Fatal overdoses involving multiple substances have been on the rise in communities across the United States for several years, according to the CDC. That’s one reason why efforts to reduce opioid overdoses must also include methods of tracking the use of emerging substances or common additives. Otherwise, by the time a drug is on the radar of the general public, many lives have already been lost.

But spotting shifts in usage can be difficult when so many drugs sold and consumed illegally consist of multiple substances. If a single drug contains many different substances, and the ratio of those substances varies by region—as is almost always the case—a substance may look relatively uncommon at the state level. Only when we drill down into the regional level can we see the actual trends.

Recognizing local usage patterns is the first step in preventing them from becoming statewide issues. Community organizations must understand the prevalence of specific substances in their communities and the outcomes of those substances on the health of their constituents.

By leveraging Virginia’s Framework for Addiction Analysis and Community Transformation (FAACT), communities in Virginia are doing just that. FAACT, developed in partnership with GCOM, provides a secure, centralized data sharing hub for organizations across the Commonwealth, allowing coalitions and groups to have access to analytics tailored to their communities.

The ability to analyze both statewide and local trends has been a critical part of community efforts to stay ahead of emerging substances and dangerous additives. By partnering with Virginia’s Department of Forensic Science (DFS), FAACT analyzes lab cases by substance and location to pinpoint disproportionately impacted areas. In January 2022, for example, several counties began to see a spike in overdoses and criminal incidents involving Xylazine, a tranquilizer typically used in veterinary medicine that is often added to street opiates.

Though the surge in xylazine usage was alarming for these communities, at the state level, xylazine usage during this time appeared relatively uncommon, peaking at 2.5% of substances tested by DFS statewide, as we see in this graph:

However, when the FAACT team drilled into the prevalence of xylazine by jurisdiction, it was clear that several communities were seeing dangerous amounts of xylazine circulating in the community. In Warren County, for example, Xylazine accounted for 14% of DFS cases.

A year-over-year analysis of xylazine cases by jurisdiction confirmed that xylazine usage would likely spread from “hot spots” to surrounding counties:

Fortunately, the FAACT team identified these hot spots and worked with local opioid coalitions to get a head start on addressing xylazine usage, months before the CDC and FDA issued national alerts.

While xylazine is still present in Virginia, the early intervention slowed the surge in cases and played a role in preventing xylazine from becoming highly prevalent across the state.