Care Denied: West Virginia's Ban on Methadone Clinics Blocks Life-Saving Medicine

Every morning in West Virginia, more than 2,000 people seeking treatment for opioid use disorder must travel long distances and stand in line just to receive medication that makes daily life possible.

Methadone has been used safely and effectively for decades. Yet, West Virginia is the only state with a moratorium on new methadone clinics — a cruel irony, given that the state has led the nation in overdose deaths for nearly 15 years.

Since 2008, nearly 12,000 people have died of an opioid overdose in West Virginia. Fifty years of scientific research and medical practice has shown that methadone cuts the risk of death from all causes, including overdose, in half. It reduces illicit drug use, decreases infectious disease transmission, and improves quality of life. Methadone allows people who have opioid use disorder to begin recovery treatment without first going through painful and dangerous withdrawal symptoms that increase the risk of relapse and death.

Between 2011 and 2025, the number of methadone clinics nationwide has nearly doubled from 1,200 clinics to over 2,000. But in West Virginia, the same nine clinics have been operating. Because of a statewide ban, health clinics are prohibited from adding methadone to their treatment options and no new methadone clinics can break ground. Now, the logistical challenges imposed by this moratorium make it difficult, if not impossible, for people to access their medication.

Since 2018, Solutions Oriented Addiction Response WV (SOAR-WV), a community-based organization, has been bridging the gap in Charleston and across the state, connecting people with opioid use disorders to services and support, including methadone clinics.

Alongside the ACLU, we’re challenging West Virginia’s moratorium and zoning restrictions that forbid additional methadone clinics from opening. The Americans with Disabilities Act recognizes opioid use disorder as a disability. By singling out the estimated 54,000 West Virginians with the condition, the state is engaging in unlawful discrimination. Additionally, while other health care providers are permitted to open as long as they comply with relevant local, state, and federal law, new methadone clinics can only open by an act of the West Virginia Legislature. Even if the moratorium were lifted, state zoning law limits clinic locations in ways that are not applied to other health care facilities.

Each of the nine methadone clinics in West Virginia is the only one in its district. Outside of Charleston, the next closest clinic is 45 minutes away. Because of limited operating hours and lack of transportation, making daily trips is nearly impossible for many with work and family responsibilities. Still, there is no other option to receive methadone.

SOAR-WV helps those who can’t access Charleston’s only facility navigate the arduous, and sometimes unsuccessful, process of transitioning from methadone to another treatment modality. But for many, methadone remains the only effective medication. Harsh regulations also fall more heavily on Black and Brown people with opioid use disorder, who are more likely to rely on methadone due to longstanding racial and economic inequities. The moratorium limits our ability to promote the health and dignity of those impacted by drug use. With more clinics throughout the state, we could more frequently refer people to providers that meet their needs.

We’re suing because we believe that no state should stand between patients and life-saving medication. The overdose crisis is not done until we’ve reached zero loved ones lost. Ending this ghoulish moratorium is a major step towards that goal.