Baltimore's heroin task force wants 24-hour treatment options to stem overdoses

Round-the-clock treatment is a goal of the heroin task force in Baltimore.

To stem the growing heroin addiction rates and overdose deaths, a Baltimore task force plans to unveil a more than $20 million proposal Monday that includes around-the-clock treatment options.

The panel is expected to outline a multifaceted approach that also includes training for families in deploying a heroin overdose antidote, an informational website and educational campaign. Some of the proposals are already being planned or underway.

City officials, as well as state and federal leaders, have been sounding alarms about the surge in heroin and prescription drug deaths. Mayor Stephanie Rawlings-Blake formed the task force in the fall. She says the recommendations will serve as a "blueprint."

"Heroin is a problem that affects not just those who use the drug but all of us," she said in a statement. "Now is the time for bold and decisive action."

The report estimates about 18,900 people use heroin in Baltimore. The drug accounted for 192 overdose deaths out of 303 drug and alcohol-related deaths last year. That's up from about 150 heroin-related deaths in 2013.

"What we need to do is move the needle in Baltimore City," said Baltimore Health Commissioner Leana Wen. "There are a lot of partners already working with the city."

Heroin overdose deaths across Maryland rose 25 percent to 578 last year. State officials convened their own task force earlier this year and plan to issue recommendations by year's end.

Nationally, more than 8,200 people died from heroin overdoses in 2013, according to the U.S. Centers for Disease Control and Prevention. The federal agency found in a recent report that heroin use has increased across genders, age groups and income levels.

Contributing to the increase is the abuse of prescription opioids, painkillers that often serve as a gateway to heroin and can be cheaper and easier to obtain, according to the CDC.

The agency recommended states expand access to treatment and provide sterile needles for users to control the spread of infectious disease. It also said states should offer training for naloxone, the opioid antidote.

Wen said the city already trains users and family members how to use naloxone.

She and Rep. Elijah E. Cummings, a Baltimore Democrat, recently questioned the drug's rising cost. She said a leading manufacturer of naloxone has raised the 10-dose cost from $97 to $370 since spring, compromising the city's ability to make it widely available.

Cummings, ranking member on the House Committee on Oversight and Government Reform, plans to join city officials Monday in announcing the task force's proposals. Last week he sent a letter to Maryland officials urging them to negotiate an agreement with the drug's maker, Amphastar, as was done in New York and Ohio.

Jason Shandell, president of Rancho Cucamonga, Calif.-based Amphastar, has defended his company's pricing, citing increasing manufacturing costs.

Wen said city health officials are implementing some of the task force recommendations, and working with public and private partners on others. A combination of city, federal and private dollars would be used to pay for the initiatives.

The recommendations include a public education campaign featuring billboards and a website called dontdie.org, with information for users and others who may administer naloxone.

The city also is working to set up a 24-hour referral line for users, combining the resources of five separate lines that were operated by public and private entities at different hours.

Also in the works is a data-tracking system that can keep tabs on addicts and space available in treatment centers.

In addition, the task force plans to recommend 24-hour treatment and case management for the most vulnerable addicts, such as the recently incarcerated. This would be the costliest to implement, and funding is still being sought, Wen said.

"We believe that people with addictions should be able to walk into any emergency room or office and get treatment, just like they would for any physical condition," she said. "We know anecdotally that people are often turned away from treatment. In Baltimore City we're not even close to capacity needed."

The task force was made up of 35 community leaders, public health experts and government officials, and was co-chaired by Dr. Samuel Ross, CEO of Bon Secours Baltimore Health System, and Bernard J. McBride, CEO of Behavioral Health System Baltimore, which oversees behavioral health and substance abuse programs for the city.

At Bon Secours more than half of patients admitted have a behavioral health or substance abuse diagnosis, Ross said. The hospital also operates two methadone clinics that serve about 700 patients.

"There is no quick fix to this decades-long social and community challenge," Ross said. "With that understanding, the task force focused on identifying short-, medium-, and long-term interventions. The recommendations you see are the result of the best thinking from task force and community members who deal with this issue on the front lines every day."

McBride said the recommendations would help maximize resources and make treatment more accessible — for those addicted to heroin and prescription painkillers as well as other drugs. He estimated only about 20 to 25 percent of Baltimore's heroin addicts are getting any treatment.

"The mayor said let's get organized and put our heads together for things we can work on," he said. "These recommendations are a good step. But it's not the end. We have work ahead."

meredith.cohn@baltsun.com

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