Fentanyl survivors build brighter future as record numbers die in the dark

A before and after photo shows Justin Smith as as he went off for treatment in West Virginia...
A before and after photo shows Justin Smith as as he went off for treatment in West Virginia and three months after.(Courtesy Justin Smith)
Published: Aug. 4, 2022 at 9:13 AM CDT
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ST. LOUIS (KMOV) -- “Oh my God. He’s alive.”

CJ Colombo woke up in the hospital with doctors and nurses surrounding him but had no idea why he was there. He’d overdosed on fentanyl and the doctors thought he was dead on arrival.

“That’s when it kind of kicked in, the last memory I had was injecting fentanyl,” he said. “And ever since that day it was the motivation of being told ‘you were dead when you got here’… I couldn’t put my family through what I know other families have had to go through.”

Colombo didn’t intend to put his family through years of hell. He didn’t commit crimes to buy fentanyl for the sake of having a good time. His addiction was, and is, a disease. He spent more than a decade of his life battling it.

Many of the kids he grew up with battled addiction as well. He estimates 10 of the 35 people he graduated grade school with have died of a drug overdose.

Colombo recounts his journey at his kitchen table in an otherwise sparse dining room in south St. Louis, where he’s called home all his life. He has a low, raspy voice, and his short haircut and tightly cropped facial hair mirror the minimalist surroundings. He’s wearing a red shirt that says “Northern California” in cursive letters. On the shelf behind him sits a piece of home decor with the word “blessed.”

Colombo’s path through addiction started long before that near-fatal fentanyl overdose. Before fentanyl, it was heroin. Before heroin, it was a doctor’s office.

“I got into a car with a buddy, we were going to a gas station that sold to underage kids for cigarettes,” Colombo said. “We were on the way there to go get cigarettes and my buddy was speeding and hit some railroad tracks, tried to make a right turn, lost control and went head-on into a tree, and I was riding front passenger without my seatbelt on and hit the windshield and lost a good portion of my forehead to it.”

At 15 years old, he was in tremendous pain after the accident. A doctor immediately prescribed 10-milligram Percocets, an opioid used to treat pain. He took them for about six months, his body slowly becoming accustomed to the pain-blocking power of prescription opioids. In fact, his biology had rewired itself to need those drugs just to function. One day his prescription ran out and he realized heroin was cheaper than pain pills.

From there, his life spiraled out of control.

CJ Colombo sits at the dining room table in his St. Louis home to talk about his years-long...
CJ Colombo sits at the dining room table in his St. Louis home to talk about his years-long drug addiction. It all started with prescription pills when he was 15.(KMOV staff)

“At the time I hadn’t realized I was becoming addicted to something,” he said. “My parents didn’t know. They were following what someone with a medical doctorate degree was telling them was good for their child. And it wasn’t until after the prescription stopped that I realized something was going on. I don’t think ‘I’m addicted’ necessarily crossed my mind right away but I noticed there was a change in myself.”

Heroin has wreaked havoc in the U.S. The CDC estimates 143,000 Americans died from overdoses involving heroin from 1999-2020. Colombo took heroin for a few years after his switch from prescription pills. Sometime around 2013, he went to buy heroin from a person he had bought drugs from many times before.

This time, fentanyl was laced into the heroin.

“Once fentanyl hit the city, it was nearly impossible to continue getting heroin and fentanyl was all that was around,” he said. “It’s cheaper. Today it’s more accessible than I think heroin might have even been 10 years ago.”

It took him and his friends about a month to figure out they were ingesting something far more dangerous than heroin, but by that time it was too late.

Like Colombo, Justin Smith didn’t know fentanyl was in a batch of heroin he took.

His addiction started in a broken home when he was young. His dad was an alcoholic, his mom verbally abusive.

“At the age of 14 I was shooting cocaine,” he said. “I just kept moving from one drug to the other until it led up to me using heroin and using a needle.”

Smith was 18 or 19 when he first took heroin. He quit for short periods of time but couldn’t stay sober.

Now in his 30s, he’s spent the majority of his life battling addiction. He shared his story with News 4 with two of his mentors in the room. He believed it was better to have support in case talking about his addiction led to thoughts of getting high again.

His caution is born of experience.

Addiction led Smith into crime, which meant spending time behind bars and losing custody of his 10-year-old son. He has spent the last 16 years under court supervision.

“My most recent charge I didn’t go to prison for and it was for second-degree burglary,” he said. “I was actively in my addiction and I was actually at a drug dealer’s house and burglarized the people that lived above the dealer. And it turned out to be a pastor at a church and that pastor showed mercy in the courtroom, which is why I didn’t go to prison and got probation.”

It was a rare moment life showed him mercy in his path through addiction. For a long time, heroin was the all-consuming drug defining his life. Then fentanyl arrived, and it became more and more available.

Justin Smith and his son pose for a picture. Smith lost custody of his son due to his addiction...
Justin Smith and his son pose for a picture. Smith lost custody of his son due to his addiction and criminal history.(Courtesy of Justin Smith)

“I was living on South Broadway and I did seek out to get fentanyl on several occasions,” Smith said. “There’s gas stations there where it was very easily accessible. Alls I had to do was provide a phone number to a dealer and he would give me fentanyl for free.

“I’ve had a dealer just walk up and stick it in my pocket after I told him no on an occasion,” he added.

Fentanyl is 50 times stronger than heroin. It doesn’t have any taste or smell, so it can easily be laced into heroin or other drugs. Users have to take it more because withdrawals happen more frequently and are more severe.

Colombo used to take heroin four or five times a day in order to feel normal. Once his body became accustomed to fentanyl, the timetable for needing his next dose accelerated.

“Fentanyl would be every 30 minutes, every hour just to get through the day. So 10, 15 times a day,” he said. “It required twice as much. Even though the high was stronger, it lasted much less.”

Assistant Special Agent in Charge of the St. Louis Division of the DEA, Colin Dickey, started his career with the agency in 2004. The biggest threats then were heroin and cocaine, which come from plants. Fentanyl is a man-made drug, making it easy to mass produce.

“[Fentanyl] is killing Americans at record rates and it’s gonna continue to do that until we continue to get a grasp of this situation through our investigations, through community engagement and raising public awareness,” Dickey said at the St. Louis DEA headquarters in February.

Dickey dressed well for a busy Monday, his hair slicked back in a high-and-tight cut with a sharp navy blue suit and plaid tie. Seven people died from a batch of drugs laced with fentanyl within three blocks in the Central West End the weekend prior.

Colin Dickey sits down for an interview at the St. Louis DEA headquarters in February. He...
Colin Dickey sits down for an interview at the St. Louis DEA headquarters in February. He started with the agency in 2004.(KMOV staff)

Members of the news media flocked to DEA headquarters that day to interview Dickey about the dangers fentanyl poses to the community. After a week or so, day-to-day media coverage of the crisis died down. However, residents have not stopped dying of overdoses in record numbers.

While the COVID-19 pandemic soared and dominated local and national media coverage, the overdose epidemic quietly grew in the shadows and was largely ignored. Overdose deaths even outnumbered COVID deaths in St. Louis City.

“After doing this for 18 years, I’ve never seen a drug threat as prevalent and as dangerous as we’re seeing right now with fentanyl,” Dickey said.

The sheer supply of fentanyl is also a major factor. It is overwhelming the St. Louis region and other communities across the country. Dickey said the price for a kilo of illicit fentanyl dropped from roughly $60,000 in 2017 to $47,500 in 2022, a sign of an abundant supply.

The DEA has seized nearly 8,500 pounds of illicit fentanyl in the U.S. and at the southern border so far in 2022. In all of 2021 it seized 11,000 pounds. The year before that it was 4,700, the year before that, 2,800.

Dr. Fred Rottnek spent 15 years as the medical director for the St. Louis County Jail and Juvenile Detention Center before becoming the medical director for the Assisted Recovery Centers of America. He said it’s not an urban myth that people turn to the street for heroin or fentanyl when their prescriptions run out.

Rottnek was taught in medical school in the 1990s that someone who had pain wouldn’t get addicted to an opioid.

“Now, that seems like foolishness,” he said. “Why I was taught that, the drug companies, yeah, they did their marketing and pushing and selling of opioids that were never typically used in outpatient settings. However, physicians, we didn’t do our homework as a profession and we fell for it.”

Rottnek said communities, and people like Colombo, are still dealing with the ripple effects of the overprescription of opioids.

Dr. Fred Rottnek speaks on drug addiction and treatment in the St. Louis region.

“What has happened with all of these different prescribing patterns, it really created a market and a demand for more and more opioids,” he said. “The stuff that people are buying on the street has an unpredictable potency and people really don’t know how strong the product is they’re using.”

Colombo described nights when he couldn’t fall asleep because of fentanyl withdrawals. He needed it in the morning just to get out of bed and say hi to his family. His dependence grew over time, making him sicker and sicker with every passing day.

Ultimately, injecting fentanyl became just as much about avoiding sickness as it was about the euphoria of getting high.

“I think the best way I could describe it is if you were freezing cold and you had a quilted blanket in the oven and you pulled it out,” he said, “and you pulled it from the tips of your toes to the top of your head, it’s about that feeling.”

The relief was always short-lived. An hour’s passing would bring back the sickness.

Not only did Colombo and Smith suffer from addiction, but their families and friends also suffered as witnesses. Smith was living with his mom at one point and recalled a time she was distraught when he walked in the door.

“She was crying, saying that she was gonna be taken out of the house on a stretcher either dead or going to the hospital,” he said. “And when she said that, it kind of clicked that I was going to be the death of my mother for everything that I’ve been putting her through, through my addiction. And that was kind of what made me finally surrender and pick up the phone and ask for help.”

Smith could stay sober for short periods of time but couldn’t get past the emotional trauma that he lived with for decades.

He tried to get sober by himself one time and nearly died from it.

“I tried to detox without any help, on my own, and once I got to a certain point in my detox stage, all the emotions that were being masked for so many years were so overwhelming that I attempted suicide by putting a shotgun in my mouth and pulling the trigger,” he said. “But by the grace of God, when I pulled the trigger, the gun didn’t go off. The same gun did go off a couple weeks later with the same bullet, so I can only chalk that up to God saving my life cause I have a bigger purpose for being here.”

Smith realized after the conversation with his mom that he was going to seriously hurt his family more than he already had. He picked up the phone and within a few hours got ahold of Art Deno, who started a foundation to help addicts get treatment ever since his 19-year-old son Austin died from fentanyl poisoning.

Two days later, he was on a plane to West Virginia. He was in violation of his parole but he didn’t care, he said, because needed to get clean and that was his best chance. He didn’t pay a dime for his treatment thanks to Deno’s help.

Deno knows the human toll of the overdose crisis better than just about anyone. Addicts and family members call when they are in desperate need of help. His phone constantly rings, and it’s been getting worse as more fentanyl seeps into the community. Earlier this year, 10 people overdosed and died in one week that Deno was trying to get into treatment, he said. It takes a toll on him, but he’s always reminded why he does the work he does.

“There’s the reason I do what I do,” Deno said, pointing to a picture of his son in his South County office. “Nineteen years old. The youth of our country is under attack.”

The DEA estimates four out of every 10 counterfeit prescription pills contain a potentially lethal dose of fentanyl. Dickey said kids can buy drugs through encrypted phone applications and have them delivered to their doorsteps.

Side-by-side images of authentic medications and fentanyl imitations.
Side-by-side images of authentic medications and fentanyl imitations.(DEA)

Forty-three teenagers died of a drug overdose in St. Louis City, St. Louis County and St. Charles County from 2018-2021, according to data from the three counties. A UCLA study showed the rate of drug overdose deaths among teenagers doubled in 2020 and rose another 20 percent in the first half of 2021. The study’s lead author attributed the rise mostly to illicit fentanyl.

Smith said his faith in God was a big factor in overcoming addiction. He pulls a green and silver rosary out of his pocket during his interview with News 4 and says he prays when he has thoughts of getting high. A friend’s mom handmade him the rosary while he was in recovery. When he prays, Smith said he thinks about what his life would be like if he continued to get high and if he hadn’t turned to God.

Colombo has a life now that wasn’t possible when he was in addiction. He has a family to take care of and sees no reason to step out of line.

“You have to play the whole tape through,” he said. “Humans, our brain is designed to remember the good times and forget the bad. To an addict, the good times [are] getting high. Every time you get high that’s a good time, so your mind almost gets rewired to recognize drugs as a good time.

“I understand that if I’m gonna get high, I more than likely won’t make it back to a treatment center or back home to my family. I’ll more than likely end up dead and I don’t want that. I love life right now,” he added.

On April 21, Smith had a court appearance to determine if he needed to stay on supervision for his burglary charge. He showed up to the Civil Courts Building on North Tucker Boulevard early and ran into someone he used to get high with. He gave him Deno’s number so he could seek help.

Smith walked into a quiet, empty courtroom at 9:48 a.m. An oddly placed Mohammed Ali poster sat on the ground, leaning against the right-side wall. “Sup fellas,” the sheriff said as he walked in.

The room slowly filled up with lawyers and others who had a court hearing that morning. Smith, who didn’t have a lawyer, finally got to the podium to face the judge after waiting 41 minutes.

He explained to the judge why he broke parole in order to get treatment in West Virginia. He told him about his two jobs working at a restaurant and doing home maintenance. He told him that he has an apartment to live in and goes to AA meetings. The judge acknowledged Smith was doing well after a short conversation.

“Congratulations, you’ll be discharged,” the judge said.

Smith was no longer under court supervision for the first time in 16 years. He walked outside and immediately called Deno on the steps of the courthouse, the sunny April day reflecting Smith’s joy.

Justin Smith calls his mentor Art Deno after being released from court supervision on April 21....
Justin Smith calls his mentor Art Deno after being released from court supervision on April 21. It was the first time in 16 years Smith was not on court supervision.(KMOV staff)

“I’m proud of you brother, keep doing what you’re doing,” Deno said on the phone call.

“I love you, Art,” Smith said. “I love you, too,” Deno replied.

That day was a huge victory towards freeing himself from the ripple effects of addiction. There is hope, Smith said, for people that once felt hopeless.

“The only thing that could have made this moment better is if they would’ve walked my son out right then and there,” he said.

Smith has seen his son twice since losing custody of him and hopes to regain parental rights. He celebrated one year of being sober on July 4.