Every year more than 500 Oregonians overdose and die on painkillers. As a result, Oregon doctors are reducing prescriptions dramatically. In this three-part series, OPB's Kristian Foden-Vencil looks at new approaches to the state's opioid epidemic. Read more: Part 1 | Part 2 | Part 3
John is a carpenter. OPB is only using his first name for reasons that’ll become clear in this story.
John grew up in southern Oregon and for 20 years had a successful business installing kitchens. Then, in 2005, he was in a car crash. “I mean, fractured my neck, fractured my back. I had to have my right shoulder replaced," he said.
John was prescribed opioids to deal with the pain.
“After about four years I was on 160 milligrams of oxycontin … and then it was 56 milligrams of oxycodone and that went on for maybe four years.”
Today, he’s a mess. He lives in his pick-up truck and is in constant pain.
Without pain killers he said, he misses work. Which is why he was alarmed recently when his doctor — following new state guidelines — started reducing his dosage.
“The first thing he did was cut me back by a full one-third," he said. "It became an argument with him. Two months later, he cuts me back by another full third," he said.
John concedes he was using too many opioids — but points out it was all legal and under a doctor’s supervision. He said tapering off the drugs left him with terrible pain in his neck and back.
“Your body becomes so jittery and moving around. And just, I mean there’s no place of comfort," he said. "I mean it’s torture.”
John said he stuck with the low doses for seven weeks, then decided to visit Old Town Portland to buy heroin.
He was incarcerated for cocaine use in the 1980s, which is how he knew where to go for illegal drugs. He said he turned to heroin because he had to have something to deal with his chronic pain.
He didn’t want to inject it, so his solution was to cook the heroin in tin-foil with a lighter — like he’d seen others do — then inhale the fumes.
"But most of the drug just goes up in smoke. So the next time I went to this dealer, I said, 'Well, how do you do it?' And he said, 'Well, I snort it.' And I said, 'Well this is black tar, how do you snort it?' And he said, 'Oh! You cook it and you put it in a needle except you take the needle off and you shoot it up your nose and snort it,'" explained John.
John said he understands the need to crack down on opioids. He knows more than 28,000 Americans overdose and die abusing the drugs every year. But, he said, acupuncture and physical therapy just don't give him much relief.
“It’s a really upsetting story and one thing that’s so upsetting about it is that it’s actually quite common,” said Dr. Eve Klein, a neurologist working on pain management. She said when somebody’s been on opioids so long, tapering often doesn’t work. She hasn’t met John but thinks he should probably go to a methadone clinic.
“And then once he’s on something like methadone and he’s stable and he’s out of that rat race of needing heroin every six hours. Then he can start looking into things like, 'OK, what am I going to do about pain management now?,'” she said.
Congress just passed a bill to reduce opioid addiction. Democratic Oregon Sen. Ron Wyden voted for it, but said it’s only a "half measure." He’s said more legal options for dealing with pain are needed, “If all you do is restrict choices to medication, the addiction does not vanish magically. You’ve got to have prevention and treatment.”
Meanwhile, John lives in his truck and seeks relief where he can. He’s terrified of the traffic stop that could land him in jail.