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Overdose emergency

The announcement by state officials Tuesday that 140 Maryland pharmacies will begin stocking a medication that can reverse the effects of heroin overdoses comes at a time when deaths from abuse of the drug are rising throughout the state. Making the overdose antidote Narcan, also known as naloxone, more widely available could help save the lives of hundreds people addicted to opiates and help steer them into treatment and recovery programs. That should be the goal of the new administration that takes office in January, and we're encouraged that Gov.-elect Larry Hogan reiterated his view this week that the upsurge in overdose deaths is an urgent statewide problem that demands a statewide response.

Though Mr. Hogan has yet to announce the specifics of his plan to combat the epidemic, he has called the rise in overdose deaths a public health crisis as well as the "No. 1 problem we have in Maryland with respect to crime." He's also spoken of declaring a "state of emergency" in hopes that he might attract federal funding for more substance abuse treatment programs and public information campaigns. Whatever new initiatives his administration comes up with, he must continue to build on the progress Maryland is making toward achieving its goal of a 20 percent reduction in heroin overdose deaths by the end of 2015.

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That will require, first of all, maintaining Maryland's investment in the treatment and recovery programs it already has and expanding them wherever possible. Maryland has some of the most effective facilities in the country, but there still aren't enough treatment slots for all the people who need them. One of the reasons heroin overdose deaths have been rising in recent years is that prescription painkillers such as Oxycontin and Percocet have become more expensive and harder to obtain as a result of the state's efforts to crack down on use. When people addicted to them turn to cheaper street drugs like heroin, they often don't realize the risks they are taking by injecting impure or adulterated products.

That's why its imperative that health officials continue to promote overdose antidotes like narcan. First-responders in several jurisdictions now routinely are equipped with the medication, and thousands of people have been trained in its use. But Baltimore's police department is still studying the idea of equipping officers with the antidote even though the city still has one of the highest rates of overdose deaths.

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Another initiative that needs to be strengthened is the use of local overdose fatality review teams, which examine every overdose fatality and look for holes in the current drug safety net. They go over each case with treatment providers, first-responders, family members and others to determine what was going on with the victim and whether anything else could have been done to save him or her. Such teams have been successful in Cecil County and Baltimore City, but they need to be scaled to cover the entire state in order to reach their full potential.

The state also needs to expand the prescription drug monitoring program introduced earlier this year, which established a statewide database of prescriptions for opiod painkillers to alert physicians and pharmacists to suspicious purchases. The state health department has proposed expanding the program to require every physician to register and take a course on appropriate opium prescribing so doctors can immediately check for potential abuse online. Meanwhile Maryland must continue a broad public information campaign to educate health professionals to the signs of addiction and to the resources for addicts to get help.

There is no underestimating the value of having the governor highlight the importance of this issue and recognize it for what it is: a problem that affects urban, suburban and rural communities alike. Mr. Hogan has indicated that he will hold a summit on the problem of heroin addiction and put Lt. Gov. Boyd G. Rutherford in charge of a work group to address it. It's also crucial that he select a health secretary who is prepared to make reducing overdose deaths a top priority, as Mayor Stephanie Rawlings-Blake did in the appointment of Dr. Leana Wen as the new Baltimore health commissioner.

Mr. Hogan's appointee could go even further than what the state already is doing, for example, by ordering certain prescription pain medications off the market completely. Some communities have had success in reducing overdoses with what seem like radical solutions — Vancouver, for example, has created so-called "safe injection rooms" where addicts can shoot up in a controlled environment monitored by health professionals. Maryland may not be ready to go that far, but we hope the Hogan administration will be willing to put whatever works on the table to reduce Maryland's rising rates of overdose deaths.

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