Pubdate: Sat, 07 May 2016
Source: Age, The (Australia)
Copyright: 2016 The Age Company Ltd
Contact:  http://www.theage.com.au/
Details: http://www.mapinc.org/media/5
Author: Andrew Purcell

SEA CHANGE AS DRUGS SCOURGE GRIPS WHITE AMERICANS

Addiction to painkillers is putting many Americans on a road that 
leads to heroin and an early grave, writes Andrew Purcell.

The United States is in the grip of an unprecedented epidemic. In 
2014, more than 47,000 people were killed by an overdose  more than 
were killed by guns, or died in traffic accidents.

" This is the worst drug addiction epidemic in United States 
history," says Andrew Kolodny, the chief medical officer of Phoenix 
House in New York. Phoenix House was founded in 1967 by six heroin 
addicts who resolved to kick the habit together and has grown to 
become the nation's leading provider of drug- abuse treatment.

It has seen heroin, crack cocaine, methamphetamine and PCP plagues 
come and go, but nothing compared to the current wave of opiate addiction.

For the first time since the Vietnam War, life expectancy is falling 
for whites. Drug use is among the primary factors. Five times as many 
whites aged 25 to 34 were killed by an overdose in 2014 as in 1999.

" Now that an epidemic is affecting mainstream white America, we're 
seeing attitudes change," says Dr Kolodny.

Republicans Ted Cruz, Jeb Bush and Carly Fiorina have spoken of the 
destructive impact of addiction on their own families. In March, the 
Comprehensive Addiction and Recovery Act passed in the Senate with 
rare bipartisan support.

At a recent drug abuse summit in Atlanta, US President Barack Obama 
called for $ US1 billion ($ 1.3 billion) in additional funding to 
combat the epidemic. He acknowledged that the shift towards treating 
rather than jailing addicts would be a bitter pill for 
African-American and Latino communities decimated by the " war on drugs".

In short, when the addicts were black and brown, addiction was a 
moral failing. Now that they are white - like 90 per cent of new 
heroin users in the last decade - it is a disease.

" The language is very different, because this epidemic is affecting 
the communities where politicians live," Dr Kolodny says.

" Pharmaceutical companies have created a market for the illegal drug 
cartels by increasing the number of Americans who are opioid 
addicted," he continues. " You now have markets for heroin where 
previously, nobody wanted heroin."

Lindenhurst, a beachfront commuter town on Long Island, an hour from 
New York, is one such community. As we pull up outside Teri Kroll's 
house on Walnut Street, two young men sitting in an idling car assess 
us with a look and slowly drive away.

Teri lost her son Tim to an overdose seven years ago. A " Timmy 
Blanket" made from scraps of his clothes is draped over a chair in 
her living room.

" This generation is really sick," she says. " It's sad when you talk 
to somebody in their late 20s. They know so many people who have this disease."

Three in four new heroin users graduate to the drug from painkillers 
such as Vicodin and Percocet. Tim was prescribed them to treat 
migraine headaches when he was 18.

In four months, he tried seven different drugs before arriving at the 
strongest prescription opioid, OxyContin 80. He became moody and 
withdrawn. When his parents took him to their GP, the doctor told Tim 
to stop taking the pills immediately. Instead he began to buy them on 
the black market. Eventually, he turned to heroin. He tried to kill 
himself several times. One afternoon, as Teri was at her church, 
asking the priest for advice, Tim closed the garage door and started 
the car. Teri found him passed out and rushed him to Nassau County 
Medical Centre.

When Tim came out, he was clean, and as far as Teri knows, he 
remained clean until the night eight months later when he came home, 
shut his bedroom door and took the dose that killed him.

At first, Teri told friends her son had died of heart failure - she 
had seen it for herself, after all, in the emergency room, as 
paramedics tried desperately to revive him - but at his funeral, 
everyone knew what had stopped his heart.

Teri is now an outspoken advocate for tighter prescription controls. 
Last summer, she led 1000 people on a march, Long Island United For 
Recovery. A national event at the mall in Washington DC, Unite To 
Face Addiction, attracted an estimated 30,000 people.

In May 2015, the chief of police in Gloucester, Massachusetts, 
Leonard Campanello, unilaterally declared that the " war on drugs" 
had been lost in a Facebook post that has been viewed more than 2 
million times. His "Angel" initiative, which directs addicts to 
treatment rather than lock-up, has been adopted by scores of police 
departments.

The Comprehensive Addiction and Recovery Act is full of such worthy 
schemes, but it fails to address the epidemic's cause: rampant over- 
prescription of painkillers.

The market for prescription opioids is worth more than $ US2 billion 
a year. Purdue Pharma initially marketed OxyContin as non-habit- 
forming and abuse-resistant. In 2007, the company paid a settlement 
of $ US600 million for this " misbranding"  an amount recouped in 
seven months of sales.

Three years later, the Food and Drug Administration obliged Purdue to 
reformulate OxyContin, so that the pills could no longer be crushed 
and snorted. It was an effective tactic, a decade too late.

Spotting a growing market, the Mexican cartels had begun to import 
record amounts of cheap Colombian heroin. " They're flooding the market.

It's a business move," says James Hunt, who leads the New York 
division of the Drug Enforcement Administration.

" You'd have a tough time finding somebody in the United States right 
now that doesn't know somebody, or have a friend, or the child of a 
friend, who's addicted to heroin," says Hunt.

Michael Ferraro, a former stockbroker, lost a wife, a home, two 
holiday houses and five cars to an addiction that began when an 
employee showed him a little green pill - OxyContin 80 - and said " 
you gotta try this". Soon he was taking 10 a day, at $ US50 each on 
the black market.

" You know if you put a frog in water and you turn it up slow and he 
doesn't realise he's screwed until it's too late? That's what the 
painkillers are like," Ferraro says.

After he was arrested trying to buy pills from an undercover cop, he 
started going to doctors, showing them an MRI scan of his herniated 
disc and circling the crying face on the pain chart to indicate that 
he was in agony.

In June 2011, a painkiller addict, David Laffer, killed four people 
in a botched robbery at a pharmacy on Long Island. The next time 
Ferraro went to see one of his " four or five" doctors, the GP pulled 
up an electronic record showing that he had been prescribed the same 
drug at a different clinic a few days earlier. Ferraro turned to heroin.

He rolls up his shirt to show me the track marks on his arms. " When 
you start to inject heroin, you know that your life is unmanageable," 
he says. " You can go to a doctor, go to a pharmacy and think ' it's 
OK', but when you're meeting the guy on the street before you go to 
work and injecting heroin in parking lots . . ."

These days, he attends an Alcoholics Anonymous meeting every morning 
at 6.30. He has a new girlfriend, a career as a medical insurance 
salesman and a baby boy. Although he lost everything, it could have 
turned out much worse.

" Kids are dying everywhere. Beautiful kids from healthy families. 
It's becoming a normal thing now," he says. For support and 
information about suicide prevention, contact Lifeline on 13 11 14, 
Kids Helpline 1800 55 1800, and beyondblue
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MAP posted-by: Jay Bergstrom