watches as they rise and fall and rise and fall until the water is still again. He glances down at his forearms in the sun and sees his track marks fading.
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