HARLAN — Kateena Haynes thought her job would be about helping kids with homework, playing games and providing a positive environment as director of the Harlan County Boys and Girls Club.
It has been, mostly, but she also found herself scrambling to come up with money for a grief counseling program after parents of 13 participants in the after-school club died of drug overdoses in one six-week stretch two winters ago. Eleven of the children witnessed a parent die, Haynes said.
The rash of deaths is just one example of the incalculable heartbreak drug abuse brings: overdose deaths, babies born addicted, homes and businesses robbed, families wrecked, and people who can't get work because of a drug conviction.
"It has completely reshaped every community in Eastern Kentucky," Haynes said of prescription drug abuse.
Among those who died in the winter of 2011-12 was a man whose daughters, ages 10 and 8, often came to the boys and girls club. Their father had drug problems, but he had gotten sober and held a job for a while. When he got a tax refund, however, he threw a party and took a lethal dose of prescription drugs, Haynes said.
His daughters asked to call 911 as he lay in the bathtub, deathly sick. Other adults in the house said no, apparently out of a fear that the father's probation would be revoked, Haynes said.
The father struggled out of the tub and into bed. His 8-year-old daughter climbed into bed with him and lay close as he died.
Haynes said her husband went to help pick up the girls' belongings before they went to foster care. There were hypodermic needles everywhere in the house, she said. When the 8-year-old and her sister came to the club while their family made funeral arrangements, she had a question for Haynes: "Could God bring my Daddy back?"
The wretchedness of drug abuse has affected the boys and girls club in other ways as well.
Some kids went hungry because their parents sold food stamps to get money for drugs, so Haynes worked to find resources for a feeding program.
Before it began, some kids wouldn't have a meal from the time they ate lunch at school until they got back for breakfast the next morning, she said.
At the club's annual Christmas party, leaders began requiring kids to open their gifts at the center before taking them home. The change was needed to keep parents from returning unopened toys for refunds to get drug money, or selling them at roadside flea markets, Haynes said.
Unlike heartache, some costs of Kentucky's drug abuse epidemic can be quantified.
In 2010, inpatient and emergency room charges related to drug overdoses totaled $78 million, and taxpayers picked up a big chunk of that through services to poor people, a University of Kentucky study found.
This fiscal year, the state budgeted $35.5 million to pay for substance-abuse treatment and $480 million to run prisons. Officials say drug abuse plays a role in why most people end up behind bars.
Will Collins, head of a state public defender's office that represents poor people in criminal cases in three Eastern Kentucky counties, said drugs fuel the bad deeds of his clients.
"Ninety percent of the crimes they do are simply to maintain a habit," he said.
Gene Clark, family court judge for Clay, Leslie and Jackson counties, said he had a staff member do some research in 2005 and found that drug abuse was a direct cause in almost 75 percent of the cases in Clay County in which caregivers were accused of abusing or neglecting children.
Those numbers have not changed significantly since 2005, Clark said.
Drug and alcohol abuse also play a role in many domestic violence cases.
"They all start with, 'He came in high,'" Clark said of the women seeking protective orders.
Gary Douglas, a substance-abuse counselor in Leslie County, said it's common for women to prostitute themselves to get drugs.
"You'll stop at nothing," Douglas said.
In Knott County, half the school-age children are being raised by someone other than a parent, and drugs play a big role in that trend, said Steve Richardson, director of pupil personnel for the county school district.
"It's horrible," Richardson said of the drug problem.