CHARLESTON, W.Va. - As bad as the state's prescription drug abuse problems are, there are medicines that may be able to blunt the addiction so treatment can take root. West Virginia has the highest rate of prescription drug overdose deaths of any state. But doctors here are increasingly treating addicts with chemicals called antagonists, which reduce the euphoria, the cravings and the chance of overdose.
Doctor Ed Eskew, an addiction specialist who advises the Kanawha County drug court, says addiction hijacks the chemistry of the brain, and the antagonists can interrupt that hijacking. But he stresses that an addict has to be in treatment - such as an inpatient programs, talk therapy, or a 12-step group - for any kind of change to stick.
"You can take the drugs and alcohol away from the person, but unless you are treating the underlying disorder, the disease of chemical dependency, they will ultimately go back to drugs and alcohol."
He says addiction is so powerful because it bypasses the rational part of the brain. The drugs flood a more primitive area of the brain, first with euphoria, then with cravings. He says the primitive brain then overwhelms the decision-making process.
"This primitive brain takes over, which is telling them, 'If you stop using you are going to die.' The withdrawal symptoms, the psychological cravings, anxiety, the panic, the fear."
Dr. Eskew says the antagonists can interrupt that, temporarily, which gives treatment time to take hold. He says some doctors are suspicious of treating drug dependency with another drug, and many in the public favor jailing the addicts. But Eskew says jail doesn't work because addicts aren't fully in control of their decisions. On the other hand, he says, enforced treatment, such as what's given at drug court, is often effective.
"I think we could make a big difference, yes. You know, I can think off hand, off the top of my head, of a lot of people now that have come though drug court, successfully completed it, that are out there, productive members of society, that would be sitting in jail right now."
Dr. Eskew ran a workshop on the topic last week during the spring conference of the National Association of Social Workers, West Virginia Chapter. That's the largest event of its kind in the country.
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A package to improve public safety is moving ahead in the California state Legislature - with a floor vote in the State Assembly on the first bill expected this week.
Assembly Bill 2215 puts into statute that police officers have the discretion to send people arrested for low-level offenses directly to supportive services.
Anthony DiMartino - government affairs director with the nonprofit Californians for Safety and Justice - said sometimes public safety is best served when people avoid arrest and instead get therapy, addiction support or help getting a job.
"We're also hoping to raise awareness that this is something officers can do, and then also encourage partnerships more with officers to look at what's in their community," said DiMartino, "as alternatives to jail booking."
A second bill would increase transparency and accountability on money sent to the counties as part of the Public Safety Realignment.
A third bill would require police officers, prosecuting attorneys and investigators to identify themselves any time they're interviewing a family member of someone killed or severely injured by police.
DiMartino said they also support AB 2499, which would ensure that survivors of violent crime and their family members can take unpaid time off work to address safety concerns and heal.
"We're hoping to broaden the scope a bit," said DiMartino, "and make it more clear that family members of victims are able to also tap into unpaid leave to support their family member that has been a victim."
A fifth bill would make it easier for justice-involved people and crime victims to speak freely during restorative justice programs - by making the communications inadmissible in other legal proceedings.
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Missouri went through with its first execution of the year, as Brian Dorsey was put to death last night, just after 6 p.m. CT.
The U.S. Supreme Court on Tuesday declined to stop Dorsey's execution. He was convicted of murdering his cousin Sarah Bonnie and her husband Ben nearly 20 years ago.
The advocacy group Missourians to Abolish the Death Penalty launched several recent campaigns on Dorsey's behalf to spare his life.
Jenni Gerhauser, a cousin to both Dorsey and Sarah Bonnie, expressed belief in his redemption.
"Brian is more than the worst moment of his life," Gerhauser stressed. "There is so much more to him."
Gerhauser fondly remembered him as fun and charming from their visits during holidays. Dorsey's current lawyers said he was in a drug-induced psychosis when he killed the Bonnies in 2006 and his attorneys at the time had been offered money, preventing them from fighting the death penalty with his guilty plea deal.
Gov. Mike Parson confirmed Monday the state would move forward with Dorsey's death sentence, rejecting a separate request for clemency. More than 70 current and former corrections officers had urged the governor to commute Dorsey's sentence, arguing he had been rehabilitated.
Claudia Boyce, also a cousin in the family, said it should not be a decision for the state to make.
"You know, that's supposed to be God's decision, not ours," Boyce contended.
Dorsey received a lethal injection Tuesday evening. Lethal injection became an option for people on Missouri's death row in 1987, alongside lethal gas.
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Amid overcrowding and unsafe conditions in West Virginia jails, state lawmakers introduced bills that would allow judges to take a 'second look' at an individual's original sentence.
If a court determines they no longer pose a threat to the community, the person could be released, placed on supervision, or receive a shortened sentence.
Sara Whitaker - criminal legal policy analyst with the West Virginia Center on Budget and Policy - said West Virginia is one of the few states that has seen its prison population balloon over the past decade, despite declining crime.
She noted that as of last month, more than 500 people in the state were in jail awaiting transfer to a prison.
"As a result, eight out of 10 of the regional jails in the state were beyond capacity," said Whitaker, "with hundreds of people assigned to sleeping on the floor."
The bills failed to advance this session, but Whitaker said advocates are hopeful lawmakers will consider them next year.
The state's jails remain among the deadliest in the country, with at least 91 people losing their lives while incarcerated in the past few years.
According to the West Virginia Center on Budget and Policy, jail bills cost counties $45 million in 2022.
Nationwide, long sentences have led to growth in the number of older people behind bars.
Whitaker pointed out that 'Second Look' legislation could help the state avoid turning its prisons into nursing homes, and said the number of elderly people in prison has tripled in the past two decades.
"In 2019, West Virginia had to open a dementia unit in one of its prisons," said Whitaker. "There are hospice units across multiple prisons. And experts predict that this is just only going to get worse."
Whitaker added that 'Second Look' policies also offer a way to correct past racial injustice in the criminal legal system.
Black people incarcerated in West Virginia are four times more likely than white people to be serving a life sentence with the possibility of parole, and five times as likely to be serving a life-without-parole sentence.
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