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Opioid-related deaths may be dropping in Maryland, but experts say larger epidemic persists

Fatal drug overdoses dropped in the first half of the year around Maryland, including in Baltimore and five surrounding counties, reversing some of the jump during the early stages of the coronavirus pandemic, a state health official told a group of treatment providers and policymakers who gathered this week in Baltimore.

The data was preliminary and could change but brought a bit of welcome news during what’s been a trying time for people with substance use disorders.

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There is still the problem, however, of the large number of people dying from overdoses. More than 1,200 died with opioids in their bodies between January and June in Maryland. Nationally, the opioid epidemic now claims more than 100,000 lives annually.

“The data is encouraging,” said Robin Rickard, executive director of the Opioid Operational Command Center, the agency that coordinates the state’s response to the epidemic. But, she added: “Every death is a tragedy.”

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She spoke to the American Association for the Treatment of Opioid Dependence, where she and others outlined steps taken and those that need to be done to ensure access to treatment for substance use disorders and reduce deaths.

Officials spoke about challenges such as paying for and expanding the use of naloxone, the overdose reversal drug, as well as adding opioid treatment providers at a time when the health care workforce is strained. They also talked about continuing to reduce stigmas surrounding treatment and medications used in treatment.

They said better outcomes will continue to flow from the work that all the providers, government agencies and others do as a group — the theme of the ongoing conference is “The Power of Collaboration.”

Mark Parrino, president of the association, said the epidemic began with prescription opioid misuse, which turned into heroin use and then use of the much more powerful fentanyl. Most people now understand that fentanyl dominates the illicit drugs available and is responsible for most deaths.

But he said the landscape continues to evolve, flummoxing officials in treatment and law enforcement. Fentanyl and its many analogs can be difficult to detect without specialized equipment. And now the substances are also mixed with methamphetamines and cocaine, two drugs contributing to more deaths recently. In the 12 months ending in June, other substances, such as fentanyl, heroin and alcohol, contributed to fewer deaths, the state data shows.

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Dr. Rahul Gupta, director of the White House Office of National Drug Control Policy, told the group gathered that tackling the issue is a priority for the Biden administration, with billions in funding being allocated and coordinated among many federal agencies.

Access to treatment remains a barrier, but the response includes expanded use of telehealth services, mobile treatment and an expanded focus on harm reduction efforts, which includes practices such as handing out clean needles and naloxone.

“You can’t treat dead people,” Gupta said. “If it’s easier to get illicit drugs than treatment in America, we’ll never solve this crisis. We need more opioid treatment providers.”

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That sentiment was echoed by Dr. Ken Stoller, director of the Johns Hopkins Broadway Center for Addiction and an associate professor in the Hopkins School of Medicine’s department of psychiatry.

Stoller, the conference chair, said there needs to be greater access to federally approved medications, specifically buprenorphine, a type of drug to treat addiction that can be prescribed by a doctor and picked up in a pharmacy. This is in addition to methadone, which is largely given out in clinics, and naltrexone, often given by medical providers as a shot. There also needs to be more access in rural parts of the state and country.

Also needed are counseling and social services to aid people who have suffered from substance use disorders, he said.

“There is no doubt these medications save lives; comprehensive treatment saves and rebuilds lives,” Stoller said. But he added: “There is no silver bullet.”


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