On an early Wednesday morning, four teams of attorneys — dressed in suits and flanked by paralegals rolling trolleys stacked high with boxes of court materials — parade into the Robert C. Byrd U.S. Courthouse in Charleston.
By 9 a.m., a vice president of one of the nation’s largest drug distributors is seated at the witness stand.
It’s the third week of a trial that’s drawn international attention, as Cabell County and the City of Huntington take on the “Big Three” drug distributors that flooded the area with highly addictive prescription opioids in earlier years.
For up to 12 weeks, the attorneys will argue whether the companies — AmerisourceBergen, Cardinal Health and McKesson — are at fault for fueling an addiction crisis that has resulted in thousands of lives lost, traumas endured and long-lasting damages to the broader community.
But while lawyers make their case in court, and the nation turns its eyes to the Mountain State, it’s business as usual for the people on the frontlines in Huntington working to help their city and their neighbors make it through the day.
Still, what happens in the trial will have major implications for the future of the city’s resources, as $2 billion is on the line. For those people in Huntington, that’s money that they say is desperately needed.
9:15 a.m., Lily’s Place
A mother rocks her baby daughter. The sound of crying newborns fills the narrow hall.
The cries aren’t the coo of a baby calling for food or wanting to be held. It’s a sound of discomfort; a newborn experiencing drug withdrawal.
When Lily’s Place opened in Huntington in 2014, it was one of the first medical facilities in the country designated specifically to caring for babies born with neonatal abstinence syndrome (NAS) — or what occurs when newborns withdraw from drugs that they were exposed to while in the womb.
A nurse at Cabell Huntington Hospital’s neonatal intensive care unit saw the number of drug-addicted babies increase amid the opioid epidemic, and she realized the need for more specialized treatment.
Lily’s Place is a refuge. It’s a calm and caring environment where moms and babies go to heal and where families receive support after birth. The organization offers a range of recovery, counseling and social services, but it’s also a full-fledged medical facility with a doctor who makes rounds and nurses on call. It’s a lifeline to some of Huntington’s newest and most vulnerable residents and the people who love them.
It’s Jennifer Chapman’s job to make sure there’s enough money to keep the invaluable operation afloat.
Chapman, the director of development for Lily’s Place, writes the grants that bring in money to keep the place open.
On this morning, she’s sitting in her office next to coworker Ryan Massie, and the two are talking fundraising strategies. They’re planning a major donor event for next year.
Lily’s Place gets by on community and foundation support. In a typical year, there isn’t enough to cover all that the facility hopes to offer — they’ve recently expanded to include family development services that go beyond postnatal care, but finding a qualified counselor on a small budget is hard and the position hasn’t been filled.
This wasn’t a typical year. Chapman and Massie agree that the pandemic has hurt.
The grants are getting smaller. The donations are too.
“There are so many things that we want to do that we’re not able to do right now,” Chapman says. “I feel the pressure. I think we both do.”
“Every amount big or small helps,” he says. “There’s a guy that sends a $3 check every month. And every month he sends a memo with it that says ‘I wish we could do more.’ It takes the big ones and the little ones and everything in between to keep this place going.”
Chapman and Massie say they’ve been watching the trial in Charleston. Attorneys for Huntington and Cabell County are seeking more than $2 billion that they say is needed to help make up for the cost of the opioid epidemic. Chapman says that money could help provide a more sustainable source of funding to organizations like Lily’s Place.
“I’ve got a Google alert on my computer,” Chapman says. “It’s definitely something we’re thinking about.”
But when they do think about it, it’s not for long. There’s work on the ground to be done: phone calls to be made, grants to be written, support offered to the patients and the staff.
“Every now and then we need to take a walk and see the babies,” Chapman says. “If a day goes by and there are no checks in the mail, it can get kind of disheartening. But then we remember why we’re here.”
11 a.m., ReBUILD House
If you pass by 1128 9th Ave., you’re likely to see people gathered around the porch. They look like longtime friends.
But many of those who gather here are strangers. The house is a community hub where anybody and everybody is invited in, arms open wide, for connection, a hug, a washing machine, a bite to eat.
That’s exactly what Renee Law intended for when she began an outreach project called ReBUILD in the house nearly eight years ago.
“This is a crossroads for anybody battling any type of thing,” says Law from the porch, the smell of biscuits wafting from the window. “We’re not a recovery house or a resource for only people in the throws of it, but because of where we’re located, a lot of our friends are battling addiction.”
Meanwhile, Eric Runyon leans back on a porch swing and gently rocks.
Creak, curk … creak, curk …
“Oh yeah, the opioid addiction, it’s real bad. It’s just a shame. It is,” he chimes in. “It seems like it’s every day [people overdose]. Two or three times a day. It’s a terrible thing.”
Runyon is relatively new to the porch. He’s been coming to the house for the last year, when he was out of work and struggling with housing. He stopped by one day because he heard there was food.
At 52, Runyon doesn’t have gray hair on his head. But it’s not for a lack of challenges. He entered the foster care system at birth, and bounced from shelter to shelter until he was 10 years old. The trauma left him with his vices.
“But you just come in here and these ladies make you feel like you’re at home,” Runyon says, gesturing toward Law. “I’ve been by here a couple of times in a bad mood, not feeling good and she just cheers me right up.”
That a trial is happening against the drug distributors several miles away is not on the minds of people like Law and Runyon. Not because they don’t care, but because they’re focused on the work that’s directly in front of them.
“We’re focused on building community and living life,” Law says. “The people here are not paying attention to [the trial] because the people here are in the middle of just trying to survive.”
Then, for a moment, it’s quiet. They listen to the sounds of the cars passing by and birds chirping in the breeze.
“Hey, is there any chance I can bum something to drink,” Runyon asks.
“You can’t bum it, but you can have one,” she says.
Law goes into the house and grabs Runyon a water bottle and he goes on his way.
1 p.m., Cabell County EMS station
“One of the things that really encourages me is when I run into someone, who is actively living free of drugs when I know where they were before,” says Pastor Fred McCarty. “That’s the measurement we need to be tracking.”
McCarty leans back in a black leather chair. He’s sitting in a conference room at the Cabell County EMS station in downtown Huntington, with friend and colleague Steven Little. CPR dummies rest against a wall in the back corner of the room.
McCarty and Little are among a growing number of faith leaders in the Huntington community who are working to address the overdose crisis in their backyards. Both pastors are people in long-term recovery themselves. When they saw the toll that addiction was taking within their own congregations, it hit home, and they began encouraging people to talk about substance use disorders, in order to decrease stigma and help find solutions.
That work extends beyond the walls of their churches.
McCarty and Little are members of the Huntington Quick Response Team. The team, operated by Cabell County EMS, was founded in 2017 to provide follow-up checks on suspected overdose calls. If somebody overdoses and calls 911 the day before, the Quick Response Team will visit the site of the overdose the next day to offer additional services.
“As faith leaders, we’re not here to proselytize, we’re here for spiritual support,” says Little. “And it’s not just for the clients, but also for the first responders. There’s a lot of suffering out there whether you’re in it or witnessing it and people need encouragement and support.”
On a typical shift, McCarty and Little are handed a stack of papers with details of overdose runs made by paramedics the day before. Then, alongside a peer recovery coach, a dressed-down police officer, and Larrecsa Cox, who heads the team, the pastors hop in a car and make runs around the city until they’ve visited each overdose site.
Last night, there were five overdose calls, which means five follow-up visits to make this afternoon. But before that, McCarty and Little chat about how people measure success and healing.
Before last year, which saw spikes in overdoses nationwide, the number of overdose deaths has trended down. But Little and McCarty say that just because fewer people are dying because of overdose reversal drugs like naloxone, it doesn’t mean the problem is going away.
“The Quick Response Team follows up the day after the overdose. And now, we try to follow up with the person six months after to see how they’re doing then,” McCarty says. “But the stat that we’re missing is what happens next. Where are these people one year from now? Where are they five years from now?”
It’s hard to know, says Little, because the resources aren’t there.
“We’re having great success through the QRT team but it’s just the beginning of what’s needed to get somebody through,” he says. “We need mental health services. We need support for the family. There needs to be a continuation of care.”
3 p.m., First Steps drop-in center
In the federal courthouse in Charleston, attorneys for the “Big Three” drug distributors have argued that they’re not at fault for the prevalence of drug use in Cabell County and the effects on the wider community.
They’ve also suggested that the crisis isn’t actually linked to the number of legally prescribed opioids poured into the community, but rather illicit drug trafficking and trade.
“Bullshit,” says Terry Collison, while seated at her desk on Wednesday afternoon.
Collison is the director of First Steps drop-in center in Huntington, a basic service center for people who are directly or tangentially impacted by substance use. It’s a place for people to stop in and hang out. There’s a TV in the back that folks will gather around and spend time cooling off in summer or warming up in winter. And there are computers in the front that are used for filling out paperwork and applying for jobs. Most importantly, it’s a place that people can come to and trust for help when they need it.
Collison is warm and kind. She has bright blue eyes and an infectious smile, but she tells it like it is. And she says it’s indisputable that prescription opioids fueled the rise in substance use disorders in Huntington and across West Virginia.
She’s seen the pattern first-hand.
“I’ve had two nieces that have come here to stay with me so they can get the services here,” Collison said. “They started out with pills. One was because the boyfriend had gotten them for an injury.”
By the time his prescription dried up, he was already hooked. When he turned to the street for his supply, Collison’s niece started using, too.
“For a long time, Oxys and Opanas were really easy to get [on the street]. But when the pills dried up, that’s when we started seeing the heroin come in,” Collison says.
The stories are endless. Collison knows teenagers who have gotten hooked. She knows a woman who became addicted at 83 years old.
Bryan Littlejohn, who works with Collison at the center, has been through the experience himself.
He’s seated at a desk at the front of the room, with a thermometer and a sign-in sheet, ready to greet whoever stops by. Normally the place would be buzzing with activity, but this day — like most days since the pandemic began and the center has had to limit services — is a quiet one.
“I used with my parents, and my parents were getting scripts of Oxys from doctors. It was all prescribed,” Littlejohn says. He’s talking with Collison and another co-worker, Wesley Alexander. They’re a team of three.
A sign overhead reads: “Naloxone Saves Lives.”
“I was using [prescribed] Oxys when I went to jail. When I came out, the pills were gone, but heroin was there,” Littlejohn says. “I just jumped right into that.”
Everybody who works at the center has lived experience. Littlejohn has been in recovery for three years now. Collison and Alexander have been in recovery longer. And while all three echoed the sentiments shared across the city — that there’s a need for sustainable funding and increased mental health services, Collison says the trial in Charleston is about something more.
“I want the people that are responsible held accountable,” Collison says. “You just want them to say sorry, we messed up, instead of acting like it’s all West Virginia’s fault.”
4:45 p.m., Cabell Huntington Hospital
Leah Ching is nose-deep in her medical textbooks. For the last two months, her days have looked the same. Wake up, bite to eat, head over to Cabell Huntington Hospital. There, she spends her days from 9 a.m. to 9 p.m. studying for exams and working in the hospital’s Health Sciences Library.
Ching is a Huntington native and a second-year student at Marshall University’s Joan C. Edwards School of Medicine. She’s also the founder and president of the Substance Use Disorder and Recovery student interest group, which she started after an introductory lecture.
“I asked if we were going to have any more lectures on the topic and was told that we weren’t,” Ching says from a third-floor study room. “It’s obviously a huge problem in Huntington and it’s our responsibility as students to seek out information and resources.”
And that’s what Ching did. The group, with at least 50 members across the medical school, is homebase for the future doctors to come together and discuss substance use and treatment. It also plays a role in community health. Ching has organized naloxone training and distribution. The group has taken part in mobile clinics.
“I try to stay away from things that are going to make the group a resume builder. I’m not really interested in that,” says Ching. “For me, it’s about chasing down opportunities to learn.”
Ching says growing up in Huntington sparked her interest and helped motivate her to learn more about substance use disorders and recovery. She says that drugs don’t discriminate and no one’s untouchable.
And while she doesn’t know what area of medicine she’s going to pursue, being knowledgeable about substance use disorders will always be useful, she says.
“I don’t know what I want to go into. But anything that I go into, I think that this is applicable,” Ching says. “You want to see your hometown prosper in every way that it can, and unfortunately we do have this cloud hanging over our heads. I’d love to be a part of the solution.”
Ching shrugs her shoulders. She gets back to work.
Forty-nine miles away in Charleston, court adjourns for the day.