Substance Use Disorder – Finding the Good News

Posted on by shannonbowles

RCAHD Community Health Update
A Roanoke City & Alleghany Health Districts publication

As public health servants, we are always pleased to have opportunities to share good news. We are thrilled to report that we have started to see decreases in the rates of drug overdose deaths in some of our localities, particularly those experiencing higher rates of fatalities. Although it is too soon to know if this will continue, this local trend appears consistent with national declines in overdose deaths.

The Centers for Disease Control and Prevention (CDC) made headlines earlier in September when they announced a remarkable 10% drop in overdose deaths across the United States. This decline in deaths has both national and local experts cautiously optimistic about progress for people experiencing substance use disorder. 

Like many places, our area witnessed a steep increase in overdose deaths during the pandemic. Locally, the rate of overdose deaths in Roanoke City and Salem more than doubled between 2019 and 2022. Reporting by the San Francisco Chronicle revealed that the Roanoke Valley has been among the top 30 U.S. areas with the highest rates of overdose fatalities. However, we are encouraged that the 2023 overdose death rates dropped by 20-35%. (Overdose death rates in the Alleghany Highlands and Botetourt, Craig, and Roanoke Counties remain elevated but mostly stable in recent years.) We are also encouraged that the rate of emergency department visits for nonfatal overdoses in the wider Roanoke Valley dropped 10% in 2023. This is an important improvement as our area’s rates have been two times as high for emergency overdose visits compared to the rest of Virginia for more than ten years.

While many people offer theories about the reasons behind this dramatic drop in deaths, most experts agree the data doesn't yet provide clear answers. There is growing evidence that community harm reduction efforts are showing results, including greater availability of naloxone (Narcan), a medication that reverses most opioid overdoses. In fact, our local health department and other partner agencies such as the Virginia Harm Reduction Coalition, the Drop-In Center and Blue Ridge Behavioral Health are among the most active in the state in making naloxone available to residents in our community. (Visit our website to learn how to respond to an overdose with our free Revive! trainings.) 

Harm reduction tools have a well-documented connection to overdose prevention. They can be used to interrupt the cycles of trauma and isolation that drive addiction, substance use, and overdose fatalities. When people enter treatment programs with medication-assisted treatments like buprenorphine or methadone, the risks of overdose and death are markedly reduced. Research shows that when people receive medication for their opioid use disorder, they are more likely to stay in treatment compared to people who don’t. 

While we are optimistic these trends are a step in the right direction, 100,000 U.S. overdose deaths per year for the last three years is still alarming and unacceptable. We still have far too many individuals who are harmed by substance use disorder. There is much work to be done. Our focus now is to ensure we keep gaining momentum through increased partnerships to expand access to prevention, destigmatize substance use disorder, and to make treatment and recovery as widely available as possible. 

October is National Substance Abuse Prevention Month. If you or a friend or loved one has an opioid use disorder (OUD), talk with a health care provider to learn how medications can help. SAMHSA’s National Helpline is a free, confidential, 24/7, 365-day-a-year treatment referral and information service (in English and Spanish) for individuals and families facing mental and/or substance use disorders.