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

In West Virginia, many of the over 2,000 people who receive methadone at one of the state’s only nine clinics face a harsh reality. They wake up to find their daily medication isn’t on the nightstand or in a medicine cabinet. Instead, before they can go to work, take care of their family, or attend to any other responsibilities, they must travel, sometimes for over an hour, to an assigned clinic. If they don’t, they won’t get their medication, and there are real consequences for their health and well-being.

It doesn’t have to be this way.

Since 2018, we at Solutions Oriented Addiction Response WV (SOAR-WV), a community-based organization, have been bridging the gap in Charleston and across the state, connecting people with opioid use disorders to services and supports including opioid treatment programs, also known as methadone clinics, but the logistical challenges imposed by West Virginia’s moratorium on methadone clinics make it difficult, if not impossible, for the people we serve to access their medication.

That’s why we joined with the ACLU to challenge 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, and by singling out the estimated 54,000 West Virginians with that disability, West Virginia is discriminating against them.

Fifty years of scientific research and medical practice support that methadone cuts the risk of death from all causes — including overdose — in half, reduces illicit drug use, decreases infectious disease transmission, and improves quality of life. Methadone, compared with other treatment medications, is particularly effective for those who are addicted to fentanyl.

Yet rather than embrace this evidence-based treatment, West Virginia is the only state in the nation with a moratorium on new methadone clinics, a cruel irony given that West Virginia has led the nation in the rate of opioid overdose deaths for 14 of the last 15 years. During that time, the number of methadone clinics nationwide has nearly doubled — from 1,200 methadone clinics in 2011 to over 2,000 in 2025 — but in West Virginia, only the same nine clinics have been operating.

At SOAR-WV, we work with individuals who have opioid use disorder, including those who can’t access Charleston’s only methadone clinic. No other health clinic around town can add methadone to their menu of treatment options, and no new methadone clinic can break ground, because of this statewide ban.

The nearest methadone clinic outside of Charleston is 45 minutes away, making daily trips to the next closest methadone clinic nearly impossible for many people with work and family responsibilities or transportation limitations.

We help individuals navigate the arduous — and sometimes unsuccessful — process of transitioning from methadone to another treatment modality. But for many, methadone is the only medication that is effective. Harsh regulations on methadone fall more heavily on Black and Brown people with opioid use disorder, who are more likely to use methadone than other medications due to systemic, structural, and racialized policies.

The moratorium also decreases accountability for methadone clinics. Instead of having to compete for patients, each of the nine clinics in West Virginia is the only one in its jurisdiction. This means that if the hours that the local clinic operates don’t work for a patient or they can’t regularly access the clinic for another reasons, they have no other option to receive methadone.

If there were more than one methadone clinic in our city or more throughout the state, we would be able to more frequently refer people to providers that could meet their needs.

West Virginia singles out methadone clinics, and by extension, people with opioid use disorder who need methadone with a uniquely harsh treatment. While other kinds of health care providers may open their doors, so long as they comply with relevant local, state, and federal law, no new methadone clinic can open without 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.

Our lawsuit aims to change that, because we believe that no state should stand between patients and the life-saving medication they need. We’re not done with the overdose crisis until we’ve reached zero. Zero loved ones lost. Ending this ghoulish moratorium would be a major step towards that goal.