In 2017, in the third annual State of the Commonwealth Report, Old Dominion economists examined the toll that opioids are taking on state residents, particularly in rural areas.

With the COVID-19 pandemic raging, and residents of every state forced to curtail normal activities dramatically, the 2020 Report re-examined prescription pill abuse in Virginia. They described the national, and Virginia, situation as "spinning out of control," imposing significant costs on all citizens, whether they used opioids or not.

"The only thing that has changed is that Virginia now finds itself in the unenviable position of being in the midst of two ongoing health crises," said Barbara Blake, chief administrative officer of the Dragas Center and co-author of the opioids chapter with James V. Koch, former ODU president and founder of the State of the Commonwealth Report. And though COVID-19, with its Virginia death toll exceeding 5,000, is justifiably garnering more attention, the authors said the effects of opioid abuse will undoubtedly linger long after the pandemic abates.

How big of a challenge is this to the commonwealth?

Since 2000, abuse rates for opioids have more than quadrupled. The U.S. Centers for Disease Control and Prevention (CDC) reports that nearly 47,000 Americans died from opioid abuses in 2018, up from 21,000 in 2010. There did appear to be a leveling off in drug overdose deaths between 2017 and 2018.

Despite Virginia faring better, on average, than neighboring states West Virginia, Tennessee, North Carolina and Maryland, urban areas like Roanoke and Colonial Heights and rural counties such as Wise and Buchanan have reported drug poisoning deaths far higher than the national average.

It has been said that drug abuse, particularly opioids, results in "deaths of despair," where victims turn to addictive substances to self-medicate for issues such as poverty, depression and chronic pain. Because of the myriad negative impacts of the COVID-19 pandemic, State of the Commonwealth researchers hypothesize there may be some spillover damage in opioid abuse.

Unfortunately, concrete evidence of a COVID-19 spike in drug abuse is two years away. Because the CDC publishes this data on a two-year lag, "it would be 2022 before we would be able to detect any impacts that COVID-19 is having on drug-related behavior," the report noted.

Anecdotally, however, the federally sponsored Overdose Detection Mapping Application Program (ODMAP) - which collects drug-related data from ambulance teams, hospitals and police - can provide a snapshot of what is happening on monthly intervals.

ODMAP figures show that in April and May, drug overdoses rose by 29% and 42% nationally, compared to 2019. "If these data are accurate, then a tentative conclusion is that COVID-19 is responsible, at least partly, for the recent upsurge in drug overdoses reported in the first months of 2020," the State of the Commonwealth noted. However, report authors suggest many other factors could be responsible for the increase in drug overdoses, a key finding of the 2017 opioids chapter.

That leads State of the Commonwealth authors to suggest that COVID-19 may have halted any progress made against the scourge of opioid abuse.

The Dragas Center for Economic Analysis and Policy produces annual State of the Region and State of the Commonwealth Reports, valued as a data-driven examination of key issues facing Hampton Roads and Virginia. This year's State of the Commonwealth Report is available at

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