East Liverpool, Ohio, was once considered the capital of the pottery world due to a thriving industry composed of more than 300 pottery companies. But like many small middle-America towns who were economically depleted due to manufacturers moving overseas, East Liverpool has become a shell of its former self. Its population now hovers around 11,000 and opportunities are scarce. The city has become “depressed,” says photographer Ben Lowy. “All the shops have closed up, there’s hardly any storefronts there. You don’t see a lot of people on the streets at all and it seems like a town in decline.”

These days, East Liverpool is known for its opioid epidemic with heroin and fentanyl high on demand. The town received national attention in September after its Police Department released a graphic photograph showing a four-year old boy in the backseat of a car while his grandmother, Rhonda Pasek, 50 and her boyfriend, James Acord, 47, were found unconscious from a heroin overdose.

The photograph, which went viral, is merely a small reminder of the opioid epidemic that is plaguing the state. A 2015 report from the Ohio Department of Health shows 3,050 died last year from accidental drug overdose, up from 2,531 in 2014. Overdoses from any kind of opioid contributed to 85% of drug overdoses in Ohio last year.

Lowy’s images show that reality, faced each day by police officers and residents alike – and there’s no end in sight. It is not uncommon for the police, as Lowy mentions, to “spend most of their time now looking for drugs.”

And it’s also not uncommon for East Liverpool officers to be called by their first names when on patrol as many of them grew up there. One of the officers Lowy spoke to said his interest in athletics led him to steer clear from the path of drugs compared to his peers who succumbed to it by choice. “Half the people who he was pulling over were people he went to high school with,” Lowy says. “He put people that were his friends in prison.”

Ben Lowy is a photographer based in New York City.

Paul Moakley, who edited this photo essay, is the Deputy Director of Photography and Visual Enterprise at TIME. Follow him on Twitter @paulmoakley.

Bianca Silva is a writer and contributor to TIME LightBox. Follow her on Twitter.

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