Wednesday’s Public Square, held at the RTD’s downtown offices, drew a standing room-only crowd, including dozens of survivors wearing T-shirts that proclaimed their achievement.

The size of the standing-room only crowd at the RTD’s 78th Public Square last week about the opioid crisis reflected the enormity of this scourge ravaging our communities. The event brought together local law enforcement, health and government officials, community advocates and many enrolled in addiction programs for a wide-ranging discussion about how the Richmond region is working together to tackle this insidious epidemic.

Moderated by RTD President and Publisher Thomas A. Silvestri, the panel of experts featured Hanover County Sheriff David Hines; Chesterfield County Fire and EMS Chief Edward “Loy” Senter Jr.; Dr. Danny Avula, director of Henrico County’s and Richmond’s health districts; and Ivy Sager, director of the Hanover County Community Services Board. The regional representation showed how the epidemic transcends municipal boundaries.

“We’re looking for solutions,” Hines told the crowd, adding that he responded to an overdose on the way to Wednesday’s event.

In a laudable regional effort, the city of Richmond and the counties of Chesterfield, Hanover and Henrico have banded together to confront the epidemic through Opioid Solutions RVA, a public awareness campaign to spread the word about resources and support to help to aid recovery. We also want to commend the outstanding jail-based drug treatment programs across our region, and the sheriffs and local officials who stepped up to fill a void.

More information and collaboration helps save lives. The website, OpioidSolutionsRVA.com, offers resources for education, prevention, treatment and recovery. Examples include the “REVIVE! Training” — sessions that help the public learn how to handle an emergency by administering narcan, a nasal form of the drug naloxone for the emergency treatment of a suspected or actual opioid overdose.

Hines said his team regularly carries narcan, which saves lives. But anyone can buy the spray at a local pharmacy, without a prescription. Hines worries that the statistics don’t tell the whole story. Lower “reported” opioid deaths fail to capture the people who self-administer narcan and barely escape a relapse on their own, without the help of law enforcement. Better data is not enough to address the crisis. More engagement and less stigma is needed.

The number of deaths is chilling. The four localities saw a more than four-fold increase in the number of fatal opioid overdoses between 2010 and 2018, according to data from the Virginia Department of Health. In 2010, Chesterfield, Hanover, Henrico and Richmond saw a combined 51 opioid-related deaths. That number escalated to 230 in 2018. Statewide, the number of overdoses jumped from 498 in 2010 to 1,215 in 2018 — with the four RVA localities accounting for nearly 20% of those deaths last year. Nationally, on average an estimated 130 Americans die from an opioid overdose every day, according to the Centers for Disease Control and Prevention.

The four counties saw a dip of eight fewer deaths from 2017 to 2018, as panelists pointed out. But what’s to celebrate when so many continue to die? Reported fatalities might be down, but who’s to say whether actual deaths have decreased?

Opioid addiction is a biological, physical dependence. Health care providers were incentivized to overtreat pain and opioids were a powerful, unfettered tool to reach that goal. Reversing the trend is an uphill battle, especially as doctors’ pay was based on patient satisfaction. Even with a tightening on prescriptions written, hundreds are still dying and hundreds more are still living with addiction. The issue is far from solved.

But the public wants to see more change than just messaging, including by proposals for criminal justice reform. Several members of the public expressed frustration over the hurdles of re-integrating into society as an opioid addict. Possession of controlled substances, such as opiates, can carry serious legal consequences. First offenders can go through treatment and other services and, if successful, the case might be dismissed. However, attendees brought up the perception of drug use as a moral wrong versus a disease. If a first offender has a relapse, attendees pleaded for pathways in the criminal justice system to create second chances instead of second felonies. The General Assembly could consider legislation on this front.

“We’ll be working on this for years to come,” predicted Chesterfield’s Senter. That’s sad, but likely true, and necessitates a coordinated approach that involves everyone affected by this plague. The well-being of our communities depend on it.

— Pamela Stallsmith, Robin Beres and Chris Gentilviso

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