Pubdate: Sun, 07 Feb 2016
Source: Washington Post (DC)
Copyright: 2016 The Washington Post Company
Author: Dan Morhaim
Note: The writer, a Democrat, represents Baltimore County in the 
Maryland House of Delegates and is a faculty member at the Johns 
Hopkins Bloomberg School of Public Health and at the University of 
Maryland School of Medicine.


I've been an emergency room physician for more than 30 years. Every 
shift, I see broken legs, lacerations, cases of pneumonia and more. 
On the surface, none appears related to the rising rates of drug 
addiction and crime plaguing our society. But they are.

Recently, I treated a man with an abscess on his inner thigh about 
the size of cantaloupe. We had complications trying to give him an IV 
with pain medicine because years of drug abuse had scarred his veins. 
He was clearly a drug user with an addiction problem, but his medical 
record will read only "abscess."

An elderly woman came to the ER with a dislocated shoulder after her 
purse was stolen. Her chart will read simply "dislocated shoulder," 
but I know after speaking with her that this was caused by someone 
desperately seeking to sustain a $50-per-day drug habit.

I treated a gunshot wound that left a man quadriplegic, leading to 
painful and costly complications throughout his life for himself and 
his family and contributing to rising health-insurance premiums. 
This, too, was a drug-related episode.

These incidents happen every day in every hospital in Maryland. And I 
see with my own eyes that the root of the majority of these problems 
is drug addiction.

Overdose rates are rising, HIV/AIDS and hepatitis C are spreading, 
and homicide rates are up. Worst of all, after 45 years, the colossal 
"war on drugs" hasn't curbed the rate of drug use one bit. The status 
quo isn't working. That is why, with support from former Baltimore 
mayor Kurt L. Schmoke and retired Maryland State Police officer S. 
Neill Franklin, I am introducing four bills that would fundamentally 
transform drug policy in our state. Each is based on proven practices 
from around the world. And each treats the drug problem as what it 
is- a health issue. If we get to the root causes of drug addiction, 
we can lower health-insurance costs for everyone, reduce violent 
crime, improve public safety and enable recovery for many. It's a win-win.

My proposals aim to reduce the harms associated with drug use, 
including rates of addiction, deadly overdoses, the spread of 
infectious disease and the incarceration of people who use drugs.

One bill would require addiction treatment in ERs. That's where 
addiction treatment should begin, and it's more effective than jail. 
Another bill would keep drug users who use minimal amounts out of the 
criminal-justice system, saving critical resources and avoiding the 
costs of saddling more Maryland citizens with criminal records and 
the related adverse consequences.

The other two bills require a shift in how we think about and treat 
addicts. One would allow for the administering of 
pharmaceutical-grade drugs to a small and unresponsive group of 
heroin abusers, with medical supervision. Such programs operate 
successfully in Europe with positive results. A trial program is 
underway in Canada.

The final bill calls for the creation of a safe-consumption program 
that would create supervised spaces for individuals to consume 
controlled substances, reducing rates of overdose death and the 
spread of infectious disease and connecting them with rehabilitation programs.

Of course, not all people with substance-abuse disorders respond 
positively to treatment. And others will respond but relapse. It's 
not a perfect fix. But if 5,000 of Baltimore's 19,000 heroin addicts 
went into treatment today, the rate of violent crime and the cost of 
health care would drop. The payback is immediate. And, for some, the 
recovery will be long-term.

These bills require a new way of thinking, but if they pass, our 
harm-reduction approach could become mainstream.

After witnessing for years how our policies have failed individuals, 
families and society, I've had enough. This is a crisis of epic 
proportions that requires a radical shift. My proposals aim to reduce 
the terrible consequences of the war on drugs and initiate 
scientifically proven models based on compassion and public health.
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MAP posted-by: Jay Bergstrom