The county health department was staying open late just for them, so after dinner, a dozen men shuffled out of the Lifehouse drug rehabilitation shelter where they were living and climbed into a battered white van.

It would be a short ride through a familiar landscape. Abandoned houses. Buckled sidewalks. Graffiti-swirled walls. A woman bent over and searching a weedy lot. A girl chasing a puppy in the late afternoon glow. "That's a beautiful dog," one said. Other than that, they rode in silence.

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