Flooded with opioids, Appalachia is still trying to recover

July 26, 2019

At her very worst, Amber Wood was so desperate for the opioid high she had a dentist pull a tooth — and not even a particularly bad tooth, just one of those molars she didn’t think she’d need as much as she needed a pill. The dentist, she said, gave her a prescription for the opioid painkiller Lortab.

She’d been abusing drugs since the age of 13.

“None of us said when we went to pre-K, ‘You know what I want to be when I grow up? I want to be a drug addict.’ Nobody thought that. But the fact that these drugs were so accessible, everyone knows what doctors to go to,” she said this week after getting off work at a diner here in southwest Virginia.

She’s in recovery now, and has been for precisely 25½ months, she said. Wood, 26, a single mother with a 6-year-old child, detoxed in jail after getting arrested in June 2017 on drug charges she can’t fully remember.

She was diverted to drug court, a program in which she got drug-tested and saw a judge on a regular schedule to avoid being put behind bars. She’s training as a peer recovery specialist. At the diner, she’s been freshly promoted from dishwasher to cook. Though apprehensive about sharing her story in public, she wants to spread a positive message to other people in her situation: “There’s hope. There’s another side of addiction. You can get clean and have a productive life.”

Southwest Virginia is among the regions in the United States hardest hit by the opioid epidemic, which has roots in prescription painkillers. The pills don’t tell the whole story of the crisis, but the crisis can’t be described without reference to the pills.

The just-released Drug Enforcement Administration data obtained and analyzed by The Washington Post shows the swollen pipeline of prescription opioids from factories to pharmacies from 2006 to 2012. Nearly 1.6 billion pills flowed into Virginia, including nearly 17 million into Russell County, home to the town of Lebanon. That’s an average of 84 opioids per county resident per year.

The county just to the west, bordering Kentucky, is Wise County, which was shipped 34.9 million opioids, an average of 120 pills per resident. That does not include the small city of Norton, which is surrounded by Wise County and was shipped more than 8 million pills, which comes out to 306 pills annually per resident.

The opioid epidemic today has ravaged big cities as well as remote towns and has spared no demographic group. But it has been particularly brutal here in central Appalachia, which has seen the coal industry contract and now has some of the highest poverty and disability rates in the nation.

“It’s sort of ground zero everywhere,” said Kristie Jones, director of adult behavioral health services for the Cumberland Mountain Community Services Board, which operates the Laurels Recovery Center in Lebanon.

For a long time, there was little stigma attached to these powerful painkillers. They could be prescribed and distributed legally. But they helped lay a foundation for a disaster.
Some small-town drugstores handled more than 5 million opioids over the seven years covered by the DEA data, which was released by a court order after a legal challenge by The Post and the owner of the Charleston Gazette-Mail in West Virginia.

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