Heroin Town Louis Theroux

This programme contains very strong language.

Your grandparents are at church now?

-Mm-hm.

-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 do 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 there right there by myself, dude,

I'd drop dead.

The city has 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, ODed?

-Yeah.

-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

-BLEEP

-exhausted.

-I'm tired. I'm really

-BLEEP

-tired.

Really tired.

Huntington lies at the intersection

of West Virginia, Ohio and Kentucky...

..an area known as Tri-state.

Once home to factories and steel mills,

it is now a hub for heroin use.

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

25-year-old Curtilia...

and her boyfriend Alvin.

You OK, Curtilia?

Yeah, I'm fine.

I just need to go to the rest room 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.

Are you OK?

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

She's shooting.

Are you doing it now?

Yeah. Yeah, it's not...

It's not, it's just something, it's like a rinse,

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 who has an addiction,

cos you always, you love them, but it's like evil,

you know what I'm saying? You love them, but you wish they'd get off,

-but it's hard.

-You would rather Curtilia was not using.

-Yes, absolutely.

-How many times do you shoot up a day?

I mean, it's at least six, seven.

So in a day, how much would you typically say,

what money value would you be using?

I could give at least 150-200.

Does that sound right to you, Curtilia?

Oh, yeah, actually that's probably less.

-It's actually the minimum.

-That's on the low end.

-Yes.

Are you able to keep down a job, Curtilia?

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

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...stripped.

-Mm-hm.

I have tricked.

-Mm-hm.

-I have...

-..robbed.

-Tricked is prostituted.

-Yes.

-Do you still do that?

I don't, not since I've been with Al.

Because he's providing?

Since we've been around each other

I've been able to find better quality

of the drug, too,

where I can not use as much.

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

with better quality product?

Yeah, I would rather go out to find her something that's going to at least be what she wants,

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

Would you consider yourself a dealer?

Consider? No, I consider myself, because of her situation,

I know people and I'd be like OK, they got something good that you want.

I know she won't get it, you know what I'm saying?

How old were you when you first

got involved in a serious way with opiates?

A serious way?

When I was about 17.

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

or was there something else going on?

Well, growing up... My family does a lot of manual labour work.

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

-Functioning.

-Yeah. I seen them just 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...

Er...

Oh, gosh, I can't...! I don't know why I'm...

Don't worry. Maybe it's hard to express like, the...

Are the questions making you nervous?

No, no.

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

then you can just...

do what you do.

OK, the man will help you, Jesus.

Oh...

Hello, there.

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

-What you talking about, what do you want to do?

-Yeah.

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.

It looks...like it needs an extreme makeover.

Petty Betty, what should I call you, Petty, or Betty, or something else?

SHE LAUGHS

My name is actually Jessica.

Everyone knows me as Petty Betty.

-Petty.

-Yeah.

-Do you, um... do you have a job, Petty?

-No.

-You're not in work at the moment?

-No.

-Do 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?

Lortabs.

-Huh?

-Pain pills, painkillers.

Where did you get them from?

Um... Medicine cabinets from my grandparents, from my mom,

anywhere I could find them, really.

Why?

Everybody else was doing it.

This is like, I was raised as a spoiled little brat, honestly,

had anything and everything I 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 mean you've got to find something to get rid of it, basically and...

..they took all the pills away from everybody here,

so then you've got to find something else to cope with.

So...

It's a bad habit, it really is.

PHONE RINGS

I think that's the call, isn't it?

-I hope.

-How do you know?

-Can I have that?

-Let me see.

He wants to see!

INDISTINCT

That is it?

That's it.

That is it. It's so nothing.

-How much was that?

-That...

40.

40?

Is that a, um?

I would have had to pay probably 180 for it.

-Is that a gram?

-That 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!

Probably, I don't know, that's what I'm about to find out.

This has a smell to it, too. Usually...

that either means they've re-cut it, or it's a decent,

decent quality.

It's got, I don't know if you want to smell it,

it's got like a vinegary...

-This is weird. OK...

-I know!

-Vinegary, there's no other word for it.

-I know.

Have you ever smelt that before?

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

Uh-oh.

I feel weird watching you do something so dangerous.

And also 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'm going to add a lighter to that.

INDISTINCT

How will I know if you're in trouble?

I'll lose consciousness, pretty much.

I'll even start to probably change colour.

That's what I call a creeper.

It's a slow, slow...

A slow rush.

It's not bad. I've had better.

It's not bad.

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

Probably with this, maybe a couple of hours.

Is he still physical with you?

Mm-hm.

Where do you see the relationship going?

Well, down the drain, but...

right now, it's going to be like this until...

Until I...

can try to overpower...

..my addiction.

He's the only way right now to get...

..what I want.

SIREN WAILS

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... You see actually, his colour's coming back a little bit.

We've popped him one, shall we go ahead and give him another Narcan?

-Thank you.

-What does the Narcan do, Jan?

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

Does it stop them from overdosing?

Yeah.

Hey, buddy.

What happened?

Hey, honey, it's cold out here.

I'm going to pull your shirt down for you, OK?

Oh...

Jan Raider is the city's fire chief.

Could he have died just then?

Oh, yeah, did you see his face when we showed up?

Very, very pale. Almost blue.

Right. Now, he was breathing,

he was breathing, but not sufficiently.

The first dose of Narcan increased his breathing rate just a little

bit, but he probably had heroin that 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 Mexico,

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.

Is he vomiting?

Yeah, he is.

That's what the Narcan has done,

it's knocked the opiates 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 the prescription, they turn to heroin,

because it's cheaper, 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 realised the drugs

were being abused in vast quantities,

they began cracking down, passing new laws against over-prescription.

Combined with disappearing employment,

the unintended result was a massive shift 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 as much as you do everyday.

No matter what, I've 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 have a 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.

Did you hear that, Mickey?

Edwin's a computer boffin.

Yeah. Hell, it kills movie stars, man. It doesn't discriminate on who you are.

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

-Absolutely, it is.

And there's no chemical solution for a God-sized problem, man.

There is not.

You will not fill this hole inside you with anything other than God.

That hole, man, that hole is there.

There is a big hole. I see it right now, I'm in withdrawal,

I feel that big hole in my chest.

I ain't going to stand here and boast to you.

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 getting where he wants him.

-Shall we do it?

-Yeah, let's go.

What were your convictions, Mickey?

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

Dude had something of some value and, uh...

I ran up and snatched it from him.

-What was it?

-He had a nice-looking laptop in his hands.

-You just snatched it?

-I just snatched it and ran and they caught me.

-And why had you done that?

I was high and I wanted some more body, so I could keep getting high.

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

My wife tells me it'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, or 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.

There's the heart beating away. We'll measure it.

The heart rate is 151.

That's good.

At Cabell Huntington Hospital,

Alicia Phillips and Ronnie Rowe were having a baby scan.

He has some hair.

-Oh!

-All that fuzzy stuff you see there on top.

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 Doctor David Chaffin.

Well, all together, we're at the 26 percentile.

So baby's growth is good.

-Fluid's good.

-OK.

How much does he weigh?

Well, now, realise this is a guesstimate, OK?

-OK.

-But...

..4lb 12oz.

-So... Good size.

-Yeah.

Doctor Chaffin?

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, 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.

So what's really scary in the case of heroin is

the withdrawal can come on very quickly, if you miss a dose,

and acute sudden withdrawal

is dangerous for the foetus in utero and so sometimes,

those babies don't survive that withdrawal.

Any questions about what you just heard?

-No. I've heard lots about it.

-OK.

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, all right, a newborn,

is absent in these babies.

And yes, it is difficult to deal with these babies.

But they are feeling...

-They are...

-Irritable, they don't want to be touched.

-Correct.

-They are crying.

Correct. The good news is, there is an end.

OK? We are weaning them off of this medication

and there will be an end to this.

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 ten 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? How do you mean?

I dropped out of college

and then I started getting arrested and going to jail

and not being able to keep a job and...

You dropped out of college, Alicia?

-What were you studying?

-Library science.

-Library science?

-Yeah.

So how did you get involved in opiates?

My stepdad was a welder, a boilermaker.

And he had had a lot of surgeries on his back

and he was receiving OxyContin.

He didn't take his prescription that often, really,

so he had a stockpile of pills and I would,

you know, take them.

You would dip into it?

-Yeah.

-Without him knowing?

It took him about two years to realise.

See 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?

Safe. And you know how all the commercials on television for all

the big pharmaceutical companies, antidepressants and pills for this,

pills 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...stay high.

I would get paid in crack and heroin to drive.

And I could have ended up doing ten years in prison.

So when did you sort of stop abusing drugs?

When me and her got serious.

And 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 Subutex?

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...?

-And one in the evening.

-And really, at this stage,

that's all your addiction...

-..is?

-Yes.

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

Yes. Yeah.

Hello.

I was back with Curtilia.

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 Alvin.

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

I'm actually really excited.

-About?

-This is the first time that I've been able to be home

-since I've with Al.

-Are you serious?

Yes.

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

Almost holding you hostage, using the drugs.

Actually, I used to be scared.

I used to be scared of him.

But...

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 the house.

Curtilia'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 are actually Curtilia's great uncle by blood.

That's right, isn't it?

-But she calls you Dad.

-Mm-hm.

-And you raised her.

-Right.

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

What was Curtilia 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 let her drive bulldozers and things like that.

Curtilia 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, er...

basically, back...

..when we was, when my wife got sick,

and I was spending so much time

in the hospitals with her,

with my wife,

and Curtilia basically had too much freedom to do as she pleased.

Maybe I've been an enabler.

In a lot of ways, I blame myself for that.

I've been an enabler.

And right now...

..she's at a point that she depends on...

Curtilia, if I'm telling this wrong, you can...

-It's OK.

-I'm not... Am I making you feel bad?

-No, you're OK, Dad.

-I'm just telling you what I think.

-Well, you tell your...

-I just don't want you to blame yourself

or feel like you had any part in any reason...

-Well, no...

-..of me picking up...

..a needle.

I see that as...

You would love me to death.

I'd rather say it like that.

And I wouldn't say enabling.

You said that you thought you might have enabled.

I had enabled her,

after she got already on drugs.

She came to me and said,

"Dad, can I have 50 bucks?"

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

Instead of buying shoes, she'd buy drugs.

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

-It did.

-Anxiety.

All the time, I'd go to bed and I'd 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. Mm-hm.

But, hey...

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

Does he not realise when you're doing heroin, would he be upset?

He... 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 money today

-to get a vehicle, or money to put on a vehicle.

-He is?

-Mm-hm.

-Today?

-Mm-hm.

-How much?

Well, 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 could have so much more with a vehicle.

If I don't spend it, don't waste it,

but God help you if you do.

I told him to not worry,

that I really didn't have to spend money like that any more.

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 you all.

-You OK?

-Yeah.

-What's the matter?

-Huh?

-What's the matter?

It just...hurts to leave him...

..and...

..go back into town to...

..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. Forget it. Thanks.

Leaving Mike's farm, I began to suspect that for Curtilia,

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 OK, right now.

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

I'm trying to get HERE, but 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 the 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 programme.

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 did 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 in my apartment on the west end, down there in Miami.

I overdosed again and...

How many times have you overdosed?

I don't know. Somewhere upwards towards 100.

-Come on!

-I'm not kidding, dude.

You were hospitalised?

Like, ten times over it, yeah.

I have 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 of 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, than I love you, and thanks for everything.

"And 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, OK?

Right.

Who are in many ways similar,

very similar to the person you're describing, that 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.

It's kind of when the pain of change

becomes less than the pain of staying the same.

Then you'll change.

But 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 need.

Darn right I crawled across that broken glass. I wouldn't hesitate.

I feel like life's going the way it's supposed to, man.

I've got a full-time job.

I pay my bills.

And I got my kids back in my life.

I've got...

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.

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, here.

-Yeah.

And you've got your glass coffee table.

Yeah, you like that?

A three-year veteran of the river bank,

he was also a dealer and something of a connoisseur of heroin.

I've definitely got some dope.

I've got the best dope in the city. The best dope in the Tri-State.

That right there...is that fire,

you know what I'm saying?

-Wow!

-See, that's kind of pink.

-Like it's pinkish looking.

-Yeah, a tiny bit. Tiny pinky-grey.

Cos that's not straight heroin, it's Fentanyl.

Cos 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, right?

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

-That's what happens...

-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 26, 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 ten 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 almost... That's kind of interesting and paradoxical.

A lot of people on 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.

Yeah. 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 time just fucking high and making money

and just comfortable and fine with it, you know what I mean?

Than I don't, you know what I'm saying?

Have you ever done rehab?

No, I haven't,

cos, er...

why would I?

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

But yet, it's kind of like how it all fell into place, though,

is cos I had gotten...

I had a baby with this girl

over in Ohio and she ended up snatching my kid up

and you know, taking off and leaving with him and disappearing.

At the time, I had a nice job welding.

How many children have you got?

-I've got the one, just got one.

-How old? It's a boy, did you say?

-A little boy, yeah.

-How old is he now?

He will be 12 on 4th July, yeah.

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 I get.

I've missed so much of my son's life,

when he was really young, cos 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...

Why are you putting it in that scab?

That's where I shoot.

-You've got, like...

-It looks like that because that's the only spot I've been using for a long time.

But, yeah, that's that.

-Anyways...

-How do you feel now?

I feel exactly the same, Bro.

It hasn'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,

cos I know it's coming.

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

-I mean...

-What could you compare it to?

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

But, um...

it's kind of like a, er...

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 possibly 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 I say, I mean,

why would I want to go to rehab and why would I want to get straight?

Clean my life up, and shit, cos I enjoy it too much, man, like,

who wouldn't, you know?

Police. Search warrant!

POLICE OFFICER SHOUTS

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

About 3,000, possibly in 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.

SIREN WAILS

That's another overdose.

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

the ravages of heroin were apparent on a daily basis.

I'm OK.

Looks all perky now.

Yeah, that's Narcan.

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

heroin has ripped the heart out of Huntington,

destroying lives indiscriminately...

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

Those people in that car, you see how they were looking at us?

Step out.

Do you have a problem with opiates or heroin?

Yeah, I've struggled with it.

Yeah.

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

-Hello.

-Hi!

-Can I come in?

Yeah, sure. Come in.

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 Rowe.

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 seven days, anyway.

He's on methadone.

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

of basically kind of...

..weaning himself off the methadone.

Yeah. He's getting diarrhoea,

mottling - it's like red skin.

Excessive sucking.

-Sneezing.

-You've met Archer, have you, Pete?

-Oh, yeah.

-He got to hold Archer before I did.

Yeah. Like, handed him right to me when he came out.

I was the one that went in with her.

-Yeah.

-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 hawked.

What was going missing?

Guns, anything that she could hawk.

So your attitude was...?

Hit the door.

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

You didn't want... 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 - had to write her a letter.

-That was awful.

-Yeah. That was AWFUL.

Saying what?

HE SOBS

It was...a bad day.

Just saying, like, um...

..how, you know, how 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.

Yeah.

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 Curtilia, her early promise had been overtaken

by a litany of crimes

and a glaring gulf between what she might have achieved

and the harsh reality.

We finally, we finally got us some good stuff.

Yes.

And today some fresh needles and good dope.

We're doing good!

Oh! Well, hi, guys!

How are you doing?

Good, how are you?

We were on an outing to Huntington's needle exchange.

I couldn't help noticing that

despite the cash gift from Curtilia's great uncle,

there was no sign of a new vehicle.

And Petty Betty's car had gone AWOL.

-This time,

-I

-was driving.

In messages, Curtilia 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?

You have your ways,

but for the most part, pretty much, yeah.

Life happens. Ain't nobody perfect.

Did you break Curtilia's nose?

-No!

-She said you did.

I didn't break your nose!

Your nose ain't broke...

Your nose been broken? Has it been broken?

-Yes, it has.

-It hasn't.

Now, put that on camera.

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

-Alvin...

-Stop lying.

-I was talking about the fight at Diaz.

You weren't talking about a fight. You're lying. Stop lying.

Your nose didn't get broke by me.

From my perspective,

there's never a good reason to be physical, to hit...

-..or be abusive.

-No - there's not a good reason.

-Physically abusive.

You don't just wake up in the morning and say...

"I'm a haul off and hit someone." Nobody does that. You can't do that. Ain't no way of thinking at all.

-You can't do that.

-So you're talking about last night.

-I ain't talking about nothing. Camera on you or me?

OK? Yeah.

You went to hospital while we were away.

-Yes, I did.

-Why?

Well, yeah... There was another...

Me and Al got in another argument

and...I was wanting to leave.

I had my bags packed and he said some really mean things.

But I pushed his grill over, his barbecue grill.

It's something, though, to him that means a lot.

He likes to grill and cook.

And after he seen that I've done that,

he pushed me and kind of slammed me down.

He didn't intend for my back to break...

..but it did, and they said

-the impact, you know, was as much as being in a car accident.

-Mm.

Are you aiming to leave the relationship?

I don't see myself...

It really is not healthy...

..but of course, now I have to say I'm happy and things are OK for me

to continue to get my dope, cos 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 to rob or steal or trick or do anything

for drugs and it's just right there.

So, 158.

-How are you?

-I'm good.

-I'm going to borrow your paper.

-So you got any needles for me?

-Oh, yeah. Definitely, definitely.

All right.

So I'm going to get you some spoons,

and you're not sharing anything with anybody, right?

I hope to see you again.

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

15 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.

SIREN WAILS

I was with Jan on another call -

a former nurse had overdosed in a known drug house.

-Hey, Mallory. 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?

Guess so, yeah.

Did you snort it?

-Mm-mm.

-No, did you shoot it?

-Mm-hm.

It's been busy, hasn't it?

Yes. We are 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...um, 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 anything.

They certainly don't seem to be

willing to stretch out a hand and help us

in our plight and that's very sad.

Cos 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.

Here.

-Thank you.

-You're welcome.

His charitable trips to the river bank

are like a little taste of his old life.

Hello!

Hello. Anybody home?

We've got some snacks and some goodies for you all.

-Want some ravioli?

-Yeah.

I figured you would, man.

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

If you'd had unlimited money for...

..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 OK in there, Nate?

-How you doing?

-Huh?

-How are you doing?

-I'm all right.

-Give me just a second.

-Shall we wait?

-Just for a minute.

-OK, cool.

Thank you.

How you doing, Nate?

-I'm good, man. How're YOU doing?

-Good.

-Really good right now.

-Yeah, hell, yeah.

-Are you high?

-I'm high as fuck, man.

-Are you?

-Oh...!

Have you got a friend in there?

Yeah, man. Ooh!

-She's not your girlfriend?

-No, she's not my girlfriend, you know what I'm saying?

-You don't have one.

-I don't have no girlfriend, like.

You going to leave me, baby girl? Don't leave me. You all go ahead.

-I'm going to speak to her for just one second.

-I've been doing it for two years.

-I can't... I don't like...

-I did it for 25.

-I like keeping myself up, you know what I mean?

Like, I still eat, make sure I keep myself healthy, like...

-How old are you?

-20.

-God.

You've been using for about two years?

Yes. I'm sorry, I've 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 the tent.

She won't be looking like it 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 'em, 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!

Shit, I tried 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 here.

-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, and 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, good friends for a long time.

-You're quite fond of Nate.

-Absolutely, yes.

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

Nate's actually quite a happy dude.

-He's happy...

-And maybe Nate doesn't really...

-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? Is he miserable?

In a certain way, yes.

-In what way?

-In the way that he's delusional.

He doesn't know right now the 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 home, Bro. You know that.

-Exactly, you know what I'm saying?

Like, I've had, 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 gave 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's important to me.

-And your son?

Exactly, like, my own child and everything,

you know what I'm saying? I've put everything on the back burner,

because, I mean, none of that should even matter,

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?

Yeah.

Yeah, but not really, cos I mean, I never really had 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 hands.

I had to do something, because I was hurting and I still hurt.

I hurt every day. If I ain't got none, I hurt.

It hurts bad. I mean...

..you ain't never seen me hurt, Bro.

Every time you see me, I feel good.

Cos I try to stay feeling good, you know what I mean?

-Yeah.

-Just remember, man, if you ever...

-Say the word, Bro.

-Oh, I already know, I mean,

I can get help any time I need it,

but I'd have to welcome all that pain back into my life.

I mean, shit...

And just knowing that if I can do this, Bro, you can, too.

God bless you, Bro. I love you.

Huntington is just one out of a growing number of places across America gripped by heroin.

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

prescription opiates for tens of millions of dollars.

In the meantime, with overdoses continuing to rise,

each small victory is held dear

as an uncertain omen of hope and rebirth.

He looks like a healthy little chap, doesn't he?

-Yes, he is.

-Pretty happy baby.

Careful, very precious.

Hello, mister.

I'm getting good vibes.

You know what time it is... Oh! Open your eyes.

Come on.

Take that from me. Come on.