A billboard imploring addicts to seek treatment overshadows tailgaters having a cook-out at Fifth Third Field in downtown Toledo, Ohio, for the Opening Day of the Toledo Mud Hens baseball season on April 13, 2017. The crisis of opioid addiction impacts daily life in Toledo in ways big and small.
Deanna Newbury, pictured on Oct. 20, 2018, found the body of her son Alex Sabatino after a fatal heroin overdose on Jan. 11, 2016. Deanna said she misses him constantly, and has sworn to live life to the fullest in his honor, "because he can't anymore."
After first using heroin as a teenager and continuing for five years, a local woman, who declined to be named but agreed to be photographed, decided to get clean the day she learned she was pregnant. Now, she and her two-month-old son, pictured on June 11, 2014, take Methadone to manage their mutual addiction.
Inmates line up to be moved from booking into other areas of the Lucas County Jail in downtown Toledo, Ohio. The booking area of the jail, which opened in 1977 and was renovated in 1995, was originally designed to hold 45 to 50 people. Today, they regularly exceed that number, including on Jan. 23, 2014, when the booking area was housing more than 80 people. Lt. Jim Williams says flooding, storage and an increase in arrests related to opioid addiction are all growing concerns for the jail. "Our officers do the best they can with what they have to work with," he said, adding that a new jail facility was sorely needed.
A pair of cuffs sits over bloodied linoleum tile in the control room of the booking area at the Lucas County Jail in downtown Toledo on Jan. 23, 2014.
Nurse Practitioner Mischel Balazs, pictured on July 26, 2017, works with babies who were exposed to opioids in utero at the NICU unit of ProMedica Toledo Children's Hospital. She estimated the number of children treated at the unit who suffer from neonatal abstinence syndrome has increased tenfold in the past three to five years. In 2012 Toledo paired with other children's hospitals around Ohio to develop better protocols for treating children exposed to opioids in the womb with an aim to standardize care and decrease the amount of time babies spent in the hospital. She estimates that out of about 5,000 babies born at the hospital annually, up to three percent are screened and then treated for opiate exposure.
Kaylee Morrison is beginning a four-year-long sentence at the Ohio Reformatory for Women in Marysville, Ohio, pictured on Aug. 25, 2014. Morrison, who is an opioid user, was convicted of tampering with evidence, possession of criminal tools and possession of drugs. While in county jail, Morrison's cellmates smuggled in cocaine which she was caught using. When she was sentenced Morrison said her judge told her, "'Why would I let you go to a non-lockdown facility when you just use in a lockdown facility.' Which, he has a point," Morrison said, continuing, "But I still need help."
Members of Toledo Fire Rescue administer the medication naloxone for a suspected opioid overdose in downtown Toledo, Ohio, on Nov. 2, 2016. First responders often administer naloxone at suspected overdoses to be on the safe side, though testing at the hospital is generally needed to confirm the presence of opioids in a patient's system. In this case, passers-by had been unable to rouse a man slumped over on the street. He woke up only after first responders administered naloxone.
LEFT: “A lot of patients now started into heroin with prescriptions that were appropriately prescribed by a physician," Dr. Michael McCrea said. "If we as physicians don't own this, it won't get better." Dr. McCrea, pictured on July 11, 2017, has been working in the emergency room at Mercy Health St. Vincent Medical Center in Toledo, Ohio, for eight years and says he generally sees multiple opioid overdoses daily. At the start of his career in medicine Dr. McCrea said he had viewed heroin addicts as people who had chosen to use and had to take responsibility for the choice to continue using. The patient that changed Dr. McCrea's view of treating opioid addicts was a young man who overdosed and died on Christmas Eve. He was 20 years old. After his death Dr. McCrea sat with the man's mother. That conversation set Dr. McCrea down a different path. Now he views addiction like any other disease and advocates a broad approach to treatment. CENTER: "It's sad because you hit a certain age and you think your kids are grown up and you're going to live your life,” Julie Odorzynski, pictured Nov. 7, 2018, said of the decision she and her late husband Mike made to adopt Julie's grandson Brendin. Julie's oldest son, who is now 39, has been addicted to drugs for two decades and using heroin for several years. Julie and her husband Mike took custody of Brendin when he was just 18 months old, but in Sept. of 2017, Mike died of cancer, leaving Julie to raise Brendin as a single parent. RIGHT: "I felt like I sold my soul on a daily basis to support my habit when I had to sell my body," Courtney Keith said of the years she spent in prostitution to support her heroin addiction. Now in recovery, Courtney, pictured on Aug. 1, 2017, is living in transitional housing while she works a 12-step program and attends a support group for survivors of domestic violence. She has placed her faith in a higher power, believing that God forgives all. "He is forgiving and He loves me despite what I may have done, and what I did does not define me."
Mother, left, and daughter, right, are embraced by a friend as they remember a family member, who died of complications from opioid addiction, during a remembrance event at the Northwest Ohio Syringe Services, a harm reduction program that works with active drug users, in Toledo, Ohio. The mother, who agreed to be photographed, said that her sister had died of endocarditis, an inflammation of the heart valve, caused by reusing syringes. She said she was also in active addition.
The women’s Heroin Anonymous 12 Step group opened at the R House in Toledo, Ohio, on May 1, 2014. With about six women regularly attending, the group offers support and counseling to members as they battle addiction and work to stay in recovery.
Lucas County Common Pleas Judge Ian English, left, embraces Jimmie Vallier after they met during a session of drug court in Toledo, Ohio, on June 28, 2017. Toledo's drug court, created in response to the rising opioid epidemic, was wrapping up its first year. Though too soon to know how many participants would ultimately stay clean and out of legal trouble, there were many anecdotal successes.
Toledo police Officers Melissa Stephens, left, and Donald Scott, center, joke with Constance Howell as the officers go door-to-door promoting a new program called, "Not in My House" on May 10, 2018. The new initiative allows Toledo residents to call police to pick up illegal drugs and firearms from private residences, no questions asked.
Jean Wilson, right, plays with her 22-month-old grandson, Jacob Quainton, while his father, Jason, stands in the living room at their home just north of Jackson, Mich., on Sept. 16, 2010. Though he still lagged developmentally by about a year, Jacob was making headway in his recovery after ingesting methadone, which caused brain damage, while in the care of his mother the previous March.
"I can't explain how happy I am today knowing that I don't have to use," Annee Mueller said about her recovery from heroin addiction on Oct. 19, 2017. She had been clean for three years. Adopted from Bulgaria at five years old, Annee struggled to come to terms with the abuse she endured at an orphanage there, as well as her sexuality. She began using drugs as a teenager and eventually became addicted to heroin and cocaine. At one point Annee overdosed and was a coma for three days, suffering seizures which led to a permanent stutter. Still, her addiction continued until she was arrested on drug-related charges that could have landed her in prison for up to 15 years. Because Annee had never been arrested before, she was able to complete a program designed to help first time offenders. Now, her record has been expunged, she's come out and is working to get her life back on track. She says she would like to help other addicts find a way to become clean. "I know I can't save every addict but if I can help them, lead them to the right path, that's all I'm asking." When she was first clean, Annee would often come down to the Maumee River in Perrysburg, Ohio, pictured, to connect with nature.
A man who agreed to be photographed prays near the chalked names of people he lost to opioid overdose during a remembrance event held at the Northwest Ohio Syringe Services, a harm reduction program that works with active drug users, in Toledo, Ohio.