OPI­OID

Times-Record - - News - Fol­low Mike Davis on Twit­ter: @mike_k­ibay­times.

“We want to take our role very se­ri­ously,” Bay­less said. “We know that the med­i­cal com­mu­nity, health care sys­tems, hos­pi­tals, have been part of the prob­lem, and we also need to be very de­lib­er­ate about be­ing part of the so­lu­tion.”

Bay­less said work over the years have in­cluded the de­vel­op­ment and im­ple­men­ta­tion of Safe Sta­tions, the cre­ation of des­ig­nated drug drop-off lo­ca­tions as well as nalox­one train­ing and over­dose sur­vivors out­reach ser vice pro­grams.

In Bal­ti­more City, Health Depart­ment Se­nior Ad­vi­sor Dr. Shelly Choo said more than 35,000 res­i­dents had been nalox­one trained, sav­ing 1,500 lives. Choo said the city is us­ing a three-pil­lar ap­proach to com­bat­ing the epi­demic.

Ad­dress­ing the over­dose deaths, the depart­ment ed­u­cates the com­mu­nity about us­ing nalox­one, some­thing Choo said ev­ery­one should have in their medicine cabi­net, like Tylenol or Advil.

The se­cond pil­lar, re­al­iz­ing nalox­one alone isn’t the so­lu­tion, is work­ing to in­crease on-de­mand ac­cess to treat­ment. Pro­grams us­ing med­i­ca­tion as­sisted treat­ment com­bined with psy­choso­cial coun­sel­ing cou­pled with wrap-around ser­vices have been shown to help pa­tients re­cover and de­crease mor­tal­ity rates, she said.

The third pil­lar is fight­ing the stigma of ad­dic­tion us­ing sci­ence and ev­i­dence to show that ad­dic­tion is a disease “rather than a moral fail­ing or a crime.”

Cardin said he didn’t be­lieve the opi­oid epi­demic had reached rock bottom as over­dose deaths con­tinue to in­crease, mainly from the in­tro­duc­tion two years ago of the dan­ger­ous chem­i­cals fen­tanyl and car­fen­tanil.

Cardin said many times peo­ple be­come ad­dicted to opi­oids through le­gal pre­scrip­tions that they do not han­dle cor­rectly. Once the pre­scrip­tion med­i­ca­tion be­comes un­avail­able or too ex­pen­sive, users move on to heroin, which is less ex­pen­sive. Cardin said the drug deal­ers have found fen­tanyl less ex­pen­sive than heroin and have started cut­ting their prod­uct with the deadly chem­i­cal.

“That cy­cle is still con­tin­u­ing and needs to be stopped,” he said.

Part of the strat­egy to ad­dress those is­sues, Cardin said, is to have proper med­i­cal pro­to­cols on how to han­dle pain. By re­duc­ing the num­ber of pills pre­scribed or by find­ing al­ter­na­tive pain-re­duc­tion meth­ods, the num­ber of peo­ple get­ting ad­dicted will lessen.

Cardin said de­spite co­op­er­a­tive pro­grams with the Mex­i­can gov­ern­ment, drug car­tels are still find­ing ways to get the il­licit drugs into the United States for dis­tri­bu­tion. He said the car­tels are op­er­at­ing with im­punity in Mex­ico and that more needs to be done to ad­dress the in­flow of drug ac­tiv­ity.

On a pos­i­tive side, Cardin said the Med­i­caid pro­gram cov­ers be­hav­ioral health and ad­dic­tion, as does the Af­ford­able Care Act, so re­im­burse­ment is avail­able for some pro­grams in­di­vid­u­als en­ter. Cardin also said as much as $10 bil­lion has been al­lo­cated in the fed­eral bud­get to ad­dress cri­sis. He said the en­tire fed­eral del­e­ga­tion sup­ports these ef­forts.

One of the ma­jor chal­lenges in reach­ing ad­dicted pa­tients is reach­ing them when they are at­ten­tive. If some­one goes to the emer­gency room at 3 a.m. with an is­sue and no fol­low up is con­ducted, the dis­charged pa­tient is “likely to be re­turn­ing to the hos­pi­tal or worse, prob­a­bly killed by an over­dose.”

Find­ing pro­grams that meet the needs of the spe­cific com­mu­nity is es­sen­tial, Cardin said, stat­ing dif­fer­ent pro­grams work in dif­fer­ent ar­eas.

In Anne Arundel County, the cre­ation of Safe Sta­tions within the past year has aided more than 500 peo­ple get treat­ment and has a 58 per­cent suc­cess rate of keep­ing peo­ple sober, said Jen Corbin, leader of the pub­lic cri­sis ef­fort in the county. The Safe Sta­tions pro­gram is run through the men­tal health agency in Anne Arundel County.

One chal­lenge pa­tients find in get­ting treat­ment is the amount of time it takes to get into a pro­gram, so Corbin and her team have come up with cre­ative ways to find a pa­tient a safe space to be lo­cated un­til what­ever treat­ment is needed can be ob­tained.

All day ev­ery day, peo­ple us­ing can present them­selves to a fire or po­lice sta­tion in the county which will then reach out to the cri­sis team that will fol­low the per­son through “the whole spec­trum.” Corbin said it is es­sen­tial to not just find the per­son the help they want but to stay with them through­out the process. Those in­di­vid­u­als fol­low the pa­tient as they en­ter a re­cov­ery house, find em­ploy­ment and aid in tasks like writ­ing a re­sume, she said.

Fund­ing can be an is­sue, Corbin said, as pa­tients exit treat­ment hav­ing not worked while get­ting sober and need to pay for food and rent. As the pro­gram is grant funded, more money al­lo­cated for grants was rec­om­mended.

Corbin said in­pa­tient ser­vices are im­por­tant but they are only a small piece to sus­tain­ing longterm so­bri­ety for an in­di­vid­ual, stat­ing the need for more sup­port ser­vices af­ter in­pa­tient care.

Hav­ing the fire and po­lice sta­tions open up their doors as a hub when pa­tients are ready to seek treat­ment is im­por­tant, Corbin said, be­cause it re­duces the num­ber of peo­ple go­ing to the emer­gency room. Once a per­son en­ters the sta­tion, per­son­nel con­tacts the cri­sis sys­tem’s “warm line,” which op­er­ates all-day, ev­ery-day, and some­one is dis­patched im­me­di­ately to as­sess and move the in­di­vid­ual to a safe place.

The cri­sis team then makes phone calls to place the in­di­vid­u­als need to screen for treat­ment, and trans­ports the in­di­vid­ual to the treat­ment fa­cil­ity. Be­cause the county has a larger cri­sis sys­tem, Corbin said, care co­or­di­na­tors visit the pa­tient dur­ing treat­ment and aid in find­ing fur­ther place­ment op­por­tu­ni­ties.

Other coun­ties in Mary­land have be­gun cre­at­ing Safe Sta­tions with the help of Anne Arundel County per­son­nel.

Queen Anne’s County Sher­iff Gary Hof­mann said con­tin­u­ing to fund grants that can be used to cre­ate Safe Sta­tions would be ben­e­fi­cial for his depart­ment and com­mu­nity. Hof­mann said the sher­iff’s of­fice is open for in­di­vid­u­als to come in to re­ceive help, “but treat­ment on the Shore is very, very dif­fi­cult for us to get.”

With only “a small emer­gency room,” Hof­mann ex­plained how first re­spon­ders many times rely on area hos­pi­tals and ser­vices, de­spite ru­ral health im­prove­ments be­ing made.

One is­sue Hof­mann told the round­table his depart­ment has en­coun­tered is res­i­dents ad­min­is­ter­ing Nar­can to an in­di­vid­ual over­dos­ing but not in­form­ing the 911 sys­tem or emer­gency ser­vices.

Hof­mann also shared how the depart­ment has tracked drug deal­ers down and sent a mes­sage to any­one sell­ing il­licit sub­stances that the of­fice will “hunt you down.”

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