Baltimore County leaders say addressing opioid addiction and use will mean expanding the number of drug treatment and recovery facilities in the county — and overhauling county zoning laws.
The county’s Opioid Response Working Group, created by County Executive Johnny Olszewski Jr., said Olszewski, the Department of Planning and the County Council need to begin the process of revising county code by March 2020 to create opportunities for more treatment programs and to allow more recovery housing in the county.
The group, which includes medical executives, doctors and local drug treatment providers, released a final report in November that recommended 11 strategies to reduce addiction and overdose deaths. The county has the second-highest number of overdose deaths in Maryland, with county police recording 202 deaths and 858 overdoses as of Sept. 19.
Olszewski has said the county must act "strategically and decisively” to address opioid overdoses. He created a position for a county opioid strategy coordinator and hired Eric Bromwell, a former Baltimore County state delegate, for the job.
“Until people understand that this is a true epidemic, that this is a true problem, they’re not going to be as amenable to the solutions,” Bromwell said. “We have to get it right ... and I think that we are in a very, very, very unique situation where we can build something here."
The opioid group’s recommendations to expand treatment, however, could run into community concerns about what treatment and recovery facilities will mean for neighborhoods and complications in rewriting existing laws and zoning restrictions.
Recovery houses are communal living settings that offer peer support to people seeking sobriety. The report deemed the county’s lack of certified recovery housing a “crucial gap.” Treatment programs give people addiction medication such as methadone or buprenorphine in places such as clinics or hospitals. Recovery housing and treatment programs can operate independently of each other, but treatment programs also can exist within recovery housing.
Housing advocates have told the county there are “significant difficulties” in opening recovery housing under the county’s zoning policies. Currently, anyone who wants to create recovery housing in Baltimore County must complete a special permitting process.
Republican County Councilman David Marks said it’s currently illegal in the county for three or more adults who are not related by blood, marriage or adoption to live together in a single family home. The council might have to consider changing that law to accommodate recovery houses, he said.
Alternatively, Marks said the county’s Department of Permits, Approvals and Inspections could issue boarding room permits to recovery houses. That zoning permit can be obtained after inspections, paperwork and a public hearing with an administrative law judge.
Obtaining a boarding room permit has been a hard process for landlords who want to rent to students in Towson, said resident Paul Hartman, but getting one for the purpose of opening a recovery house should be easier. Hartman, a longtime Towson housing activist, supports the push to create drug treatment centers and recovery housing across the county as long as county officials and providers don’t establish “10 of them in one neighborhood.”
Since drug addiction is considered a protected disability under the Fair Housing Act and the Americans with Disabilities Act, Democratic County Councilman Izzy Patoka said county officials need to consider those federal laws when they revise zoning regulations for recovery housing to ensure the revisions aren’t discriminatory, either intentionally or unintentionally.
For instance, the county could violate federal law, the opioid group report stated, by refusing a reasonable accommodation needed by a person with disabilities. Or, the county could face discrimination accusations if it requires an occupancy permit for people with disabilities to live in a single-family home, but doesn’t require one for other residents of single-family homes.
A Yale University study in October found that residents in five states, including Virginia and West Virginia, faced significantly longer drives to access opioid treatment than to reach a federal health clinic or a dialysis center, creating a barrier to treatment. The researchers recommended more communities should build new medication-assisted treatment clinics, such as those that dispense methadone, or make medication-assisted treatment more accessible in primary care clinics.
Bromwell, who previously co-chaired a General Assembly work group that studied opioid issues, said he’s meeting with a few local and statewide lawmakers to discuss the county’s drug treatment strategies. The discussion will focus on how the different agencies involved “have to get it right,” which includes addressing the county’s housing laws, he said.
Baltimore County is also in the process of working with state government to finalize the opening of an “on-demand” drug treatment center, Bromwell said. The center would open at the former Rosewood State Hospital campus in Owings Mills by “early next year,” he said.
Democratic County Councilwoman Cathy Bevins said drug treatment and recovery programs are “certainly needed” in the county. She wants the county to create a detoxification services center in her district. That would require “some rezoning efforts” and possibly new legislation, she said.
County residents dealing with drug addiction often have to go into Baltimore city or to different counties for detoxification treatment. The county does provide inpatient and outpatient therapy for people who want to maintain sobriety, but Bevins called the lack of a detox centers “bothersome” because treatment providers must connect with drug users as soon as they’re ready to be helped.
The county also must address the stigma of opioid addiction. Marks said there’s a perception across the county “that generally many people do not want these types of homes in their neighborhoods.”
“This resident has no desire for taxpayer funded halfway houses, as these locations generally attract crime and lower property values as a result,” one resident says in comments gathered by the county.
“Have a Baltimore County Inpatient Recovery Center, for God’s sake,” another resident says in the comments. “The fact we don’t have an inpatient center is abysmal and ridiculous.”
Marks said there’s a perception that drug treatment facilities will lead to criminal activity. One way the county could address this misconception is by having the community meet with the prospective operators of these facilities, Patoka said.
“We’re not immune from the problems associated with addiction,” Patoka said. “I think we need to be sensitive to our neighbors that are suffering through addiction.”
The county’s opioid panel also recommended a campaign to reduce the stigma associated with drug treatment.
The county has posted signs to track and publicize opioid overdoses and deaths, Bromwell said. Baltimore County also is working on ways to better publicize the county’s existing opioid treatment options, he said.
“The community already has a drug problem,” said George Fischer, president of the Gray Manor-Northshire Community Association in Dundalk, so he doesn’t think recovery housing will bring drug use into the community.
If anything, he said, recovery housing could reduce the amount of opioid use in the community because the program could help keep people off the drug.
“The recovery houses really need to work on trying to change the lifestyle [of these people] and not necessarily just the problem,” Fischer said.
Dundalk resident Ronald Wright also said opioid treatment and recovery housing is needed in the county. He spent the last four decades overseeing a free self-help group and referral program for people dealing with addiction.
Wright, pastor of the Merritt Park Baptist Church in Dundalk, currently donates the church’s cemetery space and resources for cremation to families who can’t afford to bury relatives who died from substance use. He lamented the number of young people he’s buried near the church after they “tried to find treatment but couldn’t find it.”
Wright said he hopes the county will successfully expand treatment options. Even so, he’s skeptical of those efforts after years of interactions with the government to maintain his now-defunct program.