NOVA

A devastating epidemic...

We just didn't know what to do.

We just felt powerless.

A parents' worst nightmare,

to find my kid not breathing.

He was always very good

at telling us, "Mom and Dad, everything's going to be fine,"

but it wasn't.

Addiction is ruining lives

and ending them too soon.

Overdose is the number one cause of death

for people under 50.

We are racing against time.

We have the equivalent

of a Boeing 737 crashing every single day.

But what causes addiction?

Individuals struggling with addiction

are actually battling millions of years of evolution,

because our brains are exquisitely evolved,

to seek rewards.

It's those cravings, the inability to stop.

A dangerous cocktail of biology and medicine

made deadlier by a drug 100 times more potent

than morphine.

Fentanyl is super toxic.

So you get a batch that comes on the street

that's a little bit hot,

and on those days, it's like,

bam, somebody's going down.

Bam, somebody's going down.

Bam!

But can new treatments offer hope?

We have extremely effective medications

that are life-saving.

This is a very treatable illness.

The solution to this

is for us to embrace addiction as a disease,

to bring it within the house of medicine.

People recover from addiction.

Nobody is unreclaimable.

The only thing that you can't recover from

is death.

"Addiction,"

on "NOVA."

McDowell County, West Virginia,

feels like a place left behind.

Yet its miners helped power America

when coal was king.

Back then, the largest city, Welch,

was a thriving community.

But as coal jobs vanished by the 1990s,

the poverty rate in the county

climbed to 38%.

Then investigators found

that over a six-year period,

drug companies had flooded the state

with 780 million highly addictive pain pills.

West Virginia was the perfect storm.

The whole state's dominated

by one of the hardest and most dangerous jobs

in the world.

Most of the old timers that work in the mines

work with pain.

And then pain pills started flooding the community,

and people that you used to know

weren't the same people that they used to be.

I mean, it, it just... it ruined everything.

Jasen Edwards and his two brothers Scott and Mark,

grew up in Sophia, West Virginia.

The town was near the Winding Gulf coal field.

Most of its residents were miners,

including the Edwards family.

All three sons would struggle with pain pills.

Jasen got his first prescription

after crushing his leg in a mining accident.

They cut my leg off the day after Christmas in 2008,

and I was back underground mid-to-late February.

First day I went back to work,

I had to crawl everywhere or ride everywhere I went,

because my stump was still too swollen

to put my prosthetic leg on.

A man hurts his back,

if he is not back to work, they will replace him.

And I could not have supported my family on the disability.

Soon, a few pills a day

could no longer stop the pain.

But Jasen could easily buy more

by visiting doctors and showing his artificial leg.

The first time I realized that I was in trouble

is when I couldn't go to work,

because I didn't have any pain pills.

And it wasn't because of how bad I was hurting,

it was because of the sickness due to detoxing.

Jasen was addicted to a powerful opioid painkiller

called OxyContin.

Opioids like OxyContin are chemically similar to morphine,

found in the opium of the poppy plant.

They mimic the body's natural pain relievers,

like endorphins,

which bind to proteins, called receptors,

calming pain and inducing euphoria.

Prolonged opioid use can alter the brain

and lead to addiction,

manifested by cravings and compulsive drug use

despite negative consequences.

As opioids were aggressively marketed,

West Virginia soon had the highest rate of overdose deaths

in the U.S.,

alarming health commissioner Dr. Rahul Gupta.

We were amongst the top states

prescribing pain pills in the nation.

At the same time,

people were losing their employment,

they were also losing a way of life.

It spelled the perfect conditions under which

addiction began to creep in.

At Stanford University,

psychiatrist Anna Lembke

also feared Big Pharma's pressure on doctors

was creating an epidemic.

When she got access to patients' prescriptions records,

her suspicions were confirmed.

Many people abusing pain pills

were getting them from doctors... Not drug dealers.

I'll never forget when I first looked at the drug database

for a patient of mine.

I mean, it was just glaringly obvious

she'd been doctor shopping,

you know, 1,600 pills, I think, in the span of a month.

And I think it's important to know

that doctors were being sued

if they did not do everything within their power

to address a patient's pain.

So there was a serious problem going on here.

Lembke was also seeing a new type of patient...

An "opioid refugee."

How's your chemistry class coming?

It's fine.

What are you guys working on in there?

Compounds, chemical compounds,

like iron...

Casey leads a protected life.

Her father Ken watched drugs destroy his brothers,

so he moved his daughters out of the city

and put them in private schools.

In her teens, Casey stayed busy with sports.

But she began having severe muscle cramps.

I remember one game in particular,

all of sudden I just started feeling really shaky

and then everything just started hurting.

My legs and my arms just cramped up really tight.

She fell straight to the ground screaming in pain.

It took me and one of her coaches to pick her up,

put her in our car, rush her out to Children's.

They did a million and one tests,

and then they found, you know, an ovarian mass.

Well, an ovarian mass in a teen, that's scary.

So then that required more medical workup

in order to discover that the mass was, in fact, benign,

but by then, you know, she had a surgery,

it had been removed,

and through all of this,

she received copious opioids.

Once I left the hospital,

I noticed that I was still having a lot of pain,

but it was nowhere near the surgery sites

that they had operated on.

We couldn't even touch her,

she was in so much pain.

She described it as

it felt like her bones were being ripped out of her body.

Now, the pain she was experiencing

was opioid withdrawal pain, but they didn't know.

So they whisk her back to the emergency room.

"What could this possibly be?

She's got terrible pain."

And, essentially, every single time

the solution was, "Prescribe more opioids."

But after a while

they didn't help as much anymore,

so I started taking way too many.

Until at one point

an emergency room doctor realized she's addicted,

and what was his reaction?

He basically went out and he shamed them.

And he's like, "Your daughter's addicted.

We never want to see her here again."

Stunned, Ken drove home,

with no idea of how to help his daughter.

Casey was now an opioid refugee,

battling cravings and withdrawal on her own.

We just felt powerless.

And as a dad, I'm supposed to be her protector,

and I just felt like I had, I had completely let her down,

that...

I just didn't,

I mean, I just didn't know what, what to do anymore.

There was implicit trust.

"If this medication were dangerous,

"they would tell me.