When the boom crane snapped its moorings and fell on Joe* in the wet, muddy Chicago fall of 1988, it was a bad start to a long Thanksgiving weekend. "It took three guys to lift the crane off me," Joe says, "but I was fine. Muddy, sore and cold, but fine. I mean, I thought I was fine." He wasn't. And 15 years, eight surgeries, two screws in his neck, five pins in his spine and another big plate in his neck later, he knew it.
In 2003, the screws in his neck popped out and the drugs he was taking for the pain were no longer working. "One day, you're a citizen, taking your meds as prescribed, doing what you're told, all that," Joe says. "Then the drugs stop working and you know it's illegal to get more, so you start changing the way you take them."
Joe — who had moved to Sarasota a few years after his accident — started crushing up his Roxycodone first. "Once you cross that line," Joe says, "it is unreal how fast shit starts to unravel." From crushed and swallowed, to smoked, to snorted, to melted down and injected. "I don't remember the timeline," Joe says, "but no matter how I took them, I just wasn't getting enough." And the issue went from pain to full-blown addiction.
WITH 100-PERCENT disability checks rolling in on a regular basis, Joe devoted his attention to his "pain management," and he met a lot of doctors. Because of the way the law works in Florida, Joe could get as many prescriptions filled as he wanted, but he could only get one prescription a month from any one doctor. To maintain his growing addiction he needed to find as many doctors to prescribe for him as he could.
"Ninety-five percent of these 'pain management doctors,'" says, lifts his hands and does the quote sign, "are crooked. All these ads you see on the backs of magazines like Creative Loafing, these guys, they don't accept health insurance so they don't have to have malpractice coverage. They only take cash or credit cards. A lot of them, they open up their own pharmacies in their offices. Often they don't open until the evenings when their clients get up and they won't accept patients under 25."
Joe named no specific advertisers, but said that checking the back page of the local alternative weekly is a common practice among users. "Every time I needed another doctor I just went out and picked up a Creative Loafing," Joe says. But there are plenty of other avenues as well: "You have to go by word on the street and local pharmacies," Joe continues, "because by the time there is any info on the Internet the place is usually already closed down or moved. It's a secret society and everyone who doctor-shops talks, so word travels fast about who the good doctors are." Good doctors meaning the ones that will prescribe the most pills in the fewest visits.
"I'd be in a doctor's office," Joe says, "it's 7 o'clock at night in August and the waiting room is full of people in sweatshirts, shivering their way through the first stages of withdrawal," Joe says. "I remember paying $800 for $400 worth of prescriptions right there in the office. Walking out and thinking: 'This shit is really, really fucked up.'"
The Sarasota County Sheriff's Office thinks so, too, which is why in November 2009 they launched their pharmaceutical investigation unit to crack down on prescription fraud and doctor shopping, and to minimize the number of overdoses. This sheriff's unit, combined with new legislation that monitors prescriptions, may have put an end to Joe's spiral, but at the time, there was very little oversight.
"Sometimes, you know, one of the 5 percent legitimate docs would request my prescription history. But, because the pharmacies, none of them are linked, I would walk in with my three-month printout from just one place," Joe says. He lights a cigarette and combination-laughs-and-coughs out a roomful of smoke. "That was the hardest part about the whole thing. Keeping the damn pharmacies straight." He shakes his head and points a finger in my direction. "You walk into the wrong pharmacy at the wrong time and they will call 911."
The "Pill Mill Bill" that Charlie Crist signed into legislation last summer aims to link pharmacies through a common database, tracking each patient to make sure they are buying only the amount of drugs allocated by one doctor for a given period.
The bill will also prohibit pain management doctors from prescribing more than a three-day supply of pills to clients who pay by cash, check or credit card. But for now, there is still nothing to stop addicts from acquiring as many pills as they desire.
"How much and what were you actually taking?" I ask Joe and his wife Lynn* — whom Joe met in 2001 while doing kitchen remodeling, his last job. Each picks up a lit cigarette from the ashtray; leans back into the brown sectional couch in their clean, well-lit living room; looks at the other and then back to me.
"Between the two of us," Joe says, "we were going through 300 30-milligram pills of Roxycodone a day. We would cook 20 30-milligram pills at a time." (Roxycodone is Oxycontin without the time-release effect.) I silently do the math in my head as they watch: about 9,000 milligrams a day, almost 300,000 milligrams a month. "Pure insanity," Joe says and looks at Lynn.
To obtain this quantity of drugs, Joe tells me, they were "shopping" 26 different doctors in Manatee, Sarasota, Hillsborough and Pinellas Counties. "One guy," Joe says, "in Pinellas County, he was a gynecologist, pulled from retirement to write prescriptions for a pain clinic up there. A lot of the places are owned by groups of investors, using anyone they can find for their medical license."
Lynn leans forward and interrupts Joe, saying: "The tolerance. You have to understand how insanely fast your tolerance goes up."
To do those kinds of drugs and maintain functionability, the pair mixed in some cocaine to keep them functioning at a level high enough to make their appointments and keep their pharmacies straight. The coke sales brought the pair closer to hitting bottom.
Joe and Lynn started keeping company with low-priced call girls and crack addicts. Their jobs long gone, they were making enough money selling pills and coke to maintain their own supply of drugs. But the crack houses and dives they were living in brought attention from the police. The cops raided one house where the pair was crashing. "We'd just shot up and the police burst in the front door," Joe says. "Instantly we're sober." Lynn nods enthusiastically. "The cops search the house," Joe continues, "search all of us, take all the drugs they find and as the last cop is walking out the door, he turns back, and I swear he stares right at me and goes: 'You'd be better off if we just took you out to the pasture and put a bullet in your head.' I'll never forget it."
THE RAID CHANGED nothing. And by 2007 the couple was buying 30-milligram Roxys for 72 cents apiece and selling them for $15. Over the next 18 months, till the time of their arrest, Joe says, "We went through about $2 million in pills."
Joe and Lynn were taking so much Roxycodone their ability to survive was fading. Lynn tells me she had an accident and broke her collarbone. "I finally went to the hospital and it turned out to have been three weeks since the accident," she says. "I remember thinking there is absolutely no way three weeks could have gone by, but the medical staff had no doubt. Apparently the bone was snapped completely in half and had already started to heal incorrectly. I'd felt absolutely nothing."
"That was rough," Joe says, referring to Lynn's brief hospital stay. "The nurses would walk in on us shooting up, scowl and slam the door — not cool. But we were beyond caring," Joe says. "Around that time, we were in Fort Myers getting a script and we were sick as fuck. So I come out of Walgreens with my script of 480 Roxy 30s — we forgot the pill crusher and didn't have any pliers so I put a handful in the paper bag from the script and folded it up and knelt down right there in the parking lot of Walgreens and beat the pile with a tire iron. Lynn was yelling at me and I was like, 'What the fuck, you want to get straight, right?' I just didn't fucking care about anything other than getting that dope in my arm to not be sick anymore."
The incessant shooting up also took its toll — the couple's arms are covered in track marks. Joe picked up a bad case of Methicillin-resistant Staphylococcus aureus (MRSA), an infection not uncommon to intravenous drug users. "The MRSA got so bad," he says, "you could hide stacks of quarters in my arms." He holds out his arms. It looks like he put them into a campfire and held them there. He points to his legs. Dark scars, the size of silver dollars, all puckered and angry, stare back at me. To control the infection, Joe performed what he calls "bathroom surgery." He would cut away the dead skin on his arms and legs with cuticle trimmers and pour hydrogen peroxide over the wounds. "I'm lucky I didn't die from the MRSA alone," Joe says. "Really, I have no right to be alive."
Not all addicts share Joe's luck. Russell Vega, the medical examiner for Manatee, Sarasota and DeSoto Counties, says that in 2009 there were 73 accidental prescription drug overdose deaths in Sarasota and 56 in Manatee. According to Hillsborough County's Consumer Protection Agency, two to five deaths involving Oxycodone occur every week. And in Pinellas and Pasco Counties, the number of deaths involving Oxycodone rose more than 400 percent from 2000-2008.
It might have been police intervention that helped Joe and Lynn avoid joining those statistics.
LYNN WAS OUT picking up some pills when she got pulled over. She called Joe from the truck, with the police behind her, running her license. "I've been pulled over," she told Joe. "I've got warrants, but they've been asking me where you are."
Joe, at home on the couch with a prostitute friend named Tia, said, "Well, don't tell them where I am," and lit a cigarette. The pair hung up before the police came back and arrested Lynn.
"I was still smoking the same cigarette when I heard the helicopters. I was like, 'No fucking way, really?' Tia the hooker looked at me, said, 'Good luck man,' and ran out the sliding door into the backyard. … The chopper kept getting closer. I'm pacing, smoking that cigarette down, just running over in my head. No. Fucking. Way. No. Fucking. Way. It was totally surreal."
When the propellers' whoosh started knocking the palm fronds into the pool cage, the reality became impossible to ignore. SWAT stormed through both the front and back door at the same time and threw Joe to the floor, burning cigarette butt and all.
"They didn't want to touch me with the staph infections and MRSA all over me," Joe says. "My lymph nodes were so swollen from the infection I could barely move my arms. They finally had to link two sets of cuffs together because I couldn't get my arms behind me." The police took him to the Sarasota County jail; they sent him straight to the hospital.
Joe was caught with prescriptions from three doctors and was looking at up to 15 years in prison. The prosecutor and Judge Deno Economou listened to Joe's public defender when he asked the court to give his client one chance to help himself. "The judge actually cussed me out in court," Joe says, "but bless his ornery soul, he gave me a break. He gave me my one chance and I'm not going to waste it. Oh, and without [Narcotics Anonymous] there is no way I could have done this. None." Joe wants to remain anonymous, as N.A. requires, and he is deeply grateful to his sponsor.
In April 2008, Joe pled guilty to fraudulent possession of a blank prescription form and was released with credit for time served. He's been clean since.
Lynn went through her own ordeal. After her arrest in 2008, she received probation. While on probation, she tested positive for opiates and was sent to drug court. In July 2009, at her court date, it was revealed that she was pregnant. She was sentenced to court-ordered methadone treatment. Joe and Lynn's baby, Faith, was born in mid-April. "I've been sick before," Lynn says. "I've gone through withdrawal, all that, but to listen to my newborn baby scream from methadone withdrawal, no other pain in my life has ever come close to that."
Faith is home now, born premature; she's hooked up to a heart and respiratory monitor 24 hours a day. (Some studies report that methadone infants have a higher rate of Sudden Infant Death Syndrome.) Joe looks down at his daughter, all swirls of brown hair, pink blanket, pink jumper and the tiniest most perfect fingers imaginable. Wires run from her small body to a square box on the coffee table.
"My 14-year-old daughter just got out of rehab," Joe says. "Every one of my kids has gotten messed up with pills. And yeah, that's probably my fault, but it's not just my kids. It's not like when I was a kid, a little pot, a little acid. These kids got habits for real. And when it's as easy as calling the number on the back of a newspaper to get drugs, how do we stop that?"
*Not their real names
This article appears in Jun 3-9, 2010.