West Virginia spends enormous sums on Medicaid-funded drug treatment, yet overdose deaths remain the highest in America. Addiction-driven homelessness is rising and our workforce participation is the lowest in the nation.
Last year alone, the state spent more than $240 million on Suboxone and methadone-based programs. A system this expensive should not produce results this poor. It is time the state of West Virginia demanded accountability. And yes, there will be pushback from the industry. The truth is unavoidable: our treatment system is failing, and we are paying for failure. Taxpayers are totally fed up!
The core problem is structural. Our Medicaid model pays for services, not results. Providers get reimbursed whether a patient gets better or not. Repeat relapses often mean more billable services. There is no accountability and no expectation that billions of taxpayer dollars should produce sober, self-sufficient citizens. Medication-assisted treatment (MAT); Suboxone, methadone, and similar therapies were meant to be a bridge to sobriety. People who genuinely need these medications should eventually become stable, working, and self-sufficient, not permanently funded by taxpayers. If someone is stable enough to remain on long-term MAT, they should also be stable enough to work and pay their own way. But that isn’t what’s happening. Many patients stay on MAT for years with Medicaid paying the bill, while others drop out entirely and never reach sobriety. These drugs are often diverted and sold illegally, meaning taxpayers are funding substances that end up fueling the crisis instead of solving it.
Meanwhile, citizens across West Virginia report that people are being bused into our cities and dropped off, adding pressure to communities already overwhelmed by addiction, homelessness, and untreated mental health issues. The problem isn’t limited to our streets, Suboxone is now a major issue inside our jails and prisons, where it is smuggled, traded, and abused. A drug intended to support recovery has become an underground currency at taxpayers’ expense. Many people say they first became addicted while incarcerated.
If this system were working, West Virginia wouldn’t be leading the nation in so many devastating categories:
• #1 in overdose deaths per capita
• Highest rate of babies born with neonatal abstinence syndrome (including Suboxone-related)
• Some of the lowest birth weights in the nation
• More children removed from homes than any other state
• Lowest workforce participation in America
These outcomes don’t show progress, they show failure built into the system. The feedback I receive from citizens is loud and clear on this subject, they want change!
That’s why I will introduce a results-based treatment bill this session. The idea is simple: if a provider cannot get people sober, they will no longer receive Medicaid dollars. Programs will have to show real progress: verifiable sobriety milestones, sustained recovery, and workforce re-entry or the state will stop paying for failure. This reform will shut down programs that profit from relapse and reward those that actually help people rebuild their lives.
West Virginians are compassionate, but we’re not naïve. We want to help people fighting addiction, but we should not be forced to fund a system that delivers no improvement in terms of helping people achieve independence. It’s time to stop pretending the current model is working. It is not!
West Virginia isn’t treating addiction, we’re subsidizing it.
