MORGANTOWN, W.Va. (AP) - West Virginia leads the nation in the rate of fatal drug overdoses, and a report released Monday says that rate is now six times higher than it was about a decade ago.
But the Trust for America's Health also gives West Virginia high marks for trying to tackle the problem, noting the state is using eight of 10 promising strategies to curb prescription drug abuse.
It says only two strategies are lacking: Good Samaritan laws that offer immunity or lighter sentencing for people who are trying to help themselves or others from overdosing; and a rescue-drug law that would give lay people access to naloxone, a drug that can be used to counteract an overdose.
The majority of fatal overdoses in West Virginia involve prescription drugs, such as OxyContin.
The report found 28.9 overdose deaths per 100,000 people in 2010 in West Virginia, the majority of those involving prescription drugs. That's 605 percent higher than in 1999, when the fatal overdose rate was just 4.1 per 100,000 people.
The other states in the top three were New Mexico, with 23.8 per 100,000 people, and Kentucky with 23.6.
"It is absolutely the biggest crime problem in my district," said U.S. Attorney Booth Goodwin, chief federal prosecutor in southern West Virginia. "It's also the biggest public health problem. And it drives so many other aspects of our crime problem."
Addicts need to get high, so they break into homes to steal either drugs from the medicine cabinet or money to buy them from someone else, he said.
Nationwide, the report says, prescription drug overdose deaths now outnumber those from heroin and cocaine combined.
And in 29 states, including West Virginia and the District of Columbia, more people die from drug overdoses than from motor vehicle accidents, the report says.
To help curb the supply, West Virginia regularly holds drug take-back days to help people safely dispose of medications, Goodwin said, because more than 70 percent of the drugs being abused are coming from friends and family - not street dealers.
"That's made it a very difficult problem for us to address," he said. Traditional strategies of going after street-level dealers, then regional suppliers and then a kingpin don't apply to prescription drugs.
"It's really unlike any drug problem we've ever seen," he said.
Jeffrey Levi, executive director of the Trust for America's Health, says the epidemic "requires nothing short of a full-scale response - starting with prevention and education all the way through to expanding and modernizing treatment."
Levi said abuse of prescription painkillers alone costs the U.S. an estimated $53.4 billion in criminal justice and medical costs, as well as lost productivity. Only 1 in 10 Americans with a drug problem receives treatment.
The trust says some strategies to curb the problem appear to be working, including public awareness, more treatment options, and Prescription Drug Monitoring Programs that provide real-time interstate information that can help identify so-called problem prescribers and so-called "doctor shoppers," people who visit multiple doctors to get more prescriptions for the same drug.
The report, funded by a grant from the Robert Wood Johnson Foundation, says a national survey found the number of Americans abusing prescription drugs dipped from 7 million in 2010 to 6.1 in 2011.
But Goodwin said that as manufacturers reformulate drugs to make them harder to crush and snort, and the price of pills rises, an alarming number of addicts are shifting to heroin for a cheaper and even riskier high. Heroin seizures by drug task forces more than quadrupled from 2011 to 2012.
Goodwin has posted a 17-minute video online that makes the problem personal. He shows it in schools, and he hopes every family in West Virginia will sit with their children to watch. The story of a father who lost two girls to a drugged driver is intertwined with that of a young woman describing her gradual descent into painkiller addiction, then heroin, then jail.
"Kids don't go straight to shooting up drugs with a syringe. They have to start off with that downward spiral," Goodwin said, "popping pills, crushing them and snorting them and getting a faster high, then shooting up. And then they move on to heroin."
Take prescription drugs out of the equation, Goodwin said, and that path is disrupted.
"It's a road kids will not go down if the only thing that's available is heroin."