Guest post by Jacqueline Sheehan

I spent a year researching the link between OxyContin and heroin, and the pharmaceutical industry and street drugs. A large part of the information stayed in my head and didn’t make it on to the page (see book The Tiger in the House). The painful personal interviews were unsettling; the police officer who became addicted to pain meds and lost his remarkable thirty-two year career, the detective in Maine who tried his hardest to help people who had been sucked into the addiction vortex, the physician’s assistant who saw only patients who were addicted, and the case worker who said, “I miss the crack head mothers; they at least had a fighting chance.”

Courtesy of Kensington
Source: Courtesy of Kensington

I went down endless rabbit holes through Google, the statistics about middle class white folks getting addicted to pain meds and when they were finally cut off, they turned to street oxy (as much as $40 a pill, cash only please) until they couldn’t afford that anymore. Then they encountered a tipping point that probably every single person thought was as unlikely as being struck by lightning. They realized that heroin was far cheaper than street oxy, just little nickel bags, and so easy to get that any one of us could go downtown tonight and after a few awkward fumbles, could come home with our own tidy packets of heroin. And that $40 that they paid for one OxyContin? It will buy you enough heroin for three days.

There were more than 1,100 deaths by overdoses in Massachusetts in 2014. That is staggering. How did this happen?

Being addicted to pain meds is like having an invader in your brain with OCD, reciting an endless repetition of what must be done, how, and how often. That’s what the ex-cop told me. Sitting in his upscale dining room with a few of the rolling hills of New England, after two rounds of treatment centers, he said, “Did you know that OxyContin is only one molecule away from heroin?”

When I worked at a college counseling center ten years ago, I could have seen what was starting to happen if I’d put two and two together. I tended to veer away from addictions because my older brother was an alcoholic during my childhood and I didn’t want to revisit the helplessness that I felt back than. Give me depression, anxiety, generations of loss, a vibrant eating disorder, or a good solid panic attack. I knew these afflictions and could offer help. But alcohol and drug addictions, not so much. I referred them elsewhere because I was not one bit helpful. I knew all about AA and NA as a resource and lord knows I sent enough people in that direction, off to work the steps.

Then I saw a few clients who had been injured, one in a car accident, the other a sports injury, and during the course of their recovery from serious injuries, their doctors prescribed pain meds. One client was a junior in college when she first came to counseling. She had been in a car accident and her injuries were healing slowly. When her doctor said, this is as good as it’s going to get for you, she knew that she still needed the pain meds. She went to various emergency rooms complaining of severe back pain, leg pain, and they’d write another script and another. One time she said to a doctor, “I think I’m addicted to these.” He must have looked at this lovely, white, blond college student and thought, no way. He wrote her another script. By the time she graduated, she was still getting oxy any way she could, including stealing them from friends and family. What I didn’t know was that this was happening all over the country, multiplied by 50 states, times 100 towns.

The drug industry couldn’t make OxyContin, Percocet, Percodan and all the rest fast enough.

Pain meds seemed like a miracle. Who can stand to see people in pain? Especially if you’re a doctor and confident that you can monitor the situation with a patient, help them through the rough patch and get them back on their feet again.

When my mother suffered through years of unrelenting pain from spinal fractures, I would have done anything to alleviate her pain. I would have mugged the first heroin pusher I could find to save her from eight years of mismanaged suffering. I get it. I get why doctors handed out pain meds like a miracle drug. It was the end to suffering.

But here’s what happens. Maybe you’ve had a rotator cuff surgery. Boom, you get addicted. Your doctor says no more. Boom! You start peeking in everyone’s medicine cabinet looking for pain meds. Boom! You buy it on the street. Boom! You try heroin, not shooting it because that would be stupid; you snort it. Boom! You shoot it. And there you are in your two-story house in white American shooting up between your toes so no one will notice.

There is ginormous money to be made because heroin expanded to the suburbs and rural areas in Maine, Vermont, and Massachusetts. Organized crime couldn’t have planned it better. Flood the market with an addictive but socially acceptable drug, covered by insurance, then cut them off, raise the price of street opioid, and finally offer a cheaper, although illegal and deadly alternative at a huge profit margin.

While it is being called a crisis, it is hard not to see the stark difference now that heroin has white victims. When the problem was more confined to inner cities and people of color, it was not a crisis, but a symptom of personal weakness and poverty. Funny how it’s a pandemic now that heroin has crossed the color line.

Many people are as ill-prepared to deal with the addictive power of pain medication as my young student of ten years ago, or the highly decorated police officer whose brain was held hostage by addiction. The brave people who spoke with me, abusers of pain medication, professionals in the medical world, and police officers helped me understand their struggle.

But fiction is a good place to tackle heroin. Believe me, you want an avatar to take on heroin. You don’t want to touch it yourself.

Jacqueline Sheehan is the author of The Tiger in the House.

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