CHARLESTON — With drug overdose deaths dropping in West Virginia, Attorney General Patrick Morrisey is using all the powers available to him to continue reversing the state’s substance use disorder crisis.

From joint letters to President Joe Biden and federal officials to reclassify certain drugs, to supervising the formation of a foundation to distribute more than $1 billion in opioid settlement cash between counties and cities, Morrisey said it is important to get every detail right.

“A lot of this is a little bit of a game of whack-a-mole. You hit one thing and something else pops up,” Morrisey said Friday morning in an interview in the attorney general’s law library.

“What I’ve found over the last 10 and a half years is that certain regions of the state have a prevalence with a particular form of drug product,” Morrisey said. “Sometimes one region of the state would be raging with a heroin problem while the other was really dealing with meth and then fentanyl … It warrants constant attention because if you don’t have your guard up for a while, any of the reduction in overdose deaths that we’ve seen could be reversed almost immediately.”

Earlier this week, the White House released a national response plan to address the growing illicit use of fentanyl, a synthetic opioid more powerful than morphine used to treat extreme pain, mixed with another drug, xylazine. Also known as Tranq, xylazine is a sedative used as a horse tranquilizer.

Dr. Rahul Gupta, the director of the White House Office of National Drug Control Policy, designated fentanyl mixed with xylazine as an emerging threat to the U.S. in April. Gupta previously served as state health officer and commissioner of the Bureau of Public Health within the Department of Health and Human Resources under governors Earl Ray Tomblin and Jim Justice.

“Since we announced the emerging drug threat earlier this year, we’ve been working tirelessly to create the best plan of attack to address this dangerous and deadly substance head-on,” Gupta said. “Now, with this National Response Plan, we are launching coordinated efforts across all of the government to ensure we are using every lever we have to protect public health and public safety, and save lives.”

The national response plan focuses on six pillars: developing new testing practices; data collection; evidence-based prevention, harm reduction, and treatment; identifying the supply chain and putting pressure to reduce supply; reviewing the scheduling of the drugs; and research.

Morrisey said he was concerned about xylazine, especially since naloxone cannot reverse the effects of an overdose of xylazine. Naloxone, as known as Narcan, can be administered to someone as a nasal spray or injection to reverse an opioid overdose. Naloxone has been widely distributed across the state to first responders, schools, medical professionals, and even businesses and nonprofits.

“One of the things that has to occur next is follow-up with the administration and follow-up with the medical community as to ways we can combat this new zombie drug, this Tranq,” Morrisey said. “We’ve just invested significantly in naloxone as a state … That requires some additional analysis. And I know I plan to follow up on that because that bothers me if naloxone is not going to be able to handle this.”

In June, a 23-state coalition that included Morrisey wrote a letter to Republican and Democratic U.S. Senate leaders urging them to support passage of HR 467, the HALT Fentanyl Act, which would permanently make fentanyl a schedule 1 drug alongside heroin, LSD, marijuana, ecstasy, and other drugs. Schedule 1 drugs are drugs that have a high potential for abuse with no acceptable medical use and are unsafe to use even under medical supervision.

In May, Morrisey joined a coalition of 39 attorneys general from other states urging both the U.S. Senate and House of Representatives to pass the S. 993 and H.R. 1839–the Combating Illicit Xylazine Act. The bill would classify xylazine as a controlled substance, making it unlawful to distribute.

“I think it’s encouraging that they’re considering scheduling it. I think that’s great,” Morrisey said. “I’m going to talk to some of my colleagues and we’ll see if we can go back and press again for Congress to move forward and do it. Congress doesn’t always move as fast as we’d like, but this shouldn’t be controversial.”

“We’ve been pressing,” said U.S. Sen. Shelley Moore Capito, R-W.Va., during a virtual press conference with West Virginia reporters Thursday. “We want to move it up on the schedule of drugs, so it’s more difficult to get. … I’m glad they have a plan. I hope that it works. I think that they’ve been slow to motivate, but in this case, I think they’re a little bit quicker.”

The West Virginia Legislature passed Senate Bill 546, whose lead sponsor was state Sen. Mike Stuart, R-Kanawha — the former U.S. Attorney for the Southern District of West Virginia and a Republican candidate for Attorney General in 2024 – adding xylazine to the state’s controlled substance list.

West Virginia has been ravaged by a substance use disorder epidemic that spiked again during the COVID-19 pandemic. For fentanyl alone, West Virginia saw a 120% increase in overdose deaths attributed to fentanyl in a two-year period according to DHHR, from 515 deaths in 2019 to 1,134 deaths in 2021.

According to the U.S. Centers for Disease Control and Prevention, West Virginia has the highest drug overdose mortality rate in the nation in 2021 at 90.1, with 1,510 deaths reported that year. But there are signs that drug overdose deaths in West Virginia have peaked. According to the CDC, West Virginia’s reported number of drug overdose deaths decreased by 13%, from 1,472 in February 2022 to 1,279 in February 2023. The national decrease during that same 12-month period was only 3%.

Kickstarting the state’s substance use disorder crisis was the use of prescription painkillers, such as oxycodone and hydrocodone. Reporting by former Charleston Gazette-Mail reporter Eric Eyre found that during one six-year period, more than 780 million hydrocodone and oxycodone pills were shipped to the state.

Morrisey, a former congressional attorney and lobbyist for pharmaceutical companies and trade groups, was elected as Attorney General in 2012. Since then, Morrisey has led civil lawsuits against some of his prior lobbying clients for their part in flooding the state with prescription painkillers.

With May’s $68 million settlement with Kroger for oversupplying opioids in West Virginia, the state has nearly $1 billion in settlements with multiple opioid manufacturers, distributors, and prescribers. Now, the work to fairly distribute those dollars to the communities hardest hit by the drug crisis has begun.

Morrisey has been traveling the state since last week attending regional meetings to select representatives to the new West Virginia First Foundation, a public-private organization that will be responsible for distributing opioid settlement funds. The foundation would divide settlements from opioid manufacturers and distributors, with 24.5% going to cities and counties, 3% going to the Attorney General’s Office and 72.5% going to the West Virginia First Foundation.

Once funds from future settlements are distributed, the funds can be used by cities and counties for developing programs for substance abuse avoidance, research and education; funding for law enforcement to combat the sale and distribution of drugs; and substance abuse treatment and recovery. All 55 counties and more than 220 cities and municipalities have signed on to the West Virginia First memorandum of understanding.

Morrisey said the foundation is more than simply spreading money around. He believes the foundation can work proactively to develop policies and fund ideas to further mitigate the state’s substance use disorder crisis and prevent future spikes. Morrisey foresees the foundation developing data-sharing agreements with law enforcement agencies, the medical community, and DHHR to spot trends. He also foresees programs that can help put West Virginians back to work.

“We have to make sure that we’re even more proactive, but we also don’t make stupid mistakes as well,” Morrisey said. “I view the West Virginia First Foundation as kind of the magnet … That’s why I call this the crown jewel. It’s not just the money. Money obviously is important. You have to have enough to address it. But money doesn’t solve problems. It’s the correct amount of resources with the right expertise and problem solving. That’s the hope for this foundation.”

Six multi-county regions have appointed their individual foundation members by a Monday, July 17, deadline. Jonathan Board, the vice president of external affairs at Mon Health System, will represent North Central West Virginia. Parkersburg Mayor Tom Joyce will represent the Mid-Ohio Valley. Dr. Matthew Christiansen, the State Health Officer, will represent Kanawha and Cabell counties and parts of southern West Virginia.

Dr. Steven L. Corder, medical director for Northwood Health Systems, will represent the Northern Panhandle. Micheal “Tony” Kelly, a doctor based in Welch, will represent the other half of Southern West Virginia counties. And Timothy Czaja, director of Berkeley County Community Corrections, will represent Eastern Panhandle and Potomac Highlands counties.

Five of the board members are appointed by the governor with the advice and consent of the state Senate, but Justice has not yet announced his appointees. A spokesperson for Justice said the deadline doesn’t apply to the Governor’s picks, but they should be announced soon.

With Christiansen, who works for a state department in the executive branch under Justice’s control, concerns have been raised about whether the governor is stacking the new foundation, making it a political tool during an election year. Justice is finishing up his second term as governor and seeking the Republican nomination for U.S. Senate. Morrisey himself is a Republican candidate for governor.

Morrisey stressed that the foundation is still far from being able to distribute monies. The Attorney General’s Office has the responsibility to hire an executive director of the foundation, though the foundation must approve the hire. The governor’s appointments must be confirmed by the state Senate. And there are still some outstanding technical issues in regard to some of the settlements before those monies can be freed up.

“There will be an intense amount of lobbying to try to get people just to fund the latest project of the day,” Morrisey said. “My hope is that that won’t happen. Now the attorney general’s office is not in charge of this process. We have oversight over it, so we’re going to encourage people to do things that are smart, sensible, best practices, and also that fund projects that don’t have these major cliffs.”