AILSA CHANG, HOST:
Americans are dying younger, and what's driving that downward trend in life expectancy is higher death rates among people who should be in their prime, people from 25 years of age to 64. One major cause of that is a spike in fatal drug overdoses. NPR's Melissa Block went to the Ohio River Valley, which has seen some of the largest increases in midlife mortality, to meet some of the people directly affected.
MELISSA BLOCK, BYLINE: A drive along this stretch of the Ohio River between West Virginia and Ohio takes you past the hulking, rusted skeletons of heavy industry...
PATRICK CASSIDY: This was all part of Wheeling Steel at one time.
BLOCK: ...One after another, the behemoth structures that built these towns...
CASSIDY: Tough little steel towns - they're called scrappy little towns.
BLOCK: ...Now hollowed out or abandoned. I'm driving with Patrick Cassidy, a labor lawyer from Wheeling, W.Va. The latest insult, he points out...
CASSIDY: Another bad sign of the times, this is one of the hospitals that just shut down.
BLOCK: In September, two hospitals closed within weeks of each other, one on each side of the river, leaving some 1,100 workers out of a job and residents with fewer options for health care.
(SOUNDBITE OF CAR DOOR CLOSING)
BLOCK: We stop along the river, and Patrick Cassidy thinks back to his father, who worked in the steel mills upriver, breathing in smoke from the coke furnaces for 40 years.
CASSIDY: And he ultimately died of emphysema, probably because of that. That's a typical story. My dad liked to say - on his final illness when he was dying, he said, son, I earned my sickness. That's the way he looked at it.
BLOCK: Wow. How did you look at it?
CASSIDY: I agreed with him, so...
BLOCK: Those days, maybe it was the job that killed you. Now, Cassidy says, it's more likely the lack of one.
CASSIDY: That's what I think it is - lack of opportunity leading to desperation leading to I don't care about my health. What's it to me? It's hard enough for me to make it through the day. Wouldn't mind trying a few opioids at night just to make me feel a little better. I think it's all about that, frankly. And it's just so sad.
BLOCK: Appalachia has been hit especially hard by the opioid epidemic, and Ohio and West Virginia have suffered the worst with the highest rates of overdose deaths.
RANDY STEWART: Alongside the roadway, pull-offs, back roads, bathrooms for gas stations, restaurants, the truck stop - we pulled overdoses out of all those areas.
BLOCK: That's Detective Sergeant Randy Stewart with the sheriff's office in Belmont County, Ohio. Since the drug epidemic started spiraling out of control, Stewart has seen it tear families up.
STEWART: Going out, taking these young kids in body bags and seeing how it crushes the parents, it's tough.
BLOCK: Do you see any sign that things are turning around?
STEWART: Not to sound negative, but we haven't beat this yet. You know, I don't even think we're close. From what I see on a daily basis, we're kind of in last place here.
UNIDENTIFIED PERSON: Hello, everyone, and welcome to today's Smart Recovery meeting for family and friends.
BLOCK: Eight people have gathered in a small fellowship room at the Church of the Nazarene in tiny Powhatan Point, Ohio. They meet weekly for support as they deal with their loved ones' addictions.
UNIDENTIFIED PERSON: Could it get any worse?
CINDY MOORE: I doubt it. I don't think it could get any worse. Oh, my God.
BLOCK: That's Cindy Moore there saying, I don't think it could get any worse.
MOORE: I have eight children. One of them is deceased. One of them is in jail.
BLOCK: When we speak after the support group, her son, Steven, has just been sentenced to life in prison after pleading guilty to murder. At his sentencing, he said, I'd like to apologize to the victims. It wasn't me; it was drugs. And Cindy Moore's daughter, Kimberly, the baby of the family and mother of two - she died of an overdose in December 2016. She was 29.
MOORE: When my husband went upstairs, I heard him say, you better come up here. And I came up there, and she was laying on the floor with the needle beside of her. It was horrible.
BLOCK: When Cindy wrote the obituary for her daughter, Kim, here's what she said. Her mother and father found her on the floor, dead from an overdose of drugs. They ask that her death would not be for nothing. If you are using drugs, her parents plead with you to stop and get help.
MOORE: I was mad when I wrote that. I was very angry. I was angry at Kim, and I was angry at the drug people. I don't know if it helped anybody or not, but I was honest about it.
CASSIDY: When I see the Ohio Valley, even with the decline, I see opportunity.
BLOCK: We're back driving along the Ohio River with lawyer Patrick Cassidy, past smokestacks and factories.
CASSIDY: I would think an outsider says, oh, my gosh, you know, I've been to some beautiful river valleys, and this isn't one of them with all this industry.
BLOCK: But Cassidy loves this area and would love to see it revived with good-paying middle-class jobs.
CASSIDY: I see that it could be different, but keeping the same values that I think it had when we were growing up, which is a place to work for an employer with reciprocal loyalties.
BLOCK: And if you want to stop that deadly cycle of despair, maybe that's where you begin.
Melissa Block, NPR News.
(SOUNDBITE OF PHILIP GLASS' "OPENING")
NPR transcripts are created on a rush deadline by Verb8tm, Inc., an NPR contractor, and produced using a proprietary transcription process developed with NPR. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR’s programming is the audio record.