Conway, 70, has been in prison since he was rounded up in a sweep of 97 “pill mill” operators in June 2012. He surrendered his medical license in court and, facing 20 years in prison, stands a good chance of dying there. Still, Murphy said, she does not feel the punishment is severe enough.

“In our communities, 90 percent of our young people are either on these pills or heroin,” she wrote. “That is not an exaggeration. This is the fact of our youth. This monster took part in this assault on our children.”

While Randy disagrees with his mother, and feels that Conway is being adequately punished, he backs her up on the estimated severity of the local drug problem. “Literally every single friend I have is on drugs,” says the Lawrence High School graduate, who began using at age 14. “I started with Xanex, then Percocet and Oxy.” By the time he got clean, Randy says, he was using 20 $10 bags of street heroin per day.

Inside the addict’s world

The progression from prescription drugs to street drugs is typical, said Claudia Rotundo, a Baldwin resident who has spent decades helping people battle substance abuse and who now orchestrates prevention programs focused on the youth. Young people start using relatively “safe” pills from their friends’ or parents’ medicine cabinets, Rotundo explained, then graduate to unregulated street narcotics once the prescription meds become too expensive or too hard to obtain.

As Randy detailed the intricacies of feeding his habit, he described himself as having been “smart about it.” He smiled when recalling a particularly well-orchestrated scheme involving a fake MRI, and seemed hazily happy when describing the high an OxyContin pill created when crushed and sniffed. (“No one eats them,” he said.)

“You have your little moves that you make,” he went on, connecting an invisible series of dots on the table with his bony fingers. “At times I was going to see seven different doctors in a month.”