Solving this problem requires the focus and involvement of a full-time governor.
A successful substance use disorder plan must be realistic, comprehensive and long term to sustain the long-term effort required for success. It must include support and treatment for those who decide they are “ready” to avail themselves of treatment and recovery services. We must support local efforts. We also must recognize other illegal substances, such as meth, must be dealt with just as fervently as opioids.
Current Medicaid regulations only allow, at best, 90 days of long-term residential treatment in three, 30-day allocations. In reality, many are doomed to fail without long-term residential treatment options available, so those Medicaid dollars are wasted. Medicaid and its contracted managed care vendors appear to have adopted a managed-cost rather than managed-care approach. Reduction in services is occurring at all levels of treatment care, perhaps most noticeably with detox services, where premature discharges have led to a spike in overdoses.
Our local law enforcement community has, for the most part, been ignored thus far. Any truly comprehensive strategy must hold accountable those drug dealers and repeat offenders who do not want help. Prosecutors and law enforcement need resources so when dealers are busted, word spreads that West Virginia is building a wall to keep them out.
Any real plan for addressing the state’s substance abuse crisis must acknowledge our children. This administration’s inaction has led directly to an inundated foster care system and surge in the numbers of grandparents and great-grandparents now raising some of our youngest children.
A crisis that unquestionably touches all sectors of our state demands the involvement of a leader who is present, with eyes and ears focused and a heart committed to marshaling all the resources at his disposal, not an absentee governor who turned a blind eye to this scourge for the past three years, allowing it to only grow.
I will lead all efforts to direct our state’s actions to combat drug abuse
As governor, I will lead cabinet meetings on substance abuse twice a week. 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.
Substance use disorder (SUD) is an illness of the body, mind and spirit. A simple detox and short-term treatment focus on body alone won’t cut it. Treatment and recovery help must be available for those who want it when they are ready for it, no matter what door they enter to receive it. Rather than simply looking to what the federal government will pay for, we must support or encourage all paths leading to recovery, whether faith-based, peer-supported, 12-step, abstinence and properly monitored medication-assisted treatment programs. Our existing drug courts must be supported.
Long-term treatment beds that provide more than 90 days of treatment for those individuals who need it will be available within the first year of my administration. Addiction recovery is, for most, a life-long journey, and community-sponsored posttreatment supports must be in place. Medicaid must be the enforcement arm that holds Medicaid’s managed care contractors accountable for ensuring provision of necessary care, leading to successful SUD outcomes, not pinching pennies. Current Medicaid regulations limiting treatment stays must be reviewed; we can no longer stand by while individuals early in recovery are discharged early and relapse, only to re-enter again. That revolving door will stop.
The state’s current heavy reliance on buprenorphine must be closely scrutinized. When coupled with required behavioral therapy, it is a good tool for many individuals addicted to opiates. But too many people divert it, using the cash to purchase other illicit drugs. It can no longer be our primary treatment model. Nonopioid pain therapies will be demanded. Many providers already understand manipulation and chiropractic care, but I will advance treatment modalities that do not rely on opioids through the state’s purchasing powers in health care. The days of over-prescribing are done. We must ensure the programs we fund as a state provide results that lead us to our goal; otherwise, those resources will go elsewhere.
Grandparents in West Virginia should be able to enjoy their golden years, spoiling their grandchildren during weekend stays and then sending the kids back to their parents. Too many grandparents and great-grandparents are left raising small children with little or no help and often with severe health problems of their own. The state must deploy support such as respite care, transportation and training to serve as a shoulder to lean on for help for grandparents’ heroic efforts.
We had a foster care crisis when Jim Justice was elected, and the problem has only grown worse 1,000 days later. A diverse economy will generate more jobs and more hope, but our first fix must be to support families.
Consideration must be given to breaking up the Department of Health and Human Resources. As one example, its Bureau of Children and Families should be allowed to advocate for those it serves rather than taking a backseat to the rest of DHHR and its many responsibilities.
West Virginia must become known as a state drug dealers fear. One of my first acts as governor will be to develop a hard labor penalty for drug dealers. Likewise, drug users who refuse treatment will be held accountable for their actions. Our law enforcement community feels left out of current efforts to address substance use disorder. We must encourage all hands on deck. The drug gangs that permeate our streets are creating death pipelines. Dilapidated structures must be torn down before they can become drug hangouts. We need more local law enforcement officers, and they must have the proper resources to stop dealers. Local prosecutors need more resources to prosecute drug dealers. We also must utilize our Attorney General for help in this arena. In drug crimes that result in death, including the sale of tainted drugs, when the guilt of a person is established beyond all possible doubt, we should consider the death penalty.
Hope is an important component in treatment and recovery. There must be hope, and jobs often generate hope.
The time for pilot projects like Jim’s Dream is long past. Treatment providers and employers must be brought together to create working programs that yield measurable results, not just empty headlines. Our programs must serve thousands of people, not just a few hundred.
We must tailor our work force training dollars for meeting the needs of the work force of West Virginia’s future, not squander them to support existing programs providing training where no jobs exist.
This may be the hardest pillar to tackle, and it should include the widest variety of partners: schools, faith-based institutions and families. We must start as early as possible. Meaningful prevention must speak to children unwillingly involved in this crisis, as well as those in recovery. Every possible step must be taken to protect our future generations.