The numbers are unrelenting.
East Tennessee's opioid scourge, which has been rising steadily in recent years, continued unabated in 2016.
In Knox County, the year saw more than 220 people die of suspected drug overdoses, many attributed to opioids. That's thought to be the highest known number of such fatal overdoses recorded in the county.
"The opioid and heroin addiction issue is an epidemic here and we need help to get it under control," says Knoxville Police Chief David Rausch.
Statewide, the state saw a record number of overdose deaths in 2015, the most year for which numbers are available for Tennessee. According to the Tennessee Department of Health, 1,451 people died from drug overdoses across the state in 2015.
Across Tennessee, the drug overdose death rate is now high than that for people who die on roads in the state, a 10News investigation showed.
A comprehensive Knox County study - titled "Drug Related Death Report" - released in August showed the number of drug-related deaths in Knox and Anderson counties has doubled since 2010. The report was prepared by the Knox County Regional Forensic Center.
Authorities are trying to curtail the abuse. For example, Knox County prosecutors, for example, are seeking more ways to charge dealers whose actions may lead to a user's death.
But much still must be done.
"We are seeing a spike in all of our cases involving drugs, so the fact that we are having more and more overdose deaths, unfortunately, is not surprising to us in the DA's office," said Knox County District Attorney General Charme Allen, who has been tracking suspected overdose deaths more than a year.
In the fight against opioid abuse, prosecutors, health officials and law enforcement officials also have worked together on a plan to use a drug called Vivitrol on inmate users. It blocks the high that users get from drugs such as heroin.
They've secured a grant to pursue a pilot program.
Many area police agencies as well as Rural/Metro now also routinely carry a drug call naloxone that can save a person in the throes of an overdose. Rural/Metro crews have used the drug dozens and dozens of times over the last year.
Knoxville Police Department officers today respond to overdose calls almost daily.
"We are giving these folks a chance to clean their life up and a chance to live," says KPD Deputy Chief Gary Holliday.
It's an added expense, but it's proved to make a difference.
"I would never put money on a life. It doesn't matter how much it costs. It's about making a difference," said Chris McLain, clinical care manager at Rural/Metro.
This year Knoxville's police chief took addiction to the national stage. Chief David Rausch spoke at the White House, part of an administration effort to focus on the problem.
"We are taking action, and I think that's probably why we continue to be called on is that we are not sitting back and waiting on someone to give us the answers," Rausch said this summer.
Another sign of the degree of the problem: White House drug czar Michael Botticelli came to East Tennessee in January to meet with officials and discuss ways to combat drug abuse. Officials announced new counties that have been designated as part of the nationwide High Intensity Drug Trafficking Areas (HIDTAs) program.
'Waking up in a nightmare'
The area's near-epidemic addiction problem threatens all ranks of the population, from babies to the elderly, the report by Knox County Regional Forensic Center shows. It hits the wealthy and the poor and people who live across all ZIP codes, the report shows.
It even affects people in law enforcement, like Roane County Sheriff Jack Stockton, whose son is an addict. A child's addiction can cause alienation in once tight-knit families.
"It's a sad situation, but as long as he's alive there's always hope for him, and we just pray for him daily and hope one day that things change," Stockton told 10News this year in a story.
Drug abuse routinely leads to the birth of drug-addicted babies in Tennessee. More than 900 were born drug-dependent this year.
Abuse takes many innocent victims, people who don't even use drugs such as Rebecca Winkler. This year, 10News reported on the story of Rebecca Winkler and her parents, Mary Lou and Jack Winkler.
In June 2005, the Winklers lost their daughter, Rebecca, after an impaired driver on Central Avenue Pike near Beaver Creek Lane smashed into her car. She went into a coma and never woke up.
She was a 16-year-old rising Temple Baptist Academy junior. As her parents recalled, she was the kind of “pleasant kid to be around,” a shy girl on her way to a summer job just before the fatal morning crash.
You don't get over the loss of a child, they said.
"It was the worst day, will always be the worst day," Jack Winkler told WBIR. "You know, I can dream about Rebecca and she's alive in the dream but when I wake up it's like waking up in a nightmare"
There is hope for recovery, however, at places such as Serenity House. And for residents such as Sonja Butcher.
"For the first time in your life, you are accepted just like you are," Butcher said.