Virginia officials have launched a war on fentanyl, vowing to greatly reduce fentanyl-related deaths in his state.
Gov. Glenn Youngkin, a Republican who came to power in 2022, called fentanyl a “weapon of terrorism.”
Fentanyl was responsible for the murder at least 70,600 Americans in 2022 and caused more than 1,950 deaths in Virginia alone.
The synthetic opioid enters the US through the southern border and contaminates the illicit drug supply, devastating local communities and major cities alike.
The Republican Governor released a laundry list of initiatives to meet his goal of reducing opioid overdoses in Virginia by 20 percent during his tenure.
Gov. Glenn Youngkin, a Republican, has set a goal to reduce opioid overdoses in Virginia by 20% during his term
Fentanyl-related deaths in the US continue to spiral out of control
The chart above shows the CDC estimates for the number of drug overdose deaths each year
Gov. Youngkin signed the executive order on Tuesday directing the Department of Health to develop a plan for wastewater monitoring “to detect the frequency, potency and occurrence of fentanyl use in specific locations.”
The order also gave individual counties within the state more leeway to secure kits of the “miracle drug” naloxone, which reverses overdose, and instructed law enforcement to step up efforts to ban drug shipments into the state.
It also directed relevant state departments, including those for health, social security and corrections, to improve fatal overdose surveillance, drug interdiction and public awareness.
Opioids, particularly the ultra-potent synthetic fentanyl, have taken a significant toll on Virginians, who have seen the number of fentanyl fatal overdoses increase 20-fold since 2013, Gov Youngkin said.
He added, “We cannot stand by and watch Virginians lose their lives if there are steps we can take to combat this deadly fentanyl poisoning crisis. We must act.’
Richmond, the capital of Virginia, is one of them the hottest spots for opioid-related fatal overdoses, with 272 deaths in 2022 and 262 due to fentanyl.
The number of fatal overdoses due to all opioids in Virginia was 2,104 in 2022, slightly down from the 2021 number of 2,229, but well above the 2019 total of 1,298.
The vast majority of those deaths were caused by fentanyl.
The drug was introduced in the 1960s as a pain reliever and IV anesthetic. By the 1990s, pharmaceutical companies were developing fentanyl patches that delivered the drug into the body through the skin to treat severe pain in cancer patients.
But it’s increasingly found in the supply of illicit drugs, often as a contaminant in other drugs, including cocaine, methamphetamine and benzodiazepines, meaning many people ingest it unknowingly.
Just two milligrams of fentanyl, equivalent to about 10 to 15 grains of table salt, can be fatal.
Preliminary state figures show that the synthetic drug that is 50 times stronger than heroin killed more than 1,950 people last year and more than 2,000 the year before.
John Littel, Virginia’s health secretary, said, “Today five Virginians will die from fentanyl.
Every day tomorrow and this year, an average of five Virginians will die from this deadly drug.
Within the next four months, the state health department will have to come up with a cost-effective way to monitor the sewage system for concentrations of opioids, including fentanyl and heroin.
The goal is to use the surveillance data to inform resource allocation, meaning the communities with the highest opiate presence will have greater access to naloxone and drug treatment options.
The order also directs the Secretary of Public Security and Homeland Security to scale up the ability of the state’s law enforcement system to prohibit illegal drug shipments into and through the state.
Youngkin further ordered a cadre of government agencies, such as the Department of Social Services and the Department of Criminal Justice Services, to come up with a more effective, thorough way to record and report fatal and non-fatal opioid overdoses “to provide an immediate prohibition, education and information. , and abatement efforts” in the neighborhoods with the largest spikes in overdoses.
Fentanyl has devastated American cities and towns of all sizes. A recent government report shows that the rate of fatal overdoses with synthetic opioids more than tripled between 2016 and 2021, from 5.7 per 100,000 in 2016 to 21.6 in 2021.
In Virginia specifically, that rate is around 22 per 100,000 persons, according to preliminary figures for 2022. In 2021, it was nearly 24 per 100,000, up from about 19 in 2020.
Fentanyl overdose rates peaked in the first year of the Covid pandemic, with 11.3 per capita in 2019, the highest-ever pre-Covid record.
The rise of fentanyl has mainly affected teenagers in recent years. Analysis of official overdose data shows that in 1999 there were only nine fatalities from fentanyl among those aged 20 and under. But by 2021, this had risen to 1,550.
Virginia is just one of 50 states and DC battling the plague of deadly fentanyl on their streets.
Neighboring West Virginia has the highest death rate of allcoming to about 91 per 100,000 total population, according to 2021 figures from the Centers for Disease Control and Prevention.
The drug was initially produced in India and China and shipped to recipients in North America. Since then, makeshift laboratories have sprung up in Mexico to receive the precursor chemicals from Asia, mix them or crush them into pills and smuggle them into the US
It takes a negligibly small dose of fentanyl to cause a fatal overdose. Just two milligrams, the equivalent of five grains of salt, is enough to cause death
Northwestern Virginia consistently has the highest rates of drug overdoses opioids excluding heroin. But southwest Virginia has seen the highest rates of heroin overdoses.
Spots two and three went to Tennessee and Louisiana with 56.6 deaths per 100,000 and 55.9 deaths per 100,000, respectively.
To address the ongoing crisis, rooted in a long history of poor regulation and malfeasance by the pharmaceutical industry, federal regulators have taken steps to make the nasal spray version of naloxone more accessible to the people who need it, as well as Good Samaritans who care that you have it with you in case someone nearby starts taking an overdose.
The appeal of the nasal spray, marketed as Narcan, is a combination of its efficacy and ease of use.
The plunger that sends 4 mg of nebulized naloxone hydrochloride into the nose resembles an over-the-counter allergy medication and starts working immediately.
A recent study by Brigham and Women’s Hospital in Massachusetts found that more than 93 percent of people who received naloxone survived their overdose.
Still, they need extra medical attention immediately afterwards because the effects don’t last long.
When inhaled, the drug is absorbed through the mucous membranes in the nose, rapidly entering the bloodstream and traveling to the brain.
Once there, the drug competes with opioids that attach to receptors in the brain.
It attaches to the brain’s receptors and replaces the opioid. This softens the effects of opiates on the brain, preventing an overdose from progressing.
Fentanyl is an incredibly insidious substance, often added as an adulterant to drugs such as cocaine, ecstasy and meth because it is both cheap and potent and keeps users coming back for more.
But often heroin and non-opiate users don’t know they’re taking fentanyl and may not have naloxone on hand.
For this reason, the federal government is striving to make the antidote ubiquitous without the need to talk to a pharmacist everywhere from big box stores to vending machines.