- By Patrick Taylor -
Earlier this week, the General Assembly approved a slew of bills aimed at curbing the opioid and heroin pandemic wreaking havoc across the state and country. Overall, the bills passed show that our legislators are treating this issue with the utmost urgency.
And urgency is exactly what is required. As of March 31, there have been 82 unofficial overdose fatalities in Baltimore County in 2017, while emergency services responded to 766 overdose calls. An exact figure on deaths related to opioids and heroin is unknown - the Office of the State Medical Examiner provides the official stats for overdose fatalities - but as it stands, it looks like Baltimore County is in for a big leap in overdose deaths this year.
As we reported in the April 6 issue, the number of overdose deaths was merely 86 between Jan. 1 and September 2015, but that number jumped to 151 in the same time period in 2016. Based on current numbers, Baltimore County will be looking at around 240 overdose deaths by September of this year if things stay the same.
There is hope that with the legislation passed this session the number of overdoses and deaths will take a big hit. A measure sponsored by State Senator Kathy Klausmeier (D-8) will see the creation of 24/7 crisis treatment centers while also increasing reimbursement rates for treatment to keep up with inflation, making treatment affordable for families who foot the bill.
Another bill that made it through the both the House of Delegates and State Senate will create a drug awareness program for students beginning in third grade, while Gov. Hogan saw two of his bills passed - one that increases the penalty for those convicted of selling drugs involving fentanyl and another that aims to diminish the amount of opioids administered by doctors. Hogan also added $10 million to the budget over five years to help tackle the issue.
By June of 2016, there were 566 heroin overdoses, 446 fentanyl overdoses and 210 opioid pill overdoses across the state.
“I’m surprised by the magnitude of the increase,” Caleb Alexander, co-director of the Center for Drug Safety and Effectiveness at the Johns Hopkins Bloomberg School of Public Health told The Baltimore Sun last year. “The fact that you see such a large number of fentanyl-related deaths demonstrates the need for greater resources dedicated to identifying and treating opioid dependence.”
Alexander went on to mention that another area that really needed to be addressed was pain pills being overprescribed by physicians.
And that, in my opinion, is where the fight against overdoses really needs to focus.
Over the course of the War on Drugs, the focus has often been on what leads to drug use - what are the proverbial gateways. What is that one thing - alcohol, tobacco, marijuana - that leads one down a path of addiction? While those (specifically marijuana) may have been the easy scapegoats in the past, it has become increasingly apparent that gateways aren’t the issue when opioids are being overprescribed.
I saw that firsthand as an athlete up until college. A player gets hurt - hernia, ACL, etc. - and gets oxycontin, oxycodone, percocet or some other drug to help them recover after surgery. But after days, weeks or months of daily medication of what is essentially heroin, cutting that out of your life can be nearly impossible. Because of doctors doling out pain pills like they’re breath mints at a restaurant, there are almost always pills available for purchase. So when Johnny Football Star’s prescription runs out, he has a friend who can keep him supplied.
And here is where things get bad. A lot of times a prescription is cheaper than the black market. So someone who has recently found themselves addicted to percocet might be a little cash strapped and only have $10 to spare instead of the $25 or $30 necessary for a pill, and that’s when heroin rears its ugly head.
Nowadays, it is common for heroin to be cut with fentanyl. Fentanyl is usually made abroad, typically in Asia. Cutting the flow of fentanyl into the U.S. would be a huge step in cutting down on overdose deaths.
For his efforts, Hogan deserves a lot of credit. Increasing the penalty for crimes involving fentanyl and pressing doctors to prescribe less will do a world of good. Klausmeier deserves applause, too, for helping make treatment affordable while working to ensure emergency services are available at all times. And Delegate Eric Bromwell (D-8) deserves recognition for his tireless efforts throughout the course of the session to achieve these goals.
But do these bills truly do enough, and what else could possibly be done? It all depends on how radical you want to get. There are those who advocate for the approach adopted by Portugal. In 2001, the Portuguese government decriminalized all drugs. If you get caught with drugs, you pay a fine and maybe seek treatment if deemed necessary. As of 2015, there were three overdose deaths per million citizens. The average for the entire European Union was 17.3 overdose deaths per million citizens.
Others would like to see only marijuana legalized to help curb opioid abuse. Recent studies have shown declining overdose deaths in states with legalized marijuana, though it’s too early to tell if there is real correlation.
Legislators hoped to pass a new set of laws to help guide the medical marijuana industry, but that legislation failed to make it through the General Assembly. Part of the bill would have allowed opioid addicts to be treated with medicinal marijuana.
Advocates argued that marijuana works as a pain killer that comes without the risk of overdose.
While there isn’t the risk of overdose with marijuana, it does have its own baggage. While physical dependence isn’t something largely observed, it is a habit-forming substance. Breaking a psychological dependence can be just as grueling as breaking from a physical one.
Looking at the slew of bills passed this session that target opioid abuse, there is reason to be hopeful in Maryland. Bromwell told reporters he wanted Maryland to be the blueprint for other states, and that very well may happen. I’m hopeful, but not exactly optimistic.
For decades, we as a country have been fighting a battle against drug abuse, throwing over $1 trillion into the War on Drugs. And where exactly has it gotten us? I don’t want to say we have nothing to show for it, because we do - it’s just negative.
When it comes to dealing with an issue like addiction, there is no perfect answer. There is no panacea that will make everything better. But everyone also knows that insanity is trying the same thing over and over expecting different results. For too long we’ve been going about addiction the wrong way. Addicts are reviled and looked down upon instead of being shown empathy and compassion. Those suffering with addiction need treatment, not time behind bars. While you would like to think that time in prison would allow someone to get clean, we can’t even keep drugs out of our correctional facilities.
Ideally, a shift away from opiates in the medical world would be the best remedy. The creation of non-habit forming pain medication should be the ultimate goal, and we should be exploring every other potential fix we can think of. But as I mentioned earlier, worrying about gateway drugs is essentially moot when doctors are prescribing what’s comparable to a small dose of heroin in opioids.
So whether the measures undertaken by the General Assembly are enough or not remains to be seen. What’s undeniable, however, is that these measures are a crucial first step in addressing what has become a major emergency across the country.
The views expressed above are solely those of the writer and not The East County Times. Patrick Taylor formerly worked with Project HEALTH, counseling and trying to secure public benefits for those struggling with addiction.