The year 22-year-old Emily Roznowski overdosed in a Starbucks parking lot across from the Harrisburg Mall, some 70,000 Americans succumbed to opioid addiction, including nearly 5,000 Pennsylvanians.
That was 2016. The nationwide crisis stealing thousands of people in their 20s, 30s and 40s had been branded an epidemic. But many of the families left behind now see the epidemic label was in name only.
Their hindsight comes four short years later, as America and the world are embroiled in the coronavirus pandemic.
The response this time has been massive: Entire countries and their economies have been shut down. Mountains of medical equipment have been mobilized and moved. First-responders and healthcare workers are rightly hailed as heroes. And victims and families are drawing support, too, with nurses and doctors lining up in applause as COVID-19 survivors are discharged.
While not diminishing the severity of the coronavirus in any way, families still suffering the long legacy of loss from opioids say it’s hard not to feel a little epidemic envy.
“I think there is a little bit of that,” said Joanne Clough, Emily’s mom and a family law attorney now working with many of those whose lives have been forever altered by opioids.
“Some people are posting, ‘this is terrible that people are dying of this (coronavirus), but wouldn’t it be nice if people reacted this way to the opioid epidemic?’” Clough said of the rising resentment within opioid support circles.
“Some people feel like their kids just didn’t matter,” Clough continued. “You look at how many people died. The year Emily died, almost 5,000 people died in Pennsylvania and 70,000 in the country that year. And that’s every year for several years. It’s just incredible.”
In addition to this perceived epidemic double-standard, there are grandparents, like Clough, who’ve been thrust into parenting roles for young children left behind by addicts. Now, they’re deathly afraid of contracting COVID-19.
The virus has been proven most dangerous to older people with pre-existing conditions. Of the more than 3,000 Pennsylvanians who have died, the vast majority had at least one other condition, such as heart disease or diabetes, Health Secretary Dr. Rachel Levine told lawmakers this week.
At 63, a heart-attack survivor and with lungs scarred from multiple bouts with pneumonia, Clough says she fits the virus’ prime target to a T.
So do the primary parents in many other opioid-altered families.
“A lot of the grandparents are really worried when things open up again and the kids go back to school and daycare, that they will bring home the coronavirus,” Clough said. “They’re going to bring it back home to us -- and I’m high risk.”
These are just some of the ways the Hampden Township attorney said her professional and private life continues to be utterly upended by her most personal experience with the opioid epidemic.
Clough now focuses much of her time advocating for addicts and supporting the families.
For Clough, the battle began May 6, 2013. That afternoon, Emily, having been banished from the family home for “bizarre behavior” at age 18, phoned her mother and asked to meet at a public park.
There, Emily made a tearful confession.
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“She told me she couldn’t stop,” Clough recounted Emily as saying. “She said, ‘Mommy, Mommy, I’m so sorry. I’ve tried and tried, and I just can’t stop. I need help. I need help’.”
With that, Clough received what she calls her one-way ticket to ride the "heroin roller-coaster.”
Ever since, she’s been unable to get off.
The 4-year-old girl bouncing off the walls of Clough’s home as both the attorney and her younger daughter, Diane Roznowski, attempt to work from home is proof.
“I always tell people, we got on a heroin roller-coaster ride and we didn’t buy a ticket,” Clough said. “It was horrible, absolutely horrible. The ups and downs. The constant worry of whether she was going to be alive or dead. It’s the worst state of chaos to live in.”
WATCH: Opioid epidemic’s tragic legacy
Baby Carter was supposed to be Emily’s saving grace.
Emily was at the height of her addiction – shooting 24 stamp bags of heroin a day – when she learned she was more than 5 months pregnant in 2015. At first, Emily was terrified about what her continuing opioid abuse would mean for her baby.
Then, the thought of another life growing inside her provided a new lease on her own.
Emily went on a methadone program. Clough said she later learned Emily was still shooting up. But at around 7 months into her pregnancy, Emily stopped -- cold.
There was another complication, however.
Emily was diagnosed with placenta accrete. Part of the baby’s placenta was attached to Emily’s uterine wall. The mother-to-be was at mortal risk for massive bleeding during labor and delivery.
It’s among the reasons most in-patient rehabs wouldn’t touch Emily during her pregnancy. One that would was in a neighboring state that could have taken custody of Emily’s baby due to her ongoing methadone maintenance, Clough said.
The family would go it alone.
Amid the joy of Emily’s baby shower, she began bleeding. First a little, then profusely.
It was a month before her due date, but the already-compromised placenta had ruptured.
The baby was coming. The questions now were whether mother and baby would survive the birth? And if so, would the newborn enter the world addicted to opioids?
Emily underwent an emergency C-section on February 27, 2016. Her daughter, Carter Harrison Gens, was born premature. But she was free of any signs of opioid withdrawal.
In fact, this little girl was strong, right from her early start on life.
“They were really lucky that they both survived,” Clough said. “Carter was doing great. She was happy, healthy -- not fussy at all. There were other babies going through withdrawal. It was very sad to hear those babies squeal and cry.”
Carter wasn’t just premature; she was impatient.
She routinely ripped off her diapers in the preemie unit. She plucked out her feeding tube, determined to eat on her own. The precocious premie lasted all of six days in the hospital neonatal unit before being discharged on the seventh day.
The extended family spanning three generation were now under one roof in Clough’s Hampden Township home. But make no mistake, Emily was the mommy.
“I was really worried about her being a mom,” Clough confessed.
There was no need.
Emily appeared to transform overnight. A light went on. Suddenly the whole world seemed different. Now it revolved around a premature baby born during the height of heroin addiction. Yet, her darling daughter had been delivered safe, sound and totally healthy.
It all had the feel of a second chance.
That’s the way it went for months. Emily stayed clean with the help of low-dose methadone maintenance. She breastfed Carter at all hours. And just weeks after the birth, Emily returned to her waitressing job at the Arooga’s on Second Street in Harrisburg, working evenings and nights.
Slowly, however, Emily’s dormant but not defeated addiction exacted its toll.
“She was exhausted,” Clough recalled. “She was nursing every two or three hours. At four weeks, she started working again.”
There were bad days, and Emily confessed she simply didn’t feel right anymore.
“She would say, ‘Mommy, I just don’t feel normal. I’m not happy anymore. I mean, I love Carter and you, but I just don’t feel normal’,” Clough recounted. “A couple of nice guys asked her out, and she said ‘no, I don’t belong with anyone normal’.”
In hindsight, Clough now recognizes all the tell-tale symptoms of “opioid brain.” The addiction alters the brain’s dopamine response, making life after heroin seem zombie-like. The lows are lower than ever. And the highs are never nearly as lofty, Clough said.
“She said, ‘I’m doing everything right and I just don’t feel the happiness’,” Clough said. “She said, ‘I just don’t feel like I belong anywhere.’ It was sad.”
Added sister, Diane: “For four years, she had been numbing all of her bad feelings out of herself.”
Now, runaway negative thoughts were crashing down all around Emily.
She was in trouble.
“We didn’t know,” Clough said. “The biggest regret I have is, I wish Emily, Diane and I knew more before Emily died about the whole dopamine thing and how heroin chemically alters the way your brain works. Maybe if she understood that, it would’ve helped her a little bit.”
Instead, nearly a year after Emily first learned of her surprise pregnancy, Diane found a used syringe in the house.
Clough didn’t hesitate. The family law attorney phoned child protective services. She wanted Emily kept away from now 8-month old Carter.
Late that night, as Emily returned home from working at Arooga’s, she was blindsided by the turn-about.
“She came home from work and said, ‘what do you mean you’re not letting me touch my baby?’” Diane recounted. “We said, ‘well how can we trust you right now?’”
It was enough to convince Emily to sign herself in at in-patient treatment. But because she had relapsed just that once, Emily didn’t go through withdrawal, Clough said.
She was out in a week. What’s more, Emily was determined to get off methadone, altogether, although this was considered premature, too.
Emily touted it as a success story.
So much so, she was talking excitedly with her mom about both of them taking their story of addiction to others -- most especially high school students. Someone shot a video during one of Emily’s early speeches. She also appeared on a podcast about opioid addiction for the Hillary Clinton presidential campaign, for which Diane was a staffer.
It was supposed to be just the beginning.
“She said, ‘Mommy when I get myself together a little better with Carter, I want us to go around and maybe talk to high schools — me from my perspective and you as the mom — cause what I was always told about drugs is not what happened to me’,” Clough said. “She said, ‘I think if people knew, maybe we could stop one person. If one person who was pregnant didn’t go through what I went through and got help -- it would be worth it’.”
Mother and daughter would never get the chance to appear together to talk in public about their heroin roller-coaster.
Within weeks, Emily was dead.
On Dec. 3, 2016, Emily failed to show up for her shift at Arooga’s, despite having left the house early that day.
She was missing for 15 agonizing hours. Then, her car was found in the Starbucks parking lot in Swatara Township.
Emily was inside, along with stamp bags of what turned out to be almost pure fentanyl.
Clough insisted upon seeing her daughter at the Dauphin County morgue.
“They don’t let you see the people, but I made them let me see Emily,” she said. “She had her little Arooga’s referee shirt on. She was all ready to go to work. She just didn’t make it.”
Emily’s autopsy revealed the only toxins in her system to be caffeine, nicotine and the nearly pure, ultimately fatal, fentanyl.
“The pack she got was a death pack,” Clough said. “100% pure.”
Clough said evidence of who sold Emily the fentanyl was on her daughter’s cellphone. Alas, police were never able to make a drug delivery death case against the suspected dealer. Clough said word of Emily’s overdose leaked on social media, and the suspected dealer didn’t take the bait when police attempted a controlled buy that might have linked his product to Emily’s death.
In a small triumph, Clough said she was eventually able to put a detective in touch with one of Emily’s old high school friends. A recovering heroin user himself, the friend agreed to make a buy from the same dealer months later. This culminated in the dealer’s arrest and conviction, with counts for possession and selling netting him months in prison.
But Clough said the dealer continued to deny any link to Emily’s death, and no connection was ever proven.
In other words, it was nothing close to closure.
Instead, Clough said she’s left with the cruel but necessary lesson that the battle against opioid addiction never ends.
“We had a great Thanksgiving and we were looking forward to Christmas,” Clough said of the time surrounding Emily’s death. “She did have a cold that day. And she was quarreling with Carter’s father. She was having a bad day. She figured she’d buy it on her way to work.”
It’s all it takes.
“The most insidious thing about this is, it can take you out anytime,” Clough said. “There’s no amount of clean time that makes you safe. You have to work the rest of your life to not die from this. It’s a terminal disease that you have to keep working every day to stay alive from. Otherwise, you either end up dead or in jail.”
In other words: No finish lines. No success stories. Only the fight. The constant battle, the forever roller-coaster.
“The saddest thing for us is we got her back that last year,” Clough said. “We really thought she was going to make it.”
Such are the embers of the opioid epidemic that still smolder, even as the fires of another epidemic now rage.
Worse yet, all the carnage caused by the coronavirus – the unemployment, dislocation, isolation and social disruption – present grave threats to recovering addicts far beyond the virus, itself, Clough warned.
She described the dictates of social distancing as severing support systems for many: 12-step meetings upended or ended. In-patient treatment and group therapy delayed or disrupted.
Clough worries the anxiety and hardships caused by coronavirus lockdowns could push more people into depression -- and ultimately -- onto opioids. She’s sounding the alarm about a second wave of death from a coronavirus-caused resurgence of the opioid epidemic.
In fact, all of what’s happening now is fuel for new addiction and relapse, she said.
“This pandemic has played havoc with the lifelines for many addicts,” Clough concluded.
It’s why both she and her daughter soldier on.
Clough provides legal services and advocates for addicts and their families. Diane works for the Washington, D.C., nonprofit Generations United, home to the National Center of Grand Families. These are grandparents, like Clough, and other close relatives now raising children. Many as a direct result of the opioid epidemic.
“It’s completely changed Diane’s focus on what she does,” Clough said of the family’s ongoing battle with opioid addiction. “It’s changed a lot of what I do. I’ve helped a lot of grandparents in our situation. And that includes relatives of those who are active addicts and those who have passed away.”
For Clough, it means securing the best possible custody arrangements for the most innocent of all opioid victims – the children. An entire generation left behind.
They’re the living legacy of the opioid epidemic.
For Clough, it’s embodied by Carter.
It’s why she wills herself to keep up with the feisty 4-year-old, now trapped at home due to the coronavirus. Carter has taken to calling her grandmother “Mommy." But Clough says she has nothing in common with all the other younger parents.
Nothing except the unconditional love she has for Carter.
“I had single-handedly raised two daughters,” Clough said. “When Emily died, she was 22 and Diane was 20. I sole-parented them since they were 4 and 5. I was done with that phase of my life. Emily dies, and now I’m raising a 9-month-old all by myself. I would fight to the death to take care of Carter, but it’s not what I ever thought my life would be.”
But where Clough never had the opportunity to partner with Emily to publicly fight opioids, Carter has joined her in public service videos, including one made by Sen. Bob Casey’s office. For her part, Clough has lost count of all her many speeches, association memberships, committee meetings and appearances – all aspects of her ongoing advocacy.
“Once I started speaking, I just started speaking more and more and more,” she said. “I’ve done a lot of advocating. When I start making a list of all the things I’ve done, it’s way more than I ever thought. We do what we can, wherever we can, and try to remove the stigma from it.”
But the victim-blaming and family-shaming go on, she said. This public perception prevents opioid addiction from being treated as a true health crisis and an actual epidemic.
The result is more lives lost.
“Emily wasn’t the first kid from her class to die from our high school,” Diane said of the seeming suburban utopia of their alma mater, Cumberland Valley School District. “Now, she’s probably the seventh or eighth -- maybe more. Like, it’s happening. By ignoring it, we’re not going to fix it.”
Despite all the talk of opioids and addiction that takes place around Carter on a daily basis, the inquisitive little girl has yet to ask the biggest question of all – how her “Mommy Emily” died.
Clough knows it’s coming. She’s bracing for it. And she won’t shy away.
“I don’t believe in lying at all,” she said. “I don’t believe in covering it up at all. When she does ask, I will try to respond in an age-appropriate way.”
Most of all, Clough said she’ll be guided by her late daughter’s good advice, given when the two were discussing plans to fight opioid addiction together.
“Emily always used to say, ‘this addiction thrives in the darkness and only dies in the light’,” Clough said. “I firmly believe that.”
Emily’s there in other ways, too.
Before Clough took the podium to deliver one of her many speeches on the subject, they played a video clip of Emily. She’d been recorded speaking just weeks before she died. There was real optimism in her eyes, long left vacant and hollow by heroin. If only for a moment, Emily had won.
It came to Clough then: A mother and daughter could still do this together.
“I don’t talk to Emily’s spirit very much, but I did say to her, ‘we always wanted to do it together, and today we did’,” Clough recounted.
Now Emily’s video is a constant part of Clough’s presentations.
“It’s not the way we wanted to do it, but I do use that clip a lot when I speak. We are able to do it together,” she said.
WATCH: Emily’s video legacy
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