PORSTMOUTH, Ohio - This is a quiet town that sits on the Ohio River at the state's southern tip, separating Ohio from Kentucky.
It's hard to believe that a prescription pill epidemic began here -- that is, until you start talking to people who live here.
"The number of deaths we have is proportionate to the number of pills prescribed," said Jay Hash, director of the Second Chance Center, which offers treatment to addicts.
Talk to people now living in the treatment centers, and you understand just how tight the grip of the pills can be.
"I didn't care," says Terry Ballengee, a recovering addict, "I was ready to die."
Terry and literally thousands of other people are battling an addiction to opium-based narcotics such as heroin.
But this crisis has a new twist - a huge one.
"This particular epidemic," said Ed Hughes, CEO of the local Counseling Center, "started between pharmacy companies and primary care doctors."
Many addicts are not hooked on heroin, but on their prescription cousins, such as OxyContin, and the number of prescriptions that doctors are writing for so-called opiates in Ohio is alarming.
In 1997, according to state pharmacy records, doctors wrote prescriptions that added up to seven opiate pills per person in the state.
Put another way, that means there were enough opiate pills prescribed to give each person in Ohio seven of them.
By 2010, that number had exploded to 67 pills per capita - nearly a tenfold increase in just thirteen years.
"It's taken control of everybody," said Jeremy Withrow, 28, a recovering addict in Porstmouth. "It's not just the people you see laying in the street. It's the judges' sons, and the cops' sons."
Ed Hughes points to a legal settlement several years ago where the maker of OxyContin pled guilty to a criminal charge and agreed to pay fines totaling some $600 million dollars to settle civil and criminal claims.
The company acknowledged misleading regulators and doctors about the drug's risk of addiction and potential for abuse.
"OxyContin was marketed to doctors in our area," Hughes said, "as an alternative to other medications, essentially telling doctors it was safer."
At the same time, this part of Ohio became now to now infamous "pill mills" - where unscrupulous doctors traded opiates for cash.
A new state law put the mills out of business, but the addiction problem remains high.
"We had 9.7 million doses (of opiates) written in 2010 with pills mills," Hughes said, "and now, here in 2012, with no pill mills, we are still writing over 7 million."
Armanda Lawson, 31, looks down at the baby that's still in her womb and worries.
"I'm very concerned about my baby's well-being," she said.
Armanda is now in treatment, but used opiates until almost half-way through her pregnancy.
One in ten babies born in Scioto County are now born addicted to opium, but the problem isn't confined anymore to southern Ohio.
"We're in the middle of an opium dependency epidemic," says David Matia, the drug court judge in Cuyahoga County.
On a typical day recently in his court, Matia had 38 defendants going through the drug court program that allows them to stay out of jail if they complete a year-long treatment program.
Half of the defendants, 19, were addicted to opiates. Of those, ten started to get hooked when they were written a prescription for a medical condition.
Everyone now agrees that something needs to be done.
In 2010, 1,544 people died in Ohio from accidental drug overdoses.
It is now the number one accidental killer in the state - surpassing motor vehicle accidents.
Behind the scenes, where the drug court team regularly meets to discuss cases, Judge Matia tosses his glasses when he hears the details of one woman who recently relapsed.
"She's going to be dead," he said.
Unfortunately, that is often how this epidemic ends for addicts - one person now dies from an accidental overdose in Ohio every six hours.