Dreamland (25 page)

But the town is also known for an illness the soil hasn’t cured. Chimayo has the highest rate of heroin addiction in America. When people discuss heroin addiction in Chimayo, they tend to talk of it in terms of a culture, something passed down through generations. Entire Chimayo families are addicted, beginning with the grandparents or even great-grandparents.

This had been true for many years when Jim Kuykendall, a few weeks into his job, called Chris Valdez, a New Mexico State Police narcotics officer up in the Española Valley.

When Valdez was growing up in the area, this illness was known but hidden. By the time he became a cop, though, heroin was about all Valdez ever saw. Several families, whose ancestors had been in the valley since the 1600s, sold the heroin. In the cloistered world of tiny Chimayo no one could touch them. Addict burglaries and car break-ins, meanwhile, grew worse every year.

For decades, Chimayo addicts had subsisted on powder heroin that Valdez assumed came from Asia somewhere. It had been cut often and was weak. Then sometime in about 1997, Mexicans arrived and began providing potent and cheap black tar heroin. Chimayo dealers wouldn’t let the Mexicans sell in town, but they were happy to buy this new product wholesale, and parcel it out to their customers. That’s when things seemed to unravel fast. With almost unlimited supply, users who’d controlled their addiction used far more. People stole wantonly. And those who had lived for years on weak powder heroin began to die on the strong black tar.

Not long after moving to Albuquerque, Kuykendall went up to the valley and Valdez drove him around. The police officer pointed out the mobile homes of heroin dealers—double- and triple-wides being especially prized among valley residents. Chimayo was an insular place, Valdez said. Cops were hated but needles were everywhere and overdose deaths were rising steadily. Few homes kept a stereo or television for long.

Three clans dealt heroin: the Barelas, with Felix its patriarch, and his many brothers, several of whom were strung out; there was Josefa Gallegos, whose son, Brian, lived in a shack out back behind her house, his arms rotting from tar heroin injections; finally there was “Fat Jose” and Jesse “Donuts” Martinez and their relatives.

These families had the nicest mobile homes and best lowriders. Felix Barela’s lowrider was the finest in the valley—a dark-purple Thunderbird known as the Wizard. The dealer families loved Harleys, too, another prized possession in Chimayo. Felix Barela also had several fine racehorses, including Red Hot Mag, the state’s best quarter horse. Each clan ran virtual convenience stores of dope, with fifty to a hundred addicts coming every day, some three times a day.

As the death toll rose through 1998 and into 1999, families of dead addicts, joined by priests from a New Mexico order known as Hermanos los Penitentes, began protest processions through the mountains to the santuario. They bore signs with the names of people who had died from overdoses, or been killed by burglars.

Kuykendall left shocked by the problem. Still, it appeared to be a local, not federal, issue—retail street dealing, it seemed to him.

A few weeks later, though, Valdez called. Get up here tomorrow, he said. There’s a meeting of a Chimayo Crime Prevention Organization. People are mad.

That night, Kuykendall walked into the Rancho de Chimayo restaurant, and was startled to see congressmen, judges, the head of the New Mexico State Police, and city councilmen, along with Bruce Richardson, the board of the Chimayo crime prevention group.

Richardson spoke. Criminal clans ran the valley and children were finding used syringes.

“You have done nothing,” Richardson told the officials that night.

He brought forward a large pickle jar filled with used syringes. The public officials gave what Kuykendall considered elected-official responses, appeasing no one.

He drove home to Albuquerque that night. The politicians’ presence told him that they knew things were bad. He had always told younger agents to focus on the biggest dealer wherever they were stationed. That dealer may not be Pablo Escobar, he would say, but the biggest dealer in a small town is still a problem to that town.

The next day, Kuykendall opened a case against Chimayo’s three heroin clans.

Liberace Shows the Way

Portsmouth, Ohio

By the end of the 1990s, Dr. David Procter was one of the few people doing well in Portsmouth, Ohio.

He had himself a $750,000 mansion, with a swimming pool, African art, and two seven-foot bronze storks. He owned a Mercedes, a Porsche, and a red Corvette—rare possessions in the Ohio River valley.

In the late 1980s, the Kentucky Board of Medical Licensure investigated patient complaints of unethical practices against him. Board agents found that he prescribed opiates aggressively and often without much diagnosis, or follow-up. He was found to have violated no Kentucky medical regulation and retained his license, but was placed on probation. In fact, the state records reflected a doctor who prescribed the drugs often yet discontinued them just as frequently, who consulted other physicians and urged his chronic-pain patients to use exercise or physical therapy to control their pain. David Procter seemed to be searching for solutions to what ailed his patients.

A decade later that had changed. A nurse in California once told me, “When you deal with people who are in pain all day long, after a while you get worn down.”

Something like that happened to David Procter. More patient complaints in the 1990s prompted a second state investigation. By then, those records show, he regularly prescribed Valium, Vicodin, the sedative Soma, Xanax, and a steady regimen of Redux diet pills—all with almost no diagnosis or suggestions for other treatment, such as physical therapy. Nor was there any discussion of improving diet as a way to lose weight and reduce pain. As I read the Licensure Board investigative reports, it seemed that many years in deindustrialized America seeing vulnerable people and manipulative people who used drugs and the government dole to navigate economic disaster had corroded any medical ethics Procter once possessed.

So I went to Portsmouth to see if I could learn more about the doctor whom locals called the Godfather of the Pill Mill, the man who had started the first business and showed others how it was done.

No one in Portsmouth had forgotten David Procter, though he was long gone by then. Some remembered him fondly. Many said they had gone to his clinic and waited in long lines for dope prescriptions.

One of them was Kathy Newman, who in 1996 was a high school cheerleader and the daughter of a contractor. Kathy had just graduated from Portsmouth High School when she broke ribs in a car accident. The emergency room in town was wary of prescribing more than ibuprofen for pain. You should go see David Procter, her friends said: He’ll give you something that works.

Kathy drove to the South Shore clinic and walked into a madhouse. The room was packed; people were standing in the aisles, tense and greedy with anticipation. After three hours, she got in to see the doctor. Procter prescribed her Vicodin and spent a half hour telling her that she would probably have back and hip pain for the rest of her life, and thus would need this prescription for that long as well. Newman went along with it, not sure what to think.

“I’m scared to death. I’m so young and afraid that I was going to be on this the rest of my life,” she said.

In fact, those Vicodins led to a fourteen-year addiction that eventually had Newman shooting up OxyContin and getting pill prescriptions from a half-dozen doctors around town. Years disappeared in zoned-out addiction. She once found herself in an abandoned farmhouse with people she didn’t know, unaware how she got there. A pit bull ran through the living room, chased by an enraged rooster.

The pain-treatment revolution had many faces and these mostly belonged to well-meaning doctors and dedicated nurses. But in the Rust Belt, another kind of pain had emerged. Waves of people sought disability as a way to survive as jobs departed. Legions of doctors arose who were not so well-meaning, or who simply found a livelihood helping people who were looking for a monthly government disability check as a solution to unemployment. By the time the pain revolution changed U.S. medicine, the Ohio River valley had a class of these docs. They were an economic coping strategy for a lot of folks. They charged cash for each visit and were quick with the prescription pad, willing to go along with whatever the patient claimed was pain, wherever the patient claimed he had it. Then along came OxyContin.

If heroin was the perfect drug for drug traffickers, OxyContin was ideal for these pill mill doctors. The drug had several things going for it, as far as they were concerned: First, it was a pharmaceutically produced pill with a legal medical use; second, it created addicts, and not just among those who looked to abuse it, but among many who came in search of pain relief. Every patient who was prescribed the drug stood a chance of soon needing it every day. These people were willing to pay cash. They never missed an appointment. If diagnosis wasn’t your concern, a clinic was a low-overhead operation: a rented building, a few waiting rooms, some office staff. And bouncers. These clinics did require bouncers. They also required a physician with a DEA registration number that permitted him to prescribe federally designated Schedule II narcotics like OxyContin. Prescriptions for Schedule II drugs had to be written each month by a doctor for a patient, who had to come to the office in person. That meant a monthly-visit fee from every patient—$250 usually. And that kept waiting rooms full and cash rolling in.

Among the very first docs in America to figure out the potency of OxyContin as a business model was David Procter in Portsmouth, Ohio. He believed all his patients. Not only that, he encouraged them to believe in imaginary pain.

“Injured people start going to him and he gives them this new wonderful medicine: OxyContin,” said Lisa Roberts, a public health nurse in Portsmouth, who had worked with Procter years before at a hospital where he had privileges. “Soon they’re getting addicted. They’d say my pain’s getting worse and he’d increase the dose. I started seeing people I know, who are hardworking decent people, acting all bizarre, rolling cars, stealing.”

Danny Colley, who grew up in Portsmouth’s rough East End neighborhood, watched Procter’s gradual corruption. Procter had been his family’s doctor when he was a child. At twenty, now fully involved in the drug world, Colley visited his former doctor’s clinic. Procter was the first cash-only doc around and was by then prescribing Xanax and Lortabs for everything. Later, he became the first to prescribe OxyContin for Colley. His clinic was full.

“He was the one guy and he was burning it down,” Colley said. “When he gave me my Lortabs, he said put these under your tongue and let them melt—do not snort them. When I got my first Oxys, he told me to be careful but that I could snort those. His exact words. He gave me the same thing he said he was taking. He’s giving me the dope I need so I’m not sick. I thought he was my dude! I thought he was looking out for me. I thought it was the coolest thing ever.”

Colley went to Procter after being injured on a job. “He got workers’ comp to pay for my medicine for a year and a half,” Colley said. “He was helping with that. He had a photographic fucking memory. We all thought he was the smartest person in the world. He was brilliant, but he was a crook.”

Local doctors took a cue from Procter. Dr. John Lilly opened in downtown Portsmouth. He had lines out the door, too. After that, things opened wide.

Kathy Newman noticed it wasn’t just the unscrupulous docs. It seemed every physician in town was under the influence of opiates’ remarkable painkilling potential. Anyway, she could find no doctor in Portsmouth offering a pain solution that didn’t involve opiates.

“They’d be, like, ‘Well, let’s try you on Lorcet tens.’ ‘Oh, that didn’t work for a month? Let’s move you on to twenties,’” Kathy Newman said. “Within three months of me telling them that Vicodin fives aren’t working anymore, I was on Oxy twenties, paying cash all the way.”

Doctors prescribed those drugs. The other truth, though, is that opiates were all most patients demanded in southern Ohio by then.

Fifty miles away, an addict who sometimes went by the name of Jeremy Wilder saw easy money and grabbed it.

Wilder, a tall, lanky guy with a heavy Appalachian drawl, was raised downriver from Portsmouth in the one-stoplight town of Aberdeen, situated between two power plants in Brown County.

Jeremy was a union carpenter. But he grew up around the kind of moral ambivalence that characterized life in the small Ohio River valley towns as the Rust Belt took shape. The easy money got the better of him.

In 1995, Jeremy heard that Dr. Fortune Williams had been hired by David Procter to start up a clinic out in Garrison, Kentucky. Williams was the first doc Jeremy went to as he emerged as one of the first pill dealers in his county. He paid Williams $250 for the visit and $200 more for prescriptions that included OxyContin. Jeremy later found a doctor in Williamsburg, Ohio, and another in Portsmouth to supply him with pills as well.

I met Jeremy as I traveled the heartland of the opiate plague, bisected by the Ohio River. Through him, I realized that as the pain revolution spread, powered by OxyContin, the area once starved for health care had seen doctors descend on it like locusts.

By the mid-1990s, Jeremy Wilder was the biggest pill dealer in Aberdeen while still working carpentry jobs in Cincinnati and around southern Ohio. He had a window in his house to which users in the area literally beat a path.