Editor’s note: names in this story have been changed to protect the identities of users.

Cruising down a stretch of highway on a cold November night, Suzy Q reaches for a lighter to spark her third Marlboro 27. Windshield wipers squeak as a light rain coats the road.

“I won’t drive too fast because it’s raining,” she says.

She rolls down her window to flick away ash. When she closes it again, a hiss of air remains, whispering through the duct tape that seals the gap in her broken passenger window.

Suzy keeps her hands at the 10 and 2 position, occasionally cursing other drivers in fits of agitation.

She’s on her way to get a fix—black tar heroin.

“I smoked a little before I left,” the 21-year-old senior confesses. “But unless I smoke a lot I don’t really get that high. It’s mainly about maintaining a state of normalcy so I don’t get sick again.”

She almost winces at her own words, perhaps reliving her last withdrawal. Just a few days ago she tried sitting up in bed only to feel her arms collapse beneath her like shattering glass. Sudden chills kept her in a warm blanket. Moments later, Suzy says she felt like she was in a sauna.

“Imagine the worst flu you’ve ever had and multiply that by ten,” she says. “I wouldn’t wish it on my worst enemy, even if I absolutely hated someone.”

Her withdrawals are so bad that Suzy feels she has no choice but to find more heroin.

“Even if it was 5 a.m., I would pick up,” she says. “It’s better than being sick.”

Three days of hell

Addicts avoiding withdrawal face more than just intense physical discomfort, says Widd Medford, the intensive services program manager at Boulder County Public Health.

“The sick and twisted part of heroin is that you don’t feel normal,” he says. “Laughing at a movie or getting a good grade on a test you thought you’d do badly on, or having sex causes the brain to pick up ‘feel good’ chemicals and you like it. For a heroin addict, those systems are essentially severely retarded and they’re held down, so endorphins drop and that person becomes caught up in cycle of smoking [heroin] just to to get by.”

As Suzy takes a drag off her cigarette, a heavy, clogged cough surfaces from her chest. It’s what she calls the “heroin hack,” her lungs attempting to filter a multitude of substances that she herself isn’t clear on.

“I’d say what I get is usually a fourth of actual heroin,” she says. “The rest is cut with all kinds of chemicals.”

She feels reassured knowing that when she smokes again, the heroin will suppress her cough. Unfortunately for Suzy, it will also continue to constipate her. Suzy reluctantly admits she hasn’t defecated in over a week.

“When I wake up in the mornings and I feel nauseous, I know I need to smoke,” she says. “When I start feeling like I have to go to the bathroom, that’s when I know I’m withdrawing and in danger of feeling worse. I usually smoke about 2 grams a day. I need at least 1½ grams to not feel sick.”

Although it takes three to four days to get through the worst of heroin withdrawal, Medford says it can be a miserable experience.

“Withdrawal is pretty rough,” he says. “It’s not going to kill them, but they’ll feel like they’re dying.”

Suzy has been smoking heroin since January. What initially started as an addiction to doctor-prescribed opiates like Vicodin and Oxycodone spiraled deeper when she first smoked heroin.

After a long day of classes, Suzy says another student approached her in Hellems after he saw her take a painkiller.

“We became friends, and one day he came over to my place with heroin,” she says. “He told me that it was a lot like Oxycodone, but better.”

Suzy recalls her first time smoking.

“It felt really, really good,” she says. “I became really relaxed and calm and nothing hurt. I wasn’t stressed, worried, upset, sad … any physical or emotional pain is completely gone and you feel really good. And then you just go to sleep. You nod off.”

Don Misch, MD of CU’s Wardenburg Health Center, says prescription painkillers are a potential step to abusing heroin.

“A doctor may prescribe 30 or 60 painkillers for something that requires only one or two, or none,” he says. “Across the country, prescription narcotics are the number-one abused prescription drugs.”

During her time as an addict, Suzy says she has been to six different heroin dealers in both the Boulder and Denver area. Tonight, she’s going to see Alex, an undocumented immigrant originally from Honduras. Although she only met him the night before, Suzy says they’ve become friends.

“[Selling drugs] is his only job, it’s what he does all day,” she says. “I feel like when you sell drugs, the people you sell to aren’t really your friends—they just want stuff from you. I think he’s kind of lonely, which is sad because he’s a genuinely nice kid. Some [dealers] are pretty sketchy, but he’s a really nice guy.”

The pickup

Suzy pulls into the parking lot of a Super 8 motel to meet her dealer. A smell of sulfur from the nearby refinery fills the night air as she walks with purpose to a rented room.

Inside, Alex sits comfortably on a bed, taking inventory of heroin and cocaine wrapped in small black balloons. A burning cigarette sits idle in an ash tray next to him.

After the transaction has been made, Suzy sits with him on the bed and prepares to test out the heroin, feeling the weight of the slightly sticky but tightly compact tar in her hands.

With a short, slender pipe wedged between her lips and a sheet of aluminum foil in one hand, Suzy places a piece of heroin on top and begins to light the bottom of the foil with her other hand. Almost immediately, the back of the foil turns a harsh black color. The heroin begins to bubble and slowly slides across the length of the foil. As it moves, thin white streams of smoke shoot up into the pipe and into Suzy’s lungs. It’s a technique often referred to as “chasing the dragon.”

As she stops burning the heroin, a brown streak can be seen across the length of the foil. Suzy will repeat this until a unique pattern of heroin residue fills the entire sheet.

As Alex packs a bowl of marijuana laced with cocaine, Suzy tells him about the drug market in Boulder.

“You should come up to Boulder with me sometime for the day,” she says to him. “You could make a lot of money.”

While Suzy has purchased an eighth of an ounce of heroin for $200 tonight, she tells Alex that he can sell an eighth for up to $300 in Boulder.

Alex agrees it’s something he’d like to do. As the two continue to get high, Suzy watches television while Alex sets up more drug runs, switching off between his iPhone and BlackBerry. His contacts read “Negro” by each name, signifying that the person is someone looking to buy black tar heroin.

Before she leaves, Suzy “shotguns” a hit of heroin to Alex, billowing white smoke passing from her mouth to his. Alex smiles and asks when he’ll see her again.

“Tomorrow,” she says simply.

Money down the drain

Back at her apartment in Boulder, Suzy sits on the couch as her boyfriend, Douglas, runs to the bathroom for this fifth time to vomit from his opiate use. Their friend, 21-year-old senior Jamie, takes a hit of heroin before passing it off.

Suzy’s apartment is relatively tidy, and it would be impossible to guess she is a heroin addict if not for the paraphernalia spread out across her coffee table, including a bottle of the anti-anxiety medication Xanax and more than 20 strips of Suboxone, a prescription medication that curbs cravings in heroin addicts going through withdrawal.

“Suboxone helps when we don’t have any heroin immediately on hand,” Suzy says.

Since starting her heroin use, Suzy’s grades have dropped.

“My whole day, before doing anything else, is centered around getting dope,” she says. “If it’s between going to class or meeting a dope dealer at a certain time, I’m going to meet my dealer. It literally controls your entire life and it doesn’t become fun anymore.”

As she struggles with balancing her schoolwork with her heroin addiction, she also worries about her finances.

“Ever since I could, I’ve worked and always saved my money,” she says. “I had seven grand and it was gone in three months. Everything I had been working for since I was 14, every babysitting gig, every job, every birthday check, every Christmas check from my family—I saved all of that, and then it was just gone.”

With the little money she has left, Suzy supports her heroin addiction by working a part-time job and occasionally receiving money from her parents.

While Suzy admits she feels bad for using her mother’s money to buy heroin, she says coming clean about her addiction would only make things worse.

“She can’t ever know,” she says.

Smoking vs. shooting

While Suzy and Douglas smoke up to an eighth of heroin between the two of them every day, Suzy vehemently rejects the idea of ever injecting heroin into her veins.

“Shooting it, once you do that, there’s no coming back,” she says. “You’re either going to die or spend the next 20 years of your life in and out of rehab. It’s a lot more dangerous than just smoking it.”

Misch, the Wardenburg physician, says users will often go from smoking heroin to shooting it because it reaches the brain faster.

“Taking heroin intravenously automatically puts it directly into your bloodstream and right to the brain,” he says. “It’s a means of getting a better high faster for users.”

Recently, CSU student Sean McGowan, an 18-year-old freshman, died after injecting black tar heroin.

Medford warns that although smoking heroin can cause fatal overdoses, injecting heroin intravenously can be a quicker way to deeper addiction or worse.

“You can certainly shoot up or smoke enough heroin to cause your central nervous system to shut down,” he says. “If that happens, you quit breathing—you go to sleep and never wake up.”

“Getting an infectious disease, like Hepatitis C or HIV, is a great risk when using needles,” he adds.

According to the Colorado Health Information Dataset, 50 people in Boulder were hospitalized for heroin, opiates and narcotics between 2008 and 2010. Of those 50, seven were college-age. In all of Colorado, 1,524 people were hospitalized during the same period for heroin, opiates and narcotics, with 87 of those hospitalizations being college-age.

Recently, The Daily Beast named the University of Colorado the No. 1 “Druggiest College in the US.”

“I know at least a dozen heroin users in Boulder,” Suzy says. “At least one of them regularly shoots up. It’s incredibly scary.”

The heroin hold

As she sets her second piece of half-charred foil on the coffee table, Suzy considers the impact heroin has had on her life the past 11 months.

Her old friends are now gone.

“I don’t know if I’d still be in the same situation with my old friends if I hadn’t started smoking,” she says. “Part of me thinks heroin might have something to do with it.”

At the mention of final exams, a moment of panic seems to strike.

“I don’t know if I have enough money to keep smoking through finals,” Suzy says. “I don’t know what I’m gonna do if I run out while I’m trying to study for that. I’m gonna be fucked, I’m gonna be so sick and I don’t know what I’m gonna do.”

She takes a hit of heroin from a red glass pipe.

“I know I’m addicted,” she admits. “I don’t plan on doing this forever. I would like to quit. I just know it’s gonna hurt. I’m afraid of hurting that bad because it’s terrible.”

Medford says there is hope for heroin addicts, but that each passing day puts them more in danger.

“It’s such an insidious addiction, it doesn’t go away,” he says. “I think it’s just important to come in and talk to someone that can help break that nasty cycle. It feels hopeless, like you can’t go on, but there is hope at the end of the day, and there are a lot of people that have dedicated themselves to helping people get their lives back.”

Students looking for help can contact Wardenburg Health Center, which has two doctors certified to treat opiate addiction, or they can call the Boulder Public Health Department at 303-441-1275.

Contact CU Independent Editor-in-Chief Sebastian Murdock at Sebastian.murdock@colorado.edu.