A slow recovery after heroin overdose

March 30--TAUNTON -- On a steamy July night last year, Lori Gonsalves watched a priest administer last rites to her son.

"It was like I was watching a scene from a movie," Gonsalves said.

Later she called in a group of about 30 from Cory Palazzi'sNarcotics Anonymous meeting, who were holding a vigil outside Falmouth Hospital.

They stood in a circle around his bed.

"I wanted them to see this is what can happen if you go back to drugs," she said.

Palazzi, 26, of Taunton, didn't die. He woke from a coma after almost a week. But he would never be the same.

Palazzi, former captain of the Taunton High School varsity baseball team and National Honor Society member, suffered brain damage from a heroin overdose on July 15.

Today the young man, who was once accepted into the University of Massachusetts Dartmouth's selective nursing program, has trouble making decisions. He is legally blind because of cognitive impairment, and can barely grip a baseball because of compromised motor skills.

He walks with a limp, and speaks slowly, as if each word requires a moment of thought. All because of heroin.

"We want people who are using to know you cannot always be shot with Narcan and be OK," said Gonsalves, referring to the overdose reversal medication. "You can overdose and have disabilities that will be there for the rest of your life."

Palazzi lives with his mother and stepfather in Taunton, where the U.S. "drug czar" R. Gil Kerlikowske spoke recently about the need to stop the number of fatal opiate overdoses, which have exceeded 185 statewide between November and February not including Springfield, Worcester and Boston.

For every fatal overdose, there are an estimated 47 who survive, according to a 2007 report by the Massachusetts Department of Public Health.

No statistics exist on how many suffer a brain injury related to an overdose, said Rob Traister, director of communications at the Brain Injury Association of America.

Total U.S. emergency room visits related to drug use between 2004 and 2011 have risen 52 percent, or by about 844,000 visits, according to the U.S. Drug Abuse Warning Network, or DAWN.

Alcohol, cigarettes and drugs cost America $510 billion in resources and lost productivity, according to a 1999 study by the Substance Abuse and Mental Health Services Administration.

Lost productivity -- that is, lifetime wages lost because of early death or acute and chronic illness or injury -- made up two-thirds of these costs.

Palazzi falls into this category. He cannot work.

Gonsalves said she avoids thinking of what her son could have been.

"I don't look back; I just look forward."

Cape Cod Times video: Cory Palazzi Talks about Heroin Overdose

'I WAS SICK ALL THE TIME'

Palazzi began using Percocet when he was 17. A doctor prescribed it after surgery on his shoulder.

"After the surgery, I couldn't throw," he said. Palazzi grieved the sudden end to his baseball future. At college, he drank a lot.

"I was sick all the time from drinking, and so I took oxycodone to help me feel better," Palazzi said. "It made me feel invincible."

At one point, Palazzi said he would take up to 20 oxycodone pills a day, which cost several hundred dollars. The need for money infected every part of Palazzi's being.

"I stole my grandfather's wedding ring and pawned it," he said.

"He hurt the people he loved the most," Gonsalves added.

Palazzi began using heroin when he was 21. By the time he was 25, he had been to 10 to 15 detoxification hospitals.

His stepfather is a middle school teacher, and his mother works for a home and auto insurance company. Their health insurance paid only for five to seven days of treatment, Gonsalves said.

Now, however, insurance pays nearly all his medical bills, which easily have exceeded $500,000, Gonsalves said.

After each detox, Palazzi would come home to the same triggers and drug dealers. Last year the family decided to spend $7,000 out of pocket to send Palazzi to long-term residential care for 30 days at the Miller House, run by Gosnold on Cape Cod in Falmouth.

At first, it appeared the treatment worked, Gonsalves said. After the Miller House, Palazzi moved into a new sober home in Falmouth. But then neighbors complained about the sober home, and it closed abruptly, scattering Palazzi and other residents.

He landed at another sober house, this one in East Falmouth.

He relapsed once the night he left the first sober home, but because he was on Vivitrol, an opiate blocker medication, he could not get high and instead became violently ill, he said.

"That was the beginning of the end," his mother said.

FROM REJOICING TO REHAB

The second sober house had less strict rules than the first. About six weeks after getting out of the Miller House, Palazzi traveled to Taunton to visit his family.

He also bought heroin.

Back in his sober home, he locked his door.

"I don't know why I used. I cannot remember," he said.

"I remember waking up in the hospital with a ventilator down my throat."

"His roommates knew he was up to something because the door was locked," Gonsalves said.

They could hear him making noise, like gurgling. Friends broke down the door and dragged him outside. Because he was choking on vomit, someone turned him on his side and cleared his airway.

No one knows how long Palazzi went without breathing, but by the time Falmouth paramedics gave him Narcan, which displaces the narcotics from the opiate receptors in the brain, damage had already set in, Gonsalves said.

It generally takes five minutes without oxygen for permanent brain damage to occur.

"I got a call from his roommate," Gonsalves said. "He said he was bad, not breathing."

This was followed by another call, 10 to 15 minutes later, from Falmouth Hospital.

"They asked my religion," she recalled.

For four or five days Palazzi lay in a medically induced coma. Falmouth Hospital nurses and doctors were incredible, Gonsalves said.

They saved his life by icing down his body to reduce the swelling in his brain.

Gonsalves sat by his bed for days. She read him the book that was once his childhood favorite, "Love You Forever" by Robert Munsch.

"I'll love you forever,

I'll like you for always,

As long as I'm living

My baby you'll be," it begins.

One day Palazzi opened his eyes. His family rejoiced.

He slowly regained some of his skills after another week in the hospital and months of rehabilitation.

Palazzi's days are now spent going from speech to physical and occupational therapy, as well as substance abuse counseling.

Though his speech, vision and motor skills have improved, no one knows how much he will recover.

Palazzi still dreams about drugs "all the time. It's in my unconscious," he said.

He has not seen any of his dealers since July. But if he did, Palazzi would have one concise statement.

"Look what you did to me."

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