Pubdate: Thu, 11 Dec 2014
Source: Baltimore Sun (MD)
Copyright: 2014 The Baltimore Sun Company
Contact:  http://www.baltimoresun.com/
Details: http://www.mapinc.org/media/37

OVERDOSE EMERGENCY

Gov.-Elect Hogan Is Right to Prioritize Maryland's Rising Number of 
Heroin Deaths; He Must Expand Upon the State's Efforts to Reduce Addiction

The announcement by state officials Tuesday that 140 Maryland 
pharmacies will begin stocking a medication that can reverse the 
effects of heroin overdoses comes at a time when deaths from abuse of 
the drug are rising throughout the state.

Making the overdose antidote Narcan, also known as naloxone, more 
widely available could help save the lives of hundreds people 
addicted to opiates and help steer them into treatment and recovery programs.

That should be the goal of the new administration that takes office 
in January, and we're encouraged that Gov.-elect Larry Hogan 
reiterated his view this week that the upsurge in overdose deaths is 
an urgent statewide problem that demands a statewide response.

Though Mr. Hogan has yet to announce the specifics of his plan to 
combat the epidemic, he has called the rise in overdose deaths a 
public health crisis as well as the "No. 1 problem we have in 
Maryland with respect to crime." He's also spoken of declaring a 
"state of emergency" in hopes that he might attract federal funding 
for more substance abuse treatment programs and public information 
campaigns. Whatever initiatives his administration comes up with, he 
must continue to build on the progress Maryland is making toward 
achieving its goal of a 20 percent reduction in heroin overdose 
deaths by the end of 2015.

That will require, first of all, maintaining Maryland's investment in 
the treatment and recovery programs it already has and expanding them 
wherever possible.

Maryland has some of the most effective facilities in the country, 
but there still aren't enough treatment slots for all the people who 
need them. One of the reasons heroin overdose deaths have been rising 
in recent years is that prescription painkillers such as Oxycontin 
and Percocet have become more expensive and harder to obtain as a 
result of the state's efforts to crack down on use. When people 
addicted to them turn to cheaper street drugs like heroin, they often 
don't realize the risks they are taking by injecting impure or 
adulterated products.

That's why its imperative that health officials continue to promote 
overdose antidotes like Narcan. First responders in several 
jurisdictions now routinely are equipped with the medication, and 
thousands of people have been trained in its use. But Baltimore's 
Police Department is still studying the idea of equipping officers 
with the antidote even though the city still has one of the highest 
rates of overdose deaths.

Another initiative that needs to be strengthened is the use of local 
overdose fatality review teams, which examine every overdose fatality 
and look for holes in the current drug safety net. They go over each 
case with treatment providers, first responders, family members and 
others to determine what was going on with the victim and whether 
anything else could have been done to save him or her. Such teams 
have been successful in Cecil County and Baltimore City, but they 
need to be scaled to cover the entire state in order to reach their 
full potential.

The state also needs to expand the prescription drug monitoring 
program introduced earlier this year, which established a statewide 
database of prescriptions for opioid painkillers to alert physicians 
and pharmacists to suspicious purchases.

The state health department has proposed expanding the program to 
require every physician to register and take a course onappropriate 
opioid prescribing so doctors can immediately check for potential abuse online.

Meanwhile Maryland must continue a broad public information campaign 
to educate health professionals to the signs of addiction and to the 
resources for addicts to get help.

There is no underestimating the value of having the governor 
highlight the importance of this issue and recognize it for what it 
is: a problem that affects urban, suburban and rural communities 
alike. Mr. Hogan has indicated that he will hold a summit on the 
problem of heroin addiction and put Lt. Gov. Boyd G. Rutherford in 
charge of a work group to address it. It's also crucial that he 
select a health secretary who is prepared to make reducing overdose 
deaths a top priority, as Mayor Stephanie Rawlings-Blake did in the 
appointment of Dr. Leana Wen as the new Baltimore health commissioner.

Mr. Hogan's appointee could go even further than what the state 
already is doing, for example, by ordering certain prescription pain 
medications off the market completely. Some communities have had 
success in reducing overdoses with what seem like radical solutions - 
Vancouver, for example, has created so-called "safe injection rooms" 
where addicts can shoot up in a controlled environment monitored by 
health professionals. Maryland may not be ready to go that far, but 
we hope the Hogan administration will be willing to put whatever 
works on the table to reduce Maryland's rising rates of overdose deaths.
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MAP posted-by: Jay Bergstrom