Those on meds, however, have a fighting chance. Because the opiates have built up in their system over time, in theory they can skip a dose. “Cheeking” a pill worth $5 adds up, even if you’re doing it only once a day because you need the other two. And there is always a buyer.
What this looks like in reality is not as neat, however. I knew an older fellow named Steve who had it all, starting with hepatitis C. Steve was also in a wheelchair, HIV-positive, and dying of lung cancer. That meant a lot of medication. The problem was, Steve liked gambling much more than he liked not being in pain. As a result, he owed almost all of his pills, all of the time. He booked his medication a week ahead, and sometimes he promised one dose to two people. When judgment day came, he’d lie to his clients about being forced to swallow his pills. But then they started to make sure, and followed his wheels to the window. Steve had an entourage of young men bickering about who was getting what out of his meds. The cup of pills he received -- it looked like 40 at a time -- was more than anyone could cheek, so Steve trained himself to swallow his pills shallowly. He’d roll away from the window to meet his eager customers. They’d thrust a baseball cap in front of Steve and he would methodically regurgitate the pills into it, trying not to lose any. His clients would pick through the mess, trying, considerately, to leave Steve his HIV pills. It was like watching a mother bird feeding her hatchlings.