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Carroll County saw more than 40 heroin and opioid related deaths in 2015

Forty people died of drug or alcohol-related overdoses in Carroll County in 2015, according to a new report by the Maryland Department of Health and Mental Hygiene released on Thursday, underscoring the persistence of the ongoing addiction epidemic in the face of actions from local and state officials.

The bulk of those deaths were related to heroin or other opioid drugs.

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Using data from the Office of the Chief Medical Examiner, DHMH identified 22 deaths related to heroin in Carroll County during 2015, up 37.5 percent from 16 such deaths in 2014. Fatalities due to illicit use of the powerful synthetic opioid fentanyl — that is, fentanyl produced and distributed on the black market and often used to cut heroin, rather than fentanyl obtained through a doctor's prescription — increased a whopping 175 percent from just four deaths in 2014 to 11 deaths in 2015, according to the report.

"It shows just why this is such a major challenge for the county and the state, and it shows why we have to really continue to push our efforts [to combat overdoses]," Carroll County State's Attorney Brian DeLeonardo said.

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Many of the deaths were related to more than one drug — 29 percent of heroin overdoses statewide also involved fentanyl, while 24 percent also involved alcohol and 20 percent involved cocaine, according to the report — such that the number of deaths associated with each individual substance do not sum to the total number of fatalities from all substances combined. Forty people died of overdoses from any cause in Carroll, but opioids of one sort or another, be they heroin, OxyContin or fentanyl, were associated with a death more than 50 times.

The increase in heroin and fentanyl deaths in Carroll is mirrored at the state level. Maryland as a whole had 749 heroin-related deaths in 2015, up 29 percent from 578 such deaths in 2014, according to the report. Fentanyl-related deaths jumped from 186 statewide in 2014 to 340 in 2015. Of the 1,259 overdose deaths attributed to any drug or alcohol in the state in 2015, 86 percent involved heroin or opioids, according to the report.

"Maryland, like many states across the nation, has been in the midst of an opioid epidemic," Van T. Mitchell, state health secretary, said in a news release announcing the report. "Health and Mental Hygiene continues our work to try to save lives by making residents aware of the peril associated with substance-use disorder and of the resources available to treat those who grapple with this problem."

In Carroll County, a number of efforts were put into place to push back against rising numbers of heroin and opioid overdoses in 2015, including wider deployment of the opioid antidote naloxone and about $2 million in funding from the Carroll County Board of Commissioners over the next three years that allowed for, among other things, the hiring of a drug treatment and education liaison at the Carroll County State's Attorney's office.

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Despite the grim increase in fentanyl- and heroin-related deaths, efforts in Carroll to reduce them may have had a stabilizing effect, according to DeLeonardo. While heroin- and fentanyl-related fatalities did increase in 2015, some other categories decreased, with deaths related to prescription opioids such as hydrocodone or tramadol decreasing from 15 deaths in 2014 to 14 in 2015, and alcohol-related deaths dropping from nine to six deaths. While Maryland had overdoses from any cause increase from 1,041 in 2014 to 2,159 last year, Carroll County had a net increase of only two fatalities, rising from 38 in 2014 to 40 in 2015.

"The numbers are still very sobering statewide, they are sobering for our county — any of those deaths is not something that we want — but I do think it shows … that we are making a difference," DeLeonardo said. "If you didn't have the fentanyl stuff running through, our numbers overall would have dropped."

This is also what concerns DeLeonardo the most — the unpredictability of fentanyl. A synthetic opioid that is 50 to 100 times more potent than morphine, fentanyl has been showing up in batches of heroin and is so potent, many people overdose fatally before any assistance can be rendered.

"Overdose doesn't mean they just took too much. A lot of times they just took what they didn't know they were taking," he said. "You might think you are drinking a beer and what you are doing is taking a shot of Everclear. It's a dramatic difference if you don't realize that's what you are doing."

Fentanyl's unique potency also makes it unpredictable and difficult to control with the efforts that seem to be working for other drugs, according to DeLeonardo, because a single batch of heroin laced with the powerful synthetic can reverse months of prevention work and kill swiftly. This is something Carroll officials learned firsthand in December.

"I remember we were sitting there and it was the beginning of December we were like, wow, this would be a huge accomplishment if we stabilize it, if we just held the line for the year," DeLeonardo said. "Then all of sudden you get five [overdoses] that come in … you don't know that the fentanyl has arrived until people start dying."

Many of the most promising new efforts to roll back the rising number of overdoses in Carroll County did not get going until August or September of 2015, according to DeLeonardo, and he is hopeful that by the time numbers are released for the first six months of 2016, those efforts will be shown to have borne more fruit.

"A lot of this stuff, putting it in place takes time," he said. "Unfortunately, the fentanyl doesn't give us any time to get to them. That's the hard thing out of the numbers."

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