Children of the Mountains Struggle to Survive

Over the two years that ABC News spent with Grim, he moved at least eight times. He stayed with assorted friends and relatives and sometimes even slept in his beat-up red truck.

In the trailer in Flat Gap, Grim's mother Tina proudly pointed out the cabinet filled with her son's trophies and showed off scrapbooks of his successes to visitors.

"I want him to have something to pass down to his kids when he does have them," she said.

She also took out the family prescription pills that she locks away with her prized coin collection. If she tried to sell them, she said, these doctor-prescribed pills for nerve and back pain could go for $120 per bottle.

"I lock up all my pain medication and my nerve pills, so that way I don't got to worry anybody else stealing 'em off me," she said.

Grim's football coach and mentor, Jim Matney, does what he can to help Grim succeed. Matney was born in the mountains and traded his high school wrestling skills for a college scholarship. He returned to his hometown and has been coaching for 27 years.

"We want him to be able to trade his gift for football to have a better life," he said.

Erica: 'I Want to Get Away'

In another part of the hills, 11-year-old Erica prayed for her mother, Mona, to beat her addiction to painkillers.

"She's almost 50, and if I don't get her out of this town soon, then she'll probably die any day. The future, we'll never know about," Erica said.

Mother and daughter live in the abandoned coal town of Cumberland, Ky., but Erica dreams of moving them to Georgia where a friend lives.

When ABC News first met Erica, Mona was being sent to rehab, but she soon returned home to her daughter and her addiction. To escape, Erica goes on walks through the boarded-up town. She says she knows when her mother is high by the look in her mother's eyes.

"The reason I go on these walks is because I want to get away from my mom when she's like that," she said.

Erica has a guardian angel, a mentor named Karen Engle, the executive director of Operation UNITE.

"She's a very special young lady and has a lot of potential, but she's got a lot of obstacles like a lot of our kids do," Engle said.

Launched in 2003, UNITE is an anti-drug initiative that combines law enforcement, treatment and education. Engle works tirelessly, confronting the prescription pill epidemic and educating students about the dangers of using drugs.

The prescription drug abuse rate that Engle sees in the mountains is twice that of major cities like New York or Miami. Kentucky is second only to Utah in prescription drug abuse.

"Every single family in our region has been affected by this," Engle said. "They're somebody's child, somebody's brother or sister, mom or dad, and it's changed the face of our region."

Many of the dealers are users themselves, traveling to places like Detroit or Philadelphia to buy OxyContin in bulk. Paying roughly $40 a pill in the big cities, they return to Appalachia with up to 150,000 pills and mark them up to about $120 because the desire is so great, the profits enormous. Engle said she's seen big dealers make almost $400,000 per month.

More common, though, she says, are the doctors who prescribe the cheaper pills like Xanax or Lortabs. Medicaid will pay for such prescriptions, which users then sell for a $4 to $10 profit per pill.

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