Overdose deaths drop 42% in W.Va.

On Wednesday, a report was published in The New York Times that cited data released from the Centers for Disease Control and Prevention, the first bit of good news on the frontlines of the opioid crisis in America. 

That CDC report showed a significant drop across the United States in drug overdose deaths, a reduction of 25% from December 2023 to December 2024. In total, roughly 80,000 people died in 2024 compared to 106,881 the year prior. In West Virginia, the numbers were even more significant—a 42.4% drop, from 1,389 reported deaths to 800. 

“Now is not the time to take our foot off the pedal. If West Virginia is down [42%], that isn’t a rounding error. That’s significant,” said Sen. Shelley Moore Capito, R-W.Va.

Capito was energized by the statistics, noting she attributes the success of various programs aimed at curbing drug overdose deaths—largely by synthetic opioids like fentanyl, where deaths dropped across the U.S. by 6.3% from 76,282 to 48,422—such as grants provided by the Substance Abuse and Mental Health Services Administration (SAMHSA) as well as on-the-ground treatment by professionals and transitional housing. 

The former director of West Virginia’s Office of Drug Control Policy (ODCP), Dr. Matthew Christiansen, shared similar sentiments, noting that officials and communities have “doubled down” on addressing the core issues associated with the opioid epidemic in the state. And Christiansen played a significant role in that. 

Taking over the office in late 2020, just as the coronavirus pandemic was in full swing, Christiansen identified paths to support those battling substance use disorder, such as increased Naloxone distribution and creating links from early screening to care, even as overdose deaths began to increase significantly. 

“We were seeing drug overdoses climb; year over year, they were going up,” he said. “At the time, we felt that it was probably due to the disconnect that people weren’t able to access in-person services ... but what we found was that, after we reopened everything, drug overdoses continued to stay level, if not increase. 

"During that time frame, the illicit drug supply was getting more and more potent. Around that time, the supply was switching from predominantly heroin to predominantly fentanyl, so that may have accounted for the increase, potentially."

Christiansen and the ODCP’s efforts were paramount, increasing Naloxone distribution by more than 300% in the state, while also strengthening screenings in emergency departments and suggesting routes to care there, as opposed to the former system of revival, treatment and discharge.

“We wanted to make sure that everyone [who] went to an emergency department had access to, either on-site or by referral, quality addiction services,” he said, noting its success.

The ODCP also expanded the ability for quick response teams, those that enter communities within 72 hours after an overdose, to connect those using illicit drugs with addiction services, but the most important initiative Christiansen was proud of was his work with officials in the state corrections system to provide care for those incarcerated. 

“Because the prevalence of substance use disorder in correctional populations is so high, [we wanted] to make sure we were getting screenings for [everyone] … figuring out what they need, getting them started on treatment, referred to treatment either within the walls or when they get out and then doing some follow-up afterward,” he said. “I still hear about that program and the progress it’s made to help get people linked to services for addiction.”

Jefferson County Prosecuting Attorney Matt Harvey supported this, citing the effectiveness the county’s criminal justice system has had on helping those struggling with addiction, such as referring them to the former independent and now-defunct Jefferson Day Report Center—with services now spearheaded by Berkeley County’s DRC—while alleviating pressure on families. 

“The criminal justice system is uniquely positioned in many ways, [where] families don’t have an advantage. We have better leverage,” Harvey said. “I’m always encouraging families and friends to help their loved ones seek treatment, but if they get into the criminal justice system, we have tools available—supervision, drug testing—and the time to ensure that the treatments and recovery are sustained long enough that it makes a difference.” 

Harvey reported it could take, realistically, 12-18 months for someone battling addiction or substance use disorder to fully reintegrate into a community, while also reiterating the stress that it puts on families. That’s where, to him, unique resources available within the justice system’s purview or through community corrections can be far more effective. 

“That’s quite a burden on a family financially and emotionally,” he said. “How can you force a loved one to take a drug test? The criminal justice system and community corrections have a pretty good model to address that. And, people in the criminal justice system have in-depth knowledge and experiences that can help someone on their path. 

"It really makes a difference with people with lived experience; they seem to have a better way to connect with people [who are addicted] because they’ve walked that path.”

Yet, despite the good news that overdose deaths are decreasing, the country is still far from the finish line in the crisis. Total deaths are still higher than they were in December 2017, two months after President Donald Trump, then in his first term, declared the opioid crisis a National Emergency, freeing up grant money and applying certain powers for agencies to combat the epidemic. Then, deaths were trending just about 70,000, and, while there was a plateau from January 2018 to January 2020, COVID-19 led to an overwhelming, record number of deaths that continued to increase until this past year. 

West Virginia trended similarly, though results can be seen once Christiansen and the ODCP began attacking the crisis, as deaths slowly declined from 2021 to 2023, before the most recent dive. Currently, the numbers are around those reported in 2019.

Christiansen was transparent regarding reactions within public health when deaths began to trend downward in 2024, noting that it was hard to believe at first. 

“When the numbers first came out, we looked at each other in the public health world and thought clearly our data was wrong, that there was something we weren’t capturing or… that there was something wrong in the data that wasn’t allowing us to pick up on the numbers,” he said. “All of us, including those people in the field who have dedicated our careers to helping people with addiction and trying to get ourselves out of this mess, have been accustomed to the trauma of continuing to see these numbers go up over and over again.

"So the thought from a self-protective standpoint is to just assume that, first, the numbers are wrong but as we’ve seen the decline … we’ve looked at the data two ways from Tuesday, we’ve observed the trends as they’ve continued, we’ve talked to people on the ground and it’s real.” 

Simply, this isn’t a glitch; something is working. But what?

“I wish I had an easy answer on that,” he said about specific measures that aided in West Virginia’s overdose death drop-off. “I will say that I think that the idea that the sum of the parts is greater than the whole concept [is at play] here. When you have a community like Southern West Virginia—like Welch, Oceana or McDowell County where there aren’t any resources or addiction care continuums—when you start to build capacity there, it looks like a prevention program in a school; it looks like a recovery residence where people can go and be around other people who are trying to stay sober and off drugs.

"When you start to have that whole care continuum be built in a community like that, you get some synergy that doesn’t previously exist, where people can drop into that care continuum in the place that’s most appropriate to them. If they do have an issue or relapse, they can bounce back to an early part of that care continuum. I think we’ve hit a critical mass of services, specifically in West Virginia, but also across many parts of the country, where people are able to access services when they need them, where they need them—just the general accessibility of those things is up. I would add things in there like Naloxone access and others, and Naloxone is a critical part of all of this.” 

Both Christiansen and Capito agreed that another critical factor in the drop-off of deaths, both in West Virginia and across the country, concerns the illicit drug supply. Christiansen, though not understanding the root cause, is in contact with sources in Mexico who have direct lines to the cartels and drug trade. 

He explained that, first, the drugs coming across the border are seemingly “less potent” than they used to be, leading to a lower chance of overdose and death. This doesn’t mean that the number of users has declined, however, just that the drugs aren’t as concentrated as before.

“[A] reason it’s important is that it suggests that there’s something happening in the supply that’s not treatment related,” he said. “Our presuppositions have always been that drugs are always going to get more potent, and we’ve seen this when pills went from hydrocodone to oxycodone to fentanyl derivatives, and then people went to the illicit market and they were getting heroin, then illicit fentanyl, then carfentanil.

“The trend has always been an increase in potency, an increase in death and an increase in the addictive nature of illicit drugs on the market. For some reason, over the last year or so, there’s been some change. I don’t know what it is. I’ve talked to a lot of people in law enforcement, a lot of people who are in Mexico—journalists, mostly—that are connected to the people in and around the drug cartels and supply, and I don’t know the answer, but there’s something out there that’s causing a change in the drug supply which would be a completely novel concept to what our existing assumptions have been about the illicit drug supply and the behavior of drug cartels.”

One factor in overdose death reduction is simply that the amount of drugs that have been coming across the southern border has dramatically reduced. According to reporting by National Public Radio, the amount of fentanyl, specifically, seized by U.S. law enforcement agents on the southern border plummeted by 20% in 2024. 

The same report by NPR, as well as a piece by the Associated Press, points to one significant factor for both the reduction in drugs crossing the border and their potency dropping: Mexican President Claudia Sheinbaum. Sheinbaum has silently abandoned former President Andres Manuel Lopez Obrador’s “hugs, not bullets” policy, which essentially allowed the cartels to operate with impunity and take footholds throughout the country. 

The AP reports that, although the policy was intended to be used toward younger members caught up in the cartels, “a string of bloody confrontations” occurred during Sheinbaum’s first month in office. The increase in violence has also caught innocent bystanders in the crossfire, however, like on Day 11 of the new administration, where three innocent people were killed by Mexican Army and National Guard soldiers while in pursuit of suspected gunmen. Still, there have also been moments, according to the AP, where soldiers have killed suspected cartel members, such as an instance in Sheinbaum’s third week, where 19 cartel suspects were killed in Sinaloa, home of one of the most dangerous Mexican cartels. 

Capito also took a moment to praise President Trump, who she said has applied pressure to China to stop the export of chemicals used to make illicit fentanyl. She also said Trump’s pressure on Canada has reduced the flow of drugs, but reporting has shown that law enforcement and drug policy experts have reported that the country’s northern neighbor has little effect on fentanyl being smuggled in— as low as 1%, according to former Canadian Prime Minister Justin Trudeau, which has been supported by data sourced from the U.S. Drug Enforcement Administration. 

“This President has said, ‘No more fentanyl, China.’ That’s part of the tariff regime, also with Canada, because it’s been coming through the northern border. So I think you have disruptions in the supply chain and I think that’s what the President has put a big emphasis on,” Capito said. “I would imagine that he keeps that, but, at the same time, we need to fund drug courts, treatment, accessibility, the mental health that goes along with it.” 

And, as for China’s role, while the country has been hard to deal with regarding the disruption of exports of those chemicals to Mexico in recent years, it finally agreed to create and execute new regulations during Biden’s final months in office. Trump’s continued pressure likely plays a role, however, with all noted factors playing into the overall reduction. 

Harvey shared a final note on failures regarding smuggling fentanyl into the U.S., saying it’s “the most important thing,” in his mind.

“I’m not naive enough to think that we’re going to totally eradicate illicit drug use in our state or country,” he said. “However, the stuff that was coming here was so potent and deadly that it was just out of control. My work with the First Foundation, we have resources to put into prevention, enforcement and treatment, but it’s very frustrating when drugs of the caliber of fentanyl … that we can’t keep them out of the state. 

“We’re not a border state, but we have those problems. We’re impacted at a higher per capita rate than any state in the country. So, yes, if it stops coming across the border, it will have an impact in West Virginia.”

While the news of the drop in deaths is exciting, one glaring problem is rising over the horizon.

That is, according to The New York Times report, that a proposed budget circulating through agencies in Washington would cut funding for important programs within the U.S. Department of Health and Human Services, led by Robert F. Kennedy Jr., while rolling them into a new subdivision. First, there’s a suggested cut of $30 million to opioid surveillance programs; second, $1 billion is on the chopping block for SAMHSA grants, which Capito and Christiansen both praised as effective tools.

Capito has worked with Kennedy on other projects, such as restoring jobs at the NIOSH office in Morgantown, and, when asked if she would speak to or work with the secretary on ensuring that funding remains in place, she said that she plans on questioning the Secretary when he appears before the subcommittee she chairs overseeing DHHS. Generally, she expects Kennedy will maintain this funding. 

“This will be one of the questions that I will ask. And I think it’s a good question,” she said. “And I think the Secretary will. … I think part of what we’ll see is that this will be a part of an overall reorganization where maybe the names change as to what the funding is called, but I still think that the recognition in Washington today is that the money is better effectively spent if its sent to the states for them to make their own decisions. And that’s what we’ve been able to do. 

“We need to continue to do that. I congratulate the folks who have been on the ground trying to do the hard, hard work and for those who are in recovery. This is hard, hard work. But I’m glad to see the statistics are bearing out and that we’ve had some success. Then I’d go to the younger people on the prevention side, I’m talking grade schoolers. We need to keep that up because it’s a new generation coming through.”

When questioned about cuts by the Times, Christiansen relayed that if the rug is pulled out from under funding, “people and programs are going to fall through the cracks.” And, after sinking hundreds of billions of dollars into addiction, Christiansen is worried that the progress, which he reported to the Times he and others in the public health sphere have been waiting a decade to bear fruit, would take serious steps back. 

“The problem is huge and it continues, and the work continues,” he said. “The cuts, I would presume, would have happened if we had a decline in overdoses or not, based on the policy agenda of the Trump Administration. Where I sit today, it’s hard to say what the impacts will be, but what I have seen is that, in some of the CDC and SAMHSA programs, is that some of the research and evaluation components are being cut, which are the programs that tell us how effectively we’re spending the dollars that we’re already spending. That’s one of my biggest concerns, which is that it appears that the first things that are being defunded are the evaluate pieces that show us what’s working and what’s not. I will be the first to say that there are a lot of things the federal government could do better and more efficiently with regards to spending the huge budgets and getting it down to states that’s coordinated and effective, but if we do it in an non-strategic way, if we’re acting like all programs are equal and defunding them all by a certain percent … it’s going to be catastrophic. 

“If they’re targeted cuts towards programs that aren’t as effective after some analysis, then I wouldn’t have as much of a concern. I think that’s the best path forward, to look at which of these programs are the drivers behind the reduction in overdose death, and I’d propose we pull the money from those programs that are less successful and put it towards the ones that are shown to be working and really double down. If that were the case, the Trump Administration would be able to take credit for a doubling of this 40% reduction over the next couple of years.

“That would be the best case scenario, not just for the people of West Virginia, but it would also be a huge win for the Trump Administration.”