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 'LIFESAVING TIPS' As fentanyl-related fatalities soar, Baltimore's strategy for reducing overdose deaths through harm reduction initiatives could be a model for the state Maryland is facing an epidemic of overdose deaths linked to drugs mixed with the painkiller fentanyl, a synthetic opioid that is 30 to 50 times more powerful than unadulterated heroin. Fentanyl-related deaths account for nearly a quarter of fatal drug overdoses statewide - up from just 4 percent two years ago - and now exceed the number of deaths linked to cocaine and alcohol. And the problem isn't just limited to Baltimore City; nearly two-thirds of the 185 fentanyl-related overdose deaths in Maryland last year occurred in the counties. That's why a public information campaign announced by Baltimore officials last week to offer "lifesaving tips" to addicts warning of the dangers of heroin overdose could serve as a model for similar efforts across the state. Given how difficult it is to persuade drug users to beat their addictions, the city initiative is no panacea. But outreach workers who have developed relationships with the populations they serve can urge people to be on the lookout for drugs that appear suspicious or otherwise different from those have used before - a different color or texture, for example - and warn them against taking drugs when they're alone. The dealers who sell drugs on the street may not even know what's in the products they're hawking, and they certainly don't warn customers that the heroin they're buying could kill them. It's up to the outreach workers to make users aware of the possibly deadly consequences of shooting up. Baltimore City's program relies on such workers because they've already become familiar to the addicts they are trying to reach through the city's needle exchange program and other city health initiatives. Some of the workers are themselves former addicts whose past experiences lend them a credibility on the streets that their clients respect. There's no permanent cure for heroin addiction, but the city's strategy of harm reduction, which seeks to minimize the risks drugs users expose themselves to in an inherently risky activity - is still a much more practical approach to reducing overdose deaths than trying to persuade addicts to stop using drugs altogether. The counties have less experience with harm reduction strategies than the city, which has been running its needle exchange program for two decades, but it's clear that an approach rooted in trying to stop heroin use altogether - whether through law enforcement or other means - will only lead to more deaths. County health officials no doubt will combine harm reduction techniques with other initiatives of their own devising. They need to conduct public information and education campaigns targeting high-risk communities, and the state needs to continue working with health care professionals and hospitals to develop best practices for prescribing and administering the opium-based prescription medications that can lead to addiction. Counties will also need to expand the number of people trained in the use of naloxone, a medication that can quickly reverse the effects of overdose if administered promptly. Notwithstanding the recent and inexplicable spike in the drug's cost, it remains a true lifesaver. Some counties already have begun to supply police officers and other first responders with the drug, and they should also make it available to the families and friends of addicts so they can intervene in an emergency to save their loved ones' lives. Finally, the counties must expand access to drug treatment facilities in order to allow addicts who are willing to kick the habit to do so safely and under medical supervision. Gov. Larry Hogan has created a task force to examine ways to reduce the number of heroin overdose deaths throughout the state, and we hope its members will take note of what Baltimore City has accomplished toward that end. City health officials admit there's no magic bullet that will solve the problem of drug dependence and drug overdoses. But many of the techniques that have worked here, including the "lifesaving tips" offered by Health Department outreach workers, hold the promise of working elsewhere as well. When it comes to reducing the tragic toll exacted by the current epidemic of overdose deaths there's no need for the counties to re-invent the wheel. - --- MAP posted-by: Jay Bergstrom