Can West Virginia Shift Its Attitude Toward the Opioid Crisis?


Shawna Hardy grew up in the early 80s “on the hill.” That’s how family referred to her Grandma Helen’s property, a quasi-farm situated atop a steep hill in North-Central West Virginia. Her family lived in a trailer next to Grandma Helen, separated by a large field outlined with thick aluminum fencing that held a chicken coop, a salt lick for the cows, and a small barn for a temperamental palomino named Golden Boy. Shawna spent her childhood running free between her house and her Grandma’s, accompanied by farm animals, countless cousins, and her younger brother, Rex, known as Rexie throughout his brief life. In 2014, at age 32, Rexie succumbed to drug addiction. Not just a number, Rexie is one of many thousands of loved ones lost to the literal death grip of the opioid crisis.

In the 80s, when Shawna and Rexie were kids, their hometown of Clarksburg was a quiet, simple place populated by middle- and working-class families. In its close-knit neighborhoods, sidewalks and streets were busy thoroughfares for bikes, big wheels, and roller skates. Despite development outside the city, downtown Clarksburg held its own with department stores, banks, barber shops, and eateries. In the mid-90s, that peaceful small-town picture began to oxidize. Painkillers like Oxycontin arrived on the market as a reaction to new medical guidelines defining pain as the “fifth vital sign.” In turn, pain medication became the norm, where in the past it would have been a last resort. In a state defined by high unemployment and high-injury jobs like coal mining—in communities with few treatment options for mental illness—pain pills were seeds sown in fertile ground. The crisis came into full bloom in the early 2000s and has continued largely unfettered, despite national attention.

As the only state falling entirely within Appalachia, West Virginia is the region’s voice, narrating its journey through this crisis for the rest of the country, and the world. As Shawna Hardy tells it, the response coming out of West Virginia reveals a chasm between what should be and what is.

In 2017 it’s a fair, albeit morbid, assumption that most West Virginians have attended the funeral of someone lost to addiction. Rexie’s service was standing room only. I was there, sitting behind his parents, my uncle and aunt. My mom’s brother Rex is the youngest of Grandma Helen’s 17 children and her most tender-hearted. A former football standout, Rex chose a welding rod over the pigskin and married his high school sweetheart. Aunt Gina is short, round and funny, her dark Italian features a genealogical foil to my uncle’s Germanic blue eyes and pale skin. Theirs is an old-fashioned kind of love, and on the day they laid their only son to rest, it was all they had left. Their agony, palpable throughout the service, was not a response to the horrors of drug abuse; rather, a testament to unconditional love.

What began as a shift in the medical and pharmaceutical industries quickly spiraled into a disaster that has touched every hill and hollow in West Virginia. Yet through our valleys runs a swift and shameful current: West Virginians see addiction as more social malady than public health crisis, and it’s leading us further down the spiral. Just last week President Trump declared the crisis a public health emergency. It remains to be seen if this is a first step toward new response efforts at the federal level. Here in West Virginia, that declaration might be little more than a semantic shift, and not one strong enough to move residents hardened by grim realities.

Shawna Hardy knows a lot about this state’s response to the addiction crisis. As the sister of an addict, she saw firsthand how communities are turning their backs on both duty and humanity: “The attitude of most people—law enforcement, medical staff, and even family—is that addicts are trash.  They are the most shunned, mistreated human beings I have ever known.” Shawna is also a nurse who takes to heart the Nightingale oath, which set expectations for ethical care. Her healthcare background made it particularly difficult to witness the way healthcare providers dismissed her brother, whose addiction was steadily eroding his health. Her parents resorted to taking Rexie to different hospitals, hoping the next one would be different, but disdain for their addicted son was evident all around.

Shawna had the abject misfortune of watching her brother’s addiction bring on bacterial and fungal infection in his heart that eventually took his life. It changed her, in ways both painful and provident. After Rexie’s death, she felt led toward advocacy. Her newfound passion led her to meet her now-husband, Darl Hardy, another Clarksburg native who lost a loved one, his sister, to addiction. Together the Hardys are devoted to making a difference where they believe it is most needed: on the ground. They participate in awareness walks; hold bingo fundraisers; attend community meetings; go door to door with a group called Neighbors in Action handing out addiction resources. They represent a powerful few in West Virginia fighting not only the relentless wave of addiction but also public response to it. Their mission is to lead with love, to let addicts know there is help without judgment.

West Virginia is down. It’s low on lists for education, health, and business and high on lists for poverty, addiction and unemployment. Communities are overwhelmed by the inordinate number of babies born addicted, a persistent news cycle of abused children, and growing crime in once-thriving neighborhoods. State funeral funds are being drained at an exponential rate by overdoses and addiction-related deaths, and there’s still no end in sight. When the rest of the country looks to West Virginians for answers, we point to the addicts — an other existing in a state itself perceived just as poorly by outsiders.

The opioid crisis has proven deleterious for Appalachia’s hardest-hit state, not only destroying families but also upending compassion. In casual conversation and in online forums, we diminish addicts as the dregs of society. In Clarksburg, residents fought the introduction of two sober living homes due to proximity to schools. In a city with drug dens plaguing its neighborhoods, a sober home should be a welcome step toward change. Instead, assumptions, slippery slopes, and personal responsibility impede progress, not just in Clarksburg but statewide. As an overwhelmingly conservative state, West Virginia’s “pick yourself up by the bootstraps” values are proving as self-destructive as drug abuse itself.

We aren’t wrong to be upset by the strains addiction has brought to our social and economic well-being, nor are we off-course to demand punitive measures for related crimes. But we lose our way when we don’t keep our frustration in check. Addiction is a complex affliction whose roots belie surface assumptions. Studies show its most dominant determiner is not marijuana use or poor judgment or even poverty: It is mental illness, which itself is complex, with a myriad of contributing factors. Behind each addict is a story we don’t know.

I spent most of my childhood on the hill with my cousins Shawna and Rexie, riding horses, chasing chickens, and running wild in that field next to Grandma’s old farmhouse.  Rexie and I rarely crossed paths as adults, but when we did, I didn’t see the addict whose behavior shocked or angered me. I saw my childhood playmate and a troubled man still so beloved by his family.

If West Virginia is the voice for Appalachia, it’s time we change our response. We don’t have to choose between pragmatism and humanity. Let’s choose both.

Danielle Costello is a freelance writer and editor with a special interest in literary journalism. After spending a few decades exploring life in bigger cities, Danielle now resides in Morgantown, West Virginia, with her two young sons and her dog, Pvt. Joker. Her defining passions are literary arts, wellness, and animal welfare. She serves as volunteer marketing director for Animal Friends of North Central West Virginia, a nonprofit rescue organization. Danielle has been published in Memphis Magazine, Memphis Flyer, Morgantown Magazine and BarkPost.