“Generation Heroin” Puts a Human Face on Florida's Opioid Epidemic

By Zachary Siegel 01/04/17

The opioid crisis in Florida has reached epidemic proportions. Some are dying in unregulated sober houses. " In fact, one in 10 of the 216 deaths profiled in 'Generation Heroin' were found overdosed in a sober home."

Florida Opioid Epidemic
Just a portion of people who died in 2015 from a heroin-related overdose in Palm Beach County. Photo via

The intended effect of “Generation Heroin,” a project about the opioid crisis produced by The Palm Beach Post, is a gut-punch of sadness. While dry statistics calculate the magnitude of the opioid epidemic, the faces and stories of the people—all of them dead—communicate the utter devastation. Scrolling through the project—past the pictures of veterans, students, moms and dads—the intended blow lands. The toll becomes too disquieting to ignore.

The daring project spotlighted 216 people who died of an opioid overdose in Palm Beach County in 2015. While other local papers across the country covered horse race politics, The Post dove deep into this public health crisis affecting the community it serves and the result has been overwhelmingly positive.

Lissa Franklin, 28, an advocate who is in recovery living in Miami, told The Fix that she thinks the project “humanized the epidemic.”

“They are honoring the fallen, educating the masses and advocating for the implementation of solutions for the sick,” she said.

Justin Kunzelman, 33, who grew up reading The Post, told The Fix he was stunned to see “Generation Heroin” on the front page. He called the project “revolutionary.”

“It’s fucking amazing,” said Kunzelman, co-founder of Rebel Recovery, a non-profit dedicated to advocating for common sense drug policy. “There has not been more comprehensive coverage of the opioid epidemic in a local community that I know of.”

Like Franklin, Kunzelman said the project illustrated “the human side of the epidemic, and gave a complete picture of what’s happening in our local community.”

It’s a bold, risky take that’s sorely missing in local newspapers across the country, Kunzelman added.

The response from Franklin and Kunzelman echoes why nearly 100 families who lost a loved one to an overdose were willing participants.

“Most families were happy” to be part of the project, said Lawrence Mower, an investigative reporter at The Post, who had the first inkling that the medical examiner’s office was tracking all of the toxicology reports where drugs were present at death. Mower continued to pull the thread and found that the medical examiner’s office was overwhelmed with overdoses and unable to keep up with the load.

The Post’s investigative team (or i-team) spent months gathering and poring over toxicology reports provided by the medical examiner. The nature of the project required exhaustive, careful reporting, explained editor Joel Engelhardt, along with Lawrence Mower, over the phone with The Fix.

Engelhardt and Mower said they felt immense pressure to get everyone’s story right. With every overdose case, the i-team had to be certain that the person who died was caught up in addiction.

“Our lawyers were saying: if you present these cases you have to be sure they fit the bill,” said Engelhardt, hence all the dreaded phone calls made to the families of overdose victims. Those kinds of necessary calls are some of the hardest that journalists have to make.

There were cases the i-team came across where people died with opioids in their system but were not addicted. An older chronic pain patient, for example, who died in his hot tub showed up as a fentanyl overdose. The man was in pain so he applied fentanyl patches to his skin that were prescribed by his doctor. Fentanyl patches work by slowly delivering fentanyl, a powerful narcotic, into one’s bloodstream through the skin.

They are also heat activated. So when the man stepped into his hot tub after applying the patch, the heat from the tub released too much fentanyl at once and killed him. Cases such as this man’s were excluded from the project because they are different from the people who, driven by their addiction, bought pills or heroin on the street.

Some families, however, became angry that their loved one was included in the project. They didn’t want their secret despair spelled out in ink.

In one case, reporters at The Post made contact with the father of a young woman who died with heroin in her system. “So we tried to talk to this guy,” said Engelhardt, who heads The Post's investigative team, “and he said his daughter didn’t die from a heroin overdose.”

But reporters making the call had the toxicology information in front of them. Thinking a face-to-face meeting might relieve some mental pain, the reporters offered to meet up and share their documents with the father.

Instead, “he became angry and very hostile,” Engelhardt recalled. The father told The Post he was worried that his youngest child might be negatively affected by the coverage.

Ten families had a similar response. A few even threatened to sue if their loved one wasn’t pulled from the project. A couple dozen families were neutral about being involved. Roughly 70 families were unreachable—but that didn’t stop the investigative team from using police and autopsy reports to reconstruct their stories. In fact, nothing stopped the reporters from showing their readers the scope of their sunny city’s dark crisis. They reported each and every overdose, despite threats of lawsuits and other misgivings.

Florida functions as one of America’s rehab destinations, making the implications of “Generation Heroin” particularly dark.

For the past two years, The Post has investigated the fraud and corruption rampant in the addiction-treatment industry. Time and time again in their reporting, The Post came across stories of young people who were convinced to fly to South Florida to heal their addiction, only to wind up becoming sicker. Some of these young people overdosed and died in unregulated sober houses. In fact, one in 10 of the 216 deaths profiled in "Generation Heroin" were found overdosed in a sober home.

Asked how many of those who died had moved to Palm Beach for recovery, Engelhardt and Mower said that was difficult to determine. “Some were down here for rehab,” said Engelhardt. He recalled one man who moved to Palm Beach for drug treatment in 2011. He was in and out of rehab ever since, the i-team found, and he just never got better. His death is included in “Generation Heroin.”

“The industry is beset by fraud,” said Engelhardt, who, along with his team, has taken shady rehab owners to task with hard-hitting reports.

The Post’s coverage of scams and double-dealing helped ignite a three-month long grand jury investigation—believed to be the first of its kind. What was found—detailed in this 241-page document—was evidence of sexual abuse, human trafficking, forced labor and insurance fraud within South Florida's addiction treatment industry.

The ongoing coverage eventually caught the attention of Sen. Marco Rubio, R-Florida, who, until recently, was absent from conversations about the opioid crisis and insurance fraud affecting his state.

Rubio called the “Generation Heroin” project “heartbreaking,” and requested the comptroller general assess the Grand Jury report for potential policy solutions to curtail fraud in the addiction treatment industry.

Florida Gov. Rick Scott, on the other hand, remains quiet on the issue.

The sheer number of people who died in Palm Beach last year from overdoses—more than from car accidents—amazed Mower and Engelhardt. But what struck them both was the demographic makeup of the deceased.

“A lot of people had high levels of education, advanced degrees and good jobs,” said Engelhardt.

Of those who died, The Post found, 95 percent were white. More than half were 35 years old and younger. And 40 percent were 30 and under.

The race and class of opioid users in Palm Beach reflects a nationwide trend across America. The fastest growing segment of heroin users, according to the CDC, is among white men aged 18-25, particularly those who earn less than $20,000 annually.

Public health advocates who were politically active during the crack epidemic thirty years ago argue that the race and class of current heroin users plays a role in the sympathetic coverage of drug users by today’s media.

The present rallying cry for drug users is to roll back unduly harsh penalties for drug possession that led to America’s swelling incarceration rates, particularly among black and Latino men. Moving forward, activists like Kunzelman at Rebel Recovery want to be sure that softer drug policies apply to everyone with addiction, regardless of their race and class.

“We’re in the middle of the worst drug epidemic, worse than crack in the ’80s,” said Kunzelman. “The response then was to militarize police and create an unhealthy justice system.”

Activists like Franklin and Kunzelman hope to see a response grounded in a public health approach to addiction. They also want to see swift justice for fraudsters that give addiction treatment in Florida a bad name.

Papers like the Palm Beach Post are playing a role in normalizing their ideas.

But the Post’s stories are written for everyday Jane’s and Joe’s who don’t necessarily have any experience with opioid addiction. And after the sadness and heartbreak from “Generation Heroin” recedes, hopefully such readers open up to the notion that people with addiction need support from their communities and families—not shame and scorn, which only throw the already suffering person into a deeper pit, a lonely place where addiction becomes stronger and harder to beat.

“Generation Heroin” was overseen by The Post’s i-team editors, Holly Baltz and Joel Engelhardt. Pat Beall, Joe Capozzi, Barbara Marshall, Christine Stapleton, Mike Stucka, Melanie Mena and Lawrence Mower did research and reporting for the project.Becca Vaughan, Mark Buzek and Robin Webb, along with many others behind the scenes, played a critical in the project’s production.

You can check out “Generation Heroin” here.

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Zachary Siegel is a freelance journalist specializing in science, health and drug policy. His reporting has also appeared in Slate, The Daily Beast, Salon, Huffington Post, among others. He writes often about addiction, sometimes drawing from his own experience. You can find out more about Zachary on Linkedin or follow him on Twitter.