Maryland is in an opioid addiction crisis; here's what the Democratic candidates for governor would do about it

Shortly after he was elected, Gov. Larry Hogan convened a high-level task force to address opioid addiction and overdoses in Maryland, and he eventually declared a state of emergency because of the problem. Yet the toll addiction has taken on communities across the state — urban, rural and suburban — remains unabated. The number of overdose deaths in the first three months of 2017 — the most recent data available — is more than double that from the same period in 2014, the year before Mr. Hogan took office. This isn’t just a Maryland problem, of course; addiction and overdoses have skyrocketed nationwide. But the fact remains that what we’re doing about the problem isn’t enough.

Most of the major candidates seeking the chance to run against Mr. Hogan in the fall have produced plans for reducing addiction and overdoses. In general, they all emphasize the need for more treatment and a smarter approach to handling addiction as a disease rather than a criminal justice issue (a view Mr. Hogan shares). They also tend to call for expanded access to naloxone, the overdose-reversing drug. But several of them offer specific ideas that are worth noting.

  • Author/entrepreneur Alec Ross says he wants to make Maryland a center for non-opioid pain management in an effort to stop people from getting addicted to the prescription painkillers that are often a precursor to the use of heroin and other street drugs. At the Sun/WJZ/University of Baltimore debate this week, two other candidates — former Obama administration official Krish Vignarajah and attorney Jim Shea — echoed the observation that our medical system is too quick to prescribe opioids. Ms. Vignarajah said that after she gave birth to her daughter by c-section, she was told to avoid alcohol and caffeine but prescribed opioids (which she refused). Mr. Shea said he was offered even more pills than she was after a hip replacement.
  • Mr. Shea emphasizes the need for the state to not only increase the availability of treatment but to better coordinate care across inpatient and outpatient drug treatment centers so that patients can get the type of care they need when they need it. Such coordination may sound like a small thing, but health care providers, law enforcement officials and others typically have no way to know in real time what slots are available in what facilities. Baltimore City has made improvements in that regard under Health Commissioner Dr. Leana Wen, but the need is acute statewide.
  • When asked about addiction and the criminal justice system during his endorsement interview with The Sun, Mr. Baker deferred to his running mate, Elizabeth Embry, a former Baltimore prosecutor and division chief in the attorney general’s office. She pointed to a need for improved pre-trial services to ensure that we aren’t locking people up primarily because they are addicts and for more effective drug treatment behind bars, where it is presently lacking.
  • State Sen. Richard Madaleno says we “need to go after the pharmaceutical industry that has created this problem.” Several counties and Baltimore City have announced plans to sue big pharma over its marketing of opioids, and Governor Hogan has authorized Attorney General Brian Frosh to do so, but he hasn’t so far, citing a lack of resources. It wouldn’t take much — funding for a handful of lawyers — to make that happen. Mr. Madaleno also proposes creating the position of statewide Director of Recovery to coordinate efforts across state and local governments.
  • Former NAACP President and CEO Ben Jealous has the most detailed platform on the opioid crisis, encompassing virtually all the points emphasized by his opponents as well as others. Some of his ideas center on expanding ideas that have shown promise in Baltimore and other jurisdictions — such as establishing overdose outreach teams that respond rapidly to areas that have seen a spike in overdoses to provide public health services; creating needle exchange programs; increasing the number of 24/7 addiction crisis centers from the one currently authorized to 10 statewide; and expanding the Law Enforcement Assisted Diversion program that steers addicts out of the criminal justice system and into treatment. Among the most crucial steps he advocates is expanding the availability of medication assisted treatment in Maryland’s correctional facilities. Methadone and buprenorphine are generally not available in the state’s jails and prisons, even for those who are already on such therapy. That’s a recipe for relapse, recidivism and, too often, overdose when inmates are released back into their communities.

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