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The devastating personal toll of West Virginia’s opioid crisis

“I don’t think there is a family that’s not touched by the disease.”

PETERSBURG, W.Va. — I haven’t come to talk about the opioid crisis. But our conversation, as with most of my conversations here, eventually turns to drugs, and the devastating toll they’ve taken on this community. 

I’m sitting on the couch in Charlie Combs’ living room in Cabins, just outside Petersburg, West Virginia. On the table beside me is a Bible, and on the wall in front of me are pictures of Combs’ family, including his two sons, Brent and Ryan.

An artist’s rendering of Brent, looking stolid in a cowboy hat, strikes me as very well done. “Yeah,” says his father, a retired forest ranger and water resource inspector, “but they didn’t get the eyes quite right.”

I’ve come primarily to talk about President Trump, who in the 2016 election won the votes of 88 percent of Grant County voters, a higher share than in any of West Virginia’s other 54 counties.

But then I mention the opioid epidemic, and ask Combs about the effect it’s had on his rural community. “My son died of a drug overdose a year ago,” Combs informs me of Brent.

Combs says that Brent had been struggling with an addiction that may have been precipitated by his parents’ divorce. “Here was a young man, athletically and intellectually gifted,” he says. “He fell in with the wrong people, just about the time of the divorce. We didn’t know it. I’m as dumb as a hog on drugs. Most of this stuff had to be explained to me.”

At the time, Combs didn’t understand that opioids activate the reward regions of the brain, causing intense pleasure and “that nothing else in life was giving [Brent] this pleasure.”

Combs says that his son thought he wouldn’t allow the drugs to get the better of him. “My son was smart, an IQ in the 130s. [Brent and his friends] felt they were smarter, had more information.”

Brent became addicted, got clean, then relapsed. Eventually he was arrested for trying to buy drugs in Baltimore. He went to prison, got out, then relapsed again.

It was fentanyl that finally did it.

“Fentanyl killed my son,” says Combs. “It’s here in Petersburg. It’s everywhere.”


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Oct. 26, Trump declared a public health emergency to address America’s drug crisis. By making the declaration, he directed federal agencies to provide more grant money to combat the epidemic. The Trump administration will also work with Congress to increase funding for recovery programs.

When people talk about the drug crisis, they’re generally referring to the increase in the use and abuse of prescription and nonprescription painkillers over the last two decades. These drugs include strong painkillers such as OxyContin as well as the ultra-strong fentanyl, a synthetic opioid that’s as much as 100 times as potent as morphine and can kill in seconds. Fentanyl is so potent that first responders can overdose just by being in close proximity to the drug. The use of heroin, which is also an opioid, and methamphetamines are also at crisis levels.

According to the Drug Enforcement Administration, overdose deaths have reached epidemic proportions. Drug overdose deaths are now the leading cause of accidental death in America, and the leading cause of death of Americans under age 50 

To put the scale of the crisis into perspective, 62,000 Americans died from drug overdoses in 2016, more than 15 times the number in 1999 and more than the number of Americans who died in the Vietnam and Iraq wars combined. Some public health experts estimate that the epidemic could kill more than half a million people over the next decade.

West Virginia is sometimes called Ground Zero for the opioid crisis. Its overdose death rate is double the national average, and by far the highest of any state in the country. The state spent $1 million just on the transportation of corpses after overdoses in the last fiscal year.

Things have gotten so bad that some drug dealers are carrying NARCAN, a medication that blocks the effects of opioids in an overdose, to give or sell to customers who overdose. The worst customer is a dead customer, they must figure.

Petersburg, the only city in Grant County, has been devastated by the crisis. In December, local pharmacy Judy’s Drug Store was sued by the West Virginia attorney general for selling too many prescription painkillers. The lawsuit alleges that over a six-year period the drug store sold more than 1.8 million doses of addictive opioids that had no medical purpose. 

The crisis in Petersburg is so acute that it is the subject of a documentary film, “Petersburg” (watch the trailer here), which chronicles how drugs took hold in this small city of 2,500 people. The film features Breanne McUlty, who grew up around drugs, began using them as a teenager and, still as a teenager, became one of the town’s leading dealers.


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McUlty sold it all—morphine, pain pills, meth, black tar heroin. The drugs were everywhere, she told me in a phone interview. Her father, boyfriend, friends—they were all using, and many were also selling. “It was like passing out candy on Halloween,” she said. “I can’t say there isn’t one person I know who hasn’t been strung out.”

McUlty was eventually caught and served several years in prison. She dreaded her release because she feared the environment that awaited her upon her return. She had reason to be scared. “I met my son’s father, also a recovering addict,” she said of what happened after her release. “I got pregnant really quickly and moved in really quickly. More drugs in the house, and I was losing my mind. I was so mad at everybody.”

In June, McUlty moved to Georgia after the overdose death of a dear friend. “I wanted to change this fucked up situation,” she said about what finally prompted her to leave.

Everyone I encounter here seems to have at least one close friend or family member who has used or died from drugs. In Mia VanSant’s case, she doesn’t know a family member who hasn’t been an addict. “I’m the only person in my family right now who hasn’t had an active addiction,” she told me when I visited her at the offices of Burlington United Methodist Family Services.

VanSant connects the children of addicts with foster families. “Right now in West Virginia we’re at a crisis point,” she said. She estimates that 85 percent of her cases are the result of substance abuse. 

I also spoke with Carrie Fradiska, who runs a home for women in recovery. I asked VanSant and Fradiska how easy it is to obtain drugs in the area, and VanSant laughs. “You can walk down the street,” she said. “There were a couple of McDonald’s where you could go through the drive thru and get it in your happy meal,” Fradiska added. 

VaSant said that from her office in Martinsburg, which is further east on West Virginia’s Eastern Panhandle, “I can look out the window of my office and see people do drug deals.”

Later I met with Allen Evans and Bill Hamilton, who serve in the West Virginia House of Delegates. “I don’t think there is a family that’s not touched by the disease,” said Hamilton, who represents nearby Upshur County. “And addiction is a disease,” he said, adding that he has a son with a substance abuse problem. 

Evans, whose district includes Petersburg and much of Grant County, said that employers are unable to fill vacancies because of drug testing requirements. “Companies are interviewing 50 people and only 10 qualify,” he said. Evans and Hamilton agree that a public health emergency declaration is necessary to address the opioid crisis.


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Back in Cabins, Charlie Combs tells me he doubts that government is up to the task of addressing the drug crisis. “I don’t think the country has the morals and values to take an issue like this head one and deal with it,” he says. What bothers him most is that the big pharmaceutical companies are still irresponsibly producing the drugs and seem not to have been held to account.

Then Combs sits back in his chair a little and glances up at the portrait of his son. “It’s been a year on April 28,” he says, his eyes filling with tears, “and it’s still surreal.”

Read More: Pedaling to Pittsburgh

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