By Michael Campbell News Editor
VIRGINIA – “This isn’t a new problem and it’s not a race or gender problem. It’s everyone’s problem and it’s affecting everyone.”
Those were the frank words of Virginia State Police First Sergeant Harvey Smith to a room of residents from across the state’s 63rd District as they received information on the growing opioid abuse epidemic in the state and around the nation while offering feedback about what can be done to curb this crisis that has not spared central or southside Virginia.
Smith was one of the several speakers invited to last week’s town hall at Dinwiddie’s Eastside Enhancement Center, hosted by Del. Lasherecse Aird (D – 63rd District) with the goal of bringing the conversation about abuse of prescription opioids, heroin, and fentanyl out from the shadows and into the public forum.
“I think that we have all had private conversations about this issue,” she remarked. “Wondering if someone is a user of these drugs or if someone you know has been impacted by opioid abuse.”
Wednesday’s forum provided attendees with the sobering statistics that have grabbed local and national headlines while reinforcing the fact that the crisis is not just a southwestern Virginia problem.
According to data provided by the Commonwealth, the number of deaths due to drug overdoses in the state has been increasing every year since 2007, from 721 during that year to a predicted total of over 1,400 in 2016. In addition, the number of fatal overdoses rose 38 percent in 2016 when compared to 2015.
Of those drug overdose deaths between 2007 and 2015, approximately 75 percent of them were tied to fatal overdoses of opioids, be it fentanyl, heroin, or prescription opiates.
Focusing on the 63rd District specifically, which is comprised of portions of Chesterfield, Dinwiddie, Prince George, Hopewell, and Petersburg, roughly 250 people have died opioid abuse-related deaths between 2007 and 2015.
The vast majority of those deaths occurred in the county with the fifth-largest population in the Commonwealth, as reported by the 2012 Census, Chesterfield. Between 2007 and 2015, over 180 people died in the county due to some form of opioid abuse.
All of the counties and cities within Aird’s representation have seen increases in the number of opioid deaths since 2007, with Dinwiddie, Hopewell, Petersburg, and Prince George averaging between 10 to 20 deaths from opiate abuse from 2007 to 2015.
Those numbers drew quiet, but audible gasps from the audience as they digested the data being presented to them by Jodi Manz, policy advisor for the Office of the Secretary of Health and Human Resources for the state, who used her time before the group to drive home the true human toll this epidemic has had on the state.
“Each of those deaths is a person and family member,” she said. “These are all people you have lost in your district during this time.”
She, along with many experts in the field who are working to curb the trend of opioid addiction, point to the time period during the 1990s when Purdue Pharma first released OxyContin, a controlled-released formulation of oxycodone, and marketed the drug aggressively to prescribers, noting that the OxyContin was not addictive by citing “one very small, very old study.”
According to Manz, that, along with the relaxation of guidelines for direct-to-consumer advertising by the Food and Drug Administration contributed to an increase in abuse of these powerful painkillers, with data showing a significant correlation between an increase in opioid sales and a similar increase in opioid-related deaths and treatment center admissions between 1999 and 2010.
As a result, following a court battle, Purdue Pharma pled guilty to misleading the public about the risk of addiction connected with OxyContin, settling the case for $600 million in 2007. During that same year, the state of Kentucky also sued the privately-held drug company for the impact the abuse of their painkillers have had in Appalachia, one of the several epicenters in this growing crisis.
The litigation continues for Purdue Pharma as a Reuters report this week states Orange County, New York is suing the company, along with Johnson & Johnson and other drug makers, for “engaging in fraudulent marketing that played down the risks of prescription opioid painkillers, leading to a drug epidemic.”
While court battles play out over the painkillers and the companies’ role in the abuse epidemic, the battle by state health and law enforcement officials marches on as they try to make sense of the problem that is growing by the day.
For those officials, they understand that much the situation in central and southeastern Virginia is two-pronged, the abuse of prescription opiates, along with heroin and fentanyl. Over the past several years, an increase in illicitly produced fentanyl, which is made by pharmaceutical companies, has tipped the scales in the opioid abuse crisis, with overdoses occurring by those ingesting heroin that has been cut with fentanyl, which is between 50 and 300 times more potent than morphine and can trigger an overdose within minutes.
Data from the 63rd District shows deaths tied to the abuse of fentanyl, heroin, and prescription opioids are tangible, with no community being spared and Chesterfield being the hardest hit, with nearly 60 deaths tied to fentanyl overdoses, 100 connected with heroin, and nearly 120 linked to prescription opiates.
“On a molecular level, these drugs are almost exactly the same,” Manz said. “[Oxycodone] is a legal version of heroin. I think this is a message that we weren’t good at getting out.”
For Manx and the panel, the priority now is to treat the addiction, not criminalize it. As part of their framework, the state is looking to find ways to help those suffering from opioid addiction by reducing further harm to them as they work to get them into treatment and ensuring adequate access to that treatment through efforts like ARTS, or the Addiction and Recovery Treatment Services program, which “expands access to a comprehensive continuum of addiction treatment services for all enrolled members in Medicaid, FAMIS, FAMIS MOMS and the Governor’s Access Plan (GAP).”
The challenge of access lies in the fact that Virginia has not taken action on expanding Medicaid in the commonwealth with Governor Terry McAuliffe’s efforts failing to gain traction in the General Assembly. Medicaid is currently only available for “a child in a low-income family, a pregnant woman, the elderly, those with a disability, or a parent who meets specific income requirements.”
“Treatment is not just one thing that is going to help with addiction,” Manz remarked. “Addiction is something that has to be treated every day and treatment does work.”
Brittany Anderson with the Office of the Attorney General echoed many of Manz’s points while highlighting the office’s efforts to stop traffickers from bringing in and moving product across the state and prosecuting those who do.
“We have a significant problem with this because we do border an ocean and a number of other states, including North Carolina and Tennessee, who move those drugs up and down the Interstate 81 corridor,” Anderson explained.
As part of the increased prosecutions, resources within the Attorney General’s Office have been dedicated to courtrooms for the prosecution of trafficking cases, while others have worked on ways to reduce available product on the street for distribution and putting safeguards in place to better track prescription opiates, along with increasing access to overdose reversal drug Naloxone.
While traditional drug trafficking via vehicles and other transport continue to keep Virginia State Police and the Attorney General’s Office busy, VSP First Sergeant Smith said parcels of fentanyl have made their way into the commonwealth through the U.S. mail and shipping companies from the dark web, beyond the site of the typical Internet user and, at times, law enforcement.
With the influx of fentanyl and the likelihood of it being used to lace heroin, Smith stressed the deadly consequences the drugs carry.
“Two milligrams of fentanyl is lethal,” he warned. “That’s about the size of 32 grains of salt or seven poppy seeds.”
As the conversation shifted into the question-answer session, some in attendance asked officials why regulations for prescription monitoring program, which is aimed at tracking the issuance of Schedule 2 through 4 drugs to reduce “doctor shopping,” where patients move between doctors to get prescriptions written, seem to be preventing people who truly need pain management treatment from getting it.
“There are people who do need this treatment,” Manz said to the concerned Chester woman. “A doctor can still write the prescription and the regulation isn’t such that they can’t, they just have to do some extra paperwork on their end. If they feel they have to go out of business, they need to call us.”
A Dinwiddie Social Services case worker harkened back to what the statewide trend showed as addiction and abuse of opioids continue to rise, noting that “80 percent” of her caseload is related to some type of addiction and the millions in additional funding dedicated in McAuliffe’s budget to tackle the drug crisis aren’t enough.
“We lack the resources here locally,” she told Delegate Aird and the panel. “A lot of these people do not have transportation and they can’t get to treatments every day so we try to get the family to help them and others don’t have insurance or are eligible for Medicaid. We don’t know where to go.”
For Aird, who serves on the House Health, Welfare, and Institutions Committee, the words from concerned constituents and community officials were eye-opening.
“If you think about the level of funding that dedicated to this and it doesn’t fit half of the need, this means more money needs to be invested because people desperately need something here,” she said.
While this was the first town hall on the subject hosted by Aird, she hopes it will serve as the catalyst for further conversation and discussion as she, along with her fellow House and Senate representatives, work to craft legislation to help curb the deadly trend of opioid abuse and addiction in the Commonwealth.
“This is just the beginning of the conversation,” the delegate closed. “We need to work together from a state level and have that get down to the locality, with police, sheriff’s offices, and departments of social services all working together to have a conversation and be made aware of what is out there and what’s being done to resolve this issue. This isn’t just a southwestern Virginia issue.”