DAYTON, Ohio—Montgomery County, in southwest Ohio, was ground zero in the United States’ opioid crisis that reached a peak in 2017.
That year, almost 50,000 people overdosed on opioid-related drugs nationwide, and Montgomery was one of the counties that suffered the highest number of overdoses. The jail was packed with drug addicts, many of whom also had underlying mental health issues.
The sheriff’s department needed to find a way to stop the revolving door of arrest, release, arrest, release.
That help came in the form of Scotty Mays and Kristen LaCaze, both former addicts and inmates. LaCaze was in and out of the jail 14 times while addicted to heroin, including a one-year stretch and two six-month stints.
The hope was that the inmates would talk more openly with peers, people who have been where they are.
In April 2018, Mays and LaCaze started providing peer support to inmates who were seeking addiction treatment. At the same time, the jail started offering medication-assisted treatment such as Vivitrol and Suboxone, which both help to control opioid cravings and assist addicts through the detox process.
Sitting in jail is “a strong motivator” to want to change your life, Mays said.
Mays and LaCaze each made a video of their stories, which are broadcast every morning at 9 a.m. in the respective male and female housing units in Montgomery County jail.
Often, after seeing their faces and connecting with their stories, male inmates will request a one-on-one meeting with Mays, while females request LaCaze.
Mays said he gets about 20 requests a week from inmates, but once others see him talking, they get curious and he expands his reach. They both connect with an average of 100 inmates a month.
“A lot of people request us now because they know that Scotty and I have both been addicted and we’re in recovery—and we’re not cops so we’re easier to talk to, from their standpoint,” LaCaze said.
Often, the issues on the women’s side are more complex. “A lot of the females have been victims of human trafficking and some of them are pregnant from a rape or from being trafficked,” she said.
“I can’t think of where more help is needed than inside those walls,” Mays said. “And to talk with a bunch of men, a bunch of manly men, who don’t want to talk about their feelings—to get them to talk about their feelings, that’s pretty amazing, you know?
“I’m primarily there to listen. … [These] are people who don’t have anywhere else to turn. A lot of family and friends have turned their backs on them—rightfully so. They’ve had to distance themselves … just because of the chaos that was created from the substance abuse and mental health disorders that go hand in hand.”
He lets inmates know that he’s not there to judge, but to help bridge the gap to wherever they want to seek treatment.
“I don’t force them to go to any treatment program. They tell me what they want to do, and I collaborate with the discharge planner, and we set a plan in place. Now, obviously it’s going to be up to the courts on what’s going to happen. But most of the time it’s successful navigating them into treatment,” he said.
Aside from medication-assisted treatments, treatment options vary from inpatient rehab centers to community meetings and sober-living homes. Depending on the outcome of their court cases, inmates can often substitute jail time for inpatient treatment programs.
Mays describes his former self as an “all-aholic.” “Whatever drugs there were, I was going to do them. Not only was I a drug addict, but I was a serious alcoholic,” he said.
Mays started young, regularly drinking alcohol by age 13 and progressively getting worse over time.
A knee surgery in 2001 got him hooked on prescription opiates, then hard narcotics. Around 80 percent of all heroin addicts start their habit through prescription painkillers.
Mays thought drugs and alcohol would help him “fit in” somewhere in society—something he’d sought from a young age.
“See, the drugs and alcohol don’t discriminate. They don’t care who I am. They’ll love me for who I am,” he said.
“But what the drugs and alcohol don’t care about, is the fact that they will kill you and they don’t have no problem with that.”
Mays ended up in the jail in 2012 for drunk and disorderly conduct. That was a “spiritual awakening,” he said. He decided to never drink again—and stuck to it. But the drug use continued.
“But those drugs destroyed my life just as much as that alcohol did. And I don’t want to get it confused—alcohol is a drug. A drug is a drug is a drug. But the opiates and the crack cocaine, all that stuff, it caused us to lose our house,” he said.
Mays, his wife, and their two children moved into a bedroom at a friend’s house in West Carrollton in 2014, where they lived for the next 18 months. His children left home as soon as they turned 18.
“I don’t blame them. You could see in their eyes that they were counting down the days to where they didn’t have to live with us anymore—that’s how toxic that environment was,” he said.
“And then late 2015, the fentanyl slowly started to creep in here.”
Fentanyl is a powerful synthetic opioid that is 50 times more potent than heroin and 100 times more potent than morphine. By mid-2017, fentanyl was more prevalent than heroin on the streets of Dayton, and the sheriff’s deputies were responding to an average of 10 overdoses a night.
“I lost a really good friend to a fentanyl overdose—and I should have been with him because he had called and wanted me to come over and party with them. I told him no. And they found him dead the next day,” he said.
A couple of weeks later, at the beginning of 2016, Mays said he was at a local park with an extension cord around his neck, ready to hang himself. Then his phone rang.
“It was a guy I hadn’t talked to in months and he said, ‘I don’t know why I’m calling you, but I wanted to see if you wanted to go to church with me,’” he said.
“I knew that there was a power greater than myself that was intervening at that moment. So I told him to come and pick me up, and I remember sitting in that church and I cried like a baby that whole hour.”
A few days later, Mays reached out for help at a community meeting run by Capt. Mike Brem from the sheriff’s office. Brem put Mays in touch with Lori Erion, the founder of Families of Addicts, who helped connect him with resources and got him involved in volunteer work.
“Between that phone call that I got from my buddy to go to church, the [captain], and Lori, those three people played a huge part in saving my life, and I’m forever in debt to all of them,” Mays said.
But he had no insurance and couldn’t find a treatment center that would take him. Frustration set in with another rejection and Mays started driving to a known drug area to get high.
He was halfway there when he got a phone call saying Recovery Works was ready to assess him and help with insurance for treatment.
“So I turned around, went back there, and had the Vivitrol injection, started treatment there, and literally my life hasn’t been the same since,” Mays said. He hasn’t taken a drug since Jan. 13, 2016.
“I definitely have another relapse in me. But I seriously doubt that I have another recovery in me,” he said. “I’m not going to lie. I loved doing drugs. I loved getting a high. It was the consequences that sucked. And there’s always going to be consequences. You can’t avoid it.”
It’s perhaps that part of Mays that the inmates connect with—a raw vulnerability that lies within them all.
Mays is still in recovery himself. It’s not a process that just ends at a certain point. “Think about going up a down escalator. So as you’re going up [the escalator], you have to keep moving, right? But as soon as you stop, you start going backwards. And that’s how I kind of look at my recovery. I’m walking up a down escalator right now.”
He’s passionate about helping people and knows that it only takes one person in your corner to provide the strength to stay clean. He makes sure the inmates know he’s there for them once they leave the jail.
“I’ll give them my card and I’m like, ‘Look, this isn’t a one-time thing. Even once you get out of here, let me be an extension of your accountability, reach out to me. This is how this works. We support each other,’” he said.
And the success rate is greater than the relapse rate—a statistic Montgomery County sorely needs.
“Even if they come back in, I still encourage them. There’s an element of success because you reached back out to get help,” Mays said.
Helping others is a way for Mays to help himself, too.
“When I see somebody struggling, I remember when I first was trying to get clean, I burned all my bridges. I didn’t have a whole lot of support, I had to build that network,” he said.
“But there’s a sense of security that comes with helping others and working with other people. Knowing that today I don’t have to pick up.” That daily habit of going to get drugs is replaced with the habit of going to help people who are relying on him.
Peer support is more than just helping someone with an addiction and mental health issues, he said. “Sometimes people just need somebody to listen to them. Sometimes they just need somebody to talk to, to where it doesn’t feel like you’re inconveniencing them. And that’s what I love about what I do.”
As for his own bridges, he has repaired his relationships with his children and says those relationships are stronger than ever. His five grandchildren also keep him busy.
“Am I going to stay sober forever? I have no idea. I don’t know. I know I am today. And that’s the only way I can look at that,” he said.
Bringing Ex-Addicts Into Jail
The jail’s treatment coordinator, Teresa Russell, was hired at the end of June 2017, primarily in response to the opioid crisis.
Russell said she acts as the “air traffic controller” for all the health service contracts with the jail, but most of her time is spent finding drug treatment centers for inmates.
She was the brains behind the peer support program that brought in Mays and LaCaze, and the success has exceeded her expectations.
She said other jails are often hesitant to bring in people with criminal backgrounds or with histories of addiction. There are fears they’d bring in contraband, or fears that they’d be responsible for putting someone in a situation that instigates a relapse.
When asked how she got past those fears here, she said “faith.”
“We just vetted the right people to bring it inside the jail. Their histories, their stories, their passion, and what they did.”
She said Mays is so good at what he does that the Ohio Department of Mental Health and Addiction Services pays him to teach others how to become an effective peer supporter.
LaCaze, who is now 28, thought her life was over when she became pregnant at 17. Still in high school and with a history of depression and anxiety, she struggled to cope with the enormous responsibilities she now faced, while her friends were buying prom dresses.
One day, after she’d had her baby, LaCaze tried snorting the painkiller Vicodin with a friend. “It was amazing. That’s when I realized, ‘Wow, I don’t have to be miserable every day. I can be happy,’” she said.
It only took two years for LaCaze to transition from Vicodin to heroin. Montgomery County started shutting down the “pill mills,” where doctors were dispensing opioid-based painkillers for anything and everything. Like LaCaze, those who were already addicted eventually turned to heroin because it was cheaper and more accessible.
“I lost my nursing assistant license when I moved to heroin. I lost my car. I lost everything. And it’s like you see everything dwindling away, but you still can’t stop. Just for fear of the physical withdrawal—it’s so severe,” she said. Her mom looked after her son.
She was charged with her first felony at 20. Unbeknownst to her, she’d racked up four—two for trafficking and two for possession, and she was hit with them all at once.
She was in and out of jail for years because she was still using drugs while on probation. She was also in and out of treatment centers, both inpatient and outpatient.
“But it still wasn’t successful until they started addressing the actual mental health issue, because that’s what kept me going back, even despite the negative consequences,” she said. “When we were able to finally address my depression and my anxiety and the trauma that came with using heroin—like having to sell your body and be a prostitute—[that] was when I was able to start to become better.”
But she had to hit rock bottom first.
In July 2015, LaCaze took a mix of heroin and cocaine and ended up in a coma, on life support, for two weeks.
“That really made me think, ‘OK, I’ve already lost my house, I’ve already lost my car, my mom’s taking care of my child, but now I’m going to lose my life,’” she said.
She went to an inpatient rehab and also started medication-assisted treatment.
“I still struggled to stay clean, but I didn’t relapse,” she said. “It was a nine-year process, four felonies, and two years of incarceration later.”
In April, LaCaze moved out of her parents’ home into a place with her son, who is now 10. After repairing relationships with her siblings, she is now allowed to see her nieces and nephews again. When she was using drugs, her parents were scared to let her into their house in case she’d steal their credit card again, or their car.
Looking back, she said the difference in her life now is dramatic.
“I don’t wake up sick in the morning anymore. I don’t have to go have sex with men to take care of my habit. I have my child, I have a car, I have a home, I go to school, and I don’t have people calling me asking me to go do crazy things with them anymore,” she said.
LaCaze is inspired by her job at the jail, both by the program itself and by the women she helps.
“I couldn’t get myself clean, but now I’m even able to help other people get clean,” she said. She sees herself in all of the women in one way or another, and it helps remind her where she doesn’t want to fall back to.
She said so many of the women tell her later that she helped them at their worst time. “When they’re in their cell and they’re throwing up and they’re dope sick, and now they’re out and they have their kids and they’re working. Just to know that I even helped a little bit in that change makes me want to keep doing it forever,” she said.
LaCaze is juggling the peer support program in the jail with college and internships, but she’s thriving on the challenges.
“I just wasted so much time. And everybody I went to school with, now they’re doctors and married with kids and I’m like, ‘I have to catch up.’ I don’t think I really will, but I want to get further. I don’t know when I’m going to stop though,” she said.
“I’d say within the last year I’ve been really happy. Because I found that I’m making a difference. I’ve found that people look up to me and they aren’t like, ‘Oh, here comes Kristen, hide your purse.’”
SAMHSA National Helpline
Montgomery County Drug Free Coalition