As the number of people who inject drugs and share needles has soared, the rate of infection with hep C has climbed, too. Yet many drug treatment patients aren't tested for the liver-damaging virus.
Two years after East Liverpool, Ohio, gained notoriety from a viral photo of an overdosed couple, the community is coming to terms with its addiction problem — and taking tentative steps forward.
When fentanyl, a synthetic opioid 50 to 100 times more powerful than morphine, infiltrated the drug supply in the U.S. it had an immediate, dramatic effect on the overdose rate.
Keri Blakinger spent nearly two years locked up on narcotics charges before becoming a journalist. "I've been so privileged in so many ways to end up with hope and second chances," she says.
Within days of an OD from opioids or other drugs, users in Huntington, W.Va., are visited by a quick-response team at home, the hospital or in jail. Reversing an OD is just recovery's first step.
This medicine to treat opioid addiction is hard to come by — only a fraction of doctors can prescribe it. So some people trying to quit a heroin habit are turning to the black market for help.
A standoff is heating up between the Trump administration and local leaders who are trying to open facilities where people can use opioids under the eye of medical staff.
Author Beth Macy details opioids' odyssey from medicine to scourge, in her book about young heroin users, their long-suffering parents, doctors, drug company executives, cops, judges and drug dealers.
More than a dozen cities from San Francisco to New York are trying to open safe injection sites for heroin users. But worries about a crackdown from the Justice Department have local leaders on edge.