Richmond is Virginia’s overdose capital. Nine of 10 fatal overdoses in the city involve fentanyl
Richmond Virginia Jan 28, 2022
Virginia is on track for yet another record-breaking number of drug deaths, with the Richmond area at the epicenter, according to data released this week by the state medical examiner’s office.
More than 2,000 Virginians died of drug overdoses through the first nine months of 2021, a 17% increase over the same time frame in 2020. Virginia is on pace to record nearly 2,700 overdose deaths in 2021, a figure nearly four times higher than when the state began tracking overdoses in 2007 in response to the painkiller epidemic.
The spike in overdose deaths — 2021 is poised to be the eighth year in the past nine that Virginia saw record highs — has been driven almost entirely by fentanyl, a synthetic opioid 50 times more potent than heroin. Fentanyl deaths have increased every year since 2012, while deaths not related to the opioid have declined in each of the past five years.
State data show that 1,551 people died of fentanyl overdoses through September 2021 — nearly as many as in all of 2020. In 2012, fentanyl was present in just over 6% of all fatal overdoses. Kathrin “Rosie” Hobron, Virginia’s statewide forensic epidemiologist who compiles the overdose data, said the drug is now present in 77% of all statewide overdose deaths.
The Richmond area is the center of the overdose epidemic in Virginia. Within city limits, where more people die of fentanyl overdoses than anywhere else in the state, 9 out of every 10 fatal overdoses involve the drug. Henrico and Chesterfield counties also rank in the top five in the state for the most fentanyl deaths.
While the highest death tolls in Virginia are in population centers around Richmond and Virginia Beach, fentanyl overdoses are spiking around the state and across the country. Death rates from prescription opioids are highest in southwestern Virginia, but fentanyl kills more than three times as many people in the region, according to the state data. And the CDC estimates that more than 101,000 Americans died of overdoses during the 12-month period ending in June 2021 — almost 65,000 of them involving synthetic opioids.
Fentanyl, originally a prescription drug used to treat severe pain in cancer patients, is now more commonly produced illicitly and sold on the streets.
Chesterfield County Sheriff Karl Leonard said that drug dealers are lacing everything from methamphetamine to marijuana with fentanyl because the easy availability, low cost and high potency boost profit margins.
“The pills are fentanyl, the powder is fentanyl,” Leonard said. “It’s all fentanyl.”
And the fact that fentanyl is killing people at unprecedented rates is not scaring users away. Lacie Slack, 27, an inmate in the Chesterfield County Jail who is currently participating in its Helping Addicts Recover Progressively program, said that when her children’s father overdosed on her supply in 2020 and died, she lied to her dealer so that he wouldn’t cut her off.
“You couldn’t tell me I wasn’t invincible,” she said. “I sold my soul for that drug.”
Slack estimated that she had overdosed at least 30 times. Stephanie Crowder, another Chesterfield inmate participating in HARP, said she had also overdosed multiple times.
Crowder, 29, started using prescription opioids heavily at 14 after a car accident and began using heroin at 18. She said that withdrawal symptoms — which often last for three to four days after heroin use — persisted for more than two weeks with fentanyl.
Jennifer Hamiel, 41, also an inmate in the HARP program, said her life “spiraled completely out of control” after she started using fentanyl.
“You’re not really living or surviving,” she said. “You’re just existing.”
Data from the Richmond Ambulance Authority show that administrations of naloxone, a medication commonly known as Narcan that can reverse the effects of an opioid overdose, have been increasing since 2019. But fentanyl is so potent that one dose isn’t always enough. Slack and Crowder said they had each experienced overdoses that required several doses of Narcan to revive them.
Hobron cautioned via email that the half-life of Narcan is shorter than many opioids — meaning that it would be possible for an overdose victim to use Narcan, then begin to overdose again as the medication wears off.
“That is why all overdoses are encouraged to go to the hospital,” she said.
The COVID-19 pandemic has complicated the problem of increasing overdoses. Hobron said the medical examiner’s office started to see spikes in fentanyl overdoses within weeks of the pandemic’s start in early 2020.
Crowder said that fentanyl became especially ubiquitous around that time, when pandemic restrictions may have disrupted the supply of heroin.
As measures designed to mitigate the spread of the virus limited in-person contact, drug users lost many of the face-to-face interactions, like Narcotics Anonymous meetings or other support groups, that could have prevented some overdoses from happening — or at least stopped them from being fatal. And for those who were either active users or relapsed during the pandemic, the isolation posed an additional danger — the possibility that if they overdosed, there might not be anyone who could get to them in time.
“Isolation is one of the worst things for someone in recovery,” Leonard said. Crowder, Hamiel and Slack all agreed, emphasizing how important support systems are to users who want to sustain their recovery efforts.
“Once you build a network and a foundation, it gets easier,” Slack said. “That’s the stuff that makes you want to keep coming back.”
Honesty Liller, CEO of The McShin Foundation, a Richmond-based recovery community, said the organization has had to be resourceful to adapt to the pandemic while still providing residential services to more than 100 people. In addition to continuing in-person treatment, McShin has used grant money to support the development of a podcast series called “Get In The Herd.”
Host Alex Bond, a McShin alumnus, talks to guests ranging from fellow recovering users to Rep. Abigail Spanberger, D-7th, who joined the show in November to discuss a bill she sponsored that would require states receiving block grants for substance abuse treatment and prevention to allocate at least 10% of that money to recovery services.
However, Liller — a recovering heroin user herself — said there is no substitute for person-to-person interaction, especially with someone who can relate to a drug user’s lived experience.
“There’s nothing like being in recovery and getting a hug,” she said. “There’s so much more to life in recovery than just not using drugs anymore.”
