A gubernatorial candidate challenging Gov. Jim Justice in the Republican primary released a plan Thursday to combat substance abuse in West Virginia.
In a four-page policy memorandum, Woody Thrasher proposes breaking up the Department of Health and Human Resources, imposing a death penalty on those found guilty of drug crimes leading to death, expanding access to long-term recovery and re-emphasizing abstinence-based programs alongside Medication Assisted Treatment.
“A successful substance use disorder plan must be realistic, comprehensive and long term to sustain the long-term effort required for success,” Thrasher said in the platform, released online. “It must include support and treatment for those who decide they are ‘ready’ to avail themselves of treatment and recovery services.”
In terms of enforcement, Thrasher said, West Virginia must become known as “a state drug dealers fear,” namely by imposing a “hard labor” penalty on dealers and holding users accountable for their actions, should they decline treatment.
He also called for demolishing dilapidated structures before they become “drug hangouts,” giving more resources to prosecutors for drug crimes and considering the death penalty for crimes resulting in death, including the sale of tainted drugs. West Virginia abolished capital punishment in 1965.
Given a surge in rates of grandparents raising children in connection with the drug epidemic, Thrasher’s plan calls for transportation, respite care and training to assist the population. Likewise, he called for breaking up the DHHR, perhaps into the different bureaus of which it’s comprised.
He also called for the state’s “heavy reliance” on buprenorphine — an opioid used in MAT for opioid dependence — to be “closely scrutinized.” He said the drug often is diverted for recreational use, and the state should shift some emphasis to non-MAT therapies.
“As governor, I will lead cabinet meetings on substance abuse twice a week,” he said. “Work groups, charged with weekly deliverables, will target each aspect of the crisis. Solving this crisis will take a dynamic process that will evolve over time.”
Medical professionals and health care advocates offered generally warm takes on Thrasher’s ideas. While they were more critical of the emphasis on enforcement and noted some missing points, most commended the plan for its focus on long-term care, assisting grandparents and highlighting prevention.
“Overall, it seems like he was in the right direction, it just needs fine-tuning and looking at the research backing up what he wants to do,” said Dr. Joshua Carter, who directs the MAT program for Cabin Creek Health Systems.
Carter praised the platform for acknowledging the rise of methamphetamine as a threat to public health and recognizing problems with insurance companies covering detox programs.
However, he cautioned against any strategy too reliant on law enforcement. He said this only affects the supply chain, not demand, causing prices to rise.
“The harder we crack down on it,” he said, “the more lucrative it gets for the people who are selling.”
Dr. Michael Brumage, medical director for Cabin Creek and a former director of the Kanawha-Charleston Health Department, held similar thoughts. He said drug dealing and unhygienic behavior can’t be tolerated but that a purely punitive approach to substance abuse has never worked in the United States.
While improving access to long-term recovery is important, he said, any plan also should ensure some kind of follow-up for that population. He said that, sometimes, people relapse after long-term recovery — with lower tolerances following the period of sobriety.
“There is a risk for people who are in long-term treatment who leave long-term to go back to their previous environment, where they are at risk for overdose,” Brumage said.
Although MAT might be worthy of scrutiny, he said, well-functioning programs can work wonders, and should not be written off.
“This can be done well,” Brumage said, “and when it’s done well, it’s life-saving.”
Kelli Caseman, director of child health for West Virginians for Affordable Health Care, an advocacy group, praised the plan’s emphasis on prevention and noted a lack of public-private partnerships or any cohesive state effort on the subject.
Additionally, she said, Thrasher is correct in identifying the need for supporting grandparents who have had to step in and raise their children’s children.
However, she said, it’s not just a foster care issue as much as it is a health care issue, whether the concern is neonatal abstinence syndrome, adverse childhood experiences or developmental displays.
“These are health care issues,” she said. “An evidence-based prevention program doesn’t help mitigate ACEs or foster resilience. I would love to see more candidates focus on these things.”