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Sunday, 02 October 2011 15:46

Medicare: The Basics

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Medicare and you

By: Nancy Mann Jackson 

How it works: Established by the Social Security Act of 1965, Medicare is a social insurance program that provides health insurance coverage to people who are 65 and over and others who meet special criteria (such as having a permanent physical disability). The basic Medicare plan pays up to 80 percent of medical costs; by adding a Medicare Advantage plan, individuals over 65 can receive more complete benefits. 

Toni Bernhard

In May of 2001, I got sick with what the doctors thought was an acute viral infection. But I didn't recover. As the months went by and I didn't get better, I felt as if I'd entered a parallel universe that I didn't know existed. One reason this universe is largely invisible is that many people living with chronic pain or illness don't look any different from those around them. We simply don't look sick or in pain.

Sunday, 18 September 2011 10:42

The Pain of Addiction

Written by

Pot, cocaine and methamphetamines aren’t the drugs that have local law enforcement most worried these days.

The new drug of choice is more insidious — prescription painkillers meant to help treat people suffering from real, chronic pain.

 

AP photo

Local authorities blame the medications for an increase in every type of crime, from simple burglaries to home invasions and homicides. Officers say most of the inmates in the Sevier County Jail are there because of pill problems.

“Ninety percent of the people we bring in now, the first thing out of their mouths is, ‘Man I’ve got a pill problem,’” said Capt. Jeff McCarter, leader of the criminal investigation division. Inmates say the same; in fact one inmate said 95 percent of the suspects in the women’s dorm of the minimum security facility are there because of a pill problem.

The street crimes unit, which focuses on drug investigations, has seen prescription drugs come to dominate the black market more than other illicit drugs. It started with pills like Hyrdocodone, a prescription painkiller, as well as abuse of Xanax, a muscle relaxant. But when Oxycontin became more widely prescribed, it became the drug of choice.

It became clear early that Oxycontin was dangerous. Derived from opiates, it’s essentially synthetic heroin and quickly got the nickname of “hillbilly heroin.” Addicts have told detectives it’s actually harder to kick than “black tar” heroin, an illicit form of the drug made for abuse.

Roxicodone, a similar pill, shows up the most these days, an officer said.

“That is what we see almost all the time now is Roxi,” said Capt. Randy Parton, who runs the street crimes unit. “We don’t hardly see Hydrocodone anymore, or Xanax or Valium unless it’s with Roxi.” Law enforcement officers do what it can to keep the drugs off the street, but it’s difficult. Unlike banned substances like pot, cocaine or traditional heroin, prescription medicines don’t start out in the hands of a criminal. They’re manufactured legally, and are supposed to be prescribed by doctors and distributed by pharmacists.

But addicts will look for ways to get additional prescriptions or reuse prescriptions, and dealers search for ways to obtain the pills. And while most doctors and pharmacists are ethical, there are some willing to abuse their positions. There are also those willing to open pain clinics that are really nothing more than dope dispensers — drug dealers posting as legitimate businesses created to help patients dealing with chronic pain.

Until recently, parts of Florida were infamous for these types of clinics, and Parton said local officials are aware of dealers or users organizing group trips down there to obtain the drug.

In the last few months, Florida lawmakers cracked down with new laws aimed at stopping that practice. Unfortunately, the result has been the rise of more pain clinics in East Tennessee, and sometimes desperate measures by addicts who are having a harder time getting their drugs.

Robberies at pharmacies have increased, and people who have Oxycontin in their homes have become targets for home invasion robberies.

Law enforcement officials can’t stay around pharmacies all the time, but they’re aware of the issue and are working with pharmacists to keep them secure, Sheriff Ron Seals said.

They’re keeping their eyes on pain clinics when they open in Sevier County as well. Local government can’t just stop clinics from opening, and some are legitimate businesses serving a real need for people in chronic pain. But Parton said they watch new clinics when they open, and it doesn’t take long to know.

“I can tell you in a couple of days if it’s a real clinic or not,” he said.

Building a case can take longer, but Parton and Seals said they’ll do what it takes to push illicit clinics out of the community.

Home invasions are on the rise in Sevier County, too, and officers said almost all the incidents they’ve seen have related to drugs. People can learn that there are prescription drugs like Roxi in a home a number of ways, but most of the time they say it happens because someone has shared or sold drugs they have at home.

Many of the people selling the drugs don’t set out to go into the drug trade. They get a legitimate prescription for one of the painkillers, and perhaps they don’t use up the prescription because they recover from the pain or they’re just reluctant to use the pills themselves.

Then, one way or another, they find out how much the pills are worth. For a person on a fixed income, that can seem like a windfall. In the tough economic times, the temptation is there for even more people.

And suddenly they find themselves dealing drugs — holding on to a commodity that their customers believe they need to survive, along with large amounts of cash they really can’t put in a bank.

It’s a dangerous situation, and it’s one of the biggest reasons the area has seen an increase in home invasion robberies. The person dealing out of their home has put a bullseye on it for anyone looking to quickly score drugs and cash. “They know (the dealer) has money and dope,” McCarter said.

Enforcing the laws against individual users can be difficult, too. Officers have to catch them making an illicit buy or show they’re misusing a prescription drug.

It’s equally frustrating to see otherwise decent people driven to crime by a drug they might have started using at the recommendation of a doctor. Officers know many of the people who start out taking the painkillers aren’t necessarily looking for a high. Doctors prescribe the drugs for chronic pain; Oxycontin was intended for treatment of patients suffering terminal cancer among others.

But people who start abusing them have a hard time stopping. It might start out with a narcotic rush, but it quickly starts having a psychological and physical effect. Once they’re hooked, addicts start to feel like they can’t function without it. And as their tolerance grows, they start needing larger doses to get their fix.

A single pill isn’t designed to give that rush. They’re meant to give a gradual, time-controlled release so a patient doesn’t get too much at once.

Soon, they’re grinding the pills and snorting them, which allows it to reach the bloodstream more quickly.

Eventually, they will start cooking it down and injecting it. “They just chase that first high, which they’ll never, ever get again,” McCarter said.

That, in turn, leads to another problem they’re seeing more and more often: overdoses. “That’s why we have a lot of the DOAs (dead on arrivals) out here now,” Parton said. “A lot of them are by overdoses.”

Pill addiction leads to most of the other crime they’re seeing; as McCarter said, a lot of the burglaries, thefts and similar crimes are being committed by junkies looking to pay for their next high.

One dealer recently convicted in circuit court was found to be in possession of stolen property from several recently burglaries; officers said that his customers had been trading the hot merchandise for drugs. Suspects arrested on theft and other charges regularly tell officers they were committing the crimes to get high.

And many of their crimes go unreported, because they take from the people closest to them: their friends and family.

“I’ve never seen a drug that caused such a social impact as these pills,” Parton said.

By: Jeff Farrell.

You can contact him here: jfarrell@themountainpress.com

Originally published on The Mountain Press

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