In Suburban Dallas, Loosening "Cheese" Heroin's Deadly Grip

They waited as long as they could before they left without him.

"Don't bother going out tonight," Kathy O'Keefe had told Brett, her 18-year-old son, the night before their family vacation. It was March of last year. Brett's older brother, Kyle, was home from college for spring break and his birthday, and the family was planning a quick trip to San Antonio from their home in Flower Mound.

"Please just stay home," she told Brett. "You can pack, you can kick back, spend time with Kyle."

Brett got home around 10 that night from his gig at a frozen yogurt place. But he insisted on going right back out. "If I'm not home tonight, I'll be home first thing in the morning," he told Kathy.

"Fine," she told him. "But we're leaving at 9 a.m., whether or not you're here."

Nine came and went with no sign of him. So did 10. They called and texted, with no response. At 11, they finally left, one short of an otherwise perfectly cliché family getaway: Brett's dad, Ben, driving, Mom buried in her crossword puzzle, Kyle under the spell of a movie glowing from his computer. They were annoyed but not totally surprised. It wasn't the first time Brett hadn't made it home from a long night with friends, and the knot of vague worry and anger in Kathy's stomach was by now a familiar one.

At 1 p.m., Kathy's cell phone rang. It was Brett, just waking up at the hotel where he'd spent the night. He had no car and no driver's license. His friends were gone. He was stuck.

"Turn around," he pleaded. But Kathy said no. They were already in Hillsboro, more than two and a half hours from home. "We gave you plenty of opportunities," she told him.

She hung up and the family continued south, snaking through the packed lanes of holiday traffic for hours. They finally made it to the hotel, a funky place just off the River Walk, sometime in the late afternoon. Brett called one more time and told his parents he was home. "I'm going to have a couple people over tonight," he said.

"That's fine," his dad told him. "Just don't make a mess."

"Make wise decisions," Kathy added. The three went out to dinner and, soon after, to bed.

The next morning, Kathy showered first, then Ben. Kyle was in last when Kathy's cell phone rang again.

"I'm with Lewisville hospital," the woman on the other end said. "Has anyone called you yet?"

"No," Kathy said.

"I'm sorry to say we did all we could," the woman began. She kept talking, but Kathy knew what she was going to say without really listening. Ben walked into the room, saw his wife's face, and stopped cold.

"Brett's dead," she mouthed to him.

The woman from the hospital was saying something about the medical examiner. He needed to call them, give them numbers, information of some kind.

"You'll have to talk to my husband," Kathy said, and handed the phone to Ben. He started to take notes. Kathy packed. The suitcases were together by the time Ben hung up with the hospital. Kyle was getting out of the shower when they told him. He kicked the walls in a fury, then curled up in the fetal position on the sofa bed where he'd slept the night before.

As they climbed back into their car, the O'Keefes still didn't know many details about their son's death, just that he had taken too much of something, passed out and never woken up. They didn't even know where Brett was when he died. Later, the family would learn that although he had been pronounced dead at Medical Center of Lewisville, the paramedics had been called to their house by Brett's two friends, who fled after calling 911. The EMTs found Brett curled up on his mother's side of the bed.

First, though, the drive. Five hours if they didn't hit much traffic. It was a freezing day, so Kathy and Ben didn't want to open a window to smoke. But they needed to smoke. They drove, silently lighting one cigarette after another, the windows up, the air growing thick and stale around them.

On May 17, more than a year after Brett O'Keefe's death, John Bales, the U.S. Attorney for the Eastern District of Texas, made an announcement that rattled the inboxes of reporters all over North Texas: A federal grand jury had indicted 17 people for drug crimes in and around Flower Mound. Twelve of them, all but one 21 years old or younger, were accused of conspiring to distribute more than 100 grams of heroin on the suburb's quiet streets, with five others charged with gun and lesser drug crimes. Ten of the 17 were Flower Mound High School grads, either class of 2009, like Brett, or just a year younger. It was a "heroin ring," the feds declared, and it was responsible for the drugs that killed at least three teenagers: O'Keefe; Harold Renz, 17, who died six days before him; and Justin Rodriguez, 19, who died last July, four months later.

The combination of young suburbanites and hard drugs caused a major, if short-lived, media blitz. News cameras camped outside courthouses to catch glimpses of the defendants, dressed as if for church and often accompanied by their mothers. One station ran a slideshow of their mug shots online. With their acne and patchy, uncertain stubble, many of them looked barely old enough to drive. News report after news report found outraged families to express shock at the existence of drugs in their suburban hamlet. "This is Flower Mound," one mom said. "This is Mecca."

The implication was that Flower Mound was experiencing something new and dark, an evil freshly imported from the big city. But in reality, the busts were just the latest turn in a long-running storyline in North Texas' suburbs and small towns, one that's played out several times over the last 15 years.

Plano is the best-known example. In the mid-1990s, around 20 people died of heroin overdoses there, many of them high-school age or barely older. In 1998, 29 people were indicted for their part in a suspected heroin ring, the majority of them young adults from Plano. The arrests sparked a media assault, including a Rolling Stone story called "Texas Heroin Massacre" and a Newsweek story headlined "Heroin High."

Less publicized, smaller outbreaks of heroin-related deaths and arrests have occurred with regularity ever since. Almost every time, the same type of heroin is labeled the culprit: "cheese," a snortable mixture of black tar and, typically, diphenhydramine, the antihistamine used in Benadryl. It's a damp powder that can be yellow, brown or white.

In 2006, The Dallas Morning News reported a "new drug" was plaguing Dallas' city schools: "a cheap combo of heroin and Tylenol PM," which was found at 11 Dallas schools and had killed an 18-year-old West Dallas woman. The Fort-Worth Star Telegram told a nearly identical story a month later, about an 18-year-old who died after overdosing on "cheese." Later that year, the Morning News speculated heroin was making a post-Plano epidemic comeback (despite evincing unfamiliarity with the drug just a month or two before), citing four deaths and 15 non-fatal overdoses in Plano and Frisco in the previous 14 months. Children as young as 11 were being found with "cheese," the paper reported.

In 2007, a group of grieving parents of teenage overdose victims founded the Starfish Foundation, dedicated to educating youth and eradicating the heroin scourge. The same year, the Dallas County Medical Examiner's Office found that the number of kids who had died from "cheese" overdoses in Dallas County rivaled the number in Plano during the height of the problem there: 22 dead by the middle of summer, including a ninth-grader. In 2008, three men were indicted on charges of killing a 19-year-old woman by giving her a fatal dose of "cheese."

"It's a starter way to use heroin," Jane Maxwell, a researcher at UT Austin's Addiction Research Institute, says of the drug. "Not as strong, and you don't need to inject," lessening the drug's stigma. New users also "believe the old lie that if you snort it, it's not addictive," she says. The antihistamines also depress the central nervous system, boosting the effects of the heroin.

The drug has had a uniquely stubborn hold on North Texas. Last year, the New York Daily News reported that federal officials had warned New York's police force to watch for the drug. Otherwise, it's barely visible in news reports outside of North Texas.

But despite its regular place in the region's headlines, the resulting disbelief is the same each time the drug hits. The term "cheese" is redefined over and over in news stories on the latest "epidemic," and the same set of terms are predictably tossed about: "starter heroin," "kid killer," the "latest teen drug craze," coming soon to a 'burb near you.

Rob Reid, a 30-year-old recovering addict and pastor at Rockpointe Church in Flower Mound, lived in Plano in the 1990s. What's going on around him now strikes him as uncomfortably similar to what he saw as a teenager: drugs, dead teens, indictments, a round of intense, brief media attention, and then, just as quickly, silence. "It's been three weeks and the flash in the pan has already occurred," he said in early June, just after the indictments were trumpeted by prosecutors. In Plano, he says, it took much longer for the community, and the media, to catch on. "Nobody got the whole Plano thing until three years later," he says. "People looked back and said, 'Wow, 18 kids have died, this is a real problem.'"

The cultural amnesia doesn't stop with parents. "Unfortunately, drug abuse is marked by 'generational forgetting,'" Maxwell, the drug researcher, says. "And over time, new users emerge who know nothing about the dangers and they start using. It's sad and discouraging."

Just last month, Maxwell's research institute released a report on substance abuse in Texas. Researchers reported that heroin users keep getting younger here, and "cheese" continues to grow its market share. Between 1996 and last year, users who reported snorting their heroin increased from 4 percent to 16, while the average age of inhalers dropped from 30 to 27.

Maxwell is leery of the term "cheese," though, a name she says sounds flippant and downplays the fact that it's heroin these kids were selling, and heroin that killed Brett O'Keefe and the two others. (All three men had both heroin and diphenydramine in their systems when they died, according to the medical examiner's reports. Kathy O'Keefe says her son actually died from shooting heroin, not snorting cheese, although he had used the snortable mix before. He had several other drugs in his system when he died, including a large amount of Xanax)

"Please don't do a big media feeding frenzy on 'cheese,'" Maxwell pleads in an email. "That will only start it up again."

Driving through Flower Mound feels like passing from one clump of high-end strip malls to another, with gated communities dropped in between. There are few signs of life outside of big-box stores and planned developments. Pedestrians are rare. But it's also lined with broad, smooth, white sidewalks, trim lawns and, here and there, lovely copses of long-limbed trees. At night, the drive into Dallas from Flower Mound can be startlingly beautiful, with the lights from dozens of Waffle Houses and storage units studding the Interstate 35 corridor like plastic jewels.

Inside one of those jewels, a friend of Brett O'Keefe's, whom we'll call Jen, brushes strands of hair from her face, blinking back tears. She is 20, slim, birdlike and very pretty in a black strapless tank. Bright streaks line her hair. As she speaks — precisely, pausing to pick her words with care — she seems much sadder and older than she should, folded up in a chair in the corner of a Flower Mound Starbucks. Her iced coffee melts into a caramel puddle as her glass sweats on the table, forgotten. "We didn't start out with bad intentions," she says.

Jen, her boyfriend and Brett formed a tight-knit trio. They did everything together during the second half of high school, she says, including drinking and drugs. But all that didn't turn into a problem, she says, until later, after everyone had graduated.

"All throughout high school I had been planning to go to college," Jen says. "I was going to go to a good college and my parents were going to pay for it. Somewhere in my senior year, I started experimenting with stuff. The first was marijuana. People say it's the gateway, and I guess it was for me. And that just led to other curiosities."

Soon, they were eating pills of ecstasy at 18-and-over clubs in Dallas.

"That was a little phase," she says. "I didn't have any problems really with that."

After ecstasy came Xanax, known in their circle as "bars." "I don't know why that didn't blow up in the news," Jen says. "Everyone was on them. People you wouldn't expect. You would just go to a party and pop one, because they make you feel drunk. That was everyone's excuse, that you could take them at a party, then go home and blow zeros if you get pulled over."

Jen was barred out the first time she snorted cheese, at some guy's house the winter she turned 19. "So when he asked me if I wanted to do it, of course I said yes," she says, "because I was already messed up. So I don't even remember if I liked it or not. I ended up falling asleep."

It quickly became the regular drug diet among her friends. "That was bad, because when people were getting into heroin, they'd mix that with their Xanax. Cheese was supposed to be heroin and sleeping pills, but people would not even use sleeping pills and just crush bars in it instead. That's a deathly combination right there. That's a quick way to die."

Brett was angry with Jen when she started using, she says, because he'd recently gotten clean. "At first he was doing heroin and I stopped talking to him for a while, like, 'That's gross, why would you ever do that to yourself?'" she explains. "Then I started doing it and then he got mad and was like, 'Why would you do that to yourself?' Because at that point he was off of it. Then it got to a point where we were doing it together."

Jen and Brett were together in Dallas the first time she shot heroin instead of snorting it. "We were at this guy's house," she says, "and I had no idea who he was. I was kind of scared to be there at first, because it was a part of Dallas where the neighborhoods — people would walk the streets, but you'd have to know each other. Or there'd be altercations, like, if you messed with the wrong person."

"We were already messed up on bars," she goes on. "It was really laid back. ... If you were sober, you totally wouldn't be chilling there, though. This place was sketchy." A friend shot it and then asked Jen, "Do you wanna do it?"

"Any other day, I'd be like, 'No, that's horrible,'" Jen says. "Why would you shoot heroin? That's like the worst thing you could do. But I was already messed up on bars."

She and Brett both liked to mix Xanax and heroin, she says, "which is bad." After that day, they started shooting heroin much more often than they snorted cheese. "It was more direct," she explains. "More potent." That was the only time they shot up in Dallas. "A lot of the time we just did it at people's houses. Parents would be at work. Wherever we were chilling was where we did it."

Jen had just woken up that morning last March when she got the call from her ex-boyfriend, the third in their trio, about Brett's overdose. He was crying so hard it took him awhile to tell her. "It was weird," she says. "I already knew what he was gonna say."

A few days later, she spoke at Brett's funeral.

"I've never even been to a funeral before," she says. "Seeing a dead person who was your friend — I basically had to be carried out."

After the third of the three young men died, the Flower Mound Police Department started investigating where the heroin that killed them was coming from. The DEA eventually joined in, on a tip from a parent. Together, they say, they were able to trace the heroin trail back to Joe Hoffman, a 19-year-old Flower Mound man, from the class behind Jen and Brett at Flower Mound High.

Hoffman had been in the news before, for his role in a car accident that killed one of his friends. He'd rear-ended the friend while they caravanned to a party, sending the 20-year-old flying off his motorcycle. Hoffman failed a field sobriety test, and cops reported seeing an open bottle of gin on the floor next to him when they arrived on the scene. Six months after the accident, he was arrested and charged with criminally negligent homicide, but a grand jury in Denton County later declined to indict him.

A year or so after the accident, Hoffman was the first to be charged in the heroin busts. A federal grand jury accused him of "possession with intent to distribute" 100 grams or less of "a mixture" including heroin, a crime that carries a potential prison sentence of five to 40 years. The court documents allege that he and two other men were responsible for "manufacturing cheese heroin," which they then sold and distributed to other "co-conspirators." He was also charged with possessing a .40-caliber semiautomatic pistol, which authorities say he intended to use "in furtherance of a drug trafficking crime." (Hoffman could not be reached.)

Over time, 16 more people were charged. All but one were under the age of 21, and most "came from middle or upper-middle class homes," says Wess Griffin, a captain with the Flower Mound Police Department. Kevin Lee Oates, 38, is the outlying older person indicted. Griffin says his name jumped out at reporters, who assumed he was "some kind of kingpin" and the other kids indicted "were his minions." In reality, Griffin says, "he was just another user."

Griffin is realistic about the fact that heroin isn't gone forever from the North Texas suburbs. "But as far as the supply into Flower Mound, I think we greatly affected it," he said. "We definitely stunted it here."

That's the authorities' bird's-eye view of things, something like a tiny prop plane flying very far above a dense, complicated jungle. On the ground, the young users of Flower Mound describe the cops' haul as a strange grab-bag of junkies, some of them more serious than others, all of whom just had the misfortune of getting caught.

"Everyone was confused when they made all those arrests," Jen says. "They were like, 'Oh, we got the heroin ring.' But that wasn't the ring at all. Those were like random junkies who were buying it." To her knowledge, the vast majority of heroin was coming from small-time dealers in Dallas.

"None of those kids are actually suppliers," says another of Brett O'Keefe's friends. "That's all down in Dallas."

Jen went along a few times on drug buys with friends, although she's not sure just where in the city they went. "It was the worst part of Dallas," she remembers. "South Dallas, like where Jamaica [Street] is. There was a lot coming out of there. The most common one we went to, it was kinda weird. It was like a family home. It was this guy, his wife, and they had babies, I guess."

It's a mistake, Kathy O'Keefe says, to see the indicted group as anything other than junkies doing whatever was necessary to feed their habits. "They're not dealers," she says. "Well, obviously they are. But really, they're drug addicts. They just had big habits. I'd venture to say Brett did the same thing."

Investigators may actually agree. Bold talk of busting a "heroin ring" has been quietly replaced with a more prosaic reality, court documents show. Most of the indicted have taken plea bargains that include time in rehab and parole, with only a handful appearing trial-bound. The actual plea bargains themselves are sealed, and lawyers for the defendants, the Department of Justice and the DEA all declined to discuss the case. If 1990s Plano is any indication, the indictments will be followed by a round of arrests of other low-level dealers. (A couple weeks ago, the feds separately announced that they'd busted a large heroin ring in Fort Worth, a high-volume, high-dollar organization that was importing heroin from Mexico and distributing it nationwide.)

The goal in these cases, it seems, is to follow the chain of drugs far enough back to net the big fishes, the main sources of heroin in North Texas. In 1999, police said they'd caught four dealers in Dallas, labeled in the Fort Worth Star-Telegram as "a large heroin distribution ring." The arrest, the DEA said, "should result in a smaller supply of heroin in North Texas."

But Maxwell, the UT Austin researcher, says the elusive kingpin doesn't really exist, at least not anywhere near Flower Mound. "Our studies with cheese heroin users a couple of years ago found that it was not some big dealer selling to kids," she says. "But they all knew small-time dealers, relatives, etc., and they were buying a $10 piece of heroin, adding a diluents powder, and producing $20 of heroin, so they could snort $10 and sell $10 to buy more heroin. It was like a horizontal distribution network of small-time dealers, uncles, neighbors selling to next-door neighbors."

"They just took a lot of people who needed help and put them in jail," Jen says. "And all the people they needed to arrest are still chilling, doing what they do. Still, to this day. In Dallas."

On a warm night in mid-June, Kathy O'Keefe sits upstairs in the meeting room of a church kindergarten in Flower Mound. The church's gym is directly below, and the faint echo of basketballs thudding against floors and backboards can be heard through the floor. On the table in front of O'Keefe sits a collection of purple and green rubber bracelets, emblazoned with the name of her drug awareness and prevention group, founded just after Brett's death: Winning the Fight, or WTF for short — a favorite phrase of Brett's that Kathy repurposed.

Two other mothers of high-school age kids sit cross-legged, purses in their laps. A few friends of Brett's are here, too: two dark-haired sisters, a blond guy with a sweet expression and edges of tattoos poking out of his pant legs and shirt sleeves, and a slim young man with a baseball cap pulled low. It's an usually sparse turnout, Kathy says. The meetings are usually full. After the indictments, they had to move into a bigger auditorium, to make room for all the worried parents.

"Love those earrings," Kathy says to one of the mothers, a woman with dangling silver crosses in her ears, and a drawn, worried expression.

The purpose of WTF meetings, Kathy says, is for young people to teach parents about drugs, to explain slang and behavior that might be difficult for them to parse on their own. "I'm not rehab, and I wouldn't want to be," she says firmly. "This is all about education."

Rob Reid, the pastor, comes in the door, his tiny blond daughter by his side and a bag of Sonic in hand. Kathy asked him here tonight to tell his story. He's pale and burly with a red buzz cut and an easy smile; of his nine tattoos, he only regrets one: "Thug Life," emblazoned on his stomach.

At 30, he's almost exactly between the ages of the kids and parents. He's introduced to one of the young men, slaps his hand in greeting, and flops down on the couch. Kathy rummages around in a cupboard and emerges with a coloring book and a container of crayons for Reid's daughter, who goes pop-eyed with awe.

One of the mothers talks first. She suspects her 16-year-old son is using again. "Everything's kinda swept underneath the rug here," she says of Flower Mound. "Nobody wants to talk about it. Nobody wants to admit their kid has a problem. Until recently, I didn't even know how many kids had died. You'd think everybody would be talking about it."

Everyone in the room shares the mom's frustration over the way Flower Mound's high school and school district handled the indictments: with near-total silence.

District officials didn't respond to interview requests, and Flower Mound High's principal, Paul Moon, politely asked the Observer to leave his office when asked for comment. But a recent Flower Mound High grad says the school's only response was a warning on the school loudspeaker to keep discussion about the indictments "quiet" and "within the school." School officials also had a group come to the school to perform for the teens. The performance was, the student says, a bizarre series of skits about the dangers of teenage depression, cutting, drinking and drug use, combined with a strong religious message. "They did this skit that represented all the bad things in our lives being destroyed by a white man in white clothes with long brown hair," he says, chuckling. "It was just taken as a joke. No one really gave a crap about it. Even afterwards, some teachers were joking about it."

The 16-year-old's mom tells the group that her son has already been through rehab once, though she can't recall the name of the facility. "It's by the Nordstrom Rack," she says. "Isn't that terrible? That's how I know." Now, she says, her son is "worse than he's ever been." She awoke at 7 a.m. the other day to find him with six other teenage boys in her house, all of them drunk. He's rude, she says, and hostile toward her and his father.

"You do know the language and how he speaks to you is the drugs, right?" Kathy asks her.

"It sure looks like him," the woman says, with a dark chuckle.

When Reid finally speaks, he addresses this woman first. "Your description of your son reminded me a great deal of myself," he says. He fiddles with ketchup packets as he describes his multiple stints in rehab. He went through nine before he finally got clean at age 21, through a Christian program called House of Isaiah, in East Texas. "Every time in my life I thought it couldn't get much worse," he says, "it always did. I had a unique ability that way." He remembers getting in "some kind of altercation" at one hospital he was in. "I slapped a nurse," he says. The teenage girls across the room giggle helplessly.

Eventually, Reid's mother had to drive to Atlanta after he overdosed in his car while sitting at a stoplight. They stayed in a hotel room and searched desperately for another rehab facility that he hadn't already tried. "My mom slept with her keys in a pillow with a bell on them," he says, so that he wouldn't be able to steal her car. He's laughing, but Kathy's taking notes. "That's a great idea," she says. The next day, it shows up on WTF's Facebook page as a tip for parents.

It's getting late now. The girls fidget in their chairs and text. The boys sink lower and lower into the couch. "Is there anything we can do for you?" Kathy asks the mother of the 16-year-old.

"I think he's too old for adoption," the mother responds. She's not smiling.

"What do you think he should do?" Kathy asks the kids.

"That's so hard," one boy says. "Age-wise, you can't just kick him out of the house."

Another boy volunteers that his parents kicked him out around that age. He lived with his friends before going to stay with his grandparents. But from the roundabout, mumbling way he's speaking, and the incredulous looks Kathy is giving him, it's obvious whatever measures his parents took didn't hold. He's clearly stoned.

"Are you clean?" Reid asks him. The boy responds opaquely with a story about how he leaped out of a moving car and has been taking hydrocodone for the injury.

"You couldn't be clean if you're jumping out of a car," Reid says cheerfully.

"Are you covering up some kind of pain?" the mother of the 16-year-old says to the boy. He shakes his head

The meeting ends soon after, and the kids head outside en masse for a smoke break. "This is what keeps Miss Kathy sane," one boy, the sober one, says of WTF, taking a meditative drag. "This is like an extended family."

Indeed, Kathy refers to the WTF teens as "my kids." She knew most of them before Brett's death. After his funeral, she says, they were at her house constantly. "They didn't know where else to go," she says. They swam in the pool, or sat in the back, smoking cigarettes and talking about Brett.

In the parking lot, another mother stands near her car, talking to Kathy about her own son. She tries to stay calm, the mom says, when he talks openly to her about his drug use, his drinking, his sexual escapades. "I didn't want to freak him out," she says, "and have him not be able to talk to me."

"We were open with Brett," Kathy says evenly. "And Brett's dead."