On Adam Shay's 21st birthday, he signed up to become an organ donor. It was characteristic of the thoughtful young man, who for three years battled the demons of heroin addiction. His life finally seemed to be getting back on track until a tragic setback just six months later.

"He had been sober a year and when he used the last time, it was his last time," says Adam's mother, Marlene.

At the time of Adam's death, Karen Goodwin's life was slipping away. Battling diabetes since age 9, Karen went through a turbulent time when she didn't manage her disease. The neglect took a devastating toll on her body.

"I had doctors even drop me as a patient, I had one doctor in particular who told me I would probably be dead by 21,” Karen says.

Karen did live to see 21, but by 42 she was out of luck and out of time. Her kidneys and pancreas failed her and she needed a transplant to survive. In death, Adam Shay answered the call.

"I received the gift of life from Adam when I thought I wasn’t going to see another Christmas or birthday, or see my son grow up," Karen said.

In Ohio, 3,000 people are waiting for a lifesaving organ transplant. In a tragic twist, the heroin epidemic is making a critical difference.

"This year alone probably up to 25% of our eligible donors died in this manner," says Lifebanc Chief of Hospital and Clinical Services, Heather Mecesa.

Karen received Adam's organs, not because she was first on the list, but because the patient before her refused them. Adam's organs were considered "High Risk," though it wasn't because of his heroin use.

"The drugs are in the system for a very short period of time so by the time that the transplant takes place those organs don’t have any traces of heroin or any other drug in their system," Mecesa says.

It was the chance Adam could have contracted H-I-V from the needle he used during his last overdose. There was no way to know until six months after the transplant.

Meanwhile, Karen didn't hesitate at all. She knew she was meant to have Adam's gift and the surgery took place on January 8th, 2014.

"Here I am...a recovering addict, here I am a person that’s been brought back to life over and over and over again and the program teaches us that God does for us what we can’t do for ourselves," Karen said.

In her twenties, Karen's life spiraled out of control. She became addicted to crack cocaine and eventually was mixing it with heroin. She understood the demons Adam fought. By 2000 she achieved sobriety and by the time of the transplant, she had fourteen years under her belt.

She desperately wanted to reach out to Adam's family and thank them for the gift of life she received, but she felt it was important to wait.

"I didn’t want to disappoint her in knowing her son, who died of a heroin overdose, had his organs go into another addict," Karen said.

Over the next few months Marlene waited to hear from the people Adam's gift had impacted. He had saved Karen and another woman.

She received a letter of thanks from that woman, but nothing from Karen. It caused her sadness and frustration.

That's when she reached out and took advantage of the bereavement services provided by Lifebanc.

Elissa Berman is Lifebanc's Director of Bereavement Services. She says about a third of her clients are families, mainly parents, who have lost someone to overdose. She expects she could have many more but the heroin epidemic causes shame for many.

She says it's her job to change that mindset, because those who give the gift of life are not remembered for how they died.

"Your loved one is so much more than their addiction, they’re a complete human being who just became a hero,” is something she frequently tells them.

Marlene found the service invaluable.

"I honestly would not be here today talking to you without Lifebanc," she said.

On the one year anniversary of Adam's death and Karen's transplant, Marlene received a letter in the mail. And something else, a gift Karen felt she needed to give.

"She wanted to give Adam a year of sobriety. Here I am thinking she wasn’t grateful and how hard it was for her to wait a year," Marlene said.

Karen sent Marlene Adam's one year sobriety chip.

"I’m so proud of her and I’m so grateful to her because she said yes and the first time I met her I said thank you and she was a little taken back by that I would say thank you to her and I said you made his life have meaning by saying yes," Marlene said.

Today the women are like family and often share their story together to encourage organ donation.

The transplant essentially cured Karen's diabetes and allows her to handle her significant responsibilities.

Her young son has Autism, her husband had a heart attack and may one day require a transplant. Her sister's failing health put her on the waiting list for a new liver and lung and through it all Karen also cares for her 75-year-old mother.

She doesn't consider any of this stress. She considers it a gift from God and one that Adam's gift allowed her to have.

To learn more about organ, tissue and cornea transplant and how to become an organ donor. Click HERE.