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It was midnight when Gwen Knox heard her landline ring almost two years ago in her cozy Baton Rouge home.

She lived alone, as just months earlier, she had evicted her son Brian Knox over his ongoing struggle with drugs. Gwen Knox let the call go to voicemail.

“This is Jefferson Parish trying to reach the family of Brian Knox,” she recited, remembering the voice when she checked her messages. 

“I said, ‘This is not good,’ so I wasn’t making that call,” she said. “I sat right here on this couch and I did my deep breathing and I was going to wait until later on that next morning possibly to call them.”

But then her youngest son Cardel Knox called. Officials had contacted her ex-husband, who in turn got in touch with their son. He called his mom, told her that his brother had died and then came over to her house.

“He just kind of fell in my arms and cried,” Gwen Knox said. “It was probably a week before I could shed a tear. I guess possibly seeing the body sends you in a state of shock. So it was just one of those things that you never hope to deal with.”

Brian Knox overdosed on heroin on Dec. 30, 2015, in a Metairie apartment. He was 40 years old.

On Jan. 23 this year, Brian Knox’s birthday and exactly two years after his memorial service, Gwen Knox was ready to take her experience with a son who couldn't overcome his drug addiction and turn it into something that could help others. After completing online training, she began a local branch of a national support group called Parents of Addicted Loved Ones.

There are plenty of people to help.

Across the country and in Louisiana, heroin and other opioid overdoses have steadily climbed in recent years, reaching what medical professionals are calling "epidemic" levels in many communities. On October 26, President Donald Trump declared the crisis a national public health emergency.

That same day, the number of fatal overdoses in East Baton Rouge Parish through that date in 2017 reached the total for all of 2016.

A local problem

Opioid overdoses have been on the rise in Baton Rouge for years. There were 92 drug-related deaths in the parish as of Nov. 15, according to the website for parish Coroner Beau Clark. Thirty-seven involved heroin, while the other 55 were connected to “other drugs.”

Clark said almost all of those “other drugs” are opioids, largely prescription drugs. In 2016, only two of the 55 “other drugs” deaths were not opioids: one Benadryl overdose and one cocaine overdose.

Even with homicides in Baton Rouge reaching record levels this year, opioid deaths are keeping pace, Clark noted. Overdoses could again surpass killings, something that happened for the first time in 2016.

Not only have the number of fatal overdoses increased in the parish, but so have the number of times the Emergency Medical Services Department has administered the overdose-reversing drug naloxone, said Mike Chustz, an agency spokesman.

EMS paramedics had administered 737 doses of the drug to overdosing patients as of Nov. 14, according to data obtained by The Advocate. That's a 40 percent hike from the 525 doses given during the same time period in 2016.

Soon, other Baton Rouge agencies besides EMS will start carrying and administering the drug. Chustz said EMS employees have been training officers with the LSU Police Department.

The Baton Rouge Police Department also received about 700 doses of the injectable version of the drug through a program with the Attorney General's Office, according to interim Police Chief Jonny Dunnam. Officers will be trained and will start carrying it after a protocol is in place.

Some addicts and their loved ones also have started carrying the drug. One mother who attends Gwen Knox’s support group said an adult child's multiple overdoses prompted her to store doses of naloxone in her medicine cabinet. They are still there even though that relative is now in a long-term recovery center outside of Baton Rouge.

“(It’s a) thing you never thought were in your realm of doing. … That’s what addiction does,” she said, asking to not be identified because of concerns for her and her child's safety.

Hitting home

“This...” Gwen Knox said as she slowly pulled out the large, black urn, “is what can happen to you when you play Russian roulette with your life.”

It was Brian Knox’s urn that Gwen Knox brought with her that day when she spoke with a group of recovering addicts at O’Brien House, a Baton Rouge-based addiction treatment and support center.

After her son's death, Knox's frank obituary about him went viral. She wrote about his beautiful eyes, "caring heart for the underdog," and wit but also his tormented history with drugs.

"They became his go-to solution for every problem. He would say, 'I can stop using anytime I want to stop' and there were times he did, but those times never lasted because when he was drug free he had to deal with all of the thoughts going through his head," Knox wrote.

She had this advice for others watching relatives trapped in the cycle of addiction: "Love your addict, know that they are sick, but don't let their sickness make you ill."

Hundreds of people ended up reaching out to her, Knox recalled. The realization that her story resonated with others eventually prompted her to begin her group, as well as give talks at Elayn Hunt Correctional Center’s New Beginnings program and classes at O’Brien House, a Baton Rouge-based treatment and support center.

“It’s something greater than me,” said Knox, remembering how she brought the urn with her that day. She said she hopes her experience can help others make the right decisions for their situation. 

When Knox leads the PAL group, they work through lesson plans prepared by the national organization, dealing with challenges like how to figure out the healthy way to help an addict. After talking through the lessons with their own experiences, the group members check in with one another to give updates and offer support or advice. Knox said the group shows parents they aren't alone and helps guide them away from enabling behavior.

“Enabling harms rather than helps because the addict has to suffer the consequences in order to move in a direction of care and sobriety for themselves,” Knox said.

Of the 45 people who have attended the group in the past several months, about half a dozen meet on a weekly basis. People in the group described similar frustrations as those in Knox's letter. The woman who attends Knox’s group and still keeps naloxone at her house said she tried everything to cope with her child's addiction and recovery.

She read hundreds of instructional books on her Kindle and attended meditation sessions at a Buddhist temple, but eventually, she found that her faith, journaling her prayer intentions and attending the support group is what helps her the most.

The struggles to get her child into rehab after two overdoses were tough to deal with. After going through detox after the overdoses, there was at first a weeklong wait and then a monthlong wait for long-term treatment beds.

She tried finding programs and treatment centers that could help, even calling the Governor’s Office one day. But she already knew about almost all of the places on the list the aide recommended.

“If you told me that I could smear my loved one in peanut butter and roll (that relative) in Cheerios and that would help, I would have done it,” she said. “But that didn’t happen.”

More connection

As awareness of the epidemic has increased, so have the amount of proposed solutions and government attention, but those efforts have not been entirely in sync, said Capital Area Human Services Executive Director Jan Kasofsky.

The goal moving forward is to change that, she said. 

Kasofsky has created a proposal that will bring specialists together on 10 separate aspects of the epidemic. Then, those specialists will “feed in like the spokes of a wheel” to create a “communitywide plan,” Kasofsky said. Until now, she said she is not aware of a similarly unified plan for the region.

“In Baton Rouge, we’re the same as everyone in the country right now,” Kasofsky said. “We’re just not equipped to really respond strongly enough to this epidemic.”

The Capital Area Human Services District is a state-funded organization that provides community-based services for mental health and addiction in the seven-parish capital region.

Some “spokes” of the plan include changing doctors' prescribing practices, improving clean syringe access, ensuring there are places for addicts to safely detox and raising public awareness. A recent law passed by the state Legislature limiting the amount of opioid pills that can be prescribed for first-time users and the existing state prescription monitoring program already are aimed at limiting the amount of prescription drugs that doctors dispense.

The East Baton Rouge Parish Metro Council recently changed a city-parish ordinance allowing for syringe exchange programs. In addition, Kasofsky said she hopes the president's recent declaration will help build awareness of the problem, though it doesn’t open the door for more funding.

But a major issue is whether there are sufficient treatment options for people who do want help getting off drugs. That will be a tougher challenge to tackle.

“My biggest fear is that when people actually are connected through outreach or a loving family member or friend to say ‘I really need help’ that there’s actually a place that they can get the help that they need,” Kasofsky said. “I am very concerned that there’s not enough places offering it.”

Follow Emma Discher on Twitter, @EmmaDischer.