Updated Friday January 12 at 4:18 p.m.
State health officials are proposing a multifaceted plan for confronting the drug crisis killing hundreds of West Virginians each year, one that would require action by everyone from lawmakers to doctors to judges to emergency responders to the general public.
Some of the changes might be possible to make administratively, but much of the work will depend on legislative approval.
"We have to stop this terrible drug epidemic. We have to," Gov. Jim Justice said in his address to state lawmakers Wednesday night. "If we don't it will cannibalize us."
A dozen state senators that day had introduced legislation to generally limit initial doctor and dentist prescriptions of opiates for acute, or short-term, pain to seven days. The bill would limit those painkiller prescriptions to three days for minors and for emergency-room outpatients.
These and many other changes are recommended in a plan released Thursday by a panel of public health experts from West Virginia and Johns Hopkins University with state agency and public input. They're taking additional comments for another week.
This plan recommends limiting initial opioid prescriptions, increasing oversight to stop inappropriate painkiller prescribing, and requiring all emergency responders to carry overdose antidotes. It also calls for expanding public awareness that addiction is a treatable disease, increasing diversion of criminal drug case defendants to treatment programs and increasing treatment options for all patients.
The report further calls for expanding programs to support families with someone addicted, expanding peer-based support and better access to contraceptives for people with drug disorders.
More than 30,000 West Virginians are already in drug treatment. The state has the nation's highest drug overdose death rate, fueled by prescription painkillers.
Overdose deaths increased from 735 in 2015 to a record 884 statewide in 2016, and the toll could be rising still.
"Mixtures of opioids and stimulants such as amphetamines, methamphetamines, and cocaine are surging in 2017," the panel wrote. "It appears likely there may be over 1,000 overdose deaths in West Virginia in 2017."
Most involved opioids. While steady increases from 212 fatal overdoses in 2001 were initially driven by pharmaceuticals, the authors noted a shift to illicit heroin that began in 2012 has since increased with more potent fentanyl added to street drugs.
By examining hundreds of deaths, the Bureau of Public Health found that 81 percent had interacted with health systems, 56 percent had been jailed, and 71 percent were on Medicaid. Males were twice as likely to die from overdoses as females.
The report calls for mandatory hospital and emergency responder reporting of non-fatal overdoses, so that outreach can be arranged.
"This is a public health crisis of the highest order," said Dr. Rahul Gupta, who heads the bureau.
The report is posted online at http://dhhr.wv.gov/bph/Pages/default.aspx.