Prescription Drug Addiction Has Unlikely Victims

Lia Johnson sat shackled in a vacant, windowless room in the bowels of the Abingdon regional jail one afternoon in March.

The young mother was handcuffed and zipped into an orange jumpsuit. Between her and the cool, spring breeze outside were two armed guards, a long hallway and two sets of fortified doors.

"This is the last place I ever thought I would be," said the blue-eyed, 38-year-old former nurse.

Johnson had never been in trouble with the law. Just two years ago, she was a full-time nurse, mother of a young son and a productive member of society.

Today, she is the new face of drug addiction in America and in Southwest Virginia. Johnson is college educated, middle class and employed, which currently is a similar demographic of the American population addicted to prescription drugs, according to research by Martha J. Wunsch, associate professor at Virginia College of Osteopathic Medicine.

'Equal opportunity' addiction

Southwest Virginia was a rural epicenter of addiction when the use of the narcotic painkiller OxyContin exploded around 2000. The drug was nicknamed "hillbilly heroin" because its use was concentrated in rural communities such as Virginia's coal mining counties, where it eased the chronic pain of some of those who labored in the mines, said Lisa Williams, director of a treatment program at Highlands Community Services in Abingdon.

In the years since, prescription pills have become the drugs of choice -- in some circles earning a new nickname, "equal opportunity."

It seems no one is immune.

A new drug, suboxone, has emerged in the last couple of years, and some say it offers hope to the addicted, only 3 percent of whom beat their addiction, said Marsha Miller, spokeswoman at Highlands.

Johnson, from Saltville, Va., was a nurse at Johnston Memorial Hospital in Abingdon when she injured her back lifting a patient in 2001. Opting against expensive surgery, Johnson managed her pain with prescription painkillers -- five milligram doses of hydrocodone per day.

In 2006, her close cousin was killed in a car crash, and Johnson realized the opiates helped with her emotional grief, as well as her physical pain.

"I started taking it every day," she said. "It numbed me."

Johnson's life spiraled out of control in the months that followed. It wasn't long before she was taking 40 to 45 pills a day.

"Trying to get pills consumed almost all of my time. When I would get a new script, I would already be worrying about running out and where I was going to get my next," she said.

One day, out of pills and on the cusp of withdrawal, Johnson crossed the line. She called a pharmacy and pretended to be a nurse at her physician's office, so she could prescribe herself a bottle of painkillers. From that point, her crimes escalated.

"When you feel like you're going to die if you don't get something, you justify it in your mind," she said.

Searching for the bottom

Johnson's life spun out of control in a matter of months. Before long, she was calling in prescriptions at various pharmacies throughout Smyth and Washington counties to support her habit.

She knew she needed help. But her insurance didn't cover substance-abuse treatment, she said, and every effort to find help led to a dead end. She called about 15 facilities, and the cheapest she could find still cost $8,000, "and that was just one week of detox," she said.

About five months into her addiction, Johnson went to a Marion pharmacy to pick up a prescription she called in for one of her former patients. She was working as a home health-care provider at the time and as her addiction progressed, she began calling in prescriptions for patients who didn't need painkillers and then picked them up for her own use. The patient whose name she used on July 23, 2007, had recently died, but she didn't know it.

She waited at the pharmacy as the clock's minute hand orbited the hour. With each tick she became more sure that something was wrong.

When she finally left, pills in hand, two Marion police cruisers were parked beside her car.

"Somebody will have to help me now," she said she thought with relief.

Johnson pleaded guilty to 32 counts of prescription fraud in Smyth and Washington counties and was allowed to complete outpatient therapy before reporting to jail on Jan. 28. After being caught by police, she had two weeks before entering a detox program in Lebanon, Va.

"I probably used more than I ever had," she said of those two weeks.

Detox lasted six days.

It didn't work.

It was then -- after police confronted her, after she pleaded guilty and confessed to her family and following detox -- that she hit rock bottom.

It happened about a week after being released from the treatment center. Johnson called a fellow patient she had met there -- who had told her he could get some pills -- and she arranged her first illicit street drug deal.

She gave the dealer the last of her money, and he promised to meet her shortly with the pills. He never showed.

That night, Johnson endured withdrawal for what she hopes was the last time.

Withdrawal, she said, is one of the most agonizing, unbearable experiences a person can go through. It lasts for weeks, unrelenting.

"I would hurt all over, runny nose, sneezing, coughing, horrible anxiety, elevated blood pressure and heart rate, chest pain, anorexia, nausea, diarrhea, night sweats, horrible insomnia -- I didn't sleep at all in withdrawal -- and cravings. You can't think of anything but the pills. Nothing. Because you know that all that misery will end as soon as you get some pills," she said.

It's the threat of withdrawal that keeps people using, she said.

By morning, scared she might kill herself, Johnson went to an emergency room at one of the hospitals where she used to work. Her former manager was in the waiting room when she arrived.

"That was rock bottom, when I went to the ER where I worked and told them I was going to kill myself if I didn't get help," she said.

Recovery rewards

After more than 10 hours in the hospital ER, Johnson was taken by police to the Southwest Virginia Mental Health Institute, where a doctor immediately started her on suboxone.

"For the first time since active addiction I had hope," she said. " ... I felt like myself for the first time in years."

Johnson spent 27 days in the hospital, paid for by a state grant. She was introduced to a 12-step program, and upon her release she continued with meetings three nights a week, along with intensive outpatient therapy at Highlands Community Services.

"The way I maintained on a daily basis was to surrender to God's will every single morning," she said.

She stopped suboxone the day before she reported to jail. She said she experienced no withdrawal or cravings, "it was just like any other day."

Johnson got out of jail on April 16. Her boyfriend of eight years, who is the father of her 6-year-old son, picked her up and took her out to eat. Then he drove her to their son's school.

"He ran into my arms and tears started rolling down his little cheeks. I didn't expect that much emotion from a 6-year-old," she said. " ... We stood and cried in the elementary school parking lot for I don't know how long. It was a very special moment."

Johnson has now been clean for nine months.

"I appreciate my bed and my bathroom. I appreciate hearing the birds and watching the lightning. I appreciate all the people who love me," she said.

"I don't want to take anything for granted."

Johnson doesn't know what the future holds. She is legally restricted from working as a nurse for five years, a fact that upsets her. She said she was good at her job and loved her work.

She says she has no desire to ever take another pain pill.

"My biggest lesson would probably be: Never say never. I fooled myself into thinking I would never be an addict. I just didn't think it could happen to me. I felt that I was a good person and things like that didn't happen to good people," she said. "I also learned that addiction is a disease ... not a moral deficiency."