State Health Commissioner Comments on Opioid Addiction Declaration

These remarks were delivered on November 21, 2016 at 10am

Good morning.  This is Dr. Marissa Levine, Virginia State Health Commissioner here with key state agency colleagues for an important announcement about the opioid addiction crisis in Virginia.  Thank you for joining us this morning.

We are here today in the shadow of the Surgeon General’s report on Addiction in America released just last week which highlights the addiction crisis facing Americans and emphasizes the need for:

  • effective public health steps to prevent and treat substance use disorders
  • a shift in attitudes toward addiction
  • and a coordinated effort among multiple sectors at community and jurisdictional levels to implement proven approaches

We are also here on the Monday before Thanksgiving when families, friends and loved ones will be gathering

So it is no coincidence that I am here with you today because the facts clearly tell us that the consequences of opioid addiction in Virginia have risen to unprecedented levels and can now be classified as epidemic.  Some of the statistics include:

  • On average, three Virginians die of a drug overdose and over two dozen are treated in emergency departments for drug overdose each day.
  • Number of emergency department visits due to heroin overdose has increased 89% for the first 9 months of the year compared to 2015
  • During the first half of this year fatal drug overdoses increased 35% when compared to the same period in 2015
  • By the end of 2016, the number of fatal opioid overdoses is expected to increase by 77% compared to five years ago.
  • In addition, our Department of Forensic Sciences just this month identified the presence of Carfentanil in Virginia. This synthetic opioid is 10,000 times more potent than morphine and 100 times more potent than fentanyl and, given its presence in Virginia, could significantly increase the death rate trends from opioid overdoses.
  • And we have the continuing prescription opioid crisis most prominent in the far southwest region of the Commonwealth where we are additionally concerned about the growing prevalence of hepatitis C and HIV resulting from injection drug use.

 With all these facts (which are the story of the people of Virginia) facing us, today I am declaring a Public Health Emergency for Virginia as a result of the opioid addiction epidemic.

This declaration is an effort to raise continued awareness among all Virginians about this worsening problem and emphasize that we must treat it as a public health issue as we have done for other health emergencies.  Our law enforcement partners have repeatedly claimed that we cannot arrest our way out of this problem.  I have heard them loud and clear:

  • This declaration has no force of law and is not a Governor’s emergency declaration. It is also not an attempt to keep opioid medications from those with chronic pain such as those with cancer pain, who legitimately need those medications.
  • In my 14 years of public health experience in Virginia, I have seen time and again Virginians rising to the emergency, coming together to work collaboratively to solve challenging, complex issues. That is my hope with this declaration- that we come together to build upon the great work that has already started as a result of the Governor’s Opioid Task Force, General Assembly actions, the AG efforts, the work of the medical and pharmacy professionals and community coalitions around the Commonwealth. We are all working to support families and communities as they help their family members, friends, neighbors and loved ones get the help they need to fight addiction.

So with all of the above in mind I am taking one more specific step in an effort to lower the death rate and prevent deaths from opioid addiction:

  • I have signed a statewide standing order for Naloxone – the rescue medicine for opioid overdose. This could only have been accomplished in close collaboration and consultation with the Virginia Department of Health Professions, its Board of Pharmacy and the Virginia Department of Behavioral Health and Developmental Services.
  • This will allow anyone in Virginia who believes they or their loved ones are at risk of an opioid overdose to buy naloxone at any of our approximately 2000 pharmacies in the Commonwealth without first having to get a prescription.
  • As we speak we have begun distributing this order to the pharmacies. The pharmacy community has been a great partner in this effort and I know they will work diligently to implement this order as soon as possible.  Realize that it may take time before every pharmacy has the order in place so please check with your pharmacy first.
  • Unfortunately the statewide standing order does not cover the cost of the Naloxone but I am confident that our collective efforts will continue to work to make Naloxone available to everyone who could benefit regardless of whether they can afford it.

I realize that this declaration and the statewide standing order cannot in anyway minimize the loss already experienced by so many families as a result of the opioid addiction epidemic.  However if the declaration and statewide standing order save even one life from here on it will have been worth it.

This Thanksgiving, as we gather around the dinner table, let us be sure we are familiar with the signs of addiction and substance use. Visit the Commonwealth’s new website VAAware ( which offers resources on how best to discuss addiction with someone you love.  As we take inventory of one another also take inventory of the medications in our household, let us also be sure to dispose of unused, expired or unwanted medications in a safe manner. Thanks to the AG office, local health departments and other community resources have drug disposal bags.  You can find a location near you on the AG website. Authorized pharmacies and some local law enforcement agencies also collect and destroy unwanted drugs.  As you take inventory this week, if you identify that someone in your life is struggling with an opioid addiction obtain Naloxone to have on hand just in case. And you can learn more about Naloxone as a result of work by our colleagues at the DBHDS through their Revive! program.  That information is also available on the website mentioned.

I realize that this is not the cheerful Thanksgiving message you may have hoped to hear, but when we live in times of epidemic and emergencies it’s important to take every opportunity as an opportunity to be prepared and informed. As we have found in every emergency the better prepared and informed we are, the more likely that we will minimize the risk of the emergency and prevent death and suffering. And in the process we build stronger connections with each other and build healthier and resilient Virginians in healthier and resilient communities.  That is what I wish this Thanksgiving and holiday season and I do so hope that you have a safe and healthy Thanksgiving.

Listen to the November 21, 2016 Telebriefing

Learn more about Opioid Addiction in Virginia.