By Claire Galofaro, David Goldman and Mike Householder
As the COVID-19 pandemic killed more than a half-million Americans, it also quietly inflamed what had already been one of the country’s greatest public health crises: addiction.
To tell that story, a multiformat AP team — enterprise writer Claire Galofaro, enterprise photographer David Goldman and video journalist Mike Householder — spent time in Huntington, West Virginia, exploring the resurgence of addiction in a community that had made progress against the epidemic of drug abuse. Then came COVID.
Larrecsa Cox, who leads the Quick Response Team that tries to track down everyone who overdoses to offer help, arrives in a neighborhood to visit a client who recently overdosed in Huntington, W.Va., March 19, 2021. The team was born amid a horrific episode of America’s addiction epidemic: On the afternoon of August 15, 2016, 28 people overdosed in four hours in Huntington. Almost everyone who overdosed that afternoon was saved, but no one was offered help navigating the bewildering treatment system. – AP Photo / David Goldman
Quick Response Team members from left, Sue Howland, Larrecsa Cox and pastor Fred McCarty check in with a young man who recently overdosed as they visit him at his home in Barboursville, W.Va., March 18, 2021. – AP Photo / David Goldman
Quick Response Team member pastor Fred McCarty, left, prays with a young man who recently overdosed, as team members visit him at his home in Barboursville, W.Va., March 18, 2021. McCarty is one of the faith leaders who ride with the team. When they reach people who overdosed, he asks if they’d like him to pray with them, and usually they do. – AP Photo / David Goldman
Pedestrians walk under train tracks in the once-thriving coal town of Huntington, W.Va., March 17, 2021. – AP Photo / David Goldman
At the home of Yvonne Ash in home in Branchland, W.Va., March 15, 2021, Larrecsa Cox, who leads the Quick Response Team, demonstrates to Ash how to administer the overdose reversal medication naloxone, just days after her son overdosed. Ash found her 33-year-old son Steven slumped among the piles of used tires behind the shop his family has owned for generations. Pleading and crying, she threw water on him because she couldn’t think of anything else to do. – AP Photo / David Goldman
Steven Ash, 33, works, March 17, 2021, at the tire shop his family owns and where he overdosed just days earlier in Huntington, W.Va. Ash was 19 when he took his first OxyContin pill and his life unraveled after that, cycling through jails, he said. He knows he’s putting his mother through hell. “I fight with myself every day. It’s like I’ve got two devils on one shoulder and an angel on the other,” he said. “Who is going to win today?” – AP Photo / David Goldman
Yvonne Ash carries back to her house a CPR kit and a supply of naloxone, the overdose reversal medication, after a visit from the Quick Response team, in Branchland, W.Va., March 15, 2021, just days after Ash’s son overdosed. “We need help,” Ash said. People have been dying all around her. “In the last six months, they’re gone.” – AP Photo / David Goldman
Yvonne Ash is handed a CPR kit and a supply of naloxone, the overdose reversal medication, after a visit from the Quick Response team, in Branchland, W.Va., March 15, 2021, just days after Ash’s son overdosed. – AP Photo / David Goldman
A man walks through a hail storm as the Quick Response Team drives to visit another client who recently overdosed in Huntington, W.Va., March 18, 2021. – AP Photo / David Goldman
Larrecsa Cox, leader of the Quick Response Team, whose mission is to save every citizen who survives an overdose from the next one, peers around a stairwell while walking through an abandoned home frequented by people struggling with addiction, in Huntington, W.Va., March 18, 2021. – AP Photo / David Goldman
Sue Howland, right, and Larrecsa Cox, far left, members of the Quick Response Team, count medications for Betty Thompson, 65, who struggles with alcohol addiction, at Thompson’s apartment in Huntington, W.Va., March 17, 2021. With preexisting conditions that make her especially vulnerable to COVID, Thompson said she was terrified of getting the virus and dying, and so she had been drinking more during the pandemic than ever before. – AP Photo / David Goldman
Sue Howland, right, a member of the Quick Response Team, checks in on Betty Thompson, 65, who struggles with alcohol addiction, at Thompson’s apartment in Huntington, W.Va., March 17, 2021. “In a way I feel empty, there’s nobody here to talk to,” Thompson said. “I drink to escape. I try to get away from feeling.” They team told her they would be back the next day and that they love her. “Who could love me?,” answered Thompson. – AP Photo / David Goldman
Sue Howland, left, a member of the Quick Response Team comforts Betty Thompson, 65, who struggles with alcohol addiction, at Thompson’s apartment in Huntington, W.Va., March 17, 2021. – AP Photo / David Goldman
A blue light illuminates the bathroom in the Cookie Carnival laundromat to make it harder for drug users to find a vein, in Huntington, W.Va, March 18, 2021. The laundromat was among several local businesses to install blue lights at the height of the city’s opioid crisis, when they would often find syringes left behind by drug users. “It was the only thing we could think of to do to help,” said manager Misti Mann-France. “And it has helped … I wish there was a solution to the bigger problem,” she said. – AP Photo / David Goldman
The message “RIP Debo” is shown spray-painted on the apartment door that had been the home of 41-year-old Debbie Barnette, a mother of three, in Huntington, W.Va., March 18, 2021. Barnette, bold and headstrong, had struggled with addiction all her life. She overdosed many times and developed the infections that often follow injection drug use. By the time she sought treatment, the infection in her heart was too far gone to save. Lying in a hospice bed, her sister Lesa told her: “The drugs got you, babe. They got you.” – AP Photo / David Goldman
While staying at his aunt’s house in Huntington, W.Va., March 16, 2021, just days after overdosing, Joshua Messer, 29, shows off a tattoo he got in prison. Messer spent nine years in prison for an addiction-fueled burglary he barely remembers committing. After prison he found a job as a cook at a restaurant and won employee of the month, but Messer said the pandemic created a “circle of nothing,” that drove him and other people he knows to using more drugs. – AP Photo / David Goldman
Joshua Messer, 29, sits on the front stoop of his aunt’s house in Huntington, W.Va., March 16, 2021, where he is currently staying days after overdosing. Messer was a high school basketball star headed to college on a scholarship. He still brags that he was such a star athlete he once met the governor. But addiction to alcohol and pills took hold. “I let my family down, now I’m trying to get it back together. I look at some people and it’s sad how they look,” he said. “I’m starting to look like that. I’m not better than other people. But I’m better than letting something take control of my life. I feel like I should be better than this.” – AP Photo / David Goldman
A police patrol vehicle sits along a stretch of railroad tracks in Huntington, W.Va., March 17, 2021. Huntington was once a thriving industrial town of almost 100,000 people. It sits at the corner of West Virginia, Kentucky and Ohio, and the railroad tracks through town used to rumble all day from trains packed with coal. Then the coal industry collapsed, and the city’s population dwindled in half. Nearly a third of those left behind live in poverty. – AP Photo / David Goldman
Ashley Ellis, 34, shows a marriage proposal video with her fiance, Brandon Williams, on one knee, in Huntington, W.Va., March 16, 2021. Ellis started using drugs in college and has tried many times to stop using. She met the love of her life, Williams, when they were both in recovery. “He had the most beautiful soul of anyone I’ve ever known,” she said. “He was just a beautiful person.” But shortly after their child was born, they both relapsed and lost everything. They were living together on the streets, and Ellis’ mom took in their children. They slept in abandoned houses and on picnic tables. Ellis was hospitalized from an infection, and found her way to recovery again, but when she saw on Facebook that a body was found in an abandoned house, she knew it was Williams. Now she’s determined to remain in recovery. “I think losing Brandon has been, quite possibly, what’s going to save my life.” – AP Photo / David Goldman
Ashley Ellis, 34, shows the necklace containing the ashes of her fiance, Brandon Williams, March 16, 2021, in Huntington, W.Va. She met the love of her life, Williams, when they were both in recovery, but shortly after their child was born, they both relapsed. – AP Photo / David Goldman
Ashley Ellis, 34, shows a tattoo on her arm of a handwritten note from her fiance, Brandon Williams, in Huntington, W.Va., March 16, 2021. – AP Photo / David Goldman
A sign advertising addiction treatment is posted to a utility pole in Huntington, W.Va., March 19, 2021. This beleaguered city offered a glimmer of hope to a nation struggling contain an epidemic of addiction. The federal government honored Huntington as a model city to emulate. Huntington won awards for its work and other places came to study the city’s success. Then COVID came, accompanied by despair. – AP Photo / David Goldman
Larrecsa Cox, who leads the Quick Response Team, walks through an abandoned home frequented by people struggling with addiction, in Huntington, W.Va., March 18, 2021. As the COVID pandemic killed more than a half-million Americans, it also quietly worsened what until recently was the country’s greatest public health crisis: addiction. – AP Photo / David Goldman
Larrecsa Cox, right, who leads the Quick Response Team, talks with paramedics at an overdose call in Huntington, W.Va., March 17, 2021. The formation of the team helped bring down the county’s overdose rate. Then the pandemic arrived, and Cox watched it undo much of their effort: overdoses shot up again, so did HIV diagnoses. “I can’t believe we’ve lost all these people. But sometimes, you just have to focus on the living,” she said. – AP Photo / David Goldman
Sarah Kelly, right, is embraced outside her home by Sue Howland of the Quick Response Team, after Howland presented her with a coin marking Kelly’s one-year anniversary in recovery, in Guyandotte, W.Va., March 17, 2021. After struggling with opioid addiction most of her life, Kelly white-knuckled her way through the pandemic. “How do you come back from this?,” she said. But she has, and it feels to her like a miracle. – AP Photo / David Goldman
A banner with the image of Jesus hangs outside a home as a mail carrier walks down the street in Huntington, W.Va., March 17, 2021. – AP Photo / David Goldman
Larrecsa Cox, who leads the Quick Response Team, walks though a tent encampment along the river in Huntington, W.Va., while looking for a client who recently overdosed, March 17, 2021. – AP Photo / David Goldman
Jeff Carter, left, becomes emotional while remember his daughter, Kayla, while sitting with his wife, Lola, right, outside their home in Milton, W.Va., March 16, 2021. Kayla grew up in a tiny town 20 miles from Huntington, in a house with a swimming pool in the backyard. The middle child of three daughters, she had a brilliant mind for math and loved the stars. Her family always thought she’d grow up to work for NASA. Instead, she was addicted to opioids by the time she turned 20. At 30 her joints were failing from infection, and last October, when she seemed to be recovering, her mother found her dead on her bathroom floor. – AP Photo / David Goldman
The ashes of Kayla Carter sit on top of a cabinetn and in a heart shaped statue below, at her parents’ home in Milton, W.Va., March 18, 2021. Her mother, Lola, talks to them every night, then cries herself to sleep. – AP Photo / David Goldman
Jeff Carter walks by a picture of his daughter, Kayla, at his home in Milton, W.Va., March 18, 2021. Kayla was addicted to opioids at age 20 and appeared to be recovery when she died in October at 30. It brings her father some comfort to think she died from complications from her surgeries, and not that she relapsed and overdosed. But either way, the drugs killed her, he said. – AP Photo / David Goldman
Experts had warned early on that the pandemic was worsening the county’s existing crisis of “deaths of despair,” from alcohol, suicide and drugs, but national data on overdose deaths is always months delayed. So the journalists explored locally available data and turned to sources in the field to determine where to root a story about the pandemic’s toll on those suffering addiction.
The AP team embedded with Huntington’s Quick Response team for a week, seeing through their eyes the devastation on the ground as they visited people who had survived overdoses. The trio carefully discussed with residents whether they would be willing to tell their story, and many agreed. The result was a unique window into the suffering those with addiction have endured as the pandemic cut off access to support systems and health care resources.
The journalists later learned that a competing national television crew arrived in the area the following week,trying for a similar story. But with the trust AP had built with members of the community,AP was able to get a sense of the competitor’s efforts, then make informed decisions about the timing the AP project.
The final package was a truly all-formats collaboration. Goldman’s haunting photography included a series of portraits shot on color film with a medium-format camera,while the field journalists also collected audio,working with the multimedia team to deliver in-depth audio story produced by Samantha Shotzbarger. Dario Lopez and Phil Holm contributed to the strong visual presentation, and Marshall Ritzel put together a graphic for the online video edit.
Jeff and Lola Carter stand with their daughter, Amanda, right, and a framed photo of Kayla, their daughter who died in October after a decade-long struggle with drug addiction, at their home in Milton, W.Va., in a March 18, 2021 photo made with a medium-format film camera. – AP Photo / David Goldman
Steven Ash, 33, stands for a portrait while working at the tire shop his family owns and where he overdosed just days earlier, in Huntington, W.Va., in a March 17, 2021 photo made with a medium-format film camera. – AP Photo / David Goldman
Misti Mann-France stands for a portrait in a bathroom at the Huntington, W.Va., laundromat she manages, under a blue light installed to make it harder for drug users to find a vein, in a March 18, 2021 photo made with a medium-format film camera. – AP Photo / David Goldman
Larrecsa Cox, 39, leader of the Quick Response Team that, within days, visits everyone who overdoses to try to pull them back from the brink, stands for a portrait in Huntington, W.Va., in a March 18, 2021 photo made with a medium-format film camera. – AP Photo / David Goldman
Sue Howland, a member of the Quick Response Team that tries to track down residents who overdose to offer help, stands for a portrait in Huntington, W.Va., in a March 18, 2021 photo made with a medium-format film camera. The 62-year-old peer recovery coach nearly drank herself to death years ago, so she can relate to the madness her clients are facing. “We’re going to love them until they learn to love themselves. We’re going to love them back to life,” said Howland, who’s been sober now for 10 years. – AP Photo / David Goldman
Pastor Fred McCarty, one of the faith leaders who ride with the Quick Response Team, poses in Huntington, W.Va., in a March 18, 2021 photo made with a medium-format film camera. – AP Photo / David Goldman
Joshua Messer, 29, sits for a portrait in his aunt’s home where he’s currently staying, days after he overdosed, in Huntington, W.Va., in a March 16, 2021 photo made with a medium-format film camera. Messer was a high school basketball star, headed to college on a scholarship. But addiction to alcohol and pills took hold. – AP Photo / David Goldman
Sarah Kelly, 37, stands in the doorway of her home in Guyandotte, W.Va., in a March 17, 2021 photo made with a medium-format film camera. After struggling with opioid addiction most of her life, Kelly white-knuckled her way through the pandemic. Then she navigated courts to get custody of her kids back after more than two years apart. “I knew there was this version of me still in there somewhere, and I knew that if I woke up every day and really decided to stay sober, I could get to be her again,” she said. – AP Photo / David Goldman
Ashley Ellis, 34, is photographed in Huntington, W.Va., in a March 16, 2021 photo made with a medium-format film camera. She met the love of her life, Brandon Williams, when they were both in recovery. But shortly after their child was born, they both relapsed. Williams was found dead in an abandoned house. – AP Photo / David Goldman
The work resonated with readers. One called Galofaro “a gifted and evocative writer” and the photos “phenomenal.” Another said,“I’m usually good for about 50% of an article,but I couldn’t stop reading and the photography was excellent.” Yet another called the writing “masterful — articulate and emotional yet subtle, too.” Buzzfeed also included the story in their “8 photo stories that will change your view of the world ” segment.
One of the most gratifying responses came from the main subject,Larrecsa Cox,who leads the Quick Response team. She said she was “ecstatic” about how well the story captured the world she sees very day: “The article has been by far the best anyone has or will ever write … (you all) did an absolutely fantastic job.”
For sensitive and compelling coverage that furthers the AP’s efforts to explore the rippling consequences of the COVID-19 pandemic,the team of Galofaro, Goldman and Householder wins this week’s Best of the States award.
Visit AP.org to request a trial subscription to AP’s video,photo and text services.
For breaking news, visit apnews.com