Many US communities are facing an epidemic of opioid and heroin abuse that is straining resources from police, to jails, to emergency medical personnel and treatment centers.
West Virginia, a mountainous state of less than two million people, is among the hardest hit, given the economic hardship in an area once dominated by coal mining, but it shares much in common with other communities impacted by the crisis.
Here are some key facts about the opioid epidemic, from the US Centers for Disease Control, US Drug Enforcement Administration, the Charleston Gazette-Mail and other reports:
-- Overdoses of opioids, including prescription drugs and heroin, killed more than 33,000 people in the United States in 2015 -- the latest year for which data are available. That was more than any year on record
-- Of the total deaths in 2015, nearly 13,000 were caused by heroin overdoses
-- 80 percent of people addicted to heroin started by using prescription drugs
-- West Virginia has by far the highest rate of death from opioid overdoses in the country: 41.5 deaths per 100,000 people in 2015, a jump of nearly 17 from the prior year
-- New Hampshire trailed West Virginia with 34.3 deaths per 100,000 population, but saw the biggest increase from the prior year, when the rate was 26.2
-- America's most populous state, California had the largest total number of overdose deaths at 4,659 in 2015, followed by Ohio with 3,310, which like West Virginia has been hard hit by the epidemic
-- Of the total deaths from opioids, more than 7,000 were people over the age of 45, including 700 over the age of 65, and 800 under the age of 25 *
-- Nearly 11,000 of those who died of overdoses were white, non-Hispanic *
-- The death rate from synthetic opioids, like fentanyl, surged 72 percent in 2015, and heroin death rates increased almost 21 percent
-- Since 1999, sales of prescription opioids in the United States have quadrupled
-- Drug companies over six years shipped 780 million prescription pain pills to West Virginia, a state of less than two million, half of those came from the three largest US drug companies: McKesson, Cardinal Health and AmerisourceBergen
-- About 1 in 10 babies born in Huntington, West Virginia's main hospital are born addicted to opioids -- suffering from Neonatal Abstinence Syndrome (NAS) -- 13 times the national rate.
* Note: the CDC data breakdowns of age and ethnicity cover only the 28 states with excellent, very good or good rates