Sick and Dying In Small-Town America

December 30, 2016

Nine women live in the little house by the railroad tracks. It’s early fall, and they’re sharing three bedrooms and a single bathroom. They rise each day at 6 a.m., brush their teeth, eat breakfast together and then get into a van to ride a half-mile to all-day group therapy. At dusk they’ll be back, typically sitting on the porch, smoking cigarettes and watching the trains go by.

The conductor will blow the horn. The women will wave, cigarettes brightening with the motion. It’s a nice little ritual, and routines like this — “repetition and reward,” as the counselors say — are encouraged for people in recovery from heroin and opioid addiction.

These women dream of returning to normal life. Several have children but lack custody of them. In the grip of addiction, they traded away what they loved most in life for transient jolts of euphoria.

Traci Andrus, 45, is known as “Mom.” She had been a city social worker until she needed routine surgery and became hooked on opioid painkillers. Familiar story: The pills led to cheaper heroin, she says, then to all manner of chaos and dysfunction, and unemployment, and jail, and finally this new existence in the little house by the tracks.

“I had a home. I had a brand-new car. I had a life,” Andrus says.

Rachel Kerner, 39, is tall, striking and known as “Fancy” because she’s always dressed to the nines. She had a good career as a flight attendant, but she used cocaine recreationally, failed a drug test and lost her job. She also lost a child three weeks after giving birth, and she began abusing prescription opioids. “I didn’t really deal with my son’s death until I got into rehab,” she says.

Lisa Touvell, 49, had steady factory work for years but has always struggled with addiction and a decade ago made the transition from pills to heroin. “I gave up. I couldn’t find a job. Two failed marriages. My kids were taken away. I gave up,” she says. She wound up in prison for drug trafficking, and she was released in March.

“I’m tired,” she says, persuasively.

These women are trying to survive an epidemic of self-destruction in small-town and rural America. Death rates have risen sharply among whites, particularly women, particularly those with a high school education or less — the white working class that played a key role in the November election. Last year, overall life expectancy in the United States fell for the first time since 1993, when HIV was rampant.

Today there is no emergent virus running amok. Instead, Americans are dying from a rash of pathologies, sicknesses and addictions that experts call “diseases of despair.”

Opioids come in many forms, from prescription painkillers to street heroin. Fatal overdoses from prescription opioids have quadrupled since 1999 and heroin overdoses have gone up about sixfold since 2001. But other drugs also play a role. A Post analysis of federal health data found that white women are five times as likely as white men, for example, to be prescribed drugs for anxiety in tandem with painkillers, a potentially deadly combination.

Meanwhile, the suicide rate among middle-aged white women has risen in parallel with prescriptions for often-ineffective psychiatric drugs. Both have roughly doubled since 1999, The Post found. According to federal health officials, nearly 1 in 4 white women ages 50 to 64 are being treated with anti-depressants.

Binge drinking is also on the rise, as women close the gap with heavier-drinking white males. As a result, The Post found, alcohol-related deaths have more than doubled since 1999 among white women ages 35 to 54. Booze is also a factor in myriad opioid overdoses.

The federal government’s response to the opioid epidemic has been slow and halting. The Centers for Disease Control and Prevention issued new guidelines urging doctors to sharply limit opioid prescriptions only this year — fully 20 years after OxyContin, the pill that helped spark the crisis, gained regulatory approval.

Law enforcement agencies have been largely ineffective. Amid pressure from the drug industry, the Drug Enforcement Administration curtailed an aggressive campaign targeting drug distributors suspected of shipping millions of opioids that wound up diverted to the black market, The Post found. Federal officials have said they are committed to combating the epidemic but are focusing more narrowly on doctors, pharmacists and companies that continue to violate the law.

Chillicothe (pronounced “chill-i-COTH-ee”) lies in Ross County, population 77,000. Last year, 40 people here died of drug overdoses, almost all from opioids. That number has tripled in the past three years.

“Forty overdoses? This, in a little sleepy county?” says John Gabis, the county coroner. “You’ve got to talk to one more parent who’s lost a child?”

Read More

0 comment