A new report from the West Virginia Center on Budget and Policy has estimated the addiction epidemic cost the state $11.3 billion in 2019 alone.
The report, written by economist Jill Kriesky, examines the dollars spent on treating and addressing the diverse array of harms that stem from West Virginia’s current addiction crisis, including hepatitis B and C, HIV, endocarditis, neonatal abstinence syndrome and an overburdened foster care system.
Using the same methodology used by the Council of Economic Advisers to the President of the United States in its 2017 analysis of the opioid epidemic in the U.S., Kriesky estimates the economic damages caused by drug-related fatalities in West Virginia totaled around $9.7 billion in 2018 and $9.8 billion in 2019. The report also found it cost Kanawha County $1.7 billion in 2019.
These figures represent nearly 15% of the state and county gross domestic products.
The report looks closely at Kanawha County because it is home to the state capital but also, as the report states, because it has not had as robust a response to the epidemic as other areas, notably Cabell County.
Despite being referred to as the “center of the opioid epidemic” at one point, Cabell County’s fatal overdose rate fell by nearly half (202 deaths in 2017 to 111 deaths in 2019) after initiating a “comprehensive drug intervention program” following the 2016 wave of overdose deaths. Kanawha County’s fatal overdose numbers remained between 150 and 153 in the same three years and is now first among West Virginia counties.
“In August 2016, 26 people in Cabell County overdosed from fentanyl-laced heroin in a five-hour period. Officials now say that while this was not the first time concern about the drug epidemic surfaced, it was a defining wake-up call,” the report reads. “Since then, Cabell County has chosen to meet its substance use disorders by developing a full array of prevention and early intervention, treatment and recovery support programs with collaborations between public officials, law enforcement, health care systems, universities, nonprofits and faith-based organizations beginning in 2016.”
In contrast, Kanawha County has fewer medication-assisted treatment programs and programs for neonatal abstinence syndrome. It also has just one small syringe service program, along with the grassroots organization Solutions Oriented Addiction Response (SOAR), which has come under fire by the Charleston City Council this year.
The report examines costs beyond overdose fatalities, including the toll of neonatal abstinence syndrome (NAS) and diseases like HIV.
In 2017, West Virginia’s rate of NAS was 53.5, an increase of 283% from 2010. The rate in Kanawha County that year was reported at 39.4, with an increase to 54.3 for the first six months of 2020.
Using estimates on the cost of NAS from a 2021 Journal of American Medical Association study, Kriesky estimates at least $1.33 million was spent on meeting the needs of opioid-dependent infants at birth in 2017 in Kanawha County.
Costs of other diseases are hard to estimate, but the U.S. Centers for Disease Control and Prevention estimates the lifetime cost of treating HIV at nearly $485,000. To treat Kanawha County’s 35 new cases for most of 2020 will cost nearly $17 million.
The report advocates for better surveillance of substance abuse-related issues and collection of data, and for robust harm reduction services, including syringe exchanges and supervised consumption facilities.
While syringe exchanges have come under fire in the state Legislature, there are no supervised consumption facilities in the state. These facilities prevent overdose deaths by having a medical professional oversee consumption of things like opioids. A study estimates the value of the lives that could have been saved in Philadelphia with a facility at between $12,462,213 and $74,773,276.
The report cites a 2019 Harm Reduction Journal study that found nearly 80% of people who inject drugs in Cabell County would be open to using a safe consumption facility.