Original subtitles

So your grandparents are at church now? Mm -hmm. So they don't know we're here?

No.

No. And they don't know you're using?

No. That's weird, isn't it? It's super weird. Nobody knows.

How did you get started?

Well, I was in a car accident, and I broke my neck, so I kept having all this

pain, and I was going to doctors, and they just kept handing me pain pills,

literally throwing them down my throat. How did that lead to you being addicted

to heroin?

I told the doctor. I said, look.

I'm addicted to these, 100%, no doubt about it. I'm sick, I'm puking, I can't

anything. You've got to help me. The doctor cut me off cold turkey.

He says, I don't know what to tell you.

Have a great day.

Shut the door and walked out.

In Huntington, West Virginia, I was spending time with heroin users.

I've heard you can OD on that.

Oh, yeah, yeah.

If I did that right there by myself, dude, I would drop.

The city's been swept up in the most deadly drug epidemic in US history.

And for several weeks, I've been trying to get to grips with why.

You responded to Brenda's call?

Yeah, we did. And you found Brenda, what, OD'd?

I just want to say thank you.

And not all of us want to be like this.

Honestly, at this point, as far as this addiction has gone and to lying to my

family about having a job and going to meetings and doing this and that, I'm

exhausted.

I'm tired.

I'm really tired.

Really tired.

Huntington lies at the intersection of West Virginia, Ohio and Kentucky, an

known as Tri -State.

Once home to factories and steel mills, it is now a hub for heroin use.

Through the city's needle exchange, I'd made contact with

25 -year -old Catilia and her boyfriend Alvin.

You okay, Cotilia?

Yeah, I'm fine.

I just need to go to the restroom real quick.

I don't want to sound paranoid, but is she shooting up in there?

No, I don't think she's shooting up.

You okay?

Yeah, I'm fine. Did you ask if I was shooting? Yeah, she's shooting.

Are you doing it now?

Yeah. Yeah, it's not, it's not. It's just, it's like a rant.

I've already done my morning shot. It's something that kind of has a little bit

of something in it that will kind of relax me.

Do you use as well, Alvin?

No, I don't use.

Not at all?

That's why it's so difficult to be with somebody that has an addiction, because

you always, you love them, but you don't want, it's like a tool of evil, you

know what I'm saying?

You love them, but you wish they'd get off, but it's hard.

You would rather Cotilia was not using?

Yes, absolutely.

How many times do you shoot up a day, then? I mean, it's at least six, seven.

in a day, how much would you typically say, what money value would you be

I can give at least $150 to $200.

Does that sound right to you, Cotilia?

Oh, yeah. Actually, that's probably less.

That's actually the minimum.

Are you able to keep down a job, Cotilia?

No. No, I've never been able to get a job.

Have you ever? You've never had a job? I've had jobs, yeah. What kind of work

have you done?

Jobs that take taxes has been just fast food.

I've stripped.

I have tricked.

I have robbed.

Tricked is prostituted. Yes. Do you still do that?

I don't. Not since I've been without.

Because he's providing?

Since we've been around each other, I've been able to find better quality of the

drug, too, to where I can not use as much.

So did I understand, Ketelia, to mean that you've been able to hook her up

better quality product?

Yeah. I would rather go out and find her something that's going to be what she

wants than something somebody put together that's going to kill her. Would

consider yourself a dealer?

Sure. No, I can see myself in her situation.

I know people, and I'll be like, okay, well, they got something good that you,

because I know she's going to get it, you know what I'm saying?

How old were you when you first got involved in a serious way with opiates?

Serious way?

When I was about 17.

Was there anything going on in your life? I mean, were you just partying in

normal way, or was there something else going on?

Well, growing up, my family does a lot of manual labor work.

A lot of people would take medicine here and there that would kind of keep

them... Keep them... Functioning. Yeah.

I've seen them as being strong and... You were trying, you saw guys around

taking it, you thought, what's that all about? You tried it and you felt... I

don't know why I'm...

Don't worry. Maybe it's hard to express.

Are the questions making you nervous?

No.

No.

If he would walk in here, and I can talk to you guys for a second, and you can

just do what you do. Okay. That man would help you. Jesus.

He just makes me feel that easy.

Yeah. Yeah.

Because I notice...

We've just been together for, you know, within the first two weeks of being

together. He had already bloodied my face and taken control of me with

the drugs.

He was able to, sometimes he likes to joke and say that he owns me.

So pretty much as you can tell, I'm almost like a pet to him, like an

for the drugs.

I wouldn't, this is, I wouldn't, this is not where I would be. I wouldn't be

here.

At all.

It's your deal.

Yeah. Yeah.

That's all I'm adding.

Hi there.

Uh -huh.

I'm starting to think now I want to get into town.

The more you talk about it, the more you want to do it.

A little later, I was invited along on an outing to a trap house

where Alvin would be attempting to rendezvous with one of his connections.

We were being chauffeured by a neighbour called Petty Betty.

It was all a little odd.

I wasn't quite sure what we were getting into.

Wow.

Looks like it needs an extreme makeover.

Petty Betty?

What should I call you? Petty or Betty? Or something else?

My name's actually Jessica.

And everybody knows me as Petty Betty. Yeah.

Do you have a job, Patty?

No.

You're not in work at the moment?

No. You use?

Yes. Do you? For how long?

I'll be 26 in three months, and I've used since I was 12.

Since you were 12.

What did you start using when you were 12?

Loratabs. Huh? Pain pills, painkillers. Where did you get them from?

Medicine cabinets from my grandparents, from my mom.

Anywhere I could find them, really.

Why?

Everybody else was doing it.

I was raised as a spoiled little brat, honestly. I had anything and everything

ever wanted, but I don't know. I guess I just wanted to fit in with everybody.

And then it becomes, you know, the sicknesses and the pains.

You've got to find something to get rid of it, basically.

They took all the pills away from everybody here, so then you've got to

something else to cope with.

It's a bad habit.

It really is.

It's picking up the call, isn't it?

I hope.

Let me see that. Can I hit that? What happened? Let me see.

He wants to see.

That is it.

That is it.

It's so nothing.

How much was that?

Forty.

Is that a... But I would have had to pay probably 180 for it. Is that a gram?

No, it ain't a gram.

Is it less?

Less. What would happen if I snorted that right now?

I guess you'd be on her level.

You're probably... Well, I don't know. That's what I'm about to find out.

No, this has a smell to it. So usually that either means they've recut it or

it's a decent decent quality It's got a Smell

it's got it like a vinegar II This is weird

Vinegary

there's no other word for it.

Have you ever smelled that before?

I've smelled it before and then I woke up with an overdose.

Uh -oh.

I feel weird watching you do something so dangerous.

And also that I feel like you're going to slightly disappear after you've taken

it. You're going to become dopey and sleepy.

There's nothing I could say that would persuade you not to do that.

I'll have to add a lighter to that.

How will I know if you're in trouble?

I'll lose consciousness pretty much.

I'll even start to probably change color.

It's what I call a creeper. It's a slow, a slow, a

slow rush.

It's not bad.

I've had better.

It's not bad.

How long were you good for now, do you think?

Probably with this, maybe a couple hours.

If I had something stronger, I mean, that's a good six.

About three, four hours at least. Just a couple hours.

Like, I'm probably going to go in there and tell him how it is and see if I can

get more, depending on if I'm supposed to do a bigger shot.

Probably end up getting in my way.

I always usually do with him.

Is he still physical with you?

Mm -hmm.

Where do you see the relationship going?

Well, I can down the drain, but right now it's going to be like this

until I can try to overpower my

addiction.

He's the only way right now to get what I want.

It's been estimated that in Huntington, as many as one out of four adults is

addicted to heroin or some other form of opiate.

The rate of fatal overdose is 13 times the national average.

Bearing the brunt of the problem are the city's emergency services and in

particular the fire department.

Increasingly... Their job revolves around reviving overdosing users.

Hey, honey.

All right.

He's breathing, but not... He sees actually his color's coming back a

bit. We popped him once. You want to go ahead and give him another Narcan?

Thank you.

What does the Narcan do, Jen?

It reverses the effects of the opiate that they took, the heroin.

Does it stop them from overdosing? Yeah.

Hey, buddy.

Hey, honey,

it's cold out here. I'm going to pull your shirt down for you, OK?

Jan Rader is the city's fire chief.

Could he have... Died just then? Oh, yeah. Did you see his face when we

up? He was very, very pale, almost blue.

Great. Now, he was breathing, but not sufficiently. The first dose of Narcan

increased his breathing rate just a little bit, but he probably had heroin

was laced with fentanyl, and so it took a full two milligrams more intravenously

to get him to wake up.

What is fentanyl?

Fentanyl is a synthetic opiate, typically made in China and shipped to

and that's where it's cut with the heroin before it's sent here.

And it's strong.

It's 100 times stronger than heroin.

Now he's in withdrawals.

He's got, is he vomiting?

Yep, he is.

That's what the Narcan has done.

the opiate off the receptors in his brain, and now he's dope sick.

So tell me about Huntington.

Huntington, West Virginia, is a town of 49 ,000 people.

Last year, we had over 1 ,100 overdoses, and probably

80 % of the people that we deal with started out with a legal prescription to

either Lortab or Percocet Oxycontin.

From a doctor? From a physician for legitimate pain.

It's sad. Once they can't get their prescription, they turn to heroin

it's cheaper and more readily available.

Addiction in Huntington is in some ways a legacy of its industrial past.

Doctors, influenced by pharmaceutical companies, prescribed pain pills for

workplace injuries.

From early 2011, when authorities realized that drugs were being abused in

quantities, they began cracking down, passing new laws against over

-prescription.

Combined with disappearing employment, the unintended result was a massive

to heroin use.

Alongside the emergency services, A variety of community and religious

volunteers are attempting to address the problem.

It's a battle every day, no matter where you're at. I struggle just as much as

you do every day.

No matter what, I still got to wake up, turn it over to God and do the right

thing every morning, no matter where I live.

Whether I live down here or I live in a house.

Jan had told me about an ex -user with a criminal past whom the fire department

had had to Narcan back to life many times, Mickey Watson.

He was helping a new arrival find a spot in an encampment by the Ohio River.

How old are you, Edwin?

I'm 42.

42? I mean, I have my degree and everything.

I mean, I owned a business up until six months ago.

What sort of business?

A computer business. I was doing network auditing and penetration testing.

That's a good living.

It's a great living. I made a lot of money at it. Did you? How much?

At one point, I was making over...

At least over 200 ,000 a year. Are you serious?

Yeah. Do you hear that, Mickey?

Edwin's a computer buffin'. Yeah. You know, it kills movie stars, man. It

doesn't discriminate on who you are.

Getting off of it, it's always waiting around the corner for you to stumble.

Absolutely it is. And there's no chemical solution for a God -sized

man. There is not.

You might fill this hole inside you with anything other than God. That hole,

man, that's what I hear a lot of people. That hole is there.

There is a big hole.

Right now, I'm in the winter and I feel that big hole in my chest.

I ain't going to sit in here and bullshit y 'all. If it wasn't for God, I

wouldn't be here right now.

God knows who I am and understands what I am.

God didn't plan for me to live down here. He don't have that plan for him

either.

Right now, what he's got planned for him is this is a stepping stone to get him

where he wants him.

Should we do it? Yep, let's do it.

What were your convictions?

I've only been convicted of second -degree robbery.

Dude had something of some value and ran up and snatched it from me. What was

it?

He had a nice -looking laptop in his hand.

You just snatched it? I snatched it and ran, and they caught me.

And why had you done that?

I was high, and I wanted some more money.

so I can keep getting high.

I'm a completely different person when I'm high.

My wife tells me that's the very devil himself that crawls out of my skin.

I'm very violent.

I don't care who I hurt or what I take from who I take it from.

I've stolen from my own kids to get high.

I've let guys suck my dick to get high.

I mean, you'll do whatever it takes.

Have you ever sucked a dick to get high? I have never sucked a dick, but I've

let a guy suck my dick to get high.

So you do have some boundaries.

Yeah, I have some boundaries, you know.

I'm beating away. We'll measure it.

Heart rate is 151.

That's not you.

At Cabell Huntington Hospital, Alicia Phillips and Ronnie Rowe were having a

baby scan.

We have some hair.

Oh, all that fuzzy stuff you do.

A recovering heroin user, Alicia had weaned herself onto a synthetic opiate

called Subutex that is thought to be less harmful to babies.

It was part of a programme run by Dr David Chafin.

All that together, we're at the 26th percentile. So baby's growth is good,

fluid's good.

OK. How much does he weigh?

Well, I realised this was a guesstimate.

Yes, OK.

But four pounds, 12 ounces.

So, good size.

Yeah.

Dr Chafin, you know, in the scenario in which Alicia was still using or

abusing... either heroin or prescription opiates.

What does that look like for the baby?

In that case, I have several concerns.

Number one, there is an increased risk of growth restriction.

Babies just don't grow when they're being exposed to those opiates. And then

what's really scary in the case of heroin is the withdrawal can come on

quickly if you miss a dose, and acute sudden withdrawal is dangerous for the

fetus in utero.

And so sometimes those babies don't survive that withdrawal.

Any questions about what you just heard?

I've read lots about it.

Last year in Huntington, one out of ten babies was born dependent on opiates.

It's hideous, the idea of a baby being born addicted to an opiate, isn't it?

Whether it's Subutex or heroin.

Let's not use the word addicted. They're going through withdrawal because

they're physically dependent.

Everything that is warm and tingly and brings a smile to your face when you

think of snuggling up with a baby, a newborn, is absent in these babies. And

yes, it is difficult to deal with these babies.

But they are feeling irritable. They don't want to be touched. They're

Correct. The good news is there is an end.

We are weaning them off of this medication and there will be an end to

In her 16 -year dalliance with opiates, Alicia had been in and out of rehab and

had picked up multiple drugs charges and a conviction for forgery.

She'd met Ronnie 10 months earlier when they were still using, now both in

recovery. They were renting space in a friend's house.

Our programme is about misuse of opiates and heroin, which has ravaged this

area. Can you tell me how it's affected your lives?

It ruined my life. Yeah.

It ruined my life. How do you mean? I dropped out of college and then I

getting arrested and going to jail and not being able to keep a job.

You dropped out of college? What were you studying?

Library science.

Library of Science?

Yeah. So how did you get involved in opiates? My stepdad was a welder, a

maker, and he had had a lot of surgeries on his back, and he was receiving the

Oxycontin. And he didn't take his prescription that often, really, so he

stockpile of pills.

And I would, you know, take them. You would dip into it without him knowing?

It took him about two years to realize.

You know, I really was addicted by the time I was 16.

Yeah. I didn't understand.

Like, I had seen, you know, movies about heroin, you know, like people getting

sick.

And I didn't understand that it was the same thing.

You thought because it's a pill from a doctor, it can't be that bad. And you

know how all the commercials on television for...

All the big pharmaceutical companies, antidepressants and pills for this,

for that, you know. How did it progress from there?

I started experimenting with heroin too.

Because at that time they were starting to close the doctors down.

Started to drive drug dealers around, trafficking drugs back and forth to say

hi.

I would get paid in crack and heroin to drive and I could have ended up, you

know, doing 10 years in prison.

So when did you sort of stop abusing drugs?

When me and her got serious, when she found out she was pregnant.

That's been a motivator for you to sort yourself out. It's been a life changer.

So where do you keep your subutext?

Usually just in the bathroom, but if I have certain people coming over, I hide

them. There are people who will steal them from me. For real? Yeah.

Why? Because they're addicted to them too.

You take one of those in the morning.

One in the morning.

And one in the evening.

And really at this stage, that's all your addiction is.

Yeah. And would the aim be to taper off that at some point?

Yeah. Yeah.

I was back with Catilia.

She'd suggested we visit the house she grew up in and the great -uncle who

raised her.

I'd been thinking about her and the strangeness of her relationship with

I was hoping the trip might be a chance to talk.

I'm actually really excited.

This is the first time that I've been able to be home since I've been with Al.

Are you serious?

Yeah.

The impression I had the other day was that it was almost like he'd almost

holding you hostage using the drug.

Actually, I used to be scared. I used to be scared of him.

Aren't you scared now?

I'm scared. I'm not scared of him as much as I'm scared of what he's

capable of doing whenever he gets angry or gets in one of those bad moods.

Yeah, this is Al.

Cotilia's great -uncle lives an hour outside Huntington in Wayne County, West

Virginia.

It's kind of idyllic, isn't it?

He's the retired owner of an oil well drilling company.

Louis. Louis?

Yes. Mike.

Mike, nice to meet you. Mike Davis.

Can we come in?

Mm -hm, yeah. Thanks for having us.

You're actually Cotilia's great -uncle by blood. That's right. That's correct.

But she calls you Dad, and you raised her.

Right. We raised her from the time that she was 15 months old.

What was Cotilia like growing up?

Well, she was a happy child.

We went on trips, we went camping.

She used to be handy around the place and liked helping out? Oh, yeah, yeah. I

would let her drive bulldozers and things like that.

Cotilia seems to me to have lots of potential.

She has.

And that she would be someone who, if she put her mind to it, could, you know.

She's very intelligent.

Do what she wanted.

Yeah. So why did she get caught up?

Well, she got caught up because of basically back when we

was, when my wife got sick and I was spending so much time in the hospital

with her, with my wife.

and could tell you basically had too much freedom to do as she pleased.

Maybe I've been an enabler.

In a lot of ways, that's why I blame myself for that. I've been an enabler.

And right now, she's at a point that she depends on.

I can tell you if I'm telling this wrong.

I'm not making you feel bad.

You're okay, Dad. I'm just telling you what I think.

I just don't want you to blame yourself. I feel like you had any part or any

reason of me picking up a needle.

I'll see that as that you would love me to death.

I'd rather say it like that than I would say enabling.

You said that you thought you might have enabled.

I had enabled her.

After she got already on drugs, she'd come to me and say, Dad, can I have 50

bucks?

And she'd say, I want to go down there and buy me some shoes.

Instead of buying shoes, she'd buy drugs.

The whole situation must have caused you a lot of stress and anxiety.

A lot of times I go to bed and I think, well, am I going to get a phone call

that she's dead?

But you gradually learn to live with that, you know.

Do you have rules for her when she's here?

Oh, yeah.

But, hey.

Rule don't count if you break the rules or if you sneak.

Does he not realize when you're doing heroin? Would he be upset?

Yeah, yeah.

Actually, one of the rules is to keep any drugs or paraphernalia out of the

house.

But you can sort of run rings around him.

Yeah.

He's going to give me the money today to get a vehicle or money to put on a

vehicle. He is?

Today? How much?

It's $800 to go towards a used vehicle.

You'll just spend it on dope, though, won't you?

I mean, I'm kind of looking at it as I'm wanting to, I really want to get a

vehicle, but I really do want to buy drugs with it.

I do.

But I can have so much more with a vehicle.

He said, no, don't spend it. Don't waste it.

But God help you if you do.

And I told him to not worry, that I really didn't have to spend money like

anymore.

Things were a little bit easier on that aspect, and I should get a vehicle.

I made him a promise, and I hate to break promises.

All right, so I'll say bye -bye.

Everybody take care.

God bless y 'all.

You okay?

Yeah.

What's the matter?

I'm just hurt believing.

Go back into town to... ..a place that I'm

not as happy as I am here.

I just can't break the chain long enough to stay here and... I don't know,

I can't talk right now.

I've got to take a seat.

Leaving Mike's farm, I began to suspect that Bucatilia, The main point of our

visit had been to get money from her great uncle.

I felt torn, seeing her evident love for him, but also the way her dependency

was causing her to deceive him.

I just want to be okay right now.

So I just go around this little circle, round and round.

I'm trying to get here.

I'm constantly going back there.

Heroin addiction is notoriously tenacious and treatment very difficult.

In the wake of the epidemic, the city has opened rehab centres, but there are

long waiting lists for beds.

One of the biggest facilities is Recovery Point.

It offers 11 months of residential treatment structured with military

discipline.

God, grant us a serenity.

to accept the things we cannot change, the courage to change the things we can,

and the wisdom to know the difference.

Less than 10 % of its intake make it to the end of the program.

Among its small cohort of successful graduates is Mickey.

How long have you been clean?

November of last year, I picked up my one -year coin.

One year of sobriety? One year of sobriety.

How'd that feel?

Like I never thought in a million years I could do that.

Where were you? What was the little sequence of events?

I was at my apartment on the West End down there, man. I overdosed again.

How many times have you overdosed?

I don't know. Somewhere up towards 100.

Come on.

I'm not kidding, dude.

You were hospitalized?

Like 10 times over it, yeah.

I woke up with hoses down my throat.

I had my stomach pumped.

And then on the last time, what was different?

It got to the point that any more than a couple hours, I was already starting to

shake. I couldn't even pass out because my body wouldn't allow me to sleep

without craving alcohol and drugs.

And I just had enough, man.

Called and got help, and I told my wife, bye. I said, I hope to see you again.

If I see you again, we'll get married.

If it's meant for us to be together, then we'll be together. If it ain't,

love you, and thanks for everything.

I've got to save my life, so I had to leave. Was she using at the time? Yeah,

she was using right along with me.

And she said the same thing to me.

We are talking mainly to people who are active in their addiction, okay?

Right.

Who are in many ways similar, very similar to the person you're describing

you were.

Yeah.

But recovery seems so out of reach for them.

So what I'm wondering is whether there's anything you can say that

would explain how someone makes that leap.

When the pain of change becomes less than the pain of staying the same, then

you'll change.

But if they're locked into a physical state in which, you know, it's like

telling them they have to...

crawl across broken glass to get to what they needed. It's damn right I'd crawl

across that broken glass.

I wouldn't hesitate.

I feel like life's going the way it's supposed to, man. I got a full -time

I pay my bills.

I got my kids back in my life. I got family that cares now.

It's amazing, man.

May I come in? For sure, man. Should I take my shoes off? No, no, no. You're

more than welcome, man. For sure. I was with a friend of Mickey's called Nate

Walsh.

You've got quite a bit of space in here. Quite a bit of space, yeah.

It's tight.

And you've got your glass coffee table.

Yeah, you like that.

A three -year veteran of the riverbank, he was also a dealer and something of a

connoisseur of heroin.

I've definitely got some dope. I got the best dope in the city. Best dope in the

tri -state.

That right there is that fire.

You know what I'm saying?

Wow. See how it's kind of pink? Like it's pinkish looking. Yeah, tiny bit.

pinky gray.

Because it's not straight heroin. It's fentanyl.

Because I've heard you can OD on that. Oh, yeah.

Fuck yeah.

If I did that right there by myself, dude, I would drop dead.

You know what I mean? And I do. I have a tolerance higher than most people in

the town.

Did you, you know, a lot of people migrate from dabbling with pain pills,

That's what happened to me. I mean, it happens to everybody.

That's what happens to... Go on, how did it work in your case?

I got hit by a car, and that almost killed me.

How old were you?

It happened September 26th of 2010.

So this is seven years ago. You were about 26?

Yeah, exactly.

The first time that I took them tabs, I mean, fuck, I ate like 10 of them. You

know what I mean? And it rocked my world.

I don't know. I mean, I wouldn't like go back in the day and like, you know,

become a heroin junkie, you know, as soon as possible.

But I mean, it's not as bad as I made it out to be and how I felt about it back

then. You know what I'm saying?

You're almost, that's kind of interesting and paradoxical. A lot of

heroin say they want to get off it and they loathe the addiction. I had a wrong

opinion about it. But I feel like you seem to be, you seem to have made your

peace with having a dependency on heroin.

Because I'm different from your average junkie in the street. You know what I'm

saying? I don't spend most of my time dope sick and broke and robbing

motherfuckers and struggling to get my fix on. You know what I mean?

I spend more of my days just fucking high and making money and just

and fine with it, you know what I mean? Then I don't, you know what I'm saying?

Have you ever done rehab?

No, I haven't, because why would I?

You got the air of someone who had opportunities growing up.

But yeah, I mean, it's kind of like how it all fell into place, though, is

because... I had a baby with this girl over in Ohio,

and she ended up snatching my kid up and taking off and leaving with him and

disappearing. At the time, I had a nice job welding.

How many children have you got?

I got the one.

Just got one.

How old? It's a boy, did you say? Little boy, yeah. How old is he now? He will

be 12 on the 4th of July.

And do you see much of him?

Not. Really, but I do see him every now and then. I don't want to be judgmental,

but what's stopping you from being more involved, would you say?

That's definitely the heroin and the dope and all that shit like that.

I've missed so much of my son's life when he was really young because, I

definitely wanted to be there. I mean, I loved my son. I mean, fuck, I enjoyed

having my kid, you know, and when she took off like the way she did.

It fucked me up, man. Like, I was tore up about that.

I've got to do this dope, bro. I mean, you're killing me, bro. Oh, yeah, yeah.

Go ahead. I'm sorry.

I mean, when I... Why are you putting it in that gap?

That's where I shoot.

You've got like a... It looks like that because that's the only spot I've been

using for a long time.

Yeah, that's that.

Anyways. How do you feel now?

I feel exactly the same, bro. It hadn't even pumped through my veins yet. I

mean, it takes a second to get there, you know what I mean?

I can start to feel it now, a little tiny bit. I know it's coming. I got that

feeling of anticipation because I know it's coming.

I mean, you know, I love it. I mean, it's hard to explain.

What could you compare it to?

I don't know. I'm starting to feel it now.

It's kind of like a stick of dynamite that's just going to do

absolutely nothing in the world except make you feel as good as you can

feel. And you light that fuse and you see the fuse burning and you know

any second it's going to fucking blow your mind. You know what I mean?

It's a good thing, man. It's not bad, you know what I mean? Like, that's what

say. I mean, why would I want to go to rehab and why would I want to get

straight and clean my life up and shit? Because I enjoy it too much, man. Like,

who wouldn't, you know?

How much would you say is the street value of that heroin?

About 3 ,000 possibly, and the heroin maybe more.

But you can see how much money's there.

We're seeing so much dope that to us, that's not that big a deal.

I mean, that's how bad our problem is.

By now, I was several weeks into my stay, and throughout the city, the

of heroin were apparent on a daily basis.

Riding on the back of the over -prescription of painkillers, heroin has

the heart out of Huntington, destroying lives indiscriminately.

While the overstretched city workers do their best to turn the tide.

Do you have a problem with

opiates or heroin?

Yeah, I struggled with it.

Yeah.

Like a contagion, it has left almost no one's life untouched.

Hello. Hi. Can I come in? Yeah, sure.

I was with Alicia Phillips.

She'd had her baby, but Ronnie, her other half, was back in prison on an old

warrant and she'd had to move in with her father, Pete.

How was the birth?

I had a C -section.

I mean, it wasn't bad. They had me kind of restrained a little bit.

He's called Archer.

Archer, David, Ivan, Roe.

But he's not home yet.

No. And he's ten days old. So what's going on?

So they watch them for a minimum of seven days anyway.

He's on methadone.

So at the moment, he's going through a tricky phase of basically kind of

himself off the methadone.

He's getting diarrhea, mottling, just like red skin, excessive sucking,

sneezing. You've met Archer, have you, Pete? Oh, yeah. He got to hold Archer

before I did.

Yeah, I handed him right to me.

Came out, I was the one that went in, wasn't I? No, because Ronnie couldn't be

there. Right.

When did you first become aware there was a problem?

You know, I didn't know exactly what she was doing, but I did know that things

were disappearing from the house and getting hocked.

What was going missing?

Guns, anything that she could hock.

So your attitude was?

Hit the door.

Because, I mean, you could see she was in trouble.

You didn't want to. What was your thinking? I mean, it's a big decision.

There's nothing that you can do to help them more than stop.

What's the word?

Tough love.

Tough love, yeah.

One of the last things we had to do was go through an intervention.

I had to write her a letter.

That was awful.

Yeah, it was awful.

Saying what?

It was a bad day.

Just saying, like, how, you know, bad I had hurt him over the years and stuff.

It hurts you thinking about the stress and all the anxiety and anguish you went

through. Oh, yeah, and her.

You know, couldn't do anything with her.

Do you have a sense of what it was that made her vulnerable to this?

Not really.

The frightening truth at the heart of Huntington's epidemic may be that anyone

can get caught up.

One bad choice can wreck a life.

Hey, Alvin.

With Cotillia, her early promise had been overtaken by a litany of crimes and

glaring gulf between what she might have achieved and the harsh reality.

We finally got to do some good stuff.

And today's needle exchange day, some fresh needles and good dope. We're doing

good.

Oh, well, hi, Dad.

How are you doing?

Dad, how are you?

We were on an outing to Huntington's Needle Exchange.

I couldn't help noticing that despite the cash gift from Cotilia's great

there was no sign of a new vehicle, and Petty Betty's car had gone AWOL.

This time, I was driving.

In messages, Cotilia had continued to allege that Alvin was abusing her

physically, and that she only stayed with him because of her addiction.

She'd given me permission to raise the issue with them both.

You were a couple, right?

Yes, sir. And would you say, like, you're in a good spot as a couple?

Yeah. You can have your ways.

But for the most part, pretty much, yeah.

Life happens. Ain't nobody perfect.

Did you break Atelier's nose?

No.

She said you did.

I didn't break your nose.

Your nose been broke?

Your nose been broke?

Has it been broke?

It hasn't.

Now, put that on camera. Now, put that one on camera.

I wasn't talking about the fight at Diaz. You wasn't talking about the

You're lying. Stop lying.

Your nose ain't getting broke by me.

Everything ain't what you read in the book.

If it was all that, why be here?

You ain't no prisoner.

You ain't hell captor.

From my perspective, there's never a good reason to be physical.

It's not a good reason.

It's not a good reason.

You don't just wake up in the morning and say, I'm going to haul it off and

something. Nobody does that.

You can't do that. There ain't no way of thinking at all. You can't do that.

That's what you were talking about last night.

I ain't talking about nothing.

You came around, you and me.

Okay? Yeah.

You went to hospital while we were away? Yes, I did.

Why?

Well, there was another, me and Al got in another argument.

I was wanting to leave. I'd had my bags packed, and he said some really mean

things. But I pushed the grill over, his barbecue grill. It's something, though,

to him that means a lot. He likes to grill and cook.

And after he's seen that I've done that, he pushed me and kind of slammed me.

He didn't intend for my back to break, but it did.

You know, with as much as being in a car accident.

Are you aiming to leave the relationship?

I don't see myself.

It really is not helping.

But, of course, now I have to say I'm happy and think it's okay for me to

continue to get my dust. Because if I don't, then I'll be back on the street

doing things that I probably this time wouldn't make it alive.

What's stopping you from getting clean?

I'm complacent right now. I'm comfortable with being able to not have

steal or trick or do anything for drugs, and it's just right there.

So 158?

How are you? I'm good. Let me borrow your paper.

So you got any needles for me? Oh, yeah, definitely. Definitely do.

So I'm going to get you some spoons. They're not sharing anything with

right?

It wasn't easy to see a way out for Cotilia.

Fifteen years of using had left its mark on her body, but perhaps more indelibly

on her sense of who she was and what she deserved.

I was with Jan on another call.

A former nurse had overdosed in a known drug house.

Hey, Mellie, what did you take, honey?

Nothing. No, that doesn't work. We gave you some medicine that only works if you

took something.

So, did you do heroin?

Yeah.

Did you snort it?

No. Did you shoot it?

It's been busy, hasn't it?

Yes, we're on pace to be 1 ,000 runs higher in 2017 than

we were in 2016, and the majority of it is overdose calls.

You know, addiction exists everywhere. People are addicted to all kinds of

things. Absolutely. Do you think if it weren't heroin and opiates, it would be

something else?

Maybe, but this is an unprecedented area.

The majority of the addiction that we're dealing with now came about in a legal

manner. You know, I think the intent of developing synthetic opiates was good,

but it quickly turned bad.

What do you think the pharmaceutical companies can do at this point? Do you

think they're doing enough?

I don't think they're doing enough. I don't think they're doing hardly

They certainly don't seem to be willing to stretch out a hand and to help us in

our plight.

And that's very sad because they've made billions of dollars on this addiction.

Even for those who are sober.

In Huntington, life isn't always easy.

For Mickey, less than 12 months out of rehab, his new routine revolves around

work. Thank you.

You're welcome.

His charitable trips to the riverbank are like a little taste of his old life.

Hello.

Hello. Anybody home?

Come on.

Got some snacks and some goodies for y 'all.

You want some ravioli?

Yeah, bud. I figured you would, man. You're welcome.

There's times in my life to this day I still miss living down here. If you'd

unlimited money for substances, would you have quite liked to have stayed down

here? No. Now I'm a part of something that's unimaginable that I wished every

individual down here could get. Which is what?

Peace of mind.

You okay in there, Nate?

How you doing? Huh? How you doing? I'm alright. Give me just a second. Should

wait? Just for a minute. Okay, cool. Thank you.

How you doing, Nate? I'm good, man. How you doing? Good. Oh, he's really good

right now. Yeah, hell yeah. Are you high?

I'm high as fuck, man. How are you?

Have you got a friend in there?

Yeah, man.

It's not your girlfriend.

No, she's not my girlfriend, you know what I'm saying? He don't have one of

those. I don't have no girlfriend.

Are you leaving, baby girl? Don't leave me.

Y 'all go ahead. I'm going to speak to her for just one second. I've been doing

it for two years. I don't like... I did it for 25. I don't keep myself up, you

know what I mean? Like, I still eat, make sure I keep myself healthy.

How old are you?

20. I've been using you for about two years.

And, uh, yes.

I'm sorry. I got to go. I'm in a hurry.

I'll be right back.

Two seconds.

That's not the person I was expecting to come out of there. Me neither.

That is not what I was expecting to come out of a tent.

She won't be looking like that very long.

It's going to be bad.

It's kind of sad. It's real sad. I see these girls all the time. They'll start

on the street. You can see them. They're real pretty.

They got all their teeth.

Three months later, six months later, they're covered in bruises and fucking

teeth are missing.

Damn, she's good looking.

I'm trying to tell her she ain't going to be very good looking very long. I was

going to say it was kind of sad to see her in this situation in a way.

How so?

I think it's just absolutely amazing to see her any time in any situation.

God.

Because I'm assuming she's in a high -risk lifestyle from her being down

That's why she trusts me, that I'm not going to ever, you know, try to hurt her

in any way. You know what I mean? She puts her life in my hands.

A lot of people do.

You like each other, don't you?

Absolutely. We've been good friends for a long time. Absolutely, yeah.

And we were sort of talking about it, and you were saying, well, Nate's

quite a happy dude.

He's happy.

Maybe he doesn't really maybe not even know he's miserable. That's what I was

telling you. You think he doesn't know he's miserable.

Maybe, is he miserable?

In a certain way, yes.

In what way? In the way that he's delusional. He doesn't know right now

state of misery he's really in because he's delusional under the influence.

I mean, he is correct about that because, I mean, like... This is not a

bro. You know that.

Exactly. You know what I'm saying? Like, I've had nice stuff.

I've had a crib.

I've had, you know... Everything.

I've had it all.

You know what I'm saying? And I give it all up.

And I don't really care about anything.

You know what I'm saying? Like, I don't even give a shit about myself no more.

You know what I mean?

Because getting high is important to me. And your son?

Exactly. Like, mom and child and everything. You know what I'm saying? I

everything on the back burner because, I mean, none of that shit even matters

once you start getting high and letting it control your life.

What do you think you'd be doing if you hadn't got onto those pills and then

onto heroin?

I don't know.

It's hard to say, bro.

I bet my life would be a lot better, though.

You know? I wouldn't have fucked up.

I mean, shit.

Do you think you did fuck up?

Eh.

Yeah, but not really. Because, I mean, I didn't really have no control over it.

The fact that a drunk driver swerves off the road and, like, hit my ass and

knocked me in the street and all that shit, that was completely out of my

I had to do something because I was hurting.

I still hurt. I hurt every day.

If I ain't got nothing, I hurt.

It hurts bad.

I mean, you ain't never seen me hurt, bro.

Every time you see me, I feel good.

Because I try to stay feeling good. You know what I mean?

Yeah. Just remember, man, if you ever do say the word, bro.

Oh, I already know. I mean, I can get help anytime I need it. But I have to

welcome all that pain back into my life.

I mean, shit.

Just know that if I can do this, bro, you can too.

I got you, bro. I love you.

Huntington is just one out of the growing number of places across America

gripped by heroin.

The city is attempting to sue the distributors of the most abused

opiates for tens of millions of dollars.

In the meantime, with overdoses continuing to rise, each small victory

dear as an uncertain omen of hope and rebirth.

He looks like a healthy little chap, doesn't he? Yes, he is. Pretty happy

You know what time it is. Open your eyes.

Come on.

Take that from me.

Come on.