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For the fourth consecutive year, opioid-related deaths in Virginia are on the rise. Last year, more than 950 people overdosed on opioids – both prescription and illegal – throughout the state. This year, the Virginia Department of Health estimates about 1,000 Virginia residents will meet the same fate.
In Norfolk, the Community Services Board (CSB) launched a pilot program last month using a new prescription drug. The three-year program, funded by a $300,000 grant from the U.S. Department of Justice, allows clients of the Norfolk Drug Court to receive substance abuse treatment services that utilize a prescription drug called Vivitrol, which prevents opioid relapses.
Vivitrol is the brand name for injectable form of the drug naltrexone.
In 2015, more than 60 Norfolk residents died from an opioid overdose. Data from the Department of Health’s website ending in June of this year shows that 49 Norfolk residents had overdosed on the same drugs.
Historically, clients receiving similar treatments were prescribed Methadone or Buprenorphine, both of which have addictive qualities. Vivitrol, which was approved by the U.S. Food and Drug Administration in October 2010, does not, according to Sarah Fuller, director of the CSB.
“Vivitrol is not as dangerous as other things on the street. It’s much safer all around,” Fuller said.
Though the drug seems to be a better alternative for clients, it does come with a much higher price tag. According to Fuller, treatments using methadone or buprenorphine can cost a couple hundred dollars a month, which typically includes other services and covers physician’s visits.
Vivitrol, which is administered with a shot and lasts up to four weeks, costs $1,000 per shot. The average person would use the prescription drug for up to one full year.
“Once you start someone on Vivitrol, the clock starts ticking. It’s very expensive, and some people just can’t afford it,” Fuller said.”
In the event that a client does use an opioid and begin to overdose, the program will also provide someone of the client’s choosing with training to administer naltrexone, which blocks opioid receptors and stops an overdose from occurring.
“This is really important, because while we’re trying to get people better, people are overdosing,” Fuller said. “Providing the naltrexone will allow us to really help those who need it to get medical attention.”
Rosie Hobron, a forensic epidemiologist with the Virginia Department of Health, said that though prescription opioid overdoses are decreasing, the illegal production of one legal drug, called fentanyl, is largely to blame for the rise in opioid-related deaths in the state.
In 2015, 23 people died from a fentanyl overdose in Norfolk, accounting for 10 percent of the total fentanyl-related Virginia deaths and making up more than one-third of opioid overdoses in the city. As of June, 28 of the 49 opioid overdoses in Norfolk residents were caused by fentanyl.
“Fentanyl has historically been a prescription drug, but in 2013, we began to see the amount of illicitly produced fentanyl going up,” Hobron said. “In 2016, almost all fentanyl overdoses are from illicitly produced fentanyl and is why the number of overdoses is increasing.”
Because of the high cost of Vivitrol, Fuller hopes to provide Vivitrol to about 8 clients at a given time.
“This will be targeted to our clients that aren’t on Medicaid, because Medicaid does actually cover it,” Fuller said. “But because Virginia is not an expansion state and substance abuse is not considered a disabling condition, most of our substance abuse clients do not have Medicaid.”
The pilot program began on Oct. 1 and will run through Sept. 30, 2019.