Noah Van Houten still carries a vivid memory of the last time he got high.
It was in the one-stall bathroom of an upscale farm-to-table restaurant in Chehalis, on his way to rehab.
Van Houten, 31 at the time, shot a mixture of heroin and methamphetamine into one of his veins. It was his elixir of choice, and the last drugs he had on him.
The potent combo, he says, made him feel “like I was going to get really high, or die, and both outcomes were appealing to me at that time of my life.”
His mother, Catherine Perrin — a woman of immense faith who goes by Kit — waited back at the table, unaware of what her son was doing.
Deep down, however, Perrin had her suspicions. She had already lost one of her three sons to drugs and feared she was about to lose another.
Their trip to Chehalis — on a cold, clear November day in 2015 — was a last-ditch effort to prevent it.
That’s because Noah, who grew up in Tacoma’s South End before moving to Puyallup in junior high school, was in the throes of opioid addiction. It had consumed years of his life, his struggle painfully emblematic of the growing opioid epidemic.
“The thought of losing another child was unimaginable,” Perrin recalls.
Not long after Noah shot up for the final time, Perrin drove her son to a nearby 45-day inpatient drug rehabilitation center. His eyelids heavy from the drugs moving through his system, he remembers dozing off during the intake.
Looking back on the day, Noah describes being “spun into a psychosis,” his throat “so swollen from drugs” that he “couldn’t even really say much more than a sentence.”
For someone in his state, getting high before entering treatment is “pretty standard,” he says.
One last fix, for old time’s sake.
While the day represents a low point in Noah’s life, it also marks the beginning of what he hopes is ultimately a story of redemption.
Today, like an estimated 23.5 million Americans, Noah is in recovery. He says he lives each day with the knowledge that some people — including his older brother — ultimately lose their battle with substance-abuse disorder.
Addiction very nearly tore his family apart.
Noah’s downward spiral is a familiar one, particularly within the context of what we now know about the opioid epidemic.
He started by abusing prescription pain pills during adolescence, he says, then moved from crushing and snorting OxyContin to smoking the powerful pain medication. When money got tight, his tolerance high and obtaining the pills on the street increasingly difficult, he graduated to shooting heroin — crossing a line he always told himself he wouldn’t.
“I was righteous in my drug use, like, ‘I would never do that.’ Those people are less than me,” Noah recalls.
“Eventually, that was a door I went through as well. That was the last line in the sand that I had.”
If there’s an overarching theme of the national opioid epidemic, it centers on death. And for good reason. According to new data released by the Centers for Disease Control, more than 42,000 Americans died of opioid overdoses in 2016. That represents a 28-percent increase from the year before.
“We’ve gone well beyond (the AIDS epidemic) now,” Robert Anderson, chief of mortality statistics at the National Center for Health Statistics, recently told the Washington Post.
Locally, between 2012 and 2016, Pierce County experienced a rate of 9.9 opioid overdose deaths per 100,000 residents, compared to the state average of 9.6, according to a report from the state Department of Health.
In 2016 alone, there were 694 opioid-related deaths statewide, with 81 of those deaths coming in Pierce County.
The year prior, in 2015, an average of two Washingtonians a day died from opioid overdose, also according to the state Department of Health. Meanwhile, heroin deaths more than doubled between 2010 and 2015, and prescription pain medication has now surpassed car crashes as the leading cause of accidental death in the state.
The impacts have been far-reaching.
A 2017 report from the Tacoma-Pierce County Health Department found that the number of people admitted into treatment programs for prescription opioids and heroin have more than doubled since 2007. The report also found that first-time opioid treatment admissions tripled from 2002 to 2015, with the biggest spike among people ages 18 to 29.
Asked whether Pierce County’s opioid problem has reached epidemic status, Tacoma-Pierce County Health Department's Strengthening Families Division director Sebrena Chambers answers without hesitation.
“Oh yes,” she says.
‘I got hurt a lot’
The name Noah has biblical connotations.
Perrin — who has spent more than 30 years doing pastoral work in local churches — says she chose it for a reason.
“Naming a child is a very important thing,” Perrin says. “I knew when he was born that there was something he was going to do with his life. I just knew it innately. I knew it as a mom.
“I didn’t know what it was going to be. But I knew he was going to change his generation.”
The life her son lived up until recently is not what she had in mind.
Noah is Perrin’s middle son. The oldest, Jason, was five years his senior. The youngest, Nathan, is five years his junior.
Looking back on Noah’s early life, Perrin remembers a boy who was different from her others, a “calm, sweet, and delightful baby” — one who slept through the night almost immediately.
Noah, she says, was “always smiling.”
At school, Perrin says her son was inquisitive and compassionate, even with a diagnosis of attention deficit-hyperactivity disorder that sometimes made things like sitting still difficult. Noah was “incredibly bright and incredibly intelligent,” she says.
He loved soccer and was adept at making friends.
If there were people Noah struggled to connect with, they were closer to home, Perrin says.
Noah’s relationship with his father, whom Perrin divorced when he was in elementary school, was strained, she says. His older brother struggled with anger and mental health issues and often took his hostility out on his younger brother.
“He was out of my weight class,” Noah says of his older brother. “And I got hurt a lot.”
Childhood abuse, Noah believes, eventually contributed to his substance-abuse disorder.
Though he’s forthcoming about the intimate details of his struggle, the specifics of the abuse he experienced as a child are ones he doesn’t want printed in the local newspaper.
“As a kid … you don’t know how to process trauma,” he says after a long pause. “So at that moment in my life, I began to look outwardly to feel better inwardly.”
He’s not alone.
According to a 2004 study on the origins of addiction, 67-percent of IV drug use amongst men and women is attributable to Adverse Childhood Experiences, like stressful or traumatic events.
Life changed for Noah, his mother believes, in his early teenage years.
In Tacoma, he started hanging out with a rough crowd. The family’s move to Puyallup – made in part to transfer Noah to Aylen Junior High, an attempt to keep him out of trouble — did little to alter Van Houten’s trajectory.
“I thought it was cool, you know? It was the ‘90s. I wanted to be a badass. I wanted to be a gang member. I wanted to be 2Pac,” Noah says. “And I decided to live like that.
“I spent a lot of time getting hurt as a kid. And then I turned a corner and decided I wasn’t going to get hurt anymore, I was going to be the one to hurt people.”
At the same time, his rap sheet blossomed. Today it includes a pass through Pierce County Drug Court and convictions for forgery, identity theft, possession of a controlled substance and unlawful solicitation.
“I loved it. And I thought that that was the way of life,” Van Houten says. “I hurt a lot of people with the way I used to live my life. I just followed chaos and harvested destruction everywhere I went. Maybe I wasn’t a bad person, but I was involved with a lot of bad things.
“But that’s not who I was supposed to be, and that’s not who I am.”
A brother’s death
Noah’s older brother, Jason Van Houten, succumbed to his demons on Halloween 2014. At least that’s how his brother and mother tell it.
Perrin describes Jason as a hardworking longshoremen and father. He had a daughter he was proud of and another he’d never have the chance to know.
The five-sentence newspaper story that ran in The News Tribune three days after Jason Van Houten’s death provides a succinct account of his death.
After crashing his Ford Ranger pickup truck into a concrete barrier, Van Houten, according to the State Patrol, “got out of the truck, walked across the ramp, climbed over the barrier and fell about 27 feet onto the pavement of I-705,” the newspaper reported.
According to the Pierce County Medical Examiner’s office, Jason died of multiple blunt force injuries. He was pronounced dead 20 minutes after the incident was reported.
He was 35.
Noah and his mother say it’s more complicated than that. They consider Jason’s death a suicide.
Perrin, her eyes welling up with tears, describes Jason’s death as “addiction-related.” Noah recalls “ominous” statements his brother made shortly before his death.
“In light of all the things that were said to my family right before, there is no doubt in my mind what really happened. My brother committed suicide. He was struggling,” Noah says.
“He had really lost his mind, with the methamphetamines, and then you factor in all the alcohol he was drinking that night. That’s what happened.”
The brothers had a long history of abusing prescription opiates together, Noah says. He also acknowledges introducing Jason to methamphetamine.
Because of this, he feels personally responsible for Jason’s death. Turning his brother on to meth, Noah says, was a move made in selfishness and amidst addiction.
“The truth of it is, I did it because my brother had money,” Noah says. “I knew that if I got him to get high on meth, too, then I would get more drugs, and he would have to get his drugs through me.
“I carry around a lot of guilt. There’s part of me that thinks maybe it should have been me.”
At the time of Jason Van Houten’s death, Noah already was grappling with opioid addiction. He lost a good-paying job during the Great Recession and spent years living in cheap hotel rooms, stealing and dealing drugs to afford the heroin he needed to “get well,” he says.
Noah recalls the chaplain knocking on his door at the Day’s Inn across the street from the Emerald Queen Casino to deliver the news of his brother’s death. He’d been released from jail the day before, under the supervision of Pierce County Drug Court.
Today, Noah describes Jason’s passing as the nudge that sent him headlong into a tumultuous tailspin of drug use, despondency and homelessness.
“After my brother committed suicide, I could barely even stay loaded,” he says. “I just had this fog over me, and I was reduced to the most petty bottom addict that you possibly could be.”
He spent much of the next year living on the streets.
A sadly familiar story
Noah’s descent into homelessness is a story that has been repeated many times in Tacoma and Pierce County, local officials say.
In filing a lawsuit against three manufacturers of prescription opioids in September, the city of Tacoma pointed to the impact the opioid epidemic has had on the city’s ongoing homelessness crisis.
“As a result of a recent survey, the City estimated that at least fifty percent of its homeless population is addicted to opioids,” Tacoma’s complaint reads in part.
While judging the accuracy of that estimate is difficult, Colin DeForrest, Tacoma’s homeless services manager, says there’s no question that opiate addiction is playing a significant role in the city's ongoing homelessness crisis.
In December, Pierce County started down a similarly litigious path. With the go-ahead from the County Council, Pierce County Prosecutor Mark Lindquist initiated litigation against Purdue Pharmaceutical and other makers of prescription opioids.
According to County Councilman Derek Young, who helped convene a countywide opioid task force last year, the move was intended to help the county “seek … policy changes that will help reduce the occurrence of addiction, injury, and deaths from opioid abuse.”
“If this was literally any other disease, we would be dumping cash toward it,” Young says. “It is a medical condition. That’s kind of long been accepted. In terms of the impacts and morbidity and mortality rates, it’s shocking just how bad this has gotten.”
Perrin recalls driving the streets of Tacoma, late at night, looking for her son.
Already dealing with the death of one son, watching Noah deteriorate and eventually end up homeless nearly broke her, she says.
Sometimes, she’d pay for a hotel room for her son, only to be shocked by the number of needles he left behind. Sometimes she’d allow Noah to stay at her house in hopes of convincing him to pursue treatment, only to be heartbroken anew when he’d take off again.
She knew that if a change didn’t come soon, she’d lose Noah for good. He’d be dead.
“I don’t sleep very well. I used to be up at 3 and 4 in the morning when I hadn’t heard from him, looking for him,” Perrin recalls. “I didn’t want to have to go out and not know where his body was.
“As horrible as that sounds, that’s how I was thinking. I wanted to be able to bury him.”
The fear was well founded.
On Halloween 2015, exactly one year after his brother’s death, Noah overdosed on heroin and nearly died. The close call, and the realization of what a second son’s death would have likely done to his mother, was enough to flip a switch, he says.
“For me to also do that to my mom, to put her through that again, was a lot,” Noah says.
“That was the one that brought me to my knees.”
Can’t Go Back
A little more than two years after Van Houten shot up in that bathroom in Chehalis, his hazel green eyes are fixed on a computer screen. He’s now 34.
Within the confines of a closed Facebook group he created, he watches people come seeking advice, connections and encouragement.
Some are looking for a person to talk to, someone familiar with the daily and even hourly challenges of being in recovery.
Others come in search of more tangible things, like clothes for a loved one who’s recently been released from rehab or a ride to a nearby 12-step meeting.
The online community is known as “Can’t Go Back.” Van Houten launched it 10 months after he kicked heroin.
“Conceptually,” he says, “it’s like a meeting that never closes.”
Over the last year and a half, Can’t Go Back has grown to include more than 2,500 users. Most are from the Pacific Northwest, though Van Houten says there are members who live as far away as Florida.
“It’s become a tool that people used for support and inspiration,” he says.
The power and potential of Can’t Go Back is just beginning to become clear, says Lauren Davis, executive director of Washington Recovery Alliance. She says it has the potential to be “hugely transformative.”
Compared to traditional 12-step programs — like Alcoholics Anonymous or Narcotics Anonymous, which rely on a principle of anonymity — the access Can’t Go Back provides to the local recovery community is “just unprecedented,” she says.
Being able to directly tap into the recovery community and use it for things like advocacy and to lobby lawmakers can be the difference between seeing an effort succeed or fail, Davis says.
It also can touch people’s lives.
Michelle Karrer, and her son AJ McNair, have witnessed both the depths of the ongoing opioid crisis and the power of Can’t Go Back firsthand. In early August, McNair survived two nearly fatal opioid overdoses in the span of 12 hours.
After the second, he was found on his family’s boat “gasping for air,” as he recalls — the result of using heroin that, unbeknownst to him, was mixed with fentanyl, a powerful synthetic opiate much stronger than morphine.
Responding paramedics administered naloxone, an emergency medication used in overdose cases that reverses the effects of opioids, and McNair was rushed to St. Peter’s Hospital in Lacey. Soon, Davis authored a post to the Can’t Go Back community on the family’s behalf, hoping that someone might be willing to make the trip to the hospital to support McNair in his moment of need.
She wasn’t sure if it would work.
A few hours after Davis posted her plea, Karrer says, at least three carloads of people in recovery descended on Thurston County to sit by her son’s side in the hospital ER and hopefully provide the inspiration he needed to turn his life around.
“Literally, ten people showed up,” Karrer says. “It’s just incredible to think that complete strangers would show up and want to encourage my son.”
“At first, initially, I felt embarrassed,” McNair, 25, adds. “But the way they just presented themselves and came up to me, there was no judgment. I could relate to them. They were also addicts. But they had something I didn’t have — they were working a program, and they were sober.
“It was a big eye-opener for me, because they had something I wanted. It just encouraged me to go to detox and get into treatment.”
While McNair’s path to recovery has had its setbacks, at the time he spoke to The News Tribune from a treatment center in Bellevue he’d been in recovery for 70 days and was preparing to make the move into a sober-living facility.
Noah and his mother realize the potential impact of Can’t Go Back.
“I think what it does is it enabled dialogue,” Perrin says. “I think people have been so ashamed, or filled with so much guilt, that they want to do everything they can to avoid discussion. And the thing that is going to help is talking about it and discussion.
“No matter how ugly it seems, we’ve got to get those things out and begin to talk.”
Noah’s memories of getting out of rehab are much clearer than those of the day he entered.
He remembers delivering a speech during the graduation ceremony, a moment he describes as one of the proudest of his life.
He remembers how his mom sat in attendance. For the first time in a long time, she was proud of her middle son.
“I really hadn’t ever finished anything but a bag of dope up until that point in my life,” Noah says.
Noah also remembers how, after all of that — the speech, the pride, the unmistakable sense of hope he saw in his mother’s eyes — he returned to the Day’s Inn in Fife that night, terrified but determined.
He had nowhere else to go.
Triggers, tempting him to use again, were all around. He turned the TV up as high as it would go, and the shower for good measure, to drown out the noise.
He laid under the covers, for hours, until it dawned on him: He was two rooms down from where he was when he learned his brother was dead.
“Man, it was just a lot for me,” he says.
Today, Noah is quick to acknowledge that in recovery, “the book’s never closed and … that freedom from active addiction is never owned, it’s rented. And the rent is due every day.”
After everything he’s been through, Noah says he also feels a conviction to offer a perspective of hope and recovery in a time when discussion of the opioid epidemic often feels heavily weighted toward despair and hopelessness.
He wants stories like his — stories of opioid-addiction recovery — to become “the norm.”
“I believe that overcoming opioid addiction should get as much airplay as overdoses,” he says. “Because when you tell a single story about a certain type of people — that we’re all just criminals, and we don’t get better, we deserve to rot in hell and be locked in prison — that starts to become true for people.”
As of this writing, Noah is enrolled at Tacoma Community College, planning to transfer to the University of Washington Tacoma and study business. Recently, he was hired as a behavioral health technician at a recovery center in Lacey. Through Can’t Go Back, he’s helping to give voice — and a connection — to thousands recovering from substance abuse disorder that might have otherwise been silent.
He is trying, in other words, every day.
It’s exactly what he’s supposed to be doing, he believes.
“Point blank, period: If people can get the appropriate resources within their window of willingness, they recover. Every single person who suffers from substance abuse disorders is worth saving,” Noah says.
“I’m not the exception to the rule.”
The Washington Recovery Helpline operates a 24/7 telephone line for people who need help for substance use, mental health crises and problem gambling: 1-866-789-1511.