Photo by: W.Va. Legislative Photography
Jeremiah Samples, a senior adviser to the Joint Committee on Government and Finance, told lawmakers on Monday that West Virginia needs to better track the consequences of substance use disorders.
CHARLESTON – West Virginia’s substance use disorder crisis was brought to lawmakers’ attention in a sobering way this week.
The Joint Standing Committee on Health received a report Monday afternoon from Jeremiah Samples, senior adviser to the Joint Committee on Government and Finance, on drug use statistics and policies in West Virginia.
“The bottom line is that we have not made enough progress in this crisis,” said Samples, a former deputy secretary of the now-renamed Department of Health and Human Resources. “We are nowhere near where we should be, and our data compared to other states and even our own expectations is well below expectations.”
“We need to re-evaluate all of our policies and spending on substance use disorder (SUD) in light of the real impact on people in our society.”
According to recent reports from the federal Substance Abuse and Mental Health Services Administration, approximately 208,000 West Virginia residents reported using illegal drugs in the past month. According to West Virginia University’s Mountain State Assessment of Trends in Community Health (MATCH) survey, 359,880 West Virginia residents used drugs in the past year.
Citing statistics from the U.S. Centers for Disease Control and Prevention, there were 1,335 known overdose deaths in West Virginia in 2022. For comparison, overdose deaths increased by more than 55% between 2017 and 2022, 135% between 2010 and 2022, and 1,690% between 1999 and 2022.
As a result, West Virginia has led the nation in overdose deaths since 2010. The overdose death rate in West Virginia was 28.2 per 100,000 residents in 2010. In 2022, it was 80.9 per 100,000 residents. The national average was 32.4 per 100,000 residents.
Tennessee had the second highest overdose rate at 56 per 100,000 residents, and South Dakota had the lowest at 11.3 per 100,000 residents. By comparison, West Virginia’s overdose death rate was 36.4% higher than Tennessee, 151% higher than South Dakota, and 85.6% higher than the national average.
As a result, West Virginia had the second lowest life expectancy in the country and the highest death rate among working-age adults.
“This is outrageous,” said Samples. “We cannot sustain this as a society. It paralyzes the state.”
Samples said total state spending on substance use disorders is difficult to track and can only be estimated. Direct spending runs into the hundreds of millions of dollars annually, not including indirect spending for the criminal justice system and the Department of Human Services.
“We have not ignored the problem. There have been hundreds of millions and billions of dollars in spending and impacts in the state,” Samples said. “But we are not seeing results and we cannot reverse the trend. We have fought.”
One report estimates that West Virginia’s drug crisis costs the state more than $11 billion annually. According to Samples’ report, the drug crisis costs the state’s economy an estimated $8.8 billion annually in health care, substance abuse treatment, law enforcement costs, lost worker productivity, and general societal burdens. That’s about one-eighth of the state’s entire economy. The per capita cost to West Virginia residents is $4,793.
The data didn’t all contain bad news. Preliminary data shows that overdose deaths in West Virginia fell by more than 7% over the 12-month period between May 2023 and May 2024. Similar preliminary federal data shows that drug overdoses in West Virginia fell by nearly 5% between March 2023 and March 2024, even as overdose deaths nationwide fell by more than 9% over the same period.
Samples urged lawmakers not to underestimate those numbers, saying preliminary data could be misleading. Once death investigations are completed, those numbers could rise.
West Virginia’s drug crisis is directly linked to the explosion in the number of children in state care. According to Samples’ report, 83% of children removed by child welfare services were from families with known drug use. West Virginia ranked either 49th or 50th in the number of children in state care – a 61% increase between 2010 and 2021.
In 2020, the state had the highest rate in the country for the number of infants tested for prenatal drug exposure. That year, Child Protective Services screened 712 infants for drug exposure, compared to California—a state with a much larger population—where the number was 526.
In recent years, there have been a number of legislative reforms designed to help reduce the number of drug abuse cases in the state, including the creation and reorganization of the Office of Drug Control Policy. Dr. Stephen Loyd, chief medical officer of Cedar Recovery in Tennessee, was recently appointed by Governor Jim Justice as West Virginia’s sixth ODCP director.
Other bills focused on improving the quality of care in substance abuse treatment facilities and reforming residential rehabilitation centers. There are more than 23 state facilities that have substance abuse treatment and rehabilitation programs. And the new West Virginia First Foundation is still working on plans to distribute hundreds of millions of dollars from the $1 billion settlement with opioid manufacturers and distributors.
But Samples said the state needs to keep a much closer eye on spending and programs to see what’s working, because programs need to be constantly reevaluated. Samples said the state needs to focus less on process measures and more on tracking societal outcomes and determining whether programs are producing measurable results.
“I think the most important thing we need to do is measure what matters so that we can then tailor and improve our response to this crisis,” he said. “We need to measure every aspect of our substance abuse policy and spending and link it to a core societal measure.”
