Pubdate: Fri, 02 Jan 2015
Source: Baltimore Sun (MD)
Copyright: 2015 The Baltimore Sun Company
Author: Scott Nolen
Note: Scott Nolen is director of the Drug Addiction Treatment Program 
at Open Society Institute-Baltimore.


At a time of partisan gridlock, one issue is attracting attention 
across the aisle. Drug overdoses in the United States have escalated 
into a full-fledged public health epidemic.

The Centers for Disease Control and Prevention report that more than 
16,000 people died after overdosing on opioid pain medications in 
2012 - numbers that do not include overdoses caused by illegal 
substances, like heroin.

Last year, U.S. Attorney General Eric Holder noted that "opiate 
addiction is an urgent - and growing - public health crisis." Here in 
Maryland, Gov. Martin O'Malley established a statewide Overdose 
Prevention Council, and the Maryland Department of Health and Mental 
Hygiene has been working closely with first responders, health care 
providers, pharmacists and local governments to create a plan of 
action. Gov.-elect Larry Hogan has also taken an early stance by 
pledging to declare a "state of emergency" to combat the spike in 
heroin-related deaths, which doubled nationwide from 2010 to 2012.

It is refreshing to see public officials at the local, state and 
national level - across all political affiliations - address this 
problem. Looking ahead, reducing drug overdoses will require major 
shifts in how we approach substance use.

First, and possibly most importantly, Maryland needs to connect 
individuals struggling with addiction to high-quality addiction 
treatment that is integrated with their primary care. Primary care 
providers should be monitoring the long-term health and progress of 
those struggling with addiction, ensuring that the substance use 
treatment they are receiving dovetails with an overall health strategy.

Next, we need better monitoring of how often pain medication is 
prescribed. Research indicates there is an increase in the 
prescription of opioids that is not driven by clinical necessity. 
Many public health officials have identified the rise in 
prescriptions of opioids as a significant factor driving 
pharmaceutical overdose deaths, which quadrupled between 1999 and 
2010, and as a gateway to other substances such as heroin.

Additionally, we need to educate patients that prescription drugs 
are, in fact, highly addictive and should be used with caution. A 
strategic and hard-hitting public awareness campaign would help 
people better understand the slippery slope from prescription drugs 
to street drugs.

And finally, we must undo the stigma that paralyzes individuals 
struggling with addiction and deters them from seeking help. This 
will require a shift in public policy - beginning at the highest 
levels - from criminalization to a focus on the medical and public 
health implications of addiction.

Open Society Institute-Baltimore acknowledges this is a challenging 
agenda. However, there is one relatively easy step the next 
administration can take: making Narcan easily accessible.

Over a decade ago, OSI-Baltimore partnered with the Baltimore Health 
Department to reduce opiate overdose deaths by training people at 
risk of overdose to administer Narcan (also known as Naloxone), which 
can revive a person near death from an overdose.

Over the last decade, Baltimore has documented that more than 200 
overdoses have been reversed because of the availability of Narcan. 
That is 200 fewer funerals and 200 fewer families grieving the loss 
of a loved one to drug addiction.

We need to do more. Working in partnership with the Baltimore Police 
Department and Behavioral Health System Baltimore, we are 
collaborating to ensure that 500 Baltimore police officers will be 
able to carry this lifesaving medication by next summer and more 
officers beyond then.

We also need a media campaign to increase awareness of overdose 
issues. Last year, the legislature passed a law that protects people 
from prosecution for drug use if they see someone else in distress 
and call to get that person medical assistance. The new 
administration should build on this first step by ensuring that more 
people are aware of this law and that more individuals who are likely 
to witness an overdose have access to Narcan and training on how to 
administer it.

Maryland must better incorporate meaningful access to addiction 
treatment into the improved health care system while expanding public 
education and provider training. If we do, we will not only prevent 
fatal overdoses but we will also seriously decrease the number of 
families hit hard by the long-reaching impact of drug addiction.

Losing150 Baltimore residents to heroin overdose last year alone 
simply underscores the need for a thoughtful but swift reaction. 
Expanding the use of Narcan is just one step toward decreasing the 
devastating impact that drugs are having on our community.
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MAP posted-by: Jay Bergstrom