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Cabell County EMS workers and Huntington Police officers responded to a possible overdose in the 500 block of 6th Avenue in 2020 in Huntington. The number of overdoses in West Virginia has increased while attention was focused on fighting COVID-19.

CHARLESTON — After two consecutive years of decreases, preliminary data show at least 1,275 West Virginians suffered fatal overdoses in 2020, setting a mortality record for the state often called the epicenter of the national drug crisis.

Opioid overdose rates are back to 2017 levels, with 85% of all fatal overdoses in the state in 2020 involving an opioid, compared to 76% in 2019. Previously, 2017 — with 1,019 people dying — was the only year West Virginia’s overdose deaths exceeded 1,000 people.

The new numbers are a 45% increase from 2019, when 878 people died, and a 25% increase from 2017, according to the data.

The overdose data were compiled from causes of death reported on death certificates certified by the Office of the Chief Medical Officer and are not final, meaning numbers could rise as more death certificates are analyzed.

Many overdose deaths include more than one drug, and, while total overdose death numbers are not duplicative, the data set lists any drug contributing to the death, according to the state Department of Health and Human Resources.

Kanawha County recorded an uptick in the number of fatal drug overdoses in 2020 after years of stagnation that saw surrounding counties’ overdose rates drop.

Last year, 207 West Virginians died from drug overdoses in Kanawha County, compared to 156 in 2019, 152 in 2018 and 151 in 2017.

Statewide, 15 counties at least doubled their number of fatal overdoses between 2019 and 2020. Eight saw drops. Of those eight, none saw decreases of more than five cases.

Southern West Virginia again bore the brunt of the overdose-related deaths in the state. In 2020, McDowell County tripled its rate, with 27 dead in 2020 compared to nine in 2019. Boone, Wyoming, Logan, Mercer and Cabell counties all lost twice as many people to drug overdoses last year than in 2019.

Logan County leads the state in the number of fatal overdoses per capita, with 159 per 100,000 residents dying by overdose. Cabell (158 per 100,000), McDowell (153 per 100,000), Raleigh (136 per 100,000) and Kanawha (116 per 100,000) counties are close behind.

In line with recent years, methamphetamine-related fatal overdoses were still on the rise, with 569 recorded so far for 2020, compared to 384 in 2019, a near 50% increase. This is a more than 1,000% increase over 2015, when 49 residents died from the drug, and the largest increase of any drug-related overdoses in the state, according to the data.

Logan County recorded 31 meth-related fatal overdoses in 2020, double its number from 2019, when it recorded 15 deaths. The county holds the highest rate of fatal meth-related overdoses in the state, with 97 per 100,000 residents dying with the drug in their system.

Boone County trails Logan with 75 per 100,000 residents suffering fatal meth-related overdoses, nearly tripling its rate from the previous year, with 16 dead in 2020 compared to six in 2019. Raleigh (70 people per 100,000), Kanawha (63 per 100,000) and Cabell (62 per 100,000) counties follow close behind.

Fentanyl-related deaths also were on an upswing, with 955 recorded in 2020 compared to 518 in 2019 — an 85% growth.

Of 55 counties in West Virginia, 22 saw double the number of fatal fentanyl-related overdoses in 2020, compared to 2019. Forty-six counties recorded two times the number of cases in 2020 than in 2015.

Two counties — Clay and Webster — saw decreases in fatal fentanyl-related overdoses between those years, while seven others saw none recorded.

According to the data, the largest growth in fentanyl deaths has remained mostly in the coalfields.

McDowell County saw the largest increase of any county between 2019 — when two people there died because of fentanyl — and 2020, when 18 deaths were reported. Cabell, Logan, Raleigh, McDowell and Kanawha counties led the state in the number of fentanyl-related fatal overdoses per capita, according to the data.

Fatal overdoses involving either cocaine or heroin dropped slightly in 2020, compared to 2019. Heroin rates, however, are still highest in the coalfields. McDowell, Mercer, Wayne, Raleigh and Wetzel counties hold the highest per capita rate of fatal heroin overdoses for 2020, according to the data.

Fatal opioid-related overdoses doubled in 27 counties between 2015 and 2020, according to the data. Logan, Cabell, McDowell, Raleigh and Kanawha counties also led the state in these deaths for 2020.

For months, experts have warned about the effect the COVID-19 pandemic could have on those with substance use disorder. Overdoses are on the rise nationwide amid the pandemic, according to the federal Centers for Disease Control and Prevention, and so are relapses.

According to the West Virginia Office of Drug Control Policy, there were more emergency department visits and calls related to overdoses last summer than any other on record. Area harm-reduction groups reported upticks in the need for Naloxone distribution, an opioid overdose-reversal drug.

Reach Caity Coyne at, 304-348-7939 or follow @CaityCoyne on Twitter.

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