The opioid crisis sweeping the country is putting a growing financial and emotional strain on many communities. More than 4,000 people died from unintentional drug overdoses last year in Ohio alone.
Many coroners in the state say the death toll will be higher this year.
CBS News correspondent Tony Dokoupil visited Middletown, Ohio, where the sheriff is refusing to allow deputies to carry the opioid antidote naloxone because of safety concerns.
According to one estimate, opioids could kill nearly half a million people over the next decade. That's like losing the entire population of Atlanta.
Middletown has already seen more overdose calls this year than in all of 2016. CBS News got a first-hand look at the problem overwhelming the city, prompting some to propose extreme solutions.
Dokoupil was along for the ride as first responders in Middletown made their way to a fifth overdose call in just over an hour.
"It seems that, you know, the dealer may have made his rounds," EMS Capt. David Von Bargen said. "And various people are startin' to fall out now."
On this call, he saw a woman turning blue on the ground outside her friend's house. Medics worked quickly and were able to save her -- at least for now.
"It's breakin' my heart," said Adonia Martin, a friend of the patient. "She just, they just told me she just overdosed two nights ago. I mean, how many times -- how many more times is she gonna, not gonna make it?"
Calls like this have risen dramatically in recent months. Last year, Middletown EMS made 532 runs for opioid overdoses. This year, they've already had more than 600 runs through June. And they're using more naloxone to counter the effects of stronger synthetic drugs.
City leaders say they've surpassed the $11,000 they spent on the treatment's last year, and are on pace to spend more than $100,000 this year.
"My issue is that we're gonna run out of money,"said.
That's why Picard is proposing a "three strikes" plan. Those who overdose once or twice would have to perform community service and pay off the cost of the emergency response. If they don't, there might not be a response the third time.
"My message to addicts is, yeah, stay away from Middletown," Picard said. "'Cause we might not show up to treat you. It's reality."
"Who are we to dictate who's savable and who's not savable," recovering addict Shelly Thompson questioned.
Middletown EMS saved Thompson's life when she overdosed on opioids in 2015.
"Yeah, I was two minutes away from not being able to be here," Thompson said.
She tells CBS News she's been clean for a year and a half, and insists any threat to withhold EMS service won't deter addicts.
"The addict is not scared, you know," she said. "They're hopeless. They're hopeless. We need to help these people, not more death."
"We need to be more involved in forcing some type of treatment," added Middletown Police Chief Rodney Muterspaw.
Muterspaw has his own proposal -- he'd like to arrest overdose patients and file criminal charges, which the government would drop if the patient agrees to get help. It's unclear how well this would work. A study last year found "little evidence that compulsory drug treatment is effective."
"You know, I can't tell you it gives me a lot of confidence," Muterspaw said. "But it's better than what we're doing now. Because we're doing nothing now."
Later that afternoon, Middletown first responders raced to another call. This time, saving a man who overdosed in a store parking lot. They say it goes on like this all day.
"I'm a city counselor," Picard said. "My job, as a city counselor, is to make sure this city can continue to function and provide services to its citizens. And at the rate we're going, we've got to do something."
"Oh, I think the wheels are definitely turning," Muterspaw added. "It's, it's hit a point where it has to change so people are forced to make change."
Middletown EMS reported to a total of eight overdose calls the day we were there. At this point, the idea to withhold the response is just that -- an idea, not a formal proposal. It's unclear whether it would ever withstand a legal challenge.
Since first raising the idea, the city councilman admits the feedback has been mostly negative. But he points out he's at least sparked a discussion about what to do.