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As the COVID-19 case count continues its incessant climb in Virginia and across the nation, the epidemic of opioid use is projected to claim a record number of fatalities in the commonwealth before year’s end.
The Chief Medical Examiner’s report was recently updated and projects 2,053 fatal overdoses in Virginia by year’s end. There were 1,626 overdose deaths reported in the commonwealth in 2019, a record that will be exceeded by 26% if the projections hold. The state reported a 66.8% increase in drug overdose deaths in the second quarter (April through June) compared with 2019, “an enormous increase in fatal overdoses since the beginning of the COVID-19 national shutdown,” according to the report. That’s almost a three-fold increase from the 690 drug fatalities in Virginia in 2010.
In Richmond, Emily Westerholm, Comprehensive Harm Reduction Program coordinator for the nonprofit Health Brigade, says her program has seen “a huge uptick” in its enrollment of new participants, and also in overdose reporting. “Yes, the statistics are heart-wrenching, but for us they come as no surprise,” she says.
There is a correlation in the uptick and the shutdown, but locally, there had been a significant increase in drug overdoses in the last three months of 2019. “It’s important to know that this uptick in overdoses preceded the pandemic, beginning really this time last year, says Julie Karr, opioid coordinator for the Richmond City and Henrico County Health Districts. She notes in an email that there were 37 deaths from opioid overdoses in the city of Richmond in the fourth quarter of 2019, “a record-breaking number for the city for any quarter.”
The numbers continued to rise in the city, with 43 opioid overdose deaths in the first quarter this year, and “a staggering” 62 in the second quarter, Karr reports. There have been 105 deaths from opioid overdoses confirmed in the city through mid-November.
Henrico County had a fourth-quarter rise in fatalities, but overdose deaths in the first two quarters of 2020 were similar to numbers reported in 2019. Overdose deaths are reported according to the locality where they occurred, not by the residency of the victim.
The VCU Medial Center reported a 123% increase in patients who had overdosed on opioids in its emergency department during the previous height of the pandemic, between March and June (227 people), compared with 102 treated for overdoses in March-June 2019.
Virginia has undertaken several steps in recent years to mitigate the devastating impact of the opioid epidemic, including increasing access to the medication Naloxone and similar substances that may reverse an overdose. Such steps may have tamped down the number of fatal overdoses. Westerholm notes that her program participants report 618 overdoses were reversed with Naloxone use since the first of the year, a 300% increase compared with a similar period in 2019. “I believe that without the campaign to provide safer using education and Naloxone, fatal overdoses would be significantly higher,” she says in an email. “COVID-19 obviously threw a giant wrench into these efforts.”
In October, the Virginia Department of Behavioral Health and Developmental Services reported that the state received a $52.6 million federal grant to pay for programs to deal with the opioid epidemic. The U.S. Substance Abuse and Mental Health Services Administration money will be distributed to local programs, with goals including improving access to treatment programs and recovery services.
The pandemic’s impact on drug use and addiction continues to be assessed. Factors including social isolation, job loss and layoffs, and concerns over lost wages, child care, and access to therapy, groups and medical care come into play and may be intensified in the pandemic, according to Dr. Gerard Moeller, the director of the VCU Institute for Drug and Alcohol Studies. He notes that some people in recovery relapsed under such stresses and that their bodies were less tolerant of the drugs, so they experienced overdoses.
Westerholm notes that the Health Brigade program saw a massive spike in fatal overdoses early in the pandemic. She also notes how isolation plays into the situation and notes that many people dealing with substance abuse have no easy access to the internet for telehealth sessions for medical care and online support groups. She adds that Health Brigade responded to the spike by bringing a mobile facility to a hard-hit community and works with other providers to stage monthly outreach events. “We literally go out on foot discussing overdoses and distributing Naloxone to community members,” she says. “If we could reduce the stigma that comes with injection substance use, and if we can provide safer using techniques and Naloxone to anyone with a history of use, it may reduce the number of fatalities.”
Image courtesy Virginia Department of Health
