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This week, indictments were announced for dozens of medical professionals across Appalachia for their involvement in illegally prescribing opioids. But patients can't just stop taking high-powered narcotics, even if the drugs are being abused. So public health workers joined the crackdown, looking out for desperate patients. Blake Farmer of member station WPLN in Nashville reports.
BLAKE FARMER, BYLINE: A pharmacist in Celina, Tenn., on the mountainous state line with Kentucky, was 1 of the 60 indicted. He was charged with 21 counts of filling medically unnecessary narcotic prescriptions. He was also Gail Gray's pharmacist.
GAIL GRAY: If I take pain medicine first thing in the morning, I usually am up most of the night with pain. I hurt all the time.
FARMER: Gray says her chronic back pain from a degenerative disc disease is totally incapacitating without medication. But with her druggist shut down, her prescriptions are tainted. She tried to fill it with the other pharmacy in town.
GRAY: They wouldn't take me because I was red-flagged on my dose and yellow-flagged on my doctors.
FARMER: Amidst the crackdown on overprescribing doctors, the U.S. Justice Department has been increasingly concerned for patients like Gray. They're also worried about the impact on those abusing prescription drugs. So Assistant Attorney General Brian Benczkowski says this week's enforcement was coordinated with health agencies and addiction treatment providers.
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BRIAN BENCZKOWSKI: That plan is designed to ensure that affected patients have continued access to care and are at the same time directed to legitimate medical professionals in the area.
MARIE WILLIAMS: This is the first time that we have had this type of heads-up.
FARMER: Marie Williams runs Tennessee's substance abuse department. She says, in previous stings, her people have gotten maybe one day to prepare. Williams says she hopes many will see the loss of their opioid supplier as a turning point.
WILLIAMS: This is an opportunity to really change your life and get to be the person that you want to be.
FARMER: The department began plastering messages online just as the indictments were unsealed, giving patients a hotline to call. Overdose prevention specialists have been deployed to train patients on how to use reversal drugs.
Suzanne Angel is an outreach nurse in the small town of Carthage, Tenn., where a doctor's practice was shuttered Wednesday as part of the federal takedown. She's been warning the local hospital and emergency responders to be on alert for desperate behavior from people.
SUZANNE ANGEL: I'm sure that they feel depression, despair, you know, anger and fear about, who's going to take care of me, and is there going to be any support? And I don't want them to feel alone.
FARMER: Angel says there are now more alternatives to opioids, and it's possible they could find another pain clinic. But the current legal focus on opioids has made it much harder to get high-dose prescriptions. And among the thousands of patients getting their medication through questionable providers, many have very legitimate needs. Here's Gail Gray again.
GRAY: I've tried therapies. I've tried injections. I've tried several different things. We didn't just start off taking opiates.
FARMER: Gray found a new pharmacy, though it means driving to the next county over. Gray says she feels like it won't be long before she's shopping for help again.
GRAY: We're being punished for people that do abuse drugs. Chronic pain patients are being punished for it.
FARMER: Health officials say they're most worried about those who can't find another option, run out of their medication and begin to withdraw, making them more likely to take a risk on deadly street drugs. For NPR News, I'm Blake Farmer in Nashville.
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