Patty Milam doesn't hide behind the death of her 23-year-old son Aaron.
She openly shares his story — one of a young man who for years battled a heroin addiction until it took his life in May 2017. She tells people his addiction, like that of many others around the country, thrived in darkness. And she's since dedicated much of her life to spreading awareness of heroin abuse in her community.
Milam, who lives with her husband in an affluent neighborhood in Argyle, specifically wants people to know opioid addiction doesn't discriminate between racial groups or social classes. It's a national crisis because it's not relegated to the downtrodden. It affects people all over Denton County, where local police grapple with drug trafficking and 29 people died from an opioid overdose in 2017.
"Addicts are people of value," Patty Milam said. "They don't want to be addicts. They need help and we need to quit stigmatizing them. … This disease can strike any family. It doesn't matter if you're poor, wealthy, white, black, purple, green — it crosses all lines."
Opioids include prescription pain pills as well as the highly addictive drug heroin, which has become available in exponentially larger quantities across the United States since as far back as 2007, according to data from the Drug Enforcement Administration. Eleven of the 21 DEA field offices in the country ranked heroin as their top drug threat in 2016. Additionally, 44 percent of people who responded to a survey last year said heroin was the greatest drug threat in their area, according to the DEA's National Drug Threat Assessment.
Milam has seen the worst of the crisis through her son's struggle and eventual death. Her passion for awareness led her to recruit renowned addiction recovery expert Tim Ryan to speak at her son's alma mater, Liberty Christian School, on Thursday night in Argyle. Most of the roughly 100 attendees were parents of adolescents. And their questions to Ryan showed an unyielding curiosity about a drug that's becoming more available to suburban teenagers.
Ryan, an Illinois man who wrote about his lifelong struggle with addiction in his book From Dope to Hope, told audience members that addiction gets passed down from generation to generation. Ryan says he came close to dying and lost his own son to a heroin overdose.
With his energetic, in-your-face style of storytelling, Ryan said the average drug addict is no longer a homeless person with a needle in his arm. It's a white, 22-year-old middle-class citizen "from a town just like this one."
"Do not be the family that [denies it] and says, 'We live in Argyle, Texas. We're a Christian family. We go to church on Sunday,'" he said. "So what? You are not with your kids 24/7."
A widely used antidote
Prescription and illicit opioids dominate drug overdose deaths in the country, according to the Centers for Disease Control and Prevention. Nationally, 33,000 people died from an opioid-related overdose in 2015 — about 63 percent of all drug overdoses in the United States — and 1,186 of those victims died in Texas, according to the CDC and the Texas Tribune.
In Denton County, 26 people died from an opioid overdose in 2015, five of whom died from heroin intoxication, according to statistics from the Tarrant County Medical Examiner's Office. Another 12 people died from mixing other forms of opioids that year.
In 2016 and 2017, a total of 49 Denton County residents died from an opioid overdose, the data shows.
At Thursday's event at Liberty Christian, Argyle Police Chief William Tackett told audience members that his officers will soon be equipped with the opioid antidote Narcan, which increasingly is used among Texas police and fire departments as the national heroin epidemic moves into the state.
Naloxone — best known by the brand name Narcan — primarily is used to reverse an opioid overdose and block its effects. The medication comes in an injectable vial or nasal spray. Texas, like most states, allows pharmacies to dispense the overdose-reversal drug to anyone who asks.
The antidote typically is used when an overdose victim is losing consciousness and near death.
Denton paramedics have carried naloxone for decades. All ambulance services in Denton County are required to have it, according to Jody Gonzalez, the county's emergency services director.
The University of North Texas Police Department equips all patrol officers with Narcan nasal spray, and other local police departments are starting to warm up to the idea of having each officer carry a dose.
Brian Glenn, the Denton Fire Department battalion chief in charge of emergency medical services, said Denton paramedics used 88 injectable vials of Narcan in 2016 and 66 in 2017.
Ryan and local officials say the number of overdose deaths in the county would be far higher without the availability of Narcan. And when Ryan talks about the need for Narcan, he speaks from experience.
"I overdosed while driving [in 2010]," he said during Thursday's speech. "I hit two cars and put four people in the hospital, one being a 9-month-old baby. ... If [Narcan] had not been administered to me, I would be dead. Because I was dead when the paramedic came up to the car."
Barriers to investigating
About 20 years ago, a large portion of heroin in the United States could be traced back to Asia. But recently, Mexican drug traffickers have been gaining a larger share of the U.S. market, according to the DEA's drug threat assessment.
Increased traffic led to an 80 percent spike in heroin seizures in the U.S. from 2011 to 2015, the DEA reports. The Denton County Sheriff's Office also has seized an increasing amount of heroin over the last three years.
Based on estimated street values, sheriff's investigators seized about $600,400 worth of heroin in 2015, compared to $1.43 million the following year, according to sheriff's office statistics obtained through an open records request. In 2017, that number jumped to $1.89 million — 14,160 grams of heroin.
Today, most of the heroin in the city of Denton originates from suppliers in Dallas with links to Mexican cartels, according to a Denton police narcotics investigator who spoke only under the condition of anonymity. The detective said releasing his identity could jeopardize ongoing investigations.
The detective said drug seizure statistics are not a reliable indicator of drug traffic in a relatively small municipality like Denton. He said the street values differ based on the drug market. Heroin cases also are some of the most difficult to work for investigators because of the drug's highly addictive qualities.
If someone buys 5 pounds of marijuana, that person may still have it five days later, he said. A heroin addict, on the other hand, consumes the drug in a matter of hours.
"Heroin seizures are really underwhelming if you're looking at it strictly from a seizure aspect — especially compared to meth, coke and marijuana — because the product goes a lot quicker," the investigator said.
Those same addictive qualities also make it difficult for investigators to work with users on heroin cases, he said.
"Joe Blow is not going to go three to four days without heroin," he said. "The process of working with someone who has an extreme heroin addiction, it's almost impossible because they're violently ill."
The detective said he hasn't personally noticed a sharp increase in the amount of heroin on Denton streets in the last several years. But, he said, the heroin crisis isn't completely tied to recreational heroin. It can also be traced to Americans' dependence on prescription pain pills, such as oxycodone and hydrocodone.
"We focus on the heroin problems but there's just as substantial of an opiate pill problem we have to crack down on," he said. A user's heroin addiction may start with a painkiller prescription for a minor back injury, he said.
That's how Ryan said his addiction started — with a dependence on painkillers after a back injury from a water-skiing accident.
Part of his mission is to make parents aware they likely have opioids in their medicine cabinets. And in many cases, those medications are readily accessible to teenagers.
Dealing with addiction
Milam also advises parents of the dangers of denial.
She said the disease of addiction takes hold quickly. Two years passed from the time her son got into treatment for his heroin addiction to the time he died. He went through multiple treatment centers, detox units and sober living homes.
In high school, she perceived the first signals of his addictive nature — drinking and smoking marijuana — as teenage antics that would eventually blow over. But after Aaron left for Oklahoma State University, the accessibility of alcohol led to his arrest on a DUI charge in 2012, she said. He couldn't drink alcohol on probation, which eventually led to his drug abuse, Milam said.
"Because that's how an addict's brain works," she said. "You've got to have something."
Another arrest in 2014 forced Milam to give her son an ultimatum: Go to treatment or stay in jail. He chose treatment while Milam joined support groups to learn about his disease.
As she learned about heroin addiction, she also learned how to separate her son from the disease, she said.
"We started learning [the difference between] when Aaron's disease was talking to us and when Aaron was talking to us," she said.
She wonders aloud whether he still would be alive had she confronted his addictive nature sooner. But she doesn't have any regrets about the way she handled his strong desire to get better.
"We had an open line of communication, because he knew that about us," Milam said. "I don't have all these regrets like, 'Oh my gosh, I wish my son knew I would have done anything for him.' He knew I would do anything for him."
For most of the week, Milam chauffeured Ryan to back-to-back speaking events in Keller and Argyle. Both have lost a son to a heroin overdose, and both want to destroy the stigma that forces some people to hide from honest discussion about addiction.
For Milam, the death of her son is still fresh. She cries when she talks about him, but she wants his death to spark healthy conversation about addiction.
Now, she takes heart in letters from people he touched in treatment centers — notes from those who saw Aaron's true, kind nature.
"Aaron's life made a difference, and now I really think his death is making a difference," she said.
JULIAN GILL can be reached at 940-566-6882.