We've gone after the suppliers - the pharmacies, the wholesalers and the dealers.
And we're constantly dealing with the symptoms - in the strained criminal justice system, the overcrowded jails and prisons and at the under-equipped mental health care and substance abuse treatment providers.
Dr. Vincent Felitti, one of the lead researchers behind the landmark Adverse Childhood Experiences study, spoke about another way to combat West Virginia's daunting drug problem: addressing the root cause of the problem, or why West Virginians want drugs in the first place. West Virginia has the highest drug overdose death rate in the nation.
Felitti, who was a keynote speaker at the "Handle with Care" conference Tuesday, said it may be comforting to say "the reason my kid's buying those street drugs is because there's a dealer on the next block."
"It's a lot more complicated to say my kid's buying antidepressants on the street," he said.
Child Protective Services workers, child advocates, law enforcement, medical professionals, prosecutors, social workers, therapists and others listened to Felitti's presentation. More than 400 people from 17 states, but mostly from West Virginia, are attending the Handle with Care conference Tuesday through Thursday of this week.
The ACE study, one of the largest investigations of childhood trauma and later health outcomes, was conducted from 1995 to 1997 at Kaiser Permanente. Researchers kept track of 17,000 patients and found that as the number of adverse childhood experiences increased, so did the risk for a variety of health problems in later life, among them: drug abuse, alcoholism, chronic obstructive pulmonary disease, depression, intimate partner violence, sexually transmitted disease, suicide attempts, risk for sexual violence, smoking and more. Adverse childhood experiences fall into three categories - abuse, neglect and "household dysfunction," such as a parent who is in prison or the victim of domestic violence.
Felitti, who founded the Department of Preventive Medicine for Kaiser Permanente in San Diego in 1975 and served as chief of preventive medicine until 2001, used to focus on symptoms of the problem, as well.
He talked about obese patients who they taught to lose weight through fasting, but the patients would quickly gain it back.
One in particular had been sexually abused by her grandfather for many years in adolescence. She would successfully fast during the day, but sleep-eat at night.
Felitti said weight gain can be a strategy for warding off sexual advances.
"She clearly made the point that what we had seen as her problem was actually her attempted solution," he said.
Dr. Michael Brumage, executive director and health officer at the Kanawha-Charleston Health Department, said most people who participate in the department's needle exchange program report more adverse childhood experience than the general population.
"They are off the chart when it comes to ACEs," he said. "What we're seeing is this does play an important role."
Felitti suggested two ways to address the effects adverse childhood experiences could be having on West Virginians.
"One would be to recognize and acknowledge that these problems exist," he said. "The second would be to recognize them routinely in medical practice."
He urges doctors and other health care providers to ask about adverse childhood experiences during screenings and ask patients how the experiences have affected them.
"And you listen, period," he said.
Felitti also commended West Virginians for beginning to recognize the impact of childhood trauma. He said only West Virginia and a few other rural areas of the country are on the "cutting edge" in that regard.
The Handle with Care program is one way police and educators have aimed for a trauma-focused response in West Virginia.
Andrea Darr, director of the West Virginia Center for Children's Justice and organizer of the conference, said the conference was similar to a child abuse conference that takes place every year, but this year numerous attendees visited from other states who are interested in implementing Handle with Care in their communities.
During his remarks Tuesday, Lt. Danny Swiger, who heads the State Police Crimes Against Children unit, said Handle with Care has spread to 35 counties and 10 states have agencies ready to implement the program.
Police officers who participate in the initiative, which began in 2013 as a project of Mary C. Snow Elementary and Charleston Police Department, notify schools when children are present at traumatic crime scenes so school staff members know to handle that child with care, whether that involves letting them take a nap, letting homework slide or setting them up with a counselor.
Reach Erin Beck at erin.beck@wvgazettemail.com, Facebook.com/erinbeckwv, 304-348-5163 or follow @erinbeckwv on Twitter.