Howard Co. Health Dept. launches plan to combat rising drug overdoses

The number of drug overdoses related to heroin and prescription painkillers in Howard County is on the rise -- a trend that has led the county Health Department to launch a series of initiatives aimed at reducing incidents.

According to a health department report, the number of deaths related to heroin and prescription painkiller overdoses has more than doubled between 2010 and 2012 -- from 8 in 2010 to 18 in 2011 and 17 in 2012.

Officials said they expect the numbers from 2013, which are not yet available, to be even higher; 17 deaths were reported through September.

Statewide, 464 people died of heroin overdoses in Maryland, an increase of 88 percent since 2011. Last week state health department secretary Dr. Joshua Sharfstein said heroin is particularly dangerous when laced with fentanyl, a prescription painkiller that he said is being illicitly manufactured in drug labs. Officials said fentanyl-related deaths doubled between 2012 and 2013, from 29 to 58.

The Howard statistics have led the department and county health officer Dr. Maura Rossman to take a "multi-pronged approach."

"We are hopeful we will change the tide of near-fatalities and fatalities in Howard County," Rossman said in a statement.

The prevention plan is called the Opioid Overdose Response Program, and is an 11-page document created earlier this year. Chief among the initiatives is a class that offers high-risk residents training and access to an antidote called Naloxone, a prescription drug that counteracts the debilitating effect painkillers, or opioids, have on the central nervous system.

Painkillers with opioids -- hydrocodone, morphine, oxycontin -- dull pain by slowing the flow of the body's respiratory and circulatory functions, which are controlled by the central nervous system. The effect causes a reduction in pain messages sent to the brain, but also causes slowed breathing. An overdose on these medications can slow breathing to a stop, resulting in death.

Naloxone, according to Rossman, acts a reset button for the central nervous system by restoring normal circulatory and respiratory function. The department says the drug has no potential for abuse.

"It works on brain receptors where opioids work, and reverses the effects of an opioid overdose," Rossman said. "Relatively speaking, it's a safe medication. If you aren't having an overdose from opioids, it won't have any effect on you."

To be eligible to use the drug, which has been used by emergency responders for decades, a civilian must be certified through a training class, which the county began offering last week. Health department spokeswoman Lisa deHernandez said the first class was attended by 17 people.

While the drug is typically administered intravenously, the class teaches civilians how to administer it through a nasal spray. After completion of the class, participants receive a prescription Naloxone kit.

Rossman said attendees include family members of users, professionals and volunteers, and that the department has received an unanticipated high level of interest.

"We are appealing to the general public who may have dealings with high-risk population for overdose. ... To folks who mix with folks who have an opioid addiction," Rossman said.

The next class will be later this month, Rossman said.

Rossman said increasing public accessibility to Naloxone through training is not a new phenomenon -- Baltimore City has employed a similar program called "Staying Alive" since 2004 -- and that the class was made possible by a grant of $22,875 from the state Department of Health and Mental Hygiene.

Both the county and the state's central region, which the county is a part of, were identified by a recent state report as areas with a "significant increase" in overdose deaths, specifically relating to heroin, which Rossman said led to the implementation of the class.

Rossman said the rise in heroin deaths, which is occurring statewide and, to a lesser degree, nationally, is an unintended consequence of policy and legislative decisions limiting the availability of prescription painkillers.

"Over the past several years, there has been a growing concern with prescription opioid abuse, which makes it more difficult for people to obtain prescription opioids," Rossman said. "Heroin has become easier and less expensive to get if you are addicted to opioids. ... We have more people using heroin now than prescription drugs for their opioid addiction."

Rossman said the class is the first step and other initiatives include increasing community outreach and education, developing support systems to prevent relapses and collaborating and supporting like-minded organizations.

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