Lt. Gov. Boyd Rutherford talks about proposed spending in Gov. Larry Hogan's upcoming budget for treatment, prevention and education on opioids. (Kim Hairston, Baltimore Sun video)
The Hogan administration announced Thursday that it wants to increase state spending on addiction treatment and substance abuse prevention to escalate efforts that have so far failed to reverse an ever-increasing death toll from opioid overdoses in Maryland.
The administration’s budget proposal for the fiscal year that begins July 1 earmarks $248 million for substance abuse services, a 20 percent increase, Lt. Gov. Boyd Rutherford said during an event in Baltimore. The plan also would increase capital spending to make room for more treatment beds across the state.
“The epidemic transcends every demographic,” Rutherford said to nearly 100 people gathered at Helping Up Mission, a shelter that treats more than 500 men in recovery. “We will continue to fight against the opioid epidemic.”
In addition to its budget plans, the administration announced a five-year, $378 million plan to build a therapeutic treatment center attached to the state-run Baltimore jail. The new facility would provide mental health and substance abuse treatment services to nonviolent offenders as they enter the jail.
The Republican governor’s spending plan, which still needs the General Assembly’s approval, also would increase funding to county jails that want to use medications to treat opioid addictions. But it does not call for using those same medications — methadone, buprenorphine and naltrexone — in state prisons, where experts say such treatment likely would have a significant impact in fighting addiction and thus reducing statewide overdose deaths.
Through the first half of 2018, Maryland recorded 1,185 opioid-related overdose deaths — 15 percent more than the same period last year. The midyear figure is the most recent the state health department has tallied. If deaths continue at that pace, as many suspect, fatalities will surpass last year’s record of 2,009. That figure ranked Maryland among the hardest-hit states as the nation recorded 48,000 opioid overdose deaths in 2017.
While overdose deaths from heroin and prescription opioids have declined, the emergence of deadly fentanyl has offset those gains.
“As the crisis has evolved so has our response,” Rutherford said.
Not enough for Del. Erek Barron, a Prince George’s County Democrat.
Barron was disappointed to see that the administration’s plan does not call for allowing medication-assisted treatment in state prisons. Barron said he plans to introduce a bill within the next week in Annapolis that will mandate such a program in Maryland’s prisons.
“That’s where we need to be if we’re serious about this opioid crisis,” Barron said.
Addiction experts say providing such medications to inmates with proven opioid addictions helps prevent overdose deaths. Prisoners who get no help are released with little tolerance, return to their normal levels of using drugs and can quickly take too much and die.
Recent evidence has shown that offering medication treatment to addicts in prison can reduce state overdose deaths overall. Rhode Island — which has had one of the worst per-capita rates of overdose deaths — in 2016 began the first and still only program in the nation to screen all inmates for opioid use and provide medications for addiction treatment such as buprenorphine. Overdose deaths among people leaving prison dropped 61 percent, contributing to an overall 12 percent reduction in the state’s overdose deaths, according to a Brown University study.
Maryland correctional officials have said they are wary of those medications, saying evidence suggests they can be misused and fuel drug trafficking problems that threaten the safety and security of state prisons.
Rutherford said people struggling with addiction in local jails typically stay for less than six months and desperately need the medication and treatment before they are released. Some local jails have already been using medication assisted treatment, he noted.
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He added that the administration wants to provide more money for shelters and transitional housing facilities across the state to help addicts find places to live when they leave detox centers, hospitals and treatment programs. The capital budget proposal earmarks $1 million to support an expansion of the Helping Up Mission. The administration has also agreed to turn over a shuttered pre-release correctional facility in Wicomico County to the local government, which plans to turn it into a treatment facility with 60 beds.
“We’re going to have it open 24 hours,” Wicomico County Executive Bob Culver said. “It’s a great partnership with the state.”
Maryland Health Secretary Robert Neall announced that the state will use $66 million in federal funds to continue distributing the overdose-reversing medication naloxone across the state, providing access to medications such as buprenorphine in emergency rooms, training more peer recovery specialists and expanding crisis walk-in centers.
Rutherford was joined by Steve Schuh, the former Anne Arundel County executive who is now Hogan’s executive director of the Maryland Opioid Operational Command Center. Schuh announced that his center will spend $2.5 million to expand public education efforts.