Author interviews, Van Zee and Sue Ella Kobak, March 3 and 4, 2017.
a physician colleague treated a septuagenarian: Author interview, Stravino.
“Nobody would listen to her”: Author interview, Dr. Molly O’Dell, March 22, 2016.
In 1997, the Roanoke-based medical examiner: Rex Bowman, “28 Deaths Linked to Drug—OxyContin Plagues Southwest Virginia,” Richmond Times-Dispatch, Feb. 9, 2001.
“a little bit unique”: Bowman, “Drug Sparks Crime Surge—Southwest Virginia Hit Hard by Opiate Abuse,” Richmond Times-Dispatch, Oct. 21, 2000. The overdose deaths weren’t reported until Bowman’s report the following February.
So it happened that in the early 2000s: Author interview, Debbie Honaker, March 16, 2016; follow-up interview, Aug. 8, 2016.
The Board of Medicine suspended Dr. Dwight Bailey’s: Lindsey Price, “Doctor’s License Suspended Amid Prescription Drug Allegations,” WCYB, Aug. 6, 2014, and confirmed in the Board of Medicine’s License Lookup: dhp.virginiainteractive/Lookup/Detail/0101031921. “Had he not given her that junk, my sister would still be here,” said Jennifer Ball, who said her sister sought help from Bailey after injuring her back while lifting her handicapped son. She died at forty-one from a heart attack brought on by a combination of blood-pressure medicine, Xanax, and opioids; author interview, Ball, Aug. 5, 2016.
“It’s our culture now”: Author interview, Crystal Street, March 16, 2016.
24 percent of Lee High School juniors: Author interview, Van Zee, Sept. 23, 2016.
Machias, Maine, was a remote town: The population of Washington County in Maine has been in decline for the last three census periods; the median household income is $38,083, according to U.S. Census data from 2010 and 2016. Nearly one in three children in the county lives in poverty, according to Tom Walsh, Bangor Daily News, Feb. 7, 2012.
The plainspoken sheriff: Donna Gold, “A Prescription for Crime,” Boston Globe, May 21, 2000.
“That’s us!”: Author interview, Sister Beth Davies, Sept. 23, 2016.
“The extent and prevalence”: Letter from Van Zee to Dr. J. David Haddox, Aug. 20, 2000. Van Zee’s medical partner, Dr. Vince Stravino, had already filed official complaints about children in the area “crushing, snorting and injecting Oxycontin” and “come to the hospital with overdoses and abscesses because of injections,” according to a Purdue response written by Mayra Ballina, the company’s associate medical director, on May 8, 2000.
“My fear is that these are sentinel areas”: Letter from Van Zee to Dr. Daniel Spyker, Purdue’s senior medical director, Nov. 23, 2000.
Forty to 60 percent of addicted opioid users: George E. Woody, “Advances in the Treatment of Opioid Use Disorders,” National Institutes of Health, Jan. 27, 2017: ncbi.nlm.nih.gov/pmc/articles/PMC5288680/#ref-1; M. J. Fleury et al., “Remission from Substance Use Disorders: A Systematic Review and Meta-Analysis,” Drug and Alcohol Dependence, Nov. 1, 2016; studies interpreted by Harvard Medical School’s John Kelly, author interview, Aug. 31, 2017.
“Among the remedies which it has pleased”: Meier, Pain Killer, 42.
makers of the painkiller Talwin: C. Baum, J. P. Hsu, and R. C. Nelson, “The Impact of the Addition of Naloxone on the Use and Abuse of Pentazocine,” Public Health, July-August 1987: 426–29.
Unemployed Tazewell miners: Author interview, Doug Clark, Aug. 9, 2016.
and he seemed intimidating: Author interview, then–Tazewell County prosecutor Dennis Lee, now in private practice, May 2, 2016.
“There’s just no comparison”: Tom Angleberger, “Panel Discusses OxyContin Problem,” Roanoke Times, Sept. 25, 2000.
Sales-rep bonuses were growing exponentially: In 2001, the average salary for a Purdue sales rep was $55,000, and the average bonus was $71,500, according to U.S. General Accountability Office report, “OxyContin Abuse and Diversion and Efforts to Address the Problem,” December 2003, gao.gov/new.items/d04110.pdf.
“starter coupons”: Ibid., 23. “In 1998 and 1999, each sales representative had 25 coupons that were redeemable for a free 30-day supply.…Approximately 34,000 coupons had been redeemed nationally when the program was terminated in July 2001.”
The trips were free: Ibid., 22.
“The doctors started prostituting themselves”: Author interview, Emmitt Yeary, Jan. 24, 2017.
Purdue had passed out fifteen thousand copies: GAO report, “OxyContin Abuse and Diversion,” 27.
“pseudo addiction”: Explained in the Purdue Pharma “I Got My Life Back: Patients in Pain Tell Their Story” video, narrated by Dr. Alan Spanos, 1997.
“go to sleep” before they stopped breathing: Thomas Catan and Evan Perez, “A Pain-Drug Champion Has Second Thoughts,” Wall Street Journal, Dec. 17, 2012.
The region had now buried forty-three: Laurence Hammack, “Deaths from OxyContin Overdoses on the Rise,” Roanoke Times, Feb. 10, 2001, and author interviews, Van Zee.
At the Lee County jail: Hammack, “Lee County Is the Epicenter of Abuse,” Roanoke Times, June 10, 2001.
“stacking ’em on the floor”: Author interview, Lee County sheriff Gary Parsons, March 3, 2017.
one of the prisoners had bought four OxyContin tablets: Rex Bowman, “Prescription for Crime,” Time, March 21, 2005.
While