As Maryland continues its battle against opioid abuse, Howard County is taking steps toward opening its first residential detoxification center, something officials say is desperately needed and overdue.
The county's fiscal 2018 budget began on July 1, and with it came $250,000 to help fund a capital project to choose a location and begin the design process for the center, according to the approved Capital Budget for Fiscal Year 2018.
This is the first of several steps in the process to build the center; no time line for the center's opening or budget for the facility itself have been set by the county, said Carl DeLorenzo, the administration's director of policy and programs.
A team including officials from the county's health department and the county executive's office are working rapidly to find an appropriate location to serve the still-growing number of substance abusers in Howard County, said Carl DeLorenzo, the administration's director of policy and programs. DeLorenzo is heading up the project alongside Howard County Health Officer Maura Rossman, with the goal of choosing a location for the center within the next year, DeLorenzo said.
The project team has started exploring some possible location options, including space on Howard County General Hospital's campus in Columbia and space on the upcoming campus for mental health treatment facility Sheppard Pratt in Elkridge, DeLorenzo said. Both organizations are being considered as potential locations and partners in the future center.
Another option is a location at Springfield Hospital Center in Carroll County; the center could then be used as a regional facility, DeLorenzo said. The group is open to exploring other locations and ideas as the process moves forward, he said.
Rossman said the $250,000 could potentially go toward tasks such as architectural drawings for the center or to enlist a real estate company to help with the location search. DeLorenzo said he and Rossman will be meeting in the coming weeks to strategize how to use the funds.
As the county embarks on its major project, the opioid epidemic continues to take its toll on Howard residents. Between January and June of this year, there were 91 reported non-fatal opioid related overdoses, 87 of which were heroin related, according to data from the Howard County Police Department.
There were 26 opioid-related deaths in the first six months of 2017, 23 of which were heroin related, according to the department.
These numbers are set to surpass last year's total, when 29 people suffered heroin-related deaths, according to data from the department. The county police department expanded its tracking this year to include opioid related deaths and overdoses, and now lists heroin as a sub-category of that.
County officials say creating a residential detox center will help put a dent in these numbers.
Both Rossman and DeLorenzo said there is large community support for the center and widespread understanding of the need for its creation, but that the biggest issue the project faces is that no one wants to live near it.
Rossman said it's particularly challenging because of the residential nature of Howard County, and that such an area is not ideal for the center.
"I think conceptually most people I talk to believe that such a facility will be very useful and of value," she said. "[But] I think there's very few people who would want such a facility in their backyard. I can understand that."
Rossman and her department have spent the last several months assessing the need for a center in Howard, and determined that there was a clear gap in services provided in the jurisdiction. This assessment involved analyzing data on drug use in the county and the type of available treatment facilities in and around Howard, Rossman said.
"In Howard County we have not bent the curve on our opioid deaths and the number of folks overdosing," Rossman said. "It is not going away."
The gap in treatment grew even larger this year, after the county's only outpatient clinic for those with substance abuse disorders who are Medicaid recipients or uninsured closed at the end of 2016.
Rossman said she wants to create a center that can offer the most intense form of treatment, inpatient detoxification, to residents. Detoxification is the process of transitioning from a state of intoxication to being "clean" and no longer presenting any symptoms related to a drug, said Andrew Angelino, chairman of the psychiatry department at Howard County General Hospital. The withdrawal process during detoxification from a drug is painful, and for opioid users, can include muscle cramps, diarrhea and other severe flu symptoms, Angelino said.
The center could also potentially provide services for the entire spectrum of treatment for substance abuse, including prevention and intervention, crisis stabilization, detoxification,recovery and treatment, but DeLorenzo said until the budget for the center itself is set, it's difficult to know what will be available.
Due to the lack of government services available, many people currently turn to Howard County General Hospital for treatment, Angelino said. He said the hospital provides as much treatment as it can in an acute setting, including detox and counseling, but that the hospital is not a detox center, and can't provide every kind of service an individual may need.
Angelino said the two primary tasks the hospital focuses on are admitting and assessing patients for whatever ailments they may have, and then determining what the next best steps are for each case.
"The hard part is when it comes to addiction, not one size fits all," he said.
Angelino said the hospital is open to being a partner in the county's detox center, though he's not sure what specific form that would take; possibilities include sending doctors to the center or providing medicine to the facility.
While officials hunt for the appropriate site, Rossman said the county is also working to create short-term solutions to help treat people before the center is ready. Rossman said there are plans to establish a "crisis stabilization center" in the county in the next year that can assess people addicted to drugs to determine the level of treatment they need and offer case management services to help ensure patients receive the right care.
Despite such plans, Angelino said the time for short-term solutions is over.
"This is not a short-term problem, this is a huge societal problem and we've tried to find a quick fix and we're not making a dent, because nobody's investing in it," Angelino said. "This is a major catastrophe, and we've ignored it long enough."
For Angelino, a solution lies in creating a center that offers not only detoxification treatment, but programming that helps put people formerly addicted on a path toward a better life.
"We need a place where people can go, get themselves off drugs and start hearing how they can improve their life," Angelino said. "They need people who are going to take them by the hand."