CHARLESTON, W.Va. (WOWK) — A familiar face provided testimony Tuesday in the state of West Virginia’s trial against three opioid manufacturers.

Dr. Rahul Gupta, the current Director of National Drug Control Policy, who also served as the director of the Kanawha-Charleston Health Department, and the state’s former Health Commissioner, testified in a previously recorded deposition.

Dr. Gupta testified about the medical community’s change in attitude towards treating pain and prescribing pain medication over the years, saying the prescribing began with small reservation and then began to “normalize.”

Gupta also discussed the three reports he commissioned about the opioid crisis during his time as West Virginia’s Health Commissioner. The reports studied the number of opioid related/overdose deaths, a breakdown of the drugs what was dubbed a “social autopsy,” and an opioid response plan.

He said that in 1999, West Virginia had a overdose death rate of  4.1/100,000 people, lower than the national rate at 6/100,000 people.

In 2001, Dr. Gupta said it “flipped” and “never looked back.”

Testimony revealed that in 2001 West Virginia’s Chief Medical Examiner said that he had a hunch that these rates were staring to rise and it was connected to opioid use and opioids that were prescribed.

Between 2001-2015 there were 6,001 overdose related deaths. The majority of the deaths occurred in Kanawha, Cabell and Berkeley Counties.

After 2015, when more controls were in place to keep opioids out of the wrong hands and the number of prescriptions went down, is when Dr. Gupta said there was an increase in the number of deaths related to fentanyl and heroin.

Dr. Gupta went on to explain that those who were addicted to prescription pills and could no longer get them turned to those drugs.  He said opioid use disorder stimulates the brain’s dopamine release and that heroin and fentanyl provided the same thing to those who were dealing with opioid use disorder, or addiction.

Gupta said in his time as the state’s chief medical officer he was aware of widespread reporting that revealed from 2007-2012, 780 million prescription opioid pills were delivered to the state of West Virginia.

West Virginia Attorney General Patrick Morrisey is asking a judge to hold Johnson & Johnson subsidiary Janssen Pharmaceuticals Inc., along with Teva Pharmaceuticals Inc., AbbVie Inc.’s Allergan and their family of companies accountable for their “unlawful, unreasonable, callous and destructive conduct.”

Company attorneys told the court 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.