The abuse of heroin and other opioid drugs is one of the most significant public health issues facing the nation. More Americans now die every year from drug overdoses than in motor vehicle crashes. President Obama has announced a "week of action" to raise awareness about the public health crisis and designated this week as National Heroin and Opioid Awareness Week.
In Maryland, heroin-related deaths tripled from 2011 to 2015, rising from 247 to 748. There has also been an alarming spike in deaths from the synthetic opioid fentanyl, rising 105 percent during the first quarter of 2016 as compared to 2015. Increases in overdose deaths have been reported throughout the state, including western and central Maryland and the Eastern Shore. It is essential to alert people about the dangers of opiate use, whether obtained through prescriptions or on the street. Everyone is at risk if they are not informed.
A national survey estimated that 1.4 million people in the U.S. abused a prescription painkiller for the first time in 2014. Approximately one in five high school seniors reports misusing prescription drugs at least once. Most first-time abusers of painkillers obtain them from a friend or relative. Parents, teachers, and medical professionals must work together to educate every child about the horrible consequences of opioid addiction.
Opioids are highly addictive and extremely dangerous. They can alter the user's brain permanently, sometimes after just one use. Many people become addicted to legally prescribed opiates. Maryland's statewide prescription drug monitoring program to help track opioid prescriptions and prevent their abuse has significantly reduced the availability of pharmaceutical drugs. The database is an important step in fighting opioid addiction.
Many addicts who can no longer obtain prescription opioids turn to cheaper and more dangerous alternatives and buy heroin, fentanyl and other opioids from drug dealers. Heroin often sells for only $10 per dose. Prescription opiates, such as oxycodone pills, cost many times more on the street.
Fentanyl is a synthetic opioid 25 to 40 times more potent than heroin. It can be absorbed through the skin, and it is so strong that the equivalent of a few grains of sugar can cause death. Fentanyl can be mixed with or sold as heroin. It is also appearing in counterfeit tablets, pills and capsules that mimic prescription drugs.
Users who purchase drugs on the street have no idea where their heroin or fentanyl comes from, nor its purity. Heroin and fentanyl can be mixed with anything, from harmless substances such as sugar, starch or powdered milk, to poison and other powerful opioids.
Narcan is a rescue medication carried by most Maryland first responders. When administered quickly to a victim, Narcan can reverse the effects of the overdose. To encourage reporting of drug overdoses, Maryland law now provides immunity from criminal prosecution for anyone who seeks emergency assistance for an overdose victim.
Unfortunately, drug abusers who are saved by Narcan may not be saved for long, because most addicts continue to use heroin. The Maryland Department of Health and Mental Hygiene has launched a number of initiatives to reduce the number of heroin-related fatalities, including programs that deliver services to overdose survivors.
As prosecutors, we seek to hold accountable criminals who illegally distribute deadly drugs. Working closely with local, state and federal law enforcement partners, we prosecute drug dealers, doctors and pharmacists who violate state and federal drug laws. A federal statute provides enhanced penalties for illegal drug distribution resulting in death, and federal prosecutors are using this statute in appropriate cases.
Overdose deaths throughout Maryland are being investigated as homicides, to help identify distributors of fatal drugs. The U.S. attorney's office and the Drug Enforcement Administration have joined the Maryland attorney general's office and local police and prosecutors to develop a best practices model for how to gather the evidence required for criminal prosecutions.
Finally, our offices are working collaboratively with law enforcement, medical professionals and educators to build community coalitions to fight this epidemic. Enforcement efforts are more effective when they are part of a larger strategy to prevent addiction by educating potential drug abusers, and ensuring that help is available to people who become addicted. Everybody must be part of the solution.
Rod J. Rosenstein (firstname.lastname@example.org) is Maryland's U.S. attorney and Brian Frosh is the states' attorney general.