MajorpainSouthwest Florida’s

trouble with

opioids

ROGER WILLIAMS A2

OPINION A4

ANTIQUES A10

BUSINESS A25

HEALTHY LIVING A46

PETS A49

MUSINGS A51

REAL ESTATE B1

ARTS C1

EVENTS C6 & 7

SOCIETY C36 & 37

CUISINE C39

PRSRT STDU.S. POSTAGE

PAIDFORT MYERS, FLPERMIT NO. 715

INSIDE

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A Lee C ounty agency has cr eated a program that benef its homeless pets, people’s waistlines and taxpay-ers’ wallets.

Lee County Domestic Animal Ser-vices has cr eated a f itness club t o complement Lee C ounty govern-ment’s initiative to encourage fitness among its employees.

Donna Ward, the L CDAS director, came up with the f itness club as a way to not onl y keep staff and v ol-unteers fit, but also to give the dogs who are in kennels during the da y a chance to get needed exercise.

The program is pu t into action every Tuesday and T hursday morn-ing at 10:30 a.m., said Ria Brown, pub-lic information officer for LCDAS.

Animal service volunteers and staff meet up at the shelt er, leash up the dogs and tr ek to Six Mile C ypress Parkway to Home Depot on the c or-ner of U .S. 41 and back.

So far, the pr ogram is a suc cess by both t wo-legged and f our-legged standards.

“The first day they (staff and vol-unteers) noticed a big dif ference,” Ms. Brown said. There were less barking and bathroom breaks.”

If veteran LCDAS volunteer BJ Gerald had things her way, she would be racing around every day with the shelter dogs.

KRISTEN TOUHEY IS AN ENTREPRENEU R. She now owns seven pain manage-

ment clinics in Florida, plus a Fort Myers pharmacy she will soon move to Dade County to establish as a wholesaler.

To achieve that success, she dropped out of Florida State Univer-sity where she studied accounting, started researching the opportunities offered by pain management clinics beginning in 2007, and opened her first, in Fort Myers, in 2009, she says.

To some, clinics like hers are preda-tory, profiting from legal drugs that

BY ELLA NAYORenayor@fl oridaweekly.com

New fitness program helps

people and pooches

SEE PAIN, A8

SEE FUR, A12

BY ROGER WILLIAMS AND OSVALDO PADILLA

rwilliams@fl oridaweekly.comopadilla@fl oridaweekly.com

www.FloridaWeekly.comWEEK OF MARCH 14-20, 2012 Vol. V, No. 50 • FREE

ERIC RADDATZ / FLORIDA WEEKLY

George Jones is making moves toward recovery after losing his family, going to jail and flatlining twice due to his addictions to illegal drugs and pain medications.

ELLA NAYOR / FLORIDA WEEKLY

Employees and volunteers from Lee Coun-ty’s animal shelter find long walks with dogs mutually beneficial.

Kristen Touhey, who operates pain manage-ment centers throughout Florida, supports statewide measures to crack down on the illegal abuse of prescription medications.

>> What: Fitness Club at Lee County Domestic Animal Services>> When: Tuesdays and Thursdays at 10:30 a.m.>> Where: Lee County Domestic Animal Services, 5600 Banner Drive Fort Myers>> Other information: The Fitness Club is free and open to LCDAS staff and volunteers. For more information, go to www.leelostpets.com.

A-list authorsReading Festival returns to Fort Myers. C1

God’s playgroundChurch to build community park. A36

Race for the CureAnd other society events. C36 & 37

Taxing timesAccountants emerge stronger after lean times. A25

www.FloridaWeekly.com FLORIDA WEEKLYA8 NEWS WEEK OF MARCH 14-20, 2012

addict and kill people who often acquire them illegally. To others, her businesses offer legitimate relief from chronic pain that most people can’t fathom.

Who’s right? Here, Florida Weekly provides the information that will let you decide. One thing is certain: Addiction to legal pain medications now places costly, sometimes tragic burdens on every com-munity.

These days, Ms. Touhey’s staff num-bers about 65 statewide, including physi-cian’s assistants, nurses and as many as 15 licensed doctors, she says.

Her clinics — one each in Orange, Charlotte and Palm Beach counties, and two each in Lee and Dade — operate on a cash-only basis.

In her eyes, that represents an egalitar-ian ideal. It’s a virtue, not a vice.

“Insurance is not required to be a patient here,” Ms. Touhey explains. “Health care should not just be for peo-ple who are insured or can afford it, it has to be available to everyone.”

That is, everyone who can pay $250 or so — typically the going price for visits to cash-only clinics unless first-time or coupon deals are available, say those who visit or manage them.

But cash only (or cash mostly) is a “red flag” for law enforcement investigators and pharmacists required by new laws to question many prescriptions for opioids, they say.

Opioids are narcotic pain relievers, a family of drugs closely related to heroin and including such legal variations as morphine, methadone and oxycodone.

The most popular, oxycodone, was created in the early 1900s and primarily used as an alternative to morphine for treating terminal patients and to relieve pain for the first few days after surgery.

Although prescriptions for opioids may be legal, so-called doctor shoppers and others develop illegal strategies to multiply their pain-med purchases and sell the drugs on the street, police inves-tigations show.

That’s led to an epidemic more destructive than the crack-cocaine plague of the 1980s and ‘90s, more deadly in its annual body count than traffic accidents by about twice, and much more danger-ous and widespread than the use of any strictly illegal drugs.

“This is perva-sive, it’s in all levels of society, every socio-economic level, every race, both sexes, every-where,” says Lt. Harold Minch, head of narcotics and vice investigations in the Collier County Sher-iff’s Office.

“Here’s how we have experienced it through our lens as a detoxification program,” explains Alex Garcia-Barbon, detox program director at Southwest Florida Addiction Services, which takes patients from several counties: “Two to three years ago, the majority of our patients would have been alcohol patients, 45 and over.

“Today about 75 percent of our patients are opiate patients. And the age group has decreased. Now, the majority of patients are between 19 and 34.”

One perfectly legal painkilling opiate in particular, oxycodone, is responsible for more deaths than alcohol, cocaine and heroin combined, according to the state medical examiner and the Florida Department of Law Enforcement.

Mr. Garcia-Barbon outlines the breadth of the problem in a few simple numbers: 72 percent of the 1,565 patients his agen-cy treated last year were opiate abusers

or addicts, he says. About 86 percent of those relied on oxycodone that appears in several brand-name drugs, 12 percent relied on heroin, 1 percent on methadone and 1 percent on other prescriptions such as vicodin or percocet.

Lee Memorial Health Systems, mean-while, has seen a 682 percent increase in opiate users in the last three years, he says.

The big surpriseFor cops on the street and for every-

body else, it all came as a big surprise.“Right now in Florida it’s as close to an

epidemic as (we’ve had) since the early 1990s, when crack was dominant,” says Lee Sheriff’s Capt. Matt LaClair. “I never thought crack would be replaced. But even a couple of years ago on the street, (we) didn’t know how bad it was. For your undercover guys now, it’s easier to buy pills than cocaine.”

The epidemic arrived almost unseen. And it hit hard.

In a single year between July 1, 2009, and June 30, 2010, about 1,400 people in Florida died with oxycodone in their sys-tems, usually in combination with other drugs or alcohol, according to the state medical examiner.

The cause of death for 8,653 of the 171,300 Floridians who died that year was listed as drugs, with pain medications playing the most prominent role.

In 2006, the Lee Sheriff’s Office had one detective working the problem, says Major Jim Jones.

“Now we have five detectives, a ser-geant and an analyst because it’s become such an epidemic. If you have a bag of weed, that’s pretty easy for us. If you have a scrip drug and a scrip (slang f or prescription), that’s not so easy.”

So investigations take many months and crimes are not easy to prove.

That makes it no less an epidemic.The beefing up of law enforcement,

along with recent local ordinances pro-hibiting the opening of new pain-med clinics owned by people who aren’t doctors and a new state law requiring

all pharmacists to track prescription requests for pain medications in a state-wide database, is having some effect.

The street price has jumped from about $10 per pill to about $25 a pill, police say. Thus, a prescription of 250 easily obtained pills containing oxyco-done, for example, can be worth $6,250 in illegal sales. Those sales happen not only on the rough streets, but in the white-collar workplace, in the fancy restaurant and the dive bar, in the neighborhood and at school.

The other side of the coinBut Ms. Touhey and others who own

pain management clinics insist their businesses are essential, not only because they help many people who legitimately and often desperately need relief, but because they don’t require insurance for treatment.

“For example, we have a large Med-icaid base, but Medicaid doesn’t pay for pain management,” she says. (The state program helps low-income pregnant women and children, those over 65, and the blind, disabled, and nursing-home needy.) “So how are those people going to get the help they need?”

They’ll get it by paying cash for the drugs that work. Her clinics and others in the region that supply the chronic pain market — there were 28 total in Lee, 10 in Collier County and eight in Charlotte as of about 15 months ago, state officials say — rely heavily on opioids such as oxycodone.

Six of the nation’s 100 doctors who prescribed the most oxycodone in 2010 were living in Southwest Florida, and 98 of the top 100 were living in the state itself, according to figures provided by the Florida Department of Law Enforce-ment.

One of them, Dr. Anthony Posca, began working last July at Ms. Touhey’s Bonita

Springs clinic, Southwest Florida Medi-cal Solutions. He was arrested in Octo-ber and indicted with six other doctors on federal charges that included drug conspiracy, distributing oxycodone that lead to death in a patient, and money laundering, all in Jacksonville pain man-agement clinics. There, the indictment showed, doctors were taking in as much as $12,000 per week.

She knew nothing of his behavior or habits when she hired him, Ms. Touhey told daily newspapers, and she fired him when she learned of the arrest.

Although some doctors behave unethically, Ms. Touhey admits, most do a great deal of good.

Patients come in, fill out a medical his-tory, have a physical, allow a doctor to determine their needs and their risk of addiction, and then get a prescription for pain.

Her doctors refer any patients who fall into a routine of abuse or addiction to such treatment centers as The Willough or the David Lawrence Center in Naples, Ms. Touhey says.

But the legitimate need remains huge, she adds.

“We treat trauma cases. We have patients who have been attacked, patients who have deteriorating bone diseases, and the bone structure won’t support their bodyweight any longer. We have all kinds of amputees. One of our patients is a man with both of his legs cut off below the hip — another man carries him in here. We treat HIV and AIDs pain. Gun-shots.”

Indeed, the question of what consti-tutes pain is frequently arbitrary, says Mr. Garcia-Barbon at Southwest Florida Addiction Services.

“The main issue here is that no one can determine if you’re in pain or not. The person really hurting is that patient with legitimate pain. Now that patient is

PAINFrom page 1

OSVALDO PADILLA / FLORIDA WEEKLY

Above: Two victims — Katie Ley, left, fights her addiction with help from therapist Rose-mary Boisvert, whose son died of an overdose four years ago. Mrs. Boisvert is managing director of the Transitional Living Center at Southwest Florida Addiction Services.Right: An austere detox room at SWFAS, where addicts spend seven to 10 days cleans-ing themselves of opioids. Several more weeks or months of therapy are required to help patients control their desire for the drug.

GARCIA-BARBON

going to the pharmacy, and some phar-macies are not filling oxycodone even when it’s prescribed. So that patient is not able to get it, because of how much it’s being abused.”

Ms. Touhey’s clinics support every law enforcement effort made to curtail the illegal sale of prescribed drugs, she notes, adding that the new laws and stricter enforcement should have happened a long time ago.

Nevertheless, she insists, “These peo-ple need their medications. It might be for six months, it might be for two years. But the pain medications allow them to work, and to carry on their lives.”

The Paul Sloan viewPaul Sloan ardently and aggressively

agrees.Mr. Sloan is one of the most vocal

defenders of pain management clinics that, he insists, follow all the rules and help police enforce them.

Like Ms. Touhey, he is also an entre-preneur.

As he recounts the story, while look-ing for a new business opportunity about six years ago, he went to supper with a doctor friend one evening and asked his advice. The doctor encouraged him to open a pain management clinic.

“‘I can’t own a pain management clinic, I’m not a medical professional,’ I told him.”

“‘Yes, you can,’ he told me.”So he did. Now he owns two — one in

Sarasota and one in Fort Myers — and he

employs licensed doctors for each, he says.To defend the reputation of his

increasingly disreputable line of work, Mr. Sloan also founded a Tallahassee-based lobbying organization, the Florida Society of Pain Management Providers.

Pain clinics, he argues, are now subject to a “witch hunt” by two groups, both of them positioned to make a great deal of money from the persecution of legiti-mate pain management businesses.

First, he points to about 250 doctors in the state who make their professions managing pain. Those doctors, he claims, don’t want competition from other doc-tors getting into the business, and they sit on professional boards that hear complaints of abuse by other doctors. Then they recommend taking away their licenses to practice medicine.

And second, he fingers the entire law enforcement community from the attorney general on down, whose war on drugs, in particular on opioids that are legal, allows agencies to beef up budgets, bring in new staff, purchase new equipment, and carry on like a growing corporation, while simultane-ously ignoring the rights of patients to relieve pain, he says.

“There is a problem with addiction to opioids, but it’s small in the scheme of things. And it’s been blown up and based on false statistics,” Mr. Sloan argues. “They cherry-pick their numbers.

“You have 75 people a day die from smoking. You have 17 die from alcohol abuse everyday.

“Based on what I consider to be false science, they say there are seven a day dying from prescription drug abuse.”

In fact, the FDLE doubles that f igure, putting it at 13.5 per day.

“I don’t know any socially redeeming factors for alcohol and cigarettes,” Mr. Sloan says. “But these (pain med) pre-scriptions are the difference between life and terrible suffering or death for many people.”

The false science in the official fig-ures, he theorizes, has to do with the fact that evidence of prescription drugs that might not have been used in “months” gets into the fatty tissues of a body and begins to break down as soon as death occurs, which means it gets identified in coroners’ reports and sometimes cited as a cause.

(Police investigators, on the other hand, say evidence of opioid abuse in a corpse sometimes dissipates too quickly to be counted as a cause, so the death rate from oxycodone and other drugs may actually be higher than the numbers show.)

Solving the big problem of abuse and addiction will require taking away the demand for the drug, not the supply, and that can be done by moving money from the war on drugs to education, and by teaching young people the risks.

Or by pouring that money into treat-ment and detoxification centers, Mr. Sloan suggests.

Who’s at faultLaudable as that may be in the opin-

ions of some, for others — law enforce-ment officials and doctors who see the downside of pain management using opi-ate-based drugs — Ms. Touhey and Mr. Sloan, no matter how “legitimate” their businesses, remain part of the problem, not part of the solution to an epidemic that destroys lives and kills people.

But who’s at fault depends on who’s doing the faulting.

Some — Lee County’s Major Jones for example — blame individuals who buy the drugs in the first place.

But many others, including several of his own detectives, blame doctors and pharmacists lured by easy cash — men or women who “use their scrip pads as cash machines,” in the words of Lt. Chris Reeves, an investigator in the Lee County Sheriff’s Office.

But all of them agree on one thing: the question always comes down to per-sonal responsibility and personal ethics, except for hard addicts, who have lost their souls to need and therefore have no sense of either.

“It’s about doctors willing to hand this stuff out just to make money — they’re just drug dealers wearing lab coats. Hippocrates would be rolling over in his grave,” insists Lt. Minch in Collier County.

Many doctors and pharmacists agree with that unflattering assessment of a few of their peers: They bemoan the fact that narcotics prescribed for long-term pain relief often doom patients to

continued suffering, without addressing the root causes of their pain.

“You’ve had unscrupulous doc-tors masquerading as pain management doctors who were prescribing meds to patients with addic-tion problems for cash remuneration,” says Dr. Jonathan Daitch, a partner in Advanced Pain Management and Spine Specialists in Fort Myers, and an outspo-ken critic of cash-only clinics and those he deems frivolous. “That’s what this all boils down to.”

Tragic endings, formidable struggles In the minds of many, it also boils

down to betrayal and terrible suffering.It boils down to shattered lives, broken

families and endless subterfuge, not to mention crimes committed by addicts who require increasing quantities of an opioid as they struggle to meet hun-dreds-of-dollars-per-day habits.

And it boils down to mortality.Oxycodone, usually used with other

drugs or alcohol, killed 36 percent of Floridians who died from legal pain medications in 2010, according to the FDLE and the state Medical Examiner.

By comparison, methadone (with or without other drugs) killed 35 percent, hydrocordone used with other sub-stances killed 17 percent and morphine

killed 12 percent of those who died with opiate-based drugs in their systems, according to the official statistics.

But those stiff numbers fail to show the suffering that goes along with the dying, not only for addicts but for people who love them.

“We went out the night before to a couple of bars, we were hanging out, then it was 3 a.m. and I was back at our place cooking everyone food,” recalls Katie Ley, a 28-year-old opioid addict now in a detoxification program at Southwest Florida Addiction Services.

That was the life she and her boyfriend had become accustomed to at the time.

“Finally we went to bed. At about 8 a.m. we woke up and I looked at my boy-friend lying beside me and he was blue. And blood was coming out of his mouth and nose.”

Her boyfriend was not only blue, he was dead. She and her roommate were taken into custody, questioned by police, and released.

“We were mixing alcohol and pills and you know it’s bad but I was too busy worrying about myself to worry about anyone else. And when he died, that just made me use more. I would get messed up so I wouldn’t have to think about it,” she recounts grimly now, sitting in a room near Rosemary Boisvert, managing director of the transitional living center at the facility.

Mrs. Boisvert understands intimately. Her two sons, Bret and Jay, were also addicts — lying to the family, struggling

FLORIDA WEEKLY www.FloridaWeekly.com WEEK OF MARCH 14-20, 2012 NEWS A9

When oxycodone kills addicts, it usu-ally does so in tandem with other drugs such as Xanax or alcohol. But whether or not it proves fatal, as an opioid it sig-nificantly and destructively alters brain function, explains Bob Long.

Mr. Long, with Dr. Raymond Johnson, a psychiatrist, manages Nova Medical, a Southwest Florida detox practice that helps addicts stop using opioids such as oxycodone, methadone or heroin.

Here Mr. Long describes opi oid addiction in a nutshell.

“We have billions of pleasur e recep-tors in our br ain. A molecule of o xy-

codone goes into a receptor and bonds and releases to that receptor at a rate of about 4,000 times per sec ond, accord-ing to medical research.

“That constant bonding and r eleas-ing over time beats that r eceptor down until a per son needs mor e and mor e just to feel normal. So it’ s not unusual for some people we treat here to be tak-ing as many as 30 o xys a day — that’s between 300 and 900 milligrams, which could kill a healthy person.”

The drug bec omes the onl y thing addicts can think about. “Besides that, it ruins your gastrointestinal system, your

immune system breaks down because you can’t absorb nu trients, of c ourse it damages your liver, and it can slo w down your breathing,” he explains.

“That’s why people die sometimes — they just f orget to breathe. Especially if they mix it with benzodiazepines like Xanax. That intensifies the danger, because those drugs also slo w down respiration.”

Dr. Johnson, like some other doct ors working to beat opioid addictions with patients, uses a clas s 3 opioid called suboxone. By c omparison to oxycodo-ne, it bonds t o and releases from plea-

sure receptors in the br ain about once every eight minu tes, instead of 4, 000 times a second.

Therefore, when patients start using it, they don’t need to increase doses. On the contrary, they can decr ease them over time.

“Most people can ’t do this alone , they can’t quit cold turkey especially if they’ve been using oxycodone for more than a y ear, because the y become so violently ill,” Mr. Long explains.

“It’s a t errible thing t o see” — suf -fering on a le vel most of us ha ve never experienced. ■

How oxycodone assaults the minds and bodies of addicts

New laws for a new epidemic

Pushers 1, Cops Zip. In almost eight months since the police agen-

cies from seven counties joined forces to stop “pill mills” — pain management clinics whose doctors prescribe massive quantities of opiate-based drugs with few questions asked to streams of patients who then sell them on the street illegally — not a single case has been brought to court in the 20th Judicial Circuit of Southwest Florida.

But the game’s not over.Following Gov. Rick Scott’s approval of a “pill

mill bill” (House Bill 7095) last June, police agen-cies from Charlotte, Collier, Lee, Hendry, DeSoto, Sarasota and Manatee counties now share $3 million for overtime, joint planning, and other costs required to bust bad guys.

The scoreboard refl ects a signifi cant fact in the fi ght against pill mills: cases require months, if not years, of undercover buys, digging through data and old-fashioned gumshoeing to make charges stick.

While investigators continue to work the problem, they’re zealously enforcing the doctor-shopping bill approved by former Gov. Charlie Crist in 2008. That one spotlights buyers and users, not sellers.

Hardly a day goes by without another mug shot of alleged doctor shoppers appearing on the monitors of the news-consuming Southwest Florida public. The strategy attacks the problem from the demand side of the economic equation, snaring users and charging them with what is now a felony — visiting various doctors and/or lying to obtain prescriptions.

Trapping a ringleaderOne thoroughfare in the “Oxycontin Express”

(the dubious nickname given to Florida) ran straight out of Cape Coral, through Fort Myers and up to Worcester, Mass. That’s where Chad Barrie Currie would ship about 10,000 pills a month in 2010, earning between $18,000-$20,000 in cash for each delivery. According to a Lee County sheriff’s investigator, Mr. Currie had about 30 people doctor- shopping for him on the state’s east coast. When authorities searched his home, they found dozens of bottles fi lled with OxyContin, Xanax, metha-done, Vicodin and Lorcet. He pled no contest and is scheduled to be released from prison in 2018.

CURRIE

DAITCH

Drugs with Oxycodone:

OxyContinPercodanPercocetRoxicet

Roxicodone

FLORIDA WEEKLYA10 WEEK OF MARCH 14-20, 2012

to find the money for their habits, tor-tured by something they couldn’t escape, she says. One night four years ago it all went south.

“They were using together that night — it was on the 24th of January — and the next morning Bret woke up and Jay did not. He died of his prescription medication.

“Families need to understand how bad it is, how much this hurts. At that point, I was almost grateful because Jay wasn’t chasing the devil anymore. Every waking moment it was, ‘How am I going to get that drug, who will I lie to or steal from today?’ The cheating lifestyle is totally enmeshed with the drug culture.

“The sad thing is, it’s the family who remains that has to remember the birth-days, the Christmases, the special days, the songs, the smells, the certain cookies he liked to eat. It took me years before I was even able to speak as I am now.”

She tells her own story, the parents’ story, from a conviction that the truth will free the tortured soul, she explains.

“I bring it right into my patients. I’ll say it: Do I miss him? Yes. Every single day.”

And there is no happy ending. Her sur-viving son remains an addict, she says.

For Mrs. Boisvert, saving her children has proven impossible. But helping oth-ers to save themselves is possible. It’s something she can do, so she does.

One long, low-down, lousy roadGeorge Jones, another addict at

SWFAS who is moving through detox and the transitional living center for the third time, says that addicts must want to save themselves before anyone else can help save them.

“You can’t do it for your parents or your girlfriend or your children. It has to be for yourself,” he says.

And while he’s trying to do that now, the cost has been steep.

At 28, Mr. Jones has been in prison twice, he helped addict his girlfriend, “the love of my life,” to opioids and then put her on the street as a prostitute to help pay for their habits (she remains on the street as far as he knows), and he lost his three children.

At one point, when her mother had taken custody of two of their children but he and his girlfriend were still liv-ing with one son, “We had no job, we were robbing and stealing to get the money. We were out of control,” he admits.

That all started with cigarettes at age 12, then progressed to marijuana and ecstasy, first only on the weekends and then more frequently, Mr. Jones says.

Then he began doing cocaine and Xanax. Finally as a late teenager he dis-covered the opioids, including oxyco-done.

It took him a couple of years to dis-cover he’d found his drug of choice, he remembers now.

“You get that uppity speedy thing like cocaine, but it relaxes you and you’re everything you want to be,” he explains, trying to describe what the appeal is.

“For me, that’s what I like about it. I can do it and be able to accomplish things.”

At first he did it only when he got paid.

For a few years he avoided needles, but when he came out of detox the first time at age 25, he injected it because “every-body said how good the high was.”

Originally he’d begun taking it by mouth, then snorting it. But finally he’d moved into the big leagues, injecting it through an IV.

That went on for years as he commit-ted crimes to fund the growing habit. Not to absorb the drug meant being physically sick with nausea and suffering that was like “the flu times 10,” he says. “It’s the worst thing you’ve ever suffered. So you have to find more to be OK.”

And then twice at the end of last year he almost died, flat-lining at the hospital.

Finally, like others, he decided he was through with that life.

Changes and solutionsMs. Ley describes the health epiphany

some addicts experience when they finally decide to get sober, this way.

“I just knew: This is not who I am. This is not what I want for my life. Thank God I didn’t push it to the point of letting my family completely go. (Her mother is helping pay for her care, while Mr. Jones, who made it to the top of a waiting list as he kept suffering through the end of last year, is receiving public help.)

“Beating drugs is hard. It goes hand-in-hand with making changes,” Ms. Ley surmises.

“I had to change everything — all the friends, everything. I’m so thankful for this opportunity. I moved to the halfway house, I have a job down at the beach, I do daily meditations, reading, I go to (Narcotics Anonymous) meetings, I have a home group involved, I do service work.”

In contrast to her previous life, it’s a splendid existence, a life she hopes never to surrender.

In the old days, “I was throwing up all the time, I couldn’t eat or sleep or func-tion. I isolated myself. It was absolute misery.”

And all of it, or at least much of it, could have been avoided had she not had access to easy-to-get opioids designed for cancer patients in the first place, sug-gests Dr. Daitch.

That’s the fault of doctors who use their “scrip pads” as cash machines.

“We don’t write for the high-dose stuff,” he says of his own practice.

“When people come to us on (high doses of) pain meds, we actually detox them. We have them on suboxone. We have found a solution to this.”

Suboxone and care may be immediate solutions, but the ultimate solution is doing the right thing as a doctor, he says. Continuing high doses of pain medica-tions is not doing the right thing.

“You’re not treating the pain, you’re treating their withdrawal symptoms. When they’re off the meds, there’s a spike in their pain because it’s with-drawal.”

So how much is too much? That’s not as hard a question as some doctors like to make it sound, he argues.

“Anything more than 80 mg of perco-cet per day is a high dose. Nobody needs that much pain medicine.”

But many are given it anyway.Result? “You have all these young people in

their 20s and 30s who are hooked on it.”You have, in short, an epidemic. ■

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