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Maryland substance abuse experts say more access to treatment and medications is essential to combating opioid crisis

After federal researchers released troubling new statistics related to the state of the U.S. opioid epidemic, Maryland doctors and substance use disorder specialists said more widespread access to treatment centers, health care services and lifesaving medications are key to stem the increase in overdose fatalities.

From April 2020 to April 2021, overdose deaths rose 21% in Maryland, according to the latest data from the U.S. Centers for Disease Control and Prevention, and by more than 28% nationwide. More than 100,000 people died due to overdoses in that time period, according to the National Center for Health Statistics, a record number that is higher than the number of people who died of gunshots and car crashes combined.

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The CDC estimates that more than 2,800 Marylanders are included in the national tally, acknowledging that the numbers may be underreported due to incomplete data. That’s up from close to 2,300 overdose deaths the year prior.

Andy Owen, a Maryland Department of Health spokesman, said the rate of fatal overdoses has stabilized in the state since 2020, and the rate of increase remains significantly lower than the national average. Maryland has a comprehensive strategy in place to respond to the crisis, he said, which includes state-sponsored town halls, targeted naloxone distribution, data analysis, peer support programs and school prevention initiatives.

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But the spike in deaths may be attributed to increased isolation, financial hardship, and sickness and deaths of loved ones during the coronavirus pandemic, said Adrienne Breidenstine, vice president of policy and communications for Behavioral Health System Baltimore, which oversees behavioral health services for the city. As the public health crisis heads into its second winter, officials are worried the opioid epidemic could intensify.

“There are steps we can take now as a state to reduce overdose deaths. In particular, we should establish overdose prevention sites, which will help prevent deaths and improve health and public safety,” said Breidenstine in a statement, adding that some 26,000 people received substance use disorder services last year in Baltimore. “These overdose prevention sites not only save lives but also can provide a pathway to treatment they need.”

Mobile services and more widely accessible telemedicine treatment should also be made available in Maryland and elsewhere, said Dr. Eric Weintraub, head of the Division of Addiction Research and Treatment at the University of Maryland School of Medicine.

Maryland may be faring better than neighboring states such as West Virginia and Virginia due to its high concentration of physicians, pharmacies and health care workers; support and cooperation from Republican Gov. Larry Hogan’s administration to stem the overdose deaths; and because of its status as a Medicaid expansion state, which covers more low-income Americans.

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States that don’t have the same infrastructure can make use of the mobile centers and telemedicine, which should help lessen some of the geographic disparities in rural regions, Weintraub said.

This is the mobile telemedicine unit health care workers use on the Eastern Shore to treat opioid disorders. Experts say mobile treatment centers are a way to expand access into remote areas without the same concentration of workers, resources and pharmacies as more urban areas.
This is the mobile telemedicine unit health care workers use on the Eastern Shore to treat opioid disorders. Experts say mobile treatment centers are a way to expand access into remote areas without the same concentration of workers, resources and pharmacies as more urban areas. (Courtesy of UMMS)

“The model and idea of telemedicine and mobile medicine is one that will really work,” he said. “Medications are so critical to stabilize what’s going on in the brain. It’s not a magic answer, but you can’t get started without these medicines, and then get grounded, and think about what you need to do.”

Weintraub also said that the proliferation of fentanyl, the synthetic opioid that is more potent and deadly than heroin, has compounded the epidemic. Most of the region’s opioid deaths can be linked back to it, he said, especially in Baltimore.

Montressa Tripps, of Bmore POWER — a branch of Behavioral Health Systems Baltimore that provides the lifesaving overdose reversal medicine naloxone, as well as fentanyl testing strips, safe-use kits, information and resources — said the group is seeing more “tainted prescription drugs” at the community level.

“Fentanyl is being added to everything, from alcohol to heroin,” Tripps said in a statement. “People do not understand how much harm fentanyl does to the body and that it can kill quickly.”

Tripps said Bmore POWER uses the overdose death data to drive outreach activities, so that when overdoses rise in certain neighborhoods, they can target those areas for naloxone distribution.

More education about fentanyl and how to reverse its damage is needed, especially among the family members, friends and loved ones of those who struggle with substance use disorder, said Corey Richey, interim CEO of Recovery Centers of America at Bracebridge Hall, a treatment facility in Cecil County.

Many people may not know that effective treatment exists, and is readily available, to intervene in overdoses, Richey said. Organizations need to be better teachers and suppliers of such treatment, she added.

“We need a sustained, broad community effort to support people who are addicted to opioids, as well as other substances. It’s important that the public know that effective treatment is within reach; in fact, there are highly effective treatment centers in many communities and neighborhoods,” Richey said in a statement.

She added that people should know that naloxone nasal spray — often listed under its brand name, Narcan, is available over the counter, and at most pharmacies.

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