It's a story well-known among the members of the Carroll County State's Attorney's Office newest unit: A person overdoses. They are revived. Treatment is either refused or the person doesn't know their options. Then the person overdoses again.
The Major Overdose Initiative is designed to change that. By using the best available data to identify the people at the greatest risk of a fatal overdose, members of the State Attorney's Overdose Response team will go door to door to offer people treatment for their addictions, before it's too late.
"We have a major offender unit that focuses on our worst offenders," said State's Attorney Brian DeLeonardo. "The mindset was, let's apply that same mentality to overdoses."
In the last six months of 2016, just 17 people represented 44 non-fatal drug overdoses in Carroll County. It's those 17 people, high risk, multiple overdose victims, that represent — to mix metaphors slightly — both tough nuts to crack and low hanging fruit, according to DeLeonardo.
The Major Overdose initiative kicked off in the third week of January, focusing first on individuals who are already involved with the criminal justice system: Of the 17 high-risk users identified, six are currently on probation and another two have upcoming court dates.
Tim Weber, the State's Attorney's Office drug liaison, is the point person for the initiative. In having battled heroin addiction and overdosed in the past himself, Weber knows of what he speaks and has been heading up the Overdose Response Team, which goes to the scene of overdoses to try to convince people to get into treatment. They are not always receptive on the first try.
"They might not do it right then, but if you plant that seed in them, at some point in their addiction, when the pain of remaining the same becomes unbearable, they will change," Weber said. The Major Overdose Initiative is a way to ramp up this effort, to make it more proactive, and to take advantage of opportunities that were previously being missed — by working with people who are already on probation or awaiting court dates, Weber has a little more leverage.
"It's a captive audience," he said. "I can come to them with a different angle and say, 'I've overdosed, I've been in this position. You're not in trouble, but you're going to die. We really want to get you some help.'"
If the person refuses help, the probation officer, made aware of recent overdoses by Weber, may keep a closer eye on the person, or even require they begin treatment as a condition of their probation.
And there is always the element of planting seeds.
"One example: I went to talk to a guy who was on probation. At first, he was like, 'No, I'll be OK, I'm not going to do anything.' Two days later, we had an overdose and we were going to it, and he didn't OD, but he was on the scene of the overdose," Weber said. "Now he is trying to work his way into treatment."
Thus far, that aforementioned man on probation, a woman who was awaiting a court date and one other high-risk, multiple overdose person have been steered toward treatment by Weber in the first few weeks of the program.
In the first two weeks of February, Major Opioid Initiative will begin the next, more ambitious phase: Going straight to the door of people who have been identified as having overdosed five times or more and offering them treatment.
"We will be able to know, is it a family home? Is it a mom and dad and the kid lives there and he's living in the basement?" Weber said. "We will know the age of the person; is it a 25-year-old female? That way someone from the Overdose Response Team, like one of the girls, could go with me."
That level of specific targeting is made possible by the work of Allen Albaugh, a drug investigator within the State's Attorney's Office, who uses Carroll County Sheriff's Office Data, regional information made available through Carroll's designation as a High Intensity Drug Trafficking Area, or HIDTA, and other databases to track multiple overdoses by zip code. He also checks to see if a person has other overdose reports in other jurisdictions.
"We had one that overdosed in Carroll County the first time we saw him show up," Albaugh said. "Well, I got to checking and he had overdosed in Baltimore County twice, in Harford County, Baltimore City."
Some people in Carroll may have only shown up as having had one overdose in local statistics, but Albaugh's research into other jurisdictions has identified them as being at much higher risk of death than previously thought — they're now on the list to get a visit, and an offer of help, from Weber.
Albaugh is also looking to see who is at the scene when a person overdoses. Having the same person at multiple overdoses could indicate that the person supplied the drugs, according to DeLeonardo.
At the same time, people who show up at overdose scenes often might simply be users who need help, or friends or family members who could be enjoined to help talk to a person with substance abuse disorder about getting help, Albaugh said.
The ultimate goal of the Major Overdose Initiative is to save lives, according to DeLeonardo, but there is also the added benefit of reducing crime. To those who are not moved by the risk of death faced by people struggling with addiction, he points out that during the course of their addiction, people are victimizing others in the community.
"When somebody has a $300 a day heroin habit, I guarantee you they are not working a job making $300 a day," DeLeonardo said. "What do you think is going on?"
In September, Weber and other members of the Overdose Response Team joined forces with the Hampstead police department to go door-to-door offering treatment in Hampstead neighborhoods that had seen a lot of overdoses — a less targeted version of what is planned as part of the Major Opioid Initiative. DeLeonardo cited a Jan. 4 letter from Hampstead's Chief of Police Ken Meekins to elected and law enforcement officials noting that burglaries and thefts in Hampstead are down 33 percent since that effort, attributing that drop to the fact that at least half the people Weber got into treatment last fall are still in a program.
That is not to say that jail is never appropriate, even for those who are minor offenders. The Major Overdose Initiative is a way to try to bring people into the system and get them help before they either commit more crimes, or die, but for some, jail is part of the recovery process, Weber said.