Jessica and Darren McIntosh were too busy to see me when I arrived at their house one Sunday morning. When I returned later, I learned what they\u2019d been busy with: arguing with a family member, also an addict, about a single pill of prescription painkiller she\u2019d lost, and injecting meth to get by in its absence. Jessica, 30, and Darren, 24, were children when they started using drugs. Darren smoked his first joint when he was 12 and quickly moved on to snorting pills. \u201cBy the time I was 13, I was a full-blown pill addict, and I have been ever since,\u201d he said. By age 14, he\u2019d quit school. When I asked where his care givers were when he started using drugs, he laughed. \u201cThey\u2019re the ones that was giving them to me,\u201d he alleged. \u201cThey\u2019re pill addicts, too.\u201d<\/p>\n
Darren was 13 when he started taking pills, which he claims were given to him by an adult relative. \u201cHe used to feed them to me,\u201d Darren said. On fishing trips, they\u2019d get high together. Jessica and Darren have never known a life of family dinners, board games and summer vacations. \u201cThis right here is normal to us,\u201d Darren told me. He sat in a burgundy recliner, scratching at his arms and pulling the leg rest up and down. Their house was in better shape than many others I\u2019d seen, but nothing in it was theirs. Their bedrooms were bare. The kind of multigenerational drug use he was describing was not uncommon in their town, Austin, in southern Indiana. It\u2019s a tiny place, covering just two and a half square miles of the sliver of land that comprises Scott County. An incredible proportion of its 4,100 population \u2013 up to an estimated 500 people \u2013 are shooting up. It was here, starting in December 2014, that the single largest HIV outbreak in US history took place. Austin went from having no more than three cases per year to 180 in 2015, a prevalence rate close to that seen in sub-Saharan Africa.<\/p>\n