This is the first part in a series on opioid abuse and addiction. — Ed.
Jacob “Jake” Wade summited Table Mountain at age 5, made a west-to-east traverse of the Tetons at age 8 and stood atop the Grand Teton three times. He was a talented freestyle skier, and his friends and family say his loving heart was even more remarkable than his “gymnastics on skis.”
But after battling an addiction to opioids for years, Jacob Wade overdosed on heroin and died in Colorado last fall.
He was 26.
What went wrong? Could his death, which cut a promising life so short, have been prevented?
His parents, Cathleen Imo and Dave Wade, have been left to grapple with those questions.
“The heartbreak is immense,” Wade said. “I’ll never be the same. I don’t know when or if I’ll ever be able to function up to my potential again. I can’t even describe the loss. I’ve cried more in the last 2 1/2 months than I did the rest of my life combined; sometimes it’s for hours a day. The loss, the way it affects our society and people and families, is immeasurable.”
Opioids, both prescription and illicit, are the main driver of drug overdose deaths in the United States, according to the Centers for Disease Control and Prevention. Opioids were involved in 42,249 deaths in 2016, and opioid overdose deaths were five times higher in 2016 than 1999.
Wyoming’s rate was 17.6 drug overdose deaths per 100,000 people in 2016, with 99 drug overdose deaths statewide in 2016, 96 deaths in 2015 and 109 in 2014.
The drugs most commonly involved in prescription opioid overdose deaths include methadone, oxycodone and hydrocodone. The numbers surrounding prescription opioids are bleak: In 2014 almost 2 million Americans abused or were dependent on prescription opioids; every day more than 1,000 people are treated in emergency departments for misusing prescription opioids; and every day 1,700 children and young adults begin experimenting with prescription and over-the-counter drugs.
Opioid abuse is even influencing a drop in life expectancy in the U.S. For the second year in a row, life expectancy has fallen due to a combination of drug and alcohol use and suicides. The National Survey on Drug Use and Health found in 2014 that overdoses kill more people than guns or car accidents, and over half of those deaths are from opioids.
The Tetons may seem a world away from places like Ohio and West Virginia, where opioid abuse has been labeled an epidemic. But local law enforcement, professionals in the addiction community and medical professionals overwhelmingly say they have noticed an increase in opiates here in Jackson.
“Yes, it happens here; and, yes, it is here; and, yes, it’s something that we deal with,” said Teton County sheriff’s Lt. Matt Carr. “Thank goodness we don’t deal with it on the scale of communities that have a serious problem. But we know it’s here, and it’s something we need to address.”
A childhood in the mountains
Jacob Wade was born July 10, 1991, in Salt Lake City.
“The nurses after a few minutes said, ‘Mr. Wade, maybe your wife would like to hold Jake for a little bit,’” Dave Wade said. “We were really close right from the get-go.”
When Jacob Wade was 2 his family moved from the Alta Ski Area in Utah to Driggs, Idaho. The toddler spent a lot of his early years in a backpack, strapped onto his parents while they skied, and he soon was skiing on his own. He loved the mountains and had an impressive list of mountaineering accomplishments.
A summit of the Middle Teton sticks out in his father’s memory.
“I remember we were walking out, holding his hand on trail, and we just talked about all kinds of stuff I’ll never forget,” Wade said. “We kind of swore our unconditional love for each other. It was really special.”
Jacob Wade got involved with the Boy Scouts and the Grand Targhee Ski Resort ski team — where he had a perfect attendance record — and, after a move to Jackson with Imo in 2002, the Jackson Hole Ski and Snowboard Club. He started racing and was a club series champion in his division at Snow King Mountain Resort two out of three years before he switched to freestyle skiing at age 14. He would perform tricks he had never practiced, wowing his friends, teammates and coaches.
His friends coined the phrase “what would Jake do” because he always tried new tricks and no one knew what to expect out of him — except for excellence.
He took to the sport like a natural, placing second in a super slopestyle competition and first in a halfpipe contest in Jackson. Plans to compete only locally changed, and Jacob Wade went on to nationals, eventually placing second in the U.S. Ski and Snowboard Association freestyle combined competition.
“I’ve got to say the most amazing part about it during this phase was his humility,” Dave Wade said. “He just wanted to do his best. He told me he was trying to turn it into a real art form. That’s what it meant to him.”
His parents say he had a good sense of humor and a great work ethic. In addition to humility about his natural athleticism, Jake’s heart was huge, Imo said. The main theme of his memorial was friends saying Jake was there for them and had a lot of compassion from a young age.
“He was the one that was giving out his clothes to the homeless, helping at food banks,” Imo said. “He had a lot of compassion. I’ve been looking through his pictures, and I never really saw any of this coming.”
During a sunset photo shoot at Grand Targhee, Jacob broke his neck. It was determined he needed surgery for the C4 fracture: a fusion at the University of Utah. His parents also believe the accident may have resulted in a brain injury, but they were never sure.
“Something changed when he broke his neck,” Imo said.
Though Jacob Wade fully recovered physically from his injury, the resulting surgery introduced his body to extended-release morphine, known as MS-Contin, at the age of 14.
Imo recalled him “freaking out” on the morphine after the surgery — screaming, crying, begging for help, saying he felt out of control. His mother, a hospice nurse who sees the same opiate medication used on patients close to death or in severe pain, discontinued the medication and gave him Tylenol instead.
“He did not appear to be in that much pain,” Imo said. “I did not think he needed such strong pain medication.”
She wonders how many others were given opioids when the drugs weren’t necessary and ended up with an opioid addiction.
According to the CDC, as many as one in four people who receive prescription opioids long term for noncancer pain in primary care settings struggle with addiction. Even though Jacob Wade was taken off the long-acting morphine quickly, his parents pinpointed the surgery and its aftermath as the beginning of his battle.
“He was a different person after that,” Dave Wade said. “He just was. It’s so hard to describe. He went from being super motivated to having struggles with depression. It all starts innocently enough, and then it snowballs into something that’s problematic for these folks who have an addictive nature.”
Doctors say that while addiction is complex and many factors are at play, a legitimate prescription is often how opioid addiction begins.
“Some people have a very high sensitivity to drugs and can become addicted very, very quickly,” said Dr. Brent Blue, a family physician and the Teton County coroner. “We could have 100 people in the hospital with broken legs and give them each a narcotic. Maybe 95 or 96 percent can’t wait to get off that stuff because they hate the way it makes them feel. But the three or four others could be addicted with the first tablet.”
Jacob Wade’s parents recall “trouble” the following fall after a summer of not being able to do anything athletic. Although it was mostly just typical teenage rebellion, drugs were involved.
A three-night stay at the Van Vleck House in Jackson, completing a program at the Curran-Seeley Foundation and being frequently tested for drugs followed. Jacob continually tested positive for weed, but he later told his parents there were opioid pills circulating at school and he was using them.
In 2008 Wade was finishing his sophomore year in high school.
“I remember vividly one evening, Jacob and I were lying on my bed,” Imo said. “I asked him, ‘Do you think you can go through the summer without touching any drugs or alcohol?’ He cried and said, ‘No, I don’t think I can, Mom.’”
If he failed a drug test one more time, juvenile detention at a facility in Worland seemed a likely option for Jacob. His parents fought that idea as hard as they could.
“This is one thing I would say to all parents who are dealing with this in Jackson,” Imo said. “Keep your child in the community. That was so frightening to me. I don’t think Jake was a criminal. He just wanted to feel normal, to feel good.”
Imo strongly felt that her son needed medical attention and psychological support, which is why, after that conversation with Imo, she and Dave Wade eventually checked their son into an extensive rehabilitation program for teens called Teton Peaks Residential Center in Idaho Falls.
But rehab wasn’t perfect — signs mental illness began to appear.
Jacob Wade, who turned 17 that summer, was released from the program after five months. While in rehab, he met a girl: a heroin addict who introduced him to a synthetic, highly addictive opioid that can produce intense feelings of euphoria. His parents didn’t know that at the time.
The CDC says heroin use has more than doubled in the past decade among young adults between the ages of 18 and 25, and heroin-related overdose deaths have more than quadrupled since 2010. From 2014 to 2015 heroin overdose death rates increased by 20.6 percent, with nearly 13,000 people dying in 2015.
A dual diagnosis of bipolar disease at age 18 increased Jacob Wade’s difficulties battling addiction. He attempted suicide that same year.
“There’s such a stigma with mental illness and addiction, and so oftentimes they are correlated,” Dave Wade said. “We need to get over that stigma. That’s absolutely huge. My son was a really exceptional individual, and he battled this every day. He didn’t give in to it. It’s just not all cut and dry.”
According to reports published in the Journal of the American Medical Association, roughly 50 percent of individuals with severe mental disorders are affected by substance abuse, and 53 percent of drug abusers also have at least one serious mental illness.
Jacob’s parents want people to know that addiction is a medical problem, not a moral failing.
“It doesn’t have anything to do with willpower,” Dave Wade said.
“I don’t know how many people said to me, especially when he was younger, ‘He should find something else to get addicted to, like road biking,’” Imo said. “I said, ‘It doesn’t work like that.’”
Jacob Wade ended up in inpatient rehab facilities many more times. Addiction, and its ups and downs, do not follow a linear timeline.
“I’ve got to emphasize, although he was an addict, most of the time he was clean,” Dave Wade said. “He really battled it. But he would have slips. Most of the time they’d only last a day or two.”
Before graduating from Summit High School in 2010, Jacob Wade worked at Teton Pines. He then moved to Salt Lake City and was clean for 18 months. But his parents say the depression was “disabling” at times. In the fall of 2011, Dave Wade said, his son “started going down the tubes” again. He was checked into rehab again, a facility called Rimrock Foundation in Billings, Montana.
“He seemed to have pretty good success there,” Dave Wade said. “Even though all this was going on, it wasn’t all dark.”
Jacob Wade continued to climb, summiting the Grand Teton a few times and 14ers in Colorado. He dabbled in unicycling, played the guitar, went to concerts all around the country and started power lifting.
In 2014, after another stay at Rimrock, Jacob went to a sober living facility called the Choice House in Boulder, where he thrived. But such places aren’t perfect or a permanent solution.
“You can’t stay there forever,” Imo said. “He’s got to be out in the real world.”
The dangers of stigmatization
Jacob Wade’s parents battled their instincts to hover with letting their grown son live his life.
“The struggle of a parent having a kid with a mental illness is getting them to stay on their medication, which is nearly impossible unless they’re under your own roof,” Imo said. “I wanted him to be on his own.”
When they did intervene they managed to place him in rehab in Montana two more times. His parents said he felt a lot of guilt and shame over his addiction and that society needs a paradigm shift in how they view addicts.
“The last thing Jacob wanted was to be addicted to opioids,” Dave Wade said. “He did love the way they made him feel; he did feel peace on them. He liked it but he didn’t want to like it. It was a real struggle. Addicts know at any juncture what they can take to feel normal or feel good, and that is so powerful. It’s inescapable.”
Stigmatizing addicts and mental illness, Imo said, doesn’t help. Trudy Funk, the executive director of addiction treatment center Curran-Seeley Foundation, told the News&Guide that the stigma is the “biggest societal misconception.”
“It’s not just a certain kind of person, a certain age or a certain socioeconomic class,” Funk said. “Addiction affects everyone. There’s a lot of guilt and shame when people are thinking, ‘I should be able to handle this, I should be able to control this,’ but it’s not about self-will. ... These drugs basically hijack your brain into thinking you need to use. In some cases our clients will report that they felt that they needed to use or else they would die. It’s very powerful. Our brains are amazing in how they can convince us of things.”
Imo said that the American ideal of “pulling yourself up by the bootstraps” and “git ’er done” isn’t easy for everyone.
“My son didn’t ask to be in the place he was,” she said. “He didn’t ask to be an addict or to be born with a mental illness. That was his path and unfortunately he only had 26 years here. But I think the shame keeps them from getting help. So if we’re constantly going to have that stigma, people are not going to reach out for help and people are going to continue to die.”
The last years
Jacob Wade eventually landed in Denver, remodeling homes and attending Red Rocks Community College. He had a solid relationship with a girlfriend of more than three years. Things were good, but addiction doesn’t always know good times from bad.
“It’s a coping mechanism,” Dave Wade said. “He expressed that the cravings were really, really hard.”
He told his mother the same.
“He was always very candid and very honest because I think he wanted help,” Imo said. “You can’t even put into words the cravings that are there every second of the day, and it doesn’t go away. It just doesn’t.”
In April 2017 Jacob Wade almost died from a heroin overdose. He went into cardiopulmonary arrest but was revived by his girlfriend, who performed CPR, and paramedics. The doctors told his parents that if he had been found a few minutes later they would have been donating his organs.
“As family members and parents we live with that fear every day that we’re going to get that call,” Imo said. “That’s the reality. That’s the harsh reality.”
He lived with his mother all summer, attended outpatient support groups and was able to get Vivitrol, a brand name of naltrexone, a drug that blocks opioid receptors in the brain for a month at a time, helping patients to prevent relapse to opioid dependence following detox while they focus on counseling. He told his parents the health care system was overwhelming and difficult to navigate, and sometimes he needed help maneuvering through it — the shots can cost $2,000 per injection if insurance doesn’t cover them.
The clinic Jacob Wade visited, the Arapahoe House, was Colorado’s largest treatment provider for drug and alcohol addiction. It has since closed.
His parents watched as the cycle of rehabilitation happened over and over.
“Of course we’d keep putting him in rehab time and time again,” Dave Wade said. “We wouldn’t have given up. People shouldn’t give up. Even if it ends in death, the six years or five months you gain is invaluable. It’s priceless, and I’ll never forget it, despite the struggle.”
But his parents said they wouldn’t change how much time and energy they invested trying to keep their son safe. Imo said parenting was a “razor’s edge” as she and her ex-husband tried to deal with mental illness and substance abuse.
“I don’t even know how much money I’ve gone through,” Imo said. “It doesn’t matter. I have no regrets about any penny I’ve spent. I advocated for my son as much as I could. They need advocates. I didn’t give him a place to live and money so he could do drugs. We just gave him a safe place in times until he was ready to get help.”
Still, there were bright lights in Jacob Wade’s life. His father fell in love while guiding in Alaska. Jacob Wade got along great with his father’s girlfriend, now fiancee, and was excited to learn that his father had proposed. Wade also got along well with his mother’s new husband. He had bought a home with Imo in Denver that they planned to fix up.
“He was so happy,” Imo said. “That’s why we were so shocked. But I’ve talked to other addicts, his friends, and they said that sometimes the highs and the lows are the most dangerous.”
Funk, Curran-Seeley’s executive director, noted that very positive things can lead to relapse.
“What we know about relapse is that any change in our lives can affect us, whether it’s a positive or negative change,” Funk said. “We know that for some people, a cause for celebration can lead to relapse.”
Jacob Wade fell ill with pneumonia in November and checked into a hospital. He missed his monthly Vivitrol shot while he was there. Doctors noted a variety of health issues to follow up on later, such as an enlarged spleen, an abnormal heart, broken glass nodules on his lungs and cardiac output being down to 30 percent of what it should be.
He was discharged Nov. 17 and was found dead the morning of Nov. 19. His parents learned from an autopsy that he died from a heroin overdose.
“His health was really, really declining,” Dave Wade said. “He turned to heroin, and it killed him. He was having big cravings and trying to cope with some major stuff. He was a human being. The numbers aren’t good with addicts surviving this.”
Living without their only son
Imo and Dave Wade’s loss makes opioid abuse personal.
“I wake up thinking about him,” Imo said. “I go to bed thinking about him. If I wake up in the middle of the night, he is my first thought.”
They’re struggling to cope and ask themselves what, if anything, they could’ve done differently. But they know that even if they had tried to live closer to him or stay married, there was no magic bullet.
“There’s no panacea,” Dave Wade said. “It’s such a strong compulsion, and it’s so dangerous. I do mostly focus on the good stuff. You can’t make sense of crazy. But of course I think about that stuff all the time, what I could’ve done differently. I’m not perfect.”
They did learn, over the years, how to parent and love their son while he battled addiction.
“I tried the tough love thing for a little while,” Dave Wade said. “I figured out that it just wasn’t working between Jake and I. I figured out if I did that, he was going to die in the streets. I told him, ‘You know, if you’re going to die, you’re going to die knowing that I love you.’”
His father said the last five years were “absolutely seamless between us” and that he learned “unconditional love” alongside his son’s struggles.
“It wasn’t enough to save him,” Dave Wade said. “But it was enough to have a good relationship.”
His mom and dad say their lives will never be the same. They miss him every day. When they’re ready, both Imo and Dave Wade say they want to make a difference by telling Jacob’s story. They want others to understand that addiction isn’t black and white, and they said they hope to, at the very least, save just one more life.
“I told Jake that he was my hero, because he battled these demons,” Dave Wade said. “I don’t know if I had these same demons if I would survive.”
The News&Guide is publishing a series on opioid abuse and addiction. See part two, law enforcement's fight to stay ahead of the crisis, here.