Heroin overdose numbers have remained steady in Cole County since public outcry forced law enforcement and local leaders to launch a full scale campaign against the drug.
In the last year and a half, Jefferson City police have reported 38 heroin overdoses, five of which were fatal. The Cole County Sheriffs Department had five non-fatal overdoses.
But Cole County EMS responded to 123 overdoses in that time, though not all were specifically heroin. The medicine narcan was used 54 times.
At its peak in late 2011 and early 2012, law enforcement reported nearly one heroin overdose everyday in the Jefferson City area.
"I think it was the equivalent of a tidal wave hitting the city," said Jefferson City police Capt. Doug Shoemaker. "Prior to that time we were hit by such a massive number of overdoses that led to deaths and we didn't have the staff, we weren't prepared for what was taking place at the time."
Jefferson City police were down 14 officers as of last week, according to Shoemaker. Some of those vacancies were once filled by officers who played important roles in the 2012 Heroin Overdose Prevention Education (H.O.P.E.) Campaign.
The H.O.P.E. Campaign was launched when the heroin overdose problem was at its worst in the Jefferson City area. It involved a law enforcement focus on the drug and a public awareness push.
Throughout 2012, officers, educators, treatment counselors and recovering addicts spoke to hundreds at several town hall meetings and continued their education into classrooms in the county.
One of those speakers was Jim Marshall, a Westminster College cross country coach.
"It sickens me when I hear all the statistics about how many kids are getting involved in this and how many families are losing kids," Marshall told ABC 17 News. "That passion has kicked in to a higher level even above and beyond even what losing a son does."
Marshall's 20-year-old son, Cody, died two days after he was found at home unconscious from a heroin overdose in September 2011. Doctors said he had Xanax and heroin in his system at the time.
That spawned Marshall's push for heroin and drug abuse education. He has spoken to health classes across central Missouri and has been working on a plan to add a drug abuse class to school curricula.
"We have drivers ed to save live," he said. "I think we need to do something at an earlier age before these kids make choices."
Marshall was also the face of another component of the heroin crackdown in Cole County - to be called the Marshall Report.
The idea was to have quarterly updates on overdoses and drug trafficking, plus on educational efforts, presented by both the Jefferson City Police Department and the Cole County Sheriffs Department.
But the Marshall Report never materialized.
"The whole essence of the Marshall Report hasn't been lost, said Shoemaker. "Certainly internally I can say for the Sheriff and for our agency is that it's just as important as it ever was."
Jim Marshall said he had noticed the lack of updates and has talked to the Report's presenters about it.
"They have their hands full with a million different things going on," he said. "I don't fault anyone, I think it had good intentions."
Those good intentions may have not been fulfilled because of the staffing shortages within law enforcement at all levels - from police, to deputies, to state troopers.
"Are we as productive as we'd like to be and as proactive as we like to be? Absolutely not," Shoemaker said. "Law enforcement is a people driven business and without the people to do it, sometimes it's hard to accomplish the mission as well as we might have done it before."
Policing and investigations was only one part of the H.O.P.E. Campaign solution. Both Shoemaker and Marshall agreed that it had to continue to be just one part of a multifaceted plan.
The community has shown continued interest in heroin in Cole County, they agreed. But, they said, the community is now more often than ever on the front lines of the fight against heroin.
"It's not a supply issue, it's a demand issue," Marshall said. "When the kids and people of our area quit demanding it, then the problem will go away."
Marshall launched a non-profit, Cody's Gift, to continue his education efforts and help spread awareness about drug abuse.