Central Illinois' rural counties are not exempt from the drug addiction epidemic ravaging households.
"Honestly, most people thought heroin was a city thing," said Pat Schou, executive director of the Illinois Critical Access Hospital Network. "But we quickly learned that wasn't the case. It affects everyone."
Starting in the mid 2000s, drug abuse, particularly methamphetamine use, has ramped up in rural communities, including places like Christian and Macoupin counties. But then opioids, legal or not, started to take hold, compounding into the crisis seen today. It's had a profound effect on law enforcement and the medical community.
"The opiate problem has gone nowhere," said Kent Tarro, an administrator for the Macoupin County Public Health Department. "It's actually increased, but the meth problem has increased, too."
Some opiate users are introduced to the drugs when using prescription pain killers, but they sometimes develop a dependency on them due to the awful side-effects from ceasing use, according to Tarro.
Most of the drugs come from Mexico to larger cities like St. Louis and Chicago and then get distributed down highways. Once it gets into a community, it becomes local law enforcement's problem, too, causing overflows in county jails.
"The type of inmates we have now is totally different, I think, from the inmates we had in the '70s," said Christian County Sheriff Bruce Kettelkamp. "It's because of the mental health problems they have and the severe drug abuse problems. I think I can safely say 90 percent of the people we have are in here because of drug abuse or alcohol."
Built in 1974, the Christian County Jail was only supposed to hold 15 to 17 people. By 1996, they converted the gymnasium into bed space for 16 more inmates. Eventually, they doubled up cells to increase capacity to 55.
But that's what described as a "perfect scenario." Men and women need to be separated, or in some cases a prisoner can't have a cellmate due to being dangerous.
"I think (from August to December) it's been over 55. I think (in October) it was right at 59," said Kettelkamp.
The lack of funding for the county has forced the jail to take in federal prisoners awaiting trial in Springfield as a last resort to stave off a tax increase for residents. The county gets money for housing these prisoners in county jail but loses more bed space.
"The county's hurting financially because we just don't have any businesses out in the county where the revenue's coming in anymore." said Kettelkamp. "So we try to house as many (federal prisoners) as we can."
Macoupin County Sheriff Shawn Kahl has noticed the amount of drug overdoses going up over the last several years.
"It puts a real strain on local law enforcement, and with overdoses it puts a real strain on our emergency health (services)," he said. "... It's not that we can't handle it. It's just time and hands."
Most agree changes are needed but there are differing views on what would work best.
"The biggest challenge is we don't have any money," said Jordan Garrison, assistant state's attorney in Macoupin County. "Budget's always an issue. ... These types of cases, especially on drug overdoses, it requires a lot of manpower and a lot of time. ... We struggle to have enough law enforcement to cover the county."
Kettelkamp says what would help the most is stopping the drug sources in Mexico. He's heard anecdotally how easy it is for drug dealers to ship their product across the southern border.
"As far as law enforcement's concerned, we really need the wall to stop the drugs from coming in," he said. "You wouldn't think the wall would help us here in central Illinois, but it would help us with the meth and the heroin."
Fighting the epidemic
In the meantime, there are already efforts to combat the epidemic throughout rural Illinois.
Schou's ICAHN is working with groups across the region to educate people on the danger of opiates and connect various organizations with resources.
"A big part of what we do is facilitating conversations," she said. "If people don't know what's available, it can't be used to help them."
Since the winter, Kettelkamp has been working on creating a "safe passage system," which allows addicts to turn in their paraphernalia and drugs to get help in finding a place for recovery.
To stem the tide of addiction, Macoupin County used federal grant money two years ago for a facility called the Maple Street Clinic to help people overcome addictions. Much of the effort involves getting those in recovery back to a normal schedule, along with monitored injections of suboxone, a prescription drug that helps addicts deal with opioid cravings, to ensure patients are on track.
They also provide mental health counseling, a program Tarro is proud of. He says 85 percent of addicts have some sort of mental distress, much of which stems from childhood.
"I've been preaching this for 25 years," he said. "You have to see what happens when we help them overcome them, help them make peace and have them learn new coping mechanisms and resiliency skills. Their behaviors change quick."
He's also trying to take the mental health approach to schools to prevent mental trauma from spiraling out of control at an early age.
Overall, Tarro feels the clinic's program is working well, with about 70 percent of patients not relapsing into drug use a year after treatment.
"That's a pretty (good) success rate," said Tarro. "(But recovery goes on), probably forever. One has to keep moving in a particular direction to not go backward and making sure you know how to handle any triggers that come up."
Currently, the clinic is working with 65 patients on an outpatient basis, which Tarro hopes to expand in the future.
"We have to hire another therapist before we can get much further," he said. "We think our capacity is going to be somewhere between 85 and 100 at best at one time. I don't know what's going to have change to get more than that."