CHARLESTON, W.Va. (AP) — The new White House drug czar has testified that the opioid epidemic got so bad in drug-ravaged West Virginia that the state was having trouble finding foster parents to care for children.

Dr. Rahul Gupta was one of the first witnesses whose video deposition was played at a bench trial Tuesday in which several pharmaceutical manufacturers are accused in a lawsuit of contributing to the crisis.

Substance abuse in West Virginia over the past two decades drove a huge increase in foster placements. Currently there are more than 6,500 children in the care of the state. “On the other hand, we had trouble finding even parents who could pass drug tests in order to have those foster children in their homes,” Gupta said.

The state’s lawsuit alleges Johnson & Johnson subsidiary Janssen Pharmaceuticals Inc., along with Teva Pharmaceuticals Inc., AbbVie Inc.’s Allergan and their family of companies misled healthcare providers and consumers about the risks and benefits of their opioid products.

Gupta was questioned over several hours on a variety of topics unrelated to the defendants, mostly about his analysis of drug-use data and his time as West Virginia’s chief health officer from 2015 until 2018. Before that he served as executive director of the Kanawha-Charleston Health Department.

Gupta was confirmed last fall by the U.S. Senate as the director of the White House Office of National Drug Control Policy.

West Virginia long has led the nation in the rate of drug overdose deaths, statistics that grew “far worse” after he left the state, Gupta said.

“My opinion is that there still exists today an opioid epidemic in West Virginia which is worsening and that includes abuse, addiction, morbidity and mortality,” Gupta said.

Gupta said the opioid crisis also led to increases in public health problems such as Hepatitis B and HIV cases and neonatal abstinence syndrome, which is a withdrawal in newborns caused by exposure to drugs in the womb and stops at birth. Gupta said “the health-care system was clearly overwhelmed. I probably heard that every single day from health-care providers.”

Gupta said a shift from pharmaceutical pills to illicit drugs such as fentanyl and heroin began in 2012 as pain pill prescriptions began to decline. Fentanyl-related overdose deaths increased fivefold alone in West Virginia from 2014 to 2016, he said.

The lawsuit filed by Attorney General Patrick Morrisey accuses the companies of creating a public nuisance and violating the state’s Consumer Credit and Protection Act.

Attorneys for the companies said in opening arguments Monday that their individual products in question had considerably less than 1% of the market share in West Virginia, were medically necessary prescriptions and could not have contributed to the state’s opioid problems.

In November, a California judge ruled in favor of Johnson & Johnson, Allergan, Endo International, Teva and others, saying that local governments hadn’t proven in a lawsuit that the pharmaceutical companies used deceptive marketing to increase unnecessary opioid prescriptions and create a public nuisance.

Nationwide settlements were finalized in February by Johnson & Johnson and distributors AmerisourceBergen, Cardinal Health and McKesson over their role in the opioid addiction crisis. That cleared the way for $26 billion to flow to nearly every state and local government in the U.S. West Virginia previously reached settlements in separate lawsuits, including $37 million with distributor McKesson in 2019, and $20 million with Cardinal Health and $16 million with AmerisourceBergen in 2017.

In Charleston, a separate bench trial wrapped up last summer in federal court in a lawsuit accusing AmerisourceBergen, Cardinal Health and McKesson of fueling the opioid crisis in Cabell County and the city of Huntington. That judge has not indicated when he will rule.

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