An analysis of overdose events at emergency departments in Fairfax County shows that opioid overdose deaths are increasing and are now the leading cause of unnatural death in the county, exceeding motor vehicle and gun deaths.

The data show that the highest rates of overdose emergency visits occur in younger age groups, are equally common among men as women, and occur throughout the county and with no geography or income pattern.

While more data analysis is underway, the CSB and community partners are examining new strategies to deal with the public health crisis, and to save lives.

Slated to begin in July, the Fairfax-Falls Church Community Services Board (CSB) will offer expanded Medication Assisted Treatment (MAT) services to people seeking support for opioid use disorder. MAT involves the use of FDA-approved medications in combination with counseling and behavioral therapies to provide a "whole patient" approach to the treatment of substance use disorders. These new MAT services include a team of doctors, a physician assistant, nurses, counselors and peer recovery staff.

According to Colton Hand, M.D., CSB Medical Director, there are multiple challenges associated with the treatment and support of individuals with opioid disorders. "This is an extraordinarily complex disease, yet we know recovery is possible. Medical and counseling staff are working side by side to best support our clients' efforts toward recovery. Our programs are making service delivery changes to help address the epidemic."

In January 2018, the Fairfax County Board of Supervisors established an Opioid Task Force to provide recommendations on how the county should address opioid misuse and disorders in our community. The group has two key goals: to reduce death from opioids through prevention, treatment and harm reduction, and to use data to describe the problem, target interventions and evaluate effectiveness.

As its title explains, MAT is medically based and designed to treat addiction as a disease. The primary medical component of MAT is Suboxone. This medication reduces opioid withdrawal symptoms, as well as reducing the risk of opioid overdose. Suboxone also helps individuals in recovery by binding to the opioid receptors in the brain to reduce cravings. Specialized training is required before a physician or nurse practitioner can be authorized to prescribe this medication, which includes a specific DEA waiver. In addition to Suboxone, other services provided include individual and group counseling, outreach and engagement, care coordination, pharmacy, nursing and primary care.

According to Dr. Hand, historically, the goal and philosophy of some substance abuse treatment has been primarily "abstinence-only" but he is optimistic that MAT will do more to save lives and support recovery. Our CSB team has now developed more individualized treatment approaches that can accommodate the multiple challenges associated with the disease of addiction. "We are working hard to add flexibility to our treatment protocols and take into account critical issues in a person's life such as employment, housing, transportation, and family obligations. These factors influence both short-term treatment and long-term recovery."

"We do as much as we can to continue to engage people in services, especially during relapses. When someone relapses, they are in a very high risk and vulnerable state. That is the time when a person needs the most support," explained Dr. Hand.

Currently, a person may access MAT services in our residential programs as well as in CSB outpatient programs. There are roughly 100 individuals enrolled in MAT now; with these program enhancements, there will be room for others. "Our multidisciplinary MAT team works closely with detox, residential, and staff across the CSB to make sure we follow up and stay engaged with our clients. The crisis demands it and we know that these changes have already saved lives. Hopefully, there will be more options on the horizon as research continues on substance use disorder treatments. We'll do our best to continue collaborating, learning and adapting."

Need help with a substance abuse issue?

Call the Fairfax-Falls Church Community Services Board:

• Emergency Services (24/7) – 703-573-5679 (TTY 711)
• Fairfax Detoxification Center (24/7) – 703-502-7000 (TTY 703-322-9080)
• CSB Entry & Referral Services – 703-383-8500
• Call 911 for life-threatening emergencies