Despite treatment, his battle with opioids lands him in and out of jail

Editor’s note: This story is part of a continuing series about the opioid epidemic in Illinois.

The driver of the pickup had struck a pole protecting the gasoline pump, but when police arrived at the station, the vehicle was idling, a young man slumped over behind the wheel.

Murphysboro police Officer Jacob Weber looked inside. A syringe rested on the driver’s lap, and other drug paraphernalia lay on the passenger’s seat. The driver had nodded off, but when Weber opened the door to take the keys from the ignition, the man sat straight up.

Christian Kistner appeared high, and although police reports don’t say what he had taken, he told Weber he planned to inject Xanax, an anti-anxiety medication for which he said he had a prescription. Later, Weber saw a brown powder wrapped in foil that looked like heroin, according to a police report.

Kistner’s heroin addiction started with an opioid prescription for a high school sports injury at 16, he told the BND. He took a 5-mg hydrocodone pill with meals and one before bed, but the pain still got the better of him, so he started taking more than he was instructed, he said. Then his doctor increased the prescription, and Kistner started scheduling his own appointments. Soon, he was taking four pills of 10-milligram strength hydrocodone every day.

“I never even got questioned about it,” Kistner said. His doctor would sometimes warn him about misusing the drugs, but “he would talk to me like a dad or something.”

When Kistner first tried heroin, it didn’t take over his life right away, he said. Two years later, he woke up in the morning with the thought of finding something he could pawn or steal to pay for his habit.

Now he was caught. It was Oct. 23, 2016, only a few weeks before his 21st birthday.

Kistner killed the Silverado and gave the keys to Weber, who told him to keep his hands in the open, according to a police report. Then the officer took the syringe from Kistner’s lap, put it with the other supplies, and escorted him behind the pickup for a pat-down and a talk.

Kistner swayed back and forth, and his pupils were constricted. As Weber performed a sobriety test on him, Sgt. Brian Brewer arrived, and Weber inspected the pickup more closely where he found what looked like heroin, according to a police report.

Weber and Brewer went to arrest Kistner, but as the officers took his arms, he tensed up, shook free, and bolted into the woods behind the gas station. Weber took off in pursuit while Brewer called for backup.

Kistner followed a wooded valley to an empty house where he entered through the unlocked back door and went to a bedroom. There, he took a wedding ring, $93 from a wallet, and a Smith & Wesson .40-caliber pistol peeking out from a picture frame on a small shelf next to the bed. Then he went to another room, where he took an orange shirt and a white baseball cap, and left.

An hour later, a sheriff’s deputy responded to Walgreens, where staff had seen Kistner with the gun in his waistband. The deputy ordered him to the ground, but he took off into a lot with tall grasses where tripped and fell. Officers found syringes in his pocket and spotted the gun nearby.

Growing trend

Kistner’s burglary is part of a growing trend stretching law enforcement across Southern Illinois.

In Rosiclare, a small town of 1,000 on the Ohio River, Police Chief Charles Lambert has seen a lot of opioid-related burglaries over the past 13 years, many of them for the drugs themselves.

Everyone knows everyone, he said, including whether they have a prescription. But, not every burglary is innocent, and some people use false police reports to get early refills from their doctors. The problem was so common that about five years ago, Lambert stopped giving out police reports for opioid thefts, even to the elderly.

Farther west and closer to the Mississippi River, Jackson County Sheriff Mike O’Leary agreed. His department focuses on enforcement — finding sources, doing stings, and getting people to flip after being arrested — but the large student population makes it difficult. Users turn into sellers to subsidize their habit, and many who start on opioids branch into heroin coming from St. Louis.

“It is an increasing problem,” he said.

After Kistner was picked up for heroin, he sat in the Jackson County Jail for a week, and then he was released by the court with an ankle bracelet while he completed two month-long, in-patient drug rehabilitation programs and a two-week outpatient program.

At the Jackson County Courthouse on Feb. 9, Kistner’s blond hair was buzzed short. He was clean-shaven, dressed in a black-and-white checkered shirt, tan pants and large brown shoes. He waited in the hallway with his lawyer and mother on a long wooden bench, and then he went in.

Two possible sentences confronted him:

▪  His first choice was to ask for probation. He would be a free man — a powerful incentive — but if he re-offended, he could go to prison for 15 years. It was a very real possibility. It was hard to stay clean, and because some people in his community now saw him as a criminal, they held him to a difficult standard, his step dad, Warren Yates, said.

▪  His second choice was entering a “boot camp,” a strict 120- to 180-day military-style program with “labor-intensive discipline,” but the program worried him. If he couldn’t keep in line, authorities would kick him out, and he wasn’t guaranteed he could take probation next. In a way, boot camp threatened prison time even faster.

Unable to come to a decision, he told the judge he wanted to wait a week to think about it, and then he went back to jail.

Later, his lawyer discovered something new, Kistner’s mother, Kathy Yates, said. At first, both the boot camp and probation seemed to offer the same thing: a way to avoid prison. But the burglary would remain on Kistner’s record. Now, Yates said her son’s attorney saw that probation would clear the felony from his record, too.

With the new information, the family warmed to the idea of probation. If the felony remained, a criminal record would haunt him for the rest of his life.

When he went back to court, Kistner applied for evaluation by Treatment Alternatives for Safe Communities, or TASC, and then he went back to jail again. It would be another six weeks before he would know whether he qualified.

Legal and medical

The competing risks of Kistner’s options highlight some of the incompatibilities of the medical and legal solutions to opioid drug abuse.

“Ultimately, the biggest issue is willing to, or having the ability to, access substance abuse treatment services before they come into contact with the justice system,” said David Olson, a Loyola University at Chicago professor who co-directs the Center for Criminal Justice Research, Policy and Practice.

Kistner sought treatment before he went to jail, but finding the right doctor was difficult. The first one didn’t last long because he wouldn’t accept insurance, and at $250 a month for treatment with buprenorphine, a drug that manages cravings, it was too expensive.

The second doctor, Ben Rathert, of Du Quoin, saw Kistner in mid-August. He told him to go through withdrawal first, and then he could come back for medicine. When Kistner returned on Aug. 21, 2016, a urine sample showed he wasn’t taking the medication correctly, but the following week, it was normal.

Then, in September, he had morphine in his system. Rathert didn’t see him after that, but not because he stopped treating him. Kistner was back in jail.

Instead of being able to try another run at treatment, Kistner fell into the legal system, which saw his problem completely differently, Olson explained. When someone has a medical problem, a doctor doesn’t put a time line on treatment, but “that’s essentially what we do in the justice system,” he said. After a relapse, the medical solution is to change treatment, but “in the justice system, we don’t have that.”

Drug courts — treatment programs in which a team of professionals, from the judge to a psychologist, works with each offender to help that person meet the goals of the court — are an example of how treatment is combining with the justice system. However, the intensive programs, with frequent drug testing and multiple court hearings a week, are reserved for the most at-risk offenders, and Kistner wasn’t one of them.

In a step from punishment to treatment, the Illinois State Commission on Criminal Justice and Sentencing Reform, established by Gov. Bruce Rauner in 2015, recommended drug offenses be legally classified less seriously, said Olson, who participated in the commission. However, those ideas failed this year because legislators believed they would also benefit drug sellers and send the wrong message.

Another way to blend treatment with the justice system is by providing medication-assisted treatment to the prison population, but only 20 percent of inmates who need it can get it, Olson said. Compared to jail, prison offers a better location to address drug-addicted people, but expanding access at that level is also limited.

A three-year, $3 million federal grant extended access to Vivitrol, a type of addiction medicine, to inmates before they’re released from jail, but it exists in just a handful of jails in Illinois. Currently, Jackson County is not one of them.

Although Kistner may have received drug treatment in Jackson County at the recommendation of the jail doctor, it is unlikely he did so. Most inmates don’t receive the addiction medication they were prescribed before entering the jail because they aren’t there long, Lt. Lee Kersten said.

Possibilities and risks

Medication-assisted treatment was at the center of the probation program for which Kistner applied.

TASC connects offenders to recovery programs and helps with monitoring and support, but the success rate — finishing treatment, not taking drugs or acquiring new felonies, and changing one’s behaviors — for those addicted to any drug was 54 percent, said Daphne Baille, the communications director. The success rate for people addicted to opioids was smaller, however, at just 44 percent.

But, there was no guarantee that Kistner could get in, as the recent two-year Illinois budget crisis led to funding decreases for behavioral health programs across the state.

“If judges know that there is a dearth of treatment available in the community, they may not necessarily mandate a lot of people to treatment if it’s not readily available,” Baille said in an email. “Conversely, if there’s funding for and availability of treatment and alternatives to incarceration, that means judges have more options when it comes to sentencing.”

Even if he got into the treatment program, Olson said, two years of probation would be a challenge, giving Kistner many chances to relapse.

In fact, before learning that completing probation would take his felony off his record, it was the length of the program that initially encouraged Kistner to favor boot camp. Even, then, however, there was a catch: It wouldn’t let him take Celexa, an anti-depressant medication to help with his anxiety.

“The (Department of Corrections) is not aware of any cases where an offender received psychotropic medications while participating in (boot camp),” Nicole Wilson wrote in an email.

The Illinois Department of Corrections runs the boot camp, formally known as the Impact Incarceration Program. Wilson wouldn’t comment on whether someone with anxiety would be separated automatically from the program.

“If someone with anxiety requests mental health services while they are participating in (boot camp), they will receive an assessment by a mental health professional,” she wrote. “If, after the assessment, it is determined that the offender’s mental disorder or disability would serve as a barrier to engagement in the (boot camp) program, the offender would be statutorily barred from participation.”

To Kistner, Celexa was the smoking gun of mental disorder. If he was taking it before the boot camp, he would have to wait at the Menard Corrections Center, a prison in Chester, until it was no longer in his system, adding to the stress of the program, he said. Then, if his mood plunged during boot camp and he did something that got him kicked out, he would again face 15 years in prison.

“It’s something I think about a lot, but I can’t control it, and I can’t do anything about it,” he said. He’d been on Celexa for years, and he didn’t know what life would be like not taking it.

“(I’m) going to have to figure it out,” he said before applying for probation, though he thought it was “a little cruel,” especially during an extreme change of environment like boot camp.

Still waiting

As Kistner waited in jail, his mother waited at home.

The past few years of Kistner’s drug problem had been unkind to Kathy Yates, or, as she put it, “pretty much hell,” and his recent run-in with the law couldn’t have come at a worse time.

After seven years in remission, Yates discovered in October that her breast cancer had come back. It was one of the things that pushed her son over the edge, she thought. At the end of the month, Yates started a series of surgeries. Her third, on Nov. 14, was a seven-hour mastectomy to remove her right breast and rebuild it with tissue from her abdomen.

Kistner, still in jail at the time, couldn’t be with her, and then he left before Thanksgiving to a rehabilitation program in Northern Illinois. While he was there, Yates’ brother became very ill. She tried bringing Kistner home, but he didn’t have his I.D., so she spent a few days figuring out how he could use the train ticket without it. He finally did get home the day after his uncle died.

Yates thought a lot about her son’s situation. Looking back, she thought it had something to do with his anxiety. It was the worst at night, when he would lay awake and sweat, she said. She pointed to social media as another cause — everything was too public.

Kistner’s presence was everywhere. It was here, on the expansive country land with woods, fields and ponds where the eighth-grader Christian crashed a four-wheeler into a barbed wire fence and got a prescription for Tramadol, his first painkiller. There were more later.

“I couldn’t hide them well enough that he couldn’t find them,” Yates said. Sometimes, he would just lay there in withdrawal and cry.

Nearly two months in a cell were beginning to wear on him, particularly the food, an unchanging patty of questionable meat. Jail was expensive, too. Yates put money on her son’s account, but everything was marked up. He and the other inmates pooled their funds to get other food and combine them in a goulash to make meals more palatable. At least the other inmates were alright this time, Yates said. During a different stint in jail, her son was living with some white supremacists.

“You’re at the mercy of the system,” Yates said about the interminable wait to know where he was headed.

Probation

Officer Jeffrey Bock responded to the crash outside a downtown Murphysboro apartment building late in the morning on June 7.

Kistner had been out of jail less than a month. On May 11, a Jackson County judge gave him 48 months of probation, double the typical amount of time, but it didn’t last long.

A 2006 Ford F-150 had run into a 2017 Dodge Journey and caused “major rear-end damage,” Bock wrote in a police report. The pickup hit the SUV hard enough that it lurched into an Acura parked in front of it.

Bock angled his car to block traffic and got out. Kistner approached him immediately. He gave Bock his keys.

“Kistner appeared very excited and jumpy,” Bock wrote. “He was sweating profusely and would not stop walking around and talking.”

Kistner told Bock that he’d pulled from his parking spot onto the road, but when he’d went to step on the brake, he accidentally hit the accelerator and hit the other vehicle.

“The more I spoke with him it was evident he was under the influence of some type of narcotic,” Bock wrote.

Discovering that Kistner’s license was revoked, Bock called for backup, and Officer Jacob Weber arrived. He was the same officer who worked Kistner’s crash at the gas station in October.

Bock and Weber took Kistner into custody, but when they put handcuffs on him, it looked like he wanted to run.

Bock “secured” Kistner and felt a case between his legs that held a used syringe, bands to tie off veins, and .7 grams of a substance that field-tested positive for methamphetamine. A screw-cap container held a small amount of what appeared to be fentanyl, a drug that’s dangerous to the touch, so officers put it back. Jail staff found another small bag on Kistner later.

Kistner posted bond on June 13. Two weeks later, he pleaded “not guilty” and requested a jury trial. He also reached out again to Ben Rathert, his doctor.

Kistner told him he still had drugs in his system, but he had to get his life back in order, Rathert said. The first urine test showed signs of drug use, but Rathert gave him a warning and scheduled to see him the next week. If he came back dirty then, Rathert said, he would separate Kistner from treatment.

“If it stops making sense, I stop writing scripts,” Rathert said.

Before the appointment, however, on July 17, Kistner’s probation was revoked, and he was taken to jail. A day later, he was granted a furlough to complete an inpatient treatment program.

His case is pending.

This story was originally published August 11, 2017 at 1:05 PM with the headline "Despite treatment, his battle with opioids lands him in and out of jail."