Maryland's opioid approach isn't working. Here's what could

Clearly, the efforts taken to curb the opioid death rate, however well intended, have not worked. Continuing current policies will bring the same results: more deaths, more disease, more crime and no drop in the opioid death rate. It’s time for a change.

I serve on the Maryland legislature’s Joint Committee on Behavioral Health and Opioid Use Disorders, and we learned that there are a number of other steps that can be taken. Unfortunately, these have been overlooked, underfunded or — worse — misrepresented for political gain.

Here are several strategies, each one proven effective:

Treatments of all types must be immediately and readily available, including faith based, long-term care and medications like methadone and buprenorphine. Different treatments work for different people; one size does not fit all. There are too many barriers to obtaining care, and addiction counselors can guide individuals to the program that suits each individual best. Every dollar spent on treatment saves $7 in downstream expense.

A detailed analysis from the Johns Hopkins Bloomberg School of Public Health showed that Supervised Consumption Facilities (SCF) are effective. Persons with substance abuse disorders who access these services “take better care of themselves, use their drugs more safely, and have better access to medical, social and drug treatment services compared to [users] who do not.” Further, these facilities “would translate to considerable medical and social cost-savings.”

Shamefully, for purely political gain, some have characterized these facilities as “bringing opium dens to your neighborhood.” Nothing could be further from the truth. Data clearly show that with the development of SCFs, crime goes down, discarded needles are reduced and more people get into treatment; there are also no overdose deaths reported in SCF because trained rescuers are always available. Experts, like Baltimore County State’s Attorney Scott Shellenberger and others, note that “upwards of 85 percent” of crime in our metro region is drug related. With Baltimore in crisis as the per capita murder capital of the U.S. and ranked second in violent crime rates, proven methods like SCF should be employed now.

Many people get hooked on drugs because of pain issues. Fortunately, Maryland now has a medical cannabis program that is helping. But medical cannabis can also help treat addictions directly. Legislation to allow this did not pass in 2018, but it is my hope that it will be re-introduced and enacted in 2019.

Last, we cannot continue to criminalize drug users. That’s been the core of the approach in the U.S. for decades, and it has not worked. If it worked, we wouldn’t be in the mess we are in now. Filling jails with users has only led to more problems in jails and upon release. Instead, those picked up for possession of small amounts of drugs ought to receive a civil citation and direction to treatment instead of a criminal conviction. Criminal convictions only serve to mark people for life and limit their ability to get education, job training, employment, housing, health care and a return to normal society. In other countries that have done this, addiction rates have gone down, and the heavy costs society pays for the multiple harms of addiction have been reduced. Just as Prohibition did not solve alcoholism, ending it did reduce toxic deaths and widespread crime.

It's time for new approaches. Otherwise we will be reading the same sad statistics again next year.

Dr. Dan K. Morhaim is a physician and Democrat representing Baltimore County in the Maryland House of Delegates. His email is dan.morhaim@house.state.md.us.

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