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Heroin crisis 'a public health issue,' health officer says

Heroin awareness signs were put up earlier this year at three sites in Harford County. The most recent updates: 84 overdoses, 10 fatal, according to the sheriff's office.
Heroin awareness signs were put up earlier this year at three sites in Harford County. The most recent updates: 84 overdoses, 10 fatal, according to the sheriff's office. (MATT BUTTON | AEGIS FILE / Baltimore Sun)

At 6:32 p.m. Tuesday, just a half hour before Harford health officials were scheduled to give their regular health update, yet another person overdosed on the deadly drug.

"This heroin thing, it's gotten more plentiful. It's gotten cheaper. Talk to your children. At 6:32 [p.m.] tonight, someone came into the Patterson Mill [fire station], and they had overdosed. It happens all the time," Councilman Jim McMahan said.

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In her update to the council at Tuesday's meeting, Harford County Health Officer Susan Kelly mentioned the new Vivitrol drug as a new tool in the county's heroin crisis. She also discussed the Zika virus and how to protect against it.

McMahan said the wave of heroin overdoses continues to sweep over Harford, as well as throughout the region.

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As of May 9, 84 people in Harford had overdosed on heroin, 10 of them fatally, according to the Harford County Sheriff's Office.

"We will never arrest our way out of it," McMahan said.

Kelly agreed, adding: "I think the community is starting to realize that you cannot lock people away and throw away the key. It's a public health issue."

She brought up the use of Vivitrol, a once-monthly, non-addictive treatment for opioid or alcohol dependence, as a significant new initiative being used in the county's Detention Center.

The drug helps those addicted to heroin avoid feeling its effects for about a month and must be used with other recovery programs, Kelly said.

Vivitrol is very expensive, about $1,100 per injection, although it is covered by insurance and the copay ends up being about $11, Kelly said.

The health department buys very little Vivitrol because insurance covers the cost, but the department can get a reduced cost for the drug, she said.

Kelly said she continues to see the effects of heroin addiction, as people come by the health department desperate to get clean but are unable to avoid the pull heroin has on them.

McMahan said in his comments at the end of the meeting: "The epidemic that is out there, I can't say it enough."

Zika virus

The mosquito-born Zika virus, which has hit South and Central America especially hard, is a source of concern for local and national health officials even though Maryland has had 17 travel-related cases so far, none of which were spread locally by mosquitoes, Kelly told the council.

The virus has caused high rates of microcephaly, a dangerous neurological condition, in newborns in Brazil, and it has no vaccine and no cure.

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The key to preventing Zika's spread is to protect against mosquitoes and prevent pregnancy for up to six months after traveling to a Zika-affected country, Kelly said.

Besides being transmitted through pregnancy, spread of the virus through infected blood and sexual contact has been reported, Kelly said.

"The state is positioning itself to prevent Zika and to control its spread," Kelly said.

Kelly urged residents to avoid mosquito bites by using repellent, air-conditioning and screens.

"Make sure everything is closed and there is not an opportunity for mosquitoes to breed," she said.

Health statistics questioned

Kelly also discussed the county's health rankings on various issues, including smoking, obesity, marijuana use, suicide and physical activity.

The county's rates of youth who smoke cigarettes, e-cigarettes, binge drink, use marijuana or report suicidal thoughts are higher than the state average, Kelly said.

The high number of young people reporting experimenting with e-cigarettes in Harford – 41.4 percent of high school-age students, versus 37.6 percent statewide – "is a big concern," she added.

Suicide mortality rates also remain significantly worse here than statewide, she said, and there has been a 142 percent increase in newborn exposure to drugs or alcohol in the past 14 years among Harford residents.

The number of drug-related or alcohol-related intoxication deaths rose by 39 percent in Harford between 2007 and 2014, while only rising by 27 percent in the state as a whole.

The rates of youth injecting illegal drugs is lower than the state average, however, and physical activity among young people is also better than the numbers statewide.

Adult obesity rates in Harford are comparable to the rest of the state, "but we would still like to see those improved," Kelly said.

Adult physical inactivity rates have improved by 8 percent over the past five years.

"We are moving in the right direction. I would like to see us move faster and we do have things in place with the community," Kelly said, mentioning programs like Healthy Harford.

McMahan, however, was skeptical about how data on issues like suicidal thoughts, drug use, obesity or physical activity could be gathered.

Kelly said the information is gathered by surveys, including surveys of middle-school and high-school students. The surveys that were done nationally were said to have a 95 percent confidence level of accuracy, she said.

McMahan also wondered why the top cause of death in Harford County in 2014 was cancer, with heart disease being second and stroke being a distant third.

He asked about a chart showing county stroke mortality rates are comparable to the statewide numbers, saying, "I thought [University of Maryland] Upper Chesapeake [Health] was highly regarded as a stroke center."

"I am just concerned that all of the charts and all of the areas [of health problems] in Harford County appears to be going up, and I would like to know why, that's all."

Russell Moy, the deputy health officer, said most other jurisdictions have heart disease as the top cause of death, so Harford is unusual in having cancer be in the lead. He said that is especially attributable to continued high rates of tobacco use, as well as factors like poor eating habits or physical inactivity.

The higher rate of tobacco use "is surprising because we are a relatively wealthy county," he noted.

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