This report summarizes information from the four executive branch agencies that provide substance use disorder treatment and recovery services: The Department of Behavioral Health and Developmental Services (DBHDS), the Department of Juvenile Justice (DJJ), the Department of Corrections (DOC) and the Department of Medical Assistance Services (DMAS). These agencies share the common goals of increasing the health and wellness of Virginia’s individuals, families, and communities, increasing access to substance use disorder treatment and recovery services, and reducing the impact of those with a substance use disorder and involvement in the criminal justice system. All of the agencies included in this report are invested in providing evidenced-based treatment and recovery services to their populations within the specific constraints each has on its ability to provide these services. In this report, the following information is detailed concerning each of these four agencies’ substance use disorder treatment programs:

1. Amount of funding spent for the program in FY 2021;
2. Unduplicated number of individuals who received services in FY 2021;
3. Extent to which program objectives have been accomplished as reflected by an evaluation of outcome measures;
4. Identifying the most effective substance use disorder treatment;
5. How effectiveness could be improved;
6. An estimate of the cost effectiveness of these programs; and
7. Funding recommendations based on these analyses.

As used in this document, treatment means those services directed toward individuals with identified substance use disorders and does not include prevention services. This report provides information for Fiscal Year 2021, which covers the period from July 1, 2020 through June 30, 2021.

Treatment Programs for FY 2021

This report provides focused data on specific outcomes. Every opioid overdose death represents many affected individuals, and every individual who commits a crime associated with substance use disorder represents many others who are also involved.(*1) Many of these individuals are struggling with functional impairment due to their substance use disorder and this is reflected in decreased workforce participation,(*2) negative impact on the economy,(*3) the potential for dissemination of blood borne diseases,(*4) and recidivism.

While we are thankful for the inclusion of Methamphetamine treatment in the monies allocated for 2020, it should be noted that singling out specific substances such as opioids, methamphetamines, or other “unfunded" substances, fails to recognize substance use disorder as being non-substance specific. In turn, this leads to “chasing" one drug or another similar to squeezing a balloon – if it gets small on one end, it will get bigger on the other. This results in duplicated services, wasted money, and poor outcomes.
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(*1) Virginia Department of Health: Office of the Chief Medical Examiner. (2021). Fatal Drug Overdose Quarterly Report. Retrieved from https://www.vdh.virginia.gov/medical-examiner/forensic-epidemiology/
(*2) Over the last 15 years, LFP fell more in counties where more opioids were prescribed." Alan B. Krueger; BPEA Article; Brookings Institute; Thursday, September 7, 2017; “Where have all the workers gone? An inquiry into the decline of the U.S. labor force participation rate"; https://www.brookings.edu/bpea-articles/where-have-all-the-workers-gone-an-inquiry-into-the-decline-of-the-u-s-labor-force-participation-rate/
(*3) Midgette, Gregory, Steven Davenport, Jonathan P. Caulkins, and Beau Kilmer, What America's Users Spend on Illegal Drugs, 2006–2016. Santa Monica, CA: RAND Corporation, 2019. https://www.rand.org/pubs/research_reports/RR3140.html. Also available in print form.
(*4) County-Level Vulnerability Assessment for Rapid Dissemination of HIV or HCV Infections Among Persons Who Inject Drugs, United States; Buchanan et. al. MJAIDS Journal of Acquired Immune Deficiency Syndromes: November 1, 2016 - Volume 73 - Issue 3 - p 323–331 doi: 10.1097/QAI.0000000000001098 Epidemiology and Prevention