The number of drug-and alcohol-related deaths in Maryland climbed 37 percent in the first three months of this year, with the biggest increase related to people taking opioids laced with the potent additive fentanyl.
There were 550 overdose deaths, including 372 from fentanyl, a cheap and powerful drug coming into the U.S. from overseas that mixed in with heroin, typically without people knowing, according to data released Friday by the Maryland Department of Health. The number of deaths from fentanyl soared 137 percent from 157 deaths during the same period last year.
The numbers were not surprising to public health officials who said they only expect the problem to get worse.
“We have not even come close to reaching the peak of this epidemic,” said Baltimore City Health Commissioner Dr. Leana Wen, who called the numbers “devastating.”
“We just have to double up our efforts,” she said.
Adrienne Breidenstine, a spokeswoman for Behavioral Health System Baltimore, said the organization’s outreach teams continue to see signs of fentanyl, and a second additive called carfentanil, on the streets.The additives are 50 and 100 times more potent than heroin, respectively. It is taking two and sometimes three times the amount of naloxone, a drug that reverses overdoses, to revive people who have taken fentanyl, Breidenstine said.
“I don’t think we are out of this yet,” said Breidenstine, whose organization oversees drug treatment in the city.
Baltimore saw 176 overdose deaths; the most in the state and 63 more deaths than during the same period last year. Of those overdose deaths, 123 were fentanyl-related.
Baltimore County had the second-largest total number of overdose deaths, 95, while Anne Arundel County saw 48 deaths, the third highest in the state.
The growing number of deaths is being repeated around the country and continues in Maryland despite Gov. Larry Hogan making fighting the opioid addiction one of his priorities. He has called opioid addiction “a national scourge,” declared the epidemic a state emergency and thrown millions of dollars at the problem.
“The number of Marylanders impacted by this crisis continues to drive our resolve to manage this epidemic as a statewide emergency,” Clay Stamp, executive director of the state’s opioid operational command center, said in statement.
The Hogan administration and public health officials hope some initiatives that went into effect July 1 will help combat the problem. Among them is a prescription drug monitoring program that will give pharmacists and doctors access to their patients’ history of opioid use so they can spot patterns of abuse. Doctors must also get prior approval before prescribing high-dose and long-acting opioids to Medicaid patients. On the treatment front, Maryland became the third state in the country authorized by the federal government to use Medicaid dollars to pay for residential substance abuse treatment.
To address fentanyl, the General Assembly passed a law during the last legislative session that ended in April allowing prosecutors to seek an additional 10 years for drug dealers who knowingly sell fentanyl and its analogs, including carfentanil.
Katie Kuehn, a spokeswoman for the governor’s opioid operational command center, called the overdose numbers “troubling” and said federal, state and local governments need to work in collaboration with community organizations and families of drug users.
“We have made real progress breaking down the silos between state and local health and emergency management agencies, and all of Maryland’s local jurisdictions have formed Opioid Intervention Teams – a milestone that ensures they are fully engaged in prevention and protection efforts,” Kuehn said.
The state has also worked with the Maryland Hospital Association to link nonfatal overdose patients to treatment. The state health department has worked with 53 primary care centers and 10 hospitals to screen patients with the potential for substance abuse. It has also expanded access to naloxone.
Breidenstine said it will take time for some initiatives to have an impact on reducing overdoses. In Baltimore, she hopes a new addiction stabilization center scheduled to open next summer at the earliest will help. The center to be located at the Hebrew Orphan Asylum in West Baltimore will serve people addicted to heroin and other drugs so they're not taking up emergency room beds. It will allow them to sober up safely and then connect them with long-term drug treatment and other social services.
“Some of this stuff we are plugging along to complete, but it takes time to get up and running,” she said. “What I hope doesn’t happen is that we get complacent, and it just becomes normal that there is an epidemic.”