HUNTINGTON - More than 20 percent of West Virginia's overdose deaths last year were suffered in Cabell County, which led the state's 55 counties for a second consecutive year with a record 152 deaths in 2017, according to the latest data from the West Virginia Health Statistics Center.
While the county shattered its own record for total overdoses in a year at 1,831 for 2017, data indicate non-fatal overdoses actually occurred at a slower pace during the last three months of 2017, according to Cabell County Emergency Medical Services, which compiles total overdose figures at the county level.
Cabell County quickly surpassed 2016's then-record 1,250 overdose total by Aug. 24 at a pace of more than five overdose reports per day, but the 2017 total would have been much higher had the same pace continued through the year, Cabell EMS Director Gordon Merry pointed out.
From January through August 2017, Cabell County averaged 5.3 overdose reports per day, placing the county on pace for 1,934 overdoses through 2017. The pace unexpectedly slowed to 4.5 overdoses per day from September through December 2017, Merry said. In 2016, overdoses in the county averaged 3.3 per day.
"We were going to do at least 2,000 overdose calls," Merry said of the 2017 totals. "But the last couple of months, and I couldn't tell you why, but we have seen a slowdown."
It remains too soon to tell if the slower pace is an anomaly or a sign of true, steady decline that will carry into the new year, Merry said. It's possible those addicted have begun using more methamphetamine, he theorized, which - while destructive in its own way - is less likely than opioids to trigger an overdose. Of Cabell County's 152 overdose deaths in 2017, 35 of the victims had traces of methamphetamine in their bodies. That was more than twice the number in 2016, when 12 victims died with the drug in their bodies.
Increasing attention to the problem by care providers, law enforcement and through the city's recent spell of violence may also be contributing factors, Merry guessed, reiterating it remains too soon to know.
"I wish I had a good answer, but I don't. It could be anything," he said. "I'm just glad it's going down."
Fentanyl - present in more than 90 percent of Cabell County's fatal overdoses - remains by far the drug most frequently found in autopsies, state data indicate. Nearly all of West Virginia's overdose victims die with multiple drugs in their bodies.
Though the opioid epidemic is often erroneously shorthanded to simply a "heroin" matter, the drug was present in only one-third of Cabell County's overdose deaths in 2017, decreasing from 43 percent of deaths in 2016.
The Mountain State as a whole suffered 724 overdose deaths in 2017 by the most recent state figures, though those numbers are expected to increase as more suspected overdose deaths are processed through the state medical examiner, said Toby Wagoner, Department of Health and Human Resources spokesman. West Virginia recorded 884 overdose deaths in 2016.
In 2016, Cabell County barely eclipsed the perennially higher Kanawha County totals by three overdose deaths - 133 to 130. But while Cabell's total overdose deaths rose to 152 deaths in 2017, deaths in Kanawha declined to 104 last year, according to the latest data.
By regional comparison, Wayne County and Putnam County each reported 24 overdose deaths in 2017, followed by Logan (20), Mingo (13), Mason (11), Boone (9), Lincoln (8) and Wyoming (6).
Overdose deaths by county, 2017
Note: Totals are expected to increase as more suspected overdose deaths are seen by the state medical examiner, a process which may take months to finalize.
State total: 724
Source: West Virginia Health Statistics Center
Cabell County overdose calls per day
The average number of overdose calls per day in Cabell County grew over the past several years but has declined in recent months.
2017 (Jan.-Aug.): 5.3
2017 (Sept.-Dec.): 4.5
Source: Cabell County Emergency Medical Services
Follow reporter Bishop Nash on Twitter at @BishopNash.