Fentanyl has made its way across America, into even the smallest towns.
Ohio is one of the hardest hit regions across the country. One hundred people are dying each week from overdoses, according to Ohio Attorney General Mike DeWine. Nationwide, 175 are dying daily.
WKYC spent time embedded with ambulance companies in small towns across Ohio to get a gritty first-hand look at the opioid epidemic. It became clear to us that the problem stretches beyond heroin.
In Trumbull County, overdose numbers are staggering. So far this year, there have been 60 fatal overdoses in the area populated by 203,750. Fifty more overdoses are still pending results. The county saw 215 overdoses in September alone.
WKYC visited the city of Warren to ride along with Med Star ambulance crews on Sept. 20. Within 90 minutes of our arrival, we saw one overdose, a man named Tyler, who overdosed in the driver's seat of a car in a Rite Aid parking lot. The day before, Med Star responded to 21 overdoses in a 24-hour span. They logged 69 by the end of that week.
Tyler's girlfriend was at the scene when we arrived with the ambulance crew. She told first responders Tyler had used heroin and first responders said they could see the track marks in Tyler's arm.
"He was barely breathing," said Dale Hughes, an EMTB. "He was breathing only a couple of times a minute, and we… it was an obvious overdose."
Tyler survived. He was taken to a local hospital after the first responders gave him four vials of Narcan. That equals eight milligrams. Thomas Young, a Med Star paramedic, said the standard dose is one vial of naloxone. Crews max out at eight vials, or 16 milligrams, per overdose. More than that can lead to liver damage.
"This week, this was my third overdose," Young said. "This month alone I've had about 10 or 15 myself. It comes in waves."
Med Star crews aren't entirely sure why the Trumbull County area has been so heavily plagued by the heroin epidemic. Some guess it's the city of Warren's proximity between Cleveland and Pittsburgh. Others guess it's the economy.
Less than two days before his brush with death, Tyler posted, "Nothing changes if nothing changes" to his Facebook page. He likely didn't know the irony of the post.
Kim Mason estimates she's responded to nearly 500 overdose calls.
"It’s just over the past five years we’ve gotten to where we’re running maybe six in one day," she said. "Maybe a couple, or we can do up to like, 13 to 14 overdoses in a day."
Mason is the Director of Operations of LifeCare in Lorain County, another area that's been flooded by fentanyl. Like Warren, which sits 30 minutes north of Youngstown, Lorain lies on the edge of a major city, 30 minutes west of Cleveland.
"In this city, it’s kind of... we could have a call anywhere. You’d be amazed at all the locations that we get calls for overdoses in. There’s a lot of nice homes, people that have nice jobs. We still go back there for overdoses," Mason said.
Three of the overdoses we saw in Lorain County were what LifeCare crews called "classic" overdoses. One was fatal.
Marcos was 43. He was found dead on his front porch by family members. His mother told WKYC the last conversation they had was the night before, when Marcos expressed concerns about his own daughter's drug habits.
In the month of August, LifeCare responded to at least 72 overdose calls.
Mason says repeat offenders are common, much like some locations tend to be overdose hot spots. Our crew passed a McDonald's, which Mason said sees a lot of overdoses. At another overdose scene, Mason realized she'd been there before.
"We were just here last week," she said.
The problem has crept into all areas. Nice houses. American flags. White picket fences. Neighborhoods where nurses and police officers raise their families.
Lorain County Coroner Dr. Stephen Evans has seen them all.
"It’s non-stop," Evans said. "I tell people, it’s like the waves of the ocean. I can’t stop it. It keeps coming, it keeps coming. It’s every day. It’s non-stop. There’s no respite from it. It just keeps coming."