Heroin-related deaths in the county doubled between 2014 and 2015. As of late September, 23 people have died in 2016 due to heroin-related causes. Many overdose deaths involve heroin, county data shows.
The epidemic is the country's latest drug scourge, driven by spikes in addiction to prescription killers and heroin. Heroin-related deaths have jumped in nearly every county across the country, according to data from the Centers for Disease Control and Prevention.
In Howard, the resources for long-term treatment and recovery, part of a state-led fight against the epidemic, are only just catching up.
Unlike neighboring jurisdictions, the county has no residential detox facility.
Although the county has multiple treatment facilities, the county's only outpatient clinic for Medicaid and uninsured recipients who have substance-abuse disorders is closing at the end of the year after the grant that operates it expires. The clinic serves about 750 people per year.
Gavin stole his mother's jewelry and rummaged through his brother's change for dimes — even nickels. As a high-schooler, Gavin paid a 55-year-old veteran with a disability for the man's medication.
A man nearly a decade older than he, whom he then called a friend, offered him the drugs for free if Gavin acted as his chauffeur. For others, prescription drugs are just a medicine cabinet away, said Joan Webb Scornaienchi, director of HC DrugFree, a nonprofit that aims to address behavioral health issues.
HC DrugFree organizes drug take-back days every year as a part of an educational outreach campaign to purge old prescription drugs from houses.
"We've not suddenly thinking there's an opioid issue," Scornaienchi said. "We've been watching the numbers rise for years. And they will continue to rise."
In between working temporary jobs on music sets and other venues, Gavin's addiction still haunts him.
That was until her son, Matt, a Centennial High School graduate, "lost everything" to it, she said.
One friend was arrested and two friends died of overdoses, pushing her son to a tipping point.
The 24-year-old is now seeking treatment in Florida and said his mother asked his permission before sharing his story with this newspaper. When contacted by phone in Florida, Matt Harbinson said it was important for the public to know his story, which he hopes will discourage others from falling into drugs.
In hindsight, Beth Harbinson can't help but recall the symptoms. Spoons went missing in her home. Her son lost weight. His finances depleted.
"Our family doesn't really fit the picture of what this issue looks like. But now that I see this in my circles, I realize it doesn't look like anything. It looks like you and me," she said.
Her experience revealed gaps in Howard's treatment services, she said.
"I was told to go to Carroll County for detox. I wanted to get my son away from everything so he went out of state. Why there isn't a detox facility in Howard amazes me," Harbinson said.
She remembers feeling powerless when she was handed a sheet of paper listing treatment services at Howard County General Hospital several years ago when her son was receiving treatment after a car accident.
"I told them my son was using drugs. I asked, what can we do? And it felt like there was no answer," she said.
Treatment that encourages long-term recovery is critical, according to Rossman, of the county health department.
At the county's detention center, which offers detox services and treatment, the window of time for treatment is extremely narrow.
But inmates often do not stay long enough to gain long-term access to treatment, said Patricia Schupple, deputy director of the county's Department of Corrections.
More frequently, patients are using Howard County General Hospital and the emergency department to seek help for substance abuse disorders, Rossman said.
Harbinson hopes to see a more coordinated and centralized effort to fight the epidemic.
"There has to be immediate access to detox and rehab services. When somebody comes in, they're ready right then. They're not ready the next day after they've gotten the drugs again," she said.
Breaking the cycle
Breaking the cycle — a challenge for local law enforcement, fire and rescue personnel and health officials — is a long and arduous process that relies on coordination and synergy.
The county is increasing cross-departmental collaboration and is hiring a heroin coordinator through a state grant to improve coordination with the different county entities that interact directly with the crisis.
The coordinator will also centralize data on the scope of the problem and help agencies better share information — an effort that is already in progress.
Howard police have long recognized the county cannot arrest its way out of the epidemic, said Police Chief Gary Gardner.
Recently, police have begun responding to overdoses cases by providing victims and family members with information for treatment options and referrals to the health department.
Arrests related to controlled dangerous substances like heroin, cocaine and opium decreased by 33 percent between 2014 and 2015, according to data from the county's police department.
The decrease is caused, in part, by a recent state law that grants expanded protections for people who report overdoses from arrests.
"This addiction is so bad that simply stating I'm not going to use heroin anymore isn't going to work," said Gardner, who hopes to see more funding to support education and intervention with intense coaching, counseling and treatment.
In a moment, naloxone can bring back an overdose victim, and law enforcement and fire and rescue services in the county have nearly doubled its use over the last few years, according to Matthew Levy, medical director of the county's emergency services.
But the drug, a nasal spray that reverses opioid overdoses, is giving some users a new safety net to reach higher highs — enabling the addiction in some cases, said Howard County Executive Allan Kittleman.
In one case, police gave naloxone to one person seven times.
"We've saved that life, but we haven't intervened to the degree that we're going to break that cycle," Gardner said.
Prevention through education and outreach is a key first step in combating the epidemic, Scornaienchi said.
For HC DrugFree, that was part of its mission far before the epidemic made headlines. The nonprofit provides free storage boxes to lock prescription medications, a common drug starter for users.
"Parents cannot love their children enough or spend enough to keep their children alive," Scornaienchi said. "The focus has to be prevention. Get the meds out of the home once you're done with them. Parents need to know they can't say 'not my child.'"
Drema Bonavitacola agrees. An Elkridge resident, Bonavitacola tells others at drug awareness events they are not alone in the long road to recovery from addiction and coping with loss.
Bonavitacola, a former nurse and paraeducator, knows that very well.
On a sunny Sunday afternoon in September 2012, Howard County police officers came to her home to tell her and her husband, Andy, that her son, Joey, a friendly, all-star high school athlete who graduated from Howard High School, was found dead from the combined effects of alcohol, cocaine and heroin at a house in Phelps Luck.
"He hid it well. There were no signs. To me, it's just unbelievable," Bonavitacola said.
She hopes that her son's death serves as a reminder of the dangers of this epidemic.