If I Die Young: ABC Action News and The Tampa Bay Times look at the prescription pill epidemic

Every day Floridians are dying from prescription drug overdoses. ABC Action News and The Tampa Bay Times documented the struggles of two families trying to find help and answers for their daughters and their addictions.

Cary Williams, New Media Producer, Lane DeGregory, Times Staff Writer, and John Pendygraft, Times Staff Photographer contributed to this report.
"This letter's purpose is to tell you the stupid mistakes I made…and how badly I wish I could take them back."
"I just kept telling her I want my Stacy back. I want that bubbly, energetic, great personality...I want my Stacy back."
These are the words written by two young women to their loved ones, desperately trying to make things right after so much has gone wrong.
Stacy and Emily led separate lives, but share a common struggle.
Stacy Nicholson, a street-smart tomboy who loves country and hip-hop, grew up in St. Petersburg. As a teen, she dropped out of high school.
Emily Rifkin grew up on the other side of the bay in the Northdale area of Tampa. She graduated with honors from Gaither High School and received a four year scholarship to USF.
Both of these women have seen the inside of a courtroom and a jail cell. One of them won't make it to their 30th birthday.
Stacy and Emily became strangers to their own families. They went places and did things no one could have imagined.
"In three months she took $11,000," Emily's sister Laura told us.
At first, Roberta and David Rifkin didn't know their youngest daughter Emily had a dark secret.
"There was very little we did not try and do for them," David said. "We provided her with piano lessons. We sent her to the Barbizon School of Modeling. We did a lot of things, maybe over the top."
Emily appeared to be an all-American girl, but she was addicted to prescription painkillers.
At age 13, Emily was injured when her father's car was rear-ended.
"That was where she first started going to pain management clinics with my dad," Laura said.
But it wasn't until Emily's sophomore year at USF that her grades plummeted and she dropped out of college. That's when her family knew there was a serious problem.
"She was an A student all the way through high school and a sweet child," her parents said. "Unbeknownst to us, other activities were going on in her life. But she hid them, she truly hid them."
Emily used real and phantom pain to get the drugs she desired, and it was directly because of the accident that she was able to obtain them.
"That was when she started actually needing to have the pills on a more day to day basis," her sister explained. "Which unfortunately then turned into an hour to hour basis."
"I think it completely tore our family apart."
For Stacy Nicholson, life was hard at times. Her parents split up when she was little and she rarely saw her father.
"I was just a single parent raising her," her mother Sherry Alkire explained. "It was tough...it was tough...but we always seemed to make it."
When her mother remarried, 10-year-old Stacy did not get along with her stepfather. But she got friendship and guidance from her cousin Frankie Herrera.
"They were very close...very close," Sherry said. "Her and Frankie were buddies."
Frankie was like a big brother, teaching Stacy how to swim and ride a bike.
But there was nothing Sherry could do to stop Stacy's wild streak.
It was a boyfriend who introduced Stacy to the little blue pill called Roxicodone, a powerful, long lasting dose of Oxycodone.
Over time, Sherry watched helplessly as her daughter slowly slipped away.
"It takes them to hit rock bottom," Sherry said. "I can want for her all I want to get better...and that's not going to make her better. It has to come within themselves."
Rock bottom for Stacy could have been a 2009 drug sweep in Pinellas County called Operation Oxy-Con.
But she had further to fall. She, along with 20 others, were accused of buying Oxycodone with fake prescriptions.
At this point, Stacy had been snorting or shooting the drug for four years.
The arrest landed her in Pinellas County drug court before a determined judge.
"You know, it's more than a disease sometimes. I mean, they say addiction is a disease. It's a cancer, it's wicked," Judge Dee Anna Farnell told us.
Judge Farnell presides over America's first all-female drug court. Women make up about half of drug cases, and Pinellas County led the state in the number of overdoses.
"As a judge, I wasn't trained for this. You know, I'm trained to be fair and impartial and to sit up and call balls and strikes," Judge Farnell said. "I was not trained to get down in this misery and to make a plan that could save somebody's life. That's not my job, but it has become my job."
Judge Farnell can order women in her court to get substance abuse treatment with money from a three-year federal grant. She tries to see potential in the shattered lives that come into her courtroom.
"I see who they could be, not maybe who they were or who they could have been but who they could be," she explained. "They have at one time, perhaps been, you know, in the top of their class, good daughters, you know, the whole bit, and that something then has happened in their lives."
Stacy would finally hit her rock bottom just weeks after appearing again in court, where she faced Judge Farnell and a five year sentence.
And her family would soon face the loss of a loved one.
Just minutes after receiving a call about an overdose, 911 dispatchers sent a rescue crew to a home off 16th Street North in St. Petersburg. The victim was lying on the floor, not breathing.
"I just had a gut feeling that someone was going to die in that house," Sherry said. "I knew they were shooting up. I knew they were doing the Roxies and the Xanax."
Stacy and her cousin Frankie, childhood friends, had been living together in that house. They had been using drugs every night.
When the ambulance arrived at Northside Hospital, the diagnosis was bleak. An overdose of Oxycodone was shutting down the vital organs.
But it wasn't Stacy losing the battle. Frankie was the one lying in the hospital bed, tubes and machines keeping him alive.
Sherry knew Frankie was the wake-up call her daughter needed. The problem was, Stacy couldn't see him. She was in jail.
"I really felt Stacy needed to see that with her drug addiction, she was living with Frank," Sherry said. "They were using together."
After her arrest in Operation Oxy-Con, Stacy faced five years in prison. Judge Farnell allowed her to plead guilty and receive probation that included a 12-step program.
The deal initially kept her out of jail, which was important to Stacy -- and her two children.
Twelve-year-old daughter Jade lived with her paternal grandparents. Stacy gave birth to her when she was 16. Richie, 2, was being raised by Sherry.
Sherry was conflicted about the help she was giving her daughter.
"You need to allow them to hit their rock bottom. I kept trying to help her and the only thing I was doing was enabling her. And I had to learn not to be an enabler."
Before long, Stacy failed a drug test, stopped going to counseling and was skipping drug court.
"You tell them what can be down this road if they'll just start Step 1. And they might start Step 1, and then, boom, they've backtracked and it's back to Square 1, and trying to figure out what else that we can do, trying to keep 'em alive," Judge Farnell said.
That's when Judge Farnell laid it on the line and asked Stacy in court if she was giving up.
"Well…are you giving up…or are you going to continue?"
"No, I have not given up," Stacy responded.
The judge gave Stacy a second chance and sent her straight to jail to get the drugs out of her system.
She spent 10 days in the medical wing, aching, shivering and nauseous. Afterwards, she started writing a journal and letters.
"I hate drugs and everything they do to people. I can't believe I have let them control my life for so long," she wrote.
Knowing her cousin Frankie had overdosed and was on life support, Stacy wrote a letter to her mother.
"I won't let this addiction take my life," she wrote.
The next day, Stacy's family asked the court to release her early from jail to start a rehab program, but first she'd witness a death. Stacy and her family went to the hospital to visit her cousin.
Death did not come quickly or easily for Frankie. He was young and his body struggled.
In the end, he surrendered and escaped from addition -- and life.
Outside Frankie's hospital room, Stacy promised her mom she wouldn't die.
"Their lives kind of turned bad there for a while and they were all using together...I think it's really affected Stacy that Frankie is gone," Sherry said.
The night Frankie died, Stacy was given a chance to start over with a six month program at a halfway house called Simply Hope.
"When Stacy first came here I thought she had a 50/50 chance of making it," said Ray Harris, operator of Simply Hope. "I think all addicts have a 50/50 chance when they come here to make it."
But Stacy had a long road ahead.
For Stacy Nicholson and Emily Rifkin, their addiction to prescription pain pills was powerful.
"I didn't want to do anything. I sat at home all day. I woke up at four o'clock in the afternoon and watched TV. I took a pill. I smoked a cigarette, watched TV, and went to sleep about six o'clock in the morning, and that was my life," Emily said.
"At night time she would just sit at my parent's house and just take pill after pill and stay up all night reading," Emily's sister Laura would tell us.
When she was younger, Emily wanted to be an actress. And, her sister would say, she was exactly that.
"She was able to say an act normal and do whatever she wanted."
Emily spent her first night in jail after a DUI.
"When she got charged with DUI by itself, although that's bad, it got worse," her father David said.
When the 21-year-old was booked into Falkenburg Jail, police found Xanax and Oxycontin pills hidden in her underwear.
"I got a DUI because I was on a lot, a lot of pills and I hit someone and I was high as a kite and I tried to bring pills into the jail and I got caught."
By trying to sneak the pills into the jail, Emily committed a third degree felony. Because it was her first offense, she only received probation and was sentenced to a six-month program at DACCO, a Tampa residential treatment facility for drugs and alcohol.
"I can't make them understand ya know what was wrong with me," Emily said. "My dad says it's a disease. Yeah it is a disease, I mean, I lost all their trust. I stole from my family."
No one in Emily's family had a known history of addiction, but researchers say about 50% of addiction is genetic.
"I know it's a disease. It's an insidious disease. It starts off small with one pill, but you have to understand your body builds a tolerance. Your body builds a tolerance...and one pill leads to two pills, leads to three pills, because what you're looking for is that first euphoric high. That's what you're always trying to get," her father said.
But addiction does more than build a tolerance. It changes how the addict thinks.
"It's very well documented that addiction is a disease. It hijacks the brain. In fact when people start using drugs, it doesn't take very long for the brain to actually change," DACCO Chief Operation Officer Liz Harden would tell us.
"Addicts don't want to be addicts. And family members, they don't want their loved ones to have a problem with drugs."
While in jail, one of Emily's biggest regrets was not being able to see her infant niece.
"Yes I want to go home. I want to see my niece. I want to see my family, but I know I'm not any good to them," Emily said. "I just want her to know…why I'm not there. And I want her to know all…all the good, bad and the ugly when she's old enough to understand it because I don't want her to ever have to go through the things that I am going through."
Her family was relieved when Emily was released from jail and had a bed at a residential drug rehab, but they were still fearful that it wouldn't last.
"She got in that mindset that I could always beat the system. I could always do this, I could always do that...and she challenged," her father said.
Only months into the program, Emily walked away from the treatment. Two days later, she was back at her parents house, not sure what to do next.
"I brought her to Orient Road and it was probably one of the hardest things I've ever done," David said. "The law was the law. She was there under court order. She violated probation, so she had no choice. She had to now be put in jail."
This time, Emily spent four months in the Hillsborough County Jail and then was sent to state prison.
"When Emily was in prison, she kept wanting me to bring my daughter up there," her sister Laura said. "And my idea of it was, well, I don't really want my daughter's first memories of you to be behind a prison wall."
By violating probation, Emily had to serve a one year sentence on the original charge of hiding drugs and bringing them to jail.
"I'm very glad that I went, because I saw the type of people that I don't want to end up like," Emily said.
Once out of prison, Emily lived under her parent's roof once again. But it wasn't long before she was back on drugs.
The family tried to get Emily back into treatment, which she had started but never finished.
David and Roberta desperately searched for answers.
"So then he and I looked at our bank accounts and we were ready if we had to...to ya know pay money for a private facility," Emily's mother Roberta said.
Residential treatment is costly. Depending on the facility, out of pocket expenses for a family run between $1,200 and $5,000 a month and can last for up to nine months.
Emily had already drained her parent's savings of more than $60,000.
The family took a drastic measure and asked the court to intervene.
After Emily Rifkin was released from prison for sneaking drugs into jail, her parents welcomed her into their home.
But soon, like many addicts, she was using again. Her parents didn't know what to do.
Hillsborough County Judge Jack Espinosa Jr. has been involved in drug court for more than 15 years, but says the problem isn't getting better.
"It's an epidemic. It's frightening," he said.
Funding for residential beds is now a major concern.
"The wait for residential beds are anywhere from four to six months...so we're not exactly getting them into treatment that they need and require as soon as possible," Judge Espinosa said.
That why, despite a judge's order, people like Emily have to go to a halfway house and wait weeks or months to get into a residential treatment program.
"We know what to do. There's a scarcity of appropriate treatment available," Espinosa said.
Emily appeared before Judge Espinosa after the family took the drastic measure of filing a Marchman Act.
"Under the Marchman Act...is really where the rubber hits the road...These are families who have petitioned for interventions...under the law...um...to help their loved ones get better," Espinosa explained.
"Family members often see that as…the last resort," said Liz Harden.
In Emily's case, the family watched her drop out of college, get a DUI, go to prison, lose control of her life and become a shell of her former self.
"They've pretty much hit rock bottom in many cases. And it's their last hope to try to gain...get...some treatment for their loved ones before tragedy strikes," said Espinosa.
While Emily was waiting for a residential treatment space to open up, a court appointed counselor provided Emily with outpatient drug treatment at The Centre in Tampa. It was there that counselors noticed that Emily's parents were overprotective.
"I know that the parents were very involved...that they were very concerned, but they also tried to protect Emily sometimes," said Sonya Bufe, a counselor at The Centre. "That's understandable because they loved her."
In comments made before Judge Espinosa, David and his wife discovered something about Emily they had not known before.
"In the court she talked about how my wife and I babied her and we didn't allow her to spread her wings and grow," David said. "She was right. She was an adult. We decided that we were part of the problem and asked the courts to put her in a halfway house."
No one knows for sure when prescription drug abuse became an epidemic in Florida and addicts from around the country began lining up at pain clinics to pay cash for narcotics.
"We didn't attack the crisis years and years ago like we should have. Florida unfortunately became the 'pill mill' state," State Senator Mike Fasano told us. 
Fasano was outraged to learn that prescription drug overdoses were taking the lives of seven Floridians every day.
"We had the Lt. Governor of Kentucky begging us here in Florida to implement a prescription drug monitoring program because he said Florida was killing their residents," he said.
The Prescription Drug Monitoring Program (PDMP) that tracks the prescribing and sale of narcotic drugs faced opposition from Governor Rick Scott, who cited privacy concerns. But when newly elected Attorney General Pam Bondi took up the cause, the program was funded. 
"We were known as the 'Oxy Express' and that was ridiculous," Bondi told us.
But the monitoring program has its limits. Pharmacists have seven days to report their sales and the reporting is optional for doctors.
"I would like it to be mandatory, absolutely," added Bondi. "We at least have it up and running which is so important to me."
Bondi also ordered a statewide pill mill crackdown. As a result, Bondi claims they cut the number of pill mills in half.
But those who enforce the law on the street aren't seeing the difference.
"The street level price remains constant at about $17 dollars a pill. And we haven't seen a change," said Pinellas County Sheriff Bob Gaultieri.
Sheriff Gaultieri says addicts and dealers always find a way around the law.
In the end, addiction always finds a way, which is why the Sheriff sees treatment and education as the only solution.
Stacy Nicholson's life was getting better. Her time at the halfway house Simple Hope had truly given her hope.
She hoped she could finish the program, stay sober, and eventually move into a place of her own with her two-year-old son Richie.
She even hoped to rekindle her relationship with her daughter Jade, who would soon become a teenager.
That hope faded when she found herself in court yet again.
Stacy got away with her first relapse. She wouldn't be as lucky the second time.
Stacy was at a friend's house and said she had a bad headache. She grabbed a pill bottle off the friend's coffee table and claimed she thought it was Tylenol.
"I'd been having real bad headaches, so I got the freakin' pills and took 'em, thinking they were something else and…they weren't," she said.
What were they?
As she did after her first relapse, Stacy reached out to her mother. This time Sherry advised her to "start flushing."
Addicts will often flush their system in hopes of fooling a drug test. But Ray Harris, operator of Simply Hope, was suspicious of Stacy and ordered her to give a urine sample.
"If only she could be honest," Harris said. "Honesty is the key to all recovery besides abstinence."
Stacy had violated her probation and the judge sent her straight to jail. Even worse, she now faced a 10 year sentence on the original charge.
The last time Stacy was in jail, it was only for two days. This time, she'll spend more than two months behind bars before seeing the judge again and learning her fate.
While in jail, Stacy thought about what it was that drove her to addiction.
She believed emotional trauma, including abandonment by her biological father, is part of what fueled her addiction.
But Stacy had no hatred for her mother, one of the few people who stood by her.
Sherry was raising her two-year-old son and regularly visited her in jail.
While in jail, Stacy maintained that she accidentally took the two methadone pills that sent her back behind bars.
After 79 days, Stacy was brought back to court before Judge Farnell and was ready to find out if she had a second chance.
"As long as you're willing to try, to do everything you can to get well, we're here for you," said the Judge.
Just like that, Stacy was sentenced to 24 months of probation and given an order to complete the program at Simply Hope.
Emily Rifkin was also struggling with her past.
"I was in a relationship for two years…of somebody I should never have let go…um. He didn't do any kind of drugs…and he couldn't stand the fact that I took pills…he didn't understand, ya know, that I needed them," Rifkin said. "He gave me four months to stop taking pills and he said he would leave…and I didn't believe him…and I choose drugs over the best thing that ever happened to me."
After Emily's parents used the Marchman act to get her before Judge Espinosa, her family hoped she would start dealing with some of her issues.
One of Emily's counselors, Sonya Bufe, said that Emily was very motivated and she would open up to counselors and talk to them about the struggles she was having.
However, she also noted that Emily wasn't always completely honest.
"She was very manipulative in ways of playing her parents against the courts. The court's against treatment. And knew what to say in order to get around the system," Bufe said.
By that time, it was clear that Emily needed residential treatment. But, as Judge Espinosa said, the wait was several months long.
The court ordered Emily to go through detox prior to her outpatient treatment, yet she still tested positive for drugs three out of for times while in treatment.
Staff at the halfway house found drugs on Emily just a few days into her stay. That's when she was moved to another halfway house where she was supposed to get closer supervision.
But that's not what her sister Laura found when she visited Emily the night of their parent's 32nd anniversary.
The two had planned on joining their parents for dinner, but they didn't make it.
Emily was high.
Laura tried to help her sister get dressed, but instead, just put her mom on the phone.
"I said, you know, thanks for ruining our anniversary, we wanted to have dinner with you, we were looking forward to it," Emily's mother Roberta said.
Laura was fed up.
"At that point I was already late for dinner with my parents, and I just said ‘ya know, I'll come and see you tomorrow.'"
While Laura was frustrated with her sister, she placed some of the blame on the manager of the halfway house.
"You should have called the judge and you should have said she violated her probation, she is high. She needs to go to detox and she needs to go to jail," she said.
The Rifkin family wanted to share Emily's story as a cautionary tale of disappointment and regret.
"I regret not pulling her out of the halfway house right then and telling my parents that we couldn't make it to dinner and just taking her over to a hospital," Laura said.
Laura says she spoke with the manager of the halfway house where she found Emily under the influence.
"The overall answer that I got was 'well she's my friend and I don't want her to go to jail.'"
Just minutes after leaving the halfway house, Laura got a call she wasn't prepared for.
"It was the manager saying 'oh my God' she's blue and she's not breathing and I don't know what to do."
They called 911 and Laura rushed back to the halfway house.
"I had to park two houses away and I ran down the entire street to get over to the halfway house...and as soon as I got in the door, they had Emily right in the front area on the floor and they were shocking her with the defibrillator paddles."
Emily was rushed to St. Joseph's Hospital, the same hospital where she was born.
She was dead.
"I've never actually seen my dad fall down before," Laura said. "When we were in the waiting room and the doctor came in and said 'we've lost her'...he fell. "
The autopsy report listed the cause of death as an accidental overdose. The drug: Oxycodone.
Emily was 25.
Emily was at the halfway house for 11 days. Seven days after her death, the court was contacted by a local rehab facility. A residential bed was available and Emily's name was on the top of the list.
Emily Rifkin lost her battle with addiction and left her family devastated.
"The pain gets a little easier but the loss is always there," her father said.
Long after her death, Emily's parents struggled with guilt and regret.
"I think about what would have been. I think about what a great aunt she would've been. I think about the possibilities of her having a husband and a family. And what that would mean to my wife, my daughter and especially to Lilliana," David said.
Her niece Lilliana was just four when Emily died.
"I didn't know how to explain it to her. Ya know? How do you explain to a four-year-old that never had a goldfish die about death and more so about someone that they've seen once or twice a week isn't going to be there anymore?" Laura asked.
Part of the answer may be found in the letter Emily started to write Lilliana while in jail.
"This letter's purpose is to tell you the stupid mistakes I made…and how badly I wish I could take them back..."
As Emily put it, it was the ‘good, bad and ugly' of her life that she wanted to share with Lilliana so she wouldn't make the same mistakes. Emily never finished the letter. Laura says she isn't sure if she'll ever show it to her daughter.
Emily's family wants her death to serve as a warning to others. Judge Espinosa makes sure of that in his courtroom every day.
"With her parent's permission, I've been using her obituary to warn others that they may not wake up too if they continue with the same behaviors," he said.
Stacy Nicholson not only completed the program at Simply Hope, but months later graduated from drug court and ended her probation.
"I think Stacy really wants to be clean," her mother said. "I think she wants to live a good life."
Maybe it took Frankie's death to save Stacy's life. She wears a necklace with Frankie's ashes every day as a constant reminder of her cousin and her addiction.
"I think the big difference there was he has no kids," Stacy said. "He has nothing to care for…or had nothing to care for."
Stacy has been able to hold down a job at a pizzeria for months. She lives with her mother and her now three-year-old son Richie. She's also spending more time with her daughter Jade.
But Stacy's fight for sobriety is far from over.
"That's what I'm struggling with right now. I know I want to be clean and I know I want to have a good life for my kids. And I want to have a good life and I want all that, but you still struggle with that every day."
Stacy says drug court is what kept her alive.
"Her (Judge Farnell) and Ray Harris did help save my life," she said. "If I didn't want it I wouldn't have done it though. I had to want it."
Both families continue to share their stories so that others know they are not alone.
"If her death helps one person, if it helps one family to recognize the symptoms, to seek out the help, to do what they can to help their loved one, then her death was not in vain," Emily's father said. 
Cary Williams contributed to this story
Print this article Back to Top