Every time Shani Damron, 34, buys methamphetamines or heroin on the streets of Huntington, W.Va., she knows the risk is extreme.
"That fentanyl is no joke," Damron said, referring to the deadly synthetic opioid that now contaminates much of the illegal drug supply in the United States. "Every time we stick a needle in our arm, we're taking a 50-50 chance. We could die."
There's also a high risk of disease from contaminated needles shared by drug users. Damron's community has seen a major HIV/AIDS outbreak.