Marissa J. Levine

State Health Commissioner Marissa J. Levine.

State Health Commissioner Marissa J. Levine has declared Virginia's opioid addiction crisis a public health emergency.

In response to the emergency, Levine has issued a standing order that allows all Virginians to get the drug Naloxone, which can be used to treat narcotic overdoses.

The state is grappling with responses to a crisis that has gripped the nation as the number of deaths and hospital admissions continue to spike, Levine said in announcing her decision to escalate the administration's response.

“The consequences of opioid addiction in Virginia have risen to unprecedented levels and can now be classified as an epidemic," Levine said.

The emergency declaration comes days after U.S. Surgeon General Vivek Murthy released a landmark report declaring drug and alcohol abuse among the nation's most pressing health crises on equal footing with AIDS and cancer.

It also comes as increasing numbers of Virginia families prepare for a Thanksgiving meal a loved one won't be around to enjoy, state officials noted.

More than 1,250 people will likely die in Virginia of a drug overdose this year, according to projections from the state health department; drug overdoses surpassed car crashes as the leading cause of unnatural deaths in 2013, and the numbers have only increased, thanks in large part to a surge in opioid abuse. Young adults are the hardest-hit group, a Richmond Times-Dispatch analysis found.

People ages 25 to 44 accounted for more than half of all drug-related deaths between 2007 and 2014 - in large part casualties of the intersection between genetic predisposition to substance abuse and the widespread availability of prescription painkillers, treatment experts say.

“Too many Virginia families have lost someone to opioid addiction," Levine stated. "These actions today will not diminish their loss, but we owe it to them and each other to work together, watch out for each other and continue to combat the seriousness of this crisis.”

Addressing an issue that impacts about one in seven Americans over the course of their lives is "a moral test" for the country, Murthy concluded in the federal report; Only one in 10 of those with substance abuse issues receives treatment, his office found.

Virginia officials last year enacted measures to expand substance abuse treatment but wait lists at the community services boards that serve as the local point of entry for Virginia's public system of mental health remain lengthy in many places.

"Obviously, there's an enormous amount of work that needs to be done - especially for (those without insurance)," said Dr. Jack Barber, interim head of the state Department of Behavioral Health and Developmental Services.

The McAuliffe administration said the state's move comes in response to a growing number of opioid overdoses and evidence that Carfentanil, described as "a highly dangerous synthetic opioid used to sedate large animals such as elephants," has made its way into Virginia.

The incidence of Carfentanil has thus far been largely confined to the Hampton Roads area but Central Virginia authorities are eyeing its emergence with caution, said Richmond police Capt. Michael Zohab.

"It's so potent it kills people almost immediately," Zohab said of the substance. "It's terrifying, but it's where we are these days.

More than two dozen people are treated for drug overdoses daily in Virginia and three die, on average, according to state officials.

The standing order on access to Naloxone acts as a prescription for the general public, removing a barrier to access. Those with insurance will be charged the cost of a co-pay. Those without may expect to pay upward of $120 depending on which version of the antidote is on-hand, officials said.

“As we see the nature of drug addiction shift, from prescription opioids to heroin and synthetic fentanyl, we must be vigilant and ready to respond quickly,” said Secretary of Health and Human Resources Bill Hazel.

Authorities welcomed the move but cautioned that applications of the reversal drug should be followed up whenever possible with medical care. Sometimes emergency responders working in the Richmond area have needed to administer two doses to an overdose victim.

Levine said that emergency room visits for heroin overdoses are 89 percent higher for the first nine months of 2016 than over the same period last year. Drug overdoses were likewise 35 percent higher in the first six months of 2016 than they were in 2015. By the end of this year, the number of fatal drug overdoses is expected be 77 percent higher than it was five years ago.

State officials also said they have seen a 28 percent increase in the number of Hepatitis C cases reported between 2010 and 2015, which they suspect may be driven by a boost in intravenous drug use.

The declaration of emergency was welcomed Monday by the Virginia Hospital and Healthcare Association, which called the proclamation "an important and appropriate step in the ongoing campaign to combat this issue."

"The human costs of this epidemic are staggering," association spokesman Julian Walker said in a statement highlighting the health sector's partnerships with public officials and community groups.

The number of people who overdosed and lived in Richmond on opioids such as heroin, fentanyl and prescription painkillers is about 350 percent higher than at this point in 2014, according to city police. The number of fatalities increased nearly 375 percent over the same time period.

As of Monday 41 people in the city had overdosed on opioids and died in 2016 and people had overdosed and lived 293 times, according to Zohab, who is organizing a nonprofit dedicated to helping combat the disease of addiction.

Henrico County's fatal opioid overdoses year over year have held steady, at 34, but the number of non-fatal overdoses rose from 72 to 140 - a nearly 200 percent increase since this point in 2015, according to county police data.

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K. Burnell Evans reports for the Richmond Times-Dispatch

kevans@timesdispatch.com

(804) 649-6922

Twitter: @kburnellevans

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