Pubdate: Fri, 02 Jan 2015 Source: Baltimore Sun (MD) Copyright: 2015 The Baltimore Sun Company Contact: http://www.baltimoresun.com/ Details: http://www.mapinc.org/media/37 Author: Scott Nolen Note: Scott Nolen is director of the Drug Addiction Treatment Program at Open Society Institute-Baltimore. REDUCING OVERDOSE DEATHS IN 2015 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. - --- MAP posted-by: Jay Bergstrom