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Fighting Back conclusion: Progress or perish in addiction battle

Fighting Back conclusion: Progress or perish in addiction battle
(DYLAN SLAGLE/TIMES PHOTO ILLUSTRATION / Baltimore Sun Media Group)

Heroin and opioid overdose deaths are still on the rise, but so are the forces being marshaled in response.

Opioid drug antidotes have been made available to law enforcement officers and civilians, and they are saving lives. Heroin interdiction efforts are focusing on dealers who fuel overdoses, while users are being directed toward treatment — whereas once they were only seeing jail.

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In Carroll County, where law enforcement and public health officials have been scrambling to get a handle on the drug addiction and overdose problem since 2012, there's a sense that progress is finally being made.

"Our local judges and our State's Attorney's Office are communicating with all the community partners better than ever to place the appropriate individual in the appropriate program, and incarcerate those that should be incarcerated and treated within the confines of the jail," Sheriff Jim DeWees said. "We've also seen measurable success with the naloxone [overdose antidote] … that deputies have been carrying. We've saved several individuals that have overdosed and been near death."

What's next?

Yet officials recognize it's not enough — these efforts must not only be sustained to prevent future overdose epidemics, but extended and built upon to reverse the current epidemic and reduce the swell of needless deaths. What must come next?

At the level of state government, the 33 recommendations of the Heroin and Opioid Emergency Task Force that were published Dec. 1 after 10 months of study and contemplation provide a potential road map. Measuring and publishing the performance of addiction treatment providers, passing legislation to enhance criminal penalties for dealers who sell heroin that results in a death and further expanding access to opioid drug antidotes are just some of the areas that will be looked at during the course of 2016, according to Van Mitchell, secretary of the Maryland Department of Health and Mental Hygiene.

"I have been chairman of the Inter-Agency Heroin and Opioid Coordinating Council, and I also am receptive to the recommendations of the Lt. Governor's Heroin and Opioid Emergency Task Force," Mitchell wrote in an email. "Both work groups were started with the goals of finding and implementing no-nonsense tools to reverse the trends Maryland has seen in opioid abuse and in overdoses, and I'm committed to that — we are looking carefully at the recommendations to see what can be implemented."

In Carroll County, one of the recommendations in the task force's final report has been on the agenda for some time, according to Sheriff Jim DeWees.

"My staff and I have been meeting with our local delegation, our local treatment partners and the governor's office on a concept called day reporting," he said. "The day reporting concept tracks, monitors through home detention, tests, and provides treatment to nonviolent drug and alcohol offenders that are awaiting trial, and for those that have been convicted and sentenced to the day reporting center."

Rather than distributing services such as drug testing, parole and probation, and even health and social services in different locations — which multiplies the possible failure points for an addict who might not want to be there — a day reporting center brings them all under one roof, according to State's Attorney Brian DeLeonardo.

"They can take a number and, like the [Motor Vehicle Administration], go to each booth and deal with whatever service they need to," DeLeonardo said. "The judge could, like a menu, list off all the things the person needs to do, and they would have no excuse for not doing it, because when you show up there, everybody is there."

Although there is no timetable for opening a day reporting center, or any detailed plans as of yet, DeWees said grant money that will allow the county to move forward might become available in 2016.

"Through our discussions with the governor's office it appears that the grant will provide funding for operation of the day reporting center," DeWees said. "The Governor's Office of Crime Control and Prevention will be overseeing the grant and providing both operating money and logistical support to the jurisdictions that are awarded the grant."

Other Carroll initiatives, just recently begun, need time to come to full flower.

The Vivitrol program in the Carroll County Detention Center, where inmates close to release can elect to be given a shot that blocks the effects of heroin and opioid drugs for an entire month prior to hitting the streets, is promising, but thus far 16 inmates have received the injection since June, according to Sue Doyle, of the Carroll County Health Department.

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Tim Weber was hired as the State's Attorney's Office drug prevention and treatment liaison in August, and although he is already having an impact, it will take time to see just how large it is.

"He gets calls, he goes to houses, he goes to the hospital, he meets with people essentially to really try to get them treatment and get them into treatment, to get them into a program," DeLeonardo said of Weber. "I know of at least a dozen [people] that he has gotten into treatment or to detox."

DeLeonardo's office also began handing out "Stamp Out Heroin" cards in August, small cards with Weber's number on them, with the hope that people who have recently overdosed might reach out to him or someone on his Overdose Response Team for help.

It's not always just addicts who call, though.

"We have situations where parents call and they know their child is addicted, and they are sort of at their wits' end," DeLeonardo said. "At least it gives us a chance to have someone who has walked that walk to go in and say, 'Look, it doesn't have to be that way,' and really try to work with them."

This is part of a "no wrong doors" philosophy — that when an addict needs help, officials help them, whether he or she has called Weber or the health department — but time will tell how this affects the number of overdoses.

What would you say to yourself before you were addicted?

When Heather Coates, currently a peer recovery support worker at the health department, had drug education in school, it was the DARE curriculum presented by a policeman named Officer Bible. Her mother, who worked in addiction counseling, used to put her to bed with stories about how terrible it was to use drugs and warnings of the addictive personalities in their family tree.

"I was one of those kids that said, 'Heroin is bad, so I am not going to do it,' " Coates said.

And she didn't; instead, Coates developed an addiction to opioid pain medications initially prescribed for a painful chronic health condition.

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"I excused it because I was in pain and a doctor was giving it to me. I wasn't meeting a dealer down on the corner, so I thought I was better than 'those' addicts," she said. "You know, 'just pills,' that's stupid. Stupid. It's still drugs."

If Coates could fool herself despite the bedtime stories from a mother in the know, what does she believe should be done for the next generation?

"The only thing I can think of that we could do different is to take people that are currently in recovery, and kids that don't understand what the consequences of their actions could be, and put them together. Have like a big brother, big sister program or something," she said. "That way it gives people in recovery a sense of purpose, helping to invest in the next generation."

Brittney Sabock, a North Carroll High School graduate who is in recovery for heroin addiction, doesn't place much stock in traditional, classroom-based drug education, either.

"I remember the first time I smoked crack," Sabock said. "I remember thinking, 'They talked about this in health class like it's so bad, but it's nothing.' "

Sabock had always felt anxious and out of place, as if she didn't fit in, but when she discovered heroin, "It was this warm feeling and made every anxiety go away and let me feel comfortable in my own skin."

Until it stopped working.

Sabock can't say for certain that there is anything anyone could have done that would have guaranteed she never used drugs, or that would have lead her to seek help sooner. But, like Coates, she believes addicts in recovery could be the key. Maybe having someone like her speak face to face about addiction, about their personal experience, would have made a difference.

That's exactly why Sabock has been touring Carroll County high schools, sharing her story, with DeLeonardo and other addicts in recovery.

"I definitely think it would make a difference; that's why we want to get these programs into schools," Sabock said. "I didn't know about [12-step programs] until I went to rehab the first time. By that time it's already too late."

There are signs that Sabock's efforts have been having an effect, according to DeLeonardo.

"We had one school in particular, I won't identify it, but one school said that after our program, four people came in and asked for help," he said. "That's having an impact."

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How to get help

Those seeking treatment or information about treatment may call the Carroll County Health Department at 410-876-4800 for evaluations and referrals.

If you've recently overdosed and need someone to help you make a change, State's Attorney's Office Drug Prevention and Treatment Liason Tim Weber and his Overdose Response Team can be reached at 410-386-2163.

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