Gov. Larry Hogan committed Thursday to spending $2 million to fight heroin addiction, and as family members of heroin addicts, we thank the governor for his continued support in fighting this epidemic. Our families have suffered not only from the turmoil resulting from the daily consequences of this disease but also the devastating effects of having children and adults in our families dying every day. Last week alone our statewide Maryland Heroin Awareness Advocates (MHAA) network has reported five heroin overdose deaths: two in Southern Maryland, one on the Eastern Shore, one in Washington County and one in Frederick County.
While $2 million is a nice gesture, we are concerned about how it will be spent and how families will benefit.
Our concerns consist of the following:
1. Some family members have been trained to administer Narcan — essentially a heroin overdose antidote — but many more need training. Those of us who are trained are finding it a challenge to identify a doctor who will prescribe the drug. One of our mothers was able to get 100 kits to distribute to others as we train them, but she had to bear the cost on her own. We, the family members, need to be recognized as first responders like the medical and police community. Kids are overdosing in their homes, and it is the parents who are able to administer the drug before 911 is even called.
2. The Good Samaritan Act was passed again this year with more amendments, but there are many adults and adolescents who may witness an overdose and are not aware of the law — which protects them from prosecution if they speak out — and as a result they fail to call 911. A public awareness campaign is greatly needed and should be strategically thought out. Many other states are doing this well.
3. It's unclear how the state and treatment providers define high quality treatment services. What do they think high quality should look like? How does that differ from what we are currently seeing and how will that change?
4. We would like to know what our current treatment capacity is. For example, how many outpatient programs do we now license vs. how many inpatient services (residential vs. medical assisted treatment), and does this meet the needs of the individuals who are currently seeking treatment? What exactly are the services these programs provide? How, specifically, will this $2 million make a difference in providing better access? There seems to be very inconsistent treatment of heroin and needle possession policies in this state, and, meanwhile, absolutely little or no access to counseling or Narcotics Anonymous or Alcoholics Anonymous meetings for a person with a co-occurring disorder in the detention centers.
5. We would like to know that all clinicians and programs will be clinically competent to care for individuals with co-occurring substance use and mental disorders and that there will be a measurement to demonstrate their level of competency. Right now, there is no consistent effort to increase research based or evidenced based instruments to make this determination even though the Behavioral Health Administration is allowing many providers to advertise themselves on its website as providing co-occurring services. National statistics tell us that out of all the people we treat, 70 percent of them have a co-occurring disorder.
6. All clinicians and programs must demonstrate that they are truly integrated according to nationally accepted standards such as integrated screening instruments, etc., along with a process to measure outcomes. There is little being done in reference to true integration, and there is no high caliber data collection system in place to collect these measures accurately.
If $2 million is going to be spent, then taxpayers and families with this disease deserve to see a detailed plan that supports good outcomes and shows evidence that their money is being spent well. What we've seen so far is way too general and with no room for accountability.
Patricia B. Miedusiewski, is a former DHMH state program administrator for co-occurring disorders, and a founder of the Maryland Heroin Awareness Advocates along with Carin Callan Miller And Ginger Rosela. Other MHAA members also contributed to this piece: Beth Schmidt, Lisa Rippeon, Carol LoSchiavo, Annette Cooney, Caressa Flannery, Anne Hott, Tina Canter, Gayle Petersen, Debbie Fling, Ramie Bruguera, Terri Paddy, Jennifer Naylor, Sherri Hamby, Wendy Messner, Melissa Eppinger, Penny Glasgow. They may be reached at carin.miller@comcast.net.