Opioid-involved and drug overdose deaths have been continuing to increase in the United States, reaching epidemic levels. Data compiled by the New York Times estimates that the number of deaths due to opioid use in 2016 rose 19 percent from 2015. Early data from 2017 suggests that drug overdose deaths will continue to rise this year. According to the Centers for Disease Control and Prevention (CDC), the majority of drug overdose deaths (six out of 10) involve an opioid. The number of overdose deaths due to opioid use has quadrupled since 1999, killing 65,000 Americans in 2016 alone. This exponential growth in overdose deaths does not extend to all parts of the United States. For example, in some states on the western half of the U.S., data suggests that deaths have plateaued or even declined. Nonetheless, many states in the eastern half of the U.S. still remain very affected by the opioid epidemic.

Now referred to as the epicenter of the U.S. opioid epidemic, West Virginia is where a resident is reported to die every 10 hours due to fatal drug overdose. According to data from the CDC, McDowell County and Kanawha County in West Virginia have the highest overdose mortality rates and the highest numbers of overdose deaths in the United States. The West Virginia Health Statistics Center reports that at least 864 people in West Virginia died due to opioid or heroin use last year. Of those deaths, 731 involved an opioid of some kind.

Experts have been trying to explain why West Virginia has been hit the hardest by the opioid epidemic, citing many factors including economic despair, widespread unemployment, inadequate mental health facilities, and a sense of isolation between communities. However, the Fiscal Times offers another explanation; reporting that drug manufacturers and out-of-state wholesalers produced a huge influx of opioid painkillers such as OxyContin and hydrocodone into West Virginia, allowing physicians to freely prescribe the drugs to patients and consequently fueling an underground market of illegal drug sales. According to the report, West Virginia become flooded with hydrocodone and oxycodone pills, with an estimated 433 pills per resident available.

Other sources have documented the trail of shipments of pain killers all over West Virginia, mostly ending up in mom-and-pop pharmacies. More than half of them were provided by three major pharmaceutical drug wholesalers, which should have reported suspicious orders for controlled substances but failed to do so. The 13 companies that were targeted for bombarding West Virginia with opioids control 85 percent of all prescription drug distribution in the United States. For more than a decade, these companies have been filling orders from tiny pharmacies in southern counties of West Virginia that ordered unnecessary amounts of pain killers.

For the moment, medication-assisted treatment centers and sober-living programs have helped some residents turn their lives around, and find sobriety. Meanwhile, experts in the area are beginning to think of ways to reverse the opioid epidemic by changing opioid prescribing and developing a new model to treat opioid addiction. A West Virginia city program was designed to help drug users by pairing law enforcement with compassionate outreach, while utilizing all the state’s resources such as the county health department, the hospitals, the medicals schools, the pharmacy schools, the churches, and the local communities