Ivana Grahovac, who started an addiction support group for college students. Photograph: Michael A Milkovich
In Ivana Grahovacs final semester of college, her mother escorted her to and from every class, and sat by her through each course.
This extreme supervision was needed to ensure Grahovac, a former White House intern, graduated from university despite a debilitating heroin addiction that began in 1999.
Nearly 10 years later, the woman who needed supervision to attend college classes graduated from the University of Michigan with a masters degree and started
an addiction support group for college students that eventually expanded to more than 160 campuses across the country.
There are students on these campuses who kicked addiction and went through the worst of it, and now theyre the best students in their class, said Grahovac, who has been sober for more than 12 years.
Grahovacs addiction arrived on the back of an untreated eating disorder. She said she sought solace in substances while suffering from the illness and was eventually turned on to heroin, which she first tried socially in Europe.
Though Grahovac was able to graduate with her mothers help, she was far from reaching the pit of her addiction.
She went in and out of short-term addiction treatment facilities six times because heroin was negatively impacting every single area of my life, but failed to get on a stable path to recovery.
She left each stint in treatment without a long-term plan to curb addiction and said those repeated experiences made her feel like a failure. It led me to believe that I am that which society portrays: that people who struggle with heroin are criminals, they are throwaways, they deserve to be locked up, they deserve to have their rights taken away from them and they dont deserve to have a successful and meaningful life, she said.
One reason she found recovery so difficult was that each rehabilitation program lasted less than two weeks. The length of in-patient drug stays are dependent on insurance policies and government regulations, and at the time, in Grahovacs home state of Michigan, insurers would cover only 11 days of residential treatment.
You cant just do one little thing to overhaul the damage that addiction does to you emotionally, mentally, physically and spiritually, said Grahovac, who is now director of advancement for Facing Addiction, an advocacy group for people with drug addiction and their families. You need to absolutely devote as much time and focus as possible to rebuilding and restructuring your entire self as youre healing.
She needed more to fight her addictive impulses but, unable to find it, ended up living on the streets of Detroit in the winter. At the time, her parents didnt know where she was and hired a private investigator who, two months later, found her in jail, where she was serving a 54-day sentence for stealing a car.
Grahovac said those 54 days ended up being the stabilization she needed to understand what recovery meant, and to process the messages that had been delivered to her in the shorter rehab experiences.
She also ate organic food, played tennis, and practiced yoga and meditation. She said those healthy living practices, with counseling, helped her recover.
After all those earlier treatment experiences, how did she know she was in recovery?
When I realized that I could wake up in the morning and have somewhere to go to counteract the old, negative, destructive, compulsive thoughts that would wake me up in the morning as I was in early recovery, Grahovac said. I knew I could go to a positive meeting down the road, and when I started to wake up and not have those thoughts any more, I started to have thoughts of hope, excitement, of joy, ambition and to help others.
Cassie, a Cleveland native, became addicted to opioids the same way many Americans do: after using OxyContin to relieve pain from a back injury she incurred at work.
I felt like thats how I wanted to feel for the rest of my life, she said of her first time using the drug. I had energy, I was happy, nothing hurt, and it also took away those feelings of feeling, like, out of place. It just numbed me.
Eventually she stopped using the pills but kept getting the prescriptions, which she resold to pay for heroin, which made her feel the same way but more quickly and for less money.
But the heroin highs still couldnt fill the hole Cassie said she was trying to fill with drugs. She had an inkling of what the solution might be, but didnt accept it until she was enrolled in an addiction treatment program near her home.
There, at an all-male rehabilitation facility, Cassie accepted for the first time that she was transgender.
She also decided she wasnt addicted to drugs and alcohol; she was just using those substances to numb her emotions about her gender identity. She accepted that self-diagnosis until it proved nearly fatal years later.
Cassie had made progress in understanding her gender identity, and moved to Detroit where she worked a corporate job and did adult film work, made good money and traveled frequently. She stopped using opioids until another injury sent her back to the drugs that had made her feel so good years earlier.
Cassie is currently in recovery from opioid addiction. Photograph: Handout
Hooked on drugs again, Cassie became suicidal. She decided to return to the same all-male treatment center she had been to before, but this time she would go back identifying as a woman.
I wasnt shy about saying what was bothering me, I just let people know: This is who I am, I dont care of you accept me, Im gonna do it for me, she said.
Cassie returned to the facility because she knew and trusted the staff and was pleased with her previous rehabilitation experience, but she was worried about encountering people who had known her before.
That fear proved unfounded. Honestly, it was a moot point, she said of her time at the treatment center. I got back into a program of recovery and life has been pretty darn good ever since, she said.
The center had expanded its services for people who complete the residential treatment program, so Cassie was able to live in a sober living house.
Cassie, who just turned 31, said her experience fighting addiction was an uphill battle, but she was happy to now be able to help people in a similar situation.
Youre facing a big battle ahead of you, but its not one you cant win, she said.
Rachel, 24, said she had everything she needed growing up. Her parents were loving and her home was safe, but she was anxious in her small town.
At 13, she began drinking and smoking marijuana with a group of friends she had known since they were children.
Some of those friends are dead now, others are using harder drugs or are in prison. Only Rachel and one other are sober.
Recovery was not a straightforward path for Rachel. She had been introduced at age 15 to OxyContin, which she used recreationally until graduating from high school.
Then she started using it daily.
Her parents sent her to a day rehabilitation program in the spring of 2011, and she stayed clean for six months with the help of suboxone, an opioid treatment that weans people off stronger opioids.
She relapsed, but the manufacturers of OxyContin had changed the pill so it couldnt be crushed, in an effort to prevent people from snorting it or injecting it. So Rachel turned to heroin, which she used during a very dark two-year period. I wasnt doing anything and I wasnt working, she said.
She met with a doctor in Minnesota, which she said marked the first time she really understood what addiction was and how it was affecting her life. I knew that I was out of control and I was just hurt by these things I was doing to myself and I was hurting the people I love, she said.
The doctor put Rachel back on suboxone, which she said was essential to her recovery. I would string along a few days, weeks, months, but I still would end up drinking or using other drugs; sometimes I would stop taking my suboxone and use other opiates, but I think it kept me alive, thats what it did for me, she said.
Rachel had medication and had attended a few counseling sessions over the years, but she wasnt attending the support meetings recommended to help keep her on track.
And she thought these treatments would cure her a common misunderstanding of how addiction works. There isnt a cure, but it can be managed over time like a chronic disease, such as high blood pressure. This whole time I didnt realize what addiction was. I feel like there is a real lack of education that this kind of thing can happen to you, she said.
She was still stumbling through treatment, turning back to drugs including occasional opiates until she was sent to jail after repeated encounters with law enforcement.
She experienced painful withdrawals there, but it put her on track for recovery.
It was a feeling I had in jail where I just completely knew I didnt know how to live, Rachel said. It was almost I just gave up, I surrendered, Im going to stop fighting this and ask for help.
Rachel said it was the first time she really tried to beat addiction.
She has been clean for more than two years and sponsors women who are attempting to get sober. I have a lot of fun in recovery, she said, noting that the community was large and had a lot of social events that helped her separate from the friends she grew up doing drugs with.
She has had a steady restaurant job, which she enjoys, for more than two and a half years. She was honest about her history on her job application and later learned her manager was also in recovery.
Rachel, who is two years away from getting her bachelors degree, most likely in psychology, had advice for young people experiencing addiction: Dont ever give up. Theres always hope where you might not see it.