An artical on my Great Aunt
A new turn -- Janet Caraway's off heroin, going her own way
By JESSICA WAMBACH
YAKIMA HERALD-REPUBLIC
KRIS HOLLAND/Yakima Herald-Republic
Tammy Chin helps her aunt, Janet Caraway, put on earrings before a Christmas shopping trip to the Valley Mall on Dec. 7. Says Janet, who ended her 20-year addiction to heroin this year: "I ask myself sometimes, 'Am I living right? Is this how people live?' "
When Janet Caraway was 14, she decided she'd had enough of Yakima.
She belonged, she thought, on the California coast.
So with little planning and a lot of trust, she and her older sister Brenda packed a few clothes and hit the highway with their thumbs out.
"We wanted to be beach girls," Janet says, smoothing her hand over the same blond hair that covered her shoulders that summer day.
But they didn't quite make it.
Instead, their adventure ended in Pomeroy, Wash., a small, sandless town on the Idaho border.
The 43-year-old can laugh at her naiveté now, but it wasn't the last time a wrong turn would steer her into a mistake.
And some of them would leave marks.
Her arms, her legs, her neck, her hands, her fingers, her feet, her stomach, her back are covered with them -- more than 10,000 scars from 20 years of heroin addiction.
Until nine months ago, nothing -- not her family's tears, the prison sentences or the occasional overdose -- was enough to make her quit.
But in March, when Janet was nearly killed by botulism, a muscle-paralyzing disease she contracted from a contaminated batch of black-tar heroin, she found her motivation.
"I believe that God has a special reason for this to happen to me," she said when she was finally discharged from the hospital a month later. "I think he wants me on this Earth. I'm gonna find out.
"I'm gonna stay clean."
ABOUT 20 YEARS BEFORE Janet was born, her parents and one or two of her older siblings left a dead-end life in Shreveport, La., and moved to a house in Union Gap.
They came west for what they saw as their own golden promise: picking fruit. Each summer, Janet's parents and their nine children worked in the fields, scraping up enough money for food, housing and school clothes.
Janet was the youngest and the most energetic.
"She'd be the one out there playing with the kids, doing cartwheels," remembers one sister who, like several of Janet's relatives, declined to be identified for this article. "She loved life and she loved to play."
The little girl dreamed of growing up to be an airline stewardess, or maybe a nurse -- although she was terrified of needles.
Once, her dad took her to the doctor's office to get a shot and when the nurse came out with the needle Janet turned and ran to the elevator.
Her dad caught her before the doors opened.
That's the way she was -- the family's cherished baby and greatest headache, says her niece, Tammy Chin, who is just one year younger.
"Janet was the leader because she was so strong," Tammy says.
But she was also stubborn, and for all the love in the Caraway home, there was little emphasis on education or discipline.
KRIS HOLLAND/Yakima Herald-Republic
Janet Caraway speaks last month with 21-year-old Jesse Caraway, one of her two sons, for the first time since he was booked into the county jail on charges of car theft and evading police. Janet has made a strong effort to reconnect with her sons since getting off heroin. Janet's other son lives with her sister.
Janet lost interest in school in the sixth grade, but kept going as long as she could, cheating her way through the ninth grade and earning a seat at her middle school graduation.
Although most of the family didn't think the ceremony would be important to Janet, one of her sisters bought her a dress and encouraged her to go.
But as the program began, the 14-year-old was getting high with some guys she and Brenda had met that day. Janet kept an eye on the clock, she remembers, knowing people were waiting for her in the gym.
She never made it.
"I wonder how that day would be," she says now.
It wasn't the only graduation she would miss. After that night, Janet never went to school again, never got the proper welcome to adulthood or the education she knows she should have.
Instead, she turned her attention to partying and men. The drug use wasn't chronic yet, mostly because Janet's world was already hectic enough. She didn't need acid or cocaine or the other drugs she'd tried that made it spin even faster.
AT 23, JANET WAS living on her own with an 8-month-old son.
One day, at home recovering from a violent fight with a boyfriend, she answered a knock at the door. It was her neighbor, coming to console her.
They sat together and drank a six-pack of beer to ease her aching body. She was feeling slightly drunk.
The neighbor stood up, asked to use her bathroom and left the room.
He'd been in there for a long time with the door locked, so she knocked and demanded that he open it.
When the door eased open, she saw him hovering over a spoon and a needle that were sitting on the back of the toilet.
"What are you doing?" she asked.
"I'm doing some heroin," he answered. "You want to try some?"
Her parents were already losing sleep over her behavior and now, with the baby to think about, too, she hesitated.
But the neighbor pointed to the fresh bruises on her face.
"Janet, I swear to God, if you try it you won't feel any pain," he told her. "All that will go away."
He set a piece of black-tar heroin in the spoon, added a little water and held a lighter underneath until it melted. Then he placed a piece of cotton over the mixture to filter out the undissolved pieces as he drew the liquid into the syringe.
He showed her how to use her left arm to cut off the circulation in her right and squeeze her wrist to prime her veins for injection.
She looked away and winced as the needle pierced her skin. Within seconds, her head sank back and she soaked in the weightless feeling.
"I remember it hit me so fast," she says. "It made me feel so warm and relaxed and calm and stress free."
It was a feeling she could get used to.
"Ever since that night, it's been every day," she says. "Every day of my life."
MANUFACTURED IN Mexico and smuggled across the border, black-tar is the most prominent form of heroin used in the western United States.
Pure heroin is a white powder, but because it is mixed with other materials in the crude production process, black-tar is typically dark brown and soft, the consistency of tar on a hot day.
For the first few years, Janet prepared the heroin as her neighbor had shown her and injected it into her veins so it could reach her brain within seconds.
Once heroin enters the brain, according to the National Institute on Drug Abuse, it's converted back to morphine -- a natural substance extracted from the seeds of poppy plants -- and quickly binds to opioid receptors, resulting in a pleasurable rush.
KRIS HOLLAND/Yakima Herald-Republic
Janet Caraway models a pair of sunglasses for her niece, Tammy Chin, while Christmas shopping at the Valley Mall on Dec. 7. For most of the two decades she was addicted to heroin, Christmas wasn't important to Janet. This year, though, she's taking pride in buying gifts for her family.
Users also immediately feel warmth, dry-mouth and heaviness in their extremities, followed by several hours of drowsiness. Cardiac and lung function slow.
"It's sick for me to say, but it's the best feeling I've ever had," Janet says. "It's like taking a Valium and a Vicodin together."
Over time, the drug hardened many of Janet's veins and collapsed others until she could no longer find any visible vessels to sink the needle into.
So she began "muscling" the drugs -- injecting them straight into her muscles. It typically takes five to eight minutes for muscled heroin to reach the brain.
Depending on the purity of the heroin, a high would last Janet two to eight hours, she says. But with continued use comes tolerance, and users who want to experience a consistent rush must regularly increase the amount of heroin they use. The more contact the brain's opioid receptors have with morphine, the more the body craves it.
"We have a disease," Janet says. "And nobody understands the disease of heroin."
The drug, according to the drug abuse institute, was literally changing her brain chemistry until eventually her only motivation was to seek more of it, no matter the cost.
THE FIRST VICTIM OF Janet's addiction was her son, Jesse.
"I knew that I wasn't giving him the attention that he needed," she says. "I would go in the bathroom and lock the door and I would hear him -- 'Mama, mama!' -- at the door."
When Jesse was 4, Janet finally approached her mother and told her what she had already suspected.
"I'm doing drugs," she said.
"Marijuana?" her mother guessed.
"No," Janet said. She held out her arms so her mother could see the scars that were already developing from the constant injections.
"Can you take Jesse till I get better?" she asked. "I don't want you to keep him -- just until I get better and go to drug treatment."
But she didn't get better.
So Janet and her son grew to know each other as visitors -- she would stop by her parents' Union Gap home nearly every day to play with him, and sometimes her parents would bring him to her.
One day while she was visiting Jesse not long after she'd given him up, Janet took a break and walked across the field that bordered her parents' yard to a motel where she could buy drugs.
Because black-tar heroin is mixed with other substances during production, dealers and users can't know how much heroin is actually in any given dose; that makes the drug a frequent, dangerous source of accidental overdose.
That day at the hotel, Janet had too much. As she left the room and tried to find her way home, she collapsed on a log and someone from the hotel called 9-1-1.
Her mother later told Janet that she and Jesse saw her collapse in the field, and when the ambulance arrived they rushed out in the yard to watch the paramedics take her away.
"Mom said every time Jesse'd hear an ambulance, he said, "Grandma, my mom, my mom, she's so sick!" Janet says. "It seems like that kind of stuff would make me want to stop -- but it wasn't enough."
IN HER PRIME, JANET could do 5 grams of heroin a day. By the time she quit, the price was $30 a gram.
It gave her life a dark simplicity: To raise that kind of money she set her inhibitions aside and relied on whatever means necessary -- abusive boyfriends, stealing, working the streets.
She was meticulous about using sterile needles to avoid HIV infection, yet more than once the things she did to get drugs nearly cost her life.
A few years ago, as she stood along Yakima Avenue, a man in a van stopped. They made some arrangements for an exchange that Janet isn't proud of, and she got in. He drove her to a vacant field behind a hotel.
She planned to earn the money for her drugs and get away as quickly as she could, but he had other ideas.
He parked the car and turned off the engine, then turned and grabbed her hair, bashing her head against the dashboard.
After abusing her, he pulled out a handgun with a long barrel, kicked her out of the van and told her to run. She'd barely gotten to her feet when he started up the van, revved the engine and began driving after her, as if to run over her.
Before he caught up with her, though, the van's tires became tangled in a barbed-wire fence that had fallen in the field. With just one look back, Janet ran as fast as she could to a convenience store a few blocks away.
Adrenaline rushing, she stood outside the store for a few minutes, expecting to see the van pull up at any time.
When it didn't come, she went to the pay phone to call the cops.
But reaching into her pockets, she changed her mind.
"I would never go home without money for the next day," she says.
So she took a deep breath and returned to the street.
The next guy who picked her up pulled a knife, she says matter-of-factly, and demanded she hand over all of her cash -- $10.
It was a scary day, she admits, but not that much different from the thousands of others she spent trying to support her habit.
NOT LONG AFTER Janet's second son was born, her sister Brenda took both of her boys for good, relieving Janet of her motherly responsibilities as she shifted between run-down apartments, shady boyfriends and jail cells.
Many of her 25 or so drug-related convictions over the years came with court-ordered drug rehab. For years, her family held out hope that one of them might work and she would return to the playful, carefree Janet of old.
After she finished her first 14-month stay in the Washington Corrections Center for Women in Purdy, they were convinced.
Her sisters recall a family gathering not long after her 1989 release when all of the nieces and nephews were daring each other to ride an old bicycle with no brakes down a steep dirt hill.
The kids didn't have the guts to do it, but then-clean Aunt Janet did.
As the bike rattled down the hill out of control, the family stood screaming at the top, sure she would kill herself.
But when they pulled her bruised body out of the blackberry bushes where she'd crashed at the bottom, her face held the grin of that blond teenager headed toward the beach.
Perhaps, her family thought, it had finally happened -- Janet's vow to clean up had stuck.
But that familiar promise turned out to be empty again. A few weeks later, she was using again and the disappointing reality of her illness took its hold on the family.
"I gave up and I think we all did," says one sister. "After 20 years, you do give up. You don't have hope."
BEFORE SHE WAS diagnosed with rheumatoid arthritis four years ago -- a condition unrelated to her heroin use -- Janet made good money for a while as a construction flagger.
But while most workers filled their day packs with food, Janet stuffed hers with syringes of prepared heroin so she could shoot up during bathroom breaks.
When the arthritis prevented her from working, Janet had to use her monthly public assistance checks to pay rent and utilities. So she decided to try dealing to support her habit.
"I'm what you call an old-timer," she says. Because so many in Yakima's drug community knew her, finding clients was easy once she hooked up with a supplier and recruited her boyfriend to help her count money and weigh the drugs.
But she made a lot of money too fast, she says, and when clients sold her out to the police, it wasn't long before authorities were knocking on the door of the dingy motel room where she and her boyfriend ran their business.
It was late at night and she felt the cold touch of a police officer's gun against her ear as she lay face down on the bed with her hands behind her back.
She knew what it meant -- another 14 months in Purdy, another period of heroin's notoriously bad withdrawals, another trip to a rehab program that would only keep her clean for a few months.
Another failure.
WHEN BRENDA WALKED through the door of Janet's Sixth Street apartment on March 22, she was sitting on her couch in silk pajamas, barely able to keep her eyes open or her head up.
Brenda cried as she carefully walked Janet to her car and drove her to Yakima Regional Medical and Cardiac Center.
"I knew something was killing me," Janet says.
Two or three weeks earlier, she had been dealt contaminated black-tar heroin. The batch she had purchased contained botulism, a common bacteria found in dirt, feces and other natural materials.
When Janet injected the heroin -- which was likely exposed to the botulism during the smuggling process -- into the low-oxygen environment of her muscles, it was able to grow and produce a paralyzing toxin that slowly made its way to her brain.
The doctors who saw Janet during her first days in the hospital couldn't figure out the cause of her gradual paralysis. It was a poison control expert who finally suggested it was botulism toxin.
"Of the things that are made by living organisms, gram per gram it's as bad as anything," says Dr. Bill Robertson, medical director of the Washington Poison Center.
Botulism toxins infect only about 110 people a year in the United States. They work by interrupting the chemical messages sent from the brain to the spinal cord to control movement. The first muscles to go are the ones that control the eyelids. If untreated, it eventually affects the muscles responsible for the lungs and other vital organs.
Three days after her admittance -- her 43rd birthday -- the paralysis was far enough along for Janet's doctors to place her on a temporary ventilator to keep her lungs working.
Few people die of the disease if the antidotal serum that stops the progression of the toxins is administered quickly. The serum was flown to Yakima from the Centers for Disease Control and Prevention in Atlanta as soon as she was diagnosed.
As Janet lay lifeless in an oversized gown, unable to close her gaping mouth, doctors made no promises to her family members, who listened quietly.
They had all been there before.
Twelve years earlier, the Caraways lost another sister when she overdosed on cocaine and died in that very same hospital room on her 35th birthday. [My beloved mother]
Parts of the hospital stay aren't clear in her memory, but Janet remembers well the words the sons she had abandoned repeated as they cried at her bedside:
"Mom, please don't die."
DOCTORS TOLD JANET it might be six months before she would be able to get around without a walker.
But when she left the hospital in late April, she clutched a floral-print cane and climbed the three steps into that same Sixth Street apartment.
Determined to stay clean and get her muscles back to normal sooner than the year she was told it would take, Janet embraced new life in her old home.
On the same blue-plaid couch inside the same white walls where just a month earlier she was getting high, she enjoyed frequent visits from her hopeful family and developed a bond with Miss Kitty, the cat she'd had for a year but had never really known.
Though her body was weak, her head was clear and she was surprised -- vaguely annoyed, even -- to find that the birds outside her window chirped loud enough to wake her before dawn.
"This whole life that I'm living is new," she said.
THE NEW LIFE WOULDN'T have been possible, Janet says, without methadone, the pink liquid in the tiny plastic cup that she starts each day with.
Controversial because it, too, is an addictive opiate, methadone is a federally regulated, legal drug used to help heroin and morphine addicts quit illicit drugs.
Central Washington Comprehensive Mental Health has operated a clinic in Yakima for more than 30 years. The program serves about 140 people a day, combining mandatory counseling and drug education with a daily dose of the man-made opiate, which satisfies natural opiate cravings for 24 to 36 hours without the same euphoric high of heroin or morphine, says Judy Newland, program supervisor.
"We stabilize them physically with methadone that's prescribed by a physician," Newland says. "Then they're able to work on the issues in their life that contributed to their addiction and dependence -- emotional problems, family problems, legal problems, the list is endless."
Within two hours of her morning dose, Janet's fear of relapse subsides and she is able to go about her day.
Many people are on the program for years before they decide they're ready to quit. Some never do. The point, Newland says, is to allow addicts to return to a normal lifestyle without the risks, mood swings and instability that come with getting high and the constant need for larger amounts of drugs.
"Our philosophy is the slower the better," Newland says. "People didn't get into this situation overnight. They certainly don't get out of it rapidly."
ONE DAY IN SEPTEMBER, as she stood admiring Miss Kitty and the eight kittens snuggled around her in a cardboard box in the living room, Janet felt confident enough to declare herself heroin-free.
"I feel like if I've made it six months, I've got it whipped," she said.
But the botulism is another matter. It was a devastating summer, despite her ahead-of-schedule recovery.
"The most irritating part is my muscles haven't come back all the way," she said.
Swimming had been one of her favorite activities since childhood, but when she tried in June she wasn't able to move her arms fast enough to stay afloat.
She kept trying and she kept sinking until the day a doctor insulted her by suggesting she try water-walking. After that, she managed a few strokes using sheer will.
After months of therapy with her legs, she was finally able to ride a bike again, too. But she was still too weak to pull one up the concrete steps into her apartment and several times fell victim to bike thieves.
To top that off, an optometrist told her she might never regain the 20-20 vision she was so proud of before her illness.
"Every day I struggle," she told her brother as they sat in her living room.
"We all do, Janet," he said.
WHEN SHE GAVE UP heroin, Janet also surrendered her only friends -- fellow addicts caught in the same single-minded lifestyle.
She misses them sometimes when she's feeling lonely, but admits the only thing she really had in common with them is no longer a part of her.
And she knows that being exposed to their lifestyle is risky.
Six weeks ago, she went to visit a few of them at one of their homes in Union Gap.
When she knocked on the door, Janet could hear clinking and shuffling inside -- the familiar sounds of people rushing to cover up their drug paraphernalia.
As the door opened, a rotting smell filled her nostrils.
Janet politely hugged her old friends as she felt a knot surface in her stomach.
"It brought back everything and just me thinking how good it would feel to feel that high again," she says.
It would have been so easy to turn back, but instead she turned to the person who drove her and said she was ready to leave.
This time, she's keeping her promise. Doubters, beware.
"I see it in my family's eyes," Janet says. "I've done it so many times in the past. I wish I could just tell them, 'Please believe me.' But they'll be worried about that probably forever.
"Me, I'm not worried. I've went too far and I am not gonna give up."
THE BEST PART OF BEING clean is when she answers the phone and it's her younger son's school on the other end.
Even if they're calling to say the 14-year-old cut class and even if he still lives with her sister, at least Janet can finally be a mother.
At least she's finally turned the right way.
"I think that's what's so different about Janet," says one of her sisters. "She actually can look back and see what she's done with her life -- how she's wasted all that time."
So now she invests herself in the discovery of adulthood.
Without the heroin to muffle her anxiety, she's been introduced to the frustrations of paperwork for every doctor's appointment, her fluctuating weight, people constantly needing something from her.
Once she had 19 messages on her answering machine before she remembered to check it.
"I ask myself sometimes, 'Am I living right? Is this how people live?'"
Her niece, Tammy, who stops in every few days to help Janet when her muscles are weak and she can't quite brush her hair, assures her that it is.
This is it, Tammy says. This is what Janet was missing.
Janet thinks for a moment and then flashes that beach-girl smile.
"I'm brave, huh?" she says.
"You're very brave," Tammy says.
By JESSICA WAMBACH
YAKIMA HERALD-REPUBLIC
KRIS HOLLAND/Yakima Herald-Republic
Tammy Chin helps her aunt, Janet Caraway, put on earrings before a Christmas shopping trip to the Valley Mall on Dec. 7. Says Janet, who ended her 20-year addiction to heroin this year: "I ask myself sometimes, 'Am I living right? Is this how people live?' "
When Janet Caraway was 14, she decided she'd had enough of Yakima.
She belonged, she thought, on the California coast.
So with little planning and a lot of trust, she and her older sister Brenda packed a few clothes and hit the highway with their thumbs out.
"We wanted to be beach girls," Janet says, smoothing her hand over the same blond hair that covered her shoulders that summer day.
But they didn't quite make it.
Instead, their adventure ended in Pomeroy, Wash., a small, sandless town on the Idaho border.
The 43-year-old can laugh at her naiveté now, but it wasn't the last time a wrong turn would steer her into a mistake.
And some of them would leave marks.
Her arms, her legs, her neck, her hands, her fingers, her feet, her stomach, her back are covered with them -- more than 10,000 scars from 20 years of heroin addiction.
Until nine months ago, nothing -- not her family's tears, the prison sentences or the occasional overdose -- was enough to make her quit.
But in March, when Janet was nearly killed by botulism, a muscle-paralyzing disease she contracted from a contaminated batch of black-tar heroin, she found her motivation.
"I believe that God has a special reason for this to happen to me," she said when she was finally discharged from the hospital a month later. "I think he wants me on this Earth. I'm gonna find out.
"I'm gonna stay clean."
ABOUT 20 YEARS BEFORE Janet was born, her parents and one or two of her older siblings left a dead-end life in Shreveport, La., and moved to a house in Union Gap.
They came west for what they saw as their own golden promise: picking fruit. Each summer, Janet's parents and their nine children worked in the fields, scraping up enough money for food, housing and school clothes.
Janet was the youngest and the most energetic.
"She'd be the one out there playing with the kids, doing cartwheels," remembers one sister who, like several of Janet's relatives, declined to be identified for this article. "She loved life and she loved to play."
The little girl dreamed of growing up to be an airline stewardess, or maybe a nurse -- although she was terrified of needles.
Once, her dad took her to the doctor's office to get a shot and when the nurse came out with the needle Janet turned and ran to the elevator.
Her dad caught her before the doors opened.
That's the way she was -- the family's cherished baby and greatest headache, says her niece, Tammy Chin, who is just one year younger.
"Janet was the leader because she was so strong," Tammy says.
But she was also stubborn, and for all the love in the Caraway home, there was little emphasis on education or discipline.
KRIS HOLLAND/Yakima Herald-Republic
Janet Caraway speaks last month with 21-year-old Jesse Caraway, one of her two sons, for the first time since he was booked into the county jail on charges of car theft and evading police. Janet has made a strong effort to reconnect with her sons since getting off heroin. Janet's other son lives with her sister.
Janet lost interest in school in the sixth grade, but kept going as long as she could, cheating her way through the ninth grade and earning a seat at her middle school graduation.
Although most of the family didn't think the ceremony would be important to Janet, one of her sisters bought her a dress and encouraged her to go.
But as the program began, the 14-year-old was getting high with some guys she and Brenda had met that day. Janet kept an eye on the clock, she remembers, knowing people were waiting for her in the gym.
She never made it.
"I wonder how that day would be," she says now.
It wasn't the only graduation she would miss. After that night, Janet never went to school again, never got the proper welcome to adulthood or the education she knows she should have.
Instead, she turned her attention to partying and men. The drug use wasn't chronic yet, mostly because Janet's world was already hectic enough. She didn't need acid or cocaine or the other drugs she'd tried that made it spin even faster.
AT 23, JANET WAS living on her own with an 8-month-old son.
One day, at home recovering from a violent fight with a boyfriend, she answered a knock at the door. It was her neighbor, coming to console her.
They sat together and drank a six-pack of beer to ease her aching body. She was feeling slightly drunk.
The neighbor stood up, asked to use her bathroom and left the room.
He'd been in there for a long time with the door locked, so she knocked and demanded that he open it.
When the door eased open, she saw him hovering over a spoon and a needle that were sitting on the back of the toilet.
"What are you doing?" she asked.
"I'm doing some heroin," he answered. "You want to try some?"
Her parents were already losing sleep over her behavior and now, with the baby to think about, too, she hesitated.
But the neighbor pointed to the fresh bruises on her face.
"Janet, I swear to God, if you try it you won't feel any pain," he told her. "All that will go away."
He set a piece of black-tar heroin in the spoon, added a little water and held a lighter underneath until it melted. Then he placed a piece of cotton over the mixture to filter out the undissolved pieces as he drew the liquid into the syringe.
He showed her how to use her left arm to cut off the circulation in her right and squeeze her wrist to prime her veins for injection.
She looked away and winced as the needle pierced her skin. Within seconds, her head sank back and she soaked in the weightless feeling.
"I remember it hit me so fast," she says. "It made me feel so warm and relaxed and calm and stress free."
It was a feeling she could get used to.
"Ever since that night, it's been every day," she says. "Every day of my life."
MANUFACTURED IN Mexico and smuggled across the border, black-tar is the most prominent form of heroin used in the western United States.
Pure heroin is a white powder, but because it is mixed with other materials in the crude production process, black-tar is typically dark brown and soft, the consistency of tar on a hot day.
For the first few years, Janet prepared the heroin as her neighbor had shown her and injected it into her veins so it could reach her brain within seconds.
Once heroin enters the brain, according to the National Institute on Drug Abuse, it's converted back to morphine -- a natural substance extracted from the seeds of poppy plants -- and quickly binds to opioid receptors, resulting in a pleasurable rush.
KRIS HOLLAND/Yakima Herald-Republic
Janet Caraway models a pair of sunglasses for her niece, Tammy Chin, while Christmas shopping at the Valley Mall on Dec. 7. For most of the two decades she was addicted to heroin, Christmas wasn't important to Janet. This year, though, she's taking pride in buying gifts for her family.
Users also immediately feel warmth, dry-mouth and heaviness in their extremities, followed by several hours of drowsiness. Cardiac and lung function slow.
"It's sick for me to say, but it's the best feeling I've ever had," Janet says. "It's like taking a Valium and a Vicodin together."
Over time, the drug hardened many of Janet's veins and collapsed others until she could no longer find any visible vessels to sink the needle into.
So she began "muscling" the drugs -- injecting them straight into her muscles. It typically takes five to eight minutes for muscled heroin to reach the brain.
Depending on the purity of the heroin, a high would last Janet two to eight hours, she says. But with continued use comes tolerance, and users who want to experience a consistent rush must regularly increase the amount of heroin they use. The more contact the brain's opioid receptors have with morphine, the more the body craves it.
"We have a disease," Janet says. "And nobody understands the disease of heroin."
The drug, according to the drug abuse institute, was literally changing her brain chemistry until eventually her only motivation was to seek more of it, no matter the cost.
THE FIRST VICTIM OF Janet's addiction was her son, Jesse.
"I knew that I wasn't giving him the attention that he needed," she says. "I would go in the bathroom and lock the door and I would hear him -- 'Mama, mama!' -- at the door."
When Jesse was 4, Janet finally approached her mother and told her what she had already suspected.
"I'm doing drugs," she said.
"Marijuana?" her mother guessed.
"No," Janet said. She held out her arms so her mother could see the scars that were already developing from the constant injections.
"Can you take Jesse till I get better?" she asked. "I don't want you to keep him -- just until I get better and go to drug treatment."
But she didn't get better.
So Janet and her son grew to know each other as visitors -- she would stop by her parents' Union Gap home nearly every day to play with him, and sometimes her parents would bring him to her.
One day while she was visiting Jesse not long after she'd given him up, Janet took a break and walked across the field that bordered her parents' yard to a motel where she could buy drugs.
Because black-tar heroin is mixed with other substances during production, dealers and users can't know how much heroin is actually in any given dose; that makes the drug a frequent, dangerous source of accidental overdose.
That day at the hotel, Janet had too much. As she left the room and tried to find her way home, she collapsed on a log and someone from the hotel called 9-1-1.
Her mother later told Janet that she and Jesse saw her collapse in the field, and when the ambulance arrived they rushed out in the yard to watch the paramedics take her away.
"Mom said every time Jesse'd hear an ambulance, he said, "Grandma, my mom, my mom, she's so sick!" Janet says. "It seems like that kind of stuff would make me want to stop -- but it wasn't enough."
IN HER PRIME, JANET could do 5 grams of heroin a day. By the time she quit, the price was $30 a gram.
It gave her life a dark simplicity: To raise that kind of money she set her inhibitions aside and relied on whatever means necessary -- abusive boyfriends, stealing, working the streets.
She was meticulous about using sterile needles to avoid HIV infection, yet more than once the things she did to get drugs nearly cost her life.
A few years ago, as she stood along Yakima Avenue, a man in a van stopped. They made some arrangements for an exchange that Janet isn't proud of, and she got in. He drove her to a vacant field behind a hotel.
She planned to earn the money for her drugs and get away as quickly as she could, but he had other ideas.
He parked the car and turned off the engine, then turned and grabbed her hair, bashing her head against the dashboard.
After abusing her, he pulled out a handgun with a long barrel, kicked her out of the van and told her to run. She'd barely gotten to her feet when he started up the van, revved the engine and began driving after her, as if to run over her.
Before he caught up with her, though, the van's tires became tangled in a barbed-wire fence that had fallen in the field. With just one look back, Janet ran as fast as she could to a convenience store a few blocks away.
Adrenaline rushing, she stood outside the store for a few minutes, expecting to see the van pull up at any time.
When it didn't come, she went to the pay phone to call the cops.
But reaching into her pockets, she changed her mind.
"I would never go home without money for the next day," she says.
So she took a deep breath and returned to the street.
The next guy who picked her up pulled a knife, she says matter-of-factly, and demanded she hand over all of her cash -- $10.
It was a scary day, she admits, but not that much different from the thousands of others she spent trying to support her habit.
NOT LONG AFTER Janet's second son was born, her sister Brenda took both of her boys for good, relieving Janet of her motherly responsibilities as she shifted between run-down apartments, shady boyfriends and jail cells.
Many of her 25 or so drug-related convictions over the years came with court-ordered drug rehab. For years, her family held out hope that one of them might work and she would return to the playful, carefree Janet of old.
After she finished her first 14-month stay in the Washington Corrections Center for Women in Purdy, they were convinced.
Her sisters recall a family gathering not long after her 1989 release when all of the nieces and nephews were daring each other to ride an old bicycle with no brakes down a steep dirt hill.
The kids didn't have the guts to do it, but then-clean Aunt Janet did.
As the bike rattled down the hill out of control, the family stood screaming at the top, sure she would kill herself.
But when they pulled her bruised body out of the blackberry bushes where she'd crashed at the bottom, her face held the grin of that blond teenager headed toward the beach.
Perhaps, her family thought, it had finally happened -- Janet's vow to clean up had stuck.
But that familiar promise turned out to be empty again. A few weeks later, she was using again and the disappointing reality of her illness took its hold on the family.
"I gave up and I think we all did," says one sister. "After 20 years, you do give up. You don't have hope."
BEFORE SHE WAS diagnosed with rheumatoid arthritis four years ago -- a condition unrelated to her heroin use -- Janet made good money for a while as a construction flagger.
But while most workers filled their day packs with food, Janet stuffed hers with syringes of prepared heroin so she could shoot up during bathroom breaks.
When the arthritis prevented her from working, Janet had to use her monthly public assistance checks to pay rent and utilities. So she decided to try dealing to support her habit.
"I'm what you call an old-timer," she says. Because so many in Yakima's drug community knew her, finding clients was easy once she hooked up with a supplier and recruited her boyfriend to help her count money and weigh the drugs.
But she made a lot of money too fast, she says, and when clients sold her out to the police, it wasn't long before authorities were knocking on the door of the dingy motel room where she and her boyfriend ran their business.
It was late at night and she felt the cold touch of a police officer's gun against her ear as she lay face down on the bed with her hands behind her back.
She knew what it meant -- another 14 months in Purdy, another period of heroin's notoriously bad withdrawals, another trip to a rehab program that would only keep her clean for a few months.
Another failure.
WHEN BRENDA WALKED through the door of Janet's Sixth Street apartment on March 22, she was sitting on her couch in silk pajamas, barely able to keep her eyes open or her head up.
Brenda cried as she carefully walked Janet to her car and drove her to Yakima Regional Medical and Cardiac Center.
"I knew something was killing me," Janet says.
Two or three weeks earlier, she had been dealt contaminated black-tar heroin. The batch she had purchased contained botulism, a common bacteria found in dirt, feces and other natural materials.
When Janet injected the heroin -- which was likely exposed to the botulism during the smuggling process -- into the low-oxygen environment of her muscles, it was able to grow and produce a paralyzing toxin that slowly made its way to her brain.
The doctors who saw Janet during her first days in the hospital couldn't figure out the cause of her gradual paralysis. It was a poison control expert who finally suggested it was botulism toxin.
"Of the things that are made by living organisms, gram per gram it's as bad as anything," says Dr. Bill Robertson, medical director of the Washington Poison Center.
Botulism toxins infect only about 110 people a year in the United States. They work by interrupting the chemical messages sent from the brain to the spinal cord to control movement. The first muscles to go are the ones that control the eyelids. If untreated, it eventually affects the muscles responsible for the lungs and other vital organs.
Three days after her admittance -- her 43rd birthday -- the paralysis was far enough along for Janet's doctors to place her on a temporary ventilator to keep her lungs working.
Few people die of the disease if the antidotal serum that stops the progression of the toxins is administered quickly. The serum was flown to Yakima from the Centers for Disease Control and Prevention in Atlanta as soon as she was diagnosed.
As Janet lay lifeless in an oversized gown, unable to close her gaping mouth, doctors made no promises to her family members, who listened quietly.
They had all been there before.
Twelve years earlier, the Caraways lost another sister when she overdosed on cocaine and died in that very same hospital room on her 35th birthday. [My beloved mother]
Parts of the hospital stay aren't clear in her memory, but Janet remembers well the words the sons she had abandoned repeated as they cried at her bedside:
"Mom, please don't die."
DOCTORS TOLD JANET it might be six months before she would be able to get around without a walker.
But when she left the hospital in late April, she clutched a floral-print cane and climbed the three steps into that same Sixth Street apartment.
Determined to stay clean and get her muscles back to normal sooner than the year she was told it would take, Janet embraced new life in her old home.
On the same blue-plaid couch inside the same white walls where just a month earlier she was getting high, she enjoyed frequent visits from her hopeful family and developed a bond with Miss Kitty, the cat she'd had for a year but had never really known.
Though her body was weak, her head was clear and she was surprised -- vaguely annoyed, even -- to find that the birds outside her window chirped loud enough to wake her before dawn.
"This whole life that I'm living is new," she said.
THE NEW LIFE WOULDN'T have been possible, Janet says, without methadone, the pink liquid in the tiny plastic cup that she starts each day with.
Controversial because it, too, is an addictive opiate, methadone is a federally regulated, legal drug used to help heroin and morphine addicts quit illicit drugs.
Central Washington Comprehensive Mental Health has operated a clinic in Yakima for more than 30 years. The program serves about 140 people a day, combining mandatory counseling and drug education with a daily dose of the man-made opiate, which satisfies natural opiate cravings for 24 to 36 hours without the same euphoric high of heroin or morphine, says Judy Newland, program supervisor.
"We stabilize them physically with methadone that's prescribed by a physician," Newland says. "Then they're able to work on the issues in their life that contributed to their addiction and dependence -- emotional problems, family problems, legal problems, the list is endless."
Within two hours of her morning dose, Janet's fear of relapse subsides and she is able to go about her day.
Many people are on the program for years before they decide they're ready to quit. Some never do. The point, Newland says, is to allow addicts to return to a normal lifestyle without the risks, mood swings and instability that come with getting high and the constant need for larger amounts of drugs.
"Our philosophy is the slower the better," Newland says. "People didn't get into this situation overnight. They certainly don't get out of it rapidly."
ONE DAY IN SEPTEMBER, as she stood admiring Miss Kitty and the eight kittens snuggled around her in a cardboard box in the living room, Janet felt confident enough to declare herself heroin-free.
"I feel like if I've made it six months, I've got it whipped," she said.
But the botulism is another matter. It was a devastating summer, despite her ahead-of-schedule recovery.
"The most irritating part is my muscles haven't come back all the way," she said.
Swimming had been one of her favorite activities since childhood, but when she tried in June she wasn't able to move her arms fast enough to stay afloat.
She kept trying and she kept sinking until the day a doctor insulted her by suggesting she try water-walking. After that, she managed a few strokes using sheer will.
After months of therapy with her legs, she was finally able to ride a bike again, too. But she was still too weak to pull one up the concrete steps into her apartment and several times fell victim to bike thieves.
To top that off, an optometrist told her she might never regain the 20-20 vision she was so proud of before her illness.
"Every day I struggle," she told her brother as they sat in her living room.
"We all do, Janet," he said.
WHEN SHE GAVE UP heroin, Janet also surrendered her only friends -- fellow addicts caught in the same single-minded lifestyle.
She misses them sometimes when she's feeling lonely, but admits the only thing she really had in common with them is no longer a part of her.
And she knows that being exposed to their lifestyle is risky.
Six weeks ago, she went to visit a few of them at one of their homes in Union Gap.
When she knocked on the door, Janet could hear clinking and shuffling inside -- the familiar sounds of people rushing to cover up their drug paraphernalia.
As the door opened, a rotting smell filled her nostrils.
Janet politely hugged her old friends as she felt a knot surface in her stomach.
"It brought back everything and just me thinking how good it would feel to feel that high again," she says.
It would have been so easy to turn back, but instead she turned to the person who drove her and said she was ready to leave.
This time, she's keeping her promise. Doubters, beware.
"I see it in my family's eyes," Janet says. "I've done it so many times in the past. I wish I could just tell them, 'Please believe me.' But they'll be worried about that probably forever.
"Me, I'm not worried. I've went too far and I am not gonna give up."
THE BEST PART OF BEING clean is when she answers the phone and it's her younger son's school on the other end.
Even if they're calling to say the 14-year-old cut class and even if he still lives with her sister, at least Janet can finally be a mother.
At least she's finally turned the right way.
"I think that's what's so different about Janet," says one of her sisters. "She actually can look back and see what she's done with her life -- how she's wasted all that time."
So now she invests herself in the discovery of adulthood.
Without the heroin to muffle her anxiety, she's been introduced to the frustrations of paperwork for every doctor's appointment, her fluctuating weight, people constantly needing something from her.
Once she had 19 messages on her answering machine before she remembered to check it.
"I ask myself sometimes, 'Am I living right? Is this how people live?'"
Her niece, Tammy, who stops in every few days to help Janet when her muscles are weak and she can't quite brush her hair, assures her that it is.
This is it, Tammy says. This is what Janet was missing.
Janet thinks for a moment and then flashes that beach-girl smile.
"I'm brave, huh?" she says.
"You're very brave," Tammy says.