The Joker Drug: James Eagan Holmes and Heath Ledger Tragedies Show Vicodin is a New US Epidemic

Tragedy has been no stranger to the Batman franchise.

The darkest part of the Dark Knight trilogy has become the high-profile deaths that have overshadowed the entertainment value of the movie. There was Aurora, Colo., on Friday — a disgusting act of human carnage that has shocked the nation to its core. But before that incident, there was the Heath Ledger death, a moment where a budding young star’s career was cut short because of drug overdose.

Though Ledger’s death can in no way be comparable to the Aurora massacre, there is a sinister twist that connects both moments:

Aurora and Ledger each involved “the Joker,” or at least men who embodied the character and the qualities of the Batman comics’ villain.

Then there is the Joker’s drug of choice: the pain killer Vicodin. Actor Heath Ledger died of a painkiller overdose. James Holmes, the Batman shooter, took a higher dose of the drug before his rampage.

The parallels with the Joker are odd, ironic almost — the Batman franchise’s greatest villain has become … the franchise’s greatest villain.

But the villain here is more than a maniacal clown bent on ripping apart society. The Batman Massacre and Ledger death shows us that drug abuse is a much more sinister problem. There have been two tragedies befall the Batman franchise, both involving prescription drug abuse. These incidents headline a wider national trend that may be spreading unchecked. As a result, these high profile tragedies will help us better explore the perscription drug crisis in America.

So why should we care?

First, the numbers.

According to the CDC, in 2010, "about 12 million Americans (age 12 or older) reported nonmedical use of prescription painkillers in the past year."

It has emerged that the Batman shooter Holmes was apparently heavily sedated on Vicodin (also known as Hydrocodone and Oxycotin) as he carried out the shooting. After the massacre, Holmes — who identified himself to authorities as “the Joker” and his hair was painted red in an ode to the Batman villain’s sinister clown appearance — calmly told detectives that he had taken 100mg of the drug.

The suggested max amount of hydrocodone is 40mg a day.

In Heath Ledger’s case, the chief medical examiner states definitively: "We have concluded that the manner of death is accident, resulting from the abuse of prescription medications.” Ledger consumed a cocktail of different pills, leading to his demise. The medications found in the toxicological analysis —    Oxycodone, Hydrocodone, Diazepam, Temazepam, Alprazolam and Doxylamine — are commonly prescribed in the United States for insomnia, anxiety, depression, and pain.

As outlined by Ocean Breeze Recovery:

Prescription painkiller overdoses killed nearly 15,000 people in the U.S. in 2008, three times more than the 4,000 people killed by these drugs in 1999.Nearly half a million emergency department visits in 2009 were due to people misusing or abusing prescription painkillers.Non-medical use of prescription painkillers costs health insurers up to $72.5 billion annually in direct health care costs.

States have to battle with widespread addiction and abuse of these painkillers. During the year 2000, the 10 states with the highest OxyContin (a more powerful version of Oxycodone) prescription rates (per 100,000 population) and those with problems of abuse were, in descending order were: West Virginia, Alaska, Delaware, New Hampshire, Florida, Kentucky, Pennsylvania, Maine, Rhode Island and Connecticut.

West Virginia, and Southeastern Kentucky have long histories of pharmaceutical abuse. In Kentucky in particular, the addiction shapes the urban geography. “Pillville USA” has become the trade name of Hazard, Ky (Perry County). A police police chief in the county reported that in a one year period (1999 - 2000), the number of OxyContin complaints called into his office increased from one every three months to three or four daily.

"The rate of overdose-related deaths more than doubled among men and tripled among women in Kentucky from 2000 to 2009, according the state Cabinet for Health and Family Services," reports McClatchy DC. 

From Appalachia, this phenomenon has gone national. According to a study by the Substance Abuse and Mental Health Services Administration and reporting by the Lexington (Ky.) Hearld-Leader, there was a 4x increase nationally in admissions for prescription pain pill abuse during the past decade. "The increase spans every age, gender, race, ethnicity, education, employment level and region."

These pills are illegally acquired with fraudulent prescriptions, through illegal sales, by pharmacy theft and doctor shopping, from loosely organized rings of individuals diverting and then selling it, and by way of foreign smuggling into America. When abuse of OxyContin drastically increased, authorities in Pennsylvania, Florida, Ohio, Kentucky and Georgia reported swelling numbers of pharmacy robberies, burglaries and theft.

Authorities have struggled to curb this epidemic. And it's only getting worse. More than 15 million Americans abuse prescription drugs, more than the combined number who reported abusing cocaine, hallucinogens, inhalants, and heroin.

The Joker in The Dark Knight is hell-bent on creating mass-anarchy. He opines in the movie: “Introduce a little anarchy, upset the established order, and everything becomes chaos, I’m an agent of chaos.”

Maybe the Joker — the agent of chaos — isn’t a single person. The real anarchy that is upsetting the established order is the drug abuse sweeping across the country. The Dark Knight tragedies in Aurora and with Heath Ledger point to a new villain destroying America.

Editor's Note: This story has been updated to properly cite language that was originally used without attribution to McClatchy DC and Ocean Breeze Recovery. We apologize to our readers for this violation of our basic editorial standards. Mic has put in place new mechanisms, including plagiarism detection software, to ensure that this does not happen in the future.