Quick answer
Cocaine was present in 64% of Berkeley County's 33 overdose deaths in 2024 - more than any other substance, including fentanyl. No medication is FDA-approved for cocaine use disorder, so behavioral care such as contingency management is the backbone of treatment. Here is the local picture.
Berkeley County's overdose data hold a surprise: cocaine - not methamphetamine, and not fentanyl - is the substance found most often in the county's fatal overdoses. If cocaine has become the thing that organizes your week, treatment here is behavioral rather than medical, and it is closer than you might think.
Cocaine leads Berkeley County's overdose deaths
The West Virginia Office of Drug Control Policy records 33 overdose fatalities in Berkeley County in 2024, down from 71 in 2023, counted by county of occurrence. Cocaine was present in 64% of those deaths - the highest of any substance - just ahead of fentanyl at 61%. Other drugs appeared in 39%; other opioids, benzodiazepines, and alcohol in 27% each; THC in 15%; and methamphetamine in 9%.
That mix sets Berkeley County apart. Across West Virginia, the Office's West Virginia At-A-Glance 2025 profile puts cocaine in 17% of the state's 2024 overdose deaths and methamphetamine in 55% - but here cocaine is the leading drug. The county sits in the Eastern Panhandle, the part of West Virginia closest to Washington, D.C. (about 75 miles via US-340), and its toxicology looks different from the rest of the state.
Earlier in the decade the county was among the nation's hardest hit. A 2025 study in the Harm Reduction Journal notes that in 2020 Berkeley County recorded 94 fatal drug overdoses per 100,000 residents, more than triple the national rate, before deaths fell by roughly 25% over the 12 months ending in September 2023. The same paper describes naloxone distribution boxes placed in the county to widen access to the overdose-reversal medication.
The crash, and why cocaine is hard to stop alone
Cocaine is a powerfully addictive stimulant that reaches the brain within seconds when smoked or injected, and the intense high is followed by a crash - the cycle that helps cocaine use disorder take hold quickly. NIDA describes withdrawal symptoms that include fatigue, sleep problems, increased appetite, and strong cravings. The crash is usually not medically dangerous the way alcohol or benzodiazepine withdrawal can be, but it is a high-risk window for relapse.
Depression during that period can be severe and has been linked to suicide risk. If you are having thoughts of self-harm, call or text 988.
Cocaine also carries direct physical dangers. NIDA notes it raises heart rate, blood pressure, and body temperature and can cause irregular heart rhythms, heart attack, stroke, and seizures - sometimes in young, otherwise healthy people - and that chronic snorting damages the nasal passages. Call 911 for chest pain, a seizure, or severe agitation.
No pill for cocaine - but real treatment
The key fact about cocaine treatment is what does not exist. NIDA states that there are no FDA-approved medications to treat cocaine use disorder, though researchers are studying several possibilities. There is no methadone or buprenorphine equivalent for stimulants. Be skeptical of any program advertising an approved medicine "for cocaine" - verify the claim.
What does have evidence is behavioral. SAMHSA's 2025 advisory names these as primary interventions for stimulant use:
- Contingency management (CM) - tangible rewards, such as vouchers or prizes, for confirmed drug-free tests. NIDA calls it a particularly promising strategy for stimulant use, and it is the first thing to ask a program about.
- Cognitive behavioral therapy (CBT) - recognizing the situations and thought patterns that lead back to use and rehearsing better responses.
- Structured outpatient programs designed for stimulants, combining therapy, drug testing, and family education.
With no medication to carry you between appointments, frequency of contact and program intensity matter more here than almost anywhere else.
Fentanyl in the cocaine supply
A separate risk now travels with cocaine. NIDA reports that cocaine is frequently adulterated with highly potent fentanyl and related substances, a major contributor to rising overdose deaths - and people usually do not know it is there. If someone is unresponsive or breathing slowly, call 911 and give naloxone if you have it. Naloxone reverses an opioid overdose and will not harm someone who is not overdosing. West Virginia's statewide standing order lets pharmacists dispense naloxone without a prescription.
Where to start in Martinsburg
East Ridge Health Systems is Berkeley County's designated comprehensive behavioral health center, providing behavioral health and substance use services in the Martinsburg area and stating that it serves people regardless of ability to pay (East Ridge). The county is not currently served by a state-certified Community Behavioral Health Clinic (CCBHC), so ask providers directly about sliding-scale fees.
Within 30 miles of downtown Martinsburg (ZIP 25401), the SAMHSA locator lists 40 substance use treatment facilities, including 6 offering detoxification, 8 with residential programs, and 36 offering outpatient care. The locator does not flag contingency management, so ask: Do you offer contingency management for stimulant use? Is it voucher-based or prize-based? How soon can I start?
Outpatient care means repeat visits, so transportation matters. The Eastern Panhandle Transit Authority (EPTA), based at 446 Novak Drive in Martinsburg, serves Berkeley and Jefferson counties with deviated fixed-route, demand-response, and non-emergency medical transit (EPTA).
Paying for cocaine treatment
Martinsburg's median household income is about $59,555, and roughly 9.1% of residents under 65 are uninsured, so cost is often the deciding factor. West Virginia Medicaid covers substance use disorder treatment for members who meet medical necessity criteria. For anyone without coverage, HELP4WV - the state's free, confidential 24/7 line at 1-844-435-7498 - helps with enrollment, no-cost options, and transportation.
How to start today
- In a medical emergency, call 911. For a mental health or substance use crisis, call or text 988.
- Call or text (800) 653-9376 to talk through behavioral treatment options with a specialist, or use this form:
Calling is free; the referral service is paid for by treatment providers, and we check your benefits before you commit.
- Search findtreatment.gov from ZIP code 25401 and ask each program whether it offers contingency management.
- If opioids may be mixed in, ask a pharmacy or local program how to get free naloxone and keep it with you.
Cocaine use disorder is treatable without a medicine, and people do recover from it. Berkeley County's treatment network is already set up for it - the first step is one call.
This page is general health information, not medical advice. It is not affiliated with or endorsed by any facility named above.
Last updated: Mon Oct 19 2026 00:00:00 GMT+0000 (Coordinated Universal Time)
Frequently asked questions
Why is cocaine such a big part of Berkeley County's overdose deaths?
The West Virginia Office of Drug Control Policy's Berkeley County At-A-Glance 2025 profile records cocaine in 64% of the county's 2024 overdose deaths - the highest of any substance, just ahead of fentanyl at 61%. That pattern is distinct from much of West Virginia, where methamphetamine is usually the second-most-common drug.
Is there a medication for cocaine addiction?
No. NIDA states there are currently no FDA-approved medications to treat cocaine use disorder. Treatment relies on behavioral therapy, and NIDA calls contingency management a particularly promising strategy for stimulant use disorders.
What is contingency management?
It is a behavioral therapy that gives tangible rewards, such as vouchers or prizes, for drug tests that show no recent use. It has the strongest evidence of any treatment for stimulant use, and it is worth asking a program directly whether they offer it.
Is cocaine withdrawal dangerous?
The cocaine crash is usually not medically dangerous the way alcohol or benzodiazepine withdrawal can be. It brings fatigue, sleep problems, increased appetite, and strong cravings. Depression during this period can be severe and is linked to suicide risk - if you have thoughts of self-harm, call or text 988.
What if the cocaine was cut with fentanyl?
Assume it might be. NIDA reports that cocaine is commonly adulterated with fentanyl, often without the buyer knowing. If someone is unresponsive or breathing slowly, call 911 and give naloxone if you have it - naloxone reverses an opioid overdose and will not harm someone who is not overdosing.