HOLO Labs

Accolades

Abstract

Context: The first intentionally recorded Fatal Opioid Overdose Total (FOOT) in rural Virginia reached 33 persons for 1997, while in 2021 the New River Health District (NRHD) alone totaled 35 persons, including the counties of Floyd, Giles, Montgomery, Pulaski, and the City of Radford1-3. In recognition of the rising death total, the Commonwealth of Virginia implemented the REVIVE! course in 2015, the state’s Opioid Overdose and Naloxone Education (OONE) program4,5. The FOOT reached 20 persons and the Opioid Overdose Death Rate (OODR) or fatalities per 100,000 population reached 12% for the NRHD in 20142. In 2015, the FOOT in the NRHD fell to 10 persons with a 5.7% OODR, a marked drop the year REVIVE! was introduced throughout the Commonwealth2,5.

Objective and/or hypothesis: If opioid overdose-related death data from 2007 to 2021 is analyzed in the context of the Commonwealth of Virginia’s REVIVE! course, then a significant improvement in mortality totals and rates should be appreciated in the NRHD following the implementation of training and the distribution of naloxone.

Methods: Publicly available opioid overdose data from the Virginia Department of Health (VDH) was analyzed alongside reported REVIVE! course session totals and naloxone distribution totals in the NRHD coverage areas. The number of REVIVE! sessions and naloxone distribution counts for each county in the NRHD was specially requested for each assessed year from the VDH. Statistical analysis was based around the assessment of mean values and rates reported per 100,000 population.

Results: Following the integration of REVIVE! in 2015, there was a noted negative difference of 6.8 percentage points in the OODR in comparison to 2014, a significant decrease compared to the previous maximums, a lower-bound negative 4.5 percentage point change from 2010-2009 and an upper bound positive 2.1 between 2009-2008.

Conclusion: An appreciable decrease in the OODR and FOOT was noted between 2014 and 2015 at the start of the Commonwealth of Virginia’s REVIVE! course. Looking past 2015, into 2021, we appreciated larger increases in the OODR and FOOT that are juxtaposed by significant reductions in the measured statistics. The impact of the REVIVE! course on the variance of this data can only be completed once the requested VDH data has been received. Further review of this data may be expanded to other health districts in the Commonwealth of Virginia.

References

1. Wunsch MJ, Nakamoto K, Behonick G, Massello W. Opioid deaths in rural Virginia: A description of the high prevalence of accidental fatalities involving prescribed medications. American Journal on Addictions. 2009;18(1):5-14. doi:10.1080/10550490802544938.

2. Opioids (All). FORENSIC EPIDEMIOLOGY. https://www.vdh.virginia.gov/content/uploads/sites/18/2023/01/Opioids-All.xlsx. Published January 2023.

3. New River Health District. https://www.vdh.virginia.gov/new-river/#:~:text=The%20New%20River%20Health%20District%20is%20
comprised%20of%20the%20counties,County%20Health%20
Department%20in%20Christiansburg. Published January 23, 2023. Accessed 2023.

4. Revive! opioid overdose and Naloxone Education (oone) program for the commonwealth of Virginia. Virginia Department of Behavioral Health and Developmental Services. https://dbhds.virginia.gov/behavioral-health/substance-abuse-services/revive/. Accessed 2023.

5. Adhikari S, Keegan B, Zimmerman D. Virginia Commonwealth University; 2020. https://cura.vcu.edu/media/cura/pdfs/cura-documents/Naloxone_Evaluation_wREVISION_FINAL.pdf.

6. National Drug-Involved Overdose Deaths, Number Among All Ages, by Gender, 1999-2021.; 2023.