ROANOKE, Va. (WDBJ) - A new report from Virginia’s Chief Medical Examiner examines the number and type of datal overdoses in Virginia from 2022.

The report is built with quarterly reports throughout the year. The creators issue one caveat, however: the 2022 report is still assessing about 150 open cases still under review.

In 2022, Virginia lost more than 2,500 people to a fatal overdose. Those kinds of deaths far outpace the number of deaths related to guns or car crashes.

“I can really say offhand that most of this just like across the nation, not here just in Virginia, but it’s really driven by the illicit Fentanyl crisis,” said Rosie Hobron, the forensic epidemiologist in the Office of the Chief Medical Examiner. She compiles the quarterly reports.

She says poly-substance use is common, meaning a toxicology report could determine a person died from multiple substances, sometimes as many as 12. The report can count one death across multiple drug categories.

Fatal cocaine and meth related overdoses rose in 2022, compared with 2021. Experts agree, many substances bought on the street are cut heavily with synthetic substances and illicit fentanyl. It’s clear, fentanyl is the biggest killer.

“Over the last three years, over three out of every four overdose deaths involves fentanyl,” said Hobron. “And we all know the lethality of it, you know, very small amounts can result in overdose or overdose death.”

Roanoke remains among the regions with the highest number per capita of overdose deaths, at the top of the list with Richmond and Fredericksburg.

That said, the 2022 report may be a starting place for good news. The overall overdose numbers appear to show almost 100 fewer deaths compared with 2021 - a year with a record high number for the Commonwealth. While it may not be statistically significant, it appears to follow a regional trend.

“We saw a decrease in 2022,’ said Hobron. “But also other states are also seeing similar trends of actually decreases in their numbers.”

The first quarter report for 2023 will be released by July. It will give us a better sense of whether more significant change is coming.