The number of people who died from drug and alcohol overdoses in Baltimore during the past 12 years was comparable to the number murdered each year, according to a report released yesterday.
Although the number in 2006 was little changed from 1995, so-called intoxication deaths rose and then fell during that period. The city Health Department recorded 244 deaths in 2006 and 248 in 1995. In 1999, the number of deaths peaked at 321. That year, there were fewer homicides in Baltimore -305.
"It says there's been progress made but we have a long way to go," said Dr. Joshua M. Sharfstein, the city's health commissioner. "Drug intoxication deaths are unconscionably high and reducing them is a very high priority."
Drug-related deaths are a good indicator of the severity of a city's drug problem, said Dr. Eric Wish, director of the Center for Substance Abuse Research at the University of Maryland, College Park.
Despite the overall downward trend in Baltimore, deaths due to drug or alcohol intoxication increased 14 percent in 2006, compared with those in the previous year. Most of the increase was in deaths associated with multi-drug combinations.
Cocaine-associated deaths in conjunction with opioids increased more than 100 percent from 2005 to 2006 and fentanyl-associated deaths increased by 200 percent. Possible reasons include a nationwide problem of fentanyl-tainted heroin in 2006 and a lack of drug treatment.
According to the report, heroin deaths have dropped sharply since the late 1990s, but still make up more than three-quarters of the drug deaths in the city. In the meantime, methadone deaths have more than tripled since the late 1990s. There were 283 heroin deaths in the city in 1999, as compared with 150 in 2006. During the same period, methadone deaths jumped from 16 to 61.
Researchers have seen the methadone trend developing and speculate the methadone - which is considered a less dangerous alternative used to help heroin addicts stop injecting the deadly street drug - could be more available as pain clinics are prescribing it more to their patients. "We'd like to understand the methadone deaths more," Sharfstein said.
Dr. Christopher J. Welsh, an addictions specialist at the University of Maryland Medical Center, said methadone use is on the rise because doctors who used to prescribe OxyContin - which is highly addictive - have turned to methadone instead.
"Part of the issue has to do with these are very good treatments for pain but they are also highly abusable," Welsh said.
The authors cautioned against putting too much faith in their own comparisons of deaths from one drug or another because of the limitations of the data provided by the medical examiner. The report associated the death with each drug identified through toxicological analysis, even if it was unclear which provided the lethal dose.
On average, according to the report, drug and alcohol death rates among Baltimore residents are more than three times higher than in Maryland and the U.S. as a whole.