CHARLESTON — Prescription drug abuse has long been a major problem in West Virginia, but the response to it has been too disorganized to make a significant dent.

That argument led to the formation late last year of the Controlled Substance Advisory Board, which is now looking for solutions. So far, they include a pilot program in the most affected counties and possible legislation.

“There has not been a comprehensive work group to approach this problem,” board chairman Michael O’Neil said Wednesday at a conference in Charleston organized by the West Virginia Prevention Resource Center.

“People don’t know what other people are doing in the state,” he said. “There’s a lack of efficiency.”

O’Neil, a University of Charleston pharmacy professor, says the board brings together police agencies, physicians, politicians and others with a stake in curbing a prescription drug abuse problem that is one of the worst in the nation.

The board is already putting plans into action, with a pilot project early in 2009 in five southern counties hit hard by prescription drug abuse.

In Cabell, Lincoln, Logan, Mingo and Wayne counties, the goal will be to educate patients as they pick up their drugs at pharmacies, possibly with a small printed card warning them of the dangers of “diversion” — moving legal drugs onto the black market for illicit use.

“Our big concern is teen diversion, because medication is around at home, or it’s at the grandparent’s house and people are helping themselves,” said Anne McGee, director of the Cabell County Substance Abuse Prevention Partnership.

The program will also give tips to doctors on reducing incidents of “doctor shopping,” in which addicts get multiple prescriptions from different physicians.

Prescription drug abuse in West Virginia gained attention in the early part of the century as oxycodone gained popularity among addicts. It has remained a problem not just for the state’s health care system, but for the family services and criminal justice systems.

Now, drugs like hydrocodone and methadone surpass oxycodone in popularity and deadliness. A CDC study found that in 2006, nine of 10 overdose deaths in West Virginia were related to prescription drugs, with methadone contributing to about a third of those fatalities.

At the Charleston conference, O’Neil said a study to be released next month will show methadone deaths in the state rising as methadone’s prescription for pain has increased.

The board’s work may yield legislation in the coming session, according to Sen. Dan Foster, a physician and a member of the board.

The Legislature might look at pain management, the Kanawha County Democrat said, and at guidelines for doctors who frequently prescribe oft-abused medications like methadone and hydrocodone.

But lawmakers will have to tread carefully, because pain management is an especially complicated matter. Patients with chronic back pain have far different needs from patients in the last stages of terminal cancer, Foster said, and a “one size fits all” approach won’t work.

“The issue for me is trying to balance the situation where there’s over-prescribing or the abuse of prescription drugs, and the need for pain management for legitimate reasons,” Foster said.