“I want you to see the place that saved my life,” said Scott Hudson. He was taking Zaine to a weekly meeting of about 100 addicts at a rehab facility in Huntington, an hour down the highway. “These guys have stories you should hear, and they should hear from you, too,” Scott said.

“That’s good if somehow I can help them, but it's not like I need to be scared straight,” Zaine said. “I’ve already seen what happens. I would never put a needle in my arm.”

“I know, buddy,” Scott said. “That’s exactly what I said. That’s what everyone says.”

They drove to Huntington down a winding road known to some locals as the heroin highway, passing chemical plants and coal towns where opioid pain pills had first become popular as a salve for workers enduring long days in the mines. But, during the last decade alone, 65,000 of those mining jobs had disappeared from the West Virginia economy, and now there was so much more poverty, pain and hopelessness to chase away. Drug companies had bombarded West Virginia’s rural towns with record numbers of narcotics, according to court records: 300,000 tablets of hydrocodone to the mom-and-pop pharmacy in the town of War, population 808; half a million oxycodone pills to Kermit, population 400. During a five-year period ending in 2013, a single drug company had shipped more than 60 million doses of hydrocodone into a state with fewer than 1 million working-age adults.

Though hydrocodone was essentially the same drug as heroin, heroin was stronger and also cheaper to buy on the street. Now the heroin highway had billboards advertising rehab programs, suicide hotlines, clean needle exchanges and budget funeral homes.

“It’s the West Virginia disease,” Scott said as he drove. “You don’t even know you’ve started and you’re already spiraling down.”

Scott often talked about his own spiral, which had continued for much of his adult life, from meth to pills to heroin. Only after his 34th arrest had he finally ended up at Recovery Point, a rehab facility run by former addicts in a converted elementary school. He had stayed for a year and remained clean for more than four years since.

Now he led Zaine into the meeting a few minutes late. The room was packed, so they grabbed extra chairs and squeezed in near the back. A recovering addict was telling a story about begging for money in his coal miner clothing. “I promised myself I wouldn’t ever use a needle,” he said. He finished his speech and then Scott walked to the front of the room. Everyone already knew who he was. After he had gotten clean, he had walked around South Charleston in a shirt that read “Neighborhood Hope Dealer” and persuaded dozens of addicts to enter treatment. He had spoken at these meetings several times. “I lit myself on fire twice while I was high and kept using,” he said. “I lost my kid. I got high around her. I thought she’d be better off without me. How many people have lost their kids to this?”

About half of the people in the room raised their hands.

“Come on. Don’t lie to yourselves,” Scott said, and another 20 hands lifted into the air.