By US reporter Amanda Walker
Sergeant Buddy Croy straps in for another police patrol.
He’s ready for anything but there’s one aspect of his daily job that’s become almost guaranteed. Fentanyl.
The killer drug is running riot in his town of Centralia, Washington and thousands more across America, leaving countless tragedies in its wake.
Its terrifying potency has managed to make heroin look almost weak.
It is easily made and smuggled - a combination that has confounded and overwhelmed US authorities.
As we explore just one small town in the grip of fentanyl, you can see why.
But this is also the home of a potential breakthrough in this American tragedy.
Sure enough, just minutes into Buddy’s shift, there’s a report from a local shop owner of a man slumped on a bench.
The police call that slump ‘the nod’. It’s the first sign that someone could be about to overdose on fentanyl.
We approach the man with caution. Buddy nudges him back to consciousness. In his hand is the foil remnant of fentanyl.
Luckily, this time he’s okay and the police let him go with a warning and information on where to get help.
One of those places is the Gather Church. It runs a medication assisted clinic which is pioneering a new treatment for fentanyl addiction.
Today, former addict Sean Boungs is getting the injection of buprenorphine, an opioid medicine widely used to tackle addiction.
"I don't feel like I need drugs, it's been a lifesaver, honestly" says former fentanyl user Sean Boungs
The difference now is its slow release over a 30 day period which Sean says has crushed his cravings.
“I started using fentanyl about a year ago. I was smoking 50 plus blues a day, the fentanyl pills. This stuff has pretty much made it to where I don't crave.
"I don't feel like I need drugs.
"It's been a lifesaver, honestly. I've gotten my life completely back. I finally got my family back. I got my kids in my life.”
By day, Dr Lily Lo is a pediatrician. Each evening she volunteers at the Gather clinic. She's seen the horror of fentanyl up close and she’s genuinely excited by what the new treatment might mean.
She said: “It has been a game changer for us.
"The injection allows them to not have to worry about taking something.
"It also takes that choice of do I take my medication or do I take this other drug?
“It has been a game changer for us," says Dr Lily Lo, who administers buprenorphine
"And the other thing is, over time, the buprenorphine builds up in their body so that eventually when it starts leaving their body, it leaves their body slower and slower and slower.
"They can actually go longer than a month in between injections. And when they start feeling the, the medication wearing out of their system, it's a very slow withdrawal. It's not that big cliff.”
She believes the treatment could be the key to loosening fentanyl’s grip on America. The challenge is getting people on it. She knows better than anyone that reaching people who’ve hit rock bottom is hard.
On the edge of town there’s an encampment where people who’ve spiraled all the way down often end up.
This place is as much on the fringes of society as its possible to get.
Flies buzz around the pungent trash littered along dirt paths between each makeshift home. There’s no electricity, no sanitation.
Of the 25 people who live here only six of them are not using fentanyl.
The majority are men but I speak to two women, both users and both mothers.
Living here is scary, they say, especially at night, but there’s nowhere else for them to go.
There’s desperation in their eyes both for the drug they crave and the children they’ve lost. I ask them what fentanyl feels like and momentarily they light up.
“Amazing” one says, “But don’t do it”.
The street fentanyl they are using is not regulated - its cooked up by dealers in garages and kitchens which does worry them.
They’ve seen friends die and they seem fully aware they could be next.
But still their days are spent desperately trying to find their next hit.
The death toll from America’s lethal fentanyl epidemic is jaw dropping. It's now the leading cause of death for people aged 18-49, killing more people than guns or car accidents.
The trial of the new injection is being funded by Washington state, and if successful could be rolled out elsewhere.
A proven treatment has multiple legislative hoops to jump through.
In a deeply divided country, nationwide consensus seems a way off.
Conflicts about how to tackle this epidemic rumble on while fentanyl continues to flood in across the Mexican border.
For every police seizure that takes drugs off the street the supply is quickly replenished.
There’s only one certainty in this tragedy: the deadliest drug crisis in US history will claim many more lives.
It’s a national emergency crying out for a unified response.
Watch On Assignment on ITV X and ITV 1 Tuesday, September 26 at 10.45pm
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