This story was reported and written by VPM News.
Newly released numbers from Virginia’s chief medical examiner show the state is nearing its pre-pandemic rate of fentanyl overdose deaths after major spikes in 2020 and 2021.
The report, compiled by the Virginia Department of Health, shows fatal opioid overdoses in the commonwealth peaked in 2021, at the height of the COVID-19 pandemic in 2021. That year, 2,229 Virginians — or nearly 26 per 100,000 residents — died from overdoses of fentanyl, heroin, and/or other prescription opioids.
The VDH report, which released preliminary data through the first half of 2024, predicts a total of 1,552 opioid-related deaths in Virginia this year — down just over 30% from 2021.
Len Dickey, a substance use disorder data analyst with the Virginia Department of Behavioral Health and Developmental Services, called the report “encouraging” and credited a variety of efforts by federal, state and local governments for the decline.
“It took an awful lot to get us there — an awful lot of horrible things,” Dickey said. “And it’s taken an awful lot of very heavy lifting by everyone.”
State and local agencies have made mitigating opioid overdose deaths a priority. In 2023, Gov. Glenn Youngkin launched a plan to address the fentanyl crisis as part of the Right Help, Right Now initiative. It included investments in education, prevention, recovery and treatment efforts. Local health departments and community service boards began making naloxone, a medicine that quickly reverses an opioid overdose, available for free to the public.
A key component of the education effort is a program called REVIVE! The goal is to teach citizens without medical training to provide aid if they’re around someone experiencing an opioid overdose. There are more than 800 REVIVE! trainers who conduct hundreds of sessions in person and online across the state each year, according to DBHDS. Experts said the program has helped decrease overdose deaths.
On a sunny October day, about 60 Virginia Department of Labor and Industry employees gathered in a hotel conference room in Richmond’s West End for a REVIVE! training.
Tiana Vazquez, the REVIVE! health education specialist for DBHDS, began her presentation by talking about substance use disorders and how people become addicted to drugs. She also spoke about recognizing the signs of an opioid overdose and how to administer naloxone in an emergency.
“My goal is to help break the stigma,” Vazquez said. “The more education, the more information that we have out there, the more we can help others.”
Using a mannequin, Vazquez walked the audience through administering the drug. First, she suggested calling 911 to get emergency responders to the scene quickly. While waiting, she said to check if the person is conscious and breathing. If they’re not breathing, Vazquez said to administer a dose of naloxone — then a second, if the person is still unresponsive after three minutes.
“They’re going to go into acute withdrawal symptoms,” Vazquez told the audience, with possible effects including severe nausea, vomiting, diarrhea or a heightened state of agitation.
But, as Vazquez explained, “At the end of the day, as long as they’re breathing, we did what we could do.”
Research indicates naloxone use is spreading nationwide. A study published in JAMA Network Open, a journal published by the American Medical Association, found that from June 2020 to June 2022, emergency medical service clinicians reported 744,078 people received naloxone across the U.S. According to the researchers, the number of people who were given naloxone by a layperson before emergency responders arrived increased 44%.
Access to naloxone is expanding as well. In 2023, the Food & Drug Administration made Narcan, a nasal spray form of naloxone, available over the counter. The FDA’s approval of the nasal spray led to an increase in availability of the drug, which decreased the cost from about $100 to $60. As of the end of September, VDH’s naloxone distribution program had dispensed nearly 105,000 boxes to its partner organizations across the state. Among those groups were local health departments and community service boards, which provide free boxes of naloxone to local residents.
Vazquez stressed that naloxone was just one part of the equation in battling overdoses.
“This is a chance for that person to have that second chance,” she said. “After you administer the naloxone, that’s when change really happens. So, this isn’t just the one go-to.”
Dr. Christopher Holstege, director of UVA Health’s Blue Ridge Poison Center, said he’s seeing firsthand evidence of the decrease in deadly opioid overdoses.
“We’re seeing a slight drop from the emergency departments,” Holstege said. “Hopefully, that trend will continue.”But Holstege said there’s not enough research to credit a particular prevention effort as having the most impact.
“There’s a whole host of efforts that have been done, and then it’s a question of which ones do we think are the most effective right now,” he said.While Holstege credits the REVIVE! trainings for spreading the word about naloxone, he warned about the impact of improperly administering the drug.
“Remember, we’re giving the naloxone for breathing, not for someone who’s a little sleepy. It’s the breathing that’s the problem,” Holstege said. “It’s cruel to an opioid addict, for example, who’s a little sedate, to give them naloxone and reverse them, and put them into withdrawal. I’ve seen plenty of complications from that, too.”
Holstege said an addict in withdrawal could be in danger of aspirating on vomit or becoming “very combative.” He said it’s important to call emergency responders for help if a person without medical training administers naloxone.
Despite positive signs showing the state’s mitigation efforts are having an impact, Dickey, the data analyst, cautioned against complacency.
“We are on target to do that,” Dickey said about surpassing the Youngkin administration’s goal of a 20% decrease in opioid overdose deaths by 2025. “But no one would say that that’s enough or that’s a stopping point. We want to get it to zero. That’s the goal.”
Copyright 2024 VPM
