Remarkably, sixty years ago the Boone Report on medical issues in the bituminous coal regions did not deal with alcoholism or other drug dependencies. Since that time, America has become much more sensitive to abuse and dependence on alcohol and drugs. Certainly, anecdotes detail heavy drinking in the coalfields of yore. Today, West Virginians provide significant evidence of addictive behavior. The U.S. Department of Health and Human Services estimates that in a month's time some 60,000 residents use illicit drugs other than marijuana and 297,000 engage in binge drinking.

Largely rural, West Virginia's most pronounced drug problems involve the abuse and clandestine manufacture of methamphetamine, marijuana consumption and cultivation, and pharmaceutical drug diversion and abuse. After the sad fatalities in WV mines this past year, the public has been sensitized to the issue of drug-use in coal mines. Some 39.1% of West Virginian's older than 12 reported using tobacco products. Each year, the deaths of 3,900 West Virginian's is attributed to smoking.

In 2001, the estimated prevalence of smoking during pregnancy for West Virginian woman was 26.2 percent. (For all U.S. women the rate was 11.4 percent.) The tie of smoking by women carrying children to low birth rates and other health issues makes this last statistic especially disturbing.

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