Nick Turse
"A World of Hillbilly Heroin: The Hollowing Out of America, Up Close and Personal" 
By Chris Hedges Illustration by Joe Sacco
Drug overdoses are the leading cause of accidental death in West Virginia, and the state leads the country in fatal drug overdoses. OxyContin — nicknamed “hillbilly heroin” — is king. At a drug market like the Pines it costs a dollar a milligram. And a couple of 60- or 80-milligram pills sold at the Pines is a significant boost to a family’s income. Not far behind OxyContin is Suboxone, the brand name for a drug whose primary ingredient is buprenorphine, a semisynthetic opioid. Dealers, many of whom are based in Detroit, travel from clinic to clinic in Florida to stock up on the opiates and then sell them out of the backs of gleaming SUVs in West Virginia, usually around the first of the month, when the government checks arrive. Those who have legal prescriptions also sell the drugs for a profit. Pushers are often retirees. They can make a few hundred extra dollars a month on the sale of their medications. The temptation to peddle pills is hard to resist.
We meet Vance Leach, 42, with his housemates, Wayne Hovack, 40, and Neil Heizer, 31, in Gary. The men scratch out a meager existence, mostly from disability checks. They pool their resources to pay for food, electricity, water, and heat. In towns like Gary, communal living is common.
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"A World of Hillbilly Heroin: The Hollowing Out of America, Up Close and Personal"

By Chris Hedges
Illustration by Joe Sacco

Drug overdoses are the leading cause of accidental death in West Virginia, and the state leads the country in fatal drug overdoses. OxyContin — nicknamed “hillbilly heroin” — is king. At a drug market like the Pines it costs a dollar a milligram. And a couple of 60- or 80-milligram pills sold at the Pines is a significant boost to a family’s income. Not far behind OxyContin is Suboxone, the brand name for a drug whose primary ingredient is buprenorphine, a semisynthetic opioid. Dealers, many of whom are based in Detroit, travel from clinic to clinic in Florida to stock up on the opiates and then sell them out of the backs of gleaming SUVs in West Virginia, usually around the first of the month, when the government checks arrive. Those who have legal prescriptions also sell the drugs for a profit. Pushers are often retirees. They can make a few hundred extra dollars a month on the sale of their medications. The temptation to peddle pills is hard to resist.

We meet Vance Leach, 42, with his housemates, Wayne Hovack, 40, and Neil Heizer, 31, in Gary. The men scratch out a meager existence, mostly from disability checks. They pool their resources to pay for food, electricity, water, and heat. In towns like Gary, communal living is common.

Read the rest at TomDispatch.com