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.
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MAP posted-by: Jay Bergstrom