Heroin: a public health emergency

Baltimore health commissioner: Make naloxone available to everyone.

As an ER doctor, I have treated hundreds of patients who were dying of heroin overdose, and I know that it is a disease that claims lives. As a family member of loved ones who struggled with addiction, I have seen that heroin isn't just an individual disease; it's a family disease. As a public health official in Baltimore, where an estimated 19,000 of our residents use heroin, I have witnessed how heroin ties into the very fabric of our city; it's a community disease.

Last October, Mayor Stephanie Rawlings-Blake convened a diverse task force of over 35 members to tackle the critical issue of heroin addiction in our city. Under the direction of Dr. Samuel Ross and Bern McBride, the Mayor's Heroin Treatment and Prevention Task Force held numerous community listening sessions and work group meetings. Last week, we released the results of the task force's hard work.

I am glad that the recommendations focus first and foremost on the imperative of saving lives. Last year, 303 people in Baltimore died from drug and alcohol overdose. That's a death nearly every day. This is a preventable tragedy because there is one medication — naloxone — that will save a life within minutes. It is imperative that we get naloxone into the hands of everyone who can save a life — which is every citizen in Baltimore.

One of the task force's key recommendations is to implement a citywide heroin overdose plan. This was such an urgent recommendation that the Health Department could not wait until the report came out; we have already started to implement this plan through "hotspotting" to get naloxone to family and friends of those most at risk and targeting outreach to prevent deaths from fentanyl-laced heroin. Our goal is to make naloxone available to everyone, just like we have defibrillators everywhere to save people who are dying from heart attacks.

Another recommendation that we could not wait to implement is an outreach campaign to reduce stigma and encourage treatment. Last week, we unveiled a new public education campaign that involves billboards across the city and a website, www.DontDie.org, to teach about how we can all save a life and prevent overdose deaths.

These and other recommendations are ones we can implement ourselves in the city. There are some recommendations we will need help to implement. For example, we must ensure that Baltimoreans can access behavioral health treatments when they need it. If you have chest pain, you can walk into the ER and get diagnosed, treated and either admitted or discharged with close follow-up planning. This is not the case for people seeking addiction services; patients are told to wait days, even weeks or months for care. I applaud the task force for championing treatment on demand, starting with a 24/7-treatment center — an ER just for substance use and mental health.

I also commend the task force for focusing on those who are most vulnerable. This includes individuals in jails. Studies show that eight out of 10 people in jail use illegal substances. These individuals need treatment in jail, including evidence-based treatment like buprenorphine and universal case management when they leave — someone to follow them to make sure they get the care they need and the resources for successful reentry. These are critical steps for us to stop criminalizing addiction and instead treat it as the chronic medical disease that it is.

If it's any city that can turn bold ideas into reality, it's Baltimore. We look forward to sharing our innovative, evidence-based approaches with the governor's Heroin and Opioid Emergency Task Force and hope that they will use our recommendations in order to fight the heroin epidemic in Baltimore and in Maryland. We will also be turning to our federal government and private partners to help to fund these necessary, life-saving interventions as part of our city's OneBaltimore recovery efforts.

The heroin epidemic is a public health emergency that is claiming the lives of our residents. The mayor's task force recommendations will not sit on a shelf. They outline actionable steps that will be taken today so we can build a stronger, healthier and more just Baltimore tomorrow.

Dr. Leana Wen is the Baltimore City health commissioner. She can be reached at health.commissioner@baltimorecity.gov; Twitter: @DrLeanaWen.

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