The opioid epidemic has been a longstanding issue in West Virginia, with the state consistently ranking among the highest in terms of overdose rates. In an effort to combat this crisis, the state has allocated significant funds to support opioid-related initiatives. However, a recent review of these funds has revealed that many counties are not using them for harm reduction strategies, which are widely recognized as a crucial component of addressing the opioid crisis. Harm reduction approaches, such as needle exchange programs and medication-assisted treatment, have been proven to be effective in reducing the transmission of bloodborne diseases and overdose deaths. Despite this, many West Virginia counties have opted not to implement these strategies, citing concerns about their effectiveness and potential negative impacts on their communities. Instead, these counties have chosen to focus on other approaches, such as law enforcement and treatment programs. While these efforts are certainly important, they do not address the immediate needs of individuals struggling with addiction, who often require access to harm reduction services in order to stay safe. The lack of harm reduction funding in West Virginia counties is particularly concerning given the state’s high overdose rates. In 2020, West Virginia had the highest age-adjusted overdose death rate in the country, with over 1,000 deaths attributed to opioid overdoses. The state’s rural communities have been disproportionately affected by the opioid crisis, with limited access to healthcare services and other resources. In these areas, harm reduction strategies are often the only option for individuals struggling with addiction. The decision not to fund harm reduction programs in West Virginia counties has been met with criticism from public health experts and advocates, who argue that these strategies are essential for addressing the opioid crisis. They point to the success of harm reduction programs in other states, which have seen significant reductions in overdose deaths and transmission of bloodborne diseases. In contrast, West Virginia’s approach has been characterized as overly punitive and ineffective. The state’s emphasis on law enforcement and treatment programs has not yielded the desired results, with overdose rates continuing to rise. Furthermore, the lack of harm reduction funding has created a sense of urgency among public health officials, who are calling for a more comprehensive approach to addressing the opioid crisis. This includes increasing funding for harm reduction programs and expanding access to these services in rural areas. The West Virginia Legislature has been urged to reconsider its approach to addressing the opioid crisis, with a focus on evidence-based strategies that prioritize harm reduction. By doing so, the state can begin to make progress in reducing overdose rates and improving health outcomes for individuals struggling with addiction. The importance of harm reduction funding cannot be overstated, as it has the potential to save countless lives and improve the overall health and wellbeing of West Virginia communities. As the opioid crisis continues to evolve, it is essential that the state takes a proactive and comprehensive approach to addressing it, one that prioritizes harm reduction and evidence-based strategies. The consequences of inaction will be severe, with continued high overdose rates and transmission of bloodborne diseases. In conclusion, the lack of harm reduction funding in West Virginia counties is a pressing concern that requires immediate attention. By prioritizing harm reduction strategies and increasing funding for these programs, the state can begin to make progress in addressing the opioid crisis and improving health outcomes for its citizens.