By Carlton's mom, Susan
Carlton Fredrick Messinger, II
Holderness, New Hampshire
October 31, 1989 - October 23, 2014
Beloved Son of Dr. John Messinger and Susan Messinger
Devoted Big Brother to Adam Messinger
Carl was a wonderful son that cared deeply about his parents, brother, and friends till the end. I have become a member of an exclusive club that I never wanted to be part of. It was never my plan to bury one of my children especially the cause of death being a drug overdose. This club seems to be growing daily. We are losing a whole generation to this epidemic.
This is Carl’s story.
We found out on Sunday, September 28, 2014, that my son Carl had been using heroin on and off for about a year. We were as shocked and bewildered as any parents could possibly be. We asked ourselves: “How does a young adult who is a college graduate and taking advanced classes in chemistry and biology, getting A’s & B’s in the classes so he can apply to dental school use heroin?” I immediately thought that’s not my child, there has to be a mistake. How did we miss this? How does a functioning member of society who six months ago started a thriving eBay business selling vintage transformer toys use heroin? There were many questions swirling around in my head after being told about Carl’s heroin use. I felt, and still do feel, at times that I am in a movie and this is has not really happened to my family. I feel that Carl is out of town and will be coming back home someday. But then reality hits and I realize Carl is never coming home.
Within minutes of being told about Carl using heroin, we confronted him. After a lengthy, calm, and rational discussion, he confessed to using and that he was weaning himself off of it with Suboxone. Carl told us he wanted our help. The result of that meeting was an agreement: Carl would immediately enter a detox program, then enter a treatment facility.
After six phone calls and much frustration, I finally found a detox center that would take Carl. The reason for my frustration was not that there wasn’t a bed available or that they didn't take my insurance; the real frustration was I was told over and over again that if they didn't take our insurance, they could not accept him as a cash-only client. These specific detox centers had an agreement with insurance companies that they would accept approved insurance clients only.
I finally found The Farnum Center in Manchester, NH, where Carl could enter as cash paying inpatient client if our insurance denied the request for coverage. As expected, our insurance denied the request to cover detox treatment for drug addiction. I was told that if Carl had an alcohol addiction it would be covered. I was also told that the insurance companies did not think you could die from drug detox.
Carl entered The Farnum Center detox program on Wednesday morning, October 1, 2014. At the end of the six-day inpatient program, everyone in the facility was convinced that Carl was going to make it. They made us feel wonderful about our son; Carl had stopped using heroin on his own two months prior and was now detoxing off of suboxone. They also mentioned how Carl had helped other patients realize they could be treated for heroin addiction and have a better life. The nurses and doctors told us that we had raised him right and Carl didn’t belong in a detox center. I felt in my heart, if we had done such a wonderful job raising him why was he here? Before departing, the discharging doctor mentioned that if Carl was not ready to go right into rehab, he may be able to stay clean on his own since he had already stopped using heroin on his own and had previously used suboxone.
In another lengthy, calm, and rational discussion Carl made a case for not going to a treatment facility. Based on Carl’s request, and the information we received from the detox doctors, we ultimately agreed. After he successfully completed the detox program Carl moved home with us, and we felt we could monitor his progress adequately. We all agreed that he would have to stay clean and sober during this two-week trial period. At the end of the two weeks, Carl would be drugged tested. If he tested positive he would enter treatment immediately. If at any time after the two week period Carl tested positive for drugs he would immediately go to treatment, no discussion. At the end of the two weeks, Carl took the drug test and passed with flying colors. We congratulated him, and hugged him. We truly felt we had our son back and on the road to recovery.
On Tuesday, October 21, 2014, Carl came down with a bad upper respiratory infection and we took him to the doctor the next day. We found out later that he never saw his regular doctor for this visit. He saw a doctor who was not familiar with Carl’s medical history, and had no idea that he had just come out of detox for heroin addiction. We also discovered later that Carl's primary care doctor never wrote in his chart about his heroin addiction, and having just completed detox. Even though his primary care doctor was part of the process of getting Carl help.
We found out after Carl died that the doctor never asked him if he had any alcohol or drug abuse issues before prescribing a codeine cough syrup for the infection. We learned that, five years before, the medical center had removed a template that would cue doctors to ask patients about substance use disorders prior to prescribing a narcotic. I had a conversation with the CFO of this medical center, only to be told that, “Yeah, we don’t do such a good job with this issue. Our clinicians need to be mindful of these issues.”
Later that day I picked up a prescription for Carl, not aware that Cheratussin AC Syrup is a codeine cough syrup. There were no labels on the bottle stating that this cough medicine does in fact have codeine, and it can stimulate drug-seeking behavior. However, buried on the second page of the patient prescription information sheet it lists the following: “Though very unlikely abnormal, drug-seeking behavior is possible with this medication.”
The codeine in the cough syrup triggered the need for Carl to use again. I found him dead in his bathroom, with the syringe still in his hand. The memory of finding him cold, dead and blue will be something I live with every day. This is an experience no parent should have to go through.
Carl died from fentanyl intoxication. There was no heroin in Carl’s system, only fentanyl, and codeine from the cough medicine. As my husband has said: this was the perfect storm. Unfortunately, it took our son’s life. Carl never had a chance to embrace sobriety. I feel some of the people we put our trust in failed Carl.
Carl was an educated, smart, and vital young man who came from a family who loved him very much. He had his whole life ahead of him and is sorely missed by his parents, brother, family, friends, and everyone that knew him. We know Carl is in a better place. Carl will always be in our hearts.
I am currently working with US Congresswoman Annie Kuster and US Senator Jean Shaheen on getting “Carl’s Law” passed in Washington. Both versions of the law have been presented to the legislative bodies in Washington. Carl’s Law will make it mandatory that for all narcotic drugs the following must be on the label: “This Drug Can Cause Drug Seeking Behavior.” Had Carl’s cough syrup been labeled accordingly, I’m sure there would have been a different outcome for my son.
Additional changes I would wish to see happen:
Mandatory questions must be asked prior to writing a narcotic prescription and for those with existing drug abuse issues, regardless of the answer, tell these individuals that this drug can cause a trigger of a relapse.
All narcotic RX must be properly labeled and visible that it is a narcotic and can cause drug seeking behavior.
All communications regarding a patient’s health history must be documented in a patient's chart.
Detox and treatment centers must take cash paying clients.
All insurance carriers must cover inpatient drug detox and inpatient rehab.
Limit the number of opiate/narcotic pills that can be prescribed at one time.
Update: As of May 2018, the drug dealer who sold Carl the drugs is going to be sentenced for causing his death on 6/14. He is going to do 5-20 years. Not as much as we would have liked.