USA: portrait of despair, opioids land more women behind bars

“Hi, Mommy,” 10-year-old Robby says to Krystle Sweat, clutching a phone in the visiting room as he looks at his mother on a screen, sitting in her cell.

Robby hasn’t hugged or even touched her since Christmas Day 2015, just before Sweat wound up back behind bars. He runs a hand through his hair, shifts his weight from one leg to another, and says that on the day his mom is released, he wants to show her how he can ride no-hands on his bike. Sweat laughs, but knows their reunion must wait.

For years now, she has cycled in and out of jail, arrested more than two dozen times for robbery, driving violations and other crimes — almost all related to her drug addiction that culminated in a $300-a-day pain pill habit. She’s tried to quit, but nothing has worked. Now she says she’s ready to make the break when she’s paroled again, possibly this summer.

“I’m almost 33,” she says. “I don’t want to continue living like this. I want to be someone my family can count on.”

This lone county jail in a remote corner of Appalachia offers an agonizing glimpse into how the tidal wave of opioids and methamphetamines has ravaged America. Here and in countless other places, addiction is driving skyrocketing rates of incarcerated women, tearing apart families while squeezing communities that lack money, treatment programs and permanent solutions to close the revolving door.

More than a decade ago, there were rarely more than 10 women in the Campbell County Jail. Now the population is routinely around 60.

Most who end up here have followed a similar path to Sweat: They’re arrested on a drug-related charge and confined to a cell 23 hours a day. Many of their bunkmates also are addicts. They receive no counseling. Then weeks, months or years later, they’re released into the same community where friends — and in some cases, family — are using drugs. Soon they are again, too.

And the cycle begins anew: Another arrest, another booking photo, another pink uniform and off to a cell to simmer in regret and despair.

Sarai Keelean has been jailed about eight times in six years. One Christmas, her mother joined her. Like Keelean, she is addicted, and had been arrested on a driving offense. Mother and daughter spent the holiday crying in each other’s arms.

Keelean is back in for violating probation for possessing meth; she’d been using the drug and also selling it to buy opioids. Locked up now for almost three years, she longs for freedom but is terrified, too. “You’re afraid that you’re going to mess up,” she says. “Nobody wants to come back here.”

Blanche Ball, who has used, cooked or sold meth for 15 of her 30 years, has been in jail several times, mostly for short periods until now. She thinks about her four children constantly and recently dreamed her 3-year-old son was a doll broken into pieces.

“I know I could have done something more with my life,” she says, but: “Once you’re like this for so long, you don’t know another way to be.”

In America’s ongoing battle against addiction, Campbell County faces formidable odds. In 2015, it had the third-highest amount of opioids prescribed per person of all U.S. counties. The numbers identified by the Centers for Disease Control and Prevention were more than five times the national average — or enough opioids to medicate every single resident here around-the-clock for 15 weeks.

Mayor E.L. Morton blames the pharmaceutical industry and doctors, and two lawsuits against opioid makers are pending on behalf of the county and its 40,000 residents. “If you were fighting the Mafia, you’d be aiming for the head of the organization,” he says. “Well, the top of this organization is fully legal, and we have the most respected profession that is doing it to us.”

Pills, though, aren’t the only problem. With 500 square miles of mountains, thick woods, winding back roads and deep hollows, this county on the Kentucky border has been a prime spot, too, for meth. While homegrown labs are on the wane, a powerful strain of the drug from Mexico has found its way here.

“Throw a rock, hit a house, and there’s drugs,” says Keelean, the 35-year-old inmate who says she didn’t have a major problem until she moved back about five years ago. “I just got sucked into a vortex of destruction and drug use.”

The county has been struggling for decades. Its once-thriving tobacco farms and coal industry disappeared long ago, taking with them a vital cash crop and jobs that supported a middle-class life. Some factories remain, but more than 1 in 5 residents are poor.

Nowadays, as much as 90 percent of the crime in a five-county district that includes Campbell is connected to drugs, the local prosecutor says. Women are often the culprits, and communities across the nation are seeing similar patterns.

Women in jail are the fastest-growing correctional population in America. Their numbers rose from 13,258 in 1980 to 102,300 in 2016, with the biggest jump in smaller counties, according to the Bureau of Justice Statistics. Similarly, the female prison population skyrocketed from 5,600 in 1970 to more than 110,000 in 2016. Between 1980 and 2009, the arrest rate for drug possession or use tripled for women, while it doubled for men.

Opioid abuse has exacerbated the problem.

In Montgomery County, Ohio, more than 3,600 women have been jailed for addiction-related crimes in the last two years, twice the number since 2014. In Henrico County, Virginia, the female jail population has grown from about 60 daily in 2000 to nearly 300; a survey of inmates found more than 4 in 10 women had their kids removed from them while on drugs. The jail has responded with an opiate treatment program.

Rural America, in particular, lacks resources and readily accessible treatment to help curb the problem, says Jessica Hulsey Nickel, president of the Addiction Policy Forum, a patient advocacy group. If someone in recovery has to drive several hours to visit a specialist or receive regular doses of methadone, she says, “It’s going to make staying on that path nearly impossible.”

Mary-Linden Salter, director of the Tennessee Association of Alcohol, Drug & Other Addiction Services, says her state doesn’t have enough psychiatrists, social workers, counselors and nurses in rural areas. Residential drug treatment, a key part of recovery, also is scarce in those communities — and Campbell County has none, she says, adding: “It’s unrealistic for people to travel 700 miles for treatment because that’s where there’s an open bed.”

Salter also notes there are twice as many residential programs in the state for men as there are for women. That’s partly because women have costlier, more complicated treatment; many have experienced trauma and abuse as children or adults. Generally, women also are slower to seek help because of societal pressures to maintain a family. Many are single mothers who fear losing their children.

“Women are the caregivers of their families,” Salter says. “They get blamed and shamed for not taking care of their children. But they get blamed and shamed for not being in recovery. It’s a horrible choice.”

A view from the glass-enclosed guard tower that peers into the women’s unit at the Campbell County Jail: Metal beds flank the walls. Giant bars seal the windows. In dormitory-like cells, the women watch TV, play endless games of cards or pace in silent frustration, counting the days until their release.

They sleep, shower and eat in the same room. On their one hour outside the cell, they can visit an exercise room, but it has no equipment so the women improvise, rolling toilet paper into balls they swat around, using their plastic sandals as makeshift tennis rackets.

Each woman has a story of bad choices, dreams of a “normal” life and nagging doubts about how long they can resist drugs on the outside.

Their voices are weary. They comfort each other, embracing when a parole bid is denied or when the unthinkable happens — an inmate’s son is killed and she sobs, grief-stricken and angry because she’s not permitted to attend his funeral.

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