2016 Maryland overdose deaths continue grim trend; 920 have died so far
Health Secretary Mitchell repeats warning about fentanyl in new PSA
Baltimore, MD (September 22, 2016) – The Department of Health and Mental Hygiene has posted to its website the second-quarter 2016 data report of fatal overdoses. From January to June, Maryland saw 920 deaths related to overdose, 319 more than this point last year. The report is posted at https://goo.gl/oNlvlz.
To help raise awareness of the role fentanyl is playing in Maryland’s overdose epidemic, the department has filmed a public service announcement in partnership with Maryland Public Television that is being broadcast on stations in Maryland. The 15- and 30-second versions of the PSA can be viewed on YouTube at https://goo.gl/vQGyOY and https://goo.gl/3uoKl1.
“We want to make sure Marylanders know that – if they are grappling with substance use disorder and are taking illicit substances – they are on the path toward overdose, possibly death, and they need to seek treatment right away,” said Secretary Mitchell.
“Fentanyl continues to be a grim factor in the scourge we’ve seen grip Maryland in recent years,” said Public Health Deputy Secretary Dr. Howard Haft. “The opioid is significantly more potent than already-deadly heroin and is sometimes added to heroin or other drugs – or replaces them altogether. This means substance users are buying and consuming fentanyl when they might think they are about to take something else. And they’re dying.”
Fighting substance-use disorder and the opioid epidemic in Maryland has been a major priority of Maryland Gov. Larry Hogan’s administration. Earlier this year, Health and Mental Hygiene released the annual report of fatal overdoses from 2015. That report logged a total of 1,259 overdose deaths occurred in Maryland in 2015. The number of intoxication deaths had nearly doubled since 2010.
In January, Health and Mental Hygiene issued a warning about seeing overdose data that suggested that a portion of the fatal overdoses were attributed to people unknowingly buying fentanyl while attempting to purchase other substances like heroin or cocaine. The department is repeating that concern.
Health and Mental Hygiene has been collaborating with federal, state and local partners to try to reduce the number of overdoses and has been combating and responding to the increase in overdose deaths. With support from Governor Hogan, the department has expanded access to naloxone, a life-saving drug that can reverse opioid-related overdoses.
In December 2015, a standing order under Deputy Secretary Haft was issued. The order allows all Maryland-licensed pharmacists to dispense naloxone without a prescription to anyone trained and certified under the Department’s Overdose Response Program. Health and Mental Hygiene has authorized 55 organizations to conduct naloxone trainings and to issue certificates, including local health departments, substance-use treatment programs, community organizations and law enforcement agencies. More than 34,165 people have been trained by these organizations since the program was established in March 2014.
The Maryland Good Samaritan Law first passed in 2013. It was updated in 2015 to include protection from arrest and expanded the pertinent crimes – such as possession of controlled dangerous substances – and also added that calling 911 would not affect someone's parole and probation status. The Overdose Response Program law and other longtime existing laws protect people who prescribe, dispense, carry and use naloxone.
Because opioid addiction often has its roots in prescribed medication, Health and Mental Hygiene last fall co-sponsored Scope of Pain, a prescriber-education seminar geared toward training providers in managing their patients’ chronic pain in ways to not facilitate addiction to opioids. Clinical provider education and resources continue to be a critical focus of the department’s addiction-prevention strategy, being achieved through Continuing Medical Education and the Prescription Drug Monitoring Program (PDMP). Maryland’s PDMP allows providers and pharmacists access to their patients’ history of prescribed medications. Providers will be required to register with the PDMP July 2017 to obtain a Controlled Dangerous Substance permit.
The Department is also expanding access to Screening, Brief Intervention and Referral to Treatment (SBIRT). SBIRT is an evidence-based tool designed to identify individuals who have the potential for substance abuse and to provide medical intervention. It has been implemented for adult patients in 22 primary care locations throughout 7 jurisdictions in Maryland (Baltimore City, Baltimore County, Prince Georges County, Montgomery County, Carroll County, Anne Arundel County and Harford County. The Department is implementing SBIRT in 3 MedStar Hospital Emergency Departments at the greater Baltimore region (Good Samaritan, Franklin Square and Union Memorial). The goal of this five-year project is to conduct 90,000 screenings in health care settings, currently over 81,000 have been screened.
Because people who die from overdoses often have histories of hospitalization for nonfatal overdoses, the department also has been working to intervene in Marylanders’ lives after they survive an overdose. The Overdose Survivors Outreach Program is an initiative to improve health outcomes for overdose survivors or those at risk for overdose by collaborating with hospitals and local health departments to facilitate interventions by Peer Recovery Specialists in the emergency department. If a patient has overdosed, or is at risk for overdose, the peer will work with the patient to assist them in enrolling in treatment or support services. If she or he is not interested in treatment, the peer will obtain consent to refer them to an outreach peer at the local health department, who will contact them via phone or field call a day or two after presenting in the emergency department, and will periodically check in to assess their needs and willingness to enter treatment. As of June 2016, four hospitals in Baltimore City are participating in this program, as are two in northern Anne Arundel County.
Maryland Medicaid also is instituting an initiative that will prioritize the role of counseling to Marylanders by facilities that provide Medicine Assisted Treatment. The process would change the Medicaid reimbursement amounts to MAT providers. Medicaid also has implemented a Corrective Managed Care program to identify participants who may be utilizing excessive quantities of controlled substances, especially when multiple prescribers and pharmacies are involved. Each month, specific participants are identified, their drug and diagnosis histories are reviewed and a determination is made whether an educational intervention letter should be sent to all prescribers and pharmacies affiliated with those participants. If intervention letters are insufficient and drug utilization does not improve, Medicaid participants can be restricted to a single pharmacy to reduce possible misuse or diversion.
Marylanders who need help finding substance use disorder treatment resources should visit http://goo.gl/nIfGm0 or call the Maryland Crisis Hotline, which provides 24/7 support, at 1-800-422-0009. For information on many of the policies currently implemented to fight addiction and overdose in Maryland, see http://goo.gl/KvEzQw. If you know of someone who could use treatment for substance use disorder, treatment facilities can be located by location and program characteristics on our page at http://goo.gl/rbGF6S.