Fentanyl Part 3: The Addict

“Every addiction starts with pain and ends with pain.” – Eckhart Tolle

Cheryl Leggio’s Old Goodwood home is tucked between Jefferson Highway and Goodwood Boulevard on a quiet street lined with manicured lawns and the occasional hum of lawn mowers and weed eaters.

I met her on a Thursday afternoon in August. She greeted me with a hug and once inside, she handed me her son’s Memorial card. It was the size of bookmark and it read: “In Loving Memory of Ryan Spencer Leggio, 01.06.1993 – 06.25.2022. Forever in our hearts.”

There is a picture of Ryan at the top, with his hat turned backwards, a small smile on his face and soulful brown eyes turned toward the camera. At the bottom of the card are two quotes: “Do not fear, for I have redeemed you: I have called you by name, you are Mine!” – Isaiah 43:1 and “I pray for you, most every day. My love’s with you, now fly away.” – Red Hot Chili Peppers.

Ryan died of a drug overdose behind the Hobby Lobby on College Drive – on a Friday in June, ending his 12-year struggle with addiction. A needle lay near his body and fentanyl was one of the drugs discovered in his system. Police found him the following morning.

He was 29 years old.

Witnessing the grief of a mother is heart wrenching and raw. And when a mom loses a child to drug addiction, there’s another level of pain that is even harder to comprehend. As a journalist, it’s my job to give Leggio the space to tell her story. As a mother, I wanted to comfort her and make all of her pain disappear.  There’s a quote often used in 12 step meetings that reads, “Addiction is a family disease… one person may use, but the whole family suffers.” For Leggio, her husband, and Ryan’s younger siblings they know this quote well. They watched drugs destroy their son and brother.

“Twelve years of struggles to have him die,” Leggio says, shaking her head from side to side in disbelief. “I never thought he was going to die. People say that at least I don’t have to go through the pain anymore, but I would go through all of this again for at least one more day with him.”

Experts say that because extensive drug use changes the way the brain functions over time, addicted drug users also change, and this change tends to mimic symptoms seen in progressive brain diseases.

“Addiction has a particular flavor and twist to it,” says Elana Israel, a Philadelphia-based life coach, recovered opioid addict and a former licensed social worker. “It has one thing in common with Alzheimer’s disease or Dementia, in that you see that person leaving mentally but they are still in there physically. The difference is that with Alzheimer’s Disease or Dementia, the person cannot function. An addict is highly resourceful and highly manipulative. You start to see your child who you thought you knew become a completely different person.”

Israel continues, “I’m a recovering addict. From the addict’s perspective, when you’re in it, the only thing you can think about is how to get your next fix. What people don’t understand about addiction is that it’s not the drug or the alcohol that’s the problem for the addict. That’ the problem for everyone else. For the addict, drugs and alcohol are the solution to how we feel when we are sober. It’s an exit to the pain.”

Ryan’s addiction to drugs began when he was 16 years old and had to switch high schools. He was lonely at his new school, missed his friends and started smoking marijuana and taking Xanax – a prescribed anti-anxiety medication that is part of the benzodiazepine family– to escape the emotional pain.

“He was always a good kid, very sensitive,” Leggio says. “Switching schools was hard on him, he started smoking marijuana and sneaking around.” They sent him away to boarding school, he graduated at 17, came home to Baton Rouge and enrolled at LSU and eventually Baton Rouge Community College. Leggio says he had trouble focusing.

Leggio talks about her son while sitting on a sofa in her cozy family room with her dog snuggled on top of one of the three couch cushions. I sit across from her, light streaming into the large room with vaulted ceilings that overlooks a large backyard with an inground swimming pool. The room is filled with framed family photos, religious statues and crosses, books and candles. There is a standing photo tree on one of the end table, heart clips holding different snapshots of Ryan’s life, the photographs jutting out at different angles.

A large white posterboard with a picture collage of Ryan’s life leans against the white bricks below the mantle of the fireplace, each picture a different snapshot. In his Class of 2010 senior portrait, he stands with his hands tucked into the pockets of his dark jeans, navy blue polo shirt untucked, a big smile on his face. In another one, he is blowing out “22” candles on his birthday cake. In another, he stands next to his dad, both in hooded sweatshirts. There’s toddler Ryan and little boy Ryan and Ryan leaning into his younger brother and sister. There is a family photo taken in front of the Christmas tree, a picture of Ryan riding a dirt bike and the last birthday picture is of him blowing out the ”29” candles on a king cake. It’s a fitting birthday cake since he was born on January 6 — King’s Day — and his name means “Little King.”

Leggio holds a Kleenex in her right hand that she occasionally dabs under her eyes when the grief starts to flow. She talks about when he worked at Roman’s Café in Hammond Aire Shopping Center and how when he died one of his customers wrote a letter about how much of an impact Ryan had on her life. Leggio framed that letter. She talks about how he helped friends who also suffered from addiction, Ryan’s tender heart and low confidence and the shame he felt from his addiction.

Her memories of his life are filled with moments of gratitude and heartache, the precious time between relapses and the toils of his addiction. She remembers his funeral and how there were so many people that a line formed outside. She tells me about how cardinals and rainbows appear as a reminder that he is always with her. She leans on her faith, attending multiple Catholic masses each week and praying to God, trying to understand and find peace with His decision to take her son so soon.

“He was loved,” Leggio says. “He was so loved. He always went back to rehab because he loved us and he was making us proud but addiction was drowning. That’s how bad his body would feel without the drugs.”

While Ryan’s addiction issues began when he was a teenager, he started taking opioids when he was 23 years old. Leggio says it began with pills, which eventually led him to heroin, and in his final years, fentanyl. He’s not alone. According to the National Institute on Drug Abuse, about 80 percent of people who use heroin started out taking prescription opioids.

“I started with pills and eventually started snorting heroin,” says Israel, who has been in recovery for five years. Her addiction began after a close friend died. She says that addiction can affect anyone. She was a social worker, helping people suffering from addiction at a rehabilitation hospital in the suburbs of Philadelphia, when she started abusing opioids to numb the pain of losing her friend.

“I had two degrees, a car, a condo and a great boyfriend. I had a great job. My life was set, and I was killing myself with drugs,” Israel says. “I stole cars and money and checks from my family, lied all the time, went to two different rehab hospitals, stayed sober for a year, relapsed, got arrested, spent time on the streets, got mugged. People look at you and say ‘I don’t get it. Why are you doing this to yourself and to us’. But it doesn’t feel like a problem to the person addicted. The problems come up when we don’t have drugs.”

Leggio and her husband tried at least eight different treatment options for Ryan. He would stay sober for a little while, and she would see her son at his best, exercising, eating a high-protein and healthy diet of chicken, avocados, salmon, and sweet potatoes. They had a great family Thanksgiving and Christmas and even enjoyed snow skiing together. And then he would relapse again, and his muscles would shrink, his skin looked gaunt, his eyes sunk into his face, and he would scratch different parts of his body, a known side effect of opioids.

“When he was high, I was like, ‘Where’s my son? I want my son back,’” Leggio says. “But I always thought he could make it work – getting sober.”

Ryan’s family tried everything to help him stay sober. When he relapsed, they sent him to an outdoor wilderness program in North Carolina and eventually multiple rehabilitation centers in Baton Rouge. They tried to help ween him off heroin with a $3,000 prescription for Suboxone, a medication that’s a combination of buprenorphine and naloxone used to treat opioid dependence and addiction.

It didn’t work for Ryan. They tried therapy. Insurance only covered the mental health portion. They paid out of pocket for his addiction treatment. They tried tough love, establishing boundaries and refusing to help when he relapsed. During that time, he spent four months homeless, begging for money at the intersection of Corporate Boulevard and College Drive.

When I ask her how much it cost financially to fight the addiction, Leggio replies, “I’ve never been brave enough to add it all up.”

Cheryl Leggio looks at a framed photo of her son, Ryan Leggio, who died in June from a drug overdose.

While a person suffering from addiction has to want to get help, there are tax payer-funded options in Baton Rouge that offer mandated help. However, like most government-run structures found in our cities, states and country, these systems are complex and often dysfunctional.

For example, anyone can go to the East Baton Rouge Coroner’s Office and file an Order of Protective Custody if they have witnessed a person who is a danger to themself or others, gravely disabled, suffering from substance abuse that leads to previously stated criteria, or observes behavior that a person is mentally ill, according to the EBR Coroner’s Web site. And the coroner can issue a Coroner Emergency Certificate if the coroner witnesses similar behavior.

These orders can mandate that a person is brought to a hospital or treatment facility and examined within a certain amount of time, and depending on the order, detained at a treatment facility for a certain number of days or evaluated and released. Anyone can request an OPC for a family member or loved one, but an OPC can only be filled out in person between 8 a.m. and 4:30 p.m., Monday through Friday. If there is an emergency beyond that time, a person must call 911.

In 2021, there were 1,350 Orders of Protective Custody and 8,433 Coroner Emergency Certificates issued.

Here’s where I see a break in the system.  

Under the OPC, if a person is released, family members are not always notified. And once discharged, there is no digital footprint of the order. If that person is detained a second or third or fourth time at the same facility or even at a different facility, there is no record of past certificates which means there is no record of past mental health or substance abuse issues.

“The process of issuing emergency certificates is still a pen and paper system,” explains EBR Coroner Dr. William “Beau” Clark. “It’s not digital. So unless a patient discloses it, there is no way to know whether or not a patient had been issued one before. They would have to scour the universe to find one.”

He has been trying to get the state to implement a digital program for the last decade, he says.

“This system would benefit everyone. We would have a database and be able to check historical information, and a lot of people could have access to it,” Clark says. “It would be a great way to look at recidivism rates and mental health treatment. It could save a lot of money, we wouldn’t have to keep repeating the same cycle, and it’s not that difficult to do.”

I reached out to Dr. Courtney Phillips, Secretary of the Louisiana Department of Health to ask about why this digital system hasn’t been implemented. She did not respond to my request for an interview.

If you’re reading this and wondering why, in 2022, with our country’s mental health and addiction issues on the rise, Louisiana doesn’t have an adequate digital database for this system, you’re not alone.

It infuriates Leggio. During the last week of Ryan’s life, she got an Order of Protective Custody on him because she was worried about his erratic behavior and thought he was a danger to himself. He was taken to the Bridge Center for Hope on Florida Boulevard under the OPC. He was released that night, Leggio says, adding that she wasn’t notified of his release by the Bridge Center employees.

According to the parameters of the OPC as written on the EBR Coroner’s Website, “it expires 72 hours from its issued date and time OR upon completion of the transport to the treatment facility. A person can only be picked up once per OPC.”

He was brought to the Bridge Center on a Tuesday, Leggio says. She knows he overdosed and was administered Narcan on Tuesday night, brought to a hospital and discharged Wednesday. Leggio picked Ryan up from the hospital and brought him to Baton Rouge Behavioral Hospital, a mental health and substance abuse treatment center on North Boulevard, on Wednesday afternoon. They never admitted him because he tested positive for COVID, she later learned after reading text messages on his phone. He died two days later, she says. When she got his phone back after his death, she read a few other texts he had sent to his friend that said he was going to “lay low” for a couple of days until he tested negative for COVID and then go back to the treatment center for help.

Under the current system, none of the hospitals would have had access to the Order of Protection unless Ryan had told them about it. It’s this gap that frustrates Leggio, along with the fact that he was released so early from a treatment center under the OPC.

“I talked to someone at the Bridge Center while he was still there and emphasized that he had the protective order,” Leggio says. “I feel like she could have called a doctor and stopped him from leaving, but she didn’t.”

Leggio tried to save her son. She had the resources and the will and the love. And when that didn’t help him, she leaned on a broken system. She wonders if he would still be alive if he hadn’t been released so quickly under the OPC. But for those who have suffered from addiction, they know that the power of the disease trumps everything else. And the hardest part about loving someone suffering from an addiction is understanding that you can’t fix it.

“Families need to know that you didn’t cause it, you can’t control it, and you can’t cure it. You’re completely powerless,” Israel says. “Everyone thinks they can say it differently and handle it differently. Maybe if I don’t let him in the house, maybe if I help him, maybe, maybe, maybe maybe.... And it creates an unbelievable feeling of fear and powerlessness. For families, emotionally you are constantly worried that something bad is going to happen. I don’t think my mom slept for three years. I was out on the streets, running around, doing what I needed to do to get high and calling her from a jail cell. Anyone who has a family member who is an addict, the worst fear is getting that phone call in the middle of the night. It robs you of sleep, it robs you of a sense of security in the world, and it robs you of your peace.”

The fourth part of this series, “The Brain” will be published Monday, October 10, 2022.

October 3, 2022