The effects, however, are lasting and potentially deadly. a StarNews review of autopsy reports summarizing medical examiner investigations into local prescription drug-related deaths in recent years shows that many users often die after a prolonged struggle with substance addiction.

Interviews granted by family members and friends help create a narrative portrait of four of those victims, all of whom lived and died in new Hanover and Brunswick counties.

Together, they offer a microcosm of a problem that’s becoming increasingly more common.

Jeffery Swaim: Brother, son

Jeffery Swaim had battled the bottle for years. But what eventually killed him came not from a bar or a liquor store, but from a prescription pad.

In July 2009, Jeffery left an inpatient rehab facility in Goldsboro where he had sought treatment for alcoholism and was on a Greyhound bus traveling home.

His mother, Sheila Buckner, and his 4-year-old niece were in a car headed toward downtown Wilmington to pick him up from the bus station.

Buckner arrived early, beating the bus by a few minutes. the sun was still out when the bus finally pulled in and parked. the two waited for Jeffery to disembark, but minutes passed and he never showed.

Wondering where he was, Buckner approached the bus and asked the driver if someone matching Jeffery’s description – “a white guy,” medium build, goatee – had gotten off.

At Buckner’s insistence, the driver boarded the bus and checked the seats for any stragglers. he appeared to Buckner a few moments later and said, “Ma’am, can you go in there and wake him up? I can’t wake him up. See if that’s your son.”

Jeffery was sitting in the last seat, next to the bathroom. he was slumped over, his head hanging limp between his knees; arms almost touching floor.

Buckner pushed him into an upright position. his skin was white and his mouth purple.

“Jeff! Jeff!” she called out, pulling him to the floor to begin CPR.

After an ambulance arrived, medics got his heart beating again. Color returned to his face. Buckner breathed a sigh of relief.

But at the hospital, the news was grim: his brain had been without oxygen for far too long.

Jeffery, 40, was brain dead.

In the whirl of the moment, Buckner hadn’t realized that while she administered CPR, a Duragesic patch was lodged in her son’s mouth.

Duragesic is a patch containing fentanyl, a drug 80 times more powerful than morphine, that is designed to be placed on the skin to relieve pain over a long period of time. While in the rehab facility’s care, a doctor prescribed him the medication to mollify pain stemming from pancreatitis.

Chewing on the patch is common practice among addicts seeking a faster, stronger high.

Most of Jeffery’s biography was drawn from interviews with his mother and ex-wife, Heather Sosebee, whom he met and married in Reno during the mid-1990s. both described a funny, soft-hearted and animated character whose vice was an addiction to alcohol.

A DUI charge in 1999 scared Jeffery into swearing off alcohol, and he stayed sober for several years. Issues with prescription drugs didn’t crop up until 2005, when Jeffery was prescribed fentanyl, morphine and methadone for pancreatitis pain.

Sosebee, who now lives in Florida but has stayed in contact with Jeffery’s mother, said Jeffery tried to wean himself off the medications after about a year.

That proved difficult, though, and he embraced drinking again as a means to help himself through it.

Soon, the substance abuse joined with other issues to drive a wedge in their relationship. and the two divorced in 2007.

Not long after the split, Jeffery was laid off. he moved to Boiling Spring Lakes to live with his mom and get on his feet again, but his drinking picked up.

Not long before he died, as Buckner and Jeffery were riding in the car together, she lit into him.

“I told him I was sick and tired of him feeling sorry for himself and … that if he wanted Heather back he was going to have to change his ways,” she recalled, brushing away tears.

Jeffery agreed. and his family set out trying to find him help. But they hit roadblocks around every turn. after a few days at the Goldsboro facility, staff there said they couldn’t provide him long-term help, and put him on a bus bound for home.

Jeffery never made it.

“I think he got a raw deal. he was trying to get help there in the end,” Sosebee said. “And that’s sad, because somebody shouldn’t have to die on the back of a Greyhound bus all alone.”

Shelia Stukes: Mother, sister

Clifton Norman woke up early one morning in January 2010 and crawled over his girlfriend, Shelia Stukes, who had been sleeping beside him. she didn’t move.

Concerned, he turned on the light, and noticed she looked stiff, her pillow was soaked with sweat and her stomach swollen like she was pregnant.

Norman ran down the street to fetch Shelia’ oldest daughter, Tashia Stukes. he banged on her door in the Houston Moore housing complex.

“Shelia’s dead!” Tashia Stukes said she heard him scream.

Shelia died at about 4:08 that morning from taking too much oxycodone, according to her autopsy.

She was 46.

Norman died a year later. But her story, as told through Shelia’s daughters and siblings, paints the picture of a mother whose health deteriorated because of a doctor that family members said prescribed her unusually large doses of narcotics.

When confronted by concerned family, Shelia told them she needed the medications to alleviate pain in her knees and back. But her daughters said she was receiving unsafe quantities of the drugs from Guy Dyer, a former doctor now facing charges of selling prescriptions for cash out of his medical office on Shipyard Boulevard.

Her death rocked a family with deep ties to Wilmington.

Shelia had a modest upbringing. Born and raised in Turnkey on the city’s north side in the mid-1970s, her father was killed in the Vietnam War, leaving her mother to care for her and her siblings.

Her sister, Regina Stukes, 45, said that as kids, the two of them twirled batons as majorettes and were cheerleaders for Pop Warner football.

Shelia, portrayed as unpretentious and motherly – the pillar of the family – ran into trying times when she became pregnant at 13. when she died, she left behind 10 children, now ranging in age from 9 to 34.

Stukes said her sister endured a long-running bout with drug abuse. Shelia used crack for nearly 20 years, Stukes said, but had shunned the drug since the birth of her youngest child.

Because of the medications, her family said she lacked energy at times and slurred her words. But she continued to insist she needed them for medical reasons.

Today, her family has trouble summoning the words to describe how they feel.

“You want to know how it affected me?” asked Shanetta Stukes, 30, one of her daughters. “I got high blood pressure. I don’t like to take my medication. I don’t like pills at all.”

Nicholas Murray: Aspiring herpetologist

On Oct. 3, 2008, 24-year-old Nicholas Murray and his 26-year-old girlfriend, Malissa Hurlburt, were found dead on the sofa in their Wilmington-area apartment, the victims of a mix of oxymorphone, hydrocodone and methadone.

A question mark still lingers over how their last moments transpired. But a timeline of the event leading up to their death was pieced together through an interview with Nicholas’ father and sister, who described an energetic young man struggling with the challenges of life.

Nicholas was born and raised in Wilmington as the son of a sheriff’s detective. his family lived in various neighborhoods throughout the city, attended church on Sunday and enjoyed cookouts and outings to the beach.

“We had an amazing childhood, I mean storybook,” said his sister, Crystal Burnett, who still lives in Wilmington.

Friends nicknamed Nicholas “Smiley,” a testament to his happy-go-lucky personality. he loved animals, particularly reptiles, and harbored dreams of becoming a herpetologist.

But Nicholas’ life was not without obstacles. Nicholas was 8 when his parents divorced, and he was diagnosed with attention deficit disorder around the same time.

His difficulties landed him at Lakeside School, the county’s former school for troubled youth. the curriculum was designed to be slower so Nicholas could keep up. But his father, John Murray, said he believes it was there that Nicholas fell in with the wrong crowd.

“He kept telling me, ‘Dad, you don’t understand. If you want pills, if you want drugs, you can get anything at Lakeside,” his father said.

As time went by, family watched Nicholas grow increasingly withdrawn. he became short-tempered. School eventually became too much for him to bear, and he dropped out in the ninth grade.

He lived with his sister and worked for her then-husband’s painting company. he stayed in most nights watching late-night TV and playing video games.

His family tried to help him overcome substance abuse and mental health issues, but Murray said the system presented insurmountable hurdles.

For example, after Nicholas had made comments about suicide to his father, his family had him enter a rehab center in Greenville, N.C. the facility kept him two days before discharging him, saying that Nicholas was not going through withdrawal symptoms, so they couldn’t keep him, according to his father.

Nicholas died less than a year later.

Nicholas’ relationship with Hurlburt entered a new phase when the two decided to move in together in late 2007 or early 2008.

“Nicholas wanted the storybook finish,” his sister said. “He wanted to be married and have a family. and he was looking for somebody to give him that everyday stability.”

Since his death, the family has channeled their sorrow into activism, pushing for tougher laws against drug dealers and more funding for the state’s treatment system.

“I sat up, nights and nights and nights, crying my eyes out,” Murray said, describing his feelings after his son’s death. “It’s lonely. I miss him.”

Jimmy Fulwood: Musician, father

Jimmy Fulwood’s troubles began with a thud.

It was the summer of 2007, and Jimmy – thin, long-blonde hair, mustache – was climbing a ladder in a friend’s backyard, reaching for a broken limb caught in the branches. At a height of 28 feet, the ladder slipped, and Jimmy tumbled down.

He landed on his feet, shattering a shin bone and both ankles.

Doctors told him he would never walk again, painful news for someone who had worked labor jobs most of his life.

Jimmy grew up on a tobacco farm on Ocean Highway West in Brunswick County. later in life, he found his niche as a carpenter and started building houses. he married twice, and had a son, who is now grown.

His mother and nephew, interviewed at their house on the farm land the family still owns, sketched a portrait of a talented musician whose injuries gave rise to a mentally debilitating bout of depression.

That, along with the physical pain in his legs and what the family said was an unscrupulous doctor who gave him whatever medicine he asked for, Jimmy became hooked on prescription painkillers that eventually killed him.

Jimmy, outgoing and energetic, played guitar in a local rock band named Crossroads and was a die-hard fan of Stevie Ray Vaughan.

“He was the life of the party,” his nephew, Kris Fulwood, said. “When Jimmy was there, everybody was cutting loose, laughing, telling jokes.”

His fall from the tree altered the course of Jimmy’s life. he underwent several surgeries on his ankles and legs; doctors prescribed him hydrocodone and other medicines to quell the pain. Unable to work, he moved in with his mom. after some healing, he could hobble around the house and do basic chores, but he occasionally relied on a wheelchair.

He never worked again. Immobility led to feelings of isolation, which in turn made him increasingly depressed.

“I think he thought,” his mother, Eulalia Fulwood, said, pausing and choking up, “that maybe he’d be a burden to me, but he wasn’t.”

According to his mother, Jimmy could not afford his doctor visits. so to get his pain medication, Jimmy worked out a system where friends drove him to the doctor’s office and paid for his care in exchange for some of his pills. he found a doctor willing to write him a prescription at any time, his mother said, even before the old one was scheduled to run out.

Recognizing his addiction and at the urging of his family to seek help, Jimmy completed a Christian-based treatment program at Alpha & Omega Home Inc. in October 2009, a certificate his mother still has framed in her home. But Jimmy later relapsed.

“He just had an addictive personality,” his nephew said. “He didn’t want to be that way. he tried his damnedest to straighten up.”

Two weeks before Jimmy died, Kris Fulwood picked up his uncle, and they took a drive. In the car, Jimmy expressed how lonely he felt. so Fulwood began making plans for Jimmy to come stay with him in Wilmington.

“Whatever you need, I’ll take of care of you,” he pledged to his uncle. “The whole nine yards; let’s just get you out of Brunswick County.”

On the evening of March 3, 2010, Jimmy came home from a doctor’s visit, walked through the backyard and into a rusty-red shed. his mother was in the kitchen cooking dinner. she looked up and noticed the shed door was ajar. she called for her granddaughter to close it. when the granddaughter neared the door, she saw Jimmy lying on the cement floor next to a chair and an extension chord.

Jimmy, 47, was dead. according to the autopsy, oxycodone killed him.

Brian Freskos: 343-2327

On Twitter: @BrianFreskos