When Rich Pagano speaks about his son, Nick, the adoration is palpable. Alongside his love, however, is a fierce determination to ensure that other families do not suffer the same fate.
"There was no way that I could have prepared for losing a child," Pagano said.
Nick left behind a legacy as a talented triple-threat performer in theater and as a young man eager to help others in the LGBT community get sober. Tragically, his family watched as he transformed over the course of five years.
"He said to me, 'I get the same feeling from smoking pot as I do from acting,'" Pagano recalled.
By age 15, Nick was consuming marijuana and pills daily.
"With that comes stealing and dealing. By maybe 17 to 18, he discovered heroin," Pagano added.
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This marked the beginning of a painful cycle involving treatment centers, Alcoholics Anonymous meetings, and sober living arrangements, drastically affecting their family dynamics and finances.
"Your life becomes not about where is he going to college, or who is his roommate going to be, or what are his interests?" Pagano said. "It was about how can we keep him alive?"
Despite living in a sober house and making progress in 2021, Nick's life was cut short by a fentanyl overdose.
"I asked the coroner, and he said it was less, less than you could fit on the head of a pin," Pagano recalled.
The Drug Enforcement Administration (DEA) reports that just two milligrams of fentanyl can be lethal, and one gram can kill up to 500 people. In 2023, 107,000 overdose deaths were attributed to opioids, predominantly fentanyl.
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David Manheim has operated a podcast solo since 2018, following the sudden death of his co-host and best friend, Chris, who died after relapsing. The two had met during their recovery from heroin addiction.
"It was totally traumatic," Manheim said. "It was brutal. I had been a drug addict for almost 20 years, and I had not lost anybody close to me."
The "Dopey Podcast" has developed a loyal following, serving as a support network for people navigating the challenges of addiction.
"The more stories that are told about real drug addicts, real consequences, real death—I think that helps," Manheim said.
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Encouragingly, trends show a decrease in drug overdose deaths. All but five states witnessed declines in overdose fatalities last year, with a significant 23.8% drop from September 2023 to September 2024.
Meanwhile, DEA lab testing revealed that in 2024, half of the recovered pills contained potentially lethal doses of fentanyl, a decrease from 70% in 2023.
For years, individuals battling addiction faced a grim choice: get clean or die. Pagano and Manheim now see a third option —harm reduction — which may include using things like marijuana, methadone, or safe injection sites.
"Four years ago, I would have said, 'No, you use, you don't have— you don't get me in your life.' I no longer have him in my life," Pagano said. "The idea of sitting and having a meal with him with the agreement that he stays with injection sites as a parent who lost a child? I take that back in a second.
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Dr. Ruben Olmedo, an emergency room physician at Mount Sinai Hospital in New York, said he sees 1-2 patients each day suffering from complications related to drug use. He views harm reduction as a critical aspect of his role.
"Using it safely with different kinds of syringes, decreasing the amount of drug that they use so that they don't overdose, making sure that they're using it in a safe place — make sure that they have Naloxone on hand," Olmedo said.
He advocates for a shift in the understanding of addiction as a disease, emphasizing the need for a change in mindset.
"If you are a drug addict, all you can really do is use or be sick," Manheim said. "If you're not a drug addict, you can do anything you want."
This story was initially reported by a journalist and has been converted to this platform with the assistance of AI. Our editorial team verifies all reporting on all platforms for fairness and accuracy.
