Chapter 10
Portsmouth, Ohio, 2011
On a warm June night in 2011, Jim Geldhof sat down on a folding chair inside a high school gymnasium in Portsmouth, Ohio. Two weeks earlier, the DEA had shut down a string of pill mills in the city and arrested several doctors. Outside the pill mills in Portsmouth, crowds cheered the raids. Geldhof and one of his supervisors in the state capital, Columbus, Kathy Chaney, were invited that night to a town hall on the opioid crisis with the city’s police chief, federal officials, and community residents.
Hundreds filed into the gymnasium. After a few people spoke, the police chief turned off the lights and the room grew dark. A large screen flickered with photographs of Portsmouth’s dead. One by one, twenty-eight bright young faces flashed across the screen. A high school cheerleader. A football player. A boy wearing a red toboggan hat. A teenage boy sporting a tie in his senior-year photo. Another teenager smiling on the beach. A young nurse.
People sitting in the rows behind Geldhof began to sob.
They were parents, siblings, relatives, and friends of the faces on the screen. Practically everyone in Portsmouth had been touched by an overdose death. The Appalachian city of 20,000 on the north bank of the Ohio River, just across from Kentucky, was saturated with opioids. It had acquired the nickname “Broward County North.”
Located almost as far south as one could travel in Ohio before reaching Kentucky, Portsmouth in Scioto County had once been a booming blue-collar industrial city known for its shoe factories and its enormous steel mill, the Portsmouth Steel Company. During World War II, it became a large producer of bombs. But the mill had closed long ago, along with the shoe factories. As unemployment climbed, abandoned buildings scarred the city. Pain clinic after pain clinic opened in Scioto County. With them came an underground economy. Residents, many on disability, used their insurance to cover the cost of opioid prescriptions and sold the pills on the street for thousands of dollars.
As the photos flashed across the screen, the sobs behind Geldhof became louder. It was gut-wrenching. Sons and daughters and grandsons and granddaughters in graduation pictures. They were dead before they had a chance to live.
The hardened DEA supervisor thought about his daughter and two sons. He had seen the stats about addiction and drug arrests and seizures. But the young faces on the screen and the weeping in the gym resonated with him in a way that no DEA report or investigation ever could.
Soon, Geldhof was in tears, too. “I’m not sure I’m going to be able to get through this,” he said, leaning over to Chaney.
Chaney was crying, too. For her, it was a particularly difficult night. She had joined the DEA because of a deeply personal loss: Her mother became addicted to Percocet after a car crash and died of an accidental overdose.
The faces on the screen were mostly White. Portsmouth was 90 percent White, as were many other epicenters of the epidemic, which in the early to mid-2000s disproportionately affected White communities. Addiction experts theorized that White people, especially those on disability insurance, had more access to doctors who were willing to prescribe opioids. Racial bias appears to have led some doctors not to prescribe painkillers to Black or Latino patients as indiscriminately as they did with Whites. Some doctors with conscious and unconscious bias deemed that minority patients would be more likely to abuse the drugs or sell them. But they didn’t have to look far to see that the vast majority of people selling and abusing pain pills were White.
One of the speakers that night was Lisa Roberts, a nurse who had worked for the Portsmouth City Health Department for twenty-two years. She was active in SOLACE—Surviving Our Loss And Continuing Every Day—a support group created a year earlier to raise awareness about how opioids were ravaging the city and to pressure local and state officials to take action. The group, which had helped to create the video, had Scotch-taped many of the same photographs from the town hall in the display window of an abandoned department store on Portsmouth’s main thoroughfare.
Roberts, born and raised in Scioto County, understood the torment of the parents around her. Her own teenage daughter had become addicted to pain pills. So had the children of some of her colleagues. Her daughter survived. Many of her friends’ children did not.
Geldhof had met Roberts several years earlier while he and his team were investigating Ohio pain clinics run by unscrupulous doctors. One of the most notorious in Portsmouth was Margaret Temponeras, a forty-six-year-old family physician who owned a clinic called Unique Pain Management. A billboard advertising the facility stood at the entrance to the city. “Legitimate Pain Care,” it read. Over six years, beginning in 2005, Temponeras ordered 1.6 million pain pills. Eight of her patients died.
Temponeras and her eighty-four-year-old father, who also worked as a doctor at her clinic, saw more than twenty patients a day from Ohio, Kentucky, and West Virginia. They were paid cash for each exam, starting at $200. When pharmacies concerned about Temponeras’s practices stopped filling her prescriptions, she opened her own dispensary. She often prescribed a combination of opioids, muscle relaxers, and anti-anxiety drugs, known as “the Holy Trinity” or the “Scioto County Cocktail.” She would later plead guilty to drug conspiracy and be sentenced to seven years in prison.
Vying with Temponeras for most dangerous doctor in Portsmouth was Paul Volkman, who had been investigated by Geldhof’s group in Cincinnati for illegally prescribing millions of painkillers. Four of his patients overdosed and died. Volkman operated out of three pain clinics in Portsmouth and one in Chillicothe, Ohio. He, too, asked his patients to pay cash and opened his own dispensaries. The DEA discovered that Volkman purchased more oxycodone than any other doctor in the nation between 2003 and 2005, prescribing millions of pills. He later received four consecutive life sentences.
When the town hall ended, Geldhof and Chaney drove to a nearby diner. They were shaken.
“That was horrible,” Chaney said
“Really rough,” Geldhof said. “Let’s get these sons of bitches.”