Over­dose deaths con­tinue sharp in­crease in Mary­land

Heroin, fen­tanyl fuel more than 50% spike over last year in fa­tal­i­ties statewide

Baltimore Sun - - NEWS - By Mered­ith Cohn mered­ith.cohn@balt­sun.com

The num­ber of drug- and al­co­hol-re­lated over­dose deaths in Mary­land in the first half of the year jumped more than 50 per­cent from the same pe­riod last year, ac­cord­ing to new data from the state Depart­ment of Health and Men­tal Hy­giene.

From Jan­uary to June, there were 920 fa­tal over­doses this year, com­pared with 601 last year, an es­ca­la­tion of the opi­oid over­dose epi­demic that star­tled even some work­ing in pub­lic health.

Heroin ac­counted for the most deaths. But fa­tal­i­ties re­lated to the pow­er­ful syn­thetic painkiller fen­tanyl, which is of­ten mixed in heroin, un­be­knownst to users, saw the big­gest spike.

Heroin deaths rose 68 per­cent to 566 in the first half of the year, and fen­tanyl deaths rose 268 per­cent to 446. Deaths from pre­scrip­tion opi­oid-based painkillers rose 10 per­cent to 210. Users who have over­dosed and died are of­ten found to have more than one drug in their sys­tem.

Al­though many in pub­lic health ex­pected the epi­demic to worsen be­fore it abated, few ex­pected it would reach cur­rent lev­els, said Caleb Alexan­der, codi­rec­tor of the Cen­ter for Drug Safety and Ef­fec­tive­ness at the Johns Hop­kins Bloomberg School of Pub­lic Health.

“I’m sur­prised by the mag­ni­tude of the in­crease,” he said. “The fact that you see such a large num­ber of fen­tanyl-re­lated deaths demon­strates the need for greater re­sources ded­i­cated to iden­ti­fy­ing and treat­ing opi­oid de­pen­dence.”

He added, how­ever, that there was “no sin­gle in­ter­ven­tion” that would sig­nif­i­cantly curb ad­dic­tion and over­doses. And, he said, in ad­di­tion to more treat­ment, an­other fo­cus should be on tack­ling the over­pre­scrib­ing of opi­oid painkillers, where many ad­dicts get their start.

Oth­ers say users need to be warned about the dan­gers of fen­tanyl, which fed­eral Drug En­force­ment Ad­min­is­tra­tion of­fi­cials have said is typ­i­cally not the kind used as a painkiller in med­i­cal set­tings but rather syn­thetic ver­sions made in labs in Asia and shipped il­le­gally to the United States.

Some deal­ers are cut­ting heroin with such fen­tanyl be­cause of its po­tency, to make their heroin more at­trac­tive to buy­ers.

Pub­lic health of­fi­cials lo­cally and across the coun­try al­ready have been sound­ing the alarm about fen­tanyl since last year, when deaths be­gan to climb.

“Fen­tanyl is a ris­ing and very con­cern­ing prob­lem,” said Dr. Leana Wen, Bal­ti­more City health com­mis­sioner. “It’s many times stronger than heroin, and it’s be­ing mixed in with heroin and other drugs such as co­caine, and users are tak­ing what they think is their usual amount and they are dy­ing from over­dose. The rise is re­ally re­mark­able and re­ally shock­ing.”

The city Health Depart­ment has be­gun de­ploy­ing teams to over­dose “hot spots” iden­ti­fied by emer­gency re­spon­ders to alert drug users and ad­dic­tion treat­ment providers that fen­tanyl is likely be­ing sold in those ar­eas. The depart­ment, as well as oth­ers around the state, also has been train­ing peo­ple in the use of the opi­oid over­dose an­ti­dote nalox­one and push­ing for more treat­ment.

Bal­ti­more City recorded the most over­dose deaths in the state in the first half of the year, with 290, an in­crease of about 54 per­cent from a year ear­lier. But in­creases in over­dose fa­tal­i­ties are be­ing recorded statewide.

The fa­tal­i­ties were up by more than 50 per­cent in a dozen coun­ties. Al­le­gany, Charles, Kent, Tal­bot, Wi­comico and Worces­ter coun­ties recorded dou­ble or triple the num­ber of deaths.

Only four, mostly ru­ral, coun­ties saw de­creases in over­dose deaths (Wash­ing­ton, Gar­rett, Car­roll and Som­er­set). Two coun­ties had no change (St. Mary’s and Queen Anne’s).

“Fen­tanyl con­tin­ues to be a grim fac­tor in the scourge we’ve seen grip Mary­land in re­cent years,” said Dr. Howard Haft, state deputy sec­re­tary for pub­lic health, in a state­ment. “Users are buy­ing and con­sum­ing fen­tanyl when they might think they are about to take some­thing else. And they’re dy­ing.”

The Rev. Mil­ton Wil­liams of Bal­ti­more, founder of The Turn­ing Point Clinic in East Bal­ti­more, knows this first­hand.

He said his med­i­cal staff, and even his se­cu­rity of­fi­cers, have ad­min­is­tered nalox­one on the clinic prop­erty. It’s frus­trat­ing, he said, be­cause those over­dos­ing are fre­quently the same peo­ple locked in a cy­cle of get­ting a fen­tanyl-in­duced “su­per high,” over­dos­ing, get­ting re­vived and then over­dos­ing again later the same day, or soon af­ter.

“This is not the an­swer,” he said of ad­dicts be­ing saved by re­peated nalox­one doses. “When this man or this woman is ready to make a change in their life, the doors of treat­ment need to be ready and wait­ing and have the ca­pac­ity to bring them in im­me­di­ately. They re­quire med­i­ca­tion and coun­sel­ing and, in my phi­los­o­phy, the help of almighty God.

“This is where we stand. This is not go­ing away.”

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