Many believe the changing face of drug abuse is behind the urgent call to action among presidential candidates, lawmakers and law enforcement officials. That would also be true for the increased call for treatment rather than the previous “war on drugs,” which concentrated on mass arrests and incarceration.
“I think it was pretty clear that our response during the crack cocaine epidemic was largely a criminal justice response,” Kolodny said. “Whenever you hear people talking about our opioid crisis, within the first few minutes you hear someone say to the effect that we can't arrest our way out of this problem.”
Democratic presidential candidates Hillary Clinton and Vermont Sen. Bernie Sanders have both called for plans that include “rehabilitation and treatment” over prison for low-level and nonviolent drug offenses.
Republican presidential candidate Texas Sen. Ted Cruz, whose half-sister died from a drug overdose, has called for faith-based treatment. GOP frontrunner Donald Trump supports treatment and prevention efforts, and like Cruz, has advocated for securing the U.S. border to disrupt the drug supply.
Treatment-based solutions to address addiction have already begun to take shape. A total of 42 states and the District of Columbia have passed legal protections for medical professionals who dispense naloxone, a prescription drug that counters the effects of an opioid overdose. Controversial measures, such as needle exchange programs for drug users, have gained support in states and municipalities across the country.
For places like Huntington, needle exchange programs have helped combat another health issue related to intravenous drug use. In 2013, West Virginia had the highest rate of hepatitis B infections in the nation with 10.5 cases for every 100,000 residents, according to the CDC. By comparison, the state with the second highest rate of hepatitis B infections that year was neighboring Kentucky, which had 4.9 cases per 100,000.
Nationally, rates of hepatitis C infection have increased as more Americans have turned to using intravenous drugs. Rates of infection in four states—Kentucky, Tennessee, Virginia and West Virginia—rose by 368% between 2006 and 2012, according to the CDC. Intravenous drug use was cited as a risk factor in 73% of those cases.
Johnson admits he was not initially a big supporter of programs aimed at harm reduction for substance abusers. What changed his mind toward adopting more of a public health approach was witnessing the devastating effects the drug epidemic was having throughout the entire community.
“In our county we were spending at a minimum of $50 million to $100 million a year just on the healthcare,” Johnson said. “When we started talking about syringe exchange it was like, 'Why aren't we doing this.' ”
Changes in the country's approach to drug abuse have also come from a national level. President Barack Obama earlier this month proposed allocating $1.1 billion over two years as part of his fiscal 2017 budget toward fighting heroin and opioid drug abuse; $920 million of that would expand medication-assisted treatment.
But the question remains whether the country has truly turned a corner in how it perceives addiction and whether the current approach will be applied to any future drug epidemics affecting all racial groups.
“I would like to think it would help to shift the climate somewhat, but I am not overly optimistic,” said Marc Mauer, executive director for the Sentencing Project, a research organization that advocates for reforms in the criminal justice system. “We still have a ways to go I think to broaden that perspective on how we approach substance abuse.”