Cautioning that there likely would never be enough money to fix Maryland's heroin problem, Lt. Gov. Boyd Rutherford said Tuesday that a state task force recommends an expansion of treatment and prevention efforts to begin addressing it.
Among the recommendations, part of an interim report to the governor, are allocations such as $800,000 to a residential treatment facility in Kent County to increase its capacity to 40 beds, and $300,000 to Baltimore for a pilot program in which recovering addicts would reach out to and help current users.
"We made some recommendations, about 10 of them, that we felt we could address immediately or in the next week or so that have no real major financial burden," Rutherford said.
But, he added, the state's heroin crisis is so vast — overdose deaths attributed to the drug have more than doubled since 2010 — that it outstrips the amount of money available.
"We're not sure how we're going to fund this," Rutherford said of a range of state and local efforts to prevent and treat substance abuse. "It's probably never going to be enough."
Rutherford, who headed a task force of representatives from law enforcement, health and addictions fields, said the group would continue studying the issue and would make a final report to Gov. Larry Hogan in December.
In its interim report, the task force did not go as far as its counterpart in the city, which last month called for round-the-clock treatment on demand but did not identify a funding source. Advocates say that is what is needed to get more addicts on the path to recovery.
"We're turning about four people a week away," said John Herron, director of Tuerk House, a treatment program based in the Ashburton neighborhood. "The need is that great."
Of the 80 beds that Tuerk House has for in-patient treatment, 58 are state-funded, and they often are filled, he said.
By turning away addicts who are ready for treatment, a program runs the risk of losing them, perhaps forever, Herron said. Not only do you not know if they'll return when a bed is available, "you don't know if they'll live to next week," he said.
Herron said that while the state is not increasing his facility's funding as part of the task force recommendations, he remains hopeful that the increased attention paid to heroin addiction in recent years will have benefits.
"I think the time is right now, even if the state doesn't have the money, for the rest of the community to step up — the private sector, the foundation community," he said.
As for Rutherford's assessment that there probably will never be enough funding, Dr. Leana Wen, the city's health commissioner, said she sees the situation differently. Wen said there are research-based solutions to combating addiction, and public officials need to find ways to support them.
"We need to make a commitment to that," she said.
Wen said the city and state heroin task forces generally agree on goals such as reducing the stigma of addiction, increasing awareness of the problem and expanding access to treatment. Much of that work is already underway in Baltimore, which was dealing with a heroin crisis long before it became more pervasive in other parts of the state, she said.
The state task force's interim report detailed how the $2 million previously allocated for prevention and treatment would be disbursed, recommendations that Hogan has already agreed to.
In addition to the funds directed to the A.F. Whitsitt Center in Kent County and the Baltimore peer outreach program, the allocations include $500,000 to local health departments for training and distribution of naloxone, the opioid overdose-reversing drug, and $100,000 for recovery housing specifically for women with children.
The governor has also approved allocations of about $189,000 in crime prevention funds to assist police agencies in battling heroin trafficking. The Ocean City Police Department, for example, will receive $124,635 for license plate reader technology to help track heroin entering the state from other areas.
"You have to stop the pipeline," Rutherford said.
Andrew Pons, program director of the Whitsitt Center, said that getting "the lion's share" of the state's $2 million treatment funds would allow the facility to reduce its waiting list, which can grow as long as 50 people at times.
The center, the only state-run residential treatment facility on the Eastern Shore, had its funding reduced a couple of years ago and dropped from 44 beds to 26 beds. It plans to add eight beds for detox in the coming month, and as it increases staff, it will add more beds, Pons said.
"Detox is where the logjam is," Pons said of addicts waiting for space in the five- to seven-day program. "Most of the people on the waiting list are in need of detox."
Rutherford said that despite the amount of attention focused on heroin in recent years, awareness of addiction problems still must be improved, especially among youngsters.
"Every third-grader can tell you how bad cigarettes are," Rutherford said. "But they can't tell you how bad it is to take someone else's prescription pills."
He said previous awareness campaigns — such as "Just Say No" and the public service announcement equating a brain on drugs with an egg being fried — were effective because of their simple and memorable messages.
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The task force, appointed shortly after Hogan took office in January, held six meetings across the state to hear from more than 200 law enforcement, medical and addictions personnel, as well as addicts and their families. Hogan, who said he has a cousin who died of an overdose, made combating heroin fatalities a campaign issue, although his initiatives to date have been similar to those put in place by his predecessor, Martin O'Malley.
Since 2010, the number of Marylanders who have died of heroin overdoses has more than doubled. Last year, 578 deaths were attributed to heroin, compared to 464 the previous year. The fatalities show no sign of abating: In the first three months of this year, 194 people died in Maryland of heroin overdoses, compared to 146 during the same period last year.
Local, state and federal officials have been scrambling to reverse those trends.
Baltimore Mayor Stephanie Rawlings-Blake's task force, in addition to calling for on-demand treatment around the clock, recommended a public education campaign and a data-tracking system to identify "hot spots" of overdoses and treatment needs. Many of those recommendations are underway, including an educational campaign launched via billboards and a website, dontdie.org.
The Baltimore-Washington area also received federal attention last week, with the White House drug czar creating a multistate public health and law enforcement effort to combat the drug in Northeast and Appalachian areas that have been particularly hard hit.