The city of Fredericksburg had the second highest rate of opioid-related deaths in the area in 2021, more than doubling the rate of the state of Virginia according to the RACSB’s recent Opiod Harm Reduction Report.
In a presentation delivered at Tuesday evening’s City Council meeting, the Rappahannock Area Community Services Board’s Health Director Dr. Olugbenga Obasanjo and Clinical Services Director Jacqueline Kobuchi explained the ongoing data trends of opioid abuse, overview and methods of harm reduction and the strategies that have been implemented in the community.
Dr. Obasanjo, an infectious disease expert with more than 20 years in practice, began the presentation by breaking down the opioid-related death rates for the surrounding counties compared to that of the state of Virginia. Those rates (per 100,000 residents) are as follows:
Caroline County: 58.3
King George: 25.6
The national rate is 30 per 100,000 people, according to Dr. Obasanjo.
The next slide in the presentation included opioid-related deaths among Fredericksburg residents, with 13 overdoses in both 2021 and 2020, a rate more than triple that of the four deaths in 2019.
“These numbers may just be numbers, but remember every number is someone’s wife, brother, son daughter, friend.”
According to the data, emergency visits are down while deaths are rising, which Dr. Obasanjo soberly added is an indication that “people are doing drugs alone.”
The RACSB’s Clinical Services Director Jacqueline Kobuchi LCSW took over the presentation with a deeper dive into the details behind harm reduction and how it’s been expanded to combat substance use and abuse.
Kobuchi detailed how true harm reduction helps addicts in a way that “meets them where they are” while not encouraging risky behavior or discouraging abstinence. Instead, the goal is to provide support, get them into treatment and on the path to long-term recovery.
She continued by reviewing the positive impacts of harm reduction. Among those listed in the presentation included “reduced experience of judgment and stigma, reduced disease transmission and reduced risk of overdose deaths, including accidental overdoses.” She noted that the strategy has received bipartisan support on both the state and federal levels, citing Governor Glenn Youngkin’s recent executive order signed in Stafford on National Fentanyl Awareness Day.
Kobuchi also noted that harm reduction helps alleviate the personal and professional costs of “vicarious trauma,” one of the more overlooked aspects of the opioid crisis often experienced by first responders that deal with emergent incidents on a routine basis.
The presentation included a continuum of harm reduction, a progressive chart of methods that began with Good Samaritan laws and continued with medication assisted treatment, Naloxone, fentanyl test strips, syringe service programs and ended with safe injection sites. Kobuchi explained that Syringe Service Programs like syringe sterilization and syringe exchange aren’t available in the Fredericksburg area but can be found in other communities in Virginia.
Council Member Jason Graham asked about the final item, safe injection sites.
“Is that something you’d like? What is your recommendation?” asked Graham.
Dr. Obasanjo responded that only one state currently offers safe injection sites (Rhode Island), while Canada has also engaged in the practice.
“We will do with what you are comfortable with.” Said Dr. Obasanjo.
“We’re just presenting the Continuum…that’s one end of the spectrum and at the other end of the spectrum is just Good Samaritan laws. We present it to the community, find out what the community has an appetite for, and if the community has an appetite for safe injection sites, it will be a bit of an uphill battle but we can make it happen.”
Council Member Kerry Devine asked about narcan training, a question that Council Member Tim Duffy also inquired about in regards to Fredericksburg City Public Schools.
Kobuchi demonstrated the contents of a Naloxone bag for the Council, explaining the differences between the two types of training sessions, which include an hour class and one with an abbreviated ten minute duration. She also explained that all five area school districts currently have approved a Naloxone policy for school nurses, and some allow students to carry with permission from a parent. RACSB has also visited each school to provide training upon request of school administration.
The RACSB currently offers medicated-assisted treatment to 55 individuals, though other providers in the area are also offering treatment. Learn more about their work at rappahannockareacsb.org.