Maryland’s opioid-related deaths dropped during the first half of the year, including those linked to fentanyl, according to new state figures that show a bit of relief from the overdose crisis that is still claiming close to 200 lives a month in the state.
There were 1,182 total drug and alcohol-related deaths from January through June, with almost 90% opioid related. That’s down 150 from the 1,332 reported in the first six months of 2018, according to data released Tuesday by the Maryland Department of Health and the state’s Opioid Operational Command Center.
While deaths related to heroin and prescription opioids have been dropping for some time, deaths related to fentanyl, the far more powerful synthetic opioid often substituted for or mixed into heroin, had been skyrocketing until this year. The number of fentanyl-related deaths dipped statewide for the first time this past winter.
The latest state health department report shows fentanyl-related deaths dropped 7.8% compared to the first half of 2018 and overall opioid overdose deaths were down 11.1%.
Deaths related to cocaine also dropped after a recent spike in use. Most of those deaths involved a mixture of the drug and opioids.
“Though the continued decline in fatal overdoses is welcome news, the heroin and opioid epidemic remains a crisis and we will continue to respond with all the tools at our disposal,” said Gov. Larry Hogan in a statement. “The fight against heroin and opioid overdoses has torn apart communities and families throughout our state and across the nation. Together, we can and we must do more in order to save the lives of thousands of Marylanders.”
Others agreed that the epidemic has not passed, including Dr. Yngvild Olsen, medical director of the Institutes for Behavior Resources Inc./REACH Health Services in Baltimore and co-author of the book “The Opioid Epidemic: What Everyone Needs to Know.”
“The declines in opioid- and cocaine-related deaths are very welcome, but there are still too many people dying,” Olsen said. “So, this is not a time to let up on efforts we know save lives. We also need to look more broadly at what is happening to people with addiction longer term, as the goal is not only to save, but also improve, lives.”
Baltimore and Baltimore County recorded the most number of overall overdose deaths, with 484 and 187 deaths respectively in the first half of the year, though deaths declined 13% in the county while the city saw a slight increase of five deaths.
The Baltimore City Health Department did not respond to a request for comment.
Adrienne Breidenstine, spokeswoman for Behavioral Health System Baltimore, which oversees substance use and mental health treatment in the city, said the numbers may mean that more aggressive steps are needed to expand access to the system of care.
Breidenstine said the city and state should consider such moves as opening overdose prevention sites, which allow drug use in a monitored environment where the users can get connected to care providers. Several cities have proposed such sites, but they are not considered legal by U.S. authorities.
"This is not a time to let up on efforts we know save lives.”
Dr. Yngvild Olsen, medical director of the Institutes for Behavior Resources Inc./REACH Health Services
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“The report is a look at 6 months compared to 6 months last year, and the numbers went down and that might be a great preliminary sign that some things we are doing are working, but we should be cautious with the numbers,” Breidenstine said. “We have the rest of the year to go and Baltimore isn’t seeing any decline. That’s a signal we need to do more and take bolder steps.”
Baltimore-area counties logged fewer overdose deaths though June this year than in the same period last year, including Anne Arundel, down nearly 27% to 104 deaths; Carroll, down 52% to 23 deaths; Harford, down 17% to 44 deaths; and Howard, down 26% to 17 deaths.
The state has been working to stem the overdoses and step up access to treatment since such deaths began mounting 10 years ago. Experts believe many people got their start on prescription painkillers, such as Oxycontin, the maker of which is now embroiled in litigation along with many other manufacturers, marketers and sellers over the companies’ roles in the ongoing crisis.
Nationally, the U.S. Centers for Disease Control and Prevention reports that more than 700,000 people died between 1999 and 2017 from drug overdoses, including more than 70,000 in 2017. Overdoses are now the leading cause of injury-related death in the United States, with almost 68% involving a prescription or illicit opioid, according to the agency.
Maryland’s Republican governor declared a state of emergency in response to the overdoses in 2017. Like other states, Maryland has expanded its Prescription Drug Monitoring Program that requires reporting of opioid prescriptions to prevent abuse. Lt. Gov. Boyd K. Rutherford also heads two panels aimed at addressing the issues, the Maryland Heroin and Opioid Emergency Task Force and the Inter-Agency Heroin and Opioid Coordinating Council.
There have been expansive efforts in Maryland, including Baltimore, to make naloxone, the overdose reversal drug, widely available without a prescription, as well as teach people how to use it.
“While we know there is still much work to be done with regard to this epidemic, the decline of heroin- and opioid-related deaths over the first two quarters of 2019 gives us hope that we are on the right track,” Rutherford said in a statement.
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The number of alcohol-related overdose deaths fell 18% to 175. The number attributed to alcohol alone dipped to 35, two fewer than in the same period of 2018.
Cocaine-related overdose deaths dropped 16% to 380, including just 41 related to cocaine alone, down from 52. Opioids such as heroin or fentanyl are sometimes mixed with cocaine in a dangerous drug cocktail known as a speedball.
And the number of deaths from the even more powerful opioid carfentanil, used as a large animal tranquilizer, seemingly evaporated in the past two years. After 46 deaths were reported in Maryland in the first six months of 2017, just one was reported in the same period last year and none through June of this year.
Federal authorities cracked down on carfentanil distribution when the drug, considered 5,000 times more potent than heroin and used in treating elephants, hippos and horses, started showing up on the streets.