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As the number of fatal opioid overdoses climbs throughout the Commonwealth for the fourth consecutive year, state officials are working to make substance abuse treatments more readily available to those in need.
To prevent fatal overdoses, State Health Commissioner Dr. Marissa Levine signed a statewide order allowing all Virginia pharmacies to distribute naloxone — a life-saving medication that stops an overdose from occurring — without a doctor’s prescription.
As of June, 663 fatal overdoses were reported by the Virginia Department of Health. More than 80 of those deaths were reported in Norfolk and Virginia Beach.
Dr. Levine estimates that if trends continue, the number of fatal opioid overdoses reported in 2016 statewide will be 77 percent higher than figures from just five years ago. Levine said, on average, three Virginians die each day as a result of opioid abuse, while more than two dozen visit emergency rooms for immediate treatment.
“The facts clearly tell us that the consequences of opioid addiction in Virginia have risen to unprecedented levels and can now be classified as an epidemic,” Dr. Levine said.
The order was issued on the heels of last week’s report on substance abuse issued by U.S. Surgeon General Dr. Vivek H. Murthy, which called for substance abuse to be treated as a mental illness, not a criminal offense.
On Monday, Dr. Levine echoed that sentiment.
“Our law enforcement partners have repeatedly claimed that we cannot arrest our way out of this problem,” Dr. Levine said. “I’ve heard them loud and clear, and I agree.”
Dr. Caroline Juran, executive director of the Board of Pharmacy, said that patients previously had to present a prescription to pharmacies that carried the drug. The statewide order will remove that barrier and make the medication readily available to those in need at more than 2,000 pharmacies in Virginia.
“The statewide standing order will allow any pharmacy to dispense naloxone to a specific person who wants to have the drug on hand for administering to a person they believe are either experiencing or about to experience and opioid overdose,” Dr. Juran said.
Compared to statistics from 2015, opioid deaths had risen 35 percent in the first six months of 2016.
Rosie Hobron, a forensic epidemiologist with the Virginia Department of Health, said that prescription overdoses are actually going down, but due to an increase of illicitly-produced opioids, deaths are on the rise. Most of those deaths were attributed to illegal fentanyl coming in from countries like China and Mexico.
For the first time, the Virginia Department of Forensic Science identified the presence of Carfentanil in Virginia, a drug that Dr. Levine said is 10,000 times more potent than morphine and 100 times more potent than fentanyl.
The order will also help those who are at risk of accidental overdose by using prescribed opioids for pain management. Pharmacists who identify a patient using prescribed opioid medications for chronic pain will now be able to recommend that the patient should also have naloxone on hand.
Though the statewide order will allow the drug to be easily dispensed, it does not yet cover the costs of the drug, which can range from about $120 for a nasal spray to an auto-injector that costs significantly more, according to Dr. Juran.
Unlike previous years, patients who have Medicaid can now use their insurance for services dedicated to substance use disorders that had previously been restricted.
“This is an excellent start,” said Dr. Jack Barber, interim commissioner of the Virginia Department of Behavioral Health and Developmental Services. “It’s by no means the end of the journey, though, as there are many individuals that do not have access to coverage or to Medicaid and face serious obstacles in getting treatment and paying for it.”
Dr. Barber said that the stigma attached to people who suffer from substance abuse disorders has resulted in “treatment being inadequate.” With patients and their loved ones able to access preventative medication, Dr. Barber said he hopes that those who use it will be able to overcome their struggles and that communities will no longer fall victim to the sudden loss of loved ones.
“Often times, the first step on someone’s path is when they experience a serious overdose and they become aware of how serious and dangerous the problem is,” Dr. Barber said.
Officials also called on residents who have expired, unwanted or unused prescription medicines to turn them in at local pharmacies, law enforcement offices, hospitals and Community Services Boards that safely destroy the medications. More than 80,000 drug disposal kits – created to combat prescription misuse and abuse – were dispensed earlier this month.
Dr. Levine said he hopes that the declaration will emphasize the growing need for public education on what he called an epidemic to minimize the risk of the emergency and prevent deaths.
“I realize that this declaration and the statewide standing order cannot in any way minimize the loss experienced by so many families as a result of opioid addiction epidemic,” Dr. Levine said. “However, if the declaration and statewide standing order save even one life from here on in, the bill has been worth it.”
For more information on opioid abuse and the use of naloxone, visit the Department of Behavioral Health and Developmental Services or VaAware.