Prescription for Crime

By Rex Bowman/Tazewell

Folks in Tazewell County know they better keep their eyes open, their toolsheds locked and their barn doors shut. Junkies, addicted to prescription pills and looking for anything to steal to pay for their next fix, have turned this 520-sq.-mi. patch of Appalachian Virginia--a bucolic tangle of wooded mountains, steep hills and rolling pastures dotted with sagging barns and country churches--into a society plagued by pilferers. They swipe guns from unlocked cabinets and push motorcycles out of garages in the dead of night. They swap or sell stolen watches, lawn mowers and sneakers for potent painkillers like OxyContin.

The drug first became a problem in Tazewell in 1998, but its national reach is well known, ensnaring even radio impresario Rush Limbaugh in a scandal that sent him into rehab. Around the nation, the statistics tell the story. A Jan. 21, 2005, report from the federal Substance Abuse and Mental Health Services Administration found that the number of people who had used oxycodone, the main ingredient in OxyContin, for nonmedical reasons jumped from 11.8 million in 2002 to 13.7 million in 2003. The increase happened even though OxyContin's maker stopped distributing its strongest pill, the 160-mg tablet, in 2001 and more states began prescription-monitoring programs to detect abusers who go from doctor to doctor looking for pills. In December the Drug Enforcement Administration announced a toll-free number to report the illegal sale of prescription drugs.

Federal authorities are at a loss to explain why prescription-pill abuse pops up in some places and not in others, and why places like central Maine, eastern Kentucky and southwestern Virginia--where OxyContin abuse first emerged as a problem--are awash in drug-related crime. But Sheriff H.S. Caudill says a clue to how it all began in Tazewell lies in one of the original nicknames for OxyContin: coal miner's cocaine. Retired miners with back injuries were among the first in the area to use the powerful drug, and as word of its effectiveness spread, abusers began diverting it, selling it for up to $1 per mg, Caudill says. "We're seeing a lot of elderly people dealing drugs," he says. "A lot of people are retired or on disability, and they think, Well, if Paw-paw can sell his pills, that's $2,400. And if Maw-maw can sell hers, that's $4,800." Census Bureau data support Caudill's notion: 12,481 of the county's 44,362 residents claim some sort of disability. If coal miners gave OxyContin its start in southwestern Virginia, injured steelworkers were among the first to use it in eastern Ohio, where its illicit use remains a serious problem, says Jennifer Bolen, a former federal prosecutor in Tennessee who advises physicians around the country on the laws governing the prescription of potent painkillers.

It has taken seven years for the full measure of the pill's stranglehold on Appalachian counties like Tazewell to become obvious--in clogged and crowded courts, in villages whose jails are so full that inmates sleep on the floor, and in neighborhoods focused on leaving nothing valuable lying around. The number of robberies, burglaries and thefts has shot up 48% in Tazewell in only five years, from 483 crimes in 1998 to 716 in 2003, even as the national property-crime rate fell 25%. "People are stealing anything that's not nailed down," says county commonwealth's attorney Dennis Lee. Testimony in a recent trial in Tazewell revealed that one man was so desperate for OxyContin, he traded his mule for four tablets.

Until lately the county was known for little more than its coal mines and crooked roads. While it's true that leaders staged a fistfight in 1800 to determine where to place the county seat--the town of Tazewell (pop. 4,100) was the winner--residents like to point up their law-and-order quietness with the story of how they once put a cow in jail because they could not tolerate the clanging bell. Now the county's crime woes have made it a case study in how prescription-pill abuse has stressed a judicial system to the breaking point, overwhelming cops, sheriffs, prosecutors and judges.

A typical night finds 230 to 250 inmates, most of them sleeping on mattresses on the floor, in the county's 89-bed jail on Tazewell's Main Street. Last year the county spent $132,000 to send its overflow of inmates to other jails. Nearly 1,100 people are on probation for felony convictions in Tazewell. Probation officers handle an average of 120 offenders each; a decade ago the average was 60. Ten years ago, grand juries that indicted two dozen people were considered especially zealous. Now grand juries indict 120 people at a time, mostly Tazewell residents, says Lee. Eighty percent of the crimes involve people stealing for drug money. The local sheriff's department is woefully understaffed, and the five-attorney prosecutor's office needs three more lawyers to meet state standards.

Though Tazewell has been particularly hard-hit, drug-related crime is booming across all of Virginia's coalfields. According to state crime data gathered by the FBI, from 1998 to 2003 the number of robberies, burglaries and larcenies jumped 131% in neighboring Buchanan County, 44% in Wise County, 62% in Lee County and 102% in Russell County. In Buchanan, where the jail typically holds more than twice the 34 inmates it was built to accommodate, the sheriff's department was so bogged down with drug-related crime that it dropped out of a four-county drug task force in order to concentrate on its own problems. In Lee, which has the same jail-crowding problem as Buchanan, local authorities have called on federal prosecutors to help take prescription-pill abusers off the street. The feds can use their power to charge abusers with crimes that carry more stringent penalties. In this rural Appalachian region, which is underserved by doctors, seven physicians have been convicted of overprescribing painkillers over the past five years.

State and local officials are building institutions virtually overnight to grapple with pill-related crime. Three regional jails are set to open this spring to ease inmate overcrowding in the state's Appalachian corner, and the Virginia general assembly recently appointed another circuit judge to help Tazewell. Also, the legislature has begun exploring an expansion of southwestern Virginia's prescription-monitoring program statewide, allowing state police and physicians to detect patients who go doctor shopping. In Tazewell, authorities are applying a big-city solution to their rural problem. They recently began a drug court dedicated to drug cases, where young narcotics offenders receive intensely monitored probation. And Lee has been appointed a special U.S. Attorney, giving him the power to prosecute weapons-for-drugs cases in federal court--a statute that doesn't exist on Virginia state books--where convictions carry a minimum penalty of five years in prison. Says Tazewell sheriff's captain Clarence Tatum: "If we could get rid of Oxy and all the related drugs, we'd wipe out 75% of the crime in this county."

In Tazewell, the pill-induced crime wave started insidiously and then changed everything. Jerry Turley, a pharmacist, says it begins with people "sneaking into their grandmother's drawers and stealing stuff." But Connie Dye, whose nephew was convicted of robbing a pharmacy, says the situation has deteriorated to the point where "we've put dead bolts on our door. We even put a lock on our gate." For many Tazewell residents, that is the most tangible evidence that their way of life has quickly been lost. o