Pubdate: Mon, 13 Jul 2015
Source: Baltimore Sun (MD)
Copyright: 2015 The Baltimore Sun Company
Contact:  http://www.baltimoresun.com/
Details: http://www.mapinc.org/media/37
Author: Meredith Cohn

HEROIN TASK FORCE WANTS 24-HOUR TREATMENT OPTIONS

Group Urges Multifaceted Approach to Help Reduce Overdoses and Deaths

To stem the growing heroin addiction rates and overdose deaths, a 
Baltimore task force plans to unveil a more than $20 million proposal 
today that includes around-the-clock treatment options.

The panel is expected to outline a multifaceted approach that also 
includes training for families in deploying a heroin overdose 
antidote, an informational website and an educational campaign. Some 
of the proposals are already being planned or underway.

City officials, as well as state and federal leaders, have been 
sounding alarms about the surge in heroin and prescription drug 
deaths. Mayor Stephanie Rawlings-Blake formed the task force in the 
fall. She says the recommendations will serve as a "blueprint."

"Heroin is a problem that affects not just those who use the drug but 
all of us," she said in a statement. "Now is the time for bold and 
decisive action."

The report estimates about 18,900 people use heroin in Baltimore. The 
drug accounted for 192 overdose deaths out of 303 drug and 
alcohol-related deaths last year. That's up from about 150 
heroin-related deaths in 2013.

"What we need to do is move the needle in Baltimore City," said 
Baltimore Health Commissioner Leana Wen. "There are a lot of partners 
already working with the city."

Heroin overdose deaths across Maryland rose 25 percent to 578 last 
year. State officials convened their own task force earlier this year 
and plan to issue recommendations by year's end.

Nationally, more than 8,200 people died from heroin overdoses in 
2013, according to the U.S. Centers for Disease Control and 
Prevention. The federal agency found in a recent report that heroin 
use has increased across genders, age groups and income levels.

Contributing to the increase is the abuse of prescription opioids, 
painkillers that often serve as a gateway to heroin and can be 
cheaper and easier to obtain, according to the CDC.

The agency recommended states expand access to treatment and provide 
sterile needles for users to control the spread of infectious 
disease. It also said states should offer training for naloxone, the 
opioid antidote.

Wen said the city already trains users and family members how to use naloxone.

She and Rep. Elijah E. Cummings, a Baltimore Democrat, recently 
questioned the drug's rising cost. She said a leading manufacturer of 
naloxone has raised the 10-dose cost from $97 to $370 since spring, 
compromising the city's ability to make it widely available.

Cummings, ranking member on the House Committee on Oversight and 
Government Reform, plans to join city officials today in announcing 
the task force's proposals. Last week he sent a letter to Maryland 
officials urging them to negotiate an agreement with the drug's 
maker, Amphastar, as was done in New York and Ohio.

Jason Shandell, president of Rancho Cucamonga, Calif.-based 
Amphastar, has defended his company's pricing, citing increasing 
manufacturing costs.

Wen said city health officials are implementing some of the task 
force recommendations, and working with public and private partners 
on others. A combination of city, federal and private dollars would 
be used to pay for the initiatives. The recommendations include a 
public education campaign featuring billboards and a website called 
dontdie.org, with information for users and others who may administer naloxone.

The city also is working to set up a 24-hour referral line for users, 
combining the resources of five separate lines that were operated by 
public and private entities at different hours.

Also in the works is a data-tracking system that can keep tabs on 
addicts and space available in treatment centers.

In addition, the task force plans to recommend 24-hour treatment and 
case management for the most vulnerable addicts, such as the recently 
incarcerated. This would be the costliest to implement, and funding 
is still being sought, Wen said.

"We believe that people with addictions should be able to walk into 
any emergency room or office and get treatment, just like they would 
for any physical condition," she said. "We know anecdotally that 
people are often turned away from treatment. In Baltimore City we're 
not even close to capacity needed."

The task force was made up of 35 community leaders, public health 
experts and government officials, and was co-chaired by Dr. Samuel 
Ross, CEO of Bon Secours Baltimore Health System, and Bernard J. 
McBride, CEO of Behavioral Health System Baltimore, which oversees 
behavioral health and substance abuse programs for the city.

At Bon Secours more than half of patients admitted have a behavioral 
health or substance abuse diagnosis, Ross said. The hospital also 
operates two methadone clinics that serve about 700 patients.

"There is no quick fix to this decades-long social and community 
challenge," Ross said. "With that understanding, the task force 
focused on identifying short-, medium-, and long-term interventions. 
The recommendations you see are the result of the best thinking from 
task force and community members who deal with this issue on the 
front lines every day."

McBride said the recommendations would help maximize resources and 
make treatment more accessible - for those addicted to heroin and 
prescription painkillers as well as other drugs. He estimated only 
about 20 to 25 percent of Baltimore's heroin addicts are getting any treatment.

"The mayor said let's get organized and put our heads together for 
things we can work on," he said. "These recommendations are a good 
step. But it's not the end. We have work ahead."
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MAP posted-by: Jay Bergstrom