Veterans fight the opioid crisis through fitness in ‘Small Town Strong’

Portsmouth, Ohio used to be an industrial hub. Sitting along the Ohio River near the border with Kentucky, the town had been home to a number of factories, steady employment and even an early professional football team. In the 1940s it had a population as big as 40,000. Then as the industrial sector declined in the 1980s, the pharmaceutical world moved in. 

Portsmouth became known as the “pill mill” of the United States. “Pain clinics” distributing opioids to residents of Scioto County, with more drugs there than residents. As many as 69 people died of overdoses in 2019. 

In 2010, Army veteran Dale King came home to Portsmouth, seeing the town struggling and people dying from drugs. He started a Crossfit gym, and one of his students was struggling with drugs. That led him to start offering Crossfit classes to other people in or seeking recovery, people who struggled with addiction or knew someone who did. In Portsmouth, almost everyone knew someone who had. Now the gym’s efforts are the subject of a new documentary. Small Town Strong, which streams on Amazon and Apple TV+ starting Oct. 3, looks at how the gym is trying to help its members recover, and scale up its fight against addiction in the region. 

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The documentary was made over several years, charting members’ recovery and growth in and outside of the gym. It’s co-directed by brothers Chase and Spencer Millsap. Chase, a veteran who served in the Marine Corps and the Army Special Forces, met King when he visited Portsmouth with his wife, who had grown up there. 

The area is one of the worst hit areas of the opioid epidemic. As users began seeking ways to feed their addiction they shifted to heroin and then fentanyl, and overdoses have risen over the years.

King had served as an intelligence officer with 10th Special Forces, including deployments to Iraq. He had grown up in Portsmouth, playing high school football there — the Spartan namesake of the Portsmouth Spartan Kettlebell Club comes from the Portsmouth Spartans, the professional football team that became the Detroit Lions — and he knew several people who had overdosed. He was able to earn people’s trust.

“[Dale and I] were both part of the pre-surge and the surge, the nation building in Iraq. It didn’t work holistically,” Millsap said. “We left Iraq with that sort of in the back of our mind, it was in my mind. If you think someone is coming to help you from the top down, it’s gotta happen organically. No one’s coming to save us. That mentality is what spurred him to action.”

When Millsap first visited the town, he’d been out of Iraq for about a year, and he said Portsmouth was worse. Way worse, he said.

“It was a warzone. I remember being really off put by that,” Millsap said. “But I’d come back, I’d see it change, see it get better. I asked what is making this change, everybody told me about the gym. ‘You got to meet Dale’ they said.”

In 2018, the gym partnered with a nonprofit health agency, providing fitness classes to those getting help. Millsap and King realized there was a story to be told on film. Millsap began filming in that same year, bringing in his brother Spencer to help as the project turned into a full-length documentary by 2020. While King had years of the members’ trust at that point, Millap had to earn it, joining the others for workouts and sweating it out together before he could bring his camera and get people to tell their own stories. 

Small Town Strong is both sweeping and intimate in its structure. News footage shows the scale of the opioid and addiction crisis in Ohio and the United States. Medical professionals explain in detail just what addiction does to the brain. At the same time, the documentary is personal, taking viewers inside the gym as members open up about their struggles. King, an imposing figure with tattoos covering one arm, is at the center of it, encouraging the others and trying to keep them motivated. People in recovery share their stories, such as member Sarah Wilson, who regularly pushes herself inside PSKC and also shows where she used to do drugs before she got clean. 

The core element of King’s work and the recovery is building a community. Giving people a shared space and a sense of belonging proved to be one of the best ways to help people get the assistance they need, to connect with counselors and find work and housing, King found. “The one thing we found that the minute you get isolated is the minute you relapse, get addicted, you want to get high,” Millsap said.

Millsap admitted that he “missed the shit out of war” but the gym helped him process that, through the community aspect. 

The documentary shows the growth of many of the gym members in recovery, but also does not shy away from the daunting nature of addiction and the scale of the epidemic in the United States. During the filming of the movie, one of the central figures, who had helped the gym connect with the health nonprofit and had been a part of the expansion, died of an overdose. He was one of three people the gym lost during filming. The loss spurred King and the brothers to keep filming and finish Small Town Strong. 

Millsap admitted he could have kept filming for many more months; recovery is an ongoing process and King and the others’ work continues. He said that the fight right now is harder than ever. More people are getting addicted, more people are dying of overdoses as the drugs become more dangerous. But the town is turning around, he said, there’s more life in Portsmouth. 

Millsap drew a connection back to his time in Iraq.

“I’m a grunt. The first thing they tell you is to go look for atmospherics. Go look for the vibe on the streets,” he said. “Here it’s almost the same thing, you walk out of the streets and areas that used to be boarded up, you can definitely buy some drugs if you looked hard enough,” Millsap said. “Now business is happening, people are staying, people are getting hired.”

Small Town Strong streams on on Amazon and Apple TV+ starting on Oct. 3.

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