Revive RVA: Regional Solutions to the Opioid Crisis

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Revive RVA: Regional Solutions to the Opioid Crisis Virginia Association of Counties Achievement Award Application Submitted by Hanover County on behalf of the Richmond Region

Executive Summary Facing an opioid addiction overdose crisis in the Richmond community, the leaders of Chesterfield, Hanover, and Henrico counties and the City of Richmond called for a regional summit focused on finding solutions to this epidemic. On August 1, 2017 a planning team comprised of staff from these four localities along with the Virginia Department of Health began planning a regional community summit to be held in the fall of 2017. With this short timeframe in mind, the planning team quickly organized into committees to plan the event. While drug forums had occurred in the individual localities, this would mark the first time for the region to come together to pool resources, share information and best practices, and determine broader goals. On October 26, 2017 Revive RVA: Regional Solutions to the Opioid Crisis community summit was held at the Greater Richmond Convention Center. Approximately 850 people attended the event to hear keynote speakers Dr. Robert L. DuPont, a national expert in the field and Dr. A. Omar Abubaker, a local dentistry professor who lost his son to the epidemic, share their perspectives and advice. Breakout sessions offered participants the opportunity to further explore areas of interest. After lunch, moderators provided summaries from the morning breakout sessions and a solution-focused community response. A recovery panel of area residents shared their experiences and success stories, proving that recovery is possible. Finally, REVIVE! training was offered to participants to teach them how to save an overdose victim and the prescription (antidote) was provided. More than 25 Exhibitors attended the event, many of them offering treatment resources and information to the community. To accomplish such an event in such a short period of time is a truly significant and a testament to the regional cooperation that exists in the Richmond region. The work that was begun by this initiative continues today, and the planning team will launch OpioidSolutionsRVA.com, a regional website dedicated to Education, Prevention, Treatment, and Recovery in September 2018. It is hoped that the regional website will offer a better way to inform the public on this issue and to share resources.

Problem Statement Opioid addiction is a national crisis (President Trump declared a national emergency the same day as the regional summit) and the Richmond region is not immune to this issue. According to the U.S. Department of Health and Human Services, in the late 1990s, pharmaceutical companies reassured the medical community that patients would not become addicted to opioid pain relievers and healthcare providers began to prescribe them at greater rates. Increased prescription of opioid medications led to widespread misuse of both prescription and non-prescription opioids before it became clear that these medications could indeed be highly addictive. In 2017 HHS declared a public health emergency and announced a 5-Point Strategy to Combat the Opioid Crisis. Opioid overdoses accounted for more than 42,000 American deaths in 2016, more than any previous year on record. An estimated 40% of opioid overdose deaths involved a prescription opioid.

The Centers for Disease Control and Prevention estimates that the total "economic burden" of prescription opioid misuse alone in the United States is $78.5 billion a year, including the costs of healthcare, lost productivity, addiction treatment, and criminal justice involvement. According to the Virginia Department of Health, the number of opioid overdose deaths among the four localities has increased by more than 50% between 2015 and 2016, with even more in 2017. The breakdown of overdose deaths fentanyl/heroin and prescription opioids by locality is as follows: 2015 2016 F/H Rx Total F/H Rx Total Henrico 28 9 37 35 11 46 Richmond 42 13 55 67 20 87 Hanover 5 4 9 8 2 10 Chesterfield 23 8 31 48 15 63 Total 132 206 The increased emergency calls are providing stress on our public safety responders, and this has resulted in police officers carrying Narcan (antidote) in their vehicles as well as EMS first responders. Exacerbating the problem further is the introduction of fentanyl and carfentanil laced heroin, which is undetectable and has proven to be significantly more lethal. Program Description Revive RVA: Regional Solutions to the Opioid Crisis was a one-day summit which occurred on Thursday, October 26, 2017 at the Greater Richmond Convention Center. This was an initiative of the counties of Chesterfield, Hanover, and Henrico, the City of Richmond, and the Virginia Department of Health. Coming

together to have a community forum, the goal of the summit was to identify and learn more about the problem, build relationships, provide training, and begin to find solutions to the crisis. Planning for the event consisted of securing a venue, developing a program and finding speakers, identifying an online registration system, recruiting moderators, arranging for lunch, and coordinating volunteers. Henrico County served as the leader for this effort and negotiated with the Greater Richmond Convention Center to hold the event. A Henrico County Public Schools registration system was utilized to be able to track attendance for the summit as well as the optional Revive training. We were fortunate to have two highly qualified and engaging keynote speakers. Dr. Robert L. DuPont, President of the Institute for Behavior and Health, Inc. and former Director of the NIH National Institute on Drug Abuse and former White House Drug Chief, provided background and his recommendation for dealing with the opioid crisis. Dr. A. Omar Abubaker, Professor and Chairman of the Department of Oral and Maxillofacial Surgery, VCU School of Dentistry, shared his personal story of having lost his son to the opioid epidemic and his views on the responsibility of the medical community in limiting prescription drugs. An array of breakout sessions offered the participants an opportunity to focus on such areas as Emergency Medical Response to the Opioid Crisis (regional overview and EMS response), K-16 Education Perspectives, National and State Perspectives on Best Practices in the Treatment of Opioid Use Disorders, Perspectives from the Medical Community, Policy and State Perspectives, and Public Safety Perspectives on the Opioid Crisis. After lunch, the breakout session moderators reported to the general audience what was discussed during the breakout sessions, including any solutions which were identified. Not having a chance to attend each breakout session, this report was an opportunity for participants to hear a summary from each session. A recovery panel of six Richmond area residents shared their recovery journeys. The planning team felt that it was important to include time for those with personal experience to hear their stories and to know that success is possible. We were grateful for their willingness to share their stories with the audience. A question and comment period was offered to participants with many area high school students making comments and suggestions. Finally, a significant number of participants received the REVIVE! training. REVIVE! is the Opioid Overdose and Naloxone Education (OONE) program for the Commonwealth of Virginia. REVIVE! provides training to professionals, stakeholders, and others on how to recognize and respond to an opioid overdose emergency with the administration of naloxone (Narcan ). REVIVE! is a collaborative effort led by the Virginia Department of Behavioral Health and Developmental Services (DBHDS) working alongside the Virginia Department of Health, the Virginia Department of Health Professions, recovery community organizations such as the McShin Foundation, OneCare of Southwest Virginia, the Substance Abuse and Addiction Recovery Alliance of Virginia (SAARA), and other stakeholders. Over 25 Exhibitors attended the summit and offered information and resources to attendees.

Planning for this event entailed regular regional meetings during the months of July, August, September, and October 2017. Numerous staff from each locality and the Department of Health worked hard to accomplish the event in a short timeframe. Additionally, many volunteers helped to staff the registration table on the day of the summit and served as hallway ambassadors to welcome and direct people to the event. Thanks to our partners, namely Richmond Region Tourism, we were able to host this successful summit at minimal cost. In fact, the only charge to the localities was for the cost of lunch ($16,569.74), a small cost for printing programs ($200), and the overall cost of bringing in and hosting our keynote speaker ($1,441.54) for a total cost of $18,211.28. Program Success Success is generally measured by achieving pre-determined objectives. In this case, the planning team from four localities and the Virginia Department of Health came together to plan and implement a major community event in a matter of months. The goal of the summit was to provide education on the topic, share best practices, build relationships, and to find solutions to the problem. The fact that over 800 interested people attended a community summit in downtown Richmond in October 2017 is significant in and of itself. A quality program was achieved, and the cost of lunch was the only major expense. A component of the registration system enabled participants to evaluate the summit and offer feedback. We receive 82 responses through the registration system with an overall rating of 9.4 on a scale from 1 to 10. Additionally, the majority of the comments that were provided were very positive. A successful outcome of the summit is the work that continues. The four localities and the Health Department continue to meet regularly to develop a mission and strategy for the regional initiative. A mission statement has been developed to drive our collective efforts: Strengthen the Richmond Region s capacity to collaboratively plan, align, and execute community-driven solutions to address the opioid crisis with strategies focused on education, prevention, treatment, and recovery. This September we intend to launch a regional opioid website which will serve as a hub for Richmonders to find information and resources to address this crisis. A grant was secured by the Virginia Department of Behavioral Health and Developmental Services to develop OpioidSolutionsRVA.com, Education, Prevention, Treatment, Recovery for our Region.

Worthiness of an Award Revive RVA: Regional Solutions to the Opioid Crisis exemplifies regional collaboration at its finest. Local leaders had a vision for a solution-focused community forum and felt that this could be best achieved on a regional level. Staff from the four localities and the Virginia Department of Health worked diligently for four months to pull off a major event with only a modest budget. Everything about the summit was first-class and demonstrates what is possible on a regional level. As one attendee commented, overall I thought the event was outstanding. Bringing together that many stakeholders at once is nothing short of a miracle. Congratulations is deserving to all those who were involved in this successful regional event.

Highlights from the event