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Drug use and associated overdose deaths have steadily increased across the United States in recent years. In Richmond, Virginia, this crisis has reached alarming levels, with the city ranking among those with the highest rates of fatal opioid overdoses in the state. Richmond—along with cities like Roanoke and Petersburg—had one of the greatest rates of fatal opioid overdoses in 2022. It’s undeniable that our city is an epicenter of Virginia’s ongoing drug crisis. However, the community is responding accordingly. With centers—like Freedom Recovery Centers—and the forming of Richmond Opioid Task Force (ROTF), there’s hope. The future may look very different from the past five or 10 years. Below, we take a closer look at current and past statistics and the future of the opioid crisis in Richmond.
Quick Facts
According to current government data for Richmond and Virginia:
- Richmond saw a dramatic increase from 60 fatal opioid overdoses in 2019 to approximately 270 in 2023 (a 350% increase)1.
- About 90-91% of overdose deaths in Richmond involved the use of fentanyl or similar opioids1.
- Males account for approximately 72-73% of drug arrests across the last five to six years2.
- Females account for about 27-28% of drug arrests over the last five to six years2.
- Drug arrests declined steadily for both genders in Richmond, but increased in 2023, potentially due to increased law enforcement2.
- White and Black individuals comprise the majority of drug-related arrests2.
- The pandemic had the biggest decrease in arrests, but increasing overdose deaths2.
- While marijuana use cases have declined since 2020, heroin, Phencyclidine (PCP), and cocaine trends have increased2.
- In Virginia, there were 2,463 drug overdose deaths in 2023, with nearly 80% involving fentanyl or similar opioids3. In Richmond, Virginia, specifically, overdose deaths continue to rise dramatically, especially since 2020, and remain at crisis levels.
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Drug Types and Usage Patterns
The drug landscape in Richmond has seen vast changes over the years. However, the one continuing truth is that addiction is a prominent problem that needs addressing. From 2019 to 2023, the use of certain substances increased, while others decreased.
Fentanyl (And Other Opioids)
Fentanyl is a synthetic opioid that is 100 times more potent than morphine and 50 times more potent than heroin4. It continues to dominate the Richmond drug scene, with even small amounts associated with overdosing. In the first six months of 2021 alone, this drug accounted for 89% of overdose deaths.
By 2023, this statistic rapidly grew—with nine out of ten overdose deaths in Richmond attributed to overdoses (primarily fentanyl). Where prescription painkillers and heroin used to be dominant, fentanyl and other opioids have taken their place, driving the drug crisis in our state and city.
Heroin & Prescription Opioids
While heroin is still prominent in Richmond, it’s increasingly laced or replaced with fentanyl. Many who began with prescription opioids may have transitioned into heroin or fentanyl use due to easier access. Heroin use further saw sharp increases between 2020 and 2023, with 2023 having the most prominent increase2.
Methamphetamine
Methamphetamine (meth) is not an opioid but it continues to be a growing concern in Richmond, Virginia. This is especially true due to the common rise in fentanyl being combined with meth5, contributing to overdose deaths and meth seizures.
Cocaine
Cocaine, a stimulant, had sharp increases in use in 2019 and 2023. It’s often laced with other opioids, which can be dangerous and deadly. However, the hope is that this trend line will turn downward as a major Richmond trafficker who distributed fentanyl, heroin, and cocaine together was prosecuted in 20236.
Marijuana
While this used to be one of the drugs with the highest violations, due to changes in the legal landscape and enforcement, marijuana arrests have been declining since 2020.
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Public Health Response and Initiatives
Drug addiction and overdose deaths aren’t being ignored. When approaching the opioid and drug crisis in Richmond, VA, city leaders have taken action in terms of immediate life-saving options and long-term strategies. There’s also been a crackdown on traffickers, with, as previously mentioned, a major trafficker being prosecuted in 2023.
Distribution of naloxone (Narcan), an opioid overdose reversal spray, has become a prominent piece of the puzzle for immediate life-saving and harm reduction approaches. The Richmond City Health District provides free naloxone kits, along with free virtual training twice a month7. This strategy has taken the stress off of first responders and also saved many lives (specifically before paramedics reach the scene).
Virginia also has Good Samaritan laws, which protect individuals who reach out for help regarding illicit drug use. This is imperative for those who want to overcome a drug addiction without fear of prosecution.
In response to the unpredictable nature of Richmond’s drug supply, health officials have developed an innovative “Spike Alert.” 8 This early warning system notifies public and emergency services when a sudden spike of overdoses occurs. This can significantly help with preparedness, allowing health officials to allocate resources effectively.
Richmond has further taken a hands-on approach to harm reduction, working with organizations like River City Harm Redux and the Health Brigade to offer syringe exchange programs, wound care, and HIV/hepatitis C testing. In 2024, the city rolled out harm reduction vending machines in public spaces9—making naloxone, fentanyl test strips, and hygiene essentials available 24/7.
But there’s also moves to prevent drug use from happening in the first place. In 2024, Richmond’s Opioid Response program launched a youth-focused opioid prevention campaign to educate adolescents and young adults about the dangers of drug use10.
Hospitals in Richmond are also stepping up with new and improved protocols, which help screen for substance abuse and guide patients to the right form of care.
While developments continue to take place, particularly fueled by the Richmond Opioid Task Force (ROTF), the hope is that Richmond, VA, will have a bright future where opioid addiction and substance abuse no longer claim or impact so many lives. Through ongoing collaboration, education, and support, the goal is to create a healthy and resilient community—where individuals struggling with substance abuse can get the care they need and deserve.
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Treatment and Recovery Resources
While challenges remain, proactive approaches continue to emerge and deter the growing substance abuse facing Richmond, VA. Freedom Recovery Centers (FRC) provides holistic and evidence-based treatments for recovery. If you or someone you love is struggling, reach out to us today at 804-635-3746. It’s never too late. Recovery is possible. When you’re ready, one of our team members is here to answer your call 24/7.
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