Editor's note: This is the first article in a three-part series documenting a Ware family's struggle with drug addiction. The second part will run Wednesday, with the final piece on Friday. In addition to this series, several articles will run in concert on drug use in Massachusetts.

On a June day in 2011, Ethan Romeo found himself sitting across from his close friend and running partner at a dining room table in the South Hadley home of a heroin dealer. To either side were the dealer and a female friend who served as Romeo's drug connection.

Ethan, then 20 years old, and his friend were in the throes of an unbearable dope sickness. They needed a way out. He watched his female connection shoot up and then his friend. He was next.

Years of fear of using a needle to shoot drugs directly into his body faded away, beaten down by the physical and mental need to not feel sick anymore. The dealer told him what to do; he walked Ethan through the steps necessary to find a good vein and prepare a clean needle. The 30 second rush from heroin was followed by a high better than any pill he had popped during the previous four years.

It took 20 minutes for Ethan to begin looking for his next high. Heroin had him.

"There were plenty of times where I would get the drugs, come home and be by myself and bawl my eyes out knowing that I was doing this only because I had to and not because I wanted to," Ethan said during a recent interview. "It was not a party drug anymore. It was not for fun. It was out of necessity to get up and go to work or get up and take a shower."

Romeo's life has been marked by an experimentation with drugs that evolved from being a means to briefly escape reality into a deep addiction, which he struggles with to this day. By the age of 17, he was physically addicted to prescription pain pills, but it would be years before he would admit to himself, or anyone else, that he was an addict.

Ethan's addiction to prescription drugs occurred through an escalating series of addictions that began at the age of 11. Having once used the drugs to ease the childhood trauma of his parents' divorce, by his late teen years he had become physically addicted, and tied to the drugs that had previously seemed so freeing.



His addiction culminated in the use of heroin, a drug that quickly broke him, sending him into a variety of treatment facilities and programs. At 23 years old and after seven years of battling his drug demons, Ethan is now back to where his journey to addiction began, in his mother's house in Ware.

It has been a struggle to get clean. After several failed attempts, Ethan has been drug-free now for nearly three months, and he is talking publicly about his addiction. He talks about the drug-laden path that culminated with him putting heroin into his arm, the despair he felt at his lowest points, and what he is doing to ensure he can avoid ever doing it again.

Ethan's story is not unique. Thousands of people, including hundreds of teens in big cities and small towns across Massachusetts, are struggling with addiction to opiates.

In March, Gov. Deval Patrick said that Massachusetts is in the grips of an "epidemic of opiate abuse." For this reason, Patrick said the state must "treat it like the public health crisis it is" and ordered the commitment of $20 million to increase drug treatment and recovery services.

Vermont Gov. Peter Shumlin devoted his entire State of the State address to highlight what he described as a "full-blown heroin crisis" in his state.

"It is a crisis bubbling just beneath the surface that may be invisible to many but is already highly visible to law enforcement, medical personnel, social service and addiction treatment providers and too many Vermont families," Shumlin said.

Not alone

The real face of heroin addiction is not drug users portrayed in a television series or in movies, such as Pulp Fiction.

"People who seem to be pretty normal, have normal lives can get into this," said Dr. Marc C. Restuccia, an attending physician in the Department of Emergency Medicine at the University of Massachusetts Medical Center and Medical Director for UMass Life Flight and Worcester EMS.

In a comment to the Boston Globe in February, Franklin County Sheriff Christopher J. Donelan, said "It's not just your back alley junkie doing heroin anymore ... It could be any kid, in any neighborhood, in any demographic."

There are many paths to opiate addiction - from getting hooked on pain medication taken after a surgery to experimental drug use - and Rustuccia has seen them all.

"It's important for people to see how easy it is for this to happen and that it's incredibly devastating not only to the patients, but to the entire family," Restuccia said recently.



From 2000 to 2011, the most recent year that data was compiled in Massachusetts, opioid-related deaths increased from 363 to 642, according to the state Department of Public Health.

In 2012, of the 105,189 adult admissions reported, 43.1 percent of those men and women sought treatment for a heroin addiction, the primary reason for entering a substance abuse treatment program, according to the Massachusetts Bureau of Substance Abuse Services 2012 annual report.

In February of this year, the Massachusetts State Police released a report that said at least 185 people have died from suspected heroin overdoses in Massachusetts since Nov. 1, a figure that does not include overdose deaths in the state's three largest cities: Boston, Worcester and Springfield. Of those overdoses, 12 were reported in Worcester County, 19 in Hampshire and Franklin counties combined, and 12 in Hampden County, according to state police. The report did not include the number of nonfatal overdoses during that time.

“It doesn't matter who you are, where you come from or where you live. None of that matters anymore,” Ethan said during a recent interview. “This disease can hit you at any time. It is powerful, it is cunning, it is insidious and it is deadly.”

Early experimentation

Ethan describes his early family life like a modern take on the Brady Bunch. His parents divorced when he was nine years old. Following the divorce he lived with his mother, two sisters, the man his mother was dating and his three children. Ethan played soccer and was strong in math, his mother, Beth Beardslee, said.

Ethan also tried marijuana, his first drug, at 11 years old.



"From the start I really loved it. It gave me a freedom I did not feel anywhere else," Ethan said of smoking marijuana for the first time. "It gave me something to escape everything I was feeling."



That first foray into drugs was something that his family wrote off as experimentation, Beth said. It was known that Ethan had smoked marijuana when he was 13, but Ethan downplayed the extent of his use.



"He wasn't known to be that troubled kid," Beth said. "He's that kid where if you see him he will hold the door open."



Beth knows what it means to be an addict. Sober for 14 years after going through detox for alcoholism, she said that she worked hard to be involved in the lives of her three children and provide them with the best home she could. Beth said that she did not take issue with Ethan smoking marijuana. At the time, she thought that it was better he do it in the house where he was safe than somewhere else, she said.



"I let my kid smoke pot. I absolutely did. I did not have a problem with it. I'll be the first to admit it," Beth said. "It's too bad I had that thinking, but I take responsibility for that."

According to Dr. Douglas Ziedonis, a professor and chairman of psychiatry at the University of Massachusetts Medical School, often it is something like cigarettes, alcohol or marijuana that is noticed by parents first. Depending upon the parent's reaction and the receptiveness of the child, the situation can improve or it can gradually lead to experimentation with prescription pills and then street drugs, such as heroin.

In denial

For Ethan, there was no stopping. By the age of 13, Ethan had moved on to other drugs that included Adderall and Oxycodone. At 16, Ethan tried cocaine. He had already sniffed drugs and when a friend offered him cocaine while he was in a basement smoking marijuana he welcomed the experience, Ethan said.



"It didn't scare me. I guess unfortunately drugs didn't scare me," Ethan said. "At the time I was 16, and I thought I was invincible and cocaine didn't scare me. It was just another thing I was going to sniff and feel good from … I remember snorting cocaine and really loving it."



Ethan would continue to use cocaine for years. The drug was plentiful and allowed him to party harder and be more social, he said.



"I was always that person that always wanted to take it to the next level. That was my personality," he said. "I was the kid using vodka to play beer pong instead of beer,"



Even as he used cocaine regularly, the concept of being an addict had never entered his mind. There were no physical withdrawals from the drug and he was able to maintain the facade of normalcy for years to come, he said.



"I knew I had a problem, but I really just blamed it on being a teenager," Ethan said. "I really just thought that one day I would put down these bad substances."

Soon after he started using cocaine, he was chasing the high down with prescription pain medicine including Benzodiazepine, Percocet and Oxycodone. The market was flooded with these pills, he said. The pills became his "bedtime medicine" to help bring him down from the upper high he had be riding during the day.



The opiate high removed him from the life and thoughts he did not want to deal with while making him more focused, Ethan said. While he was using, he felt more active and likely to leave the house.



"It was a complete lack of physical, or mental, or emotional pain. It brought me to a level where I was just numb to the things I didn't want to feel," he said. "It took me down from being this stressed out person to someone who was calm and relaxed and motivated. It took away a lot of the pain of life."

Ziedonis said that addiction and misuse of prescription pills is much more common than the misuse of heroin. Often young people may have access to pills prescribed to an adult in their life for pain that are stored in a medicine cabinet even if they're no longer needed for their intended purpose. He has heard stories of extreme measures taken by addicts to acquire pills, such as visiting open houses with the purpose of rifling through the home owners' medicine cabinets.

Full-blown addiction

At the age of 17, Ethan says he was physically addicted to opiates. He was soon taking them out of physical need.



"If I didn't have these drugs it was hard to get out of bed," said Ethan. "At this point in my life it was hard to do anything without opiates in my system."



Even in the midst of this addiction he still maintained a facade for his family and those around him, he said. This went on for the nearly four years he used prescription pain pills.



"I had a girlfriend. I had a car. I had a job," said Ethan. "On the outside, everybody really didn't see any real problems with what I was doing."



For Ethan, the pills eventually began to take a physical toll. He found himself nodding off while on the job or talking to people. Among the withdrawal symptoms for Ethan were complete exhaustion and lack of motivation coupled with a severe nausea and restless legs.



"A lot of it had to do with feeling sick to my stomach and another big thing was the lack of motivation. When I was dope sick all I wanted to do was stay in bed," said Ethan.



During a severe case of withdrawal one night at 19 years old, he first admitted to his mother that he had a problem. It was an attempt, he said, to try and get some drugs from the hospital where he asked to be taken for help.



"I was really, really sick one night and I had no money and no way of stealing anything and I admitted to her that I had a pill problem," said Ethan. "I was so sick and so broken that I thought I needed help."

Turning the wrong way

At the hospital, Ethan and his mother came up with a plan for counseling and treatment. He kicked his habit cold turkey that time, with the hospital giving him no drugs but different detox options. Ethan went back to using soon after. The pills were too much of a draw.



"I never really kicked. I just stayed clean for a few days and then was getting high behind everyone's backs," he said. "I just kind of faked it and pretended everything was going well."



He convinced people he would be okay, he said, although he now knows he was not ready to stop using. The true depth of Ethan's addiction escaped Beth even after he had admitted to her he had a problem.



"I just thought that he had come to grips with it and knew he was in trouble," Beth said. "We made a plan that he would go to online meetings. I just wanted to buy that book of goods so badly. So I bought that book of goods and let it go … it's that horrible thing they have done in society to say they are only taking pills."



By the time Ethan was 20, his pill use had gotten to the point where he was making drug deals at the Dunkin' Donuts where he worked. He had moved on to using a pain pill called Opana. It was one of the strongest pain pills on the market; designed for terminally ill patients. It was crushable, which allowed him to snort it, and a 40 mg pill cost $65. It gave him the kind of high that at this point he needed seven to eight Percocet 30 mg pills at $30 each to achieve.



Things would reach a new low point for Ethan on a day when the area pill supply ran out. He and his running partner were hurting that day in June of 2011. They were dying for something to take away the dope sickness. They had reached out to every resource they had while looking for a fix and finally the only thing they could find came through: It was heroin and they decided they were going to shoot it up.

The series continues on Wednesday with Part 2 of Ethan's story.