DES MOINES, Iowa -- Marlene Groves learned about the devastating consequences of drug addiction at an early age.
"I grew up with a mother that was addicted to drugs, so I was removed from her," she says.
She vowed she would never do drugs. Then, at the age of 22, she got into a car accident.
"They gave me a shot of morphine and Fentanyl. That was the first time I’d ever had that drug."
Then doctors gave her Percocet and Vicodin for the pain. Like so many others, that was the beginning of Grove's addiction to prescription painkillers.
"Then they just cut me off, and by that time my body had become dependent on it."
The brain produces dopamine naturally. It regulates things like movement, emotion, and feelings of pleasure. Opioids flood the brain's reward system with dopamine, which blocks pain, and in excess produces a euphoric effect. The brain takes note, leading to a learned behavior, or dependency.
"Prolonged exposure can result in the body actually changing, expecting that chemical to be there," says Kevin Gabbert, the State Opioid Treatment Authority.
Those changes can result in permanent brain damage, and when the opioid is taken away, the body goes through withdrawal.
"It’s an extremely uncomfortable situation that lasts for several days, if not weeks at a time," says Gabbert.
"My body just kind of went haywire. I wasn’t able to sleep, I started having the sweats, restless legs syndrome, and I had to get more. The only way to feel better was to get more," says Groves, who is still haunted by guilt.
"I have a lot of guilt," says Groves. "I just don't understand why, why I couldn't quit?"
The guilt stems in large part from her inability to parent while addicted to painkillers. She hasn't seen her now 15-year-old son in six years and lost her parental rights to another child. She tried to quit cold turkey. She put herself in detox, but when she got out she started using again, putting everyone around her at risk.
"I’d fall asleep at the wheel. I’d nod off driving with my son. I got into car accidents. My son was not safe in my care."
Groves shop-lifted, doctor shopped, and stole from her relatives to get painkillers.
"I was arrested for using my sister’s name at Broadlawns, because I was flagged. Every hospital knew I was a med seeker. So, I used her name and she charged me with identity theft," she says.
Sitting in the Polk County Jail, Groves started taking stock of her life.
"I was sober now. I was like, ‘What am I doing?' This is not the life that I’d intended for myself."
When she got out of jail, Groves sought treatment at a clinic that dispenses methadone, one of three medications typically used to treat opioid withdrawal.
Doctor Frank Filippelli is the Medical Director at United Community Services, one of two methadone clinics in Des Moines.
"I started six years ago. We had about 250 clients. Now we’re up to almost 800 clients."
Filippelli says his patients, on average, start using opioids at 13 or 14 years of age.
"It’s getting it out of their parents' prescription bottles or sharing it with other students at school," he says.
Painkillers like Oxycontin can go for up to $80 a pill on the streets. When pills become too expensive, people turn to other sources, typically heroin.
"Heroin can be as cheap as $10 a day," says Gabbert. "And heroin provides them with a euphoria or a rush that, in many cases, is much more powerful in the effects they're looking for."
That has also led to an increase in heroin overdoses. According to the National Institutes of Health, the number of heroin overdose deaths has more than doubled since 2002. In Iowa, the number of deaths has jumped from two in 2005 to 15 in 2016.
Kicking an opioid addiction often takes years. Some estimate the relapse rate is 80% to 85%. But the odds of recovery jump to 85% when treatment includes a combination of medication--like methadone--and counseling.
"That's what makes this job worthwhile," says Filippelli. "When you see the wonderful success stories from people who are successful at doing this. It is possible to do that, but you have to want it."
Groves wanted it, for herself and the three children she's had since saying goodbye to two others.
"I just wanted a better life. I want to give my children what I didn't have."