Fatal drug overdoses in state, region down in 2018 overall. See how Hampton Roads was affected. | U.S. Government

Fatal drug overdoses fell slightly in Virginia last year — the first time in six years that overdose deaths have declined statewide.

A new report by the Virginia Department of Health shows that 1,484 people died of drug overdoses in the state in 2018. That’s down 3.4% from the 1,534 people — the state’s all-time high — who died that way the year before.

But the overdose crisis is far from over, the numbers show.

Drug overdose deaths still are more than double the fatality rates seen 12 years ago. For the past six years, drug overdoses have killed more people than car accidents or gunfire, which includes homicides, gun suicides and accidental shootings.

In Hampton Roads, drug overdose deaths declined for the second straight year, with the 311 deaths in the region in 2018 down 7% from the year before. The fatalities were down 18% from the high-water mark of 2016, when 379 people in the region lost their lives to overdoses.

Not all cities and counties were impacted the same way: Newport News, Hampton and Gloucester saw overdose fatalities rise sharply in 2018. Others, including Norfolk, Virginia Beach and Portsmouth, saw their numbers fall, helping to drive the state and regional decreases.

The state report’s author said she’s “cautiously optimistic” about what the numbers show.

“Hopefully we’re on the trend to go down,” said Kathrin “Rosie” Hobron, the statewide forensic epidemiologist with the State Medical Examiner’s office. “We’re hoping that in the next couple of years we start seeing more of a decrease, ideally. But it’s just kind of the nature of this kind of drug epidemic. Hopefully (another drug) doesn’t come out to start the numbers rising again.”

The state’s 3.4% fatal overdose reduction came despite the fact that the third quarter of 2018 — July through September — was the deadliest quarter on record: 423 people statewide died of drug overdoses in that stretch. “The third quarter was horrific,” Hobron said. “It was the largest number of deaths in one quarter we’ve ever seen.”

Hobron looked at that spike geographically to see if one part of the state was more affected than others. “But it wasn’t just one bad area,” she said. “We just had a spike all over.”

There were reductions the rest of the year, leading to the state’s decrease.

Newport News had 47 total fatal drug overdoses for the year — up 27% from 2017 and tying with its all-time record from 2016. Hampton counted 31 overdose deaths for the year — jumping 41% from 2017, though still not quite at its all-time high of 35 fatalities set in 2016.

In both cities, overdose deaths easily outpaced homicides.

Gloucester had 10 overdose deaths — up 60% from 2017, giving the county the region’s highest fatal overdose rate on a per person basis.

Many other jurisdictions did better.

Virginia Beach, the region’s largest city, had 57 overdose deaths in 2018 — down 30% on the year. Norfolk had 60 overdose fatalities, down 27%. Portsmouth, with 34 deaths, was down 8%, while Chesapeake had 39 such deaths, a 3% reduction.

Meantime, Suffolk had 13 drug overdose deaths, James City County had seven, York County saw five, and Isle of Wight came in with four. Middlesex County had two, Poquoson and Mathews each had one, and Williamsburg and Surry had none.

Opioid deaths — which accounted for 82% of the deadly overdoses in Virginia — were down slightly statewide. In Virginia, 1,213 people died from opioids in 2018, a 1.4% reduction from the 1,230 — an all-time record — the year before. (Overdose deaths that didn’t include opioids as part of the mix were at 271 statewide, down 12% on the year.)

Opioids include heroin, a powerful heroin alternative called fentanyl and prescription painkillers.

Not many people die each year from prescription painkillers alone, Hobron said, even as experts blame those drugs for getting many people hooked on the drugs. But fentanyl is by far the deadliest drug on the street, largely responsible for the recent overdose crisis.

And fentanyl-related deaths were on the rise once again in Virginia in 2018, the report shows. Fentanyl and its analogs “caused or contributed to” 813 fatal overdoses in Virginia — up 5.5% from 2017 — and accounted for more than half of the state’s total overdose deaths for the year. In fact, the state’s third-quarter spike was overwhelmingly linked to the drug.

“That was all fentanyl,” Hobron said. “When fentanyl is present, it’s so much more likely that they are going to overdose — especially if they are doing an upper and a downer at the same time. Just doing two kinds of opposite drugs that effect you differently.”

Using a stimulant — such as cocaine or methamphetamine — in combination with a depressant such as fentanyl or heroin can be a particularly deadly combination, she said.

Though there are legitimate medical uses to fentanyl, illicit fentanyl is typically made in clandestine laboratories — mostly in China — and shipped to Mexico and Central America, then to the United States, Hobron said. It also comes in through purchases on “the dark web,” sent through the postal service and ports of entry.

The powerful low-cost drug is then combined with higher-cost heroin — and increasingly other drugs — as a way of increasing a drug dealer’s profits. But because the fentanyl quantities are so tiny, experts say, it’s easy to put too much into a dose. And end users are typically not told that the “heroin” they purchased is often laced with fentanyl.

But Hobron is hopeful that fentanyl-related overdoses could be plateauing — and could soon be on the way down, too. Though fentanyl deaths in Virginia were at an all-time high in 2018 — a 16-fold increase from the 50 such fatalities in 2012 — the 5.5% increase was the lowest in six years.

“Fentanyl is the major player in the overdose crisis just because it’s so lethal,” Hobron said. If such overdoses can be curbed, she said, that will make a huge dent in the crisis.

Newport News Police Chief Steve Drew said his city’s increase in drug overdose deaths in 2018 came despite the fact that overall drug overdoses — including non-fatal ones — declined in the city.

“This tells me that this stuff is potent,” Drew said during a recent interview. “I wish that we had it all in one neighborhood, but when you look at a map, it’s spread throughout the city … The individuals that are selling it, I need to remove them. And the individuals who have addictions, struggling with that, we’re not going to arrest our way out of that. We need to do a better job of identifying treatment.”

Drew said that when there was a spike in one neighborhood, he organized a community walk with faith leaders and people from the health department. “We passed out flyers about addictions, hotlines, just trying another method to reach people. We had four or five teams, and probably talked to about 150 people. But we are trying to find new ways to address the issue.”

Virginia Beach Police spokeswoman Tonya Pierce said the fact that the city’s police officers are now carrying Naloxone — an antidote to an opioid overdose — in their patrol cars is helping to drive down overdoses.

Police, she said, respond to all priority EMS calls, to include drug overdoses.

“A lot of times we are first on scene,” Pierce said. “There have been cases where we’ve deployed the (Naloxone) and started the resuscitation process, and (fire department medics) will come in and administer a second dose. That’s been huge.”

More broadly, she said, residents are getting more educated on overdose dangers. “Our community is becoming much more aware,” she said. “We promote trying to get ahead of things, and we have educational pieces that we are doing along with EMS. … But I wish we had an easy fix to stop this. Because not only does it impact the individual, but also family members and friends of the family.”