Pubdate: Wed, 10 Dec 2014
Source: Baltimore Sun (MD)
Copyright: 2014 The Baltimore Sun Company
Contact:  http://www.baltimoresun.com/
Details: http://www.mapinc.org/media/37
Author: Natalie Sherman
Bookmark: http://www.mapinc.org/find?132 (Heroin Overdose)

PHARMACIES IN MD. AGREE TO STOCK ANTIDOTE FOR OVERDOSE

Hogan Pledges Action Amid Rise in Heroin-Related Deaths

As Gov.-elect Larry Hogan pledged to declare a "state of emergency" 
to combat the spike in heroin-related deaths, state officials said 
Tuesday that about 140 pharmacies in 22 counties have agreed to stock 
a powerful overdose antidote.

The agreement with CVS, Safeway, Walgreens and some smaller 
businesses is part of a broader push in Maryland and elsewhere to 
make the overdose-reversing drug, known as naloxone or narcan, easier 
to access.

The state changed rules in October for the Medicaid drug benefit to 
allow doctors to write prescriptions for naloxone without 
preauthorization. Officials also sent letters to doctors urging them 
to prescribe naloxone to those receiving pain medication and others 
at risk of overdose.

The drug, which requires a prescription and can be administered by 
syringe or nasal spray, combats the effects of an overdose and is 
credited with saving thousands of lives.

"We want to make this, frankly, commonplace for prescribers," said 
Dr. Joshua M. Sharfstein, the state's outgoing health secretary. "In 
order to make it a realistic option, it has to be available."

More than 460 people in Maryland fatally overdosed on heroin last 
year - up 88 percent statewide since 2011. Of the 528 drug or alcohol 
intoxication deaths in the first six months of this year, 296 
involved heroin, according to state statistics.

A city task force recently found that Baltimore is home to about 
19,000 heroin users. Last year, 150 people fatally overdosed on 
heroin in the city.

During his campaign, Hogan faulted the O'Malley administration for 
not doing enough to combat the crime linked to heroin, calling the 
epidemic the "No. 1 problem we have in Maryland, with respect to crime."

On Tuesday, he reiterated a plan to declare a "state of emergency" to 
focus attention and efforts on combating drug problems. Last week, he 
said he would put his lieutenant governor, Boyd Rutherford, in charge 
of overseeing his administration's plan, to include an executive 
order, a task force and a summit.

"Everybody thought of this as an urban problem," but it has spread to 
Maryland's suburban and rural counties, Hogan said.

Nationwide, heroin use has increased as people hooked on prescription 
opiates such as Oxycodone turn to the illegal drug in response to 
efforts to crack down on overprescription of painkillers.

In March, Massachusetts Gov. Deval Patrick declared opiate abuse a 
public health emergency, a move accompanied by $20 million in added 
funding for drug treatment programs, as well as measures that 
mandated prescription monitoring, permitted all first-responders to 
carry naloxone and placed a temporary ban on some painkillers.

Hogan said declaring an emergency "sends a message" that the state is 
serious and hopefully will make more federal funds available. A 
spokeswoman did not respond to a request for comment about what Hogan 
would seek to do with emergency powers.

"The governor-elect is going to bring a whole new strategy, a whole 
new philosophy to fighting this war on heroin addiction," said the 
Rev. Milton E. Williams, a Hogan supporter, pastor at East 
Baltimore's New Life Evangelical Baptist Church and a founder of the 
Turning Point Clinic.

"The current administration has become entrenched in talking about it 
as opposed to bringing action and resources to the table that's going 
to make a change in stopping this thing here and now."

Sharfstein said Maryland has already done a lot to address what he 
called "one of the top crises facing the state."

Gov. Martin O'Malley established an Overdose Prevention Council in 
June. Ambulance crews and state troopers have been equipped with 
naloxone and officers in some local police departments are receiving 
training to administer the drug, among other initiatives, Sharfstein said.

Baltimore police officers do not carry the drug. The department said 
this fall that it is reviewing the idea.

The state's Board of Physicians recently moved to require training 
for doctors in prescribing pain medication, Sharfstein said. "We've 
been working very hard this year to bring everything we can to bear 
on the overdose epidemic in Maryland, but we certainly think that 
there's a lot of progress that still needs to be made," he said.

He said he was not aware of any federal programs tied to declarations 
of emergency.

Naloxone training in Maryland started in 2004 in Baltimore. The 
medication has gained traction as concerns have waned that naloxone 
would encourage drug use by making it seem safe. The antidote also 
became easier to use as it became more common to package it as nasal spray.

Maryland will be the second state in which CVS stocks the medication, 
keeping it on hand at about half the retailer's roughly 170 locations 
after the request from state officials, spokesman Michael DeAngelis said.

The company started stocking the drug at locations in its home state 
of Rhode Island this fall and preliminary discussions are underway 
elsewhere, he said.

Mishka Terplan, medical director for Behavioral Health System 
Baltimore, which works with addicts and trains people to use 
naloxone, said making the drug readily available will help avoid 
delays in filling prescriptions.

"It's excellent," Terplan said. "By having pharmacies stock 
medication, it reduces a significant barrier to people receiving the medicine."
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MAP posted-by: Jay Bergstrom