Kyle Wirtz

Kyle Wirtz shared his story - then one of redemption - of overcoming his heroin addiction in October at a town hall in Solon. That story turned to tragedy Tuesday, after Wirtz, 25, was found dead of an apparent overdose in an East Side apartment. His death shines a light on the complications of managing heroin addiction long-term.

(Cory Shaffer, Northeast Ohio Media Group)

CLEVELAND, Ohio -- Kyle Wirtz had plenty of reason to celebrate Jan. 19.

For one, the man who had overdosed on heroin six times in his life had lived to see his 25th birthday. A bigger milestone that brought him and his family together that day, though: Wirtz had hit the one-year sobriety mark.

But less than a month later, Wirtz would lose his last breath to Cuyahoga County's most dangerous drug in a first-floor apartment on a dead-end street, 1.2 miles from the clinic that got him sober.

Police found Wirtz about 1:15 p.m. Tuesday in the 7700 block of Jeffries Avenue, dead of an apparent heroin overdose, his family said. The Cuyahoga County Medical Examiner's Office has not officially ruled on his death.

Wirtz's plunge into addiction, rise into recovery, fall into relapse and slip into death follow a sickeningly familiar path for those who know heroin's power, and it raises questions about the availability and complications of long-term addiction treatment.

"This drug will chase you for the rest of your life," said Rob Brandt, whose 20-year-old son Robby died of a heroin overdose in 2011, under circumstances that nearly mirror Wirtz's addiction and death. "It is patient. It is resilient. It will whisper in your ear and wait for that one moment when it is able to reclaim what it wants most - your soul."

"I was a monster"

Brandt met Wirtz and his family, who did not wish to comment for this story, in October at a town hall forum on suburban heroin abuse in Solon. There, Wirtz first shared his story of redemption.

Wirtz, a well-spoken, clean cut man with a youthful face and strong frame, grew up in Garfield Heights. He said his addiction began in high school.

"I wasn't that bad of a kid. I simply got caught up in a group of friends," Wirtz said.

What started as drinking at parties gradually progressed as he and his friends sought a stronger high. The alcohol was traded for marijuana. The marijuana was traded for prescription pills.

"Then we went from Oxycontin to heroin, and my life went down from there," Wirtz said.

But Wirtz had no idea how far down his life would go.

He went through two separate stints of homelessness. He watched 20 friends fatally overdose and went through six overdoses of his own – one of which left him with permanent brain damage. He served time in prison on forgery and receiving stolen property in 2010. He stole from his own grandmother, and gutted his family's home of copper to score drug money.

"I was a monster. That's where heroin will take you," Wirtz said. "I took anything and everything, and I hurt anyone and anybody in my path."

Nowhere to go but up

Wirtz found his rock bottom after he burglarized a home in Garfield Heights in October 2012. He wasn't caught at the time, but decided on his own that he had nowhere to go but up.

He checked himself into an intensive, months-long in-patient program at the Absolute House - just down the street from where he grew up - in January, and was several months into the program when his past caught up with him.

Police arrested Wirtz in April for the burglary, according to Cuyahoga County Court records.

His defense attorney in the case, David Kraus, got close to Wirtz during the trial.

"He was a very personable young man with a wealth of potential in him," Kraus said. "Everybody could see that in him."

His case went before Judge Michael Astrab, who was so blown away by Wirtz's story during his sentencing hearing that he invited him to the Solon town hall after giving him 18 months' probation.

"Kyle was honest and brave in coming forward to help others fight their demons," Astrab said. "He will be missed."

Death raises questions

A few weeks after his birthday, Wirtz's story went from one of inspiration and redemption to one of tragedy and warning.

His death raises questions about the availability and complications of long-term treatment programs to a disease that research shows is at its deadliest after a period of sobriety.

William Denihan, chief executive officer at Alcohol, Drug Addiction and Mental Health Services (ADAMHS) Board of Cuyahoga County, said many of the county's overdoses involve patients who relapse after having cleaned up through jail or detox programs and lost their tolerance for the drug.

"Heroin is a killer," Denihan said. "When people go back to it, they go back to the same level as when they stopped, and that's a recipe for death."

In a 1998 study published in Science Magazine, forensic scientists at the University of Verona, Italy and the University of Alabama-Birmingham examined morphine levels in hair follicles of 37 overdose victims, 37 current users and 37 former users who had been clean for several months.

The results showed morphine levels in victims' hair were on average five times lower than in current users. Researchers estimate the average victim had used little to no heroin in about four months before they died.

That fact is not lost on county officials: After a patient completes a detox program, whether court-ordered or voluntary, they're released with a letter warning them that if they relapse and take the same dose of heroin they did before their sobriety, "they will die," Denihan said.

System needs "a complete overhaul"

Christina Delos Reyes, program director of addiction psychiatry at University Hospitals Case Medical Center, said stories like Wirtz's will persist until drug addiction treatment is completely overhauled.

Delos Reyes said addiction is treated almost as an acute illness, like pneumonia. The patient is admitted for a period until they are "healed," and then released as if cured.

"What we do in addiction treatment now is treat you and discharge you and treat you and discharge you, so every time you need help again, you basically have to start over from scratch," Delos Reyes said.

And each time a patient "starts over," that means waiting two weeks before a detox bed can free up in what Denihan described as the county's "grossly underfunded" detox program.

"If I showed up in the emergency room with a broken arm, I would never be told 'sorry, but it will take two weeks to treat you,'" Denihan said. "The capacity for assessment, detoxification, medical-assisted treatment and bed days is not there right now. We're working to relieve it, but we're not moving fast enough.

"It's now becoming apparent that we've got to do something about it. We have to let the legislators and the funders know that people are dying and we have waiting periods for them to get services," Denihan said.

Once fully implemented, the Affordable Care Act will mandate insurance plans and Medicaid to cover at least basic addiction treatment services, including risk assessment screenings and intensive outpatient programs, Delos Reyes said.

"It's a huge game changer," she said. "I think it will change the way that we do medicine."

Comprehensive approach

Managing heroin addiction is not like managing addiction to other drugs, Denihan said.

"For people with heroin, it is an extraordinary addiction to conquer," he said. "It takes a much longer period of time than other addictions we have."

That's why he and Delos Reyes both advocate for a comprehensive approach to managing addiction that includes attending 12-step programs and establishing out-patient treatment programs that monitor recovering addicts' progress on a regular basis.

Denihan said an important part of a patient's long-term recovery is removing themselves from the environment in which the addiction was fed.

"Many people even have to change where they were living," Denihan said. "They have to develop a completely new lifestyle."

Part of that new lifestyle includes managing the addiction with drugs like Naltrexone, which prevents the euphoric feeling after taking an opiate, or Suboxone and Methodone, which contain a small dose of opiates that can calm a craving and ward off withdrawal symptoms.

Critics of the drugs say they can be as addictive as heroin and are often abused and illegally sold. Legislators, fearing a blow back from unintended consequences of widespread use, have been reluctant to loosen regulations around the drug, making them difficult to attain for uninsured patients, Delos Reyes said.

That reluctance stands in contrast to the explosion of prescription opiates in the 1990s - opiates including Oxycontin, which Wirtz said was his precursor to the drug that eventually took his life.



"That is the grand irony," Delos Reyes said.

For more information on treatment options, visit ADAMHS website or call their 24/7 addiction hotline at 216-623-6888.

