56 miles from temptation: Disabled, addicted and desperately trying to save their marriage

56 miles from temptation

To save their marriage, a couple living at the crossroads of pain and addiction in rural Kentucky make a desperate escape.

Published on December 21, 2017

FLOYD COUNTY, Ky. — The trailer had looked like a good place to disappear, and so they had come, spending every dollar of his disability check on the move, and then some, pawning her wedding ring, and his guns, believing it wasn’t too late to begin a new life if only they could get away from the old. Now it was 28 days into this new life, and where were they?

Roger Ray, 48, was clean — sober for the longest stretch of time since the accident more than a decade ago. He was alone, his wife, Melinda, lying down in the bedroom, which was pretty much all she had done since her overdose just days before the move. He was in pain, in his lower back, in his right knee, feeling it with a clarity that only sobriety could bring.

Disabled America: Between 1996 and 2015, the number of working-age adults receiving federal disability payments increased significantly across the country, but nowhere more so than in rural America. In this series, The Washington Post explores how disability is shaping the culture, economy and politics of these small communities.
Part 1: Disabled, or just desperate? Rural Americans turn to disability as jobs dry up
Part 2: Generations, disabled One family. Four generations of disability benefits. Will it continue?
Part 3: Disabled and disdained How disability benefits divided this rural community between those who work and those who don’t
Part 4: ‘I am a hard worker’ Some say people on disability just need to get back to work. It’s not that easy.
Part 5: After the check is gone Her disability check was gone, and now the only option left was also one of the worst.
Part 6: 597 days. And still waiting. 10,000 people died waiting for a disability decision in the past year. Will he be next?
Above: Melinda Ray applies makeup in the trailer she moved to recently with her husband, Roger Ray. Roger lives with chronic pain from an ATV injury many years ago and Melinda has overdosed several times. In an effort to stay clean, they left their old life behind to avoid being tempted by the drug dealers they know.

He was drinking coffee, thinking.

It would be so easy to sneak back to Salyersville to meet a drug contact. So easy to deaden what he felt with whatever he could get, opioids, cocaine, methamphetamine. Fifty-six miles and five turns was all that separated him from his old life there. He could do it in less than two hours — drive, turn, acquire, use. He had promised Melinda that he wouldn’t, that she could trust him now. But every day he seemed to hurt more, and function less, and what was he going to do about that? How was he supposed to stop using drugs if drugs were the only thing that he knew of that would erase his pain?

He felt trapped, one more person caught in an ever-widening net of pain and addiction in a country where the geography of disability is increasingly overlapping with the geography of opioid use.

Over the past generation, disability in America changed. As the number of people receiving federal disability benefits surged, before tapering off in 2015, the share with circulatory disorders such as heart disease, once the plurality, shrank significantly amid medical advances. Meanwhile, the percentage of workers awarded Social Security Disability Insurance for musculoskeletal disorders — disabilities frequently treated with opioids — began to rise sharply. By 2012, nearly half of the beneficiaries were using opioids, and more than one-fifth chronically, according to a paper published last year by researchers at Dartmouth College and the University of California at Los Angeles.

Perhaps nowhere else do disability and opioid use more closely intersect than in Kentucky. It’s here where the counties with the highest rates of opioid use are also the counties with the highest participation rates in federal disability programs, clustered in the hills and hollows of Appalachia. Between 2000 and 2015, annual opioid use among adult recipients of Supplemental Security Income, for the disabled poor, more than tripled in Kentucky, according to an October report by the state Department for Income Support, from 48 pills per capita to 147. Among Kentucky’s general population, over approximately the same period, it rose from 30 pills to 72.

“The system produces the outcome,” said W. Bryan Hubbard, acting commissioner of the department. Disability applicants often need to substantiate claims of pain with prescriptions to get benefits, and “once you get the benefit . . . what else is there to do outside of exist and numb yourself? And the opioid pills, it’s exactly what they do. It deadens the person. It deadens their mind. It anesthetizes them to life.”

Roger, only beginning to understand life without anesthetic, stood, grunted in pain and went outside to his faded Ford Five Hundred with a missing bumper. “God, I would love to have a pain pill right now,” he said, starting the car, realizing that as badly as he wanted one now, he’d want one even more in four days. That was when his next disability check would come in, and he’d finally have the money either to act on temptation, or take it away altogether with suboxone, a medication that treats withdrawal symptoms.

Not knowing where else to go, not knowing what else to do, he drove to the only grocery store in miles. He pulled up, killed the engine, got out, picked up another tin of chewing tobacco, and then sat for a long moment, looking at the dashboard.

Fifty-seven miles of gas left, it said.

Fifty-six miles to his old house. Fifty-six miles to his old life.

It would be so easy.

He shook his head, took out a big pinch of chewing tobacco, and, turning right instead of left out of the parking lot, drove the three miles home.

Top left: Roger Ray relaxes at home with one of his dogs. He still bears scars –– and pain –– from an ATV accident in 2005 that tore open his right knee and twisted his back out of alignment. Top right: Roger watches videos of pit bulls. Before the accident, he took his pit bull on tour to dog shows. Above: Roger takes his pit bull out. He stopped hunting and working with elite dogs after he was injured.
Everything about the trailer he went back to had the paranoid feeling of a hideout, from the phone that wasn’t plugged in, to the blinds that were always drawn, to his hesitancy about divulging the address to anyone. He knew Melinda was trying to make it livable. She cleaned whenever she wasn’t lying down. She had hung inspirational quotes — “If life gets too hard to stand, kneel” — put out air fresheners and even placed several photo albums on the coffee table, filled with moments so distant that it seemed to Roger as though someone else had lived them.

There was Roger with the pit bull he used to take to dog shows around the country. There was Roger just off a shift at the coal mine, where he had operated a bulldozer and made $4,000 per month. This one had Roger with his shirt off, muscles upon muscles, capable of benching 365 pounds — “indestructible” was how he described feeling then, right up until the day it happened, on  Nov. 20, 2005.

It was a Sunday. He was miles off the nearest road hunting deer, on his ATV, when he flipped. As the vehicle tumbled, his boot caught its bottom, ripping open his right knee, twisting his lower back out of alignment. Then came his hunting partner, who was saying, “Roger, that’s a lot of blood,” and the parade of doctors who were writing prescriptions, and his eventual return home, knee dislocated, so frail and depressed and incapable that Melinda decided to hide his Thompson .45 just in case.

Twelve years later, what he had left was this: a monthly check for $1,240, a hollowed face frozen in a grimace, two dogs he took out every hour, less for their reprieve than for his, and Melinda, always Melinda, who was coming out of the bedroom for the first time the next day, at 4 p.m.

“My head’s killing me,” she said. “It hurt all night.” Neither had slept much since they’d quit drugs and moved here — Roger because of pain and withdrawals; Melinda because of anxiety and withdrawals — and so had gone another night, a night when some of their old acquaintances had gotten their disability checks and sent Facebook messages asking whether Roger or Melinda knew where they could get some pills. “It ain’t funny for me, you know?” Melinda said. “You know, I moved away so people wouldn’t know where I was at.”

She sat on a recliner with tape covering its tears, cross-legged, ankle jiggling.

“And Linda and James have been trying to talk to you all day,” she said of two more people in search of drugs.

“What’d you say?” Roger asked, eyes on the television.

“Well, I told them no,” she said, sighing. “It must be nice being able to waste that much money.”

They had spent so many years talking about pills that it sometimes seemed as though they discussed little else. In the months after the accident, the conversations had been reminders to take his OxyContin. Then they turned to his mounting tolerance and how difficult it was to get enough, as state authorities began targeting opioid abuse, and his daily prescription dropped from eight pills to four, to three, to two. All over eastern Kentucky, pain-management clinics were closing. Doctors were getting in trouble. Others were moving away, or writing prescriptions for far fewer pills than before, and soon Roger was looking beyond the clinics for what he wanted, not just for his pain, but because drugs and the people he met through them gave him something to do, which was how it went the night Melinda overdosed.

For weeks, he had been saying he was ready to quit, ready like Melinda, who, swearing she was done, had started taking suboxone. His last pain doctor had just moved, cutting him off, and he believed he just needed to get away from everyone in Salyersville, so they found a trailer 56 miles away. But then the end of the month arrived, and they were out of money, and there had been nothing to do for days on end. The night of Sept. 28, he put his hands on his knees and, feeling out of options, said, “I can get some on credit,” and then he did, much more than Melinda thought he would. They stayed up all night, high. At daybreak, she gave him a strange look. She said she loved him. She went into the bathroom and locked the door. He started pounding on it when she didn’t come out, worried that her disappointment in herself, and in him, might have finally become too much.

“What’s your emergency?” the 911 dispatcher asked after he’d broken in and saw what had happened.

“My wife swallowed too many pills,” he said flatly, according to an audio recording.

“Do you know how many she took?”

“I have no idea.”

“Is she responsive?”

“Not much,” he said, his voice giving way to a sob.

“Is she breathing?”

And now it was four weeks later, and they were in the trailer he had promised, on a street where they knew nobody, when he looked over at her. She was breathing. She was taking a drink from a cup with the name of the hospital where the ambulance had taken her. It was again the end of the month. There again was nothing to do. He again felt out of options. This time, he kept his temptations to himself as night came, and the lights stayed off, and the living room filled with the blue glow of the television.


Top: Melinda Ray shows off one of her tattoos, which she says “was something I could spend my money on besides dope.” The image of a skeleton reflects her life, she says –– “I was almost dead. I’ve been almost dead a bunch of times –– and is a reminder to remain sober.” Above left: Melinda shares a photo that was taken while she was using drugs. Xanax was her drug of choice, she says. Above right: Melinda and her husband, Roger, linger on their front porch.
The following day, Melinda was sweeping in the kitchen, agitated, fatigued. Roger, thrashing in pain, had kept her up all night again, and hours later, so many other things were going wrong. The refrigerator was empty. They hadn’t eaten anything besides potatoes for days, and she felt terrible for it. It had been her ultimatum — either he’d quit, or she’d leave him — that had brought them here, where they were always irritable, going through the worst of their withdrawals.

“My hair’s burning me up,” she said, lifting her dark curls off her neck.

“Yeah, it’s starting to get warm in here,” Roger said, also sweating.

She looked at the floor, annoyed that Roger had brought in dirt after he had taken the dogs out.

“I just swept twice yesterday,” she said. “Probably more than twice.”

“Honey,” he began. “I don’t know.”

She tried not to get angry. That wouldn’t put food in the fridge. Or make the floor clean. But she sometimes found it difficult not to be angry. Nothing in her life was how she wanted it to be, and some days she felt ready to explode with resentment that had compounded since they met in 2001, when she was still the talkative bartender, and he was still the confident miner who came by her bar after work. After the accident, she did everything she could to care for him. She went part time at work, then quit. She helped him in the bathroom. She drove him to appointments. She did all the shopping because he felt humiliated riding Walmart’s complimentary scooters. But ultimately it wasn’t all the things they lost — his mining salary, the blowout Christmases, the big summer parties — that bothered her as much as the habits they gained.

She had never thought of herself as someone who does drugs, not then, and not now. But she hadn’t wanted Roger to be alone, so she started using with him. She also had her own pain from three car wrecks, which led to a federal disability claim that’s pending on appeal. Then there was her childhood, which had included a dead mother, an incarcerated father, foster homes and sexual abuse. But were those merely excuses? Or was the real problem her? She was the one, after all, who had gone along with everything, even after pills came to dominate their universe, and Roger started smoking meth when he couldn’t get more, and violence seeped into their marriage, and he broke promise after promise that he would quit, including the night she overdosed.

She sighed loudly and put away the broom. “I can only clean so much, and then there’s nothing else to do.” She sat down, stood up, sat down again. “I’m about to turn the air on,” she said, reaching for an air-conditioner they tried not to run to save money, then went back to her chair and her thoughts.

Even now, she still didn’t fully trust him. She suspected that he used while she had last been in the hospital, and although she was pretty sure he wasn’t using now, she still snapped at him that morning.

“There’s your excuse to go get high if you want to,” she had yelled at him, after an argument over nothing.

“I don’t need an excuse,” he had said, going outside for what seemed like a long time, bringing in the dirt that she then had started to sweep up.

She now regretted having said that, not only because she still loved him, and didn’t want to hurt him, but because any additional stress made it more difficult for them to quit. That was particularly true at this time of the month, so close to his next disability check, when they’d finally be able to afford a suboxone appointment but were nonetheless thinking about what else that money could buy.

“Used to be back in the day, we’d be adding up the bills and we would have went and got a 30 [milligram painkiller] or two tonight,” she told Roger a little later, hours before the check was to arrive. “We’d go to the bank to get money, and the 30 dealers would be standing there, selling them. I mean, they jumped in our car before, didn’t they?”

“Yeah,” Roger said. “Or they’d call us while we were at the ATM.”

“ ‘Want to stop by? We’ll meet you,’ ” she said, mimicking the dealers, beginning to laugh, until she saw that Roger wasn’t smiling but silently staring ahead.

“Used to be we were driven back then,” she continued quickly, but he didn’t say anything to that, either.

There was a silence.

“I’m so wore out,” she finally said, wanting their arguments to be over. “I just get so frustrated. Usually when you’re hateful, I let you have the last word, but today, I didn’t.”

“Nope,” he said, but this time, he did look over at her, and his eyes were tender, and he gave her a small smile, and, together, they waited for one hour to pass to the next.

Left: Roger and Melinda Ray left this house in Salyersville, Ky., and moved 56 miles away to Floyd County because they had been tempted by drug dealers in the area. Right: Billboards advertising legal services, like this one in Pike County, Ky., are prevalent in an area where many residents rely on Social Security support.
Then it was time to go.

The check had been deposited into Roger’s bank account the night before, after midnight, and the only thing left to do was spend it. They had to pay rent, electricity, water, Internet, insurance, make the car payment, and get enough food to last until the food stamps arrived in two weeks. There was also the suboxone. Melinda’s daughter from her first marriage had found a treatment clinic nearby whose counselors didn’t accept Medicaid, which Melinda had, or Medicare, which Roger had through his disability, but could get Melinda in for an appointment that day for $200, the idea of which terrified her. She had left the house only once since they’d moved here, and that had been to the dollar store, not a doctor’s office. She put on a jingly metallic bracelet and her favorite boots and did her makeup.

“You look pretty,” Roger said.

“Too old for a pony tail,” she said, letting her hair down. “I’m knocking on 50.”

“You ready?” Roger asked.

“Not really. I’m about to throw up.”

She knew she had to be the one to get the suboxone, which effectively blocks many patients from getting future prescription painkillers, a risk Roger didn’t want to assume, considering his pain. He could handle it today, but what about next week, and next year, especially living in a place like the one they were looking at through the car’s windows?

“This makes me so depressed,” Melinda said, as the road curled along a river, going through mountains and past junk cars, unkempt trailers, the mine where Roger used to work, and a pain-management clinic where Melinda’s prescriptions were once filled. “The houses. The roads. . . . People out there on their porches all day, doing nothing. They don’t have nothing to do.”

Opioid prescriptions, overdose deaths and disability rates overlap

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  • These 695 counties have both high opioid prescription rates and high rates of overdose deaths.

    Seattle, Wash.

    Washington, D.C.

    San Francisco,

    Calif.

    Salyersville, Ky.

    Nashville, Tenn.

    High opioid use,

    high overdose death rate

    High opioid use,

    high overdose death rate

    Seattle, Wash.

    These 695 counties have both high opioid prescription rates and high rates of overdose deaths.

    San Francisco,

    Calif.

    Washington, D.C.

    Salyersville, Ky.

    Nashville, Tenn.

    High opioid use,

    high overdose death rate

    Seattle, Wash.

    These 695 counties have both high opioid prescription rates and high rates of overdose deaths.

    Minneapolis, Minn.

    New York City, N.Y.

    San Francisco, Calif.

    Washington, D.C.

    Salyersville, Ky.

    Nashville, Tenn.

    Phoenix, Ariz.

  • In these 703 blue counties, relatively few people have opioid prescriptions and few people die of overdoses.

    Seattle, Wash.

    Washington, D.C.

    San Francisco,

    Calif.

    Salyersville, Ky.

    Nashville, Tenn.

    High opioid use,

    high overdose death rate

    Low opioid use,

    low overdose

    death rate

    High opioid use,

    high overdose death rate

    Seattle, Wash.

    Low opioid use,

    low overdose

    death rate

    In these 703 blue counties, relatively few people have opioid prescriptions and few people die of overdoses.

    San Francisco,

    Calif.

    Washington, D.C.

    Salyersville, Ky.

    Nashville, Tenn.

    Appalachia has both high rates of prescribed opioids and high rates of death from opioids.

    High opioid use,

    high overdose death rate

    Seattle, Wash.

    Low opioid use,

    low overdose

    death rate

    In these 703 blue counties, relatively few people have opioid prescriptions and few people die of overdoses.

    Minneapolis, Minn.

    New York City, N.Y.

    San Francisco, Calif.

    Washington, D.C.

    Salyersville, Ky.

    Nashville, Tenn.

    Phoenix, Ariz.

    Appalachia has both high rates of prescribed opioids and high rates of death from overdose.

  • The rest of the counties in the U.S. fall somewhere in the middle of this spectrum, where the prescription and overdose rates are not extreme.

    Seattle, Wash.

    Washington, D.C.

    San Francisco,

    Calif.

    Salyersville, Ky.

    Nashville, Tenn.

    High opioid use,

    high overdose death rate

    High opioids,

    low death

    Low opioids,

    high death

    Low opioid use,

    low overdose

    death rate

    No data

    High opioid use,

    high overdose death rate

    No data

    High opioids,

    low death

    Low opioids,

    high death

    Seattle, Wash.

    Low opioid use,

    low overdose

    death rate

    The rest of the counties in the U.S. fall somewhere in the middle of this spectrum, where the prescription and overdose rates are not extreme.

    San Francisco,

    Calif.

    Washington, D.C.

    Salyersville, Ky.

    Nashville, Tenn.

    Counties like Marion County, S.C., have high rates of opioid presciptions, but relatively few recorded overdose deaths.

    Santa Barbara County, Calif., is average in both overdose deaths and prescriptions.

    High opioid use,

    high overdose death rate

    No data

    High opioids,

    low death

    Low opioids,

    high death

    Seattle, Wash.

    Low opioid use,

    low overdose

    death rate

    The rest of the counties in the U.S. fall somewhere in the middle of this spectrum, where the prescription and overdose rates are not extreme.

    Minneapolis, Minn.

    New York City, N.Y.

    San Francisco, Calif.

    Washington, D.C.

    Salyersville, Ky.

    Nashville, Tenn.

    Phoenix, Ariz.

    Santa Barbara County, Calif., is average in both overdose deaths and prescriptions.

    Counties like Marion County, S.C., have high rates of opioid presciptions, but relatively few recorded overdose deaths.

  • These counties have some of the highest disability rates in the nation. Many of them overlap with the counties that have both high opioid prescriptions and death from overdose, shown in yellow.

    Seattle, Wash.

    Washington, D.C.

    San Francisco,

    Calif.

    Salyersville, Ky.

    Nashville, Tenn.

    High opioid use,

    high overdose death rate

    High opioids,

    low death

    Low opioids,

    high death

    Low opioid use,

    low overdose

    death rate

    No data

    High opioid use,

    high overdose death rate

    No data

    High opioids,

    low death

    Low opioids,

    high death

    Seattle, Wash.

    Low opioid use,

    low overdose

    death rate

    These counties have some of the highest disability rates in the nation. Many of them overlap with the counties that have both high rates of opioid prescriptions and death from overdose, shown in yellow.

    San Francisco,

    Calif.

    Washington, D.C.

    Salyersville, Ky.

    Northern California and other yellow areas have all three factors: high disability, opioid prescriptions and overdose deaths.

    Nashville, Tenn.

    Some of the few areas with high disability rates but low opioid rates are in heavily African American swaths of Mississippi and Alabama.

    High opioid use,

    high overdose death rate

    No data

    High opioids,

    low death

    Low opioids,

    high death

    Seattle, Wash.

    Low opioid use,

    low overdose

    death rate

    These counties have some of the highest disability rates in the nation. Many of them overlap with the counties that have both high rates of opioid prescriptions and death from overdose, shown in yellow.

    Minneapolis, Minn.

    New York City, N.Y.

    San Francisco, Calif.

    Washington, D.C.

    Salyersville, Ky.

    Northern California and other yellow areas have all three factors: high disability, opioid prescriptions and overdose deaths.

    Nashville, Tenn.

    Phoenix, Ariz.

    Some of the few areas with high disability rates but low opioid rates are in heavily African American swaths of Mississippi and Alabama.

Sources: Average county-level overdose rate for 2013 through 2015 using data from CDC drug poisoning mortality; Social Security Disability Insurance by county for 2016 from Social Security Administration; Average opioid prescription rate by county for 2014 through 2016 from CDC U.S. prescribing rate map, if available.

Some days, they wondered whether they’d unwittingly fled one community overtaken by disability and drugs for one even more so. When Melinda first arrived in Floyd County, which has one of the nation’s highest opioid prescription rates, and where more than 1 in 4 working-age adults receive federal disability benefits, a man had approached her at a gas station and asked if she wanted something, and even though she declined, it had worried her. They couldn’t hide in their trailer forever. They had to leave at some point and meet people, and what would happen when they did? Would they just get sucked back in?

Their car struggled out of the mountains, eventually heading into Betsy Layne, population 688, where Roger got cellphone service for the first time in weeks. As he pulled up to a bank, his phone started vibrating with messages.

“Hah!” Melinda exclaimed, reaching for it, looking to see who had called to check in on them.

There were five voicemails.

“Ow!” Roger yelled, getting out of the car and limping to the ATM.

Each was from a different dealer.

“Every day,” Melinda said, shaking her head. She put the phone away and looked out the window. She didn’t bother listening to the messages. “Every day.”

“Got it all,” Roger said, slowly lowering himself back into the car, letting out another loud grunt.

He stared down at the money in his hands. There was $900. He slowly counted out the $200 for the suboxone appointment and handed it to Melinda.

Now she was looking at money in her hands, unsure.

“What if I spend that, and we need it for food?” she asked. “Or we need it for — ”

“I don’t know,” he said. “I don’t know what to tell you.”

She told him about the voicemails. And the drugs people had wanted to sell them.

“Same thing as always,” she said.

“Don’t have the sense God gave them,” he said.

“I can’t deal,” she said, leaning her head into one hand. “Five voicemails.”

He looked at the time. It was nearly 11 a.m. Melinda’s appointment was in half an hour. They had to make a decision.

“Where do you want to go?” he asked. “What do you want to do?”

Roger Ray rests on the front porch of his trailer in Floyd County, Ky., which has one of the nation’s highest opioid prescription rates, and where more than 1 in 4 working-age adults receive federal disability benefits.


The parking lot was nearly empty when they pulled up to the suboxone clinic, a single-story building hemmed in between an empty bowling alley and a mountain. There was only an unshaven man, crouched by its entrance, coaxing the final drags from a cigarette that looked to be all filter.

“Here we is,” Roger said. “Right on time.”

Melinda got out, knowing that Roger wouldn’t follow. He didn’t like treatment facilities. Or the counselors, their questions, along with the people who went to support groups. To him, addiction wasn’t a disease. It was a choice, and support groups were for people who wanted a lighter sentence from a judge, or to buy drugs from the dealers who sell at the meetings, so he stayed in the car, watching Melinda disappear inside.

She paid the $200 and sat down with a pile of forms that asked so many questions she felt ashamed to answer. “Have you abused prescription drugs?” “Do you abuse more than one drug at a time?” “Can you get through the week without using drugs?” For that one, she initially circled “Yes,” but then, thinking better of it, circled “No.”

“They ask you a million and one questions, girl,” said a slight man in a baseball cap, Melo Fonseca, 48, who had been a United Parcel Service employee until a car wreck partly paralyzed him and he started receiving Social Security Disability Insurance.

“Sitting here makes me feel worse, talking to a counselor,” she said.

He leaned in, and she looked up from her forms.

“I’ve been here seven years, and this place saved me,” he said. “Saved my marriage.”

“That’s what I was telling Roger,” she said, nodding.

She also had been telling Roger about her frustrations. She had looked for other suboxone clinics near them — ones that would take Medicaid — but they couldn’t take any more patients. What was the point, she increasingly thought, of having insurance if it didn’t pay for the things she needed? If there were so many people waiting for help that they would always be choosing between getting suboxone and paying the bills?

“I just paid $200, and I got to pay another $100” to the clinic, she said. “And I’m dying about it. At the same time, I know I’d waste it on something else, you know. I’ve wasted $1,000 a day before, and if I could get it back . . .”

“I’d be a millionaire by now,” Fonseca said.

“I’d be able to drive any kind of new car I wanted,” added another patient, Christopher Irick, 49, a former maintenance man, now a disability beneficiary for multiple sclerosis.

“Before I came to West Virginia and Kentucky, I never heard of a pill,” Fonseca said. “And after I got in that car wreck, that changed everything.”

“That’s how everybody started out,” Melinda said, looking around, seeing how they were ending up: disabled, defined by pain, waiting hours for suboxone, which can cause dependency, trading one addiction for another.

Hours went by, cigarettes accumulated at the entrance, the waiting room filled with people, then emptied, then Melinda, one of the final patients to leave, came out to the car, carrying a prescription for 24 tablets of suboxone, and bad news.

“I got to go to Prater,” she said as they drove away. No pharmacy nearby could fill her prescription, she had been told inside, and she had to go to her former pharmacy. That was Prater Drugs. In Salyersville.

“What do you want to do?” Roger said, speeding up, passing one car, then another. “I need to know!”

“Roger!” she said, frustrated, too. “I don’t care!”

He sighed, and on they went, driving the 56 miles neither wanted to drive, going to the town where they knew they couldn’t trust themselves, making a trip that once seemed so easy but now seemed like the most difficult thing they could possibly do. They pulled up to Prater Drugs. Roger went inside. He got the prescription. When he was coming out with the pills, he saw a man he didn’t want to see. It was the short, gaunt neighbor from their old street, with whom they had used drugs often, and here he was, coming across the street to talk.

“I’ve got some good stuff, man,” he told Roger.

Roger looked at him. Then he looked at Melinda. She was staring back at him.

“No,” was all Roger said. “No thanks.”

He got into the car and, with the suboxone, they drove the 56 miles home, back to their new house, in this new life, where, for the first time in as long as they could remember, they had a good night’s sleep.

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