www.thecentersquare.com – By Christina Lengyel | The Center Square – (The Center Square – ) 2025-05-22 11:58:00
West Virginia leads the nation in opioid use disorder (OUD) costs, paying over \$500 per capita, with OUD costs exceeding 6% of its GDP. The state’s 2024 projected expenses include \$52 billion tied to an OUD rate above 2%, far above the national average. OUD’s economic toll spans government, businesses, individuals, and society, with an average case costing \$695,000 nationally, but over \$1.2 million in West Virginia. Overdose deaths hit 80.9 per 100,000 in 2022. Treatment with behavioral therapy and medication can save up to \$295,000 per case, yet stigma and legislative resistance hinder access to effective care.
(The Center Square) – A recent report from Avalere Health shows West Virginia’s state and local governments pay more per capita for opioid use disorder, or OUD, than any other state.
That figure tops $500 per person. It also topped the nation as a percentage of GDP, coming in at more than 6% of the state total.
The study looked at past figures to project estimated costs for 2024 for federal, state and local governments, private businesses, society as a whole via lost property and crime, individuals and households.
The total national costs were in excess of $3.9 trillion. West Virginia accounted for more than $52 billion of that with an OUD rate of more than 2%.
The figures reveal what could be described as an opioid tax levied upon the entire country, one that came in three waves beginning with the overprescription of pain medications like morphine and hydrocodone in the 1990’s. It gave way to a brief few years in which heroin proliferated starting around 2010 before escalating to the current flood of fentanyl and synthetic opioids on the street.
While external stakeholders like the government bear a significant portion of the burden, individuals bear the lion’s share of the cost. Nationally, the average case of OUD was about $695,000 annually, with $532,000 on the individual.
In West Virginia, the cost per case nearly doubles the national average, amounting to more than $1.2 million.
Much of the money lost comes in earnings for both employees and employers. Meanwhile, involvement in the judicial system, medical expenses, mortality and the treatment of neonatal dependence are typical expenses for both systems and individuals.
West Virginia has the highest overdose mortality rate in the country. In 2022, the CDC reported 80.9 deaths per 100,000 people. This represents 1,335 lives and a massive economic impact.
There is some hope to be found in the projections, however. Avalere calculated the average cost savings for different forms of treatment. Behavioral therapy alone can save $144,000 per case.
When medication is added to the treatment options, that number jumps. Behavioral therapy alongside any of the three approved therapeutic drugs, which include methadone, buprenorphine and naltrexone, can save between $270,000 and $295,000.
This is an increasingly thorny problem in West Virginia, where resistance to medication assisted treatment has significantly narrowed the window of available options for patients. In March, SB 204, which would make methadone clinics illegal in the state, moved to the Senate Health and Human Services committee.
The bill demonstrates the persistent stigmatization of OUD, one of the biggest obstacles to accessing treatment. According to Avalere, educating more primary care doctors about treatment is an important step. Experts say it’s much easier to confront a case of OUD when patients are able to continue working and living in their communities while accessing help.
The study notes that Black and Latino youth are more likely to suffer from OUD, while white people are more likely to be prescribed painkillers that lead to the disorder. People who are incarcerated have additional challenges with recovery and are more likely to die from overdose after being released.
Note: The following A.I. based commentary is not part of the original article, reproduced above, but is offered in the hopes that it will promote greater media literacy and critical thinking, by making any potential bias more visible to the reader –Staff Editor.
Political Bias Rating: Centrist
The article presents a factual and data-driven report on the economic and social costs of opioid use disorder in West Virginia, relying heavily on statistics and findings from Avalere Health and the CDC. It describes the scope and impact of the opioid crisis without using charged language or advocating for specific political ideologies. While it does touch on the controversy surrounding medication assisted treatment and the state bill concerning methadone clinics, it refrains from adopting a partisan stance, instead highlighting challenges such as stigma and barriers to treatment in a neutral manner. The focus remains on informing the reader through objective reporting rather than promoting any particular ideological viewpoint, resulting in an overall balanced and centrist tone.
On June 6, 2025, Milan Puskar Health Right in Morgantown operates one of West Virginia’s three syringe exchange programs, providing harm reduction services like clean syringes, naloxone, and wound care. Meanwhile, Charleston’s Neighborhood S.H.O.P. offers showers, food, and support services but cannot provide syringes due to strict state regulations. West Virginia faces a severe opioid crisis, with the highest overdose rates nationally and rising HIV and hepatitis from closed programs. Despite receiving nearly $1 billion from opioid settlement funds, many local governments hesitate to fund harm reduction, citing stigma and political opposition, hindering efforts to curb disease and overdose deaths.
On a warm summer day in late May, about 100 people are waiting for their turn to go inside the Neighborhood S.H.O.P., located in the annex of Bream Memorial Presbyterian Church on the West Side of Charleston, West Virginia.
Inside the S.H.O.P. — which stands for Showers Healthcare Outreach Program — they will find resources like naloxone, clothing, first-aid supplies, food, showers and people offering services from rental to legal assistance. Director Derek Hudson says the no-barrier organization aids almost 2,000 people a month.
“The whole goal is to have people come in, be heard and know that at least someone is trying to help them,” Hudson said.
The kind of help the S.H.O.P. provides, broadly speaking, is harm reduction.
“Harm reduction for us focuses on meeting people where they are and empowering them with the tools to help prevent negative health outcomes from substance use,” Hudson explained. “Harm reduction, simply put, saves lives.”
Derek Hudson is the director of the Neighborhood S.H.O.P. located at Bream Memorial Presbyterian Church in the West Side Neighborhood of Charleston, W.Va. (Sam Nichols | West Virginia University)
What they won’t find inside, however, is one of the most well-known forms of harm reduction: new syringes.
Syringe Service Programs are highly regulated in the state of West Virginia, and service providers say it makes it almost impossible to run one. But SSPs are associated with an approximately 50% reduction in HIV and HCV incidence, according to the Centers for Disease Control and Prevention. They also benefit communities and public safety by reducing needlestick injuries and overdose deaths.
Hudson’s S.H.O.P. has received about $80,000 in state opioid settlement funds from the West Virginia First Foundation specifically to create a re-entry program that will house people who are coming out of incarceration. It’s a program that will reduce recidivism and homelessness in the community, Hudson says, but it is not considered a harm reduction program.
Programs that provide more typical harm reduction in the form of practical strategies that reduce the negative consequences of drug use — which can include anything from free naloxone to wound care — are not receiving any of the tens of millions of dollars coming into state, county and city level government coffers in West Virginia from the 2021 global opioid lawsuit settlement agreement so far, according to an analysis by students from West Virginia University’s Reed School of Media of Freedom of Information Act responses from 50 of the state’s 55 counties. And without those funds, many of the people working to provide these services worry that disease transmission and overdose death rates will buck a national trend and rise in West Virginia once again.
The high cost of a crisis
The funds are the result of a global settlement, agreed to in federal court, of a class action lawsuit brought by states, counties and cities across the country against opioid distributors, manufacturers, pharmaceutical companies and others, in the wake of the country’s opioid epidemic.
In 2023, more than $73.5 million of those funds were distributed to county officials in the state’s 55 counties. An analysis of FOIA responses by journalism students at West Virginia University’s Reed School of Media lacks information for five counties, but of the 50 others, Logan County received the highest distribution at $3,983,631, and Jefferson County received the least at $62,773.
Kanawha County, where the state’s capital Charleston is located, received just more than $3.9 million, and, according to County Commissioner Lance Wheeler, is focusing on funding recovery options. But Wheeler says they are also considering funding harm reduction organizations as well.
“This is something I strongly support,” Wheeler said. “We’re going to continue to do that, helping those who have a track record of success and those who are helping people who are struggling.”
The collapse of a program — and the fallout that followed
The city health department started a syringe service program in 2015, but was open for just three years before public and political pressure forced the city to shut it down. Then-mayor Danny Jones, a Republican, called the program a “mini-mall for junkies and drug dealers.”
The program’s closure in 2018, however, had dire consequences for public health. HIV and hepatitis rates skyrocketed, eventually requiring CDC officials to travel to Charleston in 2021 to help the city contain the outbreak.
Then-CDC HIV Prevention Chief Dr. Demetre Daskalakis called the outbreak “the most concerning HIV outbreak in the United States.”
The fight for evidence-based and person-first
Iris Sidikman, the harm reduction coordinator at the Women’s Health Center of West Virginia, said the reluctance to fund harm-reduction services has directly impacted organizations that go beyond providing syringe services.
“When you have a tool to give someone in a non-judgmental space, it can open a world of possibilities,” Sidikman said.
In 2024, the Women’s Health Center applied to the Kanawha County Commission for $250,000 in opioid settlement funds twice, first through an online application and again at a public commission meeting. The clinic intended to use some the funds to provide increased naloxone training and education, cover costs related to screening and treatment of HIV and Hepatitis C and to fund a portion of clinical and programmatic staff salaries for the Harm Reduction Program, Sidikman said. Their application was denied without explanation.
The Women’s Health Center also applied with Charleston City Council in August 2023 to create a syringe service program on Charleston’s West Side, but was denied due to fear of an “increase in drug use and crime.”
Research on harm reduction by the Substance Abuse and Mental Health Services Administration has shown that these practices reduce disease transmission and overdose rates, and experts believe politicians should look at the numbers more often.
“What we want to do with data analysis… is to be able to produce the evidence to show to political power that these interventions are working and capable, they are saving many lives,” said RTI International Research and Public Health Analyst Barrett Montgomery.
SOAR WV, another grassroots, Charleston-based harm reduction group, works to promote the health, dignity and voices of individuals who are impacted by substance use disorders, according to its website. SOAR and other organizations picked up the task of providing new syringes until the state Legislature passed Senate Bill 334 in 2021, which included strict regulations for running a syringe service program, such as requiring a West Virginia state ID in order to participate.
Syringes and wound care kits are provided by the syringe service program at Milan Puskar Health Right in Morgantown, W.Va. Health Right provides more than 300,000 clean syringes each year. (Ty McClung | West Virginia University)
The city of Charleston also passed stipulations requiring that each syringe be uniquely labeled for tracking purposes.
As of June 2025, West Virginia Health Right operates the only syringe-service program in Charleston, but according to one source, “doesn’t even begin to make a dent in the problem.”
The political appetite is lacking because of a lack of information around the subject, says Dr. Susan Margaret Murphy, president of the Drug Intervention Institute in Charleston.
“Unfortunately, we are in a political climate where I don’t think research and scientific knowledge necessarily pleads the case. So sometimes it’s got to be kind of a heart-on-the-sleeve storytelling type of approach,” she said.
Stigma and the struggle for support
In neighboring Boone County, Commissioner Brett Kuhn agreed.
The county currently does not have any harm reduction services, and, so far, its three elected commissioners have not spent any of their $2.9 million in opioid settlement funds to provide them.
“I think in a rural setting, you’re going to see more pushback than you would in more of an urban setting,” Kuhn said. “I think with the syringes, it’s like people think we’re subsidizing the drug use, whereas with naloxone the attitude is more like, ‘well, we’re trying to help somebody that’s in trouble.’ And really, if you look at it, in both cases, is there any real difference between the two?”
Kuhn says that informing the public about how harm reduction works and its benefits to the community is key to fighting pushback.
“You’ve got to get out ahead of the curve. You’ve got to get out there and get the information out,” Kuhn said. “I sometimes think we don’t do a good enough job of that.”
Instead of harm reduction programs, the county spent its funds on paying off its regional jail bill, supporting a food pantry, a county arrest record-keeping system, a rapid response vehicle for EMTs, and a 25-bed expansion at Hero House, a faith-based sober living home in Madison.
Kuhn and officials in other counties say the vague nature of the state’s MOU overviewing how the money can be spent puts the duty of interpretation on local officials. The county did not hold special community meetings or town halls to gather input on how to spend the funds.
But Kuhn says it’s rebuilding a sense of community that could help garner support for harm reduction services.
“I think it’s sometimes the attitude is ‘well, those people don’t want to help themselves,’” Kuhn said, “[but] if they don’t want to help themselves, then what do I need to do to try to help? And I think in a certain sense, we’ve lost that sense of community, that we’re all in this together.”
Kuhn hopes that can change in the future.
Jonathan Edwards, Purity Siroir, Tyler Cummings and Aengus Gillespie contributed to this reporting.
This story was published in partnership with West Virginia University’s Reed School of Media and Communications, with support from Scott Widmeyer.
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West Virginia Watch is part of States Newsroom, a nonprofit news network supported by grants and a coalition of donors as a 501c(3) public charity. West Virginia Watch maintains editorial independence. Contact Editor Leann Ray for questions: info@westvirginiawatch.com.
Note: The following A.I. based commentary is not part of the original article, reproduced above, but is offered in the hopes that it will promote greater media literacy and critical thinking, by making any potential bias more visible to the reader –Staff Editor.
Political Bias Rating: Center-Left
This article presents a sympathetic view toward harm reduction programs and critiques the regulatory and political barriers limiting their effectiveness in West Virginia. It highlights the public health consequences of shutting down syringe service programs and emphasizes scientific evidence supporting harm reduction. The tone favors evidence-based, compassionate approaches to drug policy and health crises, implicitly criticizing conservative political opposition, such as the cited Republican mayor’s negative framing of harm reduction efforts. However, it maintains a largely factual reporting style with multiple sourced statements and avoids overt partisan language, placing it in a center-left position focused on public health advocacy.
SUMMARY: Jay’s Evening Weather for Tuesday 07/08/25 reports showers in southern West Virginia this afternoon and evening, raising humidity and causing wet roads. Showers are mainly in western areas, including McDowell, Wyoming, and Tazewell counties, moving eastward. Dense fog may reduce morning visibility. Severe thunderstorms have been warned near Lynchburg, Virginia, with a disturbance expected Wednesday into Thursday, increasing thunderstorm intensity. The strongest storms will be east and southeast but may affect southern West Virginia. Main threats include damaging winds and flooding rains with over an inch possible, causing ponding. Temperatures will range in the 80s by day, 60s at night with scattered storms continuing through the week.
We’ve seen showers around the region this afternoon, and more are possible over the rest of the extended forecast.
SUMMARY: Fire crews are returning to the scene of a house fire that started just after midnight this morning along Township Road 1-72, off Route 7-75. Firefighters report the initial fire began around 12:30 a.m. Investigators are back on site today, searching for the fire’s cause. It remains unclear if anyone was hurt in the blaze. Meanwhile, an Arizona man has been charged with attempted murder in Dunbar following the incident, according to police. Fire crews continue to manage the situation as authorities conduct their investigation.
