My Years in the Florida Shuffle of Drug Addiction

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In February, 2017, I stepped off a plane in Tampa, drunk and dope-sick. I was twenty-four, and for the past eight years I had been shooting up heroin, cocaine, and all manner of pills: Dilaudid, Opana, OxyContin, Desoxyn, Ritalin. Now I was on my way to River Oaks, an addiction-treatment center, where I would spend the next forty-five days. River Oaks was on a gated campus, surrounded by a small forest with trails running through it. I was withdrawing from heroin and benzodiazepines at the time, and mornings were the worst: I woke in the dark at 6 A.M., the pain of withdrawal not yet mediated by the day’s first dose of Suboxone or Librium. I promised anyone who met me that I would die, simply die, of withdrawal; when, on day twenty-three, I had a seizure, I thought, Yes, I am really dying, but then I lived.

We had access to dietitians and personal trainers, yoga sessions and intravenous vitamin therapy; pharmacogenetic testing determined which medications worked best with our DNA. When it was time to leave, I had become so comfortable that I walked the grounds barefoot, making laps around the Serenity Trail, feeding apples to the horses by the stables where we met for equine therapy, on Wednesdays.

I made a few friends there, but we soon dispersed, some to Baltimore, others to New Jersey, one to wake up in the morning to find that his girlfriend had died beside him in the night, high on heroin, having aspirated her vomit. The rest of us—those without jobs, school, or families calling us home—moved into sober homes in South Florida.

South Florida—the densely populated area comprising Palm Beach, Broward, and Miami-Dade counties—has four hundred and seventy-eight licensed facilities for drug treatment. There are more treatment centers than public elementary schools. It’s difficult to live here for long without hearing someone’s sad story: the Lyft driver who loved cocaine and still does, but from a distance now; the anesthesiologist who studied at Johns Hopkins and shot up fentanyl before it was popular.

For the next few months, I moved between recovery and relapse, cycling through the Twelve Steps, then going off in search of drugs. I would walk out of group therapy in a huff and then, days later, check into another detox for whatever length of time insurance would cover. After inpatient rehab, I’d move to sober housing and enroll in an outpatient program at a nearby clinic. As long as I was insured, I didn’t have to touch money. There’s a name for this peripatetic life style: clinicians, clients, and local officials call it the Florida Shuffle.

I spent the month of May in Delray Beach, in an antebellum-style mansion with Spanish moss hanging from the trees in the front yard, spiral staircases indoors, and large white vitrified tiles in the dining room. This was a partial-hospitalization program, where people are sent after they detox from a relapse. We recited the Serenity Prayer before we ate, pleased by the way we felt ourselves rising to the occasion. Many of us were not yet twenty-five, but we had lived in a disorderly way, and because of that we felt ancient, as if we had survived something, which we had. It was only honorable that we should try to live well.

In June, I found myself living, for the second time, in an old residential motel in Boca Raton, which had been converted into apartments for drug addicts and alcoholics passing between rehab and polite society. The apartments were on a street called West Camino Real; nearby, houses sell for about a million dollars and even the grocery store offers valet parking. My building was tiny, spare, and utilitarian. Each day, we were required to attend four hours of group therapy; each week, we had our urine tested for drugs. Both of these services were billable to insurance.

In our spare time, in the desolating heat, we would sit at a picnic table in the parking lot to chain-smoke and drink Red Bull and play spades or poker. I smoked forty cigarettes a day—Marlboro Red 100s, the long ones. Struggling to bury how lonely we were, and how afraid, we traded war stories, recalling the drugs we had done and loved, and the times they took us down—each of us striving to top his neighbors’ wretchedness, to prove himself exceptional in his ability to ruin himself totally. It was easy to get lost, to lose track, to lose time between the weeks and days and palm-tree afternoons. News of relapses, of overdoses and deaths, was always breaking, and so the emergencies that one day held us rapt were soon supplanted by new ones.

We spoke about emotions, trauma, illness, about whether we had succumbed to influences, experiments, pressures—or whether we had been born this way. Perhaps the source of our addiction lay deep in our genes, beyond poppies or cartels or Big Pharma. Or perhaps we had simply made bad choices.

One day, I get a phone call from Michelle, whom I know from River Oaks. (Some names have been changed.) She moved to South Florida the week after I did, at the age of nineteen, after twelve trips to detox in the previous five months. Now she says that she left her sober housing the night before, with her boyfriend, Dylan, and that since then they have been shooting heroin in his car, where, she supposes, they live now. But the dope was so good, she says, that she had to use only a quarter of her usual dose to wreck herself.

It isn’t as if Michelle is pressuring me to get high with her, but she reminds me of drugs, of their purchase on total escape. She reminds me that I wish I were on drugs right now.

“And you’re getting more?” I ask.

For many years, South Florida’s addiction-treatment landscape was celebrated as a haven for Twelve Step programs. In 2007, the Times described the constellation of sober homes in Delray Beach, a city of sixty-eight thousand, as “a funky outpost of sobriety,” and “the epicenter of the country’s largest and most vibrant recovery community.”

This community began to take shape in the late sixties, when a doctor, a pharmacist, and a police officer—Frank Kucera, Bill Plum, and Bill Cochran—assembled the Drug Abuse Foundation, a small group of volunteers concerned with drug-use-prevention efforts. In the following years, the main substances abused were alcohol, cocaine, barbiturates, and amphetamines—Quaaludes, Miltown, Dexamyl, Dexedrine. Responding to a mounting public need, Palm Beach County started the Comprehensive Alcohol and Rehabilitation Programs, in 1967. Several new halfway houses opened, funded by the county, but many of their rehabilitation methods were experimental, such as forcing residents to wear a sign around their neck if they broke a house rule.

Still, South Florida appealed to private residential-rehab facilities, which developed outpatient treatment plans of their own. Soon, people came from across the United States to Delray Beach to open what would be called “recovery residences.” John Lehman, a consultant for the Recovery Outcomes Institute, a research agency and mentorship program, told me, “What emerged in Delray Beach was a very robust Twelve Step community, a lot of A.A. and N.A. meetings. Those meeting rooms were filled with individuals who were coming from all over the world to live in recovery residences, and it flourished—it just grew—and people were doing really well.”

This method, which came to be called the Florida Model, offered a cheaper alternative to residential rehab programs—such as Silver Hill Hospital, in Connecticut, or Betty Ford Center Drug Rehab, in California—where patients lived on large campuses. In the Florida Model, after detox and inpatient rehab, clients would move into recovery residences, or sober homes, and attend outpatient therapy.

Sober living presented an appealing option for young people in recovery, who might have criminal records or bad credit and could not afford, or manage, to live alone. These were people for whom structure and a community of peers meant the possibility of a home. Though each house had its own rules and standards, the Twelve Steps of Alcoholics Anonymous and Narcotics Anonymous were universal.

And so it went, for some thirty years, that parents would send their prodigal sons or daughters—whenever their lives had become untethered in New Jersey or Philadelphia or Ohio—to Florida, first to dry out in treatment, and then to live in a sober home. They would make new friends; find low-stress recovery jobs, waiting tables in diners, folding jeans at the mall, or answering phones at a call center; and subscribe to the Twelve Steps. Eventually, having survived their addictions into adulthood, many of them would return home. Others would remain in Florida and open sober homes of their own.

I came to Florida after a long stretch of lunacy in Brooklyn, where I was living in a building beside the J train, its tracks parallel to my window. I would sit on my air mattress with my heart gone arrhythmic and look at the trains going by. The mattress, my only furniture, was held together with electrical tape, which covered the perforations made by syringes and corkscrews and smoldering cigarettes that often fell into bed with me.

Every day, I injected at least a bundle of heroin—ten bags, each weighing around a tenth of a gram. If the dope was cut with fentanyl, I might overdose after two bags. I couldn’t always understand my dealer when he spoke, because he sometimes removed his teeth to smoke crack, but he had a valiant heart and once called an ambulance for me when I overdosed on his corner. I woke up in the hospital, pulled the I.V. out of my arm, and took the subway home.

I started smoking crack cocaine to save money, although it never quite worked out that way, and soon I was dissolving it in vinegar and injecting it as well. There was something sacramental about preparing a shot and hitting a vein, then pulling the plunger back to catch a plume of blood blooming into clouds of crimson. Cocaine psychosis led me to Bellevue, then to a homeless shelter, then to begging on the street in Greenwich Village.

When I called my mother, finally, to ask for help, I had been shooting heroin all night in a stranger’s apartment. It was on that stranger’s mattress, with only one dose remaining, that it struck me: This is how people die. They overdose in unknown company, and their bodies are shoved into coat closets in dilapidated buildings and aren’t discovered for months. I felt wretched for implicating my mother in my situation. What had she done to deserve this? I would always be the boy in the principal’s office, calling for a ride, or in jail, needing to make bail. My life, looking back, seemed to consist of scenes spliced together from emergency rooms, psychiatric wards, doctors’ offices, pharmacy queues, holding cells, therapists’ couches, street corners, pawnshops. My life scared me; it scared me to death.

Later, at River Oaks, during an exercise in which we were asked to recount what rock bottom looked like for us, and how it felt, I’d share my memory of those days, the last before rehab, of my becoming a vagrant, the plot of which seemed to align with the redemption narrative that our therapist was steering us toward. But, even then, I knew that it is useless to talk about rock bottom so early in recovery: no matter how bad things get, they might well get worse. And then they get better, and then worse again, and I seemed to have a high tolerance for suffering. There was the week I spent on dialysis, the eight times I went to rehab, the spring I got some reading done in solitary confinement, and all the times I almost died on the street.

As the biracial child of a single mother, I was an anomaly in the suburbs of Raleigh, North Carolina. We were, for a long time, one of the only families of color in the area that we knew of. My mother conceived me when she was thirty-eight, using sperm from an anonymous donor. My mother, who is black, chose a donor who was white—Italian and Irish, according to documents—and so my childhood seemed to evolve from an odd genetic question.

I was often lonely and alone and filled with hate. Nothing gratified me. There was always this matter of time happening, this question of how to spend it. On weekends, when my mother was not at work, she lay in bed in the dark, exhausted, in her fifties, raising a teen-age boy. In another room, I, too, lay in the dark. That was my impression of family life and of adulthood; I supposed that, in the future, instead of going to school, I would have some sort of job, and on the weekend I would sleep.

My outlook was myopic, given the example my mother had set. When she was in graduate school, in the early eighties, a teacher told her, with racial condescension, that she might find doctoral work too rigorous. She was the only black student in her classes, and she ultimately earned a Ph.D. in education. She had lived fully, embracing a life of work in public education, and of great love. She had dimensions, I see now—but I did not see them then.

My mother lamented my not having a male influence, and so forced me to play soccer and baseball and basketball. I sang soprano in the Raleigh Boychoir, until my voice changed. I had friends, even best friends, at times. But the feeling with which I returned home, always, was of being alone. I took what felt like every medication for A.D.H.D. over the years—Ritalin and Adderall and Dexedrine and Desoxyn—and Prozac for depression, which in time I’d come to recognize as intractable.

In high school, I was not a nerd and I was not a jock, and although I was a junkie, I was not quite a burnout—I did not smoke pot or even cigarettes. I played the clarinet in the school band, but I was too lazy to march at football games. I was openly gay, often pugnaciously so, and my failure to make an earnest bid for acceptance only alienated me from my peers. I would listen to “Lonely Planet Boy,” by the New York Dolls, jump into the tightest jeans by Cheap Monday, and get into cars with strange men twice my age, who found me exotic because I was tall and bronze and underage, black and white and very thin, a predator’s wet dream, with sad eyes and father issues.

The first time I did heroin I was sixteen. My friend Rebecca, a senior at a nearby high school, came over to my house. After getting into college, Rebecca had started using heroin every day. I was a sophomore and already taking amphetamines and cocaine; wiry and enervated, I was ready to come down. One Friday afternoon in the spring, she brought over some dope.

I snorted the powder off the jacket of a book about raising boys, one of my mother’s child-psychology volumes. Rebecca shot up. Taking a syringe from a bundle of about thirty held together with rubber bands, she gripped the rig between her teeth and untied a blue ribbon from her hair. After wrapping the ribbon around her bicep, she pulled it taut, and, holding the syringe like a pencil, she lowered it into a vein in the crook of her elbow. I was squatting on the floor, staring up at her; as the sun came through the bay window behind her, illuminating dust, she looked beautiful.

During my senior year, I worked at a bar downtown, to afford the heroin that I used every day. I made about two hundred dollars a night and spent it all on dope. By the time I got to college, in New York, my drug use had escaped control. In the morning before classes, I’d shoot cocaine strong enough to get me off the floor, where I’d passed out hours before, after banging too much heroin. With everything silenced except for a clear note in my head, I’d shamble to the bathroom and vomit blood that looked like coffee grounds, the result of organ damage.

On that stranger’s mattress in Brooklyn, I was desperate and alone and knew to call my mother. Only by dint of her emphatic competence was I able to access the kind of help I needed. We had our differences, my mother and I. We were both only children, raised by single mothers. We were both alone in the world, it sometimes seemed, but we were doing it together, whatever it was.

For the first eight months that I lived in Florida, as I hopped from one detox clinic or sober home to another, I had no notion of the industry in which I was enmeshed. In 1986, there were approximately seven thousand treatment facilities for substance abuse in the U.S.; today, there are at least fifteen thousand, a figure that doesn’t include most sober homes. In the same period, the addiction-treatment industry’s revenue rose from nine billion dollars to more than fifty billion dollars. In Palm Beach County, addiction treatment is a billion-dollar industry, and the profusion of sober homes, treatment centers, and detox facilities overlaps with South Florida’s most lucrative industries—tourism, real estate, construction. Iatrogenesis, which derives from the Greek for “brought forth by the healer,” refers to a medical phenomenon in which efforts to treat an illness only cause further complications. It’s possible to regard the Florida Shuffle as a by-product of drug-addiction treatment.

The Affordable Care Act, which became law in 2010, has changed the landscape of addiction treatment, requiring that insurance companies cover services for substance-use disorders. (It also allows children to remain on their parents’ policies until the age of twenty-six.) Building on the Mental Health Parity and Addiction Equity Act, of 2008, the A.C.A. prohibits insurers from enforcing stricter benefit limitations than those applied to manifestly physical ailments, such as a knee replacement or cataract surgery. It also prohibits limiting treatment on the basis of a preëxisting condition. Roughly sixty-two million people received new access to mental-health and behavioral care. Today, addiction itself doesn’t count as a preëxisting condition, but a relapse can make it one.

Relapses are common among addicts, even when things seem to be going well, and treatment is expensive. A month of inpatient rehab can cost tens of thousands of dollars; in the past, this kind of treatment was mostly limited to the wealthy. The A.C.A. made it easier for the owners of treatment centers to bill insurers, and rehab, suddenly democratic, fell within reach of the well-insured middle class and its children.

Because there is no federal licensing framework for addiction-treatment centers, insurance companies trust the facilities to abide by state regulations. But little in medicine is as ill defined or as anecdotal as addiction treatment. Most rehab centers are not hospitals. The counsellors are often not psychologists. The medical directors can submit instructions from a distance.

A few years ago, as the opioid crisis became the heroin crisis—now we keep it simple by calling it the overdose crisis—a variety of fentanyl analogues, with names like carfentanil and acetylfentanyl, began augmenting heroin to poisonous degrees. The elevated potency of street drugs meant that relapses were frequently deadly. In 1999, seventeen thousand Americans died from drug overdoses. In 2017, more than seventy thousand did—a death count exceeding that of the height of the AIDS crisis. That year, as the National Civic League gave Delray Beach the All-America City Award, the Times, NBC, and the Palm Beach Post described the city as the center of an opioid-overdose epidemic. An analysis by Peter Haden, of WLRN, Miami’s public-radio station, found that the money that the Delray Beach Fire Department spent on naloxone, which is used to treat opioid overdoses, rose thirteen hundred per cent between 2013 and 2016. People who had come to South Florida for recovery were suddenly dying en masse. One month in 2016, there were “ninety-eight overdoses reported and eighteen deaths believed to be overdose-related in Delray Beach,” Marc Woods, a city official, recalled.

Like any industry in a period of explosive growth, addiction treatment attracted wrongdoers. Insurance fraud became rampant. The most profitable kind involves inflated charges for urinalysis reports—a practice that has come to be called the “liquid gold rush.” Urine tests provide evidence to rehab centers that clients are drug-free, but there aren’t any regulations that define standard practice. Traditionally, urinalysis has been performed using test strips; a typical dipstick test, which changes color to reflect a positive or negative reading, costs some five dollars and can be done anywhere. Sending urine to a laboratory, which uses gas or liquid chromatography to render results more accurately, can cost thousands of dollars.

In 2011, Frank Cid, an owner of high-end treatment programs in South Florida, opened his own lab. He recruited detox centers to send him urine—they would be reimbursed by insurance companies for collecting it, and he would bill the companies for testing it. According to court documents, in 2014, an affiliate of Goldman Sachs that wanted to buy Cid’s business valued it at more than thirty-two million dollars. (The deal ultimately fell through.)

Soon, many of the facilities that had been sending urine to Cid began to open labs of their own. Sober-home owners quickly followed suit. It was an extraordinarily lucrative business. A patient tested three times a week could generate twenty thousand dollars a month. Between April and July, 2017, Addiction Labs of America, Lab Geeks, and Physicians Group of Boca Raton billed my insurers more than seventy-five thousand dollars.

Between 2011 and 2015, prosecutors allege, staff at Good Decisions Sober Living, a sober home in Palm Beach County, filed a hundred and six million dollars in claims for urine drug screens with eighty insurance companies, and insurers paid out $31.1 million. According to an indictment, Kenneth Bailynson, the owner of Good Decisions, had opened his own lab and taken over the sprawling Green Terrace Condominiums, where he housed dozens of recovering addicts; he used the clubhouse by the pool as a collection site for urine. The Palm Beach Post reported that Bailynson turned Green Terrace into “an armed camp, where guards with guns made sure addicts did not leave.” At his detention hearing, Jim Hayes, the Assistant U.S. Attorney for the Southern District of Florida, described Good Decisions as a “piss farm,” in business “only to harvest residents’ urine.” (Bailynson has pleaded not guilty. His lawyer declined to comment.)

As the urinalysis business grew, owners of sober-living facilities started competing with one another for patients. They began to lure addicts with incentives: an iPhone, perhaps, or a gift card for groceries every week, or reduced or free rent. Brochures touted properties on the Intracoastal Waterway.

The kids who arrived for treatment soon saw that their insurance policies could be used as expense accounts for detox or sober living. John Lehman, of the Recovery Outcomes Institute, told me, “They also learned that these predators didn’t care if they stayed sober.” It was possible to leave a sober home in Delray Beach, get high by the ocean in Miami, and, whenever things grew dicey, book a room at a detox facility in West Palm Beach, whose staff would send a car to pick up patients. South Florida had become, as Lehman put it, “the relapse, rather than the recovery, capital of the world.”

“So long as you got into the van to go pee in cups,” Lehman said, “and as long as insurance was still reimbursing for those drug tests,” it became possible to live on the dole of one’s health plan. He has seen facilities where a person could “smoke crack in the bathroom, shoot dope on the porch, and drink Jack Daniel’s on the living-room couch.” Dave Aronberg, the state’s attorney for Palm Beach County, described relapse as “more profitable than sobriety.”

The competition for well-insured patients can veer into what’s known as patient-brokering. The Florida Patient Brokering Act prohibits people and health-care facilities from offering any kind of “commission, bonus, rebate, kickback, or bribe, directly or indirectly, in cash or in kind,” in exchange for patient referrals. Depending on the number of paid referrals, patient-brokering can be a first-degree felony in Florida, resulting in a sentence of up to thirty years in prison. But the practice remains common. Many patient-brokers pick up young drug users from the street. The castaways of treatment centers are easy to spot as they walk around, their bedrolls wrapped in black garbage bags, wild and disconsolate from loitering all day in the heat.

Last August, Haley went missing. I had met her in 2017, during Hurricane Irma. The owner of our sober home had moved us to an empty house, on a golf course in Coral Springs, which was supposed to be weatherproof. As the palm fronds lashed in the wind, we became friends. Haley was tall and blond, and had voted for Donald Trump in 2016, but the #MeToo movement caused her to consider feminism.

When she disappeared, she had been dating a patient-broker named Greg. She lived with him in a sober home in West Palm Beach. In practice, it was a flophouse, with seven rooms housing twenty people. The landlord worked at a treatment center nearby, where he sent tenants who relapsed—this happened all the time, because he funded much of their drug use. Haley would tag along with Greg until 7 A.M., chasing bodies to deposit at the detox facilities.

Haley described how Greg and other patient-brokers would entice addicts. “They’d be, like, ‘Why don’t you do this and I’ll pay you,’ just to get somebody to go in, or ‘We’ll get you high and then we’ll take you in,’ ” she said. The landlord “would cut them a check for a couple grand. So he knew what they were doing, but he turned his head to act like he didn’t.”

Haley told me later that, at the house, “the only rule was don’t get high, but then, when you broke that rule, it was, like, they would work with you for a while.” Haley said she returned to detox five times between August and September.

Greg disappeared with Haley’s car, and she traded her phone for drugs. She trundled through strange neighborhoods, smoking crack and seeing stars amid the slums of Boynton Beach, and we all wondered where she was. She couldn’t have told us.

Florida’s Department of Children and Families licenses treatment facilities, but it has no authority over sober homes. The Americans with Disabilities Act treats those enrolled in recovery programs as a protected class, and the Fair Housing Act mandates that neighborhoods make accommodations for people in recovery who want to live together. This makes it difficult to regulate sober homes. The Florida Association of Recovery Residences, a nonprofit, is the only organization that is designated by the D.C.F. to assess and certify sober homes, which happens on a voluntary basis. Yet FARR has only four field assessors.

In 2016, to address the crisis of patient-brokering, Aronberg, the state’s attorney for Palm Beach County, established the Sober Homes Task Force, a joint effort between prosecutors and local law enforcement. “We kept hearing about people with substance-use disorder being exploited by bad actors who take advantage of well-intended federal laws, like the Americans with Disabilities Act and the Affordable Care Act, and that they keep them in an endless pattern of relapse to siphon off their insurance benefits,” Aronberg told me. “The rogue sober homes don’t have to register; they don’t have any mandatory certifications or inspections.”

Lehman spent three years trying to get local and state law-enforcement agencies to investigate the bad actors in the recovery industry, and finally succeeded in meeting with the state’s leading insurance-fraud investigator, who contacted the F.B.I. Lehman told me, “I just dumped all this frustration, all these different cases that were in various different states of data collection on our end, and they asked me to provide them with a list of the top ten offenders.” He said that six of the ten names that he gave were among those indicted by the Department of Justice last year, in part of the largest crackdown on health-care fraud in American history. Federal authorities charged a hundred and twenty-four people in South Florida alone, and dozens of sober homes were shut down. (No facilities certified by FARR were implicated in the crackdown.) “The sober houses had all the protections of the Americans with Disabilities Act, and were warehousing kids for their insurance cards,” Marc Woods, the Delray Beach official, said.

In 2017, Kenny Chatman, who ran several treatment centers and sober homes, went on trial for money laundering, sex trafficking, and insurance fraud. He pleaded guilty, after evidence surfaced that he had held female clients hostage for sex work. One victim testified that she had been bound in shackles in the basement of one of Chatman’s houses while men paid to rape her. “I recall close to 150 in total different faces of rapists abusing me daily over a period of 3-4 weeks,” she wrote. “I was unrestrained for brief periods, only to be cleaned up of bodily fluids. I thought I was going to die there.”

Chatman, who was sentenced to twenty-seven years in prison, owes millions of dollars in damages to thirty-two insurance companies, including eight million dollars to Blue Cross Blue Shield.

There are signs that the local and federal crackdowns have had some effect. Between 2017 and 2018, opioid deaths in Palm Beach County fell by forty per cent, and the number of reported overdoses in Delray Beach have fallen to an average of seventeen a month. According to Woods, about half the sober homes in Delray Beach have closed. In April, the managers of the facilities where I stayed in Delray Beach and Boca Raton were arrested on charges of patient-brokering, and both residences have since closed. But, as the treatment industry has retreated in Florida, it has expanded in other states. California, home to the so-called Rehab Riviera, around Los Angeles, is estimated to have at least two thousand sober homes.

The Florida Shuffle is not just about moving from one bad place to another; it is about doing so without aim or sense of place. It is about people who, at the end of a twenty-eight-day course of rehab, or a stint at detox, find that they have nowhere to go. It is about never growing up. To spend one’s twenties moving between clinical settings and halfway houses is fundamentally arresting. Sometimes people return home after years of “working on themselves” to find that they do not quite fit in anywhere. The Florida Shuffle becomes a way of moving through life, and the only lens through which one understands it.

Last winter, I was living in a sober home on the border of Pompano Beach and Deerfield Beach—a few streets down from the motorcycle dealership where the rapper XXXTentacion was shot to death, the previous June. When I moved in, the oldest tenant in the house had lived there for six years, the house manager for two, another tenant for ten months. This stability is rare. But then, between August and March, twenty-one people passed through the house, settling in for a few days or weeks before they relapsed, or moved elsewhere, or died.

My friend Brandon, who had moved into the house in August, left one night in February without telling anyone. He visited my room to ask for a cigarette before leaving, and I wonder now what was crossing his mind as he stood there, leaning against the doorframe.

Later that night, I walked down the street to 7-Eleven to look for him. People often wound up there, by the dumpsters—always the dumpsters, an unofficial annex of the departed. None of my housemates would come with me; they sat looking at their phones, and then at the TV, sighing, having washed their hands of Brandon. The stragglers by the dumpsters, the pawnshop, and the laundromat all said that I’d just missed Brandon; he’d breezed by about seven minutes earlier.

Brandon was diabetic, and had never been able to manage his disease—that is, even when he could afford insulin, along with the ancillary drugs that he required for neuropathy. Around 1 A.M., he called me. He was drinking stolen red wine behind a Target, where he was planning to sleep before going to work at Panera Bread, in the morning. There was a spigot in the alley where the freight trucks dock, a benefit of choosing Target over Walmart.

A few days later, Eddie, a housemate who had been clean since July, overdosed and died in a motel room in Deerfield Beach. He had left in frustration on a Saturday and was dead by Wednesday. I can still see him bounding around corners—his forehead framed in grease and dirt and sweat from the garage where he worked, his tattoos beginning in a sleeve around his neck and ending at his ankles. They had set him back something like twenty thousand dollars through the years, he said. We liked the same music, and on the speakers in the back yard we would play Townes Van Zandt and Bruce Springsteen, John Prine and Warren Zevon: “Carmelita, hold me tighter / I think I’m sinking down / And I’m all strung out on heroin, on the outskirts of town.”

It robs you of something, after a while, to see this sort of thing happen, over and over. When Eddie died, not knowing how to express our emotions, or how to apprehend them properly, we said to one another, “That’s crazy about Eddie.”

Most young addicts I knew didn’t get funerals with a viewing; they were burned to bits in furnaces and, as ashes, thrown into the ocean or tossed to the wind from a mountaintop. I wonder, if I had the opportunity to look on my dead friends one last time—if I could see them as they were in the end, as pale bodies—whether that might startle me into something like closure.

Instead, I see them on Facebook, the dead I have known and still know. I have become obsessed with death; I see it everywhere.

A couple of weeks after Eddie’s death, I ran into Brandon walking down a sidewalk in Pompano. He was wearing a waiter’s uniform, from the restaurant where he worked at night, and carrying an old patent-leather satchel that I had given him. He was heading to a liquor store that sold cheap margaritas on Fridays. He said he was going to San Diego soon, to live in a motel where the rooms cost twenty-seven dollars a night. The sky was orange and roseate as we parted. We said, “I love you, man,” and promised to keep in touch, but we never did.

After Michelle calls me in June, I walk from West Camino Real to Palmetto Park Road, where Michelle, who is driving Dylan’s car, is stalled in traffic. She doesn’t have a license, and she doesn’t know how to drive a stick shift. I can’t drive stick either, and I haven’t driven at all since I was nineteen, when a judge revoked my license after I was arrested a couple of times for driving drunk. But I take the wheel, and we manage to move the car to a parking spot in front of Boca Raton’s City Hall.

In order to afford drugs, we must drive to the pawnshop to trade in Dylan’s Xbox, so Michelle calls Jacob, who lives in the apartment below mine, and whom we know from our recovery groups; inviting anybody to join our hateful dissolution seems unwise, but she tells me that it’s fine.

“We should go to 7-Eleven while we wait for him,” I say. “And get forties.” Somehow, I never can get past age seventeen.

When Jacob arrives, I offer him some of the Four Loko that I have stolen from 7-Eleven. He declines, saying that he is coming up on a sobriety anniversary, of six months or whatever, and, after all, he is driving. I am aghast. “Why are you here with us, then?” I ask. “Because Michelle said you guys needed my help,” he says. Jacob drives us to the pawnshop, where we pawn Dylan’s Xbox for sixty dollars, and to the dealer, to buy heroin. Jacob doesn’t use with us, nor does he regard us with disdain.

Soon we are shooting up in the car, taking turns with the syringe. The tip is frayed and curling backward, so that it snags against the flesh; removing the needle reminds me of excising an ingrown hair. In my eight years of intravenous drug use, it is the first time I have shared a syringe. Never again, I tell myself, but, a few months later, I do.

Here I am again, still hung up on this adolescent outlaw kick of mine, slouched by the window in the back seat of Dylan’s car, crowded with tools and clothes—everything he owns, I suppose, as he no longer lives anywhere—my head now dropping low. The heroin is likely fentanyl—and it isn’t lovely and it isn’t terrible, either, but it is not the same as it used to be. End-stage addiction forecloses novelty.

We go everywhere that day with our dirty blood and hot bodies and Michelle’s pretty dark hair falling down her back in greasy skeins, and I hate who we are. Somehow, we are on the beach, and I wish we were young and fun, svelte and bronze, and maybe I even say this aloud. I wish I liked the beach.

If we minded how we lived, the consideration was mild. If we worried that our sober home might evict us for using drugs, we also understood that we could fall back into detox, where we could watch Netflix over Gatorade and Valium, and then have chicken cordon bleu in bed. Then we could transfer to yet another treatment center or sober home. Beyond one place, another like it stood, and whether or not we said goodbye seemed not to matter—we trusted that we would meet again. So long as we were not dead, we were fine, there was hope—we would make it, after all. ♦