By 2013, the year Williams became mayor, opioid abuse had spiraled so far out of control that Cabell County's fatal heroin overdose rate rose to nearly 13 times the national average.
Officials have responded with a series of progressive policy initiatives, from a needle exchange program to help curb hepatitis outbreaks to landing a donation of 2,200 naloxone auto-injectors (worth $1.5 million) to be given away to residents. Williams also took the unprecedented step for such a small town of appointing a drug czar, responsible for getting everyone -- paramedics and pastors, judges and jailers, cops and community leaders -- on the same page to combat the opioid epidemic.
Unlike other drugs that came to West Virginia, Williams says, heroin doesn't discriminate, affecting both men and women, white and black, homeless and lawyers, grandchildren as young as 12 and grandparents approaching 80. The mayor never knows who might overdose, so he carries a naloxone injector everywhere he goes.
On days like today, the priorities shift from running heroin out of town to saving lives. The mayor hopes residents can be spared the coffin.
It's been nearly a decade since Teddy Johnson buried his 22-year-old son. News of the overdose outbreak hits hard, but he's not surprised given heroin's takeover.
The 65-year-old father has warned of the scourge the last nine years, long before heroin reached historic levels in Huntington. He's stared down his son's dealer in court and an undocumented immigrant connected to a Mexican cartel responsible for distributing black-tar heroin in the region. Neither dared return his glare.
Every week Johnson visits his son's gravestone in Spring Hill Cemetery. He trims the grass with a hedge clipper and weed whacker. He polishes the stone with a rag and granite cleaner. He outlines the engraved letters of his son's name with a black Sharpie.
Then he steps backs and takes a look at the inscription: "Adam Tyler Johnson: Our star on earth, God's star in heaven."
The father runs a plumbing shop founded by his grandfather 78 years ago. He's expanded the business to make showcase bathrooms, designer kitchens and dynamic outdoor patios. Adam, who was a history major at Marshall University, was in line to become the fourth generation to carry on the family business.
Instead, visitors to the showroom are greeted by memorials to Adam.
Shortly before 4 p.m., Capt. Rocky Johnson, commander of the Huntington Police Department's special investigations unit, prepares to lead a drug raid at Marcum Terrace, a cluster of two-story, red-brick public housing units that dot a hill on the city's east side. The neighborhood is home to the town's poorest folks, a place where fistfights get posted on YouTube and scores are settled with knives. A preacher says baby's shoes hanging from telephone wires indicate drop-off sites for drug dealers.
The complex is within a stone's throw of where first responders earlier treated seven overdoses.
Johnson's phone rings. It's the chief, Joe Ciccarelli.
"Are you monitoring the radio traffic?" Ciccarelli asks. "We're having all these overdoses."
When Ciccarelli joined the force in 1978, Huntington only had about a dozen known heroin addicts. Officers chased after those few users and monitored parking lots for people smoking weed. Now, the addicts have multiplied. Though the drug has origins south of the border, the chief says the dealers here are "so far down the chain, they can't spell Mexico."
He orders Johnson to abandon the raid. There's a new assignment: Find the source of today's heroin.
Dressed in jeans and T-shirts, Johnson and his nine undercover officers break cover and shift gears. If the spread of this particular batch isn't reined in quickly, dead bodies will be found all over Huntington.
Johnson and his officers begin conducting interviews. They're told an out-of-towner, a man about 6 feet 4 inches and built like a middle linebacker, cruised through the neighborhood about an hour before the first overdose occurred. His nickname was Benz, though he drove a white Chevy Cruze.
Some residents say he handed out free samples; others say he sold a new product.
When he stopped and took a stroll, witnesses tell police, scores of people followed.
It was like he was the pied piper.
A mother needs her fix
Andrea has followed the lure of the high for a decade now. She shoots up twice a day regardless of costs. Addiction has robbed her of her job, friends and family.
She agrees to be interviewed and photographed on the condition that her last name be withheld. She says paramedics saved her life twice. She sought refuge in rehab once -- attending a 30-day treatment center. She stayed clean for more than eight months -- 264 days to be exact. She shook her habit but kept her friends, staying in a circle that led to relapse.
The 36-year-old former nurse says her three children -- ages 18, 14 and 11 -- live with her grandmother. Her own mother and father refuse to speak to her. Her oldest son, she says, hates her. Her daughter, the youngest of the bunch, found her on the bathroom floor two years ago.
The girl cries and prays for her mother.
In spite of today's overdoses, Andrea chases her fix and chooses to shoot up anyway. Prayers be damned.
"The devil has come to Huntington," Sara Murray says. It's as simple and complicated as that.
Newborns in the nurse's hospital ward weren't just exposed to heroin; the pregnant addicts have often downed alcohol, taken prescription painkillers or dabbled with the latest fad, the anti-seizure drug Neurontin.
Most babies in the unit will likely suffer long-term neurological problems. Nearly 1 in 10 can expect to suffer from Hepatitis C in their lifetime.
When babies are born with drugs in their systems, state child protection workers are notified. Murray recalls one shattering case where doctors and nurses believed a fussy baby boy would be in danger if sent home with his parents. She says they shared notes with child protection services about the family's behavior and pleaded on the child's behalf.
Murray rarely knows the outcome when a child leaves her care, but this time the case made headlines in the local paper. The father was arrested, accused of killing the boy.
She and her fellow nurse, Rhonda Edmunds, made a pledge: "That will never happen on our watch again."
They lobbied the hospital to open a neonatal therapeutic unit. As heroin use climbed, so did the number of babies suffering from withdrawal. Their fussiness disturbed the care of others in the neonatal intensive care unit. The therapeutic unit opened a year later.
The two continued their dedication by opening a separate facility, called Lily's Place, to provide a homier environment for babies exposed to drug use before birth. Each newborn has a separate room, and young mothers are taught skills for dealing with their babies. Most of the moms want to learn; some do not.
Nearly all the children get sent home with a parent. Most of the time it's their birth mom or dad. Once in awhile, they go to foster care or are put up for adoption, but that's a rarity.
One mother confided to Murray that she finally got help when her child was 4 months old and she couldn't recall if she'd fed her baby at all one day. The mother asked a relative to care for the child while she went into treatment.
Murray worries about the addicts who don't feed their babies and don't call someone for help. She empathizes with their chemical dependency but says it's difficult to hear parents prioritize their fix over their family with a simple justification: "I like being high."
"We have generational addiction and that's their normal. It was their mother's normal. It was their grandmother's normal," Murray says. "And now, it's their normal."
A normalcy that is completely abnormal.
Lt. McClure marches up a footpath that cuts through brush behind Marcum Terrace. The next victim is splayed out beneath a hollowed out area of bushes, amid needles and a heap of sticks and water bottles piled up like a campfire.
Time for naloxone.
Less than 20 feet away, on the other side of the path, Capt. Ray comes across an overdosed man lying on a bed of brush. Another life saved.
Sweat drips from beneath the bill of Ray's brown EMS baseball cap. The oppressive heat won't let up. Neither will the overdoses.
A commotion erupts outside an apartment. People scream for a medic. As Ray makes his way down the narrow sidewalk, distrustful bystanders pull out cell phones and record his every move.
He can't let the cameras faze him. Another man is down, clutching groceries in one hand, a bag of needles in the other.
The overdose count nears 20.
'They can't unring the bell'
It's nearly 5 p.m., closing time at the Cabell County Courthouse, as Family Court Judge Patricia A. Keller wraps up another day of child support cases. Within the hour, the 58-year-old West Virginia native is home and flipping on the news in her living room. She stands there in shock, unable to focus on preparing dinner.
How many overdose victims are parents, she wonders. Will those families fracture?
Keller never thought drugs would consume her court. Fifteen years ago, she was mostly setting visitation schedules for alcoholic dads. Now at least a third of the cases she sees involve protecting children from the havoc wreaked by opioid addiction.
Every week Keller decides whether moms and dads who have lost custody, like the ones at Lily's Place, can see their children again. Whenever possible, she prefers to create avenues for heroin users, including mothers like Andrea, to regain visitation rights. First, they must typically meet with a counselor and submit to random drug tests.
Far too often, addicts aren't willing participants. In some cases, parents show up high to her chambers, if they show up at all. Sadly, some parents lose their children for good.
"When people have been in the madness of their addiction, being a good parent is the last thing on their minds," Keller says. "When they start to become clean, they can't unring the bell."
Likewise, Keller never thought her job would also mean being a counselor. But she can't ignore the fact that about three of every four parents in her court are so poor they can't afford a lawyer. She's encouraged dads struggling with heroin addiction to get clean needles at the exchange. Other times, she's offered moms literature about recovery programs.
Keller also presides over a local drug court that's one of West Virginia's largest. Founded in 2008, it gives nonviolent criminals with a high risk of reoffending or relapsing a chance at treatment instead of incarceration. Half of the participants drop out, leading them back to prison. For the other half who graduate, 9 out of 10 don't commit another crime, Keller says.
But the drug court has limitations: Addicts can only get help once they're in the criminal justice system, a point where families have already suffered the consequences. For those who want assistance before that point, it can be hard to find.
"A lot of people want to get help," Keller says. "But we don't have enough treatment beds. It's so frustrating. You've got to get it for them as soon as they're ready."
Resurrected in recovery
While the 6 o'clock news airs, Will Lockwood sits in a crowd of about 70 at the Expression Church of Huntington, a refuge for recovering addicts sandwiched between Cabell Huntington Hospital's emergency room and Spring Hill Cemetery.
Tim Hazelett, an administrator with the county's health department, takes the stage and acknowledges the string of overdoses that have occurred this afternoon. Then he uses the pulpit as a teachable moment.
The people who are overdosing, he says, are in need of help. Put out the word, he tells the crowd. There's a batch of heroin laced with something that can kill you -- so stay away from it.
He dives into a PowerPoint presentation, 37 slides in total, that describe how to recognize the signs and symptoms of an overdose, how to administer an intranasal form of naloxone and what to do if a child overdoses.
Lockwood, who helped organize this session, relates to every word. The 25-year-old overdosed four times in a three-year period. He's stayed clean for nearly two.
Two summers ago, he embarked on a mission to end his life by means of a lethal fix.
He holed up in room No. 216 of the Coach's Inn, a dingy pink motel where passersby can see walking skeletons stumble from room to room. Lockwood overdosed for what he hoped would be the last time. When he awoke, his drug dealer pounded his chest in a bathtub, cold water running down his face.
He stood and, as he came to his senses, glimpsed at his reflection in the mirror. His body-builder frame had withered by more than 60 pounds.
"You are worth more than this," he told himself. "You have a son. You have a family. You know exactly what you need to do."
Now Lockwood works as a peer coach for The Lifehouse, a faith-based recovery center that helped him get sober. As part of his job, he mentors men who are desperately trying to quit.
"I empathize with the people of this community," he says. "A lot of them don't want to be in this situation. Truly, what it boils down to is fear."
Fear of rejection. Fear of judgment.
Tonight, everyone learns the value of life-saving intervention. When the naloxone course ends, worship begins. Lockwood and the rest of the congregation proclaim their commitment to God, to one another and to themselves. Many of his fellow worshippers have skirted death -- in biblical terms, resurrected.
Just blocks away, as the church service continues, a man stiffens in the bathroom at the Marathon convenience store. His legs, contorted, stick up straight in the air. His pupils are dilated.
A woman lies sprawled on the floor, beneath the sink.
This is one of Lt. McClure's final stops -- almost exactly 12 hours into a shift that began at 7 a.m. His clothes are drenched in sweat and the stench of a hard day's work.
Two more get narcanned.
Almost two hours later, as darkness falls, Mayor Williams' phone buzzes once again. He swipes his screen. It's an update from Huntington Fire Chief Carl Eastham. The victim of the final overdose -- a 19-year-old woman just outside the city limits -- has made it alive to Cabell Huntington Hospital.
"There have been no OD deaths that we can find at either hospital," Eastham texts a few minutes before 9 p.m.
"Thank heaven for that," the mayor replies, before firing off another text: "Obviously carfentanil has arrived."
"Appears that way," Eastham writes.