Dead­lier than car crashes

The U.S. at­tor­ney and the Mary­land at­tor­ney gen­eral say we are all at risk of feel­ing the ef­fects of the heroin epi­demic

Baltimore Sun - - MARYLAND VOICES - Rod J. Rosen­stein and Brian E. Frosh, Bal­ti­more Rod J. Rosen­stein (us­­ments@us­ is Mary­land’s U.S. at­tor­ney and Brian Frosh is the state’s at­tor­ney gen­eral.

The abuse of heroin and other opi­oid drugs is one of the most sig­nif­i­cant pub­lic health is­sues fac­ing the na­tion. More Amer­i­cans now die ev­ery year from drug over­doses than in mo­tor ve­hi­cle crashes. Pres­i­dent Barack Obama has an­nounced a “week of ac­tion” to raise aware­ness about the pub­lic health cri­sis and des­ig­nated this week as Na­tional Heroin and Opi­oid Aware­ness Week.

In Mary­land, heroin-re­lated deaths tripled from 2011 to 2015, ris­ing from 247 to 748. There has also been an alarm­ing spike in deaths from the syn­thetic opi­oid fen­tanyl, ris­ing 105 per­cent dur­ing the first quar­ter of 2016 as com­pared to 2015. In­creases in over­dose deaths have been re­ported through­out the state, in­clud­ing West­ern and Cen­tral Mary­land and the East­ern Shore. It is es­sen­tial to alert peo­ple about the dan­gers of opi­ate use, whether ob­tained through pre­scrip­tions or on the street. Ev­ery­one is at risk if they are not in­formed.

A na­tional sur­vey es­ti­mated that 1.4 mil­lion peo­ple in the U.S. abused a pre­scrip­tion painkiller for the first time in 2014. Ap­prox­i­mately one in five high school se­niors re­ports hav­ing mis­used pre­scrip­tion drugs at least once. Most first-time abusers of painkillers ob­tain them from a friend or rel­a­tive. Par­ents, teach­ers, and med­i­cal pro­fes­sion­als must work to­gether to ed­u­cate ev­ery child about the hor­ri­ble con­se­quences of opi­oid ad­dic­tion.

Opi­oids are highly ad­dic­tive and ex­tremely dan­ger­ous. They can al­ter the user’s brain per­ma­nently, some­times af­ter just one use. Many peo­ple be­come ad­dicted to legally pre­scribed opi­ates. Mary­land’s statewide pre­scrip­tion drug mon­i­tor­ing program to help track opi­oid pre­scrip­tions and pre­vent their abuse has sig­nif­i­cantly re­duced the avail­abil­ity of phar­ma­ceu­ti­cal drugs. The data­base is an im­por­tant step in fight­ing opi­oid ad­dic­tion.

Many ad­dicts who can no longer ob­tain pre­scrip­tion opi­oids turn to cheaper and more dan­ger­ous al­ter­na­tives and buy heroin, fen­tanyl and other opi­oids from drug deal­ers. Heroin of­ten sells for only $10 per dose. Pre­scrip­tion opi­ates, such as oxy­codone pills, cost many times more on the street.

Fen­tanyl is a syn­thetic opi­oid 25 to 40 times more po­tent than heroin. It can be ab­sorbed through the skin, and it is so strong that the equiv­a­lent of a few grains of su­gar can cause death. Fen­tanyl can be mixed with or sold as heroin. It is also ap­pear­ing in coun­ter­feit tablets, pills and cap­sules that mimic pre­scrip­tion drugs.

Users who pur­chase drugs on the street have no idea where their heroin or fen­tanyl comes from, nor its pu­rity. Heroin and fen­tanyl can be mixed with any­thing, from harm­less sub­stances such as su­gar, starch or pow­dered milk, to poi­son and other pow­er­ful opi­oids.

Nar­can is a res­cue med­i­ca­tion car­ried by most Mary­land first re­spon­ders. When ad­min­is­tered quickly to a vic­tim, Nar­can can re­verse the ef­fects of the over­dose. To en­cour­age re­port­ing of drug over­doses, Mary­land law now pro­vides im­mu­nity from A sign out­side the Anne Arun­del County Po­lice North­ern Dis­trict sta­tion raises aware­ness of the heroin epi­demic. crim­i­nal pros­e­cu­tion for any­one who seeks emer­gency as­sis­tance for an over­dose vic­tim.

Un­for­tu­nately, drug abusers who are saved by Nar­can may not be saved for long be­cause most ad­dicts con­tinue to use heroin. The Mary­land De­part­ment of Health and Men­tal Hy­giene has launched a num­ber of ini­tia­tives to re­duce the num­ber of heroin-re­lated fa­tal­i­ties, in­clud­ing pro­grams that de­liver ser­vices to over­dose sur­vivors.

As pros­e­cu­tors, we seek to hold ac­count­able crim­i­nals who il­le­gally dis­trib­ute deadly drugs. Work­ing closely with lo­cal, state and federal law en­force­ment part­ners, we pros­e­cute drug deal­ers, doc­tors and phar­ma­cists who vi­o­late state and federal drug laws. A federal statute pro­vides en­hanced penal­ties for il­le­gal drug dis­tri­bu­tion re­sult­ing in death, and federal pros­e­cu­tors are us­ing this statute in ap­pro­pri­ate cases.

Over­dose deaths through­out Mary­land are be­ing in­ves­ti­gated as homi­cides, to help iden­tify dis­trib­u­tors of fa­tal drugs. The U.S. at­tor­ney’s of­fice and the Drug En­force­ment Ad­min­is­tra­tion have joined the Mary­land at­tor­ney gen­eral’s of­fice and lo­cal po­lice and pros­e­cu­tors to de­velop a best prac­tices model for how to gather the ev­i­dence re­quired for crim­i­nal pros­e­cu­tions.

Fi­nally, our of­fices are work­ing col­lab­o­ra­tively with law en­force­ment, med­i­cal pro­fes­sion­als and ed­u­ca­tors to build com­mu­nity coali­tions to fight this epi­demic. En­force­ment ef­forts are more ef­fec­tive when they are part of a larger strat­egy to pre­vent ad­dic­tion by ed­u­cat­ing po­ten­tial drug abusers, and en­sur­ing that help is avail­able to peo­ple who be­come ad­dicted. Ev­ery­body must be part of the so­lu­tion.


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