By Natalie Barr
(CNS) – Virginia localities can now get a look at the estimated money they will receive from multibillion-dollar national opioid settlements, to help with prevention and treatment in the ongoing opioid crisis. The recently established Opioid Abatement Authority released on Dec. 7 a lookup tool for localities to search the projected settlement funds estimated through fiscal year 2039.
Anthony McDowell is the executive director of the Opioid Abatement Authority. His team reviews funding requests and distributes money from the abatement fund to provide treatment for communities most affected by opioid misuse and overdoses, McDowell said.
The authority is in its early stages, and only just beginning to distribute money and notify localities of funding, McDowell said. Funding is based on factors including if the settlement originated from that locality and other conditions identified in the settlements. The organization also will review requests from localities.

Settlements, according to the authority, are with the manufacturer Janssen; distributors AmerisourceBergen, Cardinal Health, McKesson and Walmart; and the marketing company McKinsey & Co.

Sen. George Barker, D-Fairfax, introduced Senate Bill 1469 in the 2021 General Assembly session to establish the Opioid Abatement Authority. The measure will be effective in creating long-term change to help counteract the opioid crisis, Barker said.

“I think we were very responsible and responsive to the people who have been dealing with these issues for years in helping to get funding to come in as part of some of these settlements and to be able to address it from both the public safety and the health care standpoints,” Barker said.

The funds can be used for “anything” targeting prevention and treatment, and supporting people in recovery from opioid misuse, according to McDowell.

“Every dollar has to be spent on efforts to abate the opioid epidemic, and the definition of the law under the settlement is pretty broad,” McDowell said.

There will be multiple public listening sessions in coming months to help determine funding priorities. State leaders are dedicated to helping those affected from opioid misuse, McDowell said.

“I know what motivates them is the passion to save lives and to help communities and families heal from the harm that has come about from the prescription opioid crisis,” McDowell said.

The five localities that will receive the highest percentage of opioid settlement money are Fairfax County, Virginia Beach, Henrico County, Richmond City and Chesterfield County, respectively, according to data from the state attorney general’s office.

The Virginia areas with the most opioid overdose deaths in 2021 are Petersburg, Richmond, Hopewell and Portsmouth cities and Henry County, respectively, according to a VDH forensic epidemiologist.

Fatal drug overdoses continue to be the leading cause of unnatural death in Virginia since 2013, followed by gun and motor vehicle-related deaths, according to recent VDH data.

Opioids, especially fentanyl, continue to drive a nearly decade-long spike in fatal overdoses. Fentanyl, prescription and illicit, contributed to over 76% of all fatal overdoses in 2021, according to VDH.

There have been 966 fentanyl-related overdoses this year from January through June, compared to 1,034 during the same period last year, according to VDH data. That is a 6.6% decline.

Almost 1,300 total overdoses occurred from January through the end of June, and all but 238 were opioid-related, according to analysis of the most recent VDH data. However, for the first time in roughly a 10-year period, the projected overdose deaths for the year showed a decrease.

Despite a slight decrease in projected fatal overdoses for 2022, the total deaths are over 57% higher than pre-pandemic totals.

Fatal cocaine and methamphetamine overdoses increased in recent years, according to VDH. Last year, fatal overdoses involving methamphetamine and cocaine escalated by 42% and 24%, respectively.

Fentanyl, often unknown to the buyer, is mixed with other drugs as a way to increase potency. Fentanyl was found in over 84% of the 801 fatal cocaine overdoses in 2021, according to VDH. Fentanyl was found in almost 66% of fatal methamphetamine overdoses in 2021.

Pharmaceutical fentanyl is a synthetic opioid approved for treating severe pain. It is 50 to 100 times more potent than morphine, according to the Centers for Disease Control and Prevention. Most fentanyl connected to overdoses is illegally made. For perspective, the amount of fentanyl that can prove fatal could fit on the tip of a pencil, according to the Drug Enforcement Administration.

Christopher Ronquest is the assistant director of operations at McShin Recovery Resource Foundation, a Henrico County-based organization that provides recovery services. Opioid misuse numbers continue to rise in the state, Ronquest said, and more services and more funding are needed.

There are 1,029 beds available for people seeking recovery in Virginia, Ronquest said. McShin provides 145 beds, he said. There were roughly 10,000 emergency room visits across the state for opioid misuse in 2021, Ronquest said, but McShin only served 498 participants. Almost 400 were new participants, according to data from McShin.

“A whole lot of people out there need recovery and might not know about it,” Ronquest said.

McShin was the first certified recovery community organization in Virginia when it was founded in 2004 and one of the first in the nation, Ronquest said. A distinction from a traditional rehabilitation center is the McShin peer-based recovery program format. There are 15 resident houses, with the majority located in Henrico County.

McShin has two 28-day intensive residential program houses, one located in Henrico County for males and females, and a women’s recovery house in Chesterfield County, Ronquest said. The foundation does not require insurance, and funding assistance is available for individuals who cannot pay for their recovery, he said.

“The whole idea is to teach people how to get off drugs and alcohol, and then show them a life that is attractive enough to stay off drugs and alcohol,” Ronquest said.

Elizabeth Powell has been sober for 22 years and is a certified peer recovery specialist with Richmond City Health District. Powell formerly used crack cocaine, she said. Powell works directly with individuals and communities to provide information about available recovery options. She gets alerts when overdoses occur and responds to the scene to provide support and distributes Narcan.

“They can contact someone like me that has a lived experience,” Powell said.

The number of individuals affected by opioid misuse is startling, Powell said, and many have limited access to recovery facilities to treat opioid addiction. A good way for individuals to learn about recovery is first “just knowing it exists,” she said

“I honestly believe in starting with first responders and working with the hospitals, so they can give that information out to these individuals when they do have overdoses, and go out into the community,” Powell said. “I guess just getting out there with outreach is the best way.”

The drug doesn’t discriminate and addiction is “everywhere,” she said.

“It’s out in the country,” Powell said. “It’s in the city. It’s in neighborhoods.