By Faith Redd, Capital News Service
RICHMOND, Va. – Klay Porter, 32, recalls overdosing alone at his aunt's house five years ago from heroin laced with fentanyl, a synthetic opioid. He remembers slipping away and thinking “this is it.”
Porter isn’t alone. Opioid overdoses led to more than 9,900 emergency room visits in Virginia in 2020, a roughly 30% increase from 2019, according to the Virginia Department of Health. Fatal opioid overdoses increased roughly 260% in a decade, from 2011 to 2021. Fatal drug overdoses have increased almost every year in that time frame and have been the leading method of unnatural death in Virginia since 2013, according to VDH.
Fentanyl is the driving force behind the increase in Virginia’s fatal overdoses, according to VDH. Three out of every four overdoses in 2020 included fentanyl. Fentanyl is mixed with other drugs such as heroin, illegitimate prescription opioids, and cocaine to increase potency, resulting in the likelihood of a fatal interaction, according to the Drug Enforcement Administration. Two milligrams of fentanyl can be lethal depending on a person's size, tolerance and past usage. That amount could fit on the tip of a pencil, according to the DEA. Over 9.5 million counterfeit pills—imitations of prescription medication— were seized by the DEA in the fall of 2021, more than the last two years combined. There has been a “dramatic rise” in the number of counterfeit pills containing a potentially lethal dose of fentanyl, according to the DEA.
To understand the scope of drug overdose deaths, the second leading cause of unnatural death in Virginia is gun-related fatalities. There were about twice as many fatal overdoses as gun-related deaths in 2020 and the health department forecasts the state is on track for that to happen again once 2021 numbers are final.
As overdoses sharply increase, addiction treatment and recovery advocates, lawmakers and government officials are working to save lives and combat the opioid epidemic.
Recovery centers
Porter survived his 2017 overdose and is now a volunteer and recovery coach at the Henrico County-based McShin Foundation, a recovery community organization. McShin is Porter's second attempt at recovery. After his initial stay at another recovery program he went straight to his dealer's house and relapsed, he said.
Porter was attracted to McShin because he was able to define what works for him with the provided tools and resources without being forced to follow a specific way of recovery. McShin offers a 28-day residential program and partners with physicians for drug and alcohol detox.
Most staff members at McShin have experienced addiction or have close connections with someone who has, according to McShin CEO Honesty Liller. The peer-to-peer program is the most helpful in the recovery process, she said.
“There's nothing like a hug,” Liller said. “There's nothing like someone with lived experience with the disease of addiction but also recovery.”
Porter's most recent drug charge caught up to him after a year and a half of staying at McShin, he said. He turned himself in to avoid 10 years incarceration, he said.
Porter's sentence was reduced to two months, which he only completed 52 days of. He was released early on bond because of his sobriety. He continued his sobriety throughout and after his sentence. When he returned to McShin he was hired as a peer recovery specialist.
“I've had multiple rock bottoms,'' Porter said. “I've struggled for a good, long while. I've lost everything multiple times.”
Porter has struggled with addiction since age 11, starting with alcohol and moving to hard drugs.
“I didn't know how to cope with the world around me, and the best thing I could think of was to check out, disassociate or black out,” Porter said. “Detach myself from the world around me.”
Porter said he has been sober for about 21 months. The death of many loved ones as a direct result of substance use has motivated him to stay sober, he said.
The county still needs more resources to assist individuals seeking recovery.
A $12 million detox facility is set to open in 2024. Henrico County was granted $1 million in federal funding for the Henrico County Detox and Recovery Center. The center will provide same-day inpatient detox services with “no barriers based on income or other resources,” Tyrone Nelson, county supervisor said during a press conference earlier this year.
“The center is meant to be a resource for the county to have a place to bring people who are in the middle of a substance abuse-related crisis,” said U.S. Rep. Abigail Spanberger, D-Va., who helped secure the funding.
Henrico County created a roundtable in 2019 to recommend ways to strengthen local addiction and recovery programs, which included the detox center. The roundtable’s 2020 report noted that when Henrico Police responded to a drug overdose, they were likely to charge people who overdosed with possession because they could detox in jail, where detox and treatment services were available.
“Henrico Police reported to the Roundtable that if they had the option to take drug users to a treatment center instead of the jail, this would be preferable,” the report stated. “However, no such drop-off facility currently exists.”
The Chesterfield County Police Department launched the Helping Addicts Recover Progressively, or HARP, program in 2016, in response to rising overdoses in the county. The program is run out of the jail and provides addiction-recovery and mental health resources to participants. The first part of the program takes six months to complete and the second phase involves a transition process and participation in work release or home incarceration. HARP has received federal grant money over the years.
Root causes
The Loudoun County Sheriff's Department is working diligently to reduce overdoses, according to 2nd Lt. Kevin Tucker.
The department has worked with federal, state and local partners to prosecute drug dealers, according to Tucker. Loudoun County also offers mental health and substance abuse help and provides the D.A.R.E program to fifth grade students.
“This is somebody's father, mother, son, brother and so my opinion on the opioid epidemic is it's an absolute shame,” Tucker said. “It really is. It shows a deeper sort of systemic problem.”
Tucker believes finding the root of drug use is the beginning to solving the drug crisis in Virginia.
“If you want to solve the problem, you have to start asking the question ‘why?’” Tucker said.
Solely targeting the individual illegally selling drugs won't get to the root of the problem, according to Tucker. The start to solving the crisis is understanding the long term effects of why someone suffering with addiction got to where they are currently.
“We've routinely seen that people who overdose, and kind of find themselves in the same situation that they were before the overdose, are very likely to overdose again,” Tucker said.
Save a Life
Richmond and Henrico health districts offer free fentanyl test strips to reduce the risk of overdose. The strips are used to test for fentanyl in injectable drugs, powders and pills. Test strips are available at in person Narcan training and community dispensing events, according to VDH.
Recovery advocates, families and friends also want to stop overdoses. Opioid overdose reversal medication known as naloxone, often called Narcan by brand name, can be accessed through pharmacies, local community organizations, licensed emergency medical service agencies and health departments, according to VDH.
Loudoun County implemented a Heroin Operations Team initiative in 2015 to promote the pilot program of deputies carrying Narcan, according to Loudoun County Sheriff’s Office.
“The county does a pretty good job of getting Narcan out to people who have sort of high recurrence,” Tucker said. “It's on request. Family members can request and have requested.”
REVIVE! is a virtual opioid overdose and naloxone education training program offered weekly for Virginia residents. The program offers two types of training. One trains participants to better understand opioids, how opioid overdoses happen, risk factors for opioid overdoses, and how to respond to an opioid overdose emergency with naloxone, according to the program’s website.
The other training prepares a person to become a REVIVE! instructor and train others.
A person can receive a REVIVE! kit and Narcan nasal spray free of charge after attending the training, according to VDH.
Richmond recently introduced a spike alert program to indicate the presence of illegal or diverted prescription drugs in the community that may be potent or cause overdose. The program allows people in the greater Richmond community to be notified of overdose occurrences in the area, according to VDH. People can sign up for the alerts, here.
Legislation
Lawmakers in 2015 began efforts to increase access to medicine that reverses overdoses. Over the past seven years, lawmakers have also expanded protections to people who report overdoses.
The Good Samaritan law went into effect last July and expands on legislation initially introduced in 2015. A person reporting an overdose will not be arrested or prosecuted for public intoxication, underage drinking, or purchasing or possession of a controlled substance or drug paraphernalia. A person also has immunity if they administered CPR or naloxone while another person reported the overdose. The individual must remain on scene and identify themselves to law enforcement.
“We cannot charge for possession,” Tucker said. “It doesn't matter how bad that one possession is. If it's just a possession it is exempt under the current code.”
The General Assembly established drug courts, which exist within the judicial system, to assist individuals in drug or drug-related cases and provide an alternative to incarceration. Drug courts are reported to reduce recidivism by allowing individuals to go through intense treatment options while under heavy supervision, in effort to increase recovery rates.
Lawmakers last year unanimously passed a joint resolution that designated Aug. 31 as an International Overdose Awareness day in Virginia. The U.S. and Virginia flags are to be lowered to half-mast in memory of people who have lost their lives to addiction. In the 20-year period between 1999 and 2019, over 770,000 people died from drug overdoses, according to the resolution.
The resolution acknowledges addiction is a medical disease. The dedicated day is intended to raise awareness and encourage the discussion of the prevalence of addiction, implement new policies, remove barriers to treatment and overdose prevention and address the evolving need for support and resources relating to substance use disorder, according to the measure.
Although the recent resolution declared addiction a disease, Porter stresses that he’s an individual not defined by substance abuse. He said he loves art and creative expression. He's always wanted to go to art school and plans on doing something to utilize his artistic talents after he stabilizes his life and gets off probation.
"We're all some very talented people,” Porter said. “They have worth, but all that gets overlooked because of substance use or the alcohol addiction.”