This piece was published in partnership with the Influence.
Editor's note: The letter below, which has been lightly edited for length and clarity, was written by Elizabeth Elliot* to her mother in late 2010.
Elizabeth was in a halfway house in New Jersey, following a spell in state prison for drug-law violations. The return address on her letter was "10th Circle of Hell."
She experienced problems with heroin throughout her adult life, and had previously attended several rehabs without success.
Following her release from the halfway house, she spent her last years in Florida; at that time, the state had no legal syringe exchange programs. She died in 2014, aged 29, from endocarditis due to IV drug use with contaminated needles and related conditions.
Her mother has shared this letter with the Influence because she believes it demonstrates the need for people struggling with drugs to be offered a range of options in addition to abstinence-based treatment, including much wider availability of harm-reduction services.
More details about Elizabeth's life and death, based on her mother's descriptions, are below her letter.
Hey Mama!
Well I'm sorry I was so cranky when I spoke to you on Friday night. This place is just getting to me, especially the . Tomorrow I'm going to be sitting down with Anissa to go over the itinerary.
I miss you and love you! Hope to talk to you soon!
Love, Little Lizzie
Elizabeth grew up in Pennsylvania. She thrived in elementary school and junior high, achieving straight As through eighth grade. She also excelled at music, arts and sports, and music remained important to her throughout her life. She suffered from social anxiety from a young age, but insisted she did not want therapy. Funny, kind and compassionate, she continued to do well academically and at other activities in high school.
She first tried marijuana aged 15; when her mother found out, Elizabeth said she was just experimenting. She later told her mother that she had begun smoking weed both before and after school and before bed during this period.
She went to the University of Delaware for fashion design. However, experiencing severe anxiety and depression, she rarely left her dorm room and dropped out due to non-attendance of classes.
At 19, she got a job as a waitress, and through her coworkers tried cocaine and then heroin. She soon became addicted to heroin.
She told her family that she was addicted, and that she had hepatitis C from sharing needles. Her family sent her to rehab; she ended up going to a total of six 12-step-based rehabs, including a locked facility in New Jersey.
She was kicked out of two facilities for fraternizing with men, and escaped from the locked rehab. She always relapsed soon after her release.
She also married and had a baby during her 20s. She lost custody when her baby was six months old, and her husband divorced her while she was in jail.
After Elizabeth was arrested, the authorities didn't want to send her to state prison. But she failed at pre-trial intervention by escaping the locked rehab, and was ineligible for drug court due to suicidal thoughts. She failed on probation due to positive drug tests.
She was sentenced to three-to-five years for possession of a controlled substance and paraphernalia. She spent three months in state prison in Clinton, New Jersey, was released on parole, then relapsed, failed parole and went back to prison for 11 more months.
After her release from the halfway house where the letter was written and her arrival in Florida, Elizabeth called a sober friend who turned out not to be sober. Within days, she was smoking crack and shooting heroin again. She took a job with an escort service to pay for her drugs and rent.
She then moved in with a boyfriend and stopped working as an escort. She and her boyfriend would smoke crack for days at a time, then come down by shooting heroin.
In 2012, she was hospitalized for a few days with a blood infection. Later in 2012, she borrowed money from her grandparents for a final try at rehab. She relapsed the day she got out.
In December 2013, she was hospitalized with endocarditis, which she got from reusing needles; there were no needle exchanges where she lived. She cleaned her needles with bleach but that was not enough. A surgeon cleared growths off her heart. She was in the hospital for six weeks.
While in the hospital, she planned to go to a burprenorphine clinic. She left the hospital on a Sunday, and found the clinic was closed. She began shooting up again that night.
For the next several months she had recurrences of endocarditis. She went to hospitals but would not stay for treatment because they would not give her enough painkillers.
On April 18, 2014, she went to an ER. That afternoon, a doctor called her mother and said that Elizabeth would not survive. She was unconscious but comfortable. The doctor did not know how she had managed to walk into the ER.
Elizabeth died in the early hours of Saturday, April 19, 2014. Her cause of death was given as severe sepsis, endocarditis from IV drug use, renal failure and respiratory failure.
*Elizabeth's last name and one other identifying detail have been changed, to protect the privacy of some members of her family.
This article was originally published by the Influence, a news site that covers the full spectrum of human relationships with drugs. Follow The Influence on Facebook or Twitter.
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