DOI

10.3389/fpubh.2025.1678130

Abstract

Introduction:

Rates of fatal overdose due to opioid and substance use in Richmond, Virginia increased from 44.6 in 2018 to 129.5 per 100,000 city residents in 2023. The underlying contexts surrounding the increase in substance use and overdoses in Richmond, Virginia remains poorly understood.

Methods:

Using community based participatory research principles (CBPR), a series of “community conversations” with neighborhood residents were conducted between May–December 2023. These events included educational information, resource connection, and facilitated qualitative focus group discussion on factors contributing to substance use and overdose, as well as resource needs of people engaged in substance use. Participants also completed a survey on personal substance use experience.

Results:

Approximately 121 adults participated in 11 community conversations. Of 107 participants with survey data, 37.4% and 47.4% reported ever engaging in non-prescription or prescription opioid use, respectively. Factors leading to local overdose reflected three themes: (1) Diversity in Substance Use Narratives, (2) Coping with Impactful Life Events and Mental Health Experiences, and (3) Community- and Institutional-level Access to Substances. Resource needs were categorized as three themes: (1) Knowledge and Information-sharing around Substance Use, (2) Community Cohesion and Social Support, and (3) Consistent Wraparound Resource Support.

Discussion:

Richmond-area resident perspectives align with results from prior studies while highlighting locally-nuanced factors regarding prevention, treatment, and community supports. Participants emphasized the need for comprehensive, multi-pronged approaches that expand clinical and corrections-based services, improve resource navigation, and provide personalized, family-engaged support to strengthen neighborhood cohesion. These insights showcase the value of CBPR in elevating lived experience to guide actionable, community-tailored strategies.

Document Type

Article

Publisher Statement

© 2026 Shepheard, Mundy, Watts, Pushkin, Gordon, Shelton, Blondino, Werner, Prom-Wormley and Viray. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

Publication Date

1-26-2026

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