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Layla Kegg, 17, has struggled for years to deal with the addiction consuming her mom, Nikki Horr (inset).

Alyssa Schukar/The New York Times (Layla Kegg, Nikki Horr)

My Mother Is an Addict

The opioid epidemic is ravaging the lives of young people like Layla Kegg who are trying to cope with their parents’ addictions

Layla Kegg’s mother, back home after three weeks who knows where, says she’s done with heroin, ready for rehab, and wants to be part of her daughter’s life. But Layla has heard all of this before and doesn’t believe a single word.

Layla’s trust was broken long ago, after years of watching her mother cycle in and out of addiction and rehab. And now this latest discovery: “I found a needle in your purse the other day,” says Layla, her arms crossed.

A pause, and then a tumble of excuses from her mom: She doesn’t know why the needles were there; they were only syringes, actually, and not needles; she was keeping them for a friend.

Layla, 17, rolls her eyes and sighs.

“It’s almost like you want me to be using,” her mother pleads tearfully, in a voice children more often use with their parents. “Everything I do is never going to be good enough, so what’s the point?”

Five days later, Layla’s mother, Nikki Horr, is gone again.

Layla Kegg’s mother has come back home after three weeks who knows where. She says she’s done with heroin, ready for rehab, and wants to be part of her daughter’s life. But Layla has heard all of this before and doesn’t believe a single word.

Layla’s trust was broken long ago, after years of watching her mother cycle in and out of addiction and rehab. And now this latest discovery: “I found a needle in your purse the other day,” says Layla, her arms crossed.

A pause, and then a tumble of excuses from her mom: She doesn’t know why the needles were there; they were only syringes, actually, and not needles; she was keeping them for a friend.

Layla, 17, rolls her eyes and sighs.

“It’s almost like you want me to be using,” her mother pleads tearfully. Her voice sounds like one children often use with their parents. “Everything I do is never going to be good enough, so what’s the point?”

Five days later, Layla’s mother, Nikki Horr, is gone again.

iStockPhoto/Getty Images (drugs)

Opioid addicts often shift to illegal drugs like heroin if they no longer have access to pills.

Generation O

More than 20 years after the introduction of the prescription painkiller OxyContin, which authorities say has played a big role in spurring a nationwide opioid  epidemic that has killed nearly 400,000 people, a generation is growing up amid the fallout. Call them Generation O: the children whose families are trapped in a relentless grip of addiction, rehab, and prison.

In Portsmouth, Ohio, where Layla now lives with her grandmother, everyone seems to know someone who’s struggled with drug addiction. In Scioto County, where Portsmouth is located, 51 people died of an overdose in 2017. At one school, administrators say, four kindergartners lost parents to drugs and a fifth to a drug-related homicide.

Young people here describe chaotic home lives full of neglect and abuse. They recount begging their parents—who more often spend money on the next fix than on food—to stop using drugs. And they describe finding relatives unconscious or frothing at the mouth after overdosing.

School is a refuge for many students—a place where they not only attend classes but also have access to hot meals, hot showers, and donated clean clothes. On Fridays, students can take home backpacks full of food so they won’t go hungry over the weekend.

It’s been more than 20 years since the prescription painkiller OxyContin hit the market. Authorities say the drug has played a big role in spurring a nationwide opioid epidemic. Opioid overdoses have killed nearly 400,000 people. A generation is growing up amid the fallout. They’re the children whose families are trapped in a relentless grip of addiction, rehab, and prison. Call them Generation O.

Layla now lives with her grandmother in Portsmouth, Ohio. Everyone in town seems to know someone who’s struggled with drug addiction. In Scioto County, where Portsmouth is located, 51 people died of an overdose in 2017. At one school, administrators say, four kindergartners lost parents to drugs and a fifth to a drug-related homicide.

Young people here describe chaotic home lives full of neglect and abuse. Their parents often spend more money on the next fix than on food. They recount begging their parents to stop using drugs. And they describe finding relatives unconscious or frothing at the mouth after overdosing.

School is a refuge for many students. It’s not only where they attend classes. It’s a place where they also have access to hot meals, hot showers, and donated clean clothes. On Fridays, students can take home backpacks full of food so they won’t go hungry over the weekend.

Parents spend money on the next fix instead of on food for their kids.

Portsmouth High School offers students not just breakfast and lunch but also laundry facilities. Many students frequently come to school wearing the same, unwashed clothes days in a row, so shelves are stocked with clean garments, along with shampoo, bars of soap, and deodorant.

Yet some of the teenagers change back into their own clothes after the final bell rings and the last class ends “because parents will take new clothes and sell them for drug money,” says Drew Applegate, an assistant principal.

“We don’t live in a third world country, but some of these kids are living in third world conditions,” he adds. “Kids out there are raising themselves to the best of their abilities.”

Portsmouth High School offers students breakfast and lunch. Students can also use the laundry facilities on-site. Many of them frequently come to school wearing the same, unwashed clothes days in a row. In response, the school stocks shelves with clean garments. Shampoo, bars of soap, and deodorant are also provided.

Yet some of the teenagers change back into their own clothes after the final bell rings and the last class ends. That’s “because parents will take new clothes and sell them for drug money,” says Drew Applegate, an assistant principal.

“We don’t live in a third world country, but some of these kids are living in third world conditions,” he adds. “Kids out there are raising themselves to the best of their abilities.”

Ground Zero for Opioids

Like many American towns ravaged by opioids, Portsmouth, which hugs the Ohio River and borders Kentucky, was once an economic powerhouse. Nearly a century ago, it was home to thriving shoe and steel industries and a professional football team. But today, much of Portsmouth is forlorn and frayed. Vacant brick buildings, their windows boarded up, dot downtown. Addicts wander along the train tracks at all hours, offering to sell their bodies for drug money. Billboards along the main highway advertise rehab services and the opioid treatment Suboxone.

Scioto County has long been considered ground zero in Ohio’s opioid epidemic. In 2010, nearly 9.7 million pills were prescribed there—more than in any other part of the state and enough to give 123 pills to each county resident, according to official statistics. Over the years, as opioid prescriptions have fallen, many drug users have moved on to heroin and fentanyl, a potent synthetic opioid that frequently causes overdose deaths.

As the epidemic has spiraled out of control, the addicts’ children have become collateral damage. Harrowing stories of living amid addiction spill out during therapy sessions at school or in halting conversations with a sympathetic basketball coach.

Christian Robinson, 18, who plans to join the Marines after he graduates from high school, says his mom went to rehab when he was 11, but she relapsed last year on meth and heroin.

“Mom has said that even us kids are not a good enough reason to stay clean,” Robinson says. One of his sisters was born dependent on crack cocaine, he says, and a brother was born dependent on the prescription opioid oxycodone.

“I’ve seen what drugs can do to a family, and it’s not worth it to me,” Robinson says.

Portsmouth hugs the Ohio River and borders Kentucky. Like many American towns ravaged by opioids, it was once an economic powerhouse. Nearly a century ago, it was home to thriving shoe and steel industries. It even had a professional football team. But today, much of Portsmouth is deserted and frayed. Vacant brick buildings, their windows boarded up, dot downtown. Addicts wander along the train tracks at all hours, offering to sell their bodies for drug money. Billboards along the main highway advertise rehab services and the opioid treatment Suboxone.

Scioto County has long been considered ground zero in Ohio’s opioid epidemic. In 2010, nearly 9.7 million pills were prescribed there. That was more than in any other part of the state and enough to give 123 pills to each county resident, according to official statistics. Over the years, as opioid prescriptions have fallen, many drug users have moved on to heroin. They’ve also turned to fentanyl, a potent synthetic opioid that frequently causes overdose deaths.

As the epidemic has spiraled out of control, the addicts’ children have become collateral damage. Harrowing stories of living amid addiction spill out during therapy sessions at school. And these stories are part of halting conversations with a sympathetic basketball coach.

Christian Robinson, 18, plans to join the Marines after he graduates from high school. He says his mom went to rehab when he was 11, but she relapsed last year on meth and heroin.

“Mom has said that even us kids are not a good enough reason to stay clean,” Robinson says. One of his sisters was born dependent on crack cocaine, he says. One of his brothers was born dependent on the prescription opioid oxycodone.

“I’ve seen what drugs can do to a family, and it’s not worth it to me,” Robinson says.

Brian Snyder/Reuters

Medics respond to an overdose on the streets of a Boston suburb in 2017.

Dabbling in Pills

Layla used to live in a middle-class neighborhood with her half-sister, her stepfather, and her mom. They sat down most evenings for dinners cooked by her mother, who worked then as a hospice nurse.

“We always had everything we wanted, and they made sure of that,” says Layla, an avid athlete who loves country music and dreams of becoming a nurse practitioner.

But her mother was secretly stealing bags of morphine and other painkillers from hospice patients who had died. Nikki Horr, 38, says her plan was to sell the stockpiled pills around town. That changed one day when, feeling overwhelmed at work, she began “dabbling in pills.”

Layla used to live in a middle-class neighborhood with her half-sister, her stepfather, and her mom. They sat down most evenings for dinners cooked by her mother, who worked then as a hospice nurse.

“We always had everything we wanted, and they made sure of that,” says Layla, an avid athlete who loves country music and dreams of becoming a nurse practitioner.

But her mother was secretly stealing bags of morphine and other painkillers from hospice patients who had died. Nikki Horr, 38, says her plan was to sell the stockpiled pills around town. That changed one day when, feeling overwhelmed at work, she began “dabbling in pills.”

In 2013, after hospice officials discovered she was overprescribing narcotics, she was given a drug test. She failed and was promptly fired. She entered outpatient rehab and stayed clean for a while.

But after losing an appeal to regain her nursing license during Layla’s freshman year of high school, Horr  lost her resolve. Distraught, she tracked down one of her sisters, who introduced her to heroin.

“I went straight to the needle,” Horr says.

At first, Horr left no trace of her drug use. But soon stray pills were tucked into sofa cushions, and syringes were rattling at the back of drawers. Then one day, Layla, who had grown suspicious, peeked through a porch window and watched with horror as her mother wrapped her arm with a rubber strap and pierced her skin with a needle.

As her mother surrendered to the drugs, Layla says their home filled up with filthy dishes, dog feces, and strangers who came over to shoot up.

“I’d be crying, begging her to stop,” Layla says, “but she was too out of it to care.” The addiction got so bad that Layla became too embarrassed to invite friends over.

For a while, the family survived on money sent by Layla’s stepfather, who worked out of state for months at a time. In his absence, her mother began a relationship with another drug user, and more and more of the money went to buy drugs.

In the summer of 2017, the family moved to a shabbier house. The girls spent many nights at home alone, sustaining themselves on cans of ravioli and frozen dinners. “Sometimes I’d have to go without eating,” Layla says, “so my sister could eat.”

In 2013, hospice officials discovered she was overprescribing narcotics. That led to her being given a drug test. She failed and was promptly fired. She entered outpatient rehab and stayed clean for a while.

But she lost an appeal to regain her nursing license during Layla’s freshman year of high school. After that, Horr lost her determination. Distraught, she tracked down one of her sisters, who introduced her to heroin.

“I went straight to the needle,” Horr says.

At first, Horr left no trace of her drug use. But soon stray pills were tucked into sofa cushions, and syringes were rattling at the back of drawers. Layla had grown suspicious. One day, she peeked through a porch window to catch her mother. Layla watched with horror as her mother wrapped her arm with a rubber strap and pierced her skin with a needle.

As her mother surrendered to the drugs, Layla says their home filled up with filthy dishes, dog feces, and strangers who came over to shoot up.

“I’d be crying, begging her to stop,” Layla says, “but she was too out of it to care.” The addiction got so bad that Layla became too embarrassed to invite friends over.

For a while, the family survived on money sent by Layla’s stepfather, who worked out of state for months at a time. In his absence, her mother began a relationship with another drug user. That led to more and more of the money going toward buying drugs.

In the summer of 2017, the family moved to a shabbier house. The girls spent many nights at home alone. They sustained themselves on cans of ravioli and frozen dinners. “Sometimes I’d have to go without eating,” Layla says, “so my sister could eat.”

Alyssa Schukar/The New York Times

Layla and her mother, Nikki Horr, during one of her mom’s infrequent appearances.

‘At a Breaking Point’

n the summer of 2018, Layla’s mother overdosed on painkillers in a Walmart parking lot. She spent 45 days in rehab before abruptly leaving and resuming her drug use. Layla’s stepfather left for good, and her half-sister went to live with her paternal grandparents in another town. With her own father long out of the picture, Layla moved in with her grandmother.

Through it all, Layla has managed to maintain a 3.8 grade point average—while playing center on the basketball team and right field on the softball team, where she’s also one of the team’s top hitters.

“School’s my happy place,” she says.

More than half the members of the softball team have a close family member who uses drugs, and many live with their grandparents or a neighbor, says Kristen Bradshaw, the coach.

In the summer of 2018, Layla’s mother overdosed on painkillers in a Walmart parking lot. She spent 45 days in rehab before abruptly leaving and resuming her drug use. Layla’s stepfather left for good. Her half-sister went to live with her paternal grandparents in another town. With her own father long out of the picture, Layla moved in with her grandmother.

Through it all, Layla has managed to maintain a 3.8 grade point average. She’s played center on the basketball team. She’s also played right field on the softball team, becoming one of the team’s top hitters.

“School’s my happy place,” she says.

More than half the members of the softball team have a close family member who uses drugs. Many of the players live with their grandparents or a neighbor, says Kristen Bradshaw, the coach.

The stress of her mother’s addiction has taken a toll on Layla.

For years, Layla’s love for her mother, plus her stepfather’s support, helped contain the anxiety wrought by the disorder of her home life, and Bradshaw marveled at the girl’s inner strength and her ability to focus on the field. But these days, with Layla’s family absent, Bradshaw says the stress has taken a toll.

“She’s at a breaking point,” Bradshaw says. “Her emotions are just out of whack.”

It’s hard for Layla to hide her constant dread and disappointment.

“There are times I still see the mom I used to know,” Layla says. “Other times I’m like, where did she go, and when will she come back? It’s heartbreaking. She was my best friend.”

Nearly a week after she disappeared, Horr texts Layla during math class. Layla begs her to come home and to enter inpatient rehab. Her mother refuses, saying that she’s sober but is going away for a while.

“I want to be nonexistent,” her mom texts.

“You’re ill, you can’t admit it,” Layla replies. “Get help and become my mom again.”

For years, Layla’s love for her mother, plus her stepfather’s support, helped contain the anxiety caused by the disorder of her home life. Bradshaw marveled at the girl’s inner strength and her ability to focus on the field. But these days, with Layla’s family absent, Bradshaw says the stress has taken a toll.

“She’s at a breaking point,” Bradshaw says. “Her emotions are just out of whack.”

It’s hard for Layla to hide her constant dread and disappointment.

“There are times I still see the mom I used to know,” Layla says. “Other times I’m like, where did she go, and when will she come back? It’s heartbreaking. She was my best friend.”

Nearly a week after she disappeared, Horr texts Layla during math class. Layla begs her to come home and to enter inpatient rehab. Her mother refuses, saying that she’s sober but is going away for a while.

“I want to be nonexistent,” her mom texts.

“You’re ill, you can’t admit it,” Layla replies. “Get help and become my mom again.”

Dan Levin covers youth issues for The Times.

Dan Levin covers youth issues for The Times.

Tackling the Crisis

Will more money and more treatment make a difference?

Drew Angerer/Getty Images

Last April, President Trump addressed a meeting of addiction specialists and made this promise about the nation’s opioid crisis: “We will end this terrible menace!”

The federal government has recently ramped up efforts to cut off the supply of opioids and given some $1 billion in grants to states and local communities to, among other things, buy Narcan, a drug that can reverse the effects of an overdose. Officials have also tried to focus less on punishing drug users and more on treating them. Meanwhile, a $572 million court ruling against Johnson & Johnson, one of the manufacturers of prescription opioids, along with a $3 billion proposed legal settlement with another, Purdue Pharma, seemed to indicate that additional litigation against drug companies might succeed.   

In 2018, the number of overdose deaths from prescription opioids declined for the first time in decades. But the number of deaths from heroin and fentanyl overdoses continued to rise, so experts say it’s too early to say it’s a turning point.

“We need to recognize that there’s no magic bullet that’s going to fix this,” says Richard Blondell, an addiction specialist at the University at Buffalo. “That said, if there’s one thing we can do, it’s prevention. As long as we’re creating people addicted to prescription opioids faster than we can treat them, we’ll have an epidemic.”

—Patricia Smith