A blue light illuminates the bathroom in the Cookie Carnival laundromat to make it harder for drug users to find a vein in Huntington, W.Va, Thursday, March 18, 2021. The laundromat was among several local businesses to install blue lights at the height of the city's opioid crisis, when they would often find syringes left behind by drug users. "It was the only thing we could think of to do to help," said manager Misti Mann-France. "And it has helped tremendously." She said people have overdosed several times in the parking lot of their business. "I wish there was a solution to the bigger problem," she said. "There are so many out there on drugs, and it's sad, it really is."
(AP Photo/David Goldman)A banner decorated with the image of Jesus hangs outside a home as a mail carrier walks down the street in Huntington, W.Va., Wednesday, March 17, 2021. This beleaguered city offered a glimmer of hope to a nation impotent to contain its decades-long addiction catastrophe killing by the tens of thousands. The federal government honored Huntington as a model city to emulate. They won awards for this work. Other places came to study their success.
(AP Photo/David Goldman)Larrecsa Cox, who leads the Quick Response Team that tries to track down everyone who overdoses to offer help, arrives in a neighborhood to visit a client who recently overdosed in Huntington, W.Va., Friday, March 19, 2021. The team was born amid a horrific crescendo of America's addiction epidemic: On the afternoon of August 15, 2016, 28 people overdosed in four hours in Huntington. Almost everyone who overdosed that afternoon was saved, but no one was offered help navigating the bewildering treatment system. One of them, a 21-year-old woman, overdosed again 41 days later. That time she died.
(AP Photo/David Goldman)Quick Response Team member pastor Fred McCarty, prays with a young man who recently overdosed as they visit him at his home in Barboursville, W.Va., Thursday, March 18, 2021. McCarty is one of the faith leaders who ride with the team. When they reach people who overdosed, he asks if they'd like him to pray with them, and usually they say yes. On his keychain he carries the coin he got in 1985, when he finished treatment for his own alcohol addiction. It says "one day at a time," and it's worn down from rubbing his finger across it for more than 30 years. "Recovery is about sharing your strengths and hopes with others," he said. "Our hope is that a lightbulb will come on. And they'll say, if you can do it, I can do it."
(AP Photo/David Goldman)Sue Howland, center, walks down a street to check on someone who overdosed days before with fellow members of the the Quick Response Team, from left, pastor Virgil Johnson, Sgt. Greg Moore and Larrecsa Cox, Monday, March 15, 2021, in Huntington, W.Va. Howland, the 62-year-old peer recovery coach, nearly drank herself to death. She's been sober now for 10 years. "We're going to love them until they learn to love themselves," said Howland of the people she tries to help. "We're going to love them back to life."
(AP Photo/David Goldman)Joshua Messer, 29, sits on the front stoop of his aunt's house where he is currently staying days after overdosing Tuesday, March 16, 2021, in Huntington, W.Va. Messer was a high school basketball star, heading to college on a scholarship. He still brags that he was such a star athlete he once met the governor. But addiction took hold, to alcohol and pills. "I let my family down, now I'm trying to get it back together. I look at some people and it's sad how they look," he said. "I'm starting to look like that. I'm not better than other people. But I'm better than letting something take control of my life. I feel like I should be better than this."
(AP Photo/David Goldman)Joshua Messer, 29, shows off a tattoo he got in prison, Tuesday, March 16, 2021, while staying at his aunt's house just days after overdosing in Huntington, W.Va. Messer spent nine years in prison for an addiction-fueled burglary he barely remembers committing. In prison, he got 2020 tattooed on his chest because that was the year he was to be released, and supposed to be the year he was to be reborn. He'd gotten a job as a cook at a restaurant and won employee of the month but Messer said the pandemic created a "circle of nothing," that drove him and other people he knows to using more drugs.
(AP Photo/David Goldman)Larrecsa Cox, foreground, and Sue Howland with the Quick Response Team, walk past addiction-themed graffiti near a tent encampment along the river looking to check-in with a client who recently overdosed in Huntington, W.Va., Wednesday, March 17, 2021. The Centers for Disease Control and Prevention estimates that more than 88,000 people died of drug overdoses in the 12 months ending in August 2020, the latest figures available. That represents the highest number of overdose deaths ever recorded.
(AP Photo/David Goldman)Sue Howland, right, a member of the Quick Response Team which visits everyone who overdoses to offer help, checks in on Betty Thompson, 65, who struggles with alcohol addiction, at her apartment in Huntington, W.Va., Wednesday, March 17, 2021. "In a way I feel empty, there's nobody here to talk to," Thompson said. "I drink to escape. I try to get away from feeling." Howland crouched next to her. "We just need to get you back on the right path," she said. They told her they'd be back the next day, and that they love her. "Who could love me?"
(AP Photo/David Goldman)Larrecsa Cox, who leads the Quick Response Team, demonstrates to Yvonne Ash outside her home in Branchland, W.Va., Monday, March 15, 2021, how to administer the overdose reversal medication naloxone, just days after her son overdosed. Ash found her 33-year-old son, Steven, slumped among the piles of used tires behind the shop his family has owned for generations. Pleading and crying, she had thrown water on him because she couldn't think of anything else to do.
(AP Photo/David Goldman)Larrecsa Cox, who leads the Quick Response Team whose mission is to save every citizen who survives an overdose from the next one, peers around a stairwell while walking through an abandoned home frequented by people struggling with addiction, in Huntington, W.Va., Thursday, March 18, 2021. As the COVID pandemic killed more than a half-million Americans, it also quietly worsened what was before it the country's greatest public health crisis: addiction and despair.
(AP Photo/David Goldman)Steven Ash, 33, works at the tire shop his family owns in Huntington, W.Va., Wednesday, March 17, 2021, and where he overdosed just days before. Ash was 19 when he took his first OxyContin pill and his life spiraled after that. The last year has been particularly brutal. He took more drugs to numb the pain, but it made things worse, a vicious cycle, he said, but he isn't sure how to escape it. He knows he's putting his mother through hell. "I fight with myself every day. It's like I've got two devils on one shoulder and an angel on the other," he said. "Who is going to win today?"
(AP Photo/David Goldman)Yvonne Ash carries back to her house a CPR kit and a supply of the overdose reversal medication naloxone after a visit from the Quick Response team, which visits everyone who overdoses to offer help, Monday, March 15, 2021, in Branchland, W.Va., just days after Ash's son overdosed, "We need help," Ash said. People have been dying all around her. Her nephew. Her neighbors. Then, almost her son. "People I've known all my life since I was born, it takes both hands count them," she said. "In the last six months, they're gone."
(AP Photo/David Goldman)Sue Howland, right, and Larrecsa Cox, left, members of the Quick Response Team whose mission is to save every citizen who survives an overdose from the next one, help Betty Thompson, 65, who struggles with alcohol addiction, count her medications at her apartment in Huntington, W.Va., Wednesday, March 17, 2021. Thompson called that morning to say she needed help. With preexisting conditions that make her especially vulnerable to COVID, she'd been terrified she'd get the virus and die, and so she's drank more these months than she ever has before.
(AP Photo/David Goldman)A man walks through a hail storm as the Quick Response Team's vehicle drives to visit another client who recently overdosed, Thursday, March 18, 2021, in Huntington, W.Va. Huntington was once ground-zero for this epidemic. Several years ago, they formed the team that within days visits everyone who overdoses to try to pull them back from the brink. It was a hard-fought battle, but it worked. The county's overdose rate plummeted. They wrestled down an HIV cluster. They finally felt hope. Then the pandemic arrived and it undid much of their effort: overdoses shot up again, so did HIV diagnoses.
(AP Photo/David Goldman)A city wrestled down an addiction crisis. Then came COVID-19
The Associated Press — By CLAIRE GALOFARO - AP National WriterHUNTINGTON, W. Va. (AP) — Larrecsa Cox steered past the used tire shop, where a young man collapsed a few days before, the syringe he’d used to shoot heroin still clenched in his fist.
She wound toward his house in the hills outside of town. The man had been revived by paramedics, and Cox leads a team with a mission of finding every overdose survivor to save them from the next one.
The man’s mother stood in pink slippers in the rain to meet her. People have been dying all around her.
“People I’ve known all my life since I was born, it takes both hands to count them,” she said. “In the last six months, they’re gone.”
As the COVID-19 pandemic killed more than a half-million Americans, it also quietly inflamed what was before it one of the country’s greatest public health crises: addiction. The Centers for Disease Control and Prevention estimates that more than 88,000 people died of drug overdoses in the 12 months ending in August 2020 — the latest figures available. That is the highest number of overdose deaths ever recorded in a year.
The devastation is an indictment of the public health infrastructure, which failed to fight the dueling crises of COVID-19 and addiction, said Dr. Michael Kilkenny, who runs the health department in Cabell County, which includes Huntington.
Simultaneously, Kilkenny said, disruptions in health care exacerbated the collateral consequences of drug use — HIV, hepatitis C, deadly bacterial infections that chew flesh to the bone and cause people in their 20s to have open-heart surgeries. There were 38 HIV infections tied to injection drug use last year in this county of fewer than 100,000 people — more than in 2019 in New York City.
Huntington was once ground zero for the addiction epidemic. On the afternoon of August 15, 2016, 28 people overdosed in four hours in Huntington. Connie Priddy, a nurse with the county’s Emergency Medical Services, describes it as their “day of reckoning.”
By 2017, the county had an average of six overdoses a day. Some businesses changed out their bathroom lightbulbs to blue — to make it harder for drug users to find a vein.
They couldn’t ignore it anymore. The county got two grants and selected Cox, a paramedic, to lead a crew of addiction specialists, faith leaders and police officers who crisscross the county, tracking down people who overdosed. “Facing addiction? We can help,” reads the decal plastered on the side of the Ford Explorer.
If the people they find are ready for treatment, they get them there. If they aren’t, they give them the overdose-reversal medication naloxone and other supplies to try to help them survive in the meantime.
A white board in their office lists the names of clients they’ve ushered into treatment — about 30% of those they’re able to track down. After two years, the county’s overdose calls dropped by 50 percent.
The federal government honored Huntington as a model city. Other places came to study their success.
The first couple months of the pandemic were quiet, said Priddy, who coordinates the team and tracks their data. Then came May. There were 142 EMS calls for overdoses, nearly as many as in the worst of their crisis.
By the end of 2020, Cabell County’s EMS calls for overdoses had increased 14% over the year before.
“That makes us sick,” Priddy said, but she’s heard from colleagues in other counties that their spike was twice as high.
The CDC estimates that across the country overdose deaths increased nearly 27% in the 12-month span ending in August 2020. In West Virginia, fatal overdoses increased by more than 38%.
Report after report arrived on Cox’s desk. In October, she saw a name of a woman she knew well and lost her breath: Kayla Carter.
Carter had a brilliant mind for math and loved the stars. Her family always thought she’d grow up to work for NASA.
Instead, she was addicted to opioids by the time she turned 20.
“We went through living hell,” said her mother, Lola.
Carter overdosed dozens of times. At 30 years old, she already walked with a cane that she painted her favorite color, pink. Infection coursed through her body. She had Hepatitis C and HIV.
In 2018, HIV started spreading among injection drug users here. Kilkenny said the county ramped up testing, treatment and the needle exchange program that offers clean syringes to drug users, recommended by the CDC. Cases subsided.
But they’ve surged again.
As Huntington tries to beat back the damage the pandemic has done, Priddy said it feels like their own state is working against them. The state legislature is pushing a bill to strictly limit needle exchange programs, citing the dangers of discarded syringes.
Syringe programs have been the subject of decades of scientific study. The CDC describes them as “safe, effective, and cost-saving,” — they do not increase drug use, studies have found, and they dramatically cut the spread of HIV.
Priddy sent her legislator a message imploring that if they restrict syringe exchanges, many more will die.
Carter was hospitalized last summer with endocarditis, a heart infection from using dirty needles. Her parents stood at her bedside and thought she looked 100 years old. They cried all the way home.
She stayed off drugs when she got out of the hospital. She gained 30 pounds. She said she was sorry for all she’d missed: babies born, birthday parties, funerals. They thought they had her back.
Then she stopped answering calls. Her mother went to her apartment and found her dead on her bathroom floor.
They are still waiting for the medical examiner’s report, but her father Jeff, a retired paramedic, would rather never see it. It brings him comfort to think she died from complications from her surgeries, and not that she relapsed and overdosed.
Now the box of her ashes sits in their living room. Her mother talks to them every night, then cries herself to sleep.
