Dopesick - Beth Macy Page 0,18

the New England Journal of Medicine written in 1980. The letter was never intended as a conclusion on the risks of long-term opiate use, one of the authors would much later explain, yet it was trotted out repeatedly during OxyContin’s first decade.

At Dine ’n’ Dash gatherings and in doctors’ offices from the coalfields to the California coast, this letter about an unrelated initiative was repeated and tweaked until its contents no longer resembled anything close to the authors’ intention, like an old-fashioned game of telephone gone terribly awry.

A year after starring in the Purdue Pharma video, that same doctor, South Carolina pain specialist Dr. Alan Spanos, gave a lecture insisting that patients with chronic noncancer pain should be trusted to decide for themselves how many painkillers they could take without overdosing—just as the morphine-dispensing doctors had said of wounded Civil War veterans a century before. He reasoned that the patients would simply “go to sleep” before they stopped breathing.

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By March 2001, Van Zee was as fed up with letter writing as the alarmed Richmond doctor had been in 1884, precisely two decades before his peers took up the cause and three decades before the government began regulating the drugs: I have heard them, with tears in their eyes, say that they wished it had never been prescribed for them.

Van Zee’s neighbors were dying. The region had now buried forty-three people, dead of oxycodone overdose, since Purdue launched its drug. Addicted users had gone from snorting to routinely injecting the liquefied crushed-up powder with livestock syringes they bought (or stole) from local feed stores. At the Lee County jail, seventy-nine people were crammed into cells designed to hold thirty-four. “We were so overwhelmed, we were just stacking ’em on the floor,” the sheriff, Gary Parsons, told me; one of the prisoners had bought four OxyContin tablets by trading away his family’s mule.

While attempting to make a night deposit at the bank next door, the manager of Payless Supermarket in nearby Coeburn was gunned down by a masked robber trying to fund his next Oxy fix.

A half hour away in Clintwood, a man made the bold move of throwing a cement block through the front door of a pharmacy, even though it was across the street from the courthouse and the sheriff’s department. “A deputy heard the alarm go off, and here’s this guy running away and dropping pill bottles along the way, he’s so high,” Richard Stallard, the lieutenant, recalled.

In small towns where residents were used to leaving their doors unlocked, patrol officers were suddenly seeing people pushing stolen lawnmowers, four-wheelers, and even garden tillers down the street. “We called it ‘spot and steal,’” recalled Rev. Clyde Hester, who joined Van Zee and Sue Ella in their Lee Coalition for Health, the grassroots group. “They’d look for things during the day—weed eaters were popular—and then at night they’d come back and pick them up,” he said. To fuel his OxyContin habit, Hester’s own son stole his gun, which the minister later retrieved from a local pawnshop.

A man in Dryden killed a young man attempting to break into his house to steal his wife’s prescription drugs, which he’d spotted above the kitchen-sink windowsill—down the road from Van Zee’s house. And as metal prices rose, Sheriff Parsons reported thieves stealing everything from copper cemetery vases to wires plucked from a telephone pole that addicted users had chopped down. Parsons even had his stepson arrested for stealing his own personal checks to buy black-market OxyContin. “There is literally not a family in this county that has not been impacted by this drug,” he told me in 2017, a statement I heard in every Appalachian county I visited.

In early 2001, Van Zee and the Lee County Coalition for Health launched a petition drive asking the FDA to order a recall of the potent painkiller, via a website called recalloxycontinnow.

Drawing deeper lines in the sand between Van Zee and the industry, and also between him and most of his physician peers, the petition received more than ten thousand signatures, most from Lee County and the result of a standing-room-only town-hall forum he organized at the high school in March 2001. “In a place where people barely have money for gas in their cars, by far this was the biggest crowd I’d ever seen gathered in Lee County,” one organizer told me. Eight hundred people attended, some sitting in the auditorium aisles. Roanoke-based U.S. attorney Bob Crouch called OxyContin “the crack of Southwest Virginia,” with Oxy overdose