By Rekha Basu

The obituary for 23-year-old Brittany Kock was gut-punchingly raw. Her parents shared the cause of their only child’s death without sugar-coating or blame, and their own anguish without self-pity.

“Brittany was our gift from God that had to be returned before we were ready,” began the item in a Des Moines Register earlier this month. “She was taken from us on March 4, 2017, by the Demon known as Heroin. She wanted nothing more than to be sober and have a normal life but the disease took over.”

Robert and Sheryl Kock’s candid desire to educate and advocate for families struggling with heroin addiction drew me to Hamilton’s Funeral Home, where a room full of mourners struggled to comprehend the tragedy and comfort each other. A subsequent conversation with Bob, an emergency medical technician, and Sheryl, a nurse, in their home gave context to recent headlines about the new grip of an old opioid, once associated with ’60s hippies squatting in fetid apartments. It also underscored the impossible choice parents can be forced to make in turning a child in to police just to keep her safe.

In recent days, four children in an Ohio suburb found their father, a Spirit Air pilot, along with their mother, dead in their bedroom from an apparent overdose of heroin and fentanyl. They were among three sets of Ohio parents this month to have overdosed on heroin while watching their children.

A 24-year-old Jet Blue passenger foaming at the mouth caused a flight in New York to return to the gate for help. Officials blamed it on heroin and anxiety medication.

In Cincinnati last year, an estimated 78 heroin overdoses took place over two days.

Coincidentally, or maybe not, the Kocks pinpoint the start of their daughter’s problems to the family’s move to Ohio in 2006 when she was entering junior high school. The adjustment was tough, they say: The vivacious girl went from a Catholic school with 30 students in her class to a public school class of 1,200. The former cheerleader who played volleyball, softball and basketball now had to compete with the best athletes to get picked for teams. She struggled to find belonging.

She joined a Christian youth group, where her parents fault a talk by a youth minister for starting her on a long, painful journey. Brittany was adopted privately at birth, a fact she always knew. The Kocks say her birth mother struggled with addiction, and two other children had been put up for adoption. But while they were placed with relatives and had an ongoing connection to each other, Brittany had struggled with knowing no family member had claimed her. Then the minister, who was also adopted, told kids they would never be complete until they were reunited with their birth parents, Sheryl says.

After that, she says, “things started to spiral.” On Brittany’s insistence, Sheryl arranged a meeting with her birth mother in Arkansas and took her there. That launched a relationship filled with ups and downs that sometimes fed Brittany’s insecurities. At 14, Brittany connected with kids who drank and smoked pot, and she joined them, also refusing to take her medicines for attention deficit disorder. At school, drugs were found in her purse, and she was sent for an evaluation, which led to an outpatient drug treatment program. There, her mother says, “she met new friends who were doing much harder-core stuff.”

The family returned to Iowa in 2011, and a year later, at 18, Brittany moved out to live with a boyfriend who worked with her at a pizza place. Her parents suspected something was wrong, and their fears were confirmed when they got an accidental call from her cellphone and overheard her telling someone she was going to ask her parents for help getting off heroin.

They confronted her and she admitted to it but was unwilling to get treatment. So they tried to commit her involuntarily, but a court ruled against them.

They also struggled to find a place that could address both her drug habit and her ADHD. “We were really stupid about programs. We didn’t know what was out there,” Sheryl said.

So they resorted to getting her arrested, after she moved back home and stole several thousand dollars from their checking account. After 60 days in jail, she was transferred to a mental health-linked addiction program attached to a correctional facility. She was discharged after 14 days, when her parents say their insurance plan stopped covering treatment. Once out, she was using within a week.

That was 2012, but the cycle kept repeating itself. She’d be in and out of treatments and jails, only to get out and find her way to people — some she’d met in treatment — who were using drugs. Her father says she’d sober up and feel great shame and guilt for what she’d done to feed her drug habit, including stealing and pawning her mother’s jewelry and her father’s tools. Then, to take the pain away, she’d use again.

“The worst day of my life was the first day I put the needle in,” her mother says she once told her. “Since then it’s had control of me.”

Sheryl understood. “It’s a choice to put the needle in, yes, but once you’ve made that choice, then it is no longer your choice,” she said, noting addiction is a brain disease with a genetic component that causes cognitive distortions. In fact, in the six years they struggled with her addiction, her parents say they became like addicts in that they were equally controlled by her addiction. They grew isolated, caught up in the same shame and stigma addicts face. While other parents talked about their kids’ successes, they felt they’d be seen as failures at parenting.

Brittany’s obituary urged people to view addiction as they would a type of cancer and treat addicts accordingly, not cutting them off from care if it returned. “The disease is ruthless and unforgiving and does not care where you came from or who your family is,” it said.

The Centers for Disease Control and Prevention agrees. It says U.S. heroin use has grown “among men and women, most age groups, and all income levels,” and some of the biggest increases are among women, the privately insured, and people with higher incomes. The National Center for Health Statistics found one quarter of all drug overdose deaths in 2015 involved heroin, triple the percentage in 2010. And according to the National Council on Alcoholism and Drug Dependence, more people in the U.S. died from drug overdoses in 2014 (47,055) than in any other year on record. More than half — 28,000 — were from opioids. Even small children are affected: In 2015, 51 children under age 5 died from opioid use, the CDC reported.

Also growing is the combined use of heroin and other substances, especially cocaine and opioid prescription painkillers.

Ironically, going to prison can be the best way to get decent treatment that’s covered. The Kocks say Brittany was in a great treatment program at a women’s prison in Iowa, on a probation violation, but she wasn’t there long enough. The prisons offer four-month cognitive behavior treatment programs at no cost to inmates.

Two weeks before her death, Brittany was released from a county jail. She got out saying she wanted to be off drugs and start a family. But it wasn’t long before a 3 a.m. call to her cellphone had her up one night and out of the place she shared with a boyfriend.

“That’s how it always started,” says Sheryl, referring to drug dealers. “They would hunt her down.”

Later that day, after texts and phone calls had gone unanswered, came the knock on her parents’ door. Police said Brittany was found unresponsive in a run-down Des Moines rental house. They estimated she had been dead for 12 hours. Whoever was with her had taken off without getting her help. Toxicology reports have yet to come back, but the medical examiner told her parents that hers would be the third heroin death that day.

In their struggle to give meaning to her death, Brittany’s parents have pledged to do what they can to help others struggling under heroin’s grip.

They plan to funnel memorial donations into a fund to help drug addicts trying to get sober. They hope to meet federal and state officials and law enforcement agents and lobby for faster interventions and longer stays to treat addicts. They say most inpatient programs last 30 days, but it takes that long just to clear the substances out of one’s system. They believe a yearlong residential program could have saved their daughter. And since every addict is different, they want insurance companies to avoid imposing uniform limits to coverage.

They also call for a cultural shift that holds drug dealers accountable under Iowa law just as bartenders are when they over serve alcohol to someone who then drives drunk.

“For six years it’s controlled us,” says Sheryl of heroin. “For the rest of our lives, we’re going to fight to control it.”

Rekha Basu is a columnist for the Des Moines Register. Send comments to letters@dailyjournal.net