US opioid policies in West Virginia and Texas yield opposite results

An analysis compares two U.S. state approaches to the opioid crisis. In West Virginia, aggressive policing targeted both dealers and users, which according to the Journal of Public Health Management and Practice led the state to top the nation in overdose deaths since 2013. By contrast, Texas reclassified hydrocodone combination products from Schedule III to Schedule II in 2014 and tightened prescription monitoring. That strategy helped Texas achieve one of the lowest overdose rates in the United States.

The piece argues that the effectiveness of authority depends on how it is applied: heavy-handed enforcement may worsen outcomes, while nuanced regulatory changes can reduce harm.