it hadn’t been for the supply expansion, then this [epidemic] would not have happened,” Courtwright said.
If history was any indication, the moment OxyContin and other opioid pills became too expensive or too cumbersome to get, illegal drug peddlers would step in to fulfill the market demand, just as they had done a century earlier when heroin became illegal. For centuries, dealers of opium, morphine, and heroin understood that an addicted person’s fear of running out—of becoming dopesick—portended one hell of a business model.
The author of several books on the history of drug addiction, Courtwright said he used to tell his students that “what most surprised me in my lifetime were things like the internet, or seeing tattoos on respectable women. But I’ve got to add this to the list of real shockers. I’m sixty-four years old, and I have to admit, I didn’t think I would ever see another massive wave of iatrogenic opiate addiction in my lifetime.”
*
Courtwright wasn’t the only one. Though it took nearly a decade before police, the press, and drug-abuse experts fully understood what was happening, Ed Bisch watched the urbanization of the pill epidemic play out on his front lawn in 2001, as paramedics carried his son’s body away.
He retreated to his computer, where he was shocked to learn that his son’s death had been the region’s thirtieth opioid overdose in the past three months.
How was that possible when he’d only just learned the word? “The internet was still new, and back then it was mostly message boards as opposed to websites,” he said.
Bisch channeled his grief into computer code. Hoping to warn other families, he created his own message board, giving it the bluntest moniker he could think of—OxyKills. Within weeks it had morphed into a scrolling database of grief, warnings, and statistics. The website became a clearinghouse for the latest Oxy-related overdose numbers reported by local medical examiners and the DEA. Bisch promoted news stories about OxyContin, such as when the New York Times noted that the drug’s sales in 2001 hit $1 billion, outselling even Viagra.
Parents from Florida to California joined Bisch in memorializing their dead children on his site, which became a running tally of dead athletes and young mothers and former beauty queens, many no more than twenty years old. “I was answering every email, and it was consuming me,” Bisch recalled. “Probably ten deaths a day, sometimes a hundred emails a week.”
Lee Nuss of Palm Coast, Florida, was too grief-stricken to reach out to Bisch initially, but her daughter, Monique, called him one night, begging him to talk to her mom. Turned out they had grown up in the same section of Philly, in the same working-class neighborhood of Fishtown, less than a mile apart. And the similarities didn’t end there.
Nuss, too, had lost an eighteen-year-old son, Randy, who died of a single, crushed-up 80-milligram Oxy bought from a friend whose mother wanted him to sell it to pay their rent. “I had no idea he was using pills until this happened,” Nuss said. She told herself that Randy hadn’t been using long, because she still had opioid pills prescribed to her in the wake of dental surgery that were untouched at the time of his death.
The Fishtowners made an informal alliance with Van Zee and Sister Beth after reading Barry Meier’s 2003 book, Pain Killer. If OxyContin nationalized the opioid supply chain, Nuss and Bisch nationalized the opposition to it, launching a grassroots nonprofit called Relatives Against Purdue Pharma (RAPP). It was Ed Bisch’s message board sprung to life, a nonvirtual resistance party that would play out politically and in person over the next decade.
Together the parents-turned-activists would lobby for the creation of statewide prescription monitoring programs, or PMPs, so doctors could check a patient’s prescription records and prevent themselves from being shopped. Members would sponsor drug-prevention workshops in schools and hold signs outside Purdue’s corporate headquarters featuring poster-sized pictures of their dead kids. They would battle—online and at times in person—with chronic-pain patients who praised the drug for allowing them to function and to sleep through the night. Bisch suspected (correctly, in a few cases) that some were “paid advocates,” hired by Purdue to troll his website and post contrary views.
From court cases to medical seminars, RAPP could be counted on to turn up whenever and wherever Purdue was in the news. In 2003, its members traveled from Rhode Island and New Jersey to rally outside a drug-abuse-prevention conference held in Orlando at the Caribe Royale resort—because