Dopesick - Beth Macy Page 0,52

local young women. Shortly after President Obama signed a law banning the sale of the products, Vice magazine swooped into Roanoke for a scoop. Looking back, the bath-salts blight was a red herring, problematic but short-lived—and a distraction from a much quieter, even deadlier drug.

“That’s how it got way out in front of us,” Hans said. “And the doctors didn’t see their role in it, either. When a doctor prescribed our teenagers thirty Percocet pills for a pulled wisdom tooth, we didn’t know to complain. It was like we were all in a big fog of denial.”

Within five years, Hans would have the numbers of multiple mothers of addicted kids programmed into her cellphone. She would find herself rushing from the funerals of heroin-overdosed twentysomethings to giving prevention talks in the auditoriums of the high schools they once attended. Spencer’s master class in drug abuse had gone unheeded, boxed away into a category of Things That Happen to Other Families.

Andrew Bassford, the assistant U.S. attorney who prosecuted Spencer’s case, took an angry phone call from the Roanoke County school superintendent, who was mad that he’d openly addressed the accessibility of heroin and OxyContin in her schools.

“How dare you tell the newspaper these things?” the superintendent seethed.

Bassford, who also works as a brigadier general in the U.S. Army Reserve, was unmoved by the scolding.

“I say these things because I know them to be true,” he said. “Your schools are a pit because your students have money, and money attracts drugs.”

*

The Hidden Valley teenagers called the green 80-milligram Oxys Green Goblins. They scored them from an array of sources: a restaurant co-worker, a brother who’d had them prescribed in the wake of wisdom-tooth surgery, an Iraq war veteran who had legitimate pain but was prescribed twice as many pills as he needed and funneled the rest to the kids down the street in exchange for cash.

“Parents didn’t really know what was going on when it was just pills,” recalled Victoria (not her real name), who tried her first OxyContin pill her senior year after a friend ratted her out to school officials for smoking weed.

Victoria remembered the first time she tried to crush an abuse-resistant Oxy, following Purdue’s long-awaited reformulation in 2010, and it worked exactly as Barbara Van Rooyan envisioned it would when she petitioned the FDA, demanding an opioid blocker, or antagonist, be added to the drug: “If you tried to crunch ’em, they’d gel up on you. You couldn’t even snort ’em, let alone shoot ’em. After that, the pills either went dry or were just too expensive to get. And everybody who used to deal pills starting dealing heroin instead.”

I noticed another, lesser-known pattern among the addicted suburbanites I interviewed: The Green Goblins were typically preceded by a starter pack of a very different drug. Almost to a person, the addicted twentysomethings I met had taken attention-deficit medication as children, prescribed pills that as they entered adolescence morphed from study aid to party aid. On college campuses, Ritalin and Adderall were not just a way to pull an all-nighter for the physics exam, never mind that they were prescribed to your roommate, not you; they also allowed a person to drink alcohol for hours on end without passing out. That made them a valuable currency, tradable for money and/or other drugs.

Between 1991 and 2010, the number of prescribed stimulants increased tenfold among all ages, with prescriptions for attention-deficit-disorder drugs tripling among school-age children between 1990 and 1995 alone. “And we’re prescribing to ever- and ever-younger children, some kids as young as two years old,” said Lembke, the addiction researcher.

“It’s just nuts. Because if we really believe that addiction is a result of changes in the brain due to chronic heavy drug exposure, how can we believe that stimulant exposure isn’t going to change these kids’ brains in a way that makes them more vulnerable to harder drugs?” she added.

The science is far from clear, according to a 2014 data review. Some studies show that ADHD-diagnosed children treated with stimulants have lower rates of addiction to some substances than those who weren’t medicated, while other studies suggest that exposure to stimulants in childhood can lead to addiction in adulthood.

“A lot of us think that doctors have overdiagnosed children with ADHD, so a diagnosis is something to very carefully discern, and parents should always monitor the medicines their children and teenagers are on,” said Cheri Hartman, a Roanoke psychologist.

Lembke pins the opioid epidemic not just on physician overprescribing fueled by

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