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How One Town Got Hooked
By Debra Rosenberg
NEWSWEEK
http://www.msnbc.com/news/553447.asp?cp1=1
4-24-1

No one could blame Joshua Coots for wanting to escape. Bored and frustrated, the pale, soft-spoken teen felt trapped in the tiny town of Hazard, Ky. The place didn't offer him many options. Left behind by the economic boom, the town of 5,500 still depends largely on the aging coal and timber industries.
 
"I don't know how to explain the buzz. It's just this utopic feeling. You feel like you can conquer the world... It's a better high than anything else." - Joshua Coots
 
Empty Storefronts dot the depressed Main Street. Highway strip malls are about the only places left to go for a night out. Coots couldn't imagine a lifetime hauling logs or toiling in the mines, where his father once worked. Instead, he took a job as a telemarketer. In his off hours he hung out with friends in the park, smoking pot and popping pills. The drugs were a mild distraction, but did little for his mood. Then someone gave him the powerful prescription painkiller OxyContin. When crushed, the pills delivered a euphoric, heroin-like punch. "I don't know how to explain the buzz," says Coots, now 21. "It's just this utopic feeling. You feel like you can conquer the world... It's a better high than anything else."
 
Coots was hooked. He started out with a modest 20mg, but before long, he says, he needed 400mg just to make it through the day. And that took money. OxyContin is known as the poor man's heroin, but at a street price of $1 per milligram it can be anything but cheap. Coots quit his job and spent all his time in pursuit of the precious pills. Each morning began with an orange 40mg tablet, which he downed before getting out of bed. "I couldn't hardly walk if I didn't have it." At first he crushed and snorted the pills, after sucking on them to remove the time-release coating. Later he dissolved the powder in water and injected it for a quicker buzz. He floated through the days in a dreamlike stupor, not even bothering to eat. His waist dropped from 42 inches to 36 inches in two months.
 
As his cravings got worse, he found creative ways to get hold of the pills. Sometimes he would fake back pain and get a shady local doctor to write him an Oxy prescription. Once, he even stole the pills from his grandfather, who was taking them to dull the pain from a fractured spine. "I had to have more and more," he says.
 
These days, nearly everyone in Hazard has an OxyContin horror story to tell. In the last year, local officials say, the drug has swept through the small town, wrecking lives and destroying families. Precise statistics are hard to pin down, but the number of local addicts runs in the hundreds. Oxy abuse cuts across income and age lines.
 
Teens meet for Oxy parties in the park. Miners blow their paychecks to feed their addictions. Even grandmothers peddle their prescriptions for quick cash. In February police rounded up more than 200 Oxy dealers in Hazard and surrounding counties, the largest drug bust in state history. Hazard's crime rate has soared; the jail is packed with Oxy-addicted inmates. In nearby Harlan, Judge Ron Johnson sentenced a woman to 10 years in prison for selling just four of the pills. OxyContin is "a pure scourge upon the land," he fumed from the bench. It is, he said, "demonic fire."
 
Hazard isn't the only place struggling to quell the flames. Oxy has taken hold in other rural Appalachian states and in New England, places where it's tougher to get more familiar street drugs like heroin and crack. The drug's maker, Purdue Pharma, says it is appalled by the widespread abuse of the drug, a form of synthetic morphine. "When this drug is used properly, it has the potential to save lives. When it's abused, it has the potential to take lives, just like any other strong medication," says Dr. J. David Haddox, Purdue Pharma's medical director. In an effort to stem the damage, Purdue has held workshops for doctors and met with the DEA and officials from five states. The company is even researching new drugs that would be more tamper-proof and less addictive. But those efforts are years away from pharmacy shelves. Hazard isn't willing to wait. In recent months police and community activists have joined forces to get OxyContin off the streets, and out of their town.
 
That could prove difficult. Hazard has a long tradition of self-medication. Moonshine and marijuana, grown in its fertile soil, have long helped to blot out depression, boredom, even physical pain. Eastern Kentucky has one of the nation's highest cancer rates, and many residents suffer from chronic mining and timber injuries. OxyContin seemed like the most potent antidote yet to the local despair. "If there's ever been a drug made that will knock depression out for the short term, it's OxyContin," says therapist Mike Spare. "The euphoria sucks you in." Cindy McCain shares her story
 
When the then police chief, Rod Maggard, first heard about Oxy in the summer of 1999, he had to ask his pharmacist what it was. But by spring, he knew all too well what the drug was doing to his town. Burglaries and domestic-violence reports were up. Overdoses were mounting at the local hospital. (State police count 19 OxyContin-related deaths in Kentucky this year alone. Purdue Pharma disputes the number.) Maggard, 57, who retired as police chief in March, was flooded with hundreds of calls from families begging him to help get a son or daughter off the drug. "I have never seen anything take off like this did," says Maggard, a square-shouldered, gray-haired cop. "It has mushroomed." On the wood-paneled wall above him hangs a prized painting called "The Protector"-an image of Jesus with his hand on the hood of a flashing police cruiser.
 
Maggard was especially outraged that the town's sole refuge, leafy, peaceful Perry County Park, had become an open-air drug market. Clusters of teens and young adults jammed the parking lot near the Little League fields, lining up to buy Oxy. "Nobody wanted to get stoned. Nobody wanted to get drunk. Everybody wanted to go get an OC and sit in the park," says Holly, a recovering addict who's now 21. Girls carried ceramic bathroom tiles in their purses so they could be ready to crush a pill anywhere, any time. In a futile effort to control the trade, Maggard patrolled the grounds in his unmarked car, installed surveillance cameras and had the park gates locked late at night. Nothing seemed to work. When addicts started referring to the park as "Pillville," Maggard called in the Feds for help. The DEA and other law-enforcement agencies set up an undercover task force.
 
By then Hazard was in the throes of a crime wave sparked by Oxy addicts searching for a fix. James Wallace, a baby-faced 20-year-old, was locked in the dilapidated Perry County Jail for receiving stolen property. Leaning on a blue plastic picnic table in the jail's smoky visitors' lounge, Wallace admits he stole televisions, guns, knives-all to earn money for Oxy. Sometimes he'd even go into stores and claim the soda machine outside had taken his dollar. "You'll do everything and anything," he says. In Hazard, whatever he got his hands on could be traded for the drug. Addicts even lifted grocery-store steaks. At one Hazard fruit stand, you could swap food stamps for the pills.
 
Playing With Pain Killers
 
Throughout the fall, Maggard's undercover task force quietly plugged away. Police eventually seized 10,000 OxyContin pills and bought an additional 3,500 in sting operations. As they worked, Maggard and his team traced the drug's route to Hazard. Most of the pills came through a disturbingly convenient pipeline: the local pharmacy. Dealers would fake injuries or visit a few unscrupulous doctors willing to write prescriptions for a $100 fee. Several doctors have already been charged, and Joseph Famularo, U.S. attorney for the eastern district of Kentucky, hints his next round of indictments may target health-care workers explicitly. Though Kentucky has a computer system designed to track narcotics prescriptions, Hazard was close enough to five other states that "doctor shoppers" could easily cross borders. Many users paid cash for the pills. Others were bold enough to get Medicaid or private insurance to pick up the tab. Police even found some elderly patients who rationed their own pain pills and sold the rest. "People were selling what they should be taking," says Maggard.
 
The task force got tips from an unlikely source: local churches. Late last fall pastors found themselves conducting funeral services for a growing number of Oxy overdose victims. One October evening the weekly Bible-study session at Petrey Memorial Baptist Church became a virtual OxyContin support group, as congregants spontaneously began sharing their stories about the drug. The Rev. Ronnie (Butch) Pennington launched a faith-based group, People Against Drugs. When he called a communitywide meeting on Oxy, so many people responded that he had to move the location twice to find a room large enough for the crowd. In the end, more than 400 people showed up. After the meeting participants called in 60 tips about possible Oxy dealers.
 
Police put them to use. As the sun rose on Feb. 6, more than 100 officers fanned out across eastern Kentucky with a sheaf of arrest warrants. By evening, Operation Oxyfest 2001 had rounded up 207 dealers. But a month later people wondered if the arrests had even made a dent. Frustrated, Kentucky prosecutor John Hansen has vowed to file murder charges against Oxy-overdose survivors, including family, friends and dealers.
 
With the whole town focused on catching the dealers, Hazard's addicts have largely been left to fend for themselves.
 
The town still has no rehab program. Joshua Coots bottomed out about a year and a half ago. He'd lost his car, declared bankruptcy and wound up getting arrested for stealing the family truck. One day he collapsed on his parents' kitchen floor. "Mom and Dad, I'm on Oxy and it's killing me," he sobbed. At a religious revival meeting, a visiting pastor preached about evil in people's lives. He seemed to be looking straight at Coots, who wept steadily, tears dripping off his mustache and down his chin. Was he ready to step into a new life? the preacher asked. Coots was. He quit Oxy cold turkey. "It was miraculous," he says.
 
Today, Main Street in Hazard has one fewer boarded-up storefront. In the building that once housed a campaign office, Coots and his father, Pastor Donnie Coots, refer Oxy addicts to private rehab programs out of state. In Pillville, police are still rounding up dealers and users on weekends. The hundreds of busts have managed to decrease the supply, making the drug more expensive. Yet the Oxy market continues to thrive. Too many people in Hazard, it seems, are willing to pay any price.
 
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