Pubdate: Fri, 05 Feb 2016
Source: Baltimore Sun (MD)
Copyright: 2016 The Baltimore Sun Company
Author: Lindsay LaSalle
Note: Lindsay LaSalle is a staff attorney for the Drug Policy 
Alliance (


Nearly 47,000 Americans died from a drug overdose in 2014 - more than 
from gunshot wounds or car crashes.

In Maryland, the governor's office has defined the problem as an 
"epidemic ... destroying lives." Indeed, heroin deaths alone have 
increased by 186 percent from 2010 to 2015 in the state.

Not only are drug-related deaths on the rise, so are the associated 
harms, including: drug-related crime and violence, the spread of 
HIV/AIDS and Hepatitis C and the financial burden for taxpayers who 
shoulder the costs of health care and criminal justice.

The rapid increase of overdoses and addiction has put our nation in 
crisis mode with everyone from parents to presidential candidates 
looking for new solutions.

To that end, at a news conference in Annapolis tomorrow, state Del. 
Dan Morhaim, who is also a practicing physician with 30 years of 
front-line experience in emergency rooms, will introduce a 
comprehensive legislative package proposing a different approach in 
Maryland - one that recognizes the epic failures of our current drug 
war and is based on sound policies being successfully implemented 
elsewhere in the world.

The first bill would provide treatment on demand in emergency rooms 
and hospital settings.

Estimates show that for every $1 spent on treatment approximately $12 
is saved in criminal justice and health care costs.

For a wide variety of reasons, hospitals are an excellent location to 
initiate treatment. (Studies show that addiction is the underlying 
cause for 60 to 80 percent of patients who present to ERs without 
insurance.) This legislation requires acute-care hospitals to have a 
counselor available or on-call 24/7 and to have defined arrangements 
for patient transfer to appropriate rehabilitation services.

The second bill allows individuals to use drugs in approved 
facilities while supervised by trained staff who also provide sterile 
equipment, monitor the person for overdose and offer treatment 
referrals. Similar facilities operate in Europe, Australia and Canada 
with excellent results, including reducing the spread of diseases and 
eliminating overdose deaths.

These programs also provide a critical access point to drug treatment 
for the most hard-to-reach users.

A study in Canada found that after one such facility opened, there 
was a 37 percent increase in people entering detoxification programs.

The third bill supports the creation of a four-year 
"poly-morphone-assisted treatment" pilot project that would allow 
doctors to use pharmaceutical grade opioids, including heroin, to 
treat a small group of heroin users under their supervision who have 
failed all other forms of treatment and who are directly responsible 
for a significant portion of street crime and uncompensated health 
care costs borne by taxpayers.

Programs of this sort have been established in the United Kingdom and 
much of Northern Europe with great success.

Studies of these programs show they are cost-effective, reduce 
illegal drug use, lead to other treatments and even abstinence, 
decrease crime, and reduce the black market for heroin.

The final bill decriminalizes the possession and use of very small 
quantities of drugs.

Rather than reducing drug use, criminalizing substance users 
increases stigma, drives people away from needed treatment and harm 
reduction services, and amplifies the risk of fatal overdoses and diseases.

This bill would keep some drug users - those possessing minimal 
amounts - out of the criminal justice system, thereby saving critical 
resources and avoiding the costs of saddling more Maryland citizens 
with criminal records and their adverse consequences. In 2001, 
Portugal became the first country to eliminate criminal penalties for 
low-level possession and use of illicit drugs, and it has not 
resulted in increased drug use or crime. Rather, it has actually 
reduced rates of HIV/AIDs and overdose, increased the number of 
people in treatment, and reduced social costs of drug misuse.

To some, Delegate Morhaim's bills might seem radical.

But the legislation simply follows the rest of the world in treating 
drug use as what it is: a public health issue.

And there is nothing radical about wanting to improve health and 
societal outcomes.

Indeed, even the University of Maryland Department of Psychiatry has 
stated its support for both safe consumption and 
poly-morphone-assisted treatment programs.

Yes, this is a paradigm shift in how we think about drug use. But if 
we want to see comprehensive progress on reducing drug use and all of 
its associated social impacts, we need comprehensive policy change.
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MAP posted-by: Jay Bergstrom