Shannon Hartley admits he has long been a nicotine addict. But after a 5,000-pound machine fell on his back in a workplace accident, street heroin became his eventual drug of choice.

Of course, it didn't start that way. The city resident is a married father of three, who had a job and a life until that accident. After his injury, he was prescribed OxyContin for pain. Hartley said his physician was liberal with refills and knowingly fed his growing addiction to the Schedule II narcotic with six years' worth of prescriptions. Hartley knew he was addicted after the first year, when his transparent stories were gladly accepted by his doctor.

"He'd give me a bottle of 100 pills and three days later, I'd call him and tell him, 'I dropped them down the toilet,' " Hartley said of his doctor. "He'd say, 'Come on in.' "

Hartley soon found himself "doctor shopping" and visiting local ERs to maintain a 60-pill-a-day addiction to this popular opioid. The little pills pack a whopping high when misused — that is, crushed and snorted or injected into a vein. A lesser-known fact about this and other opioids is that they hook users for life by changing their brain chemistry.

By the time Hartley began visiting street dealers for heroin, he was avoiding his children, staying locked in his room for days or leaving early in the morning and not returning until late at night.

"I asked God to just kill me so many times," he said. "I missed my kids so much."

Every time he tried to kick his habit, the gnawing cravings of opioid addiction returned. Paired with crippling physical addiction, he had little chance — heroin is cheap and readily available here, as evidenced by last week's $30,000 heroin bust in Millersville.

"I could go out the door with $5 and get some, but for a perfect day, you need at least $25," Hartley said. "I did over $100 a day."

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Over the years, Hartley tried four rounds of 28-day, inpatient detox programs that replace opioids with intense counseling. He wasn't the only one who failed.

"So many people walked out of there before the 28 days was up, they should have had a revolving door on the place," he said. "You're just so sick from the withdrawal, you can't benefit from any counseling. You just can't think."

That's when a friend told him about a methadone clinic in Coatesville. It changed Hartley's life.

But the thing about methadone is, an addict still needs a dose every single day. Without methadone, he will still go through physical and mental withdrawal — or go back to a street dealer to get an illegal high.

"I remember standing along the side of the road holding out a $20 bill trying to get a ride (to the Coatesville clinic), and going through withdrawal in August heat," Hartley said. He's a tall, solid man, so when he says he wanted to die, it's convincing.

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Withdrawal means cramps, vomiting, bone pain, cold sweats, involuntary defecation, repeated kicking movements and that unrelenting craving. Withdrawal can kill by causing stroke, heart attack and suicide.

Last month, Hartley was like any other father talking about his oldest child, who's in college now. Even years after starting methadone therapy, when the conversation switches to heroin — its euphoric high, its mysterious spell — he tears up and his voice breaks.

"Without it, you don't feel normal," he said. "You don't ever feel normal again."

Methadone eases opioid cravings, but doesn't give a high. Addicts can get back a life they lost with methadone, though it is a changed life — now harnessed to legal methadone rather than illegal opioids.

"I'm able to work again. I'm taking care of my kids again," Hartley said. "This place saved my life."

"This place" is Addiction Recovery Systems, a nondescript suite in a nondescript building on Lancaster's Embassy Drive that saves Hartley a 76-mile round trip to Coatesville every day.

A year after ARS opened, the state approved an increase of ARS's client slots from the initial 75 to 250. About 30 of those slots currently are open.

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ARS is a lifeline for people like Hartley and Heather Richards, who used heroin off and on for five years. She dropped out of college, ended up withdrawing in prison, and returned to using as soon as she was released.

Most of her counselors told her to avoid methadone as a means of quitting heroin. But after failed attempts to quit without it, she started methadone therapy in Coatesville.

Within a month, she was back in college and working. Now she gets methadone at the Lancaster clinic.

"It took away my craving for drugs and alcohol," the Lancaster resident said. "Because heroin was out of my life, I could focus on other things."

Still, the Millersville University psychology major says she's been trying to wean herself off methadone for more than a year now.

"The problem with it is it's really difficult to get off of," she said. "It's worse than heroin withdrawal. You have to go down really gradually, so it takes a long time."

She knows people who have decreased their methadone dose to a mere 2 milligrams a day but can't stop it altogether without experiencing withdrawal. Many former addicts use methadone for the rest of their lives to keep cravings at bay.

"You miss a day and you're mentally and physically drained," she said. "Every pore of your body wants it."

In the group counseling room at ARS, a dry-erase board reads, "HALT," for "hungry, angry, lonely, tired," the familiar feelings of cocaine addiction last discussed here in a group session.

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On the other end of the well-secured suite is the methadone dispensing area. Behind a window, a nurse uses a pump to fill cups with the cherry-flavored liquid. The reserves are held in a giant vault at the end of the secured area.

Next door is a bathroom with mirrors angled above a corner toilet. A shuttered window allows nurses to look in, making sure no one cheats on random drug tests.

Even if a client fails a drug test, though, methadone is dispensed and counseling is boosted to help them get back on track.

The center opens at 5:30 a.m. and visits cost about $11 a day — just over $4,000 a year — which often is paid by private insurance providers or Medicaid.

"Methadone results are so good, they're willing to pay," said Rick Kastner, executive director of Lancaster County Drug and Alcohol Commission, who sends clients to ARS. "And it's better for them than paying for much more expensive treatment."

Kastner said 27 percent of his clients are recovering heroin addicts.

"It's a very dangerous, quick-acting drug. Some people in the field say it's a meaner, leaner drug because it catches people much quicker," he said. "But it's so inexpensive and accessible, once someone uses it once, they want more."

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ARS vice president Adam W. Kegley, who opened the center last year with his late father, Jeffrey Kegley, said he expects the Lancaster center to be approved for 350 slots within the next two years. He does his best to normalize what his business is all about, citing a mass of research endorsing methadone treatment.

"What's the difference between this and a person with high blood pressure taking blood pressure medication?" Kegley said. "It's far more productive to support a program like this than for people to be out on the streets consumed with how they're going to get enough stuff to survive the day."

Kegley prefers calling ARS a "medication-assisted treatment center" rather than a "methadone clinic." He works hard on its image.

"We like to demystify the stigma associated with methadone treatment," he said. "We work very hard for this to look like any other doctor's office."

And it does. The difference might only be known to the clients inside.

"I will do anything to get the word out that this place is here to help," Hartley said. "… because without methadone, I'd still be using. The drug's still my master."

E-mail: slindt@lnpnews.com