Richard Koenig’s 65 years have been shaped by sorrow. He is haunted by the ghosts of his military service in the Vietnam War. Now, Koenig is experiencing cycling emotions of grief and guilt over the loss of a friend he loved for 26 years at the hands of a suspected heroin overdose.

“I miss her,” Koenig, a thin, unshaven man, said of Jessica Runstrom.

Runstrom died March 9 at the age of 56, several months after she and a roommate were treated for a heroin overdose that occurred at their residence on Madison’s Pine Street. Koenig believes Runstrom’s death resulted from complications from the overdose.

Madison Police Department spokesperson Joel DeSpain confirmed an investigation into Runstrom’s death is ongoing.

“She had a way of breaking down the walls I built from Vietnam,” Koenig added, tears crossing his face. He twisted a newspaper in his hand as he recounted his story. “I connected with her. How often can you find a soulmate in your life? I know we loved each other unconditionally.”

Koenig lived with Runstrom and her roommate for several months and acted as their caregiver.

According to Koenig, Runstrom battled with several illnesses, including emotional issues caused by traumatic events she experienced as a teenager. At the age of 18, Runstrom was raped, he said.

“For her to have survived … ,” Koenig took a long pause. “She had this strength to survive that much during her lifetime. Most people would have just broken. She was 18; can you imagine”?

To recover from the strains of caregiving, Koenig moved to Stevens Point shortly before Runstrom’s alleged heroin overdose.

“I keep having these regrets because I moved up to Point to recover from the caregiving, and I keep thinking what I could have done differently,” Koenig said. “Jessie would know if I was there, I would’ve stopped [the overdose.]”

Koenig estimated the overdose took place in late January, when Runstrom called police and told them her roommate was unconscious before passing out herself. Both survived the incident, Koenig said, but days later Runstrom suffered from a series of miniature strokes.

In February, Runstrom was admitted to Meriter Hospital to repair an obstructed colon. Medical officials kept her on life support until she died March 9.

According to Koenig, Runstrom had not used heroin prior to the incident, though she had taken prescription medications, including Vicodin and morphine, that friends had provided her with.

Koenig suggested Runstrom’s friends may have proved to be a powerful influence in her decision to use drugs to self-medicate her pain.

“In 2010, … a friend picked Jessica up and said they were going to go shopping,” Koenig said. “This friend really manipulated Jessie. She came back and dropped Jessica off at the curb, and she could hardly walk. She fell down a couple of times. I went out and helped her. … I looked at her pupils and they were dilated, and I worked with her for about eight hours, walked with her, gave her coffee and water, … and she finally came out of it. But her friend is a heroin addict.”

Koenig said he is convinced other friends may have been involved in the overdose incident that he believes led to Runstrom’s death.

Runstrom’s story is not an uncommon one. Madison is in the midst of what officials have called a “heroin epidemic.” According to Dane County reports, 132 heroin overdoses were documented in 2011, up from 84 in 2010. Twenty of those heroin overdoses resulted in the death of the user.

Officials have repeatedly said Madison has experienced an emerging profile of heroin users who drive when they are under the influence. According to Madison Police Department Lt. Brian Ackeret, a member of the Dane County Drug Task Force, these users often fall into a coma-like unconsciousness while behind the wheel, compromising their safety and that of others on the road.

Runstrom did not fit this stereotype that has become all too familiar to Ackeret, but that is no consolation for Koenig, who said he has lost his best friend.

University of Wisconsin family medicine professor Richard Brown said heroin abuse often begins with the use of prescription medicine, particularly potentially addictive pain killers like Vicodin and opioids. As the pills become too expensive for users, they may often make the transition to heroin.

Brown added individuals with mental illnesses may utilize prescription medicine or narcotics to escape pain they may feel as a result of their condition. 

“One reason that people may take an opioid could be to self-medicate,” Brown said. “If somebody is depressed, for example, heroin or Vicodin may help numb the emotional pain, and that can help get people started with abusing the medication.”

He added it is common for individuals to obtain prescription medicine through friends or family members.

Ackeret said several initiatives have been implemented both at the city and county level to combat the epidemic of heroin users in the area. These initiatives are primarily targeted at drug distribution, including both medication prescriptions and other sources for obtaining narcotics.

“We’re working with some physicians groups that are looking at the amount of opiates that are being prescribed,” Ackeret said. “We’re trying to reduce the amount of drugs being prescribed and increase closer monitoring of patients to look for abuses.”

He added steps have been taken to increase education of drug users, particularly concerning the risks of needle exchanges and using narcotics while driving.

Despite Runstrom’s death, Koenig believes her spirit is still right there with him.

“Sometimes when I’m driving up to Point, I’ll swear Jessica is sitting right there, and I’ll carry on a conversation with her,” Koenig said. “Sometimes, I’m at a loss for words.”

Koenig expressed his hope that Runstrom’s story will dissuade others in a similar situation from using heroin to lessen their pain.

“The whole idea is to give a voice to Jessica,” Koenig said. “I know it is a heroin epidemic; I know the statistics bear that out. But human beings are dynamic, diverse, unique, priceless, vital human beings, and so was she.”