Roanoke, Virginia was highlighted by Beth Macy in the book-turned-TV series Dopesick. The flood of prescription opioids in the early 2000s, combined with rapidly changing socioeconomic conditions, kicked off cycles of addiction and trauma. As of 2022, Roanoke had a rate of 113 overdoses per 100,000 residents, compared to the state rate of 29 per 100,000 residents [Virginia Dept of Health, Vital Records]. This is 2 fatalities a week, averaged over the year. State averages identify fentanyl as the cause of 80% of these fatalities.

 

Concurrently, the Roanoke region saw a 54% spike in homelessness in 2023, the highest year-over-year increase in more than a decade, according to a count conducted by the Blue Ridge Interagency Council on Homelessness. Inflation, the expiration of eviction protections and pandemic-related benefits, lack of housing inventory, and rising rental costs created tremendous pressures on low-income populations.

 

Unhoused populations are particularly vulnerable, with 44% experiencing a mental health disorder and 22% experiencing substance-use disorder. The Virginia Harm Reduction Coalition is uniquely suited to meet these needs, both by addressing the needless loss of life caused by overdoses and providing street outreach to people who are unstably housed, which makes up 75% of our organization's participant base.