Mapping the Opioid Death Epidemic


This map illustrates a key point in the previous post. The localities marked in blue show increases in opioid-related deaths between 2011 and 2017, and the localities shaded red experienced a decrease. While the opioid epidemic has intensified in Virginia overall, the increase (in raw numbers) has been concentrated in Virginia’s metropolitan areas. The rural pockets of “despair” have seen the problem stabilize or even recede — except, strangely enough, in the far-flung exurbs of Washington.

I’m still trying to figure out the free Datawrapper software, and I can’t get the colors in the table to match up with those on the map. And I can’t figure out how to adjust the color for poor Richmond County (the dark blue spot on the Northern Neck), which somehow got tagged with the same color as the City of Richmond. Hopefully, I’ll get better at displaying data with future maps.

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15 responses to “Mapping the Opioid Death Epidemic

  1. Interesting data! Suggest you flip the color scale, as most immediately will interpret red to be bad and blue as good, and that’s the opposite of the story you’re trying to tell. Also, does your data source have county populations? May be nice to control for difference in population sizes. 🙂

  2. er… we’re looking at one toe of an elephant in the bigger picture of drug use.

    we get these tight focus on specific data type narratives and I’m no fan of them because they lack important overall context.

    yes opioid use is up – and yes, in urban areas – but it just joins an existing ecosystem of dozens and more drugs that people already use – both prescription and illegal.

    drugs are like fashions – they come and go – so what we’re looking at is folks who use drugs – gravitating away from heroin/crack/meth/etc to the new kid on the block – opioids and fentanyl but it’s the same basic drug problem that has been around for decades, albeit is on the rise.

    But people for decades have drowned their myriad sorrows in alcohol and a phalanx of “legal” prescription drugs that the rich have access to – while the poor have to go to the “street” to get their stuff where the police then feast on them and we taxpayers pick up the tab to imprison them then fund their entitlements when they get out since they emerge as felons.

    At some point – hopefully -we recognize that opioids and where they are used geographically – currently – and trend – is just one toe of that elephant and it’s the elephant that we need to deal with and not get distracted by the current favored drug.

  3. Imagine if you are a self-employed cleaning lady, single or living with a self-employed handy man, two emigrants who live in Woodbridge, Va. have 4 children aged 4 to 10, and each of you, both mom and dad, have to drive around northern Virginia and Montgomery County, Md. every day from job to job, to earn a living to feed yourself and your kids.

    And imagine that both you both have been doing this since you arrived in Northern Virgia from central America in 1999. And that every year you have been trying to get around to the homes of those you work for, but every year that gets harder and harder, and more unreliable by the year, and it tears you away from your home and children, more and more, now leaving home at 5 a.m, and returning at 7 or 8 pm, after earning maybe $90 or less that day.

    Then suddenly a few ago, it all was made twice as bad for you by the tolls you could not afford, tolls that drove even more traffic onto the roads you had to used because they were free, and how sometimes to escape them to get home to feed your kids, your were forced to wipe out all more most of your earnings for whole day.

    Often now you can be forced to drive, stuck in a car or truck, 4, 5, 6, and 7 hours a day, to get to work cleaning peoples homes, or doing home repairs, as many as you can fit in, trying to work at least 4, 5, 6, or 7 hours a day at $15 dollars an hour. Sometimes, you never get to work at all, just drive, drive, drive, until having to turn around, and go home empty handed.

    Thousands upon thousands of our neighbors in Fairfax County who work for us, live like that every damn day, in plain sight, working in thousand upon thousands of our homes, and offices even, people like dental assistants, car wash people, clerks, lawn cutters, helpers of all sorts. And now we wonder why all the hard working people are dying of despair, and addictions. And does it even occur to us that we should have done something to fix this problem we created for these people. Why we didn’t, if only for their kids.

    • And traffic is and will only get(ting) worse. Fairfax County supervisors have admitted publicly that the first time they ever paid any attention to the traffic generated by new development was Tysons. They freely admitted that they approved development and left it to VDOT to fix the traffic. And they did that (tie development and traffic) only because of citizen group pressure applied constantly for years.

      The County’s own studied showed that at 84 MSF of development, Tysons would collapse all major connecting arteries into total gridlock. Yet, there was pressure from landowners to allow more than 220 MSF of development. While market forces generally prevent development of every square foot permitted, the Task Force’s recommendation (> 220 MSF) would have destroyed any semblance of quality of life.

      The County knew for years that the American Legion Bridge was a huge bottleneck, it still approved more development that has put more drivers on the roads and because of Maryland residents trying to avoid the Inner Loop for as long as they can, cut-through traffic is shutting down both arteries and residential streets in McLean. Indeed, the pastor of my church discussed pm traffic on Georgetown Pike in a sermon.

      Absent a huge number of people working from home almost everyday, I don’t think Fairfax County traffic will ever get better than the 7th circle of Hell and might well descend to the 9th. If only Dante had lived in 21st Century Northern Virginia.

  4. I do believe the enormity of the traffic issues in NoVa and do not diminish their impact… but………

    1. – Anyone who has been to Atlanta, Houston, LA, Seattle, Chicago, NY sees the same thing…

    2. – the “theory” of urban density was that people would use transit not single occupancy cars…

    3. – I just don’t see where more roads could be built … yes some minor connectors here and there but even those will require the destruction of private property and the loss of taxes – increasing taxes on others.

    4. – even if you COULD build more WHERE would you get the money and whose taxes would increase to pay?

    It’s like a total disconnect with reality… I hear the gripes but no solutions from those who gripe… just blame… and recriminations…

    By the way, we get NoVa escapees down our way and I have to say – you folks up North are rude and aggressive on the roads… and now we’re “infected”!

  5. Nice map; hope you can penetrate the software issues.

    I agree with RF that the population of NoVa includes many who face mind-numbing jobs and transportation hassles and a cost of housing that might well drive them to despair, and to opioids in that despair. But I’m not reading that “people like dental assistants, car wash people, clerks, lawn cutters, helpers of all sorts” are the source of NoVa’s opioid abuse problem. What about all those overworked young lawyer-associates and Congressional staffers and defense contractors and lobbyists and military officers and hospital residents and FBI agents and the like, collectively, our young professionals? The married ones with their double incomes barely covering their mortgages and nannies and get-away weekend expenses; the single ones living fast, perhaps the bar-scene life? Isn’t there sufficient pressure to dabble in opioid use among that crowd; and can’t they better afford the habit, at least initially?

    Before we go pinning the problem on “lawn cutters, helpers of all sorts” from “central America,” I daresay the abusing population has its origins a lot closer to home. But I don’t have the breakdown for what economic percentile, what educational percentile, what marital status, what country of origin these opioid deaths in NoVa represent.

    Jim B., this is where County-wide statistics just don’t give us the picture we need. Yes, it’s striking that rural abuse in Virginia may be declining and urban areas are where the problem is growing, now; but among what urban demographic? What slice of urban life is it that most needs the targeted outreach, today, of our health and social services folks? What is Richmond’s experience with this?

    • You might well be right, Acbar. I can only speak from my direct anecdotal experience. The young professionals I know today, and recall from the past where I lived and worked, were able to insulate themselves from these problems best I can tell or now remember, just as I did, although no doubt there were then exceptions to that general rule, including some that I can now recall, but those exceptions did not seem out of the ordinary in number at the time, or now either, not epidemic, just matters of within normal inabilities of some to deal with stress over time.

      Of course, I have been out of the “race” now for quite a while, and since time began folks in all sorts of urban environments have been dealing with these issues. Here I would call your attention to the Victor David Hanson article linked in below, how the affluent in California are able to insulate themselves from stresses and challenges that the middle class there apparently no longer can. Hanson refers to those those folks today as “Zombies” trying to escape. Yes, likely the range of folks so no afflicted range well above the disadvantaged I listed. I see that right here locally where I am alleged to be “retired”.

      See https://www.nationalreview.com/2019/01/california-coastal-elites-poor-immigrants-fleeing-middle-class/

      This Hanson article is a very powerful piece of journalism.

      • Yes, powerful. A quote from VDH: “Did any bi-coastal Americans think that by de-industrializing and deprecating the value of traditional hard work there would be no cultural consequences, given the historic roles of the middle classes as custodians of American values?” Yes, there have been cultural consequences, and I agree with VDH that many of the old entrepreneurial farmers of California have left the Left Coast and moved elsewhere, due to urbanization and high taxes and, yes, unpalatable (to them) political correctness. But that does not explain California today. Those California farmers survived as long as they did on the backs of the very immigrant labor that VDH now disparages for cultural reasons. Meanwhile, California has embraced the technology economy and made it work for those who have pursued the education necessary to participate in it. Sure, that has left many other Californians behind, just as we see in Virginia and Maryland.

        As for 2016, if those left behind — those whom VDH calls the “American middle classes” — thought they were electing someone to reject the “bi-coastal” elites and restore the “value of traditional hard work,” they are now finding that the champion they empowered is uneducated, disorganized, brutally selfish, and all too often less canny than brash and reckless. We are fast exhausting a tremendous backlog of goodwill abroad towards America, and deeply stressing our economy and our domestic civic institutions’ ability to function normally — for what? I do not think even Professor Hanson believes that is a bargain destined to make America great again.

  6. Opioid abuse occurs in rural areas without traffic issues and it occurs in inner city where others who are poor and without jobs live.

    We have thousands upon thousands of people who commute from the Fredericksburg area every day to jobs in NoVa and I have to say, I’d be shocked to see any studies saying that that terrible commute drove them to opioids but if such a study emerged, I’d re-think my views.

    Traffic is bad in NoVa but I’ve also personally driven in places like Atlanta, Houston, LA… Chicago and my personal opinion is that they are also similar – we just live in a car-centric world where gas is cheap and cars are also and most all of us prefer to drive solo when we want to and where we want to’ it’s a basic freedom for all of us.

    But sorry, I just don’t see traffic congestion as a cause of opioid use – that’s a bridge too far.

    • Believe it or not, I actually agree with Larry this time. I doubt that long-distance commuters turn to opioids to relieve themselves of the tedium and stress of the commuting lifestyle. If the Washington exurbs are seeing an increase in opioid use and abuse, I would more inclined to explore the impact of exurbanization on rural communities — especially rising housing prices that put stress on poor and working-class Virginians. But even that would be pure conjecture at this point.

      Still, it’s an enigma worth exploring.

      • “Believe it or not, I actually agree with Larry this time.”

        That’s a compliment. You are open minded.

        On the other hand, I suggest we need to see this in a holistic way. I believe that gridlocked traffic, stealing lives in lost time and livelihoods from citizens, especially those who’s lives are already stressed, can easily be the tipping point pushing those people over the edge. I have seen that happen. And the examples I used are real people, including the dental assistant.

        There was interesting news this morning that the Virginia General Assembly is considering bills to:

        1/ Authorize the building of a new “private” presumably tolled lane on I-95 in Northern Virginia.

        2/ Lock in long term higher toll rates on the privately owned and built Dulles Greenway, built during the mid-1990s.

        3/ Award all members of General Assembly special vanity license plates to show themselves off to their fellow citizens as they drive around their roads and highways. Perhaps next they will need State Troopers to escort them, riding shotgun.

      • We agree; this must be viewed holistically. It’s a lifestyle issue. I’m not in the exurbs but way inside the Beltway and it’s terrible to see the stresses on the young families in the neighborhood trying to achieve their parents’ standard of living.

  7. In a monopoly environment, where I worked for about 8 years of my career before the 1984 Bell System Divestiture began working, the system can sustain considerable inefficiencies including higher wages, generous retirement and benefits. Had I been in the job I had when I left the Company in those early years, I would have had a company car and company-paid investment advice. And my deferred retirement would have included paid health insurance.

    But competition forced prices closer to economic cost and the niceties for upper middle management went bye-bye. I had no company car or investment advice. I did get to keep my deferred vested pension but I received a letter a few years after I left and learned that I no longer qualified for health insurance when I received my pension.

    Take this little example and apply it to the American economy. Few businesses are free from competition. And the cost of regulation has skyrocketed. State and local taxes are up. Government payrolls are much bigger than in the past. The overhead, which is incompatible with a competitive American economy is being pushed onto ordinary workers in the form of lower salaries, at least in real terms.

    And while American education has improved in some areas, it also has people less prepared in other areas. Have you read anything written by a 20 or 30 something? Bottom line, a much smaller percentage of young adults will be able to match their parents.

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