Folks in Tazewell County know they better keep their eyes open, their toolsheds locked and their barn doors shut. Junkies, addicted to prescription pills and looking for anything to steal to pay for their next fix, have turned this 520-sq.-mi. patch of Appalachian Virginia--a bucolic tangle of wooded mountains, steep hills and rolling pastures dotted with sagging barns and country churches--into a society plagued by pilferers. They swipe guns from unlocked cabinets and push motorcycles out of garages in the dead of night. They swap or sell stolen watches, lawn mowers and sneakers for potent painkillers like OxyContin.
The drug first became a problem in Tazewell in 1998, but its national reach is well known, ensnaring even radio impresario Rush Limbaugh in a scandal that sent him into rehab. Around the nation, the statistics tell the story. A Jan. 21, 2005, report from the federal Substance Abuse and Mental Health Services Administration found that the number of people who had used oxycodone, the main ingredient in OxyContin, for nonmedical reasons jumped from 11.8 million in 2002 to 13.7 million in 2003. The increase happened even though OxyContin's maker stopped distributing its strongest pill, the 160-mg tablet, in 2001 and more states began prescription-monitoring programs to detect abusers who go from doctor to doctor looking for pills. In December the Drug Enforcement Administration announced a toll-free number to report the illegal sale of prescription drugs.
Federal authorities are at a loss to explain why prescription-pill abuse pops up in some places and not in others, and why places like central Maine, eastern Kentucky and southwestern Virginia--where OxyContin abuse first emerged as a problem--are awash in drug-related crime. But Sheriff H.S. Caudill says a clue to how it all began in Tazewell lies in one of the original nicknames for OxyContin: coal miner's cocaine. Retired miners with back injuries were among the first in the area to use the powerful drug, and as word of its effectiveness spread, abusers began diverting it, selling it for up to $1 per mg, Caudill says. "We're seeing a lot of elderly people dealing drugs," he says. "A lot of people are retired or on disability, and they think, Well, if Paw-paw can sell his pills, that's $2,400. And if Maw-maw can sell hers, that's $4,800." Census Bureau data support Caudill's notion: 12,481 of the county's 44,362 residents claim some sort of disability. If coal miners gave OxyContin its start in southwestern Virginia, injured steelworkers were among the first to use it in eastern Ohio, where its illicit use remains a serious problem, says Jennifer Bolen, a former federal prosecutor in Tennessee who advises physicians around the country on the laws governing the prescription of potent painkillers.