Opi­oid death epi­demic con­tin­ues to hit state

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mand Cen­ter.

From Jan­uary to June this year, 199 peo­ple died from pre­scrip­tion opi­oid over­doses, com­pared with 213 in the same months last year. Deaths in­volv­ing heroin slipped to 469 from 587 over the same pe­ri­ods.

“Lots of good peo­ple are work­ing re­ally hard on this is­sue across the state,” Stamp said. “We didn’t get into this overnight and we are not go­ing to get out of it overnight.”

Mean­while, deaths re­lated to co­caine surged 54 per­cent from last year. The in­crease was mostly at­trib­uted to co­caine com­bined with opi­oids, which were found in 90 per­cent of co­caine over­dose cases, ac­cord­ing to the health de­part­ment.

Co­caine-re­lated deaths now out­pace heroin-re­lated deaths, mak­ing the ad­dic­tive stim­u­lant the sec­ond most preva­lent drug among over­dose deaths.

Many co­caine users are sur­prised to find their drugs were laced with fen­tanyl, said Fran Phillips, deputy sec­re­tary for pub­lic ser­vices with the Mary­land De­part­ment of Health.

“This is a very dif­fer­ent pop­u­la­tion and a very dif­fer­ent mar­ket,” Phillips said. “In the past co­caine users had some sense of safety. They weren’t the users who might have been im­pacted by fen­tanyl. Now, we have to get that mes­sage out to them about the risk.”

The state has de­ployed a com­pre­hen­sive ap­proach to ad­dress­ing the epi­demic, in­clud­ing ex­pand­ing ac­cess to nalox­one, a drug that re­verses over­doses and work­ing with hos­pi­tals to urge peo­ple into treat­ment. Med­i­caid ex­panded the num­ber of res­i­den­tial treat­ment beds it would cover and the state helped to fund a sta­bi­liza­tion cen­ter in Bal­ti­more that serves as a safe place for drug users to go when they are in­tox­i­cated to get med­i­cal treat­ment and links to other so­cial ser­vices. The state also has worked to in­crease the num­ber of med­i­cal providers who can pre­scribe buprenor­phine, a med­i­ca­tion that re­lieves with­drawal symp­toms.

There are also ef­forts by lo­cal ju­ris­dic­tions. Bal­ti­more re­cently be­came one of sev­eral cities to par­tic­i­pate in a pro­gram with the fed­eral Drug En­force­ment Ad­min­is­tra­tion to ad­dress the epi­demic on many fronts. For ex­am­ple, the agency is work­ing with Bal­ti­more Po­lice De­part­ment and the Bal­ti­more State’s At­tor­ney’s Of­fice to eval­u­ate cases that could be tried in fed­eral courts, which of­fers length­ier sen­tences.

In Bal­ti­more, long con­sid­ered the epi­cen­ter of the opi­oid epi­demic in the state, 483 peo­ple have died from over­doses through June of this year, the high­est num­ber of deaths in the state. That is an in­crease of 22 per­cent from 395 last year.

Bal­ti­more County had the sec­ond high­est num­ber of deaths at 215, up 14.3 per­cent from 188. Anne Arun­del County re­ported 139 deaths, up 25 per­cent from 111.

Stamp said he hopes that new leg­is­la­tion re­cently passed by Congress will help stop il­licit fen­tanyl from en­ter­ing the coun­try — the eas­i­est route be­ing the postal sys­tem. The new law puts in more track­ing guide­lines on pack­ages com­ing from other coun­tries, he said. The postal ser­vice is the only trans­porta­tion car­rier that does not gather elec­tronic in­for­ma­tion on over­seas cargo. Cus­toms and Bor­der Pro­tec­tion agents have a harder time screen­ing pack­ages for drugs be­cause of this.

But Clay and oth­ers in pub­lic health said the epi­demic is as much about de­mand as sup­ply. There are cus­tomers who want the drugs. Get­ting more of these peo­ple into treat­ment is still key to end­ing the epi­demic, Stamp said.

Adrienne Brei­den­s­tine of Be­hav­ioral Health Sys­tem Bal­ti­more said many of the pro­grams that have been de­ployed to com­bat the epi­demic haven’t been around long enough to see their full ef­fect. The city’s sta­bi­liza­tion cen­ter, for ex­am­ple, has only been open since the spring.

“We have ini­ti­ated many things that I think will bet­ter ad­dress the cri­sis that we still haven’t seen the full ef­fects,” Brei­den­s­tine said.

No­body can guess when the epi­demic will take a turn for the bet­ter, so the state will con­tinue to de­ploy re­sources to ad­dress the prob­lem, Clay said.

“The pro­grams we have in place are good and they are ev­i­dence-based and ex­pand­ing,” Stamp said. “As they con­tinue to ex­pand, we will see progress. It is not static.”

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