Manatee County, on Florida's west coast, is home to more than 300,000 people. It's known for its beaches, and if you go just a short distance inland, you'll pass by the iconic fruit stands and working citrus groves.
"This is a really fabulous place to live. We have a lot of great things going on here,” said Melissa Larkin-Skinner, who has lived in Manatee County since the age of 3. “I grew up here and I love it."
But as the chief clinical officer at Centerstone, the only in-patient detox facility in Manatee County, she sees her hometown starting to be well known for something else -- hundreds of overdoses and dozens of people dying from heroin.
"For inpatient (services), we are at capacity pretty much every other day,” Larkin-Skinner said. “So we try, as hard as we can to serve everyone, but we're not able to, particularly in our inpatient and our residential (treatment). Because the beds fill up."
From 2013 to 2014, Centerstone saw the number of patients arriving at its door saying they were using heroin more than double, from about 300 people up to around 670. When the center is at capacity, the staff tries to find patients a spot somewhere else, but that can mean sending them an hour north, to Pinellas or Hillsborough Counties.
Stephen Krivjanik, chief of Manatee County Public Safety Department’s EMS Division, said November 2014 is when they started to see a spike in 911 calls for overdoses. In July 2015, they responded to more than 200 calls.
"That includes -- and this really was shocking to me -- 35 repeat overdose cases just in the month of July,” he said. “So that means they overdosed, went around the corner and overdosed again. Got out and overdosed again. So that just illustrates the impact that this addiction has on these folks."
During the first six months of this year, Manatee County emergency responders issued more doses of Narcan, a medication used to reverse the effects of an opiod overdose. That's more than they issued than all of 2014, Krivjanik said.
Law enforcement officers also are feeling the strain, as they respond to calls for overdoses and try to stop traffickers who are providing the drugs. Capt. Todd Shear of the Manatee County Sheriff's special investigations unit said the uptick in heroin use in is affecting all departments.
"We're taxed...It's something that, there's only so many hours in a day, there's only so many detectives I have,” Shear said.
The strain heroin has in Manatee County has now spread even to the deputies who are used to serving subpoenas and evictions. Now, they are serving more papers to force addicts into rehab under the Marchman Act.
"If the person doesn't want to help themselves, and sometimes that's what the case is, the families can petition, or even (three) friends for that matter, they can petition the courts to actually make somebody get mandated treatment,” Shear said.
The deputies use the papers from the court take the patients to Centerstone in Bradenton. The rehab facility is just down the street from Mixon Fruit Farms, where a sign celebrates "75 years of Southern Hospitality."
That image, and others that remind people of old Florida, have been fighting for attention alongside a Manatee County Larkin-Skinner says is dealing with so many heroin overdoses.
“It’s incredibly sad,” she said. “But maybe what good will come out of it is that this community will finally recognize that we do have a problem, and it's not just paradise here."
Manatee Sheriff's Lt. Richie Cunningham, says said deputies are seeing the impact of heroin everyday, responding to more property crimes, and to parents who call because their teenagers are overdosing. It's reached an extreme this year, he said.
"It's very traumatic for the deputies. It's very traumatic for the families. There's a lot going on,” he said.
So much so that the strain stays with Cunningham at the end of every shift.
"I reflect on this a lot. I go home and communicate with my kids just about every day because I see what's happening here,” he said. “Whether it's heroin or anything, you really don't want to miss the signs."