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 improving 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. In this report, the following information includes each of these four agencies’ substance use disorder treatment programs:

1. Amount of funding spent for the program in FY 2024;

2. Unduplicated number of individuals who received services in FY 2024;

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 to increase efficiency;

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 FY 2024, which covers the period from July 1, 2023, through June 30, 2024.

Treatment Programs for FY 2024

This report provides focused data on specific outcomes. Every fatal drug overdose represents many affected individuals, and every individual who commits a crime associated with substance use disorder represents many others who are impacted.(*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.

The inclusion of methamphetamine treatment in monies allocated for 2020 allowed for much needed expansion of services. It should be noted that earmarking funds to ameliorate the impact specific drugs have on health outcomes may fail to acknowledge that substance use, or substance use disorder (SUD) is not limited to a specific drug. SUD is a non-substance specific recognized and diagnosable disorder. Lack of flexibility to utilize funding when addressing misuse of ALL drugs may indirectly result in increased use. We observe that while fatal overdoses due to opioids and methamphetamines decreased from 2022 to 2023, overdose rates increased for cocaine.(*5) A reactive or drug specific approach to substance use funding may result in duplicated services, and poorer outcomes.
_________________________________________________
(*1) Virginia Department of Health: Office of the Chief Medical Examiner. (2024). 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-theworkers-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
(*5) Virginia Department of Health: Office of the Chief Medical Examiner. (2024). Fatal Drug Overdose Quarterly Report. Retrieved from https://www.vdh.virginia.gov/medical-examiner/forensic-epidemiology/