Dreamland (39 page)

Many of these bootleggers became almost advance men for the epidemic.

One of them was a man named Timmy Wayne Hall. Hall had grown up on Branham Creek Holler in Floyd County, the son of a factory worker who was also a preacher in the Church of God. Hall's siblings and relatives worked in the nearby coal mines. Floyd County hadn't many jobs outside the coal mines, which were tough places to make a living. Hall had other things in mind and never did work a day in his life.

In 1980, he married into a family of bootleggers. He began driving down to Perry County, buying cases of Schlitz beer, the cheapest available and thus the bootleggers' favorite, and selling them out of the family's house in Floyd for triple. After Floyd County voted to go wet, Hall applied for SSI and, like several families in his holler, began getting the monthly check. He was prescribed Lorcet after a car accident, which he could afford with his Medicaid insurance card. He promptly grew addicted to the pills.

There weren't many drug addicts in Floyd County back then, and most, like Timmy, used 10 mg Lorcets—a pill that combined hydrocodone with acetaminophen. But in 1996 OxyContin came out, and soon people from all over were getting addicted to it. No doctor would prescribe Hall OxyContin at first.

“Nobody was supposed to get them but cancer patients,” Hall said. Plus in 1999 the state put in its prescription-monitoring program.

With Kentucky off-limits, Hall found an Oxy connection through a Floyd County friend in Detroit. He also found other connections in Dayton and Toledo. He had read about New York mafioso John Gotti and Colombian drug lord Pablo Escobar years before. OxyContin allowed him, a man without much else in his life, to imagine following in their footsteps. He began driving regularly up to Ohio and Detroit for pills. These connections were reliable enough so that things got bad in Floyd County where OxyContin was concerned.

But in 2004 Floyd County began to get a lot worse. A local trucker named Russ Meade was driving across Louisiana one day. Meade spotted billboards for a clinic called Urgent Care in the town of Slidell that mentioned prescription pain pills.

Being from Floyd, Meade knew pills' value. He stopped in, was prescribed a bunch, brought them home, and sold them. Onto something, he began driving down to Slidell—a seventeen-hour trip—with several Floyd County addicts, paying for their visits, then keeping half the pills they were prescribed. Among them was a man named Larry Goble. Goble was a former miner on disability with black lung, who had briefly been a deputy sheriff. Meade later died, but Goble kept driving down to Urgent Care with addicts, paying for their trips and five-hundred-dollar doctor visits, which he saw amounted to a charade with a physician. In payment, he took half the pills they were prescribed. Goble later testified in federal court that he used some and sold the rest.

Soon dozens of folks from Floyd County were driving the seventeen hours to Slidell. The clinic's owner, Michael Leman, next opened another in Philadelphia, hiring a drug-addicted, alcoholic doctor named Randy Weiss to see patients. Despite the Urgent Care name, Weiss later testified, the clinic had no equipment to treat people with urgent medical needs, such as make casts or stitch wounds. Leman's clinics charged eastern Kentuckians $500 per visit, while locals paid only $250. Then he opened an Urgent Care in Cincinnati. He hired Dr. Stan Naramore, who had been convicted of murder in Kansas, then had that conviction overturned on appeal. Carloads from Floyd County began making pilgrimages to Philadelphia and to Cincinnati each week.

From these Urgent Care clinics, a new flood of pills washed into Floyd County, upsetting a tenuous balance in the hollers. Along these creeks, some families led lives of quiet decency, trying to raise children and hold what jobs they could get in an area where work was hard to find. Other families, though, had been unemployed for generations and on government assistance. Up to then, they had resorted to small-time criminal activities, but remained minor irritants in holler life. When Oxy came along, however, the sorriest families were transformed into dominant and unruly forces.

Timmy Wayne Hall was among the biggest customers of Leman's new Urgent Care clinic in Philadelphia. Hall traveled constantly back and forth, paying others to drive for him because he was heavily addicted.

“I was taking twenty, twenty-five people a month to Philadelphia. The patients would sit in the car. I'd go in there and get their scripts. Then go to the pharmacy in their name; it was only twenty feet away.”

With each patient receiving close to five hundred pills, and Hall taking half of that, he was clearing more than four thousand dollars for every person he hauled up to an Urgent Care. He was also scoring pills from Detroit and connections in three other states—though never in Kentucky, as he feared the state's prescription-monitoring program. Back home, he made a killing on the first of the month when the SSI checks arrived in Floyd County.

He began hiring dealers to sell for him. At his peak, he figured he had dealers selling in five counties in eastern Kentucky. When he heard of competitors, he would go to their customers and offer them Oxy 80 mg pills for sixty-five dollars apiece instead of the seventy dollars the competitors were charging. He sold all over, watching as OxyContin seeped into every corner of eastern Kentucky. Men with professional jobs in wealthy Pike County were his pill customers; so were the construction guys who worked on their houses.

Hall, a man who'd never worked, now bought a dozen houses in and near Branham Creek Holler. He often took friends on road trips and paid for everyone's hotel room. A coterie of junkies hung about him, and he paid them to cook, wash his clothes, vacuum his house, cut the grass, and do odd jobs on his properties. He grew intoxicated with the power and the fact that pills allowed him to be, for Kentucky, the magnanimous don. He had a habit of up to twenty OxyContin 80s a day.

Hall was arrested in 2007. During withdrawal, he went into a seizure and was briefly pronounced dead, then spent six months learning to walk again. When he pleaded guilty, Hall confessed to selling two hundred thousand OxyContin and methadone pills, though the real figure was likely far higher.

“I'm sorry for the things I done,” Hall said when I spoke to him by phone from the federal prison where he is now serving fifteen years. “I was brought up in the church and didn't want to hurt no one. But I was an out-of-control drug addict who didn't realize who I was hurting.”

With money and addiction urging them on, meanwhile, Floyd County addict-entrepreneurs were like bloodhounds sniffing out shady docs in far-flung places.

An oxycodone 30 mg pill cost eight dollars in Florida and could fetch thirty dollars back home. Florida had no prescription monitoring, so any pharmacist would fill a script. The first Floyd County guy to discover Florida was apparently Jim Marsillett II, who ran a stable of addicted women down to Fort Lauderdale in an RV once a week. Marsillett first ventured to Florida after federal investigators closed down the Urgent Care clinics in Philadelphia and Cincinnati, where he had been buying.

With the opening of the Florida territory, a new Appalachian migration began, south this time. Campers voyaged weekly down from the Oxy-wracked regions of Ohio, Kentucky, and West Virginia for doctor visits. The OxyContin Express was the name given to flights from Huntington, West Virginia, to Fort Lauderdale. By 2009, of the top ten oxycodone-prescribing counties in America, nine were in Florida. The other was Scioto County, Ohio, where Portsmouth is located. Broward County had four pain clinics in 2007 and 115 two years later.

Initially, Florida officials didn't seem too concerned as long as the hillbillies left their money and took the pills with them when they left. It wasn't until 2009 that Florida put in a prescription-monitoring system—the last state in the country to do so. By then, customers from as far away as Colorado were heading to Florida.

Yet it was hard-up folks from Ohio and Kentucky who discovered the Sunshine State. Randy Hunter, a Kentucky state police detective from Floyd County, ended up traveling the country, following the Floyd County pill migration. He made cases in New Orleans, Philadelphia, Houston, and cities in Florida against the shady docs and pain-clinic owners who sold to itinerant Floyd County addict entrepreneurs.

“We saw a lot of eastern Kentucky go out of state,” said Hunter, now retired, as he took me on a tour of the hollers of Floyd County one day. “They traveled like gypsies, roaming around looking for pills. When they found a honeycomb of pills, they stayed, and not only stayed, but they brought friends and family.”

 

More Cases Than Car Crashes

Southern Ohio

The gaunt addict known as Jeremy Wilder, from the town of Aberdeen, on the Ohio River, left prison and came home in 2007.

He was locked up in 2003 for breaking into pharmacies, his addiction out of control. When he left Aberdeen that year, the town possessed a small group of drug addicts to whom he sold his OxyContins. Now, four years later, his brother and everyone he knew was heading to Florida to buy pills. But things had gone far beyond pills. Many people in Aberdeen were on heroin. They wandered the small town half dead, proud of their needle marks.

“When I was selling Oxys, it was a certain group of people,” he told me. “When I come home, it was a certain group of people plus everybody else. Cops’ kids. Poor kids, rich kids, smart kids, dumb kids.”

The area had spawned a generation of young people who had nothing to look forward to, whose families had been unemployed for years. Many of these kids grew addicted. But kids at the bottom were not who moved the market. It was really the rich kids who did that. Jeremy sold to two brothers whose parents were well-off business owners in town. Another customer was going to inherit several houses.

From his place on the Ohio River in 2007, Jeremy Wilder could see the change. First pills, now heroin. Lots of both. But it was nothing anyone in an official position in Ohio recognized until, as luck would have it, some data passed across the desk of a guy in a state office cubicle up north in Columbus who liked being alone.

Ed Socie loved numbers.

Socie was an epidemiologist with Ohio’s department of health. He worked on the eighth floor of the department’s building in Columbus, in the Violence and Injury Prevention section. He followed data of deaths from violence and injuries. By mid-2005, he had been at his job for twenty-two years.

An admittedly reclusive fellow, Socie was fascinated with statistics and data and the stories hidden beneath them. He possessed enormous curiosity for the topic.

“I just sat at a computer all day crunching numbers on death data,” he said. “I enjoyed crunching the numbers. Out of curiosity, I looked at everything I could.”

By 2005, Socie was supervising data for a lot of hot-button topics. Among them were homicides and suicides, which rose and fell with some frequency. One number he counted on to stay put, however, was deaths from accidental poisonings. People just didn’t poison themselves to death all that much, nor did the numbers vary much from year to year.

So in 2005 Socie was startled to notice that poisoning deaths in Ohio were climbing.

His data came from the federal Centers for Disease Control. Ohio coroners’ death certificates are submitted to the CDC, which codes them according to cause of death and sends the figures back to the state for easier evaluation.

It all began with the figures for unintentional injury deaths. Sitting at his desk one day, Socie saw that deaths coded for unintentional injury were heading up. He dug further and found that most were coded as accidental poisonings. Why would they be rising? Intrigued, he kept digging into the CDC data and codes. The poisoning deaths, it turned out, were actually drug overdoses. This was new. Cocaine and methamphetamine—the popular drugs through the 1980s and 1990s—are damaging drugs, but people don’t often fatally overdose on them. Heroin, which people do overdose on, hadn’t been a sustained problem since the 1970s. Drug overdoses in Ohio had remained pretty constant for decades.

Socie graphed these new numbers. After remaining stable for decades, the deaths suddenly took off like an airplane, almost tripling in six years.

A good chunk of the deaths—known in CDC coding as X44s—were due to “unspecified drugs.” But an equally large segment—the X42s—were from narcotic overdoses. Socie began running his computer through its paces, asking about deaths from specific drugs: oxycodone, hydrocodone, heroin, cocaine, morphine, opium. Opiates were present in virtually all the deaths where the drugs were specified.

The numbers alarmed Socie. He showed them around the department. At first, his work “fell on deaf ears,” he said. “I got no feedback that this was something I should explore much further. I was a little disappointed because I thought it was important.”

Socie bided his time, watching as the numbers kept rising over the next eighteen months.

In January 2007, Christy Beeghly took over as the supervisor at the department’s violence and injury prevention unit. Beeghly was from a children’s hospital, where kids were injured from what was under the sink, not so much from what was in the medicine cabinet. But maybe it helped that she was not an old hand at violence and injury prevention. Socie brought out his data and charts showing the sudden increases in fatal drug overdoses. Ninety five percent of all Ohio poisoning deaths were drug overdoses; the greatest part of these overdoses was due to prescription pills.