What OxyContin Addicts in West Virginia Tell Us About the War on Drugs

A dire portrait of life on "hillbilly heroin," and its implications for the policy debate over prohibition.

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An excerpt from a new book by Chris Hedges and Joe Sacco describes a part of West Virginia where OxyContin is the drug of choice. "It was as if we were interviewing zombies," Hedges says, introducing Days of Destruction, Days of Revolt. "The speech and movements of those we met were so bogged down by opiates that they were often hard to understand." What follows is every bit as awful. For example:

The reliance on government checks, and a vast array of painkillers and opiates, has turned towns like Gary into modern opium dens. The painkillers OxyContin, fentanyl -- 80 times stronger than morphine -- Lortab, as well as a wide variety of anti-anxiety medications such as Xanax, are widely abused. Many top off their daily cocktail of painkillers at night with sleeping pills and muscle relaxants. And for fun, addicts, especially the young, hold "pharm parties," in which they combine their pills in a bowl, scoop out handfuls of medication, swallow them, and wait to feel the result.

A decade ago only about 5% of those seeking treatment in West Virginia needed help with opiate addiction. Today that number has ballooned to 26%. It recorded 91 overdose deaths in 2001. By 2008 that number had risen to 390.

Drug overdoses are the leading cause of accidental death in West Virginia, and the state leads the country in fatal drug overdoses. OxyContin -- nicknamed "hillbilly heroin" -- is king. At a drug market like the Pines it costs a dollar a milligram. And a couple of 60- or 80-milligram pills sold at the Pines is a significant boost to a family's income. Not far behind OxyContin is Suboxone, the brand name for a drug whose primary ingredient is buprenorphine, a semisynthetic opioid. Dealers, many of whom are based in Detroit, travel from clinic to clinic in Florida to stock up on the opiates and then sell them out of the backs of gleaming SUVs in West Virginia, usually around the first of the month, when the government checks arrive. Those who have legal prescriptions also sell the drugs for a profit. Pushers are often retirees. They can make a few hundred extra dollars a month on the sale of their medications.

The temptation to peddle pills is hard to resist.

The indispensable writer Rod Dreher alerted me to this reporting. Here's a small part of his response: "Ye who think that legalizing drugs will lead us all to a libertarian paradise should read Hedges' account of spending some time in the living room of these sad desperate men, and think about what in the world they could be good for in their current condition. How, exactly, would making it possible for them to obtain their pills legally change their lives for the better?"

I find that question frustrating, because the answers are so obvious to me, and the fact that Dreher isn't familiar with them means that the arguments of legalization advocates aren't being heard.

How would legalization improve on the status quo?

For some addicts, it wouldn't -- they'd be no better off, but no worse off either. The nightmare scenario described in the piece is, after all, what is happening after decades of the War on Drugs, amid an ongoing policy of prohibition.

For other addicts, legalization would mean less likelihood of death by overdose due to standardization of supply and dosage; getting high based on the safest drug that gets the job done, rather than the one most easily available, even if much more dangerous and addictive; no need to transact business with drug dealers, who are sometimes dangerous and violent; an ability to seek medical attention for oneself or one's family members without fear of arrest; and more opportunities for subsidized treatment, if even a fraction of the money spent on policing and incarceration were spent on social services. There's also the fact that fewer would face long prison sentences. And if you think once imprisoned they're clean, I suggest studying prison drug culture.

Of course, it isn't drug users alone who are affected by prohibition.

Lots of people who don't use drugs suffer from the violence that inevitably springs from black markets; some police officers are corrupted by the temptation of getting rich by allying with cartels; municipal police forces are arming themselves like paramilitary squads; all of our civil liberties suffer due to drug war-inspired legal innovations like asset-forfeiture law; money that could be put to better uses is spent incarcerating nonviolent drug offenders; and still drugs are easily available.

I don't think legalization or decriminalization will lead to "a libertarian paradise." I just think it will mitigate many of the ills I just mentioned. And I fail to see how whole communities destroying their lives under prohibition can possibly be invoked as an argument against a new approach.

This is the logic of the drug warrior: Were the drug problem getting better, they'd point to their approach and say we need more of it; and when the problem gets worse, it is used to justify more of the same. No matter what happens, the drug warriors call for a more intense War on Drugs. How's that going?

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Conor Friedersdorf is a staff writer at The Atlantic, where he focuses on politics and national affairs. He lives in Venice, California, and is the founding editor of The Best of Journalism, a newsletter devoted to exceptional nonfiction.

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