Fentanyl Story Archives - West Virginia Public Broadcasting

Health Care Providers Expand Substance Use Disorder Resources For Veterans

As fentanyl overdose deaths rise nationally, West Virginia health care providers are looking for new ways to support veterans struggling with substance use disorder or mental health issues.

As fentanyl overdose deaths rise nationally, veterans face new challenges overcoming historic barriers to health care.

Mark Mann, chief of staff for mental health services at the Martinsburg VA Medical Center (VAMC), said that West Virginia’s veteran community has been no exception to this struggle.

“The VA is doing a good job of curbing that, but we still are losing veterans every year to poisoning from fentanyl and other things that are mixed into the drugs,” he said.

Veterans have long faced bureaucratic difficulties and stigma when seeking support for substance use disorder. But the rising prevalence of fentanyl has also tested current mental health resources for veterans, requiring new strategies.

In response, health care providers at the VAMC are working to expand current resources to better serve veterans struggling with substance use disorder and other forms of mental illness.

On Friday, medical professionals and members of the local community gathered at the facility for a summit on substance use disorder among veterans.

The event featured discussions from both national and local medical professionals, who discussed substance use disorder among veterans at large and specific services at the VAMC supporting veterans’ mental health needs.

Those resources include traditional medical resources, like residential inpatient services, intensive outpatient programs and medication-assisted therapies, Mann said.

But it also includes providing a full “continuum of care,” supplementing medical services with social interventions and support.

In 2022, Mann said staff members at the VAMC helped advocate for the creation of a three-digit hotline number for suicide and mental health crisis intervention, 988.

Joseph Liberto, national mental health director for substance use disorders at the Department of Veteran Affairs Office of Mental Health and Suicide Prevention, answers audience questions.

*Photo Credit: Jack Walker/West Virginia Public Broadcasting*

Some veterans who contact the hotline are put in touch with the VAMC, who can then provide follow-up services and ensure they are safe.

Mann said providing a simple and remote resource like this has helped the VAMC provide more immediate support to veterans in need, and keep lines of communication open once patients step off the facility’s Martinsburg campus.

The VAMC has also created on-campus resources that provide counseling, like a chaplain assigned specifically to support veterans with difficulties surrounding mental health or substance use.

Roosevelt Brown, chief chaplain at the VAMC, said that the creation of this position allowed the VAMC to directly help local veterans, and point them to resources specific to their mental health needs.

“Part of what we’re doing now is trying to say, ‘Hey, how can we make sure we open the door and let them know that we have services available for them?’” he said.

As chaplains, Brown said that he and his colleagues offer spiritual or emotional guidance to patients at the VAMC, and also encourage them to access specific resources that could support them through periods of difficulty.

Brown said that fewer people used the VAMC’s chaplain services during the COVID-19 pandemic, but that turnout has returned to pre-pandemic levels with the creation of these new resources.

He added that he hopes this trend will continue, and that the VAMC will be able to further support veterans struggling with substance use disorder.

“We’re motivated to do something about those who need help,” he said. “My hope is that what we can do is [bring] a better quality of life [to] veterans.”

New Fentanyl Education Discussed By Education Committee

Whether or not to teach middle schoolers about fentanyl and overdose-reversing medicine sparked discussion in the House Education Committee, while Senate Education modified a House bill on special education.

Titled Laken’s Law, House Bill 5540 would mandate fentanyl prevention and awareness education, as well as use of naloxone, in grades six through 12.

The bill sparked more than a half hour of discussion and debate in the House Education Committee Wednesday, with many delegates expressing concern about whether it was appropriate to teach sixth graders how to administer opioid-reversing medication.

State Superintendent Michele Blatt told the committee that drug prevention has been a focus of health education in schools for years and reflects the lived reality of many students in the state, even in middle school.

“I think middle school is where a lot of those problems begin,” she said. “One of the surveys that we do, the safe and drug free school survey, students start talking about as early as sixth and seventh grade being exposed to it or having the opportunity to use it. So I don’t think it’s too early to share the messaging of the dangers and the harms of it.”

Fentanyl has been a leading cause of overdose deaths in recent years. But data released last June by the Office of Drug Control Policy revealed a decline in opioid overdose rates, marking a positive turn in the fight against the ongoing drug epidemic. Health officials attribute the positive trend to a combination of factors, including expanded availability of naloxone. Blatt compared training for the use of naloxone products, such as Narcan, to first aid and CPR.

“Sadly, the world we live in now, it may be a matter of the student learns to use it, because they’re going to have to use it on mom or dad at home when they can’t wake up their parents or something,” she said.

The bill was amended to include heroin and other opioids in the new mandated education, and now goes to the House for its consideration.

House Education also discussed:

HB 5405, Providing additional professional development and support to West Virginia educators through teacher and leader induction and professional growth.
HB 5553, To provide and change graduation requirements and change duties relating to academic content standards.
HB 5607, Relating to public charter school’s application for funding
HB 5650, Allow suspended school personnel to enter school property functions open to the public.
SB 507, Relating to repeal of WV EDGE.

In the Senate

The Senate Education Committee focused on one Senate bill and two House bills Thursday morning.

House Bill 4860, which originally freed general education teachers from documenting special education accommodations, was hotly debated when it passed through the House Education Committee Jan. 22. Bill sponsor Del. Elliot Pritt, R-Fayette, a middle school teacher, called existing documentation requirements onerous, while critics of the bill raised concern that the bill would open the door for shirking of legal responsibilities to special education students.

Thursday morning, the Senate Education Committee changed the bill to re-introduce some documentation requirements for all teachers. Pritt was on hand to approve of the changes.

“In Fayette County, many other counties right now, we’re required to complete just an onerous amount of daily paperwork to prove that we’re already doing what we’re required to do by law in the first place,” he said. “I spoke with Chairwoman Grady and have agreed with the changes he’s proposed to the bill. It still equals a desired outcome of less onerous paperwork and but still meets, I guess, addresses the concerns that some people had about there being no daily documentation.”

The bill now heads to the full Senate for consideration.

The Senate Education Committee also discussed:

SB 727 – Revising process for county boards of education to hire support staff
HB 4768 – Relating to increasing the number of out- of-state medical students receiving in-state tuition rates who agree to practice for a specific time within West Virginia.

Lawmakers Legalize Drug Testing Strips

A bill to legalize drug test strips passed both chambers last week.

A drug test strip is a small strip of paper that can detect the presence of cutting agents, like fentanyl, in all different kinds of drugs.

Under the current state code, drug testing strips are considered drug paraphernalia. This means someone who is found in possession of drugs can be additionally charged for possession of drug paraphernalia if they have drug testing strips.

Senate Bill 269 removes drug testing strips from the state’s list of drug paraphernalia. It passed the Senate on Tuesday and the House of Delegates on Friday. The bill has gone to Gov. Jim Justice’s desk for his signature.

Lawmakers passed a similar bill in 2022, exempting testing strips that detect fentanyl from that statute. House Bill 4373 went into effect in June of that year.

Proponents of the bill like Iris Sidikman (they/them), harm reduction program director for the Women’s Health Center in Charleston, say it could save lives.

They said while the fentanyl testing strips have been useful, the newest cutting agent, xylazine is the most requested test strip. Under current state law, it would be illegal for the clinic to distribute xylazine tests.

“The most immediate thing that this legislation would allow is for us to distribute xylazine test strips, which many people have asked me about here at the clinic as part of our Harm Reduction Program. People are interested in them,” Sidikman said.

According to the Bureau for Public Health’s Drug Overdose Mortality report, in 2021 fentanyl and fentanyl analogs were involved in 76 percent of all drug overdose deaths occurring in West Virginia, up from 58 percent in 2017.

According to a June 2023 report from the Centers for Disease Control and Prevention (CDC) brief, in 2021, the highest rate of drug overdose deaths involving xylazine occurred in Region 3, which includes Delaware, the District of Columbia, Maryland, Pennsylvania, Virginia, and West Virginia.

Fentanyl was the most frequently co-occurring drug mentioned on xylazine death records between 2018 and 2021.

Sidikman said people knowing what is in their drugs allows them to use more safely and better respond to overdoses around them.

“I think that they allow people to make better, more informed decisions about their health and what they do with their bodies and I think that that’s a good thing,” Sidikman said.

Sidikman said the harm reduction program aims to provide people with the tools necessary to stay healthy and safe while they navigate their lives.

“Whether or not they choose to end their substance use, reduce their substance use whatever they choose,” Sidikman said. “In order for people to be able to make positive changes in their life, they have to be alive.”

Sen. Eric Tarr, R-Putnam, was the only legislator to vote against Senate Bill 269.

“So in spite of all the efforts that we’ve made on these enablement measures, and that’s what I see, this is just, it’s another enablement feel-good measure,” Tarr said. “We are seeing still an escalation of our population that is using drugs and being significantly harmed by them.”

Tarr said he wants West Virginia to be the last place someone would want to use or sell drugs.

“West Virginia ought to be the absolute worst place in the country to be involved in the drug industry, illicit drug industry,” Tarr said. “This should be the absolute last place in the world you want to come to do drugs, sell drugs, be busted for drugs, and frankly, for rehab, because our rehab has been an abysmal failure.”

Sidikman said the legalization of all drug testing strips would allow them and their team to stay ahead and the newest cutting agents.

“If there is a new drug that enters the supply that we that testing strips are developed for, we would automatically be able to give those out and we wouldn’t have to wait and go back to the legislature and get those legalized before being able to give them out,” Sidikman said.

Appalachia Health News is a project of West Virginia Public Broadcasting with support from Charleston Area Medical Center and Marshall Health.

22 Pounds Of Fentanyl Seized In Major Eastern Panhandle Drug Bust

The investigation yielded 10 kilograms, or 22 pounds, of fentanyl, along with cocaine, methamphetamine, firearms, and hundreds of thousands of dollars in assets.

Federal agents say a multi-state drug trafficking operation based in the Eastern Panhandle has been terminated.

Eighty-two people have been indicted by a federal grand jury for a drug trafficking syndicate that distributed fentanyl, methamphetamine, and cocaine in the Eastern Panhandle.

Following the large-scale arrest operation in West Virginia, Virginia and Maryland, 11 of the 82 defendants are still at-large.

In a press release, the U.S. Attorney’s Office noted that drug ring leaders supplied others with large quantities of fentanyl capsules and powder for redistribution in Berkeley and Jefferson Counties.

The investigation yielded 10 kilograms, or 22 pounds, of fentanyl, along with cocaine, methamphetamine, firearms, and hundreds of thousands of dollars in assets.

The collaborative investigating effort involved dozens of federal, state and local law enforcement agencies.

A listing of the defendants still-at-large and the agencies involved in the investigation can be found here.

Ihlenfeld To Chair Washington-Baltimore Drug Trafficking Board

In 2022, the units disrupted the sale of more than $100 million of drugs, including fentanyl and methamphetamine.

U.S. Attorney William Ihlenfeld has been appointed chair of the Washington-Baltimore High Intensity Drug Trafficking Area (HIDTA) executive board.

That board supports 43 drug task forces in West Virginia, Virginia, Maryland and the District of Columbia. In addition to drug seizures, they also bolster treatment and prevention efforts.

In 2022, the units disrupted the sale of more than $100 million of drugs, including fentanyl and methamphetamine.

Ihlenfeld, the U.S. attorney for the northern district of West Virginia, said he’d work to strengthen the response to the threat of Mexican drug cartels.

Ihlenfeld previously served as chair of the Appalachian High Intensity Drug Trafficking Area. That includes parts of West Virginia, Virginia, Kentucky and Tennessee.

Recent Statistics Show Decline In Opioid Overdose Rates

According to provisional data, the state’s overdose rate fell from February 2022 to February 2023. The data shows that opioid overdose rates have dropped by approximately 8 percent, marking the most substantial decrease since the onset of the COVID-19 pandemic.

Recent data from the Office of Drug Control Policy has revealed a decline in opioid overdose rates, marking a positive turn in the fight against the ongoing drug epidemic.

West Virginia overdose rates are slowly falling to pre-pandemic levels. Advocates say while this data is preliminary, this improvement is in part credited to in-person harm reduction services resuming after the COVID-19 pandemic.

“Yes, we are seeing less people overdose, and I think there’s a variety of reasons for that,” Michael Haney, director of PROACT, said. “I think West Virginia has done an excellent job in keeping the substance use problem in sight.” PROACT is an addiction treatment center in Huntington.

Health officials attribute the positive trend to a combination of factors, including expanded availability of naloxone, a medication that reverses opioid overdoses, as well as the implementation of harm reduction programs. Harm reduction refers to a set of practical strategies and ideas aimed at reducing negative consequences associated with drug use.

“The drug problem has been there for decades. I think it really didn’t get people’s attention until you suddenly had people in large numbers dying, and you can’t attribute it to anything else, it was obviously the drugs doing it,” Haney said. “I think that calling attention to that, supporting treatment efforts, encouraging people to get into treatment. I think medication-assisted treatment has helped a great deal.”

West Virginia was one of only eight states in the nation predicted to see a decline in overdose fatalities in 2022. While the data is still preliminary, some advocates are encouraged by the success of harm reduction programs and public education since the end of the Public Health Emergency and COVID-19 pandemic.

According to the Center for Disease Control and Prevention’s Fatal Overdose Data Dashboard, West Virginia lost 1,453 people to overdose deaths in 2021.

A Changing Landscape

Lyn O’Connell, associate director for the Division of Addiction Sciences at Marshall University’s Joan C. Edwards School of Medicine, said it is important to note only four months of data are available for 2023.

“We do know that drug trends vary throughout the annual calendar year with some rhyme and reason and other times without much explanation,” O’Connell said. “We do suspect that drug overdose deaths are changing in that the type of drugs being utilized are changing.”

Of those deaths, 1,146 were attributed to illicitly manufactured fentanyl, 103 to heroin, and 295 to prescription opioids. Overdoses occur with other drug types as well, including stimulants, to which 949 West Virginians lost their lives in 2021.

O’Connell said PROACT, Project Hope and programs like it had made significant amounts of progress in her community in 2019.

“The pandemic destroyed that. We had to pull a lot of people out of public spaces,” O’Connell said. “In general, as a community, people resorted to substance use, because they didn’t have to get up and go to work. It’s often a disease of despair, and it was very easy to feel despair during 2020 and 2021 especially. People lost their jobs, so it might be easy to turn back to drug use or selling drugs.”

In 2019, West Virginia lost 870 lives to drug overdoses, according to the Centers for Disease Control and Prevention (CDC). During the COVID-19 pandemic, from 2019 to 2022, the state’s overdose death rate went from 870 to 1,453, a 67 percent increase.

“So we built on it over the past year, but it was going to take a while for us to see those things go into effect again,” O’Connell said. “I think the hope is that we do stabilize and or see a downward trend.”

Haney said isolation encourages use and is one of the major problems with substance use disorders. Alternatively, peer recovery programs like the ones offered at PROACT, encourage people with substance use disorder to interact with fellow peers in recovery.

“Now that we’re coming out of COVID, we’re back to doing in-person services, people are going too, and a lot of things happen when you do in-person services,” Haney said. “There is that sense of accountability that patients have when they’re going to treatment. They also get to see other people who are in treatment, and they have that sense of shared experience.”

Advocates say a rise in methamphetamine use is concerning and took the lives of 786 West Virginians in 2021.

“There’s other factors, there’s the use of methamphetamine, the use of xylazine, the use of alcohol or marijuana,” O’Connell said. “And so there are other things that impact how we can determine the effectiveness of, or if there is any decrease because there are just so many factors at play.”

Five of the most frequently occurring opioids and stimulants – alone or in combination – accounted for 71.5 percent of overdose deaths in 2021. Illicitly manufactured fentanyl and methamphetamine topped the list with 28.8 percent of deaths.

The use of multiple drugs at once accounted for 52.1 percent of 2021’s overdose deaths on opioids and stimulants.

Erin Winstanley is a research scientist in the department and associate professor at West Virginia University in the Department of Psychiatry.

She also encouraged vigilance, especially against new cutting agents appearing each day.

“I think many clinical researchers and researchers working in the field of addiction are concerned about the increasing number of people using illicitly manufactured fentanyl,” Winstanley said.

While the decline in opioid overdose rates is undoubtedly positive, experts caution against complacency.

“I think from the national perspective, it is too early to say whether overdose deaths are declining,” Winstanley said. “So it does appear that the numbers are on a downward trend. But it isn’t clear if they’re going to return to a pre-pandemic level.”

Appalachia Health News is a project of West Virginia Public Broadcasting with support from Charleston Area Medical Center and Marshall Health.