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Pills, booze, family and justice: A Tennessee opioid crisis story

COOKEVILLE, Tenn. — Larry Elmore was high on Percocet and Xanax as he climbed a ladder onto the roof of his mother’s house to clean the gutters. On the top rung, he lost his balance and tumbled, shattering his right femur as he crashed to the ground below.

Someone called 911. Elmore limped inside and took more Percocet as he waited for an ambulance. By the time he got to the hospital, he was so high that doctors couldn’t operate.

It was September 2014, and pills were how Elmore solved all his problems. If he felt tired or sick, he took Percocet. To sleep, he took Xanax. If the Xanax left him too groggy, he took more Percocet. If the Percocet left him too wired, he took more Xanax. Elmore told himself this was a delicate balance of legal, helpful prescriptions. But he knew the truth. He was woefully addicted. He was trapped.

“When I was taking these pain pills, it felt like it had sucked my soul right out of me,” said Elmore, 59, of Cookeville. “I felt like I was in a cage that I would never get out of.”

If the Tennessee opioid epidemic were a person, it would look a lot like Elmore: a white, middle-aged, rural, blue-collar worker who once knew nothing about the dangers of prescription medication. Like many ensnared in the epidemic, Elmore took his first opioid pill to treat legitimate pain, then fueled an addiction by leaning on an unscrupulous doctor who ignored red flags and prescribed unjustified painkillers. Elmore then spent years wallowing in a drug haze from which many never escaped. Now, much like the state of Tennessee itself, he strives to recover from an addiction that should have been stopped long before it began.

For this story, Tennessean journalists conducted an in-depth interview with Elmore and his son, Justin, and reviewed hundreds of pages of government transcripts in which they testified under oath about addiction. Taken together, the interviews and testimony paint a portrait of a quintessential victim of the Tennessee opioid crisis, which has killed about 5,000 people and ruined the lives of countless more.

Elmore was born in 1959 to a coal mining family in Wilder, an impoverished community of only a few hundred in the mountains northeast of Cookeville. He grew up in a wooden shack with cardboard walls and without indoor plumbing on the edge of railroad tracks that carried coal to Nashville. When his dad and granddad weren’t mining, they were brewing moonshine in the woods. As a boy, Elmore helped clean the fermentation jugs.

Moonshine gave Elmore his first taste of addiction, although it took him years to recognize it for what it was. He dropped out of high school and started drinking heavily, then spent most of his 20s as a functioning alcoholic working on Tennessee farms, construction sites and oil fields.

Elmore married in 1989, had a son in 1993, then got divorced in 2000 — all while his alcoholism worsened. He was arrested for DUI at least eight times, and vividly remembers one day in 2001 when his ex-wife and son visited him in jail.

His son, 8, spoke through a jail phone, pressing his hand against the glass wall between them.

“Daddy, this looks like a zoo,” Justin said.

“Son,” Elmore responded, “that’s what it is for people who can’t do right in life.”

10 years sober, then painkillers

Jail gave Elmore the time he needed to sober up. After a tearful goodbye with his son, Elmore enrolled in a jailhouse treatment program, then joined Alcoholics Anonymous when his jail stint was done.

At AA meetings, Elmore found himself surrounded by sobriety for the first time in his life. He quickly forged a friendship with Sam Barnes, a Tennessee doctor who had struggled himself with alcohol years before, who hired Elmore to help on his farm in Cookeville.

Elmore walked to work until he got his driver's license back and saved enough money to buy a dependable car. He paid his child support and built a relationship with his son that he never had when he was drowning in alcohol.

“It was a totally different, better life than I had ever had before,” Elmore said.

Eventually, a now-sober Elmore returned to the job on which his dad and granddad had built their livelihood. He was hired at a zinc mine in Carthage, spending his days blasting with dynamite in road-sized tunnels more than a thousand feet underground.

The pay was good, but long days working underground took a toll on Elmore’s right knee, which he injured a decade earlier on an oil rig. His family doctor prescribed him a few low-dose Percocet but was hesitant to provide more because of his history with alcoholism.

Elmore didn’t understand. His vice was booze, not pills, and he had been taught that dangerous drugs came from dealers, not doctors.

“I didn’t know nothing about pain pills,” Elmore said. “I really didn’t think that pills would do what it did.”

At first, just one pill did the trick. A single Percocet erased his knee pain and invigorated his body so he wasn’t drowsy during long, dark days in the zinc mine. Then it took two pills to achieve the same rush. Then three. Within weeks, Elmore was taking his Percocet faster than prescribed. Then a drug test showed he was experimenting with other opioid painkillers outside of his prescription. Worried, his doctor cut him off.

While Elmore was spiraling in secret, his friends and family were celebrating — 10 years had passed since he walked out of jail a sober man. At a local clubhouse, Barnes and about 25 others gathered around a cake for an anniversary party.

Soon, it was obvious something was wrong. Elmore was missing.

“Larry didn’t show,” Barnes said. “That’s because Larry was so honest — so straightforward — he could not pretend any longer that he was sober.”

Percocet, Xanax and a negligent doctor

Elmore had lost his prescription, but new opioids were not hard to find.

Pill addicts were rampant among the battered bodies of the zinc mine, and miners weren’t shy about their source. Soon, Elmore was given the name of a doctor who would write him all the prescriptions he wanted — Dr. Brian Waggoner.

On the very first visit to Waggoner's clinic, the doctor wrote Elmore a Percocet prescription that was four times stronger than he had before, according to state medical discipline records obtained by The Tennessean. If Waggoner knew about Elmore's alcoholism, DUIs or failed drug test, it didn't stop him.

Soon, Elmore was taking more than 10 Percocet a day, and his addiction had worsened to the point where he could no longer work in the mines. State records show Waggoner then upped his opioid prescription repeatedly and added Xanax, a benzodiazepine that can be dangerous when combined with painkillers.

Elmore spent more than four years bouncing between Percocet and Xanax with no end to his prescriptions in sight. Pills, he said, were now his full-time job.

“I had to have pills to get out of bed in the morning, and then pills to go back to sleep,” Elmore said. “And if I didn’t have any Xanax, after three days with no sleep, I couldn’t focus. I couldn’t think. I couldn’t do nothing. I was delusional.”

Once, while lost inside a prescription fog, Elmore tried to chug bug spray. In another instance, police brought him home after he spent an entire winter night wandering outside in just shorts and a T-shirt. Then he fell off the roof and broke his leg while in a drug stupor. And finally, in 2015, Elmore was arrested for driving while high, then went to court so stoned and blabbering so much nonsense that a judge delayed the hearing.

These were the worst years, when Elmore only existed when one pill wore off and before another kicked in, said his son Justin Elmore, by then a college student. At times, it felt as if the dad he bonded with during a decade of sobriety was now gone.

Emotionally, he prepared himself for his dad to die.

“Not only was I seeing my hero fall from grace, it was like being with someone who had the same face as your hero but was the complete opposite,” Justin Elmore said. “He wasn’t my dad anymore.”

Waggoner, apparently, didn’t notice. State records show the doctor testified under oath that he never saw Elmore exhibit any red flags or signs of prescription abuse.

Elmore, he said, was “a model patient."

Death, justice and a long journey home

It was January 2017 when Elmore finally realized he had to escape.

His elderly mother, whom he had lived with during years of worsening addiction, was diagnosed with cancer and given only a few months to live. Someone had to manage her affairs, but Elmore knew he was too addicted to be in charge.

His son, now more of an adult than his father, volunteered to take over. Although he was about to move across Tennessee for a new job, Justin Elmore quit so he could care for his grandmother, hoping to give his father a chance to go to rehab.

“If that was the only option that got him clean, I didn’t care,” he said. “I didn’t care if it took three months or six months — whatever he needed — I knew this was the chance to get him out.”

This was a long-overdue moment of clarity for Elmore, who finally knew how deeply he had failed his mother and son. He called Barnes, a friend he had not spoken to in years, to ask for help. Later that night, Barnes helped Elmore enroll in a rehab program at Cookeville Regional Medical Center, where he spent the next four days bedridden by withdrawal. On the fifth day, doctors bolstered Elmore with a low dose of Vivitrol, a non-addictive drug used to wean addicts off opioids. He left the hospital a day or two later.

“I felt better than I had in years,” he said. “For the first time in about six or seven years, I had hope.”

That was two years ago, and with the exception of one short Xanax relapse last fall, Elmore has maintained his sobriety and begun to rebuild a good life. Elmore moved in with Barnes and his wife, helping the elderly couple tend to their farm just as he did while recovering from alcoholism. He recently started a job as a part-time janitor in a nonprofit office in Cookeville. The work isn't glamorous and the paychecks are small, Elmore said, but he finds pride in the normalcy of a day job after years of chaos.

Elmore found justice, too. Six months after getting sober, he was a star witness in the medical discipline trial of Waggoner, the doctor who supplied him with Percocet and Xanax.

State records show Waggoner wrote unjustifiable prescriptions to at least 14 patients, some of whom had received prescriptions more than 10 times as strong as Elmore's. This year the Tennessee Board of Medical Examiners put Waggoner’s medical license on probation and forbade him from prescribing opioids without having his prescriptions monitored by an outside company.

Waggoner, who still operates a clinic in Cookeville, did not respond to requests for comment.

Most importantly, Elmore rebuilt the relationship with his son that he nearly lost. They speak on the phone every day and meet at least one weekend a month, often working together on Barnes’ farm.

At first, Justin Elmore visited his father to keep an eye on him, worried about a relapse, but nowadays he just visits.

On an average Saturday, they clean a chicken coop together and spend hours chopping firewood. Elmore seizes every chance to brag about his college-educated son. Justin Elmore begs his dad to drink more water and smoke fewer cigarettes.

They chat and joke and reminisce like any family should.

Nobody mentions alcohol or opioids or Xanax.

Some things don't need to be said aloud.

“I think back to those times when I didn’t have him, and now I need to spend time with him more, because I can,” Justin Elmore said. “That’s what family is all about.”

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