By Jeremy Redmon
The Atlanta Journal-Constitution

Somebody help me!

Pat Strickland was about to watch a movie in the den of her Gwinnett County home two years ago, when she heard her 11-year-old grandson screaming upstairs.

She rushed up the ten carpeted steps to her daughter’s bedroom and found her slumped over on the edge of her bed, a needle and syringe between her legs. Pat scrambled to resuscitate the mother of two, filling her lungs with air. But it was too late. Stephanie Futrell’s lips had already turned blue. Pat knew her 33-year-old daughter — once a fun-loving Phoenix High School graduate who aspired to be a journalist — had finally succumbed in her years-long drug addiction.

Stephanie had overdosed on heroin spiked with fentanyl, a short-acting pain reliever that is as much as 50 times more powerful than heroin. For years, doctors have prescribed fentanyl in the form of patches and lozenges to treat severe pain, typically from advanced cancer. Lethal in tiny amounts, drug dealers are now making it in clandestine labs in Mexico and mixing it with heroin to boost its euphoric effects, often without the user’s knowledge.

In March, President Barack Obama appeared at a summit in Atlanta to bring attention to the nationwide painkiller and heroin overdose epidemic that killed more than 28,000 people in 2014, more than any year on record. Obama noted that more people are now killed from drug overdoses than traffic accidents. The month after the president appeared in Atlanta, Prince — the songwriter and singer — died from an accidental fentanyl overdose.

The number of people dying from fentanyl-related overdoses — prescription and illegal — has more than quadrupled over the last three years in Georgia, from 64 to 257, according to an Atlanta Journal-Constitution analysis of medical examiner reports. More than half of those deaths happened in the Atlanta area last year. The Drug Enforcement Administration has reported hundreds of other fentanyl-related overdose deaths across the country and issued a nationwide alert, identifying the drug as a public safety threat.

Stephanie’s story illustrates how prescription painkiller abuse can pave the way to heroin and fentanyl drug addictions. She first became addicted to pain medication before using heroin. So did the two other young people who died after using the fentanyl-laced heroin they and Stephanie bought from Carlos Ramirez or his girlfriend, according to the Gwinnett County District Attorney’s Office. And before he started selling heroin, Ramirez got hooked on painkillers.

Stephanie’s story also reveals how drug addictions can devastate generations of families. Now raising her daughter’s two little boys, Connor and Caleb, Pat remains mystified by the power painkillers and heroin had over Stephanie.

“Nobody should have to give their children CPR,” says the 61-year-old Texas native, her eyes rimmed with tears. “I don’t understand how you can let a pill come between you and the rest of your family.”

“A loss on all sides”

The house with gray siding and white trim on Chisholm Way is hard to miss with the handwritten “Go Away!” sign hanging on its wrought iron front door. Sitting in a quiet, leafy neighborhood in Lilburn, this is the house where Ramirez sold the drugs that were killing people, court records show.

Paul and Maureen Pierce — Connor and Caleb’s grandparents — were inside recently, cleaning up the tens of thousands of dollars in damages they say Ramirez left behind. They bought the place in 1987 and then eventually started making a living on the road, hauling goods for a local trucking company. While they were away, they let their son, who worked with Ramirez in construction, live there. They say their son invited Ramirez to stay with him without their consent.

The Pierces said they had no idea Ramirez was selling drugs from their property. After he went to jail, they found holes cut in the floors and walls. More than two dozen hypodermic needles lay behind the drywall and the carpet reeked of chemicals. They showed a visitor where someone threw steak knives at the living room wall and shot a BB gun at the ceiling. They are now renovating the place with plans to sell it.

“I avoided this place as much as I could because it was depressing,” Paul Pierce — a tall, affable trucker with a gray and white beard — says as he and his wife sift through some paperwork on their dining room table. “I would just like to get out from under it.”

Ramirez is among 16 people Gwinnett police have arrested amid a months-long undercover investigation. Police declined to comment on their probe because it is continuing. But in February of last year, they issued a news release, saying they had seized $2.5 million worth of heroin, cocaine, marijuana and methamphetamine as well as 12 vehicles that were involved in transporting the drugs.

It’s a probe with international ties. Ramirez and most of the other suspects in the massive drug ring are Mexican natives who were living in the country without legal status before they were arrested, a county prosecutor said. Nicknamed “TNT” and “Jackpot,” the fentanyl-laced heroin they were selling was coming from south of the U.S.-Mexican border. Fentanyl is so potent that dealers can aggressively dilute it and increase their profits.

Prosecutors say they have connected three deaths to Ramirez. In October of 2014, authorities found Tracy Childs’ body in a Waffle House bathroom in Lilburn. She had overdosed on heroin spiked with fentanyl that she bought from Ramirez at the house on Chisholm Way. Three days later, Jordan Johnson died from an overdose after buying the same drugs from Ramirez at the same location. The following month, Ramirez was in jail on a shoplifting charge at a Walmart in Gwinnett. While in jail, Ramirez called his girlfriend and told her to continue selling his drugs. Days later, Stephanie bought drugs from Ramirez’ girlfriend and died from an overdose.

At a sentencing hearing in January, Assistant District Attorney Mike Morrison said Ramirez kept selling the drugs even though he knew they were killing people. He recommended a 360-year prison sentence for one set of the drug charges to which Ramirez pleaded guilty, the longest sentence Morrison has ever recommended for any drug case in his more than 10 years as a prosecutor.

Ramirez’ court-appointed attorney, Martin Hilliard, called that recommendation “artificially inflated” and “ludicrous.” Ramirez was a humble man who befriended Tracy, Jordan and Stephanie and was visibly shaken by their deaths, Hilliard said. Ramirez, Hilliard continued, sold heroin to maintain his own drug habits. He got into a car accident in Florida years ago, was prescribed hydrocodone for his pain, got hooked on it, then got addicted to heroin and even survived an overdose, Hilliard said.

“You have heard the saying, ‘There but for the grace of God go I?’” Hilliard told the judge at Ramirez’ sentencing hearing. “Well, you know, Mr. Ramirez could have just as likely have been one of those people who OD’d.”

The prosecutor wasn’t swayed.

“If he is an addict,” Morrison said in an interview about Ramirez, “he knows how devastating the product is to others and he still peddles it. I find it more egregious, honestly.”

In a postcard he sent from Dodge State Prison where he is serving his sentence, Ramirez, 32, wrote that he had been “railroaded” because he couldn’t afford to hire an attorney. He didn’t respond to a letter from the AJC containing a list of follow-up questions. Federal immigration authorities have already asked the state prison system to notify them when Ramirez is released so they can seek to deport him.

As Judge Warren Davis sentenced Ramirez to 60 years in prison, he turned to the victims’ parents in the courtroom — including Pat Strickland — and expressed his condolences.

“I’m sincerely sorry for your loss,” he told them. “And it’s a loss on all sides.”

Finding mom

Connor Pierce, now 12, is standing in the cluttered upstairs bedroom where he found his mother’s body the evening after Thanksgiving two years ago. Silent and largely undisturbed, the room is still choked with the stuff his mother hoarded in the final years of her drug addiction: brightly colored party cups, her purple recipe notebook, a pair of crutches, laundry baskets brimming with clothes and her children’s elementary school projects.

Hanging on the wall is a picture of a little white church, some sheep grazing in the verdant foreground. At the bottom of the picture, the beginning of Psalm 23:1 reads: “The Lord is my shepherd.” In dark ink on a wall in the corner, Stephanie recorded Connor’s successive heights, writing his name in bubbly script next to them.

“I haven’t been in here in forever,” Connor says before picking up a copy of an effusive essay he wrote about his love of fourth-grade. “I’m told that my and her handwriting look just alike nowadays.”

The family rarely enters the room because the memories inside are still too painful. Connor recalls the evening he knocked on his mother’s door two years ago. He wanted to ask her if a friend could sleep over that night. No one answered. So he picked her lock with a penny. He found his mother sitting on the edge of the bed, her head drooping. She had a leftover Thanksgiving turkey sandwich in her lap.

Connor thought she was asleep, so he nudged her. Her body fell over on the bed. He had an idea what was happening because he had a similar experience two months before when he found her suffering from a heroin overdose in their home.

“I see her face is blue — her lips are blue,” he says.

Connor has mixed feelings about his mother. She possessed a keen sense of humor and liked to make people laugh. But Connor also recalls the rapid mood changes that came with her drug use. He points to a spot in the kitchen where is mother ripped the phone off the wall in a fit of rage.

“She would be happy for a few days and all of a sudden she would be mad or sad and just cuss you out, randomly,” says Connor, whose seven-year-old brother, Caleb, prefers not to talk about their mother. “It would be kind of confusing because you remembered yesterday she was all happy and we were all laughing.”

Connor has his mother’s expressive eyes, even her impishness. His self-conscious smile reveals a glint of braces. He is simultaneously holding at bay his dark memories while navigating through the intense peer pressure that comes with middle school. Listening to rap music and playing video games helps him keep his mind off his past. He’s taking advanced math and science classes, while dreaming about becoming a video game designer one day.

“I miss her,” Connor says of his mother, “but I don’t really think about it. I kind of think more positively most times.”

“The system is broken”

Pat is reminiscing in the tidy den of the family’s brick home in Tucker. It’s the same room with the floral print wallpaper where she was sitting when she heard Connor screaming for help. She is sifting through photos of her daughter. One shows her as a smiling young girl in a dark blue dress with a white lace collar. She is a grown woman in another, grinning and cradling in her arms her 19-pound gray and white cat, Fuzzy. Pat slips into the present tense as she shows more photos of her daughter clowning around and sticking out her tongue.

“This is Stephanie, usually, OK?” she says, chuckling. “In all of our pictures of Stephanie she has some face.”

Stephanie was a practical joker, a poet and a big-hearted woman who brought runaways home with her. At the same time, she was battling depression and anxiety. She enrolled in Georgia Perimeter College after graduating from high school, hoping to study journalism. But she suffered panic attacks on her first day and was too frightened to set foot in the classroom. She eventually dropped out.

Stephanie started abusing a pain medication called Lortab in her 20s. She was in and out of the hospital, complaining of various ailments and returning home with prescriptions for more painkillers. In 2011, she pleaded guilty to forgery after she was caught writing herself prescriptions for Lortab at the pain clinic where she worked in Snellville. Stephanie never held another job and didn’t move out of her mother’s home after that. She spent time at the house on Chisholm Way. That’s where a friend convinced her to try heroin, Pat says.

Sleeping around the clock in a drug-induced haze, Stephanie started neglecting her children. So Pat took charge of the boys. If she wasn’t around, Connor would feed Caleb. Laundry and trash started piling up in Stephanie’s room to the point where there was only a narrow path to her bed. Pat repeatedly urged her daughter to get on with her life. Frustrated, Stephanie would scream: What do you want? Her mother would reply, I just want my daughter back. I hate who you have become.

The family had been here before. Stephanie’s little sister, Rebecca, was the first to battle a drug addiction. Suffering from a birth defect and kidney stones, Rebecca got hooked on a painkiller doctors prescribed her: fentanyl. Sitting across from her mother with her dachshund cuddled in her lap, Rebecca recalls how she was finally able to beat her addiction through sheer willpower and “the grace of God.”

Rebecca and her mother both blame doctors, accusing them of contributing to the overdose epidemic by overprescribing pain medication. After Stephanie died, Pat discovered numerous bottles of painkillers and other medication in her daughter’s nightstand. Stephanie, Pat adds, repeatedly sought admission to rehab centers in Georgia but was denied because she was taking antidepressants. They told her they didn’t have the staff to dispense any drugs.

“The system is broken,” Pat says.

A soft-spoken divorcee who has remarried, Pat is now renovating her home with plans to sell it and retire from her job as a legal assistant in Atlanta. She wants to move the family out to the Northeast Georgia countryside, away from the Atlanta area, away from her daughter’s room and away from the family’s painful memories. The granddaughter of farmers, she is dreaming of buying a sprawling ranch that could serve as a rehab center for addicted mothers and a refuge for their children. Imagine, Pat says, what it would be like for them to grow up in such a pastoral setting with vegetable gardens, horses, cows and chickens, knowing what life could be like without drugs, without crime, without experiencing what her family has been through.