Here, the opioid crisis is bigger than politics. As rehab centers replace pill mills, an Ohio River city fights back

PORTSMOUTH, Ohio — Dale King rumbled into the parking lot in his military Jeep, a black 1940s-style clunker that he maneuvered with a skull-tipped stick shift. Heavy metal music blasted from the garage that he and some friends had converted to a gym for the neighboring addiction center.

Patients from next door were packed inside wearing worn T-shirts, faded athletic gear, and other hand-me-downs. Half the class were barefoot. Some wore jeans, others ankle monitors.

It was October 2018, and King, a 38-year-old retired Army intelligence officer turned fitness trainer, characteristically got straight to the point.

“Who here has overdosed?”

Every hand in the room went up.

“So, clearly you are not afraid to die?”

A few nodded back in agreement.

“Well, if you’re not afraid to die, don’t be afraid to go all out in this class,” he shouted. “Don’t be afraid to live.”

He barely noticed the young man with a wrestler’s build in the back.

For years, King’s hometown here on the banks of the Ohio River was so ravaged by opioid abuse that it earned the notorious moniker of America’s Pill Mill. Governors and congressional leaders, Democrats and Republicans poured money into drug investigations and rehabilitation in attempts to lift Portsmouth and similarly hit communities in Ohio.

Donald Trump campaigned in 2016 on the promise to build a wall along the nation’s southern border and renew American manufacturing in places like this. That helped him win Ohio comfortably by capturing the anxieties and frustrations of white blue-collar workers and rural voters worried about changing demographics and a stagnant economy. He also pledged to address the opioid crisis that hit hard across this state. That vow in particular resonated in and around Portsmouth.

Trump carried Scioto County, where Portsmouth is located, with around 65 percent of the vote — some 15 percentage points better than Republican Mitt Romney when he nipped former President Barack Obama here four years earlier.

While much of the country is divided over Trump and his policies, some here credit him with calling attention to the opioid crisis. Still, many people working on the issue would rather avoid talking about Trump or the 2020 election altogether, fearful the polarized climate could endanger bipartisan local and state efforts. And those at the heart of the matter — people working through addiction — say they are simply focused on the daily act of living and trying to stay clean.

But as King prepared to open the new gym, there were few signs that all the government money and political rhetoric had made much of a difference in this rural Appalachian region that many saw as the epicenter of the national opioid crisis.

Portsmouth stubbornly remained one more washed-up Rust Belt city with a sad story, known for its abandoned factories and bygone days when the United States used to make a lot of things.

To King, who did tours in Afghanistan and Iraq, the situation reminded him of his time in Baghdad amid a mounting insurgency. “Help wasn’t coming,” he said. “We were on our own.”

And so, he and a group of fitness instructors, rehab counselors, and businesspeople decided to try a new strategy: addiction recovery meets CrossFit, the hard-core exercise regimen that has a cult-like status around the country. The self-funded venture would become part of a larger effort to turn the city around.

All through the dog days of summer, they oversaw the transformation of The Counseling Center’s old garage into a gym. By the time King pulled up in his Jeep last fall, the space was outfitted with the sparse essentials: blue mats, weights and kettlebells, and a Bluetooth speaker.

King carried himself with the confidence of a soldier. He was the owner of three successful businesses, including a fitness center down the street, PSKC CrossFit, and a line of “combat-ready” ointments and essential oils that landed him and his business partner on the television reality show “Shark Tank.”

In the first class that morning, Andrew Wright was shy and didn’t talk to anyone. Six months before, he had been sleeping in libraries, avoiding friends he couldn’t help but disappoint, and picking up felonies. He didn’t know a thing about CrossFit.

But in King, he saw who he wanted to become.

Stay long enough in Portsmouth and someone is sure to mention “Dreamland.”

Named after a massive swimming pool in town where many spent their summers, the 2015 book by Sam Quinones chronicled how the opioid crisis led to the decline of this once-booming community. Portsmouth still has the look of an all-American city, a picturesque place of 20,300 tucked along the Ohio River, with a quaint downtown of low-slung brick buildings, old factories, and white church steeples set against lush, green hills.

But the scars from its illegal pill mills — up to 12 at one time — run deep.

Doctors from around the United States cycled through the county to see patients. Most accepted only cash. Some even had their own pharmacies. There were no checks on who could run the facilities, no requirement they have a medical background.

It was how one physician, Margo Temporas, managed to dispense more than 1.6 million pills. Or how Dr. Paul Volkman led the nation in prescribing the painkiller Oxycodone.

Sergeant John Koch was a young detective with the Scioto County Sheriff’s Office, busting mom-and-pop meth labs in the hills, when the long lines of people waiting outside the “pain clinics” captured his attention around 2004.

Until then, he had only ever heard of Oxycodone being prescribed for severe chronic pain associated with terminal cancer. Now it seemed anyone could obtain it for a broken shoulder or injured back — no medical examinations necessary.

“It was being handed out like candy,” he said. “Officers knew there was an opioid crisis in Southern Ohio before any politician in the state called it that.”

He and other investigators successfully worked to shut down the clinics, struggling with few resources to gather evidence on cases that spanned cities and states and were difficult to prove. How do you convince a jury that a doctor handing out legal drugs is engaging in a crime?

But as the last pain clinic closed in 2011, prices for pills rose. Then new scourges arrived. Heroin, fentanyl, and crystal meth, or “ice,” flooded the market, supplied by Mexican drug cartels, and shipped in by dealers from Dayton, Columbus, and Detroit.

“I’d like to say that being involved in the takedown of the pill mills was satisfying,” Koch said. “And it was, it really was. But for guys that had worked narcotics back then — fellow narc officers across the state — we knew what was coming.”

The synthetic opioids were deadlier. This time, there were no gram amounts printed on pill bottles. People had no idea how much heroin they were consuming or whether fentanyl was laced in, and the overdoses piled up. Places like Portsmouth with high levels of economic distress saw the greatest amount of opioid use.

King missed the worst of it. He left for the Army in 1999 and returned in 2007 to what looked to him like another war zone: the set of “The Walking Dead,” all shuttered businesses and billboards for pain clinics. “What the [expletive] is a pain clinic?” he wondered.

“There was a dark feeling of despair,” King recalled. “People had zero belief, zero hope that anything would ever change.”

He tried to ignore the problem, taking up work as a defense contractor, and later cofounding a fitness center and program with a friend who had lost a leg in Afghanistan. They dubbed it “Team Some Assembly Required.”

The experience inspired him to open his own gym in 2014 in an abandoned auto shop. Portsmouth Spartan Kettlebell Club — named after the city’s 1930s NFL team that later was sold and became the Detroit Lions — is a brick building painted black and military green, with the words “Portsmouth Strong” emblazoned in white. Out of the same place, King founded his ointment line, DocSpartan, and a clothing line, “Third and Court,” named after the cross streets of its location.

King remembers his own struggles after returning from the war, missing the camaraderie of military life and wallowing in a general lack of purpose. In those early days of PSKC, he would stare out the window and couldn’t help but feel angry at the men and women shuffling down the wide, empty, downtown streets to the nearby counseling center.

He had made a choice to never use hard drugs and built a life after Iraq. He’d find himself thinking, “Why can’t they just get their [expletive] lives together?”

President Trump declared the opioid crisis a national public health emergency soon after he took office, and this September, he touted the passage of bipartisan legislation that earmarks nearly $3 billion in federal funding to better track overdoses, intercept fentanyl at the border, and provide money to state rehab programs.

In Ohio, the aggressive efforts started long before. When Republican John Kasich became governor in 2011, he assembled multiple state agencies to crack down on drug trafficking, expanded services under the Affordable Care Act, and poured millions of dollars into prevention and recovery. Republican Mike DeWine, who as attorney general had worked to shut down the pill mills years earlier, continued the push when he succeeded Kasich as governor this year.

The attention and funds over the past decade marked a cultural shift in the approach to the addiction crisis as it seeped into almost every facet of life. Emergency responders grappled with overdoses and injuries. Children with addicted parents overwhelmed the foster care system. People shuffled in and out of jails.

In Portsmouth, the pain clinics that once dotted city corners were replaced with roughly a dozen rehab centers, their billboards now advertising addiction treatment medication such as Suboxone. Some residents saw glimmers of hope in businesses like King’s slowly moving into downtown.

Revitalization efforts also started to take hold as state dollars flowed in and county and city officials, law enforcement officers, and community leaders mounted their own initiatives to decriminalize drug use, improve mental health treatment, and clean up condemned and foreclosed homes that attracted illegal activity.

But homeless and drug-addled people continued to congregate around blighted buildings last fall. Bill Dever, a lawyer and member of King’s gym, had represented many clients with addiction issues before becoming the head counsel for The Counseling Center, and was concerned there was little oversight on this new “rehabilitation gold rush.”

Many centers churned out addiction treatment meds — which Dever agreed were needed — but offered few, if any, programs to integrate people back into society or provide them with housing, work, or life skills.

Dever and a coordinator at the center approached King with an idea for a fitness program that would help people in recovery develop the strength and willpower to resist returning to old habits.

“Everybody that’s running for office has an answer and a solution — and it’s all this [expletive],” Dever said.

King, too, felt he could not look his children in the eye if he refused to help. Here, after all, was the sense of purpose and duty he had yearned for after he left the military.

“I had an opportunity to do something or do nothing and let people die because I thought I was better than them,” King said.

Andrew Wright, now 31, came in as part of the first pilot group. He worked so hard he soon drew the attention and respect of King, who dubbed him “Ninja Turtle.”

Wright had been a star high school wrestler in a nearby town. But he got kicked off the team after he failed AP calculus his senior year. He broke up with his girlfriend a month later, and soon after that she told him she was pregnant. The revelation, in turn, strained Wright’s relationship with his own mother.

He soon left home and started taking opioid pills. When those got too expensive, he switched to heroin. The next 15 years were a blur.

He graduated from Marine boot camp only to be thrown out of the military a few months later after testing positive for cocaine. He had a second child with another girlfriend. He said he cycled through jails and 14 recovery centers and programs but not once was sober for longer than four months.

The Counseling Center downtown has roughly 260 clients at a time in 60- to 90-day treatment programs. Some check themselves in or are brought by friends and family. Others, such as Wright, are ordered there by criminal court judges.

That first day of CrossFit was brutal — an onslaught of instruction in the proper techniques for air squats, sit-ups, and pullups. Wright said he felt like so many of the other patients in the class: broken. Yet moving through the exercises also felt like the release of so much pent-up pain and frustration. As they plunged into heavy metal workouts, rehab patients challenged each other to keep coming back and competed with other classes for better scores.

“To be able to push through something, when I really physically feel like I’m not going to make it but I do, made me realize how strong like I really am”

Andrew Wright

“To be able to push through something, when I really physically feel like I’m not going to make it but I do, made me realize how strong . . . I really am,” Wright recalled.

Near the end of his 90-day treatment program, Wright, like so many others, planned to move to a homeless shelter to wait for transitional housing to open up. When King found this out, he offered him a job at PSKC, bottling and packaging DocSpartan ointments.

Wright spent as much time as he could at the fitness center to avoid the shelter, where his roommate and so many others were still hooked on meth and other drugs. On Thanksgiving, when PSKC was closed, Dever told Wright to text him every hour so they could make sure he was OK. Every hour, Wright sent a text saying he was.

Along the Ohio River, a mural covers the length of a 20-foot floodwall. Downtown Portsmouth now has quaint shops; abandoned houses that once were drug dens have been razed, the lots now green with neatly trimmed grass.

The economic recovery helped with local revitalization efforts, but there’s debate here over how much progress has been made against the opioid crisis. Deadly overdoses have dropped, but emergency responders say that could be because the state has made cans of Naloxone, or Narcan, more readily available. Spray the treatment drug in a person’s nose as they overdose, and chances are they live. But many still go on using.

Discussing politics here is a delicate matter, and Police Chief Robert Ware, who works closely with state officials on opioid issues, tries to walk a middle line. His fear, he said, is not so much who is in the White House, but how far the political pendulum will swing in either direction.

“There’s some progressive ideologies or agendas that are really good, and there might be conservative ones that are really good,” he said. “But as that pendulum swings back and forth, I feel like we are going to lose the ability to grab from each side.”

King, Dever, and their crew try to center their efforts on changing attitudes among their friends and families toward those with addiction problems. Some would rather see them locked up. Others worry the growing recovery industry is drawing people from across Ohio who end up staying in Portsmouth, ratcheting up drug-related crime.

The CrossFit program has expanded into a job training initiative as King has hired more rehab patients at his company. The typical tourist stop in Portsmouth, locals say, is to get photos of the giant, 19th-century factory that was once home to the largest shoelace manufacturer in the country. Barely noticed is the business next door, Graf Custom Hardwood, which ships tables and chairs around the world and is now hiring workers from The Counseling Center.

So is developer Tim Wolfe, whose restaurant, Patties and Pints, two blocks from King’s gym, quickly became a favorite hangout of PSKC members. Wolfe also served in Afghanistan and returned to find former high school friends in the throes of addiction. “Prom kings, football stars, people I thought were going to go on to do great things,” said Wolfe.

Now, he is training recovering addicts in construction and restoration; on any given morning, a handful of workers can be found preparing to gut a building on empty downtown streets.

The rebuilding process is spreading. One Sunday late this summer, King, Dever, Wolfe, and several crew members met up early and took a van along winding country roads, past horses and giant Trump signs, to a sister Counseling Center site in Scioto County, where they transformed another garage into a CrossFit gym. King helped lay black mats and assemble the poles for the rigs and pullup stations.

The gym opened in late summer, and the head coach was Andrew Wright.