Those numbers stunned Tennessee state Sen. Richard Briggs, who is also a cardiovascular surgeon.
"Absolute shock," Briggs said. "It would be no different than if there was a rock lying there. And if you lifted it up, and this horrible smell came out, and this monster came out. We had no idea that the organized retail theft was related so intimately with the opiate and drug trade in general in Appalachia."
Briggs sponsored legislation this year that requires all transactions involving cash for gift cards on the secondary market to be reported to local law enforcement. But the law does not impose a penalty for not complying, and Briggs said he plans to push for tougher rules next year.
Tennessee loses more than $14 million a year in sales tax revenue due to this crime, according to a retail industry report.
"The criminal element is very creative," Briggs said. "And I don't think this is the sole problem to solving financing of the opiate problem in Tennessee. But it's one part of the problem. And right now it's a very big part of the problem."
Home Depot said it has changed its policy to crack down on return fraud and acknowledged the link between gift cards and drugs.
"Of course, it impacts our bottom line, but it's also about safety of the community, drug trafficking, even terrorism," Home Depot spokesman Matt Harrigan told CNBC.
Home Depot only accepts "store credits for in-store purchases and we require proof of ID when store credits are redeemed at checkout because of the increase in return fraud," Harrigan said. "We never want to inconvenience our customers, but this policy impacts more than just our bottom line. It helps minimize returns fraud tied to bigger organized crime in the community."
The home-improvement retailer's store credits differ from gift cards because they cannot be used online, which limits their resale value. Its gift cards are more open to resale.
The company also does not allow customers "to buy gift cards with store credits or another gift card due to the potential fraud linked to that behavior," Harrigan said in a statement.
Target's return policy also attempts to limit gift-card fraud. If the store can't find a receipt when employees try to look one up, they may offer exchanges or store credits.
The company also says it limits the number of returns without a receipt.
Walmart has "in place a series of policies and procedures to closely monitor merchandise returns where no receipt is required," said Charles Crowson, senior manager of corporate communications.
Lowe's, which also works with law enforcement and the retail industry to combat return fraud, will "hold perpetrators accountable for their illegal conduct," said Steve Salazar, corporate communications manager.
On the police side, the Coalition of Law Enforcement and Retail sees the return fraud-opioid connection as a top priority.
The group will be "leveraging its public and private partnerships to combat the crisis in both areas," said Curt Crum, president of the coalition.
The larger business community is also taking aim at the issue.
Retail Theft Analysis, a Florida-based private company, is pitching software to police departments to help track the number and value of gift cards that stores buy and individuals sell.
CEO Matt Ryan said the company found one example of a customer who sold $349,000 worth of gift cards to a store in Tennessee during a three-month period. Most of them were iTunes cards.
"This data tells me this is somebody that they should look at pretty closely," Ryan said. "The other thing I would look at is what store he is selling to. Because this type of store is obviously not really examining who they're buying cards from. Because anybody that's bringing in [$349,000] worth of iTunes cards is probably doing something fraudulent."
To the drug abusers in treatment, all of these efforts are positive signs as they all try to rebuild their lives.
"I've always told myself I'd be a wonderful mom," Booth said, wiping away tears. "I'd do anything for my little girl. And it's crazy to look back and see all the times that I didn't care, how selfish I can be."