The usual handwringing over the heroin problem turned into panic in this small city in May when a supercharged blue-tinted batch from Chicago sent more than 30 overdose victims to the hospital and two to the morgue in a 12-day stretch.
Like many places in America, Marion - an hour's drive north of the Ohio capital of Columbus - has gotten used to heroin. Emergency crews in the city of 37,000 have become accustomed to treating an overdose patient about once a day for the past year or so. But they were stunned when the unprecedented onslaught began on May 20.
They say if it hadn't been for naloxone, an antidote carried by paramedics, most of the survivors probably would have died, too. They ranged in age from their late teens to early 60s.
"We were going from one to another to another, sometimes going back to the same house twice in one day for two different people," said Police Chief Bill Collins, who called for help from state and federal agencies. They hope to find the source of so-called "blue drop" heroin laced with the powerful painkiller fentanyl that is believed to have caused 56 overdoses and five deaths here since mid-April.
Collins and others say the recent spike in overdoses and drug-related crime underscores how outgunned they are by a growing public-health scourge that has invaded nearly every neighborhood and taxes emergency services already cut to the bone. Not nearly enough addiction treatment is available.
"Most of the time I feel like I'm drowning," said Jody Demo-Hodgins, head of the Crawford-Marion Board of Alcohol, Drug Addiction and Mental Health Services, the clearinghouse agency for trying to treat and prevent addiction. "It's something that's happening everywhere."
For many in Marion, an industrial town that's been slow to recover from hard economic times, the past two months brought the crisis home.
Facebook pages are supporting those in recovery and organizing such efforts as cleaning alleys and parks where addicts tend to leave discarded needles. A tattoo artist created a special design for recovering addicts and their supporters, vowing to give half of the money to the fire department to buy more naloxone. A recovering addict spends his days and nights driving people to detox centers in other cities and helped raise money for the funeral of a 19-year-old single mother who died from an overdose on May 21.
"It's like it's not the same town you grew up in," says Justin Cantrell, the 31-year-old tattooist who came up with the "Fight the Fight, Stay Clean" design he has inked on a few people so far. A Marion native, Cantrell went to school with a 31-year-old man who was killed by an overdose on May 22. He knows 15 to 20 people who have become heroin addicts.
"It's just getting heavy on the heart," he said.
The increase in heroin use nationwide over the past few years has its roots in the raging pain pill epidemic. When states clamped down on "pill mill" clinics and prescription drugs became harder to get, many addicts turned to heroin because it's cheaper and easier to find. When the blue heroin came to town, it was immediately in demand.
"It may sound sick and twisted, but if you tell a drug addict there is dope so good that it's going to kill you, it doesn't make them not want to try it. It makes them want to try it even more," says Michael Pack, a 39-year-old recovering addict who has helped dozens of users get into detox, sometimes driving them to other cities where there is space in treatment programs.
The Centers for Disease Control and Prevention reported in March that heroin overdose deaths in the United States quadrupled from 2000 to 2013, with most of the increase coming after 2010. In Ohio, heroin overdose deaths rose from 697 in 2012 to 983 in 2013, the last year for which statistics were available.
Many more likely would be dying if not for naloxone, better known by its brand name Narcan, which was administered 15,493 times by emergency medical crews in Ohio last year, according to the state health department. Ohio is among a handful of states taking steps to make the lifesaving drug available to virtually anyone willing to be trained to use it.
Officials in Marion hope they've seen the worst of the latest heroin skirmish. On Wednesday, 60 law enforcement officers raided three addresses in Marion, arrested four people and seized more than two pounds of the blue heroin that has plagued the city.
But they know there will be more, and that the heroin crisis probably hasn't peaked yet, here or anywhere else.
Kelly Clixby is a 37-year-old recovering addict whose life was saved by two shots of naloxone from a paramedic after she shot up some fentanyl-laced heroin in January 2014. Now clean for seven months, she helps run the Facebook page offering support for recovering addicts and is trained to administer naloxone. She worries that a certain amount of heroin addiction is now viewed as the new normal in Marion.
"It's not getting better, it's just becoming acceptable," she says. "Our town has just broke down. It's just in a bad state."