Richmond lost $526 million in opioid economic costs in 2023 — highest in Virginia: VCU database
RICHMOND, Va. (WRIC) — A newly updated data dashboard from Virginia Commonwealth University (VCU) found that Richmond had the highest opioid economic costs across all Virginia localities in 2023.
VCU announced Tuesday, Nov. 11, that its Center on Society and Health has partnered with the Virginia Department of Health (VDH) to release the latest round of data on opioid care and expenses in the state for counties and cities.
Opioids include prescription pain relievers such as oxycoden, hydrocodone, morphine, fentanyl and heroin, the release said.
The Virginia Opioid Cost Data Tool shows that Richmond has the highest opioid economic costs in Virginia, totaling more than $526 million in 2023. These costs include lost labor, health care, child-related and criminal justice expenses.

(Graphic: VCU’s Center on Society and Health and the Virginia Department of Health)
At roughly $263.3 million and $204.5 million in opioid epidemic costs, Henrico and Chesterfield counties ranked fifth and sixth respectively.
According to VCU and the VDH's analysis, cities and counties with the highest overdose rates have lower media household incomes and higher poverty rates compared to Virginia as a whole.
Five localities with the highest opioid costs per person in 2023 were Hopewell, Richmond, Petersburg, Norton and Portsmouth.
Data tool said opioid care can save lives and money
VCU database also argued that scaling up opioid care could prevent at least 2,000 fatal overdoses and save the Commonwealth up to $5.2 billion.
According to the release, nearly 137,000 Virginians used opioids in unhealthy ways in 2023, with 2,082 that died due to fatal overdoses.
Data from the VDH revealed that of 1,403 drug-related deaths in the state in 2024, roughly 1,066 — or about 76% — are opioid-related.
The data tool estimated that the Commonwealth could have saved a total of $5.2 billion in 2023 opioid epidemic costs. At nearly $3.41 billion, lost labor made up about 65% of the total cost.
“Of course, it’s impossible to fully measure the human impact of this crisis. But we are hopeful the website redesign makes it easier to understand both the epidemic’s felt impact across Virginia communities and the potential benefits of investing in a healthier future,” said Derek Chapman, director of VCU Center on Society and Health. “With newer localized data, state and local agencies can invest in care to support those impacted and the wider communities.”
Visit the Opioid Economic Impact interactive map to see opioid costs, fatalities and more information for your county.
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