Why Does West Virginia Have Such a Huge Problem with Opiate Addiction?

By May Wilkerson 05/03/16

A high unemployment rate is one of the major factors leading West Virginia to have the highest overdose death rates in the country.

Why Does West Virginia Have Such a Huge Problem with Opiate Addiction?
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The U.S. opioid epidemic has affected the entire country, but it has hit West Virginia particularly hard. The state had the highest rate of drug-overdose deaths in the country in 2014, according to a recent CDC report. It also has one of the highest rates of opioid prescriptions, following only Alabama and Tennessee, and is among the 10 states with the highest rate of prescriptions given out for high-dose and extended-release opioids, which are both more likely to be abused.

The problem may be worse in West Virginia than other parts of the country due to two factors: A higher rate of jobs involving manual labor (like coal mining, logging, and manufacturing) and high unemployment rates.

As reported by Business Insider, opioid prescriptions began to surge in the state in the ‘90s, like the rest of the country, when powerful new painkillers like Oxycontin were introduced to the market. "There was a big push saying we had a big problem with the under-treatment of pain," opioid researcher Dr. Ted Cicero, a psychiatry professor at Washington University in St. Louis, told Business Insider. "Opioid prescriptions skyrocketed from the early '90s until about 2010."

But in addition to the influence of Big Pharma and overprescribing, the state, known as “coal country,” has a lot of manual labor jobs, which put workers at greater risk of injury. As a result, opioid abuse tended to spike in areas with higher populations of miners, said John Temple, a professor at West Virginia University and the author of American Pain. “In a mining camp, there aren't a lot of doctors,” he said. “That doctor is going to be more likely to opt for the quick fix and give people pills to fix their pain and get them back into the mine, rather than give them rest or therapy or those things that can actually cure pain."

The second factor is the state’s declining economy and heavy job loss over the last two decades. At 6.5%, West Virginia has the second-highest unemployment rate in the country, with nearly 20,000 jobs lost from 2014 to 2015. As unemployment rose, so did the rate of substance abuse, as people turned to drugs to medicate boredom and financial stress. “Low education levels, high rates of unemployment and job-related injuries are closely linked to abuse of alcohol, illicit drugs and prescription medications,” said a 2009 report from the Appalachian Regional Commission.

And with opioid prescriptions on the rise, painkillers are becoming the recreational drug-of-choice. According to Dr. Carl "Rolly" Sullivan, who runs the addiction program at West Virginia University Hospitals, said 90% of his patients were alcoholics in the 1990s, whereas by 2002, between 90% and 95% had been addicted to painkillers.

Nationwide crackdowns on “pill mills” and other efforts to limit painkiller supplies have been somewhat successful in reducing rates of painkiller distribution in West Virginia and other states. But it was too late for many people already hooked on opiates. Subsequently, many people have switched to heroin, which is cheaper and more readily available as drug dealers capitalize on the growing market. By 2010, Sullivan said the “vast majority” of his patients were being treated for heroin addiction, which remains the case in 2016.

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May Wilkerson is a writer, comic and Managing Editor @someecards. Co-host of the podcast Crazy; In Bed w/alyssalimp. She is also the top Google result for "insufferable lunatic." Follow this insufferable lunatic on Twitter.