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McDowell County leads in opioid hospitalizations, study says

McDowell County led West Virginia in the number of people hospitalized for opioid related reasons in 2014, according to recently released data from the Agency for Healthcare Research and Quality, a subset of the federal Department of Health and Human Services.

In 2014, the most recent year for which data are available, a ratio of about 750 residents per 100,000 in McDowell County stayed at a hospital because of opioid abuse, including overdoses. This is a jump from 2013, when 620 per 100,000 people sought hospital treatment related to opioids.

The study relies on discharge information released by insurance companies and hospitals, according to Lorin Smith, a spokesman for AHRQ. Of West Virginia’s 55 counties, 51 were accounted for in the study. Counties where less than 11 people per 100,000 were treated for substance abuse issues — including opioid overdoses — were withheld, to ensure that individuals could not be identified by that data, Smith said.

Since it’s based on discharge information, the data does not account for individuals who have died because of opioid abuse. West Virginia has the highest overdose death rate in the nation, and while last year’s overdose deaths are still being counted, officials have stated that they are expected to reach a record number.

Smith said that, in recent years, AHRQ has held “a big focus on the opioid epidemic.” The agency was “asked to really start paying attention to substance abuse.”

For the 2014 data, counties in 32 of the nation’s 50 states released information included in the study. Notably absent from the study is Ohio, where more than 15 West Virginia towns, cities and counties are pursuing lawsuits against a handful of drug distributors they allege fueled the opioid crisis by flooding excessive amounts of pain pills into their limits.

Of the states accounted for in the data, West Virginia held the highest rate of people hospitalized for opioid abuse, at 408 per 100,000 residents, nearly double the nation’s average of 218 per 100,000.

Of all these counties, McDowell ranked 18th in the rate of people hospitalized for opioids, coming after 10 counties in Kentucky and a handful from other states, including Maryland, Massachusetts, Minnesota, North Carolina, North Dakota and Tennessee.

“This just shows how disproportionately affected these counties — this area — is per capita by this opioid epidemic,” said Letitia Chafin, a Williamson-based lawyer who is representing McDowell County and the city of Welch in ongoing lawsuits against drug firms. “For [McDowell] to be so high in the nation — that’s a testament for the problem right there in the county.”

Between 2007 and 2012, drug firm AmerisourceBergen — one of the companies Chafin is litigating against — shipped 1.46 million hydrocodone pills and 193,000 oxycodone tablets to pharmacies in McDowell County, DEA records show.

“These cases [against drug firms] are being brought not just to shine a light on distributors or try to maintain them,” Chafin said. “We want to show the need the people in these areas have for help. We want facilities to see that.”

Brooke County, in the Northern Panhandle, came second to McDowell, with a rate of about 720 hospitalizations per 100,000 people. Mercer County, which is a neighbor to McDowell, came third, with 700 per 100,000. These two counties, Chafin said, hold tremendous differences in terms of access, compared to McDowell.

Interstate 70 runs just outside Brooke’s county limits, connecting to Ohio and Pennsylvania, and W.Va. 2, which connects with Interstate 77 to Huntington, cuts through the county. In Mercer, I-77 runs straight through the county to Virginia. This means easier access to and from the counties for people driving through, and more connections to surrounding communities.

McDowell, though, has none of these. While the county shares a border with Virginia, the main route through the area is U.S. 52, a windy, narrow two-lane highway that serves as a main street for the small towns and hollows that make up McDowell County. Rural roads and side streets can take drivers farther south, if need be, but the isolation of the county means their most frequent travelers are residents and miners who might travel for work.

“This is huge, because it shows McDowell isn’t being influenced by these outside sources,” Chafin said. “You don’t have a lot of those there — there’s no easy way to get there, there’s not a lot of people coming in. It shows this problem is centered on the area.”

Patients in McDowell County — which had a population of about 20,000 in 2014, per U.S. Census estimates — spent a total of 985 days in the hospital for opioid abuse, amounting to more than $900,000. When accounting for all economic costs related to the opioid crisis, McDowell ranked 19th in the nation for highest costs, according to a recent study by the American Enterprise Institute. Boone County led the nation.

Chafin said she’s watched McDowell struggle to battle this epidemic the past few years, and has seen the fallout from it. Her law firm regularly works cases in the county.

“There are so many efforts here to make things better, and the people who are trying are going to keep trying. I don’t think, though, that Southern West Virginia — and even the nation — have hit rock bottom for as low as [the opioid crisis] can get. These numbers aren’t as high today as they’re going to be,” Chafin said. “When facts, numbers like these come out, though, it sort of reinvigorates us. I guess it reminds us that we can’t stop trying. We can’t give up fighting for people here, for West Virginia.”

Caity Coyne is a corps member with Report for America, an initiative of The GroundTruth Project. Reach her at, 304-348-7939 or follow @CaityCoyne on Twitter.

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