Photo by nixki/Thinkstock
After a quick review of the statistics, it’s easy to see why Virginia has declared a public health emergency in its battle against opioid addictions and abuse:
- an 89 percent increase in emergency room visits for heroin overdoses in the state in the first nine months of this year compared with the same period in 2015
- a projected death toll of 1,259 by year’s end; a 97 percent increase from the 690 Virginians who died from overdoses in 2010 and a 23 percent increase from 2015’s toll of 1,021
Gov. Terry McAuliffe and other officials declared opioid addiction in the state a public health emergency in an announcement on Nov. 21. McAuliffe said the declaration “provides a framework for further action.”
The state also offered Virginians a new tool to fight the rising death toll, issuing a standing order that allows residents to obtain prescriptions for Naloxone, a medication that blocks the effects of an overdose. The standing order serves as a general prescription that the public can use.
A combination of factors is at work in the rise in opioid overdoses in the state, according to Dr. Hughes Melton, chief deputy commissioner of the Virginia Department of Health. Abuse of prescription opioids has decreased a bit, but there has been a rise in deaths from heroin and from illicit fentanyl, made in China and elsewhere. The product is at times mixed with heroin or abused on its own. It’s a white powder that’s hard to differentiate from other drugs, so “you really don’t know what it is,” says Melton.
Fentanyl is a synthetic opioid that in its prescribed form is used as a painkiller primarily in cancer patients. It’s 80 times more potent than morphine.
Naloxone costs vary depending on its form, ranging from $70 for a nasal spray delivery version to $3,000 for a device similar to an Epipen, according to Melton.
Anyone can obtain a prescription, but some training is required. Get it from your local pharmacist, and she can provide some basic education by talking with you and providing you with a pamphlet. For more advanced training, there’s REVIVE, which provides classes and information on its website for laypeople, first responders, healthcare professionals and others. The training is free.
The Naloxone order is a first-line emergency treatment to help when someone has overdosed, but does little to ward off the addiction and abuse in the first place. That’s going to take a change in mindset and a combined effort of stakeholders, according to Melton. He wants to see a concerted effort undertaken by all facets of the community, including law enforcement, health care, faith and pharmacy.
In addition to making Naloxone available, a needle exchange program would also help in the fight against addiction, says Melton. “Solutions that initially seem sort of illogical become logical when you understand the nature of addiction,” he says.
Melton also calls for a greater understanding by the general public of the nature of addiction. “Part of our hope is that by understanding the disease better, we can destigmatize it,” he says. “[The] science is there to show it’s a disease, but [we] need people to understand that when considering what to do.”
Danny Avula, director of the Richmond City Health District, notes that the groundwork is already being laid. In Richmond, he’s working with groups including the Richmond Ambulance Authority, health and mental health workers, and law enforcement to review and understand data and determine who the abusers are, and from there determine what preventive programs would work best here.
Some potential models include programs in some jurisdictions in Massachusetts, where addicts are provided treatments and therapy instead of facing jail and prosecution. There also needs to be an increase in access to treatment for addiction, says Avula.
“There are just not enough places for people to go to get the medication and the accompanying therapy that’s needed,” he says.
The faces of the addicts in this epidemic are as diverse as the state’s population. Avula notes that most calls for overdoses involve patients who are in their 30s or older, but that in general “We’re seeing a pretty good cross-section racially.”
Melton notes that Virginians should realize that addiction is as common as depression in the general population, so they’re going to encounter it, either in a loved one or in the community.
“The fact that this has been so widespread should make us as a society think differently about it, and try to intervene in a different way than we have historically,” says Avula.
Learn more about addiction, treatment and recovery at VaAware.
DRUG OVERDOSE DEATHS 2007-2015
247 Chesterfield County
268 Henrico County
374 Richmond City
DRUG OVERDOSE DEATHS 2015
37 Chesterfield County
42 Henrico County
65 Richmond City
DRUG OVERDOSE DEATHS 2016 THROUGH JUNE
30 Chesterfield County
30 Henrico County
43 Richmond City
HEROIN OVERDOSE DEATHS 2007-2015
67 Chesterfield County
92 Henrico County
168 Richmond City
DEATH BY HEROIN OVERDOSE 2015
18 Chesterfield County
27 Henrico County
24 Richmond City
DEATH BY HEROIN OVERDOSE 2016 THROUGH JUNE
12 Chesterfield County
18 Henrico County
24 Richmond City
Source: State Medical Examiner’s Office
CAPSULES
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