RACHEL MARTIN, HOST:
We're going to spend some time now in a place called Vinton County, Ohio. There are only about 13,000 people. McArthur is the county seat. And the big talk of the town now is the new grocery store that recently opened because, up until a few months ago, it was easier to buy opioids here than it was to buy fresh produce. It didn't take us long to get a glimpse into what that means when we visited a couple of weeks ago.
MIKE: Well, we've had a lot of walk-ins. But that's the first, I think, near-death OD I've had here in a parking lot.
MARTIN: On our first night, we drove by an ER dispatch. The paramedics there were still trying to wrap their heads around what had just happened. One of the paramedics - a guy named Mike, who asked us to use only his first name so he could speak freely - told me they were inside when they heard a car pull into the driveway.
MIKE: So we come out, and there's a girl laying in the back seat on her side, unresponsive, not breathing. After we woke her up with Narcan, she admitted to heroin.
MARTIN: How long ago was this?
MIKE: A couple of hours ago.
MARTIN: How old was she, do you think?
MIKE: How old was she? I know she said she had four children. She said she'd been in rehab, last used in January - claims she wants help today. We advised the ER of that. And we'll see if they get her some help. She's there, and it's back in her hands now.
MARTIN: You can hear that sense of resignation in his voice. Everyone we meet seems to know someone struggling with addiction. For the past few years, that something has been opioids and, when people are desperate, heroin - like the woman in the back of that car. But over the past few months, the situation in Vinton County has morphed into something bigger, something darker.
MIKE: We used to do, you know, a lot of pills. Now the hot one's meth.
MARY ANN: They've moved to the meth.
AMANDA LEE: So right now that's our biggest challenge - is methamphetamines.
MARTIN: That last voice you heard there is Amanda Lee. Though there is only one stoplight in town, there are three rehab centers. All of them on the main street. Amanda is a counselor at Health Recovery Services. There's a glass cabinet in the corner of the therapy room. It's got a bunch of VHS cassettes, with titles like "Family Trap" and "Relapse Prevention." Amanda moved here not that long ago with her kids.
LEE: Without the drugs, it could be like Mayberry.
MARTIN: But the drugs are easy to come by here. And the latest threat is meth.
How long has that been the case?
LEE: It's been - I would say about four or five months. It's really increased a lot.
MARTIN: Why do you think?
LEE: I think partly because of the Vivitrol program.
MARTIN: So let's back up and explain this. Vivitrol is a drug that's used to wean people off opioids. For a while, a lot of people in recovery here were also using a drug called Suboxone. But that was a pill that people started abusing too. Vivitrol is a shot that has to be administered by a health professional. So you can't abuse it in the same way. But Amanda says the problem now is that even though drug users are getting this Vivitrol treatment for their opioid addiction, they are still desperate to get high.
LEE: The Vivitrol injection does not cover receptors in the brain for methamphetamines, so they can still get high on meth.
MARTIN: So the Vivitrol numbs the part of the brain that has the craving for the opiate.
LEE: Right.
MARTIN: But it doesn't do anything about the other part of the brain that would still get high on a different drug.
LEE: On amphetamines, yeah.
MARTIN: On amphetamines. So as a result, people are looking for that high somewhere else.
LEE: Right. So they are using methamphetamines on top of the Vivitrol injection.
MARTIN: What kind of physical effects does that have?
LEE: There's paranoia. There is hallucinations. It almost looks like people have schizophrenia.
MARTIN: Is it possible to say whether it's more debilitating, more damaging than opioid addiction?
LEE: Absolutely. Methamphetamines scare me more than opiates ever did.
RYAN CAIN: I mean, you can see the dirt on the carpets - the little TV in the corner. And they would all make meth.
MARTIN: This is Detective Ryan Cain. We're talking to him inside the Vinton County Courthouse, and he's showing us these photos of a recent meth raid.
CAIN: That's the stovetop - just all of it. I mean, it's - you can't really describe the smell.
MARTIN: He can't describe the smell, but he knows what it is.
CAIN: It's a combination of lithium out of a battery. A lot of them use Coleman camp fuel. It's a solvent. They use ammonium nitrate, which is usually out of a cold pack. And all of it's very cancerous.
MARTIN: Not only is he the lead detective on counternarcotics in the county, he is also the guy who puts on the big protective suit and goes out to decontaminate the meth labs after he busts them. He and the county prosecutor, Trecia Kimes-Brown, have been working on the frontlines of the drug crisis here for years. And in those years, they've not only observed a surge in meth. They've also noticed a shift in where it's coming from.
TRECIA KIMES-BROWN: What everybody is doing now is just buying the cheap Mexican meth and not cooking anymore.
MARTIN: We called the U.S. Drug Enforcement Administration, and they told us that Mexican drug traffickers have indeed become the primary manufacturers and distributors of meth to cities throughout the United States. All of this has left Trecia with an overloaded criminal justice system. One example - Vinton County doesn't have its own jail. So prisoners have to be housed outside the county, and that's expensive. Trecia says a sixth of the county's budget goes to pay that jail bill. That's almost $500,000 a year. And when there are no spaces available in any nearby prison, she has to make hard choices.
KIMES-BROWN: What I have to do is call one of the judges and say look. We got so-and-so in jail right now. They may have already been convicted of a sentence. They may be serving time. But if they're a misdemeanor - lower-level risk to society, I literally have to put them on the street to put this other more violent offender in jail. That happens at least once a week.
MARTIN: It's clear this work has taken a toll on her and the detective. Trecia rarely stops working before midnight. He once chased down some suspects while his 5-year-old daughter happened to be with him in his car. Both of them have endured threats to their own safety. Things have gotten more dangerous since the opioid epidemic has evolved into a meth problem and now a full-blown drug crisis. But what really gets them - what they cannot shake is the effect the drug crisis is having on the youngest victims. In those photos they shared with us - the ones of that meth bust - you can make out kids in the background sleeping on squalid floors.
CAIN: That's how they were sleeping - and piled in there. I believe there's a kid right there - two here.
KIMES-BROWN: When you're living in a house where people are making meth, it's not just the health effects. These kids are living in these environments where, you know, they're not being fed. They're not being clothed properly. They're not being sent to school. They're being mistreated. And they have a front-row seat to all of this.
MARTIN: We'll bring you the stories of those kids later this week.
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