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I moved back to WV after almost 40 years around the world but mostly NoVA. I have to say I am astounded by the opioid numbers.

I guess the loss of theming jobs has a role but I blame the “drug intoxication” culture that grew out of the 1960s.
It’s been absorbed into our play-time as cool & the thing to do! My hometown mayor made the claim on the radio that 60% of Kanawha County residents are not hirable because they can’t pass an employment drug test.

When I came back I spent some time reconnecting with old friends. They all had a story of a direct family member - child or grandchild, nephew/grandnephew or neighbor etc. with a opioid addiction story. However none of the stories started out as “so-n-so” lost his/her job and they were so distraught they turned to alcohol drugs, opioids! Or had an industrial injury then treatment where one thing led to another then BAM addicted to opioids! In every case it was part of the youthful (even not so youthful!) partying having a good time etc.! Now this is the Charleston-Huntington area so it’s at the northern edge of the coalfields but it’s not that different plus the stories ranged through the state!

I really appreciate your viewpoints
They are valid and statistically relevant

I was just in Huntington last year at a funeral
The social decay was palpable
Shortly afterward a huge bust of Fentanyl occurred there

http://wvmetronews.com/2018/04/17/task-force-takes-down-detroit-to-huntington-drug-family

760 grams of heroin, 450 grams of fentanyl and 167 grams of cocaine.

I live in the mountains of Kentucky and we have the same issues with drug abuse and deaths as well. Obama’s declaring war on coal is still causing issues as many mines have not reopened yet.

I suspect the number of deaths being reported is actually low for drug overdoses. My mother-in-law works at a funeral home and many times I will see where a person under 50 has passed and she will ask if I knew them, sometimes yes, sometimes yes but hadn’t seen them since high school or no. Then I ask what happened and she will say overdose but the obit will read sudden illness or something similar. She said under age 50 over half are OD’s, just where she works alone.