The Big Fix

Hope After Heroin


By Tracey Helton Mitchell

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This item is a preorder. Your payment method will be charged immediately, and the product is expected to ship on or around March 1, 2016. This date is subject to change due to shipping delays beyond our control.

After surviving nearly a decade of heroin abuse and hard living on the streets of San Francisco’s Tenderloin District, Tracey Helton Mitchell decided to get clean for good.

With raw honesty and a poignant perspective on life that only comes from starting at rock bottom, The Big Fix tells her story of transformation from homeless heroin addict to stable mother of three—and the hard work and hard lessons that got her there. Rather than dwelling on the pain of addiction, Tracey focuses on her journey of recovery and rebuilding her life, while exposing the failings of the American rehab system and laying out a path for change. 

Starting with the first step in her recovery, Tracey re-learns how to interact with men, build new friendships, handle money, and rekindle her relationship with her mother, all while staying sober, sharp, and dedicated to her future. A decidedly female story of addiction, The Big Fix describes the unique challenges faced by women caught in the grip of substance abuse, such as the toxic connection between drug addition and prostitution. 

Tracey’s story of hope, hard work, and rehabilitation will inspire anyone who has been affected by substance abuse while offering hope for a better future.




Like many Americans, my road to addiction started with a trip to a medical professional. At seventeen, I got my first taste of opioids after my wisdom teeth were extracted. I was a talkative yet very shy teenager, so my exposure to drugs had been limited to the small world around me, mainly my older siblings. Witnessing them in their experimentation phases had made me keenly aware of how silly a person on weed or alcohol could act. I had tried both of those substances a few times myself. I found neither to be all that appealing. But those white pills—they seemed like magic. I remember all the troubles of the world slowly melting away into a pool of euphoria. Little did I know, I would spend eight years of my life chasing that feeling on a daily basis.

Fast forward to a few years later. I had been imagining a way to return to that feeling. How could I get access to those magical pills? I wondered about acquiring some as I entered the hurried world of university life. It didn’t take long until I found a solution through friends. Their parents had pills on hand—from injuries, from surgeries, and from medical procedures that had healed long ago. They had forgotten about those bottles in their medicine cabinets. When you moved aside the cough medicine and the Q-tips, these glorious substances appeared from behind the hair gel as a beacon of hope. There they were! The picture showing the droopy eyes and the words MAY CAUSE DROWSINESS and DO NOT OPERATE MACHINERY signaled a good time was in our future.

The pills seemed the perfect enhancement to any night out. A few drinks, some pills, I was a happy woman. Sure, I lost some friends. That hardly mattered to me. I made new ones! I made better ones! I made friends who were not only accepting of my changing lifestyle, they encouraged it. They asked me if I wanted to try the needle. Injecting the pills would be the best use of my limited resources, they told me, after they worked some magic to separate out the binders and lick off the coating, and I held out my arm. I barely felt a thing. The first time wasn’t much, nor the second. What was I missing? But after trying a few more times, I began to see the appeal. Pins and needles in my extremities. A numbness in my core. My appetite only increased with time until, finally, I graduated to Lady H.

Heroin was supposed to be the ultimate drug experience. I was completely unaware of the nature of the diminishing returns. No time is like the first time—it felt like the best orgasm, the best hug, and the warmest blanket all wrapped up into a pile of ahh yes! I spent many years trying to recapture that feeling that soon slipped away from me. My drug-induced confidence was quickly replaced with anxiety. My painless days were followed by sleepless nights. I lost everything that I hadn’t already sold or traded for this drug, until I was brought into my new life in handcuffs.

It would be misleading to imply that my recovery was a linear process. It is true that once I made the decision to stop using and enter recovery, I never relapsed. However, there were many failures before there were many successes. I would be remiss if I excluded the ten other times I had kicked heroin, only to return to it. Let me outline my major attempts. I quit drinking and drugs for six months at nineteen years old. This was with just my “willpower.” I had one painful detox at home on my couch in Cincinnati. There were a few months at a time when I swore off drugs before I moved to San Francisco. I lived in a national park in Colorado for almost a month in an attempt to quit hard drugs. There was a twenty-one-day methadone detox. There were three different times I kicked on my own—once while I was living on the sidewalk, twitching and puking into the gutter. There were two different times I was forced to kick heroin in jail, only to return to drugs within hours of my release. Finally, there were two weeks on methadone maintenance a month before my final arrest.

I was also a polysubstance user who switched from drug to drug, complicating my recovery. During the last few years, I was using them all together, like a cocktail to celebrate my destruction. Between extended periods of heavy drinking, cocaine use, and methamphetamine-fueled binges, heroin was the thread that tied up my dysfunction into a not-so-pretty package. It wasn’t “just” the heroin. The heroin was just my first and last crutch. I gave up all substances, including alcohol, to be free. That is my personal story.

I may not have stayed sober every time I tried, but I learned something from each attempt to get clean. By the time I went to jail for the last time on that foggy night in late February 1998, I was ready to put all my hard-earned knowledge into practice. With each passing minute, with each passing hour, with each passing day I got stronger for my attempts. No matter how many times you have tried in the past, you only need to get it right one time. I tell people seeking my assistance: Make NOW that time.

The process of getting clean was a road with many twists and turns. The brief summary of my recovery goes like this: jail, detox, rehab, sober living, twelve steps, support groups, and therapy. Those were the things that worked for me.

I didn’t start my recovery thinking I would become an advocate for addicts; at first my focus was just on staying clean myself. But I have seen people change before my eyes when they hear my story and begin to believe recovery is possible. Many addicts say to me, “Tracey, you are such a role model.” What do I say to them? Do I take the credit for the little bit of luck and the big portion of fear that have motivated me to stay clear of active addiction? Do I give advice when I feel as if I don’t even have mastery of my own life and my own emotions? Generally, I am so humbled by the opportunity to help someone that it leaves me speechless, so all I can say is, “Thank you.” Thank you for caring enough to take time out of your life to talk to me. I gain strength knowing that I can still contribute to a world when I spent so much time taking from everyone around me.

To some, my story, my journey to recovery, is a cautionary tale. To others, it is a light in the dark world known as addiction. When I look at the life I have built for myself, it is hard for even me to believe that I was ever a homeless drug addict. To this day, when I reflect on how I went from college student to junkie, I have more questions than answers. Could something have changed the trajectory of my life? I am not sure. Was I hooked from the very start? It is hard to say. These questions are impossible to answer. What I do know is when I hold my child’s hand or help a person in need, all of the pain I suffered becomes transformative. I have learned from my journey that I am strong. I am capable of great things. Not despite my past, but because of it. To honor all those who have been lost to drugs and to avoid losing more, we must demand changes to our current policies. Don’t be left wondering whether you could have done something to help the user in your life. We can all do something that will make a difference. I am the proof.

Chapter 1


When I get to work this morning, I glance through the notifications on my phone and something unusual catches my attention. This is more than someone liking my picture on Instagram. This isn’t telling me about a 15 percent off sale, if I can just drag myself into a hideously crowded store. This is something different. “I wanted to tell you that you saved my life. When I was . . .” Someone must have left a message on one of my profiles. Even though it seems like I have so many ways to connect with the world, there are still so many moments that are lonely. I often think about how addiction is the constant state of dissatisfaction and disconnection with the positive things in life. Many days, even without drugs, I still feel that state of unease. This phone, these messages, let me connect with others who understand. When I get a minute away from my desk, I’ll sneak off to the bathroom to read the rest of the message. For now, I need to focus on getting myself together for a long day at the office.

My morning started off with the cat jumping on my head. He is really an asshole. I love him, of course, but his behavior can be intolerable even by cat standards. When that didn’t wake me up, he stuck his paw in my eye. He is so mean that many people refuse to come over to my house—they are afraid of him. He reminds me of myself. He is sweet to those he loves, but is constantly on the defensive. We both are so afraid of being wounded, we end up spending a lot of time curled up in a ball, holding on for dear life. Anyway, apparently he thinks 5:02 AM is a perfect time to eat. I, on the other hand, wanted to savor my last twenty minutes in bed.

My night was filled with tossing and turning—otherwise known as the joy of perimenopause. I still cannot understand how I can be in perimenopause when my youngest is still in diapers. My relatively late-in-life third child reveals a whole other realm of my ironic life decisions. Having a toddler in my forties is exhausting. Not quite staying-up-for-three-days-on-cocaine exhausting, but exhausting nevertheless. When my three children get through college, I will be well into my sixties. But this is all part of a life I never imagined, much less planned. When I was young, I had dreamed of having a baby one day. Then I traded in that dream for a bag of heroin, and my plans changed to “live fast and die by thirty.”

Who could have ever imagined me, the junkie whore, as a caring mother? Yet when I gave birth to my children, mothering came naturally to me. I will always remember them as my beautiful miracle babies snuggling with me in the hospital. They were the true gifts of my recovery, gifts beyond my comprehension. The joy I felt as a new mother was easily the highlight of my life. I suppose it also provided me with a dose of the happy chemicals I read about on the mothering forums. Nursing and cuddling with a child are supposed to provide oxytocin, which results in a warm and content emotional state. I suppose I have gotten attached to my natural baby high. Giving up nursing, that feeling of connection, as my children grow is bittersweet. When I formed this bond with my first child, it was as if I had run a marathon. I felt as if I had achieved the impossible. I had overcome addiction and created a new life. My children were the manifestation of that. Nurturing each child reminded me of how I had nurtured myself.

Not that it’s always been easy. Given my history, I had to fight with medical providers when I wanted to nurse my baby. Nursing is the last link to joy-filled time after having a new baby. Even now, I’m still bitter over a thoughtless comment a nurse made when I’d just had my first child and she saw on my chart that I used to be an intravenous drug user.

“Are you sure this is okay?” she asked me.

I pretended not to hear her. I stroked the hair of my baby as I fed her. I drank in her smell. The smell of my new baby was more intoxicating than any drug combination I had put into my body. I experienced more love in that moment than I have ever felt through a needle. For a brief second, my life was complete. That empty pit in my heart I had filled with substances was gone. It was as if those ten years on drugs had been erased with the birth of my daughter. I was more than an addict. I was a powerful woman. Finally, I had created something good in the universe. When my daughter arrived in my arms, I was reborn.

She started again. “Are you sure you should be doing that?”

“What do you mean?” I asked, still half ignoring her.

Nurses were constantly coming in and out of my room, offering unsolicited advice. While the majority of the medical staff were helpful, it only took one to sour my experience.

She continued. “Are you sure you should be breastfeeding the baby with your history?”

I wanted to throw something across the room. Can’t she see that I have changed? Can’t this woman see that I’m a new person? The arrogance—on my part. I actually believed I could be a normal woman. I actually believed I could be accepted as something beyond my history. I ignored her again. She needed to get the fuck out of my room.

The buzz of the alarm interrupts me. I had turned over in hopes of getting five more minutes of sleep. I guess I slipped into a dream, or, really, a painful memory. My husband is already at work, long gone. He is a solid, hardworking man. He is the type of man who supports me while giving me the freedom to be myself. He works in construction, and I love him for his white T-shirts and blue jeans. He provides stability to balance out the crazy thoughts that run around in my mind. He loves me without judgment. I respect him, especially on a day like today. Many mornings, he leaves the house at 4:30 AM for the long commute to his jobs down the peninsula. I sometimes wonder how he can function with so little sleep.

I give myself exactly one hour to get ready in the morning. I have to feed myself, wake the kids, feed the kids, dress the kids, make my lunch, make their lunch, and get out the door without losing my shit. I wonder how many parents out there are also about to pull their hair out with stress. I find it strangely comforting when I see another family struggling with their children in my morning travels. When a mom has to pick her fitful toddler off the ground or I see a dad struggling with a stroller on the train, I give them an empathetic nod of recognition. I see you, weary warrior. Having children is hard work. So many things to do in the morning! It will be a miracle if I can do all of this without raising my voice. Two kids go off to the elementary school and one to daycare. Fortunately, I have some help with transporting the big kids to school.

I had a “little” incident a year or so ago when I had a panic attack while driving seventy miles an hour on the highway like a madwoman to get to the train station so I could get to work on time. I am not sure if it was the three and a half cups of coffee a day I drank to stay awake. Maybe I had just reached some type of mental mommy critical mass. The panic attack was an ugly scene that made me question the way I managed my life and my time. That was one of many breaking points. After that, I knew it was time to look for some new solutions. One of the gifts of my recovery is that I have learned to ask for help. One of the teachers at the school kindly agreed to drop off my older kids for less money than I spent on gas. That change makes my morning flow instead of coming to a screeching halt. I also cut back on the caffeine.

In the category of everyday miracles, both my trains were on time this morning. This makes me feel like the commuter equivalent of a rock star. I made it to work with a few minutes to spare this morning. In fact, my son cooperated every step of the way. I had the assistance of some snacks for minor bribes. The best part of not driving in the morning is I get a few extra cuddles with my son. As he sits next to me looking out the window, I bury my head in his hair. That sweet smell brings a smile to my face. The softness of his hand inside my hand can make being ten minutes late seem completely insignificant when it used to be everything. I used to practically have a mental breakdown if I was late. I was that irritating person who always showed up early for everything. Now, I feel satisfied if I arrive at all with clothes on that match. I am no longer just working harder, I am working smarter. Of my four years of business school, this seems to be the one thing I remember. For my own mental health, I need this time with my son. I deserve this time. When he waves goodbye to me, my heart breaks. Mothering time is over.

I snap back to my routine at my desk. In the middle of multitasking, my mind frequently wanders off. Fortunately, I seem to have some sort of muscle memory that can help me navigate even when I am on autopilot. I have so many things to cram into a single day. I come back into the moment in front of a white screen full of emails needing my attention. I have twenty minutes or so to stuff my face with yogurt and tea. Supposedly hydration is the key to balance. I find this amusing, since the only hydration I practiced before my thirties involved a syringe and a cotton for a filter. Now, here I am drinking tea by the fistful, waiting for the staff to start trickling in. Since today was a miracle day with ten whole extra minutes, I have time to look at my new message.

           I saw the movie Black Tar Heroin: The Dark End of the Street in high school. The film had a huge impact on me. It only briefly stopped me from trying opiates at 20 years old. My boyfriend got me started with OxyContin and switched to heroin when oxy became too expensive. There is no harm reduction here, no treatment I can afford. After years in and out of jails and rehab, I have 32 days clean. I saw some of your videos. You are such an inspiration to me.

The writer pleads with me to explain to her what I did to stay clean. I push myself back into my chair. I need to take a moment. When I read these kinds of messages, I try to knock all of the elements of my rational mind down a notch and let my emotions flood in. It would be really easy to provide a long list of clinical advice. First you need to do this, then that, and good luck to you. But that is not what this person is seeking. When people contact me, they want a connection. They saw me on the screen. They feel as if they know me. This person wants to connect with me, the addict. She wants to know what I did to put myself in that place again when I was struggling to keep the needle out of my neck. She doesn’t want some rote catchphrases devised in rehab. She wants me to reflect and respond.

Her words make my heart ache. I know this pain. While thirty-two days is enough time to physically feel much better, the road to real restoration is a much longer path. When I look at her face in the compressed photo next to her name, I see myself at twenty-seven. She has that overly made-up face, a mask to deflect from her emotions. I remember standing at the mirror putting on eyeliner like it was somehow a ring that would hold back my tears. I caked foundation on my scars, applied lipstick to draw away from my chipped front tooth.

She sees me as a heroine.

To a generation of young people struggling with addiction, I am known as the heroine of heroin. The documentary this woman is referring to—Black Tar Heroin—featured me when I was a junkie in my mid-twenties. It was aired on HBO in 1998 and still has a cult following around the world. Articles have been written about me since then extolling the fact that I have done what seemed completely impossible: I have been clean since February 27, 1998. That makes an impression on anyone who knows anything about this drug. When I agreed to do the film, I thought I would soon be dead from an overdose or homicide and that my story would be no more than a cautionary tale that would live on long after I was gone. My story is now one of transformation. I have escaped what has killed so many others.

This young woman is reaching out to me for answers. I might have a few, but I’m not sure I can fully explain in a few sentences what has taken me so long to learn. I can try. I need to explain that recovery is a long process full of ups and downs. Getting off heroin is just the start. The real work comes after you put down the drugs. Heroin controls every element of your life. Heroin dictates your finances, your sex life, your family relationships, your mental health, your physical health, your spiritual condition.

I always take a few minutes to collect my thoughts before replying to such a thoughtful message. I reflect on the massive changes in my life since I stopped slowly poisoning myself. Why was I one of the few to get out of that life? Why was it me? What is it about me that made my story so different from that of hundreds of young people I knew who died in addiction? I was what is known as a low-bottom junkie. My using took me into horrors rarely witnessed, and rarely escaped.

I was using heroin during the era of AIDS. When a friend first pushed a needle into my arm, it was a used one. We would use the same needle—hoping it wouldn’t break off in our arm—until the numbers on the side of the syringe wore off. Needle exchange programs and other services to assist users were nonexistent where I grew up in the Midwest. If you went to the hospital for an overdose or an infection, you could easily be taken to jail. People who had overdosed were dumped on the street, in hallways, or, if they were lucky, outside the hospital. A heroin user was considered to be the lowest of the low in society. We were told AIDS was cosmic retribution for our sins. The world would be a better place if we all just died off.

Heroin was expensive back then. The first time I tried it, I paid $30 for a bag that I split with another person. The bag started out at one-tenth of a gram. I have little doubt one of my friends dipped into the bag before I did. This was probably for the best. Recently one of our friends had overdosed and had to be revived, so everyone agreed I should only do half of that bag. “You can always do more,” my friends said. “You can never do less.” It was a “stamp” bag from New York City. It was engraved with 666. This should have been an omen. To me, it was a dream come true. After a year of planning it, I was finally going to try heroin.

I was cautious, afraid to put my life in the hands of another junkie who had agreed to inject me. My friend reminded me that this was something I had wanted to try for a long time. I held my breath, then motioned for my friend who had agreed to inject me to go ahead. It was exciting and terrifying at the same time, but nothing would stop me from experiencing the ultimate high.

Heroin was not widely available in the U.S. at the time—it took us months to find it. It was clustered mostly in larger cities like Chicago, Detroit, Philadelphia, New York City, and San Francisco. These cities had what are called open-air drug markets on street corners where heroin could be purchased. New York had storefronts that doubled as drug houses. A person could purchase a pack of gum and a bundle of heroin. My friends and I would travel to large cities to buy it and bring it back. When that ran out, we would go back to our normal routine—school, work, life—occasionally taking pills we stole from our parents. It was tough to have enough access to really get addicted. The first time I experienced any type of withdrawal, no one could tell me what was wrong with me.

The world in which this young woman lives now is entirely different from the one I left seventeen years ago.

Now heroin is readily available across most of the U.S. From the cities to the suburbs, heroin has penetrated most communities. If you have the funds, it can even be ordered off “dark market” sites on the Internet and shipped directly to your front door. Mexican cartels have been creating routes straight through the border to towns in the Midwest, where deaths from prescription drugs used to be king. As the government cracks down on legal opiates, users are turning to heroin as a less expensive substitute. This includes places like Cincinnati, near where I grew up. I went there recently for a benefit for their controversial new syringe exchange program. Users there reported to me that the streets are so flooded with heroin, dealers are known to hand out free samples to get new customers. Free samples! I am not sure I would have survived this current era.

Heroin has moved from the shadows into the living room. Somehow it has managed to become a more social experience. I hear about groups of high school students who started out stealing their parents’ pills and end up railing lines of heroin together on the weekends during marathon Xbox sessions. When I started using heroin as a recreational user I was repeatedly told within social circles and by mere acquaintances that I was a “loser” and “ruining my life.” Friends of mine were scolded by their friends for even associating with me. By the time I stopped using, many of these same people were asking me to get heroin for them. Heroin in social groups takes off like deadly dominoes, knocking people off one by one, until someone breaks the cycle. Users compare the process to making vampires: You hate the person who started you on the path, yet you find yourself creating new victims. That way you will not be so alone.

Heroin is now cheap, a ridiculous idea when I think of my twenty-two-year-old memories. With a few minor exceptions, heroin is cheaper in many places than a mixed drink at a bar or a pack of cigarettes. No more scrimping and saving and planning are necessary. A person can make a split-second decision to use that may change the course of his or her life. The woman who wrote me that message lives in a world where heroin is an option, not an exclusion. It isn’t a struggle to get an affordable experience, one that has the potential for dire, unexpected consequences.

Heroin is also now extremely potent. In my using days, the heroin I was getting was tested at 20 to 38 percent pure. When street heroin would reach higher levels of purity, there were clusters of overdose deaths that followed. One nice lady in the cell next to me when I was in jail in 1996 had a brother who had died of an overdose, and she got a special overnight pass to attend his funeral. A few days later, the inmates received word she had also overdosed and died. A family was destroyed, taken by heroin in just a few days. Her son would no longer have a mother. But that was “heroin-lite” compared to what is now available to the young woman who wrote to me. Some samples recently tested on the East Coast are up to 70 percent pure.

I also did not have to worry about deadly additives like fentanyl back when I was using. Fentanyl, a synthetic opioid, looks like heroin but is much more potent. Clusters of


On Sale
Mar 1, 2016
Page Count
244 pages
Seal Press

Tracey Helton Mitchell

About the Author

Tracey Helton Mitchell is a recovering heroin addict. After completing rehab in 1998, she dedicated her life to the care and treatment of heroin users. Tracey entered school through an ex-offender’s program where she earned a bachelors of business administration and masters of public administration.

In addition, she is a certified addiction specialist and supervisor. She was featured in the move Black Tar Heroin: The Dark End of the Street. She has also been featured by CNN, Anderson Cooper, Vice, the Huffington Post, and the New York Times. Tracey lives in the San Francisco Bay Area with her husband and three children.

Learn more about this author