Last year, a photo showing a middle-age couple in East Liverpool, Ohio, in the throes of a dual heroin overdose inside their car while a 7-year-old grandchild helplessly watched shocked the nation.

That image, taken by one of the police officers who helped saved the couple, garnered some complaints about privacy, but given that the couple’s car nearly struck a school bus, it’s a myopic and ridiculous criticism at best.

They’re among the thousands of Ohioans who have been beneficiaries of naloxone, a drug that reverses the effects of a heroin overdose and literally brings people back from the dead.

Because so many addicts who are saved from overdoses are repeat customers, it was inevitable that questions would arise over the cost and effectiveness. Increasingly, taxpayers are wondering aloud how many times should a person be saved from themselves?

Five? Twenty?

Seventy-times-seven?

Should such a question even be asked?

Death stalks Appalachia

Heroin and opioids have cut a swath through Ohio like the Four Horseman of the Apocalypse. In his bestselling memoir, “Hillbilly Elegy,” J.D. Vance talks about splitting his childhood between Middletown, Ohio, and Kentucky, where the crisis has been equally devastating.

Vance notes that addiction not only has hollowed out parts of Appalachia, but also profoundly has changed and endangered the culture of a people who pride themselves on hard work and defying assumptions.

Middletown Councilman Dan Picard recently sparked a national debate after proposing a “three strikes” limit on Narcan doses for repeat abusers, arguing that the struggling city simply can’t afford limitless doses.

By Ohio law, first responders are required to do whatever they can to assist a person in distress. But is the law being stretched out of shape by people who repeatedly place themselves in harm’s way?

Perhaps this is the wrong question. Drugs, after all, have existed for centuries. But why this particular surge at this particular time? How did we become a nation awash in pills and powder?

My colleagues Shane Hoover and Jessica Holbrook recently wrote a compelling series about addiction, and as good as it was, it only scratched the surface of the stories that could be told.

According to the U.S. Centers for Disease Control, alcohol kills more than 89,000 people each year and costs the economy more than $200 billion a year, and another 33,000 Americans die each year from drug overdoses.

Though the instances of teen addiction and impaired driving are climbing, states are pushing to legalize recreational marijuana, all for a chance to stack skyscrapers of cash.

Protest and support

What’s going on in America right now that so many of us are feeling a need to escape?

Throughout the state of Ohio, first responders are being worn down by “rescue fatigue.” In Butler County, Sheriff Richard K. Jones doesn’t even permit his deputies to carry Narcan, the most popular brand of naloxone, a policy that has sparked protests and its share of support.

Jones says he’s worried about deputies’ exposure to such lethal drugs as fentanyl, and says the paramedics who respond to the same calls can administer Narcan.

Butler County, population 180,000, is on pace for 300 overdose deaths this year. That nearly half the number of overdoses as occur in Cuyahoga County, where a population of 1.2 million people is on pace for 775 overdose deaths, according to the county Medical Examiner’s Office.

Each dose of Narcan costs about $37. Ohio offers cities some grants to cover the cost, but money is a finite thing.

In a state where the economy doesn’t feel robust, the hard question of how many second chances an addict should get could become a moot point.

— Reach Charita at 330-580-8313 or charita.goshay@cantonrep.com