Governor’s Advisory Commission on Opioids and Addiction Discusses Prevention, Intervention, Future Efforts

June 5, 2019

Secretary of Health and Human Resources Daniel Carey opened the May 17 meeting of the Governor’s Advisory Commission on Opioids and Addiction on a hopeful note, although members agreed that much work remains to be done to prevent, identify, and treat substance use disorder in Virginia. Secretary Carey presented preliminary data from the Office of the Chief Medical Examiner suggesting that overdose deaths declined slightly in Virginia in 2018 relative to 2017, the first time that overdose deaths have decreased relative to the previous year since 2012. While the decrease in fatalities is a welcome change, the report documents the continued threat posed by fentanyl, which was implicated in nearly 55 percent of all fatal overdoses in 2018, and also highlights increases in overdose deaths caused by non-opioids, particularly cocaine and methamphetamine.

Keith Cartwright, Behavioral Health Wellness Consultant with the Department of Behavioral Health and Developmental Services (DBHDS), made a presentation on the long-lasting effects of traumatic experiences in childhood, which can include substance use disorder. A famous study in 1998 revealed a connection between certain Adverse Childhood Experiences (ACEs), such as psychological or sexual abuse or violence directed toward a mother or stepmother, and poor health outcomes, including risk for substance abuse, later in life. Research on the effects of stress on the developing brain continues, and many human services providers are striving to practice “trauma-informed care” as well as to educate communities about how they can address the effects of trauma.

Dr. Patty Ferssizidis, Assistant Professor at George Mason University, spoke about the Virginia Screening, Brief Intervention, and Referral to Treatment (SBIRT) Project, which she leads. The program is supported by a grant from the federal Substance Abuse and Mental Health Services Administration (SAMHSA) and is intended to fill a gap between prevention efforts and specialized substance use treatment. In the Virginia program, SBIRT entails a universal, brief screening for alcohol, drug, and tobacco use and depression; individuals who demonstrate a mild risk are engaged in a short discussion designed to encourage motivation to change risky behaviors, and individuals who appear to be at higher risk are referred to treatment, either on-site or in the community. SAMHSA has documented positive outcomes for the program at the national level and it appears to be succeeding in Virginia as well, particularly with individuals at lower levels of risk.

Secretary of Public Safety and Homeland Security Brian Moran reported on trends and solutions discussed at the recent National Prescription Drug and Heroin Summit, including an increase in cocaine and methamphetamine seizures and overdoses and an increase in the illicit use of prescription stimulants. Priority recommendations included eliminating the stigma associated with substance abuse and linking individuals to treatment, especially priority populations such as pregnant women, incarcerated individuals, and chronic pain sufferers.

Commission members broke into informal subgroups and discussed challenges and promising programs in Virginia for consideration for future Administration efforts. Common themes included the importance of access to medication-assisted treatment and the inclusion of peers in the recovery process; the need to recruit a workforce to provide substance use disorder treatment; and the need for community education on the effects of ACEs.

The Commission’s next meeting is scheduled for July 26.

VACo Contact: Katie Boyle

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