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Baltimore City health officials and syringe service providers discuss drug user support amid COVID-19 outbreak

As Baltimore continues to grapple with the coronavirus pandemic, officials and advocates stressed the importance of maintaining clean syringe services around the city to stop the spread of infectious diseases among opioid users.

Baltimore City Health Department officials and community-based organizations to discuss appeared at a City Council hearing Tuesday to discuss how aid is being provided throughout the city despite the challenges of the pandemic.

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City Council President Scott, who’s widely expected to become the city’s next mayor after winning the Democratic party’s nomination in June, said Baltimore has been “experiencing an overdose epidemic in my lifetime,” and said he wants to see a more comprehensive response to intravenous drug use in the city.

He said that what past administrations “have been afraid or unwilling to do … is to address overdoses as a public health issue."

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“I am interested in how this work has changed and transformed as we continue to navigate COVID-19,” said Scott. “This is about continuing the conversation for overdose prevention and harm reduction in city government so that we can begin to invest in proven solutions and save lives.”

Maryland reported that drug- and alcohol-related deaths increased 9.1% across the state from January to June this year compared with the same months of 2019, with opioids responsible for nearly 90% of the 1,326 deaths. Officials attribute the uptick largely to COVID-19 exacerbating people’s addictions as they’ve quarantined inside their homes to help curb the virus.

Baltimore City actually saw a more than 14% decrease in opioid overdoses in the first quarter of 2020 compared to last year, but the city still saw 205 total deaths due to opioids, more than 120 cases higher than the next closest jurisdiction in Baltimore County, which saw 80 during that same time period.

Derrick Hunt, executive director for the city’s needle exchange program, said the pandemic has not slowed down the program, as 1.2 million syringes have been distributed since the beginning of this year. The program has been handing out more than 1 million syringes annually in the city for several years, peaking at nearly 1.5 million in 2017.

But Hunt stressed that the program also connects drug users with various city services and treatment agencies, saying that officials work with community leaders and members to address users' needs.

“The biggest thing with syringe exchange is building these relationships,” Hunt said. “We try to let them know that they are part of this society.”

Other officials spoke about how the clean needle exchange program also serves as a means to mitigate the spread of Hepatitis and HIV/AIDS. Baltimore City and Prince George’s County were authorized to set up clean needle exchange programs in 1994 amid growing HIV/AIDS cases among intravenous drug users.

Victoria A. Cargill, the assistant commissioner of the Baltimore City Health Department, explained that there has been a consistent decrease in HIV cases and the agency remains on track to continue the decline.

But other blood-born infections, like Hepatitis-C, is largely linked to injection drug use. Baltimore City has the highest number of Hepatitis-C cases in the state, at about 384.9 per every 100,000 individuals.

“In 2016, there were 2,214 reported cases in Baltimore City. But I would caution that this is most likely undercounted because of the nature of the illness can be very mild flu-like and [people] may not think to seek testing,” said Cargill.

That same year, the Maryland General Assembly passed legislation that allowed local health departments to coordinate with state health officials to set up their own clean syringe exchange program.

However, Hunt said it took other jurisdictions years before they had their own operational programs, and the city’s program was still the only active one until 2018. Unlike those of some neighboring states, which coordinate needle exchanges through state-run programs, the 2016 legislation left the authority with county and jurisdictional leadership as to whether they want their local health department to start a program.

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East Baltimore-based Charm City Care Connection, which was founded in 2009, is a nonprofit organization working with city officials to directly assist drug users with case management, harm reduction services and health screenings.

The organization’s executive director, Natanya Robinowitz, says that the group is focused on “providing harm reduction that is not conditional” as way to serve those most impacted by drug use.

“Users often get kicked out of programs or lose access to services for relapsing, but we offer support that is conditional,” Robinowitz said. "A program like ours, helps people when they need it most and we do not cut them off or kick them out.

Baltimore Sun reporters Phil Davis and McKenna Oxenden contributed to this article.

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