The Joint Commission on Health Care received a staff briefing on Thursday presenting interim findings from a comprehensive study of the Commonwealth’s fentanyl crisis, including recent trends in overdose deaths, demographic patterns and an inventory of Virginia strategies across prevention, intervention and treatment.

The briefing matters because fentanyl has driven a large share of opioid overdose deaths, and staff will use the study to develop policy recommendations due to the commission in September 2025.

JCHC staff described the study’s three research questions: measure trends and demographic/geographic differences in fentanyl use and overdose deaths; identify strategies Virginia is using across the public‑health spectrum and assess evidence of effectiveness; and find gaps or unmet needs. Staff said they are combining descriptive data analysis, literature reviews and interviews with agency staff, community organizations and people affected by fentanyl.

Staff reported that deaths from illicitly manufactured fentanyl represent a third wave of opioid mortality in Virginia. Fentanyl‑involved deaths began rising around 2013, increased sharply through 2021, stabilized, and — according to preliminary data presented by staff — fell markedly from 2023 to 2024. Staff cautioned that while rates have declined toward pre‑pandemic levels they remain high relative to other drug categories.

The presentation highlighted demographic patterns: males die of fentanyl overdoses at roughly three times the rate of females, and Black or African American residents have experienced higher fentanyl overdose death rates than Hispanic or white residents in recent years. Age patterns showed adults roughly between 30 and 55 experienced higher rates, with the 30–34 cohort having the highest rates through 2023; that cohort’s rate fell substantially between 2023 and 2024, staff said.

On causes and drivers, staff said COVID‑19 played a twofold role: pandemic‑related social and economic stressors may have increased substance use, and disruptions in supply chains helped drive fentanyl into illicit markets because it is potent, transportable and relatively inexpensive to manufacture. Staff also noted that illicit fentanyl appears in counterfeit pills and mixed with other street drugs, increasing the risk of unintentional exposure.

JCHC staff cataloged more than 50 strategy types in Virginia across five secretariats and other entities, concentrated in intervention and treatment. They labeled naloxone distribution, evidence‑based medications for opioid‑use disorder and peer‑support services as evidence‑based measures that reduce overdose deaths or improve recovery outcomes. Staff said they found fewer statewide prevention and recovery strategies specifically targeting fentanyl and that interviewees described the Commonwealth’s response as moving from an emergent approach to a more strategic, sustained response.

Staff said the final report, to include policy options, will be presented at the commission’s September 2025 meeting. They also encouraged public written comments; the staff briefing included directions for submitting material for the study record.

Commissioners asked whether the 2023–24 decline has a single cause; staff responded that no single factor explains the decline and that Virginia’s multi‑pronged approach — including interdiction, naloxone distribution, and expanded treatment access — likely contributed. Staff said their final analysis will examine monitoring and evaluation practices and how resources are distributed to identify gaps and sustain effective strategies.