PLAYBOY FORUM - Hollow

PLAYBOY FORUM
Tom Hatcher, mayor of the mountain town of War,
West Virginia, has been keeping a tally for the past
few years of the local folks killed by drug overdoses.
One family has lost three daughters. Another has buried
two brothers. An 83-year-old woman is raising the grandson
left behind after the deaths of her son, daughter-in-law
and granddaughter. Hatcher’s nephew fatally overdosed
in 2010 in a shabby apartment right across the street from
Hatcher’s office. And dozens more.
For an area that’s home to only about 6,000 people, it’s
an astonishing body count. Almost all died not from a
lethal hit of heroin or cocaine but from legally manufactured
prescription pills. “There isn’t a family that hasn’t
been affected,” says the silver-haired Hatcher, sitting
in his office
in War’s city
hall. “We’re
just overwhelmed
by
prescription
drugs.”
War is in
the hottest
hot zone of
a lethal epidemic
that has
spread across
A m e r i c a .
More people
now die from
overdoses
of pharmaceuticals—
primarily
opiate-based
painkillers
such as
OxyContin,
Vicodin and
methadone—
t ha n f rom
OVERDOSE COUNTY, USA
why do prescription drugs kill so many people?
War, West Virginia
heroin and cocaine overdoses combined. Painkillers are
an enormous help to those suffering from cancer, injuries
or other serious conditions. But too often, instead of
improving lives, pills are ending them. Fatal painkiller
overdoses quintupled nationally from 1999 to 2008 (the
most recent year for which statistics are available), reaching
nearly 15,000 a year. Prescription drug overdoses
now kill more Americans every year than car crashes.
No place is harder hit than McDowell County, a remote
corner of Appalachia that includes War. Once coal country,
it’s now an impoverished rural backwater. Since most
of the mines shut down in the 1980s, an abundance of
pills—coupled with unemployment, hopelessness and a
lack of treatment services—has driven drug use, and overdose
rates, through the roof. People in McDowell County
By vince Beiser
are dying of prescription pill overdoses at a rate 20 times
higher than in the rest of America.
The rising death toll is a side effect of the increased
use, both legitimate and otherwise, of pharmaceuticals.
Sales of narcotic painkillers have grown sevenfold since
the 1990s. During that decade, regulations controlling
opiates were relaxed, making it much easier to get a
prescription. Meanwhile, pharmaceutical companies
began to push their products more vigorously.
In 1997 the FDA cleared the way for companies to advertise
pills on TV and radio. That made the U.S. one of only
two countries that allow prescription drugs to be advertised
on prime-time television. The pharmaceutical industry
now spends roughly $4 billion every year on ads. Even
after recent
c u t b a c k s ,
the number
of sales representatives
the industry
deploys to convince
doctors
to prescribe
their products
has g rown
by 50 percent
since the
mid-1990s.
The industry
also doles
out research
grants and
hosts allexpenses-paid
“educational”
retreats in
vacation
spots.
All of which
has paid
off. In 2010
Americans spent a record $8.5 billion on narcotic painkillers,
including $3.1 billion on OxyContin. With huge
profits at stake, drug companies can be reluctant to let
truth interfere with their sales pitches. Purdue Pharma,
which makes OxyContin, was fined $600 million in 2007
for encouraging doctors to overprescribe the drug and
deceiving the public by downplaying the risks of addiction
and overdose. The following year, Cephalon, Inc.
paid $425 million to settle a federal investigation into
its marketing of a fentanyl-based painkiller.
“They’re just drug dealers,” says Claude Adams, chief
firefighter in the McDowell County town of Berwind,
whose department responds to more than 300 overdose
calls every year. “They couldn’t care less who dies.”
Many users assume pills can’t hurt them—after all,
39

40
they’re legally prescribed medicines.
One study found that
40 percent of teens surveyed
considered prescription drugs
“much safer” than illegal ones.
More than a quarter thought
painkillers weren’t addictive.
In fact, such pills can deliver
a high stronger than heroin’s.
That makes them tremendously
appealing to drug abusers, and
tremendously addictive. Worse,
they can kill if mixed with
other medications or alcohol.
The traffic in pills is especially
hard to stop because,
unlike street drugs, most pills
are purchased legally at first,
from ordinary pharmacies.
Thanks to the high injury rate
in coal mining, West Virginia is
awash in legally acquired pills,
says Wayne Coombs, executive
director of the West Virginia
Prevention Resource Center.
“Many people start out with a
legitimate prescription and get
addicted,” he says.
Locals “from teenagers to
80-year-olds” have learned
there’s good money to be
West Virginia is awash in OxyContin.
made selling their extra pills,
says Mark Shelton, chief field
deputy with the McDowell
County Sheriff’s Department.
Or users can simply find an
unscrupulous doctor, claim an
injury and come home with a
load of painkillers. “Dealers
will rent a van and take 14 or
15 people to North Carolina
or D.C. to see doctors they
know will help them out,” says
Shelton. He’s all too familiar
with the damage those drugs
can cause: He has been raising
his own teenage nephew
since the boy’s mother died of
an overdose.
“Ninety-five percent of
the people in this town are
FORUM
dopeheads,” says Brandon Pendry,
a 23-year-old pill user in
War. His father and one of his
friends died of overdoses, and
Pendry says he was recently
hospitalized when he snorted
cocaine that had been cut
with too much methadone. I
meet him on the porch of the
War Hotel, a flophouse that is
one of the few businesses on
Main Street that haven’t been
boarded up. Pendry interrupts
our conversation to offer to sell
pills to a passing friend. “It’s
the only way to make money
here,” he says.
Addicts trying to quit are
pretty much on their own.
There isn’t a single rehab facility
in McDowell County, and
there’s a chronic shortage
of treatment beds statewide.
“Unless you’re nine months
pregnant with a needle in
your arm, you’re not getting
treatment,” says Kathie Whitt,
executive director of FACES, a
McDowell County family services
agency. She and Hatcher
have for years campaigned
for the state to fund
a rehab center, so far
with no results.
Even treatment
doesn’t guarantee anything.
Mayor Hatcher
knows that from personal
experience. His
son John has been
hooked on pills for
years. Hatcher has twice
put him through rehab
clinics in other states,
with little to show for
it. John, 36, is unemployed.
He lives with his wife
and 11-year-old son in a spare
room in his father’s modest
house. Hatcher keeps his bedroom
door locked because John
has stolen things to sell for pill
money. “I hate living like this. I
hate being an addict,” says John.
“But I can’t shake it.”
He’s overdosed four times
in the past few years but each
time received medical treatment
before it was too late. Tom
Hatcher doesn’t think his son’s
luck will last. “I think the reality
is he will kill himself eventually,”
says Hatcher. “We see so much
of this here. A lot of people say
there’s nothing we can do. But
we can’t stop trying.”
A fAkE CRiSiS
why we shouldn’t oBsess
over our Budget deficit
BY jONAThAN TASiNi
A
president warns the
nation of a looming
threat to national
security. A congressional
bipartisan wave builds to
meet the threat, spurred
on by the editorial boards
of leading newspapers and
backed by reams of policy
papers. The nation hurtles
forward to face the
enemy. Dissenting voices
are drowned out.
Does this sound like the
hysteria leading up to the
Peter Peterson
Iraq war? Indeed. But this time it’s the growing
drumbeat around the debt “crisis.”
There is no debt crisis. We have been summoned
to the barricades to combat a mirage artfully
built with phony evidence proffered by political
leaders and gobbled up by the very serious
people in power. Some of these people also told
us housing prices would never go down, the Dow
would reach 30,000 and Bernie Madoff was an
investing genius.
The solution to this “crisis,” say the very serious
people, is austerity: Cut “out-of-control” spending
on pensions, Medicare and roads. If you say “Social
Security is in crisis,” you are treated as a serious
person—even though the actual numbers show that
Social Security will be entirely solvent for many years
to come and hasn’t contributed a single dime to the
debt “crisis.”
We do have a major crisis. The people who
run our markets and our companies have failed,
breaking basic rules we lived by. While they enriched
themselves, they turned our country into
a place where economic fairness is evaporating.
Our political leaders have abandoned us because
of the legal but corrupt system of raising money
for campaigns, which means they serve the powerful
interests that write big checks.
Big corporate interests have hurt the economy,
making inefficient use of our nation’s wealth at
great cost to our financial stability. Chief executive
salaries of tens of millions of dollars—which
empty corporate treasuries and leave nothing for
average workers—exist because our leaders have
enabled a corporate governance system that allows
such looting.
The truth: Right now we need large deficits.
We have a huge hole in spending because people
don’t have jobs and thus can’t spend money. Deficits
finance jobs when our economy goes down
the drain. Deficits finance roads—that our children
will use to get to their schools and, in the
future, to their jobs. Deficits finance schools—so