As heroin addiction takes over entire families and neighborhoods, even the U.S. government describes it as an epidemic. And when the governor of Vermont devoted last year's entire "State of the State" address to battling heroin, the nation took note: the state with perhaps the greenest image is struggling with a dark side.
In Rutland, police sergeant Matt Prouty has watched the heroin problem build for a least a decade. He took CBS News on a ride-along through some of the hardest-hit areas of the city, pointing out drug dens that have physically transformed the community.
"It used to be that I only knew maybe a handful of people that used heroin. Now it's hard to go down the street and not see somebody that you know is in recovery or actively using," Prouty said.
In 2014, the state treated 2,258 people for heroin use, a staggering 64 percent increase over 2013. More than 400 users are on waiting lists for detox.
Rutland, a blue collar city, has been singled out as the epicenter of Vermont's drug epidemic. But Vermont State Police say the drug has penetrated every community throughout the state. However, the struggling neighborhoods of Rutland have been especially vulnerable, as addicts switch from prescription painkillers to cheaper heroin. Drug dealers stream in from New York because profits are larger here, according to authorities.
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To prevent the potential spread of HIV and hepatitis C among users sharing needles, Vermont Cares established a syringe exchange in Rutland. Mary Kathryn Charbonneau helps run the exchange. She says she sees users exchanging up to 500 needles at a time.
"It's almost like it's the norm for them. Dad shoots so I'm going to shoot," she said.
One user, who was came to exchange 160 needles, shared that before he starting coming to the exchange, he would use needles until they broke off in his arm.
He did not want to be identified but says he has been an addict for 20 years. Following a car accident, he says he was prescribed prescription painkillers. He eventually made the switch to the more powerful and cheaper heroin. The father of four hides his drug use from his children and girlfriend.
"For people who are just starting out it's all about the high, but when you've been doing it for a long period of time, it becomes the sickness," he said.
The city has both acknowledged the problem and taken on the challenge, establishing Project Vision - an umbrella group of law enforcement, community members and businesses working to rebuild neighborhoods, reduce crime and get people help. Last year, they reduced crime by 17 percent.
"I'm not saying drug abuse will never be a problem here again, it will probably be with us forever. But we're honest about it, we're dealing with it," said Joe Kraus, chairman of Project Vision.