Not long ago, 11 people applied for a job with a small Southwest Virginia business. Five walked away when told they would have to take a drug test. Another five took the test and failed.

That left the company with just one drug-free applicant to fill the position.

Such a scenario is all too common, according to a coalition fighting a prescription drug abuse problem that took hold a decade ago in far Southwest Virginia and has yet to let go.

"What we've heard, time and time again from employers, is their frustration that so many people they are trying to hire are either unwilling to take, or unable to pass, a drug test," said John Dreyzehner, chairman of the board of One Care of Southwest Virginia.

In a region where prescription drugs have long been abused, the costs are often measured by the number of arrests, the growing demand for treatment and the annual death toll from accidental overdoses.

But in addressing something that has killed more than 2,000 Southwest Virginians over the past decade, the coalition is broaching a less-talked-about casualty.

"This is a business, economic and workforce issue," said Carl Mitchell.

Mitchell is executive director of One Care of Southwest Virginia, a consortium of substance abuse coalitions, health care professionals, law enforcement officers and community leaders that last week released a 68-page plan of action.

Concerns about a workforce diminished by drug abuse are based largely on anecdotal evidence, group members acknowledged.

And, they say, an unwillingness in the business community to talk openly about a sensitive topic makes it even more difficult to quantify.

"We have a number of companies who say, this is what we're facing, this is what we're dealing with, but don't say anything about it being company X, Y or Z, because it could have an impact on our ability to recruit, or an impact on our safety record, or an impact on our health care coverage," Mitchell said.

It was only after he was sworn to secrecy, Mitchell said, before a small-business owner told him about his experience of having 10 of 11 job applicants eliminated by drug use.

A second, larger company related a similar story: At a recent job fair, it received about 1,000 inquiries for 100 job openings. Half of the prospective applicants decided the work was not for them, and about 250 others did not have the necessary job skills.

Of the 250 that remained, Mitchell said, about half either refused to take a drug test or tried and failed. That left just 125 applicants to fill 100 positions.

"I think it's a real problem," Glen "Skip" Skinner said of drug use among Southwest Virginia's workforce. "I just don't have any real data I could cite."

Skinner is executive director of the Lenowisco Planning District Commission, which covers Lee, Norton and Wise counties.

One coal company executive once told Skinner about prospective job applicants whose first question was whether they had to take a drug test. When told they would, the applicants turned and left.

An official with the Virginia Employment Commission said the agency had no information about the number of job applicants turned away because of drugs.

But given the scope of prescription drug abuse in Southwest Virginia, some say it's inevitable that what might be considered a street problem has made its way into the labor pool.

By one estimate, one in six people misuse prescription drugs in a region that stretches from Montgomery County to the western tip of Virginia. That is based on a projection from the Office of National Drug Control Policy, which says that for every fatal overdose from prescription medication in a region, about 460 people are likely using the drugs for nonmedical reasons.

And the number of fatal overdoses in the region is no secret.

"With over 200 drug overdose deaths each year in Southwest Virginia since 2003, at rates three, four and five times higher ... than our nation or state, we have lost more than 2,000 people to this epidemic in this decade," the One Care coalition wrote in a letter announcing regional meetings held before the report was issued.

In some years, more people have died of drug overdoses than in homicides, house fires and alcohol-related automobile accidents combined.

The impact of prescription drug abuse on the region's economy was just one of many aspects covered by the report released last week by One Care of Southwest Virginia.

Among the report's recommendations: increasing outreach efforts, treatment programs and drug courts in the region; requiring health care professionals to report suspected cases of prescription drugs being used illegally; and expanding multijurisdictional law enforcement efforts.

The report also calls for employers to join in a program aimed at treating drug-addicted workers in a way that would allow them to keep their jobs.

One Care of Southwest Virginia is a consortium of more than 20 substance abuse coalitions that have sprung up in 21 cities and counties across the region.

Prescription drug abuse came under a spotlight in the early 2000s with the advent of OxyContin, a potent painkiller that thrill-seekers abused by crushing the pill's protective coating and snorting or injecting the powder.

The drug caught on quickly in far Southwest Virginia, where it was prescribed abundantly to treat pain caused by injuries in coal mining and other high-risk occupations.

Since then, prescription drug abuse has been spreading.

"It has moved east," Mitchell said. "What started with OxyContin in the coalfields is now a major statewide issue."