More than 28,000 people died from opioid overdoses in the US in 2014. The epidemic has hit Virginia too, with more than 5,000 deaths since 2007. In the first of our week-long 88.9 WCVE News series Facing Addiction, John Ogle looks at the scope of the crisis in Virginia.
The first signs of opioid abuse emerged in Southwest Virginia more than a decade ago.
Mellie Randall: We saw a tick in deaths related to opiates that really caught us by surprise.
Mellie Randall is Director of the Office of Substance Abuse Services at the Virginia Department of Behavioral Health and Developmental Services. Her office and staff with the State Medical Examiner began digging deeper. They made a connection between opioid use and people working in coal and forestry jobs, that were physically taxing and led to disabilities at an early age.
Randall: Whereas before, they had relied on a lot of alcohol in their disability, Oxycontin, in particular got introduced as an opiate based medication that supposedly wasn’t supposed to be addictive.
That turned out not to be the case.
Randall: Physicians there, and everywhere, prescribed it very freely so we became very concerned about how to educate people, how to prevent, and then how to treat it.
Some of the highest rates of fatal drug overdoses continue to be in Southwest Virginia, but the problem spread across the state. Between 2007 and 2015, nearly 300 Richmond residents fatally overdosed on opioids.
Dr. Jim May: The biggest drug of abuse, if you will, in Richmond has been heroin since 1999.
Dr. Jim May with the Richmond Behavioral Health Authority says they’re seeing increasing numbers of young and older people who start with prescription pain medicine and then turn to heroin.
May: Some of them are coming to us and it’s still there drug of choice but they’re buying prescription drug medicines off the street. But a lot of them started with prescription drugs and when became unavailable through prescription means and they had to start buying on the street they realized heroin was cheaper and they switched to heroin. So, we’re seeing a lot of that. It’s a different avenue to get there, but heroin is still number one.
Health experts also warn about fentanyl, the drug Prince overdosed on. The synthetic opioid is made by drug companies and in illegal labs. Virginia is one of the top 10 states where illegally made fentanyl is being confiscated, according to the CDC. That agency says the drug is “50 times more potent than heroin and 100 times more potent than morphine.” And it’s often mixed with heroin. Richmond went from no fentanyl deaths in 2007 to at least 16 last year. Statewide the number jumped from about 50 to more than 200 during that same time period. Another dangerous combination is mixing benzodiazepines, like valium, xanax and klonopin, often prescribed for anxiety. Randall explained.
Randall: They are the shadow of this epidemic, they are not prescribed with the same frequency as opioids but they are often over prescribed for people who come in and say I can’t sleep or I’m worried about something.
She says withdrawal from the drugs, often called “benzos” is incredibly difficult.
Randall: Once you become dependent on benzos you really have to be withdrawn under a medical supervision because you can experience fatal seizures if you try to do it by yourself.
At the Richmond Behavioral Health Authority, Dr. James May and CEO John Linstrom say they often see people addicted to prescription opioids, heroin and benzodiazepines.
John Linstrom: Those things when taken in close proximity have a cocktail effect there's an additive effect and sometimes those things become dangerous when they run contrary to each other in terms of their effect.
May: You have some snowball syndromes that start to roll faster faster down the hill. So if I’ve been taking heroin for a long time and this is a particularly difficult week around Richmond and I'm having a little harder time finding it or it's costing more money than it usually does or I have to go to a different part of town--I start to get anxious about that because I'm thinking “Oh my God where's my dose coming from?” And the more anxious I get, the more I want to reach those benzos over here and take an extra one of those to help calm me down and then I find my heroin and now I have extra benzos in me and I have maybe some stronger heroin, turn out the lights that point.
Since 2007, the number of yearly fatal overdoses in Virginia has risen by more than 50 percent, from about 500 to more than 750. May and others are hopeful that policy changes and new programs will eventually stem the epidemic, but say that for now, we’re still in the “contagion” stage. John Ogle, WCVE News.
A special thank you to the McShin Foundation for allowing WCVE to record and share stories of recovery.