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A fatal addiction [Editorial]

Our view: An actor's overdose death shows the varied face of heroin addiction

4:19 PM EST, February 3, 2014

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The death this weekend of acclaimed actor Philip Seymour Hoffman from an apparent drug overdose has left his fans and colleagues in the film industry devastated by the loss of a great talent at so young an age. Mr. Hoffman was 46 when he was found dead in his New York apartment Sunday with a hypodermic needle stuck in his arm and packets of what appeared to be heroin nearby. His tragedy was a reminder that heroin addiction has many faces, from the rich and famous to people of severely limited means.

Mr. Hoffman had battled his addiction for years before ultimately losing that struggle. But his death has re-focused attention on the rising number of drug overdoses responsible for killing dozens of people across the country, including in Maryland. As The Sun's Andrea K. Walker reported on Saturday, Maryland law enforcement and health officials are alarmed by a recent uptick in overdose deaths, 37 of which were caused by addicts injecting heroin laced with fentanyl, a powerful painkiller used to treat cancer and other illnesses that when combined with heroin greatly increases the risk of death from overdose.

Yet drug dealers have begun selling this potent cocktail on the street without warning customers of its potentially deadly consequences. Addicts who use it thinking they can shoot up the same amount as they normally would often don't realize it can kill them or that fentanyl's quick-acting agent is hundreds of times more powerful than unadulterated heroin. Death from respiratory failure can come so quickly the user doesn't even have time to withdraw the hypodermic needle used to inject the drug.

It's unknown whether fentanyl was involved in Mr. Hoffman's death, though police in New York will surely test the suspected drug samples found in his apartment to determine the chemicals they contained. But officials say the adulterated form of the drug has been sold up and down the Interstate 95 corridor as far north as Rhode Island and in states as far away as Washington. It's spread means local and state health departments need to be more proactive in identifying people at risk of addiction and getting them into treatment to prevent more such deaths.

In Maryland, overdose deaths from fentanyl-laced heroin have been reported in all parts of the state, including Western Maryland, the Eastern Shore and Central Maryland. But because Baltimore City has the highest rate of heroin addiction in the state, it's been hit particularly hard by the increase in fentanyl-related overdoses. Since September, more than a quarter of reported deaths involving fentanyl in Maryland have occurred in the city, even though Baltimore makes up only about one-tenth of the state's population.

To combat the surge in overdose deaths, Baltimore's health commissioner, Dr. Oxiris Barbot, will convene a task force of police and fire department first responders, addiction and mental health service providers, corrections officials and medical directors of residential treatment facilities to forge a coordinated response aimed at reducing overdose fatalities. Though exact figures are difficult to calculate, Ms. Barbot estimates there may be as many as 12,000 city residents who are addicted to heroin and potentially at risk of fentanyl-related overdose.

The team will focus on two main areas: A public information and education campaign targeting high-risk communities and individuals with messages about the increased risk of overdose from fentanyl-heroin mixtures, and working with doctors, dentists, pain management therapists and mental health professionals to ensure they are following best practices for prescribing and administering opium-based prescription medications, which can lead people into addiction unless carefully monitored.

The goal is to minimize the number of people who continue using heroin and other opiates while maximizing the number of people entering treatment and the length of time they stay there. Ms. Barbot also wants to take advantage of legislation passed last year that allows families and friends of addicts to be prescribed Naloxone, which can prevent overdoses, so they can use it to help loved ones who are overdosing.

Sadly, there is no permanent cure for opiate addiction. As Mr. Hoffman's case starkly demonstrated, even addicts who have been through recovery and stayed clean for many years can relapse without warning, often with fatal results. Baltimore's approach recognizes that there is no magic bullet that will make addiction go away but that cities can take steps to reduce the harm heroin inflects on it users, their families and their communities and that such efforts have the potential to save the lives of hundreds of city residents who otherwise might have shared Mr. Hoffman's fate.


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