Gov. Larry Hogan outlined a package of anti-heroin proposals Tuesday — including strict limits on doctors' ability to write prescriptions for the opioid pills that can turn patients into addicts.
Hogan also proposed stiff penalties for dealers who supply deadly drugs and created a new command center to coordinate authorities' response to what he acknowledged is a worsening crisis.
"It's getting more and more dangerous and it's evolving as a crisis," Hogan said at a news conference at the Anne Arundel Medical Center.
The prescription proposal would limit doctors to providing an initial week's supply of opiates, with some exceptions for patients in hospice care and undergoing cancer treatment or treatment for substance abuse.
Such measures have faced opposition in other states from doctors who object to legal limits on the care they can provide, but Massachusetts, New York and a handful of other states adopted limits last year.
Gene Ransom III, head of Maryland's medical society, said its position would depend on the details of Hogan's proposal. But he said doctors are concerned about losing flexibility to deal with exceptional circumstances.
"We generally do not like these types of mandates," Ransom said. "We need to understand what he's proposing and why he's proposing it."
Hogan tasked Lt. Gov. Boyd Rutherford in 2015 with leading a heroin task force and moved last year to implement a suite of its recommendations — including new criminal laws and expanded monitoring of prescriptions.
But the crisis shows no sign of abating. Twice as many people died from opioid overdoses in first half of 2016 as in the same period in 2015. Hogan pointed to increasing illicit use of fentanyl — an incredibly powerful opiate — as bearing much of the responsibility for the mounting death toll. "It's killing people left and right," he said.
Steve Schuh, the Anne Arundel county executive, said five people die from opioid overdoses in his county every two weeks, more than double the rate when he first came into office. County officials have taken multiple steps to try to tackle the problem, Schuh said, with limited results.
"Despite all that effort, all that energy, it's not working," said Schuh, a Republican.
Rutherford said the administration's plans also include legislation that would impose a 30-year prison sentence on dealers who supply drugs that cause an overdose death. A similar measure previously failed to pass in the General Assembly.
While many of the governor's ideas require legislation, he signed an executive order Tuesday creating an "opioid operational command center."
Doug Mayer, a spokesman for Hogan, said the command center would gather data to quickly identify trouble spots and could send out emergency response teams if, for example, one part of the state experiences a spike in overdose deaths.
The command center won't have access to people's personal medical information, officials said, but they are looking for ways to securely share that data among health agencies so that providers can intervene in individual cases.
"There are a lot of resources already on the ground — they just need to be better coordinated," Mayer said.
Democrats in the General Assembly are working on their own package of ideas. Del. Eric Bromwell, vice chairman of the Health and Government Operations Committee, said members of both chambers have been meeting to come up with ideas but were not yet ready to share details.
"It's all hands on deck. Everybody's doing everything we can," the Baltimore County Democrat said.
House Speaker Michael E. Busch said that the governor's ideas would fall short of stopping the crisis and that any answer to the problem has to begin with treatment.
"That means an investment of money," Busch said, suggesting that contractors could be hired to treat addicts. He did not offer specifics of how that would be paid for.
The problems have touched the families of some of the state's top officials. Hogan has said a cousin died of an overdose and Anne Arundel County State's Attorney Wes Adams revealed Tuesday that his wife's brother died of an overdose this month.
Adams said his brother-in-law had been through several bouts of treatment and had been clean for 99 days.
"He was very invested in his recovery," Adams said. But after leaving a Narcotics Anonymous meeting he relapsed, overdosed and died, Adams said.