Maryland is one of the states that has been worst hit by the national opioid crisis. The state ranked 14th-highest in overdose death rates in 2015. In 2016, according to the Maryland Department of Health and Mental Hygiene, 1,856 Marylanders died from opioid overdose. Thousands of Marylanders died from heroin and fentanyl overdose, and more than 400 died from prescription opioid overdose.
The epidemic is gaining ground quickly. Not only did 2016 mark the sixth year in a row that drug overdose deaths increased in Maryland, but it was also the year of the highest increase in drug- and alcohol-related intoxication deaths, with deaths up 66 percent between 2015 and 2016.
Maryland’s opioid epidemic has become so widespread that Gov. Larry Hogan declared a state of emergency in February 2017. The state of emergency will increase first response, public health, and treatment funding related to the opioid epidemic.
Opioid addiction — particularly heroin addiction — has long been a problem in Baltimore.
Opioid use isn’t limited to the city, however. Opioid deaths have started to rise in areas outside Baltimore. In Kent, Talbot, Wicomico and Worcester counties, on the Eastern Shore, opioid overdose deaths doubled or tripled between 2015 and 2016.
The opioid surge in rural parts of the state has strained resources. During 2016 and 2017, Western Maryland Health System, a major health care provider in Allegany County, reported spending $1.5 million on unexpected costs for medical care related to opioids. First responders struggle to keep up with a surge in calls and often struggle to fulfill other duties.
“[Opioid response] eats up a lot of resources,” Craig Robertson, the Allegany County sheriff, told Herald-Mail Media. “It takes away the ability for us to do normal law-enforcement functions like checks on high-crime areas and speeding enforcement.”
One Marylander, Amanda Ashley, was prescribed the opioid oxycodone as a teen after she was injured in a car accident. Unfortunately, she soon found herself struggling with opioid addiction. Eventually, Ashley started using heroin.
Amanda’s story isn’t unique. According to a study published in the journal Substance Abuse and Rehabilitation, 39.8 percent of heroin users reported problematic prescription opioid use before they started to use heroin.
Some people who have become addicted to prescription opioids make the switch to heroin because the prescription drugs are much harder to obtain than cheaper, more abundant heroin. In recent years, doctors and pharmacists have learned about the growing opioid epidemic and become reluctant to prescribe large amounts of prescription painkillers.
People who become dependent on prescription painkillers may visit multiple doctors to obtain the drugs. Eventually, they run out of providers or run low on money and switch to heroin. According to the state health department, the rise in prescription opioid deaths between 2012 and 2016 is “in large part a result of the use of these drugs in combination with heroin and/or fentanyl.”
Heroin is cheap, and it’s now available in every town in Maryland. Unfortunately, someone who becomes dependent on opioids can wind up hooked on an even more dangerous drug.
Maryland lawmakers have made efforts to reduce opioid prescriptions. In 2017, state health officials began requiring doctors to get authorization before prescribing some painkillers to the state’s Medicaid recipients. By July 1, 2018, Maryland doctors and pharmacists will be required to log all opioids they prescribe in the state’s prescription drug monitoring database. If a caregiver wishes to prescribe more opioids than allowed by the Centers for Disease Control and Prevention standards, they will need to obtain special permission.
At the same time, the Maryland State Medical Society, the state’s AMA-affiliated doctors’ group, has encouraged its members to prescribe fewer opioids. The Society is teaching doctors about the correct, safe uses of prescription opioids. The Society has also asked doctors and hospitals to review their prescription refills to find prescriptions that have run for too long or above necessary doses.
Local governments have begun to hold drug disposal drives. Community members can take their drugs to police stations and other public buildings. Disposal drives get unneeded opioids out of circulation and let officials get rid of them safely. In 2017, four disposal drives in Frederick County drew 5,533 pounds of prescription opioids.The Maryland opioid crisis has also drawn attention at the federal level. The acting director of the Office of National Drug Control Policy, Richard Baum, visited Anne Arundel County in November 2017 to talk with students about the opioid crisis. The visit was sponsored by the county’s Students Against Destructive Decisions program.
Prevention initiatives such as Anne Arundel County Public Schools’ program and the availability of treatment are essential to the fight against opioid addiction.