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I am writing to you to express my concern about alcohol and drug addiction among adults and the unfortunate state of affairs in Baltimore. I look forward to your action to make a difference as soon as possible.
Let me remind you that when the state released its 2019 report on the amount of people who died from drug and alcohol addiction between January and June, the attention was on the fact that, after years of growing difficulties, the state is experiencing another reduction in drug overdoses. But while the state claims an 11 percent drop in opioid overdose deaths from the same period last year, a deeper look at the numbers reveals that the recovery is mainly in the Maryland suburbs, not in Baltimore, where authorities say most drugs are coming from in the region (Chen et.al.,2019). The use of such drugs as fentanyl, cocaine, and alcohol is one of Baltimore’s leading causes of death.
The number of deaths from these drugs can even be compared to the homicide rate in the region. Baltimore accounts for just under half of all fentanyl overdose deaths in the state, as the city accounted for 44 percent of all fentanyl deaths in Maryland from January to June 2019. While a lot of the violence in Baltimore is related to the drug trade, the drugs themselves killed at least 180 more people than homicides in the city as of 2019.
There is no secret that much of the drug trade in the region comes from Baltimore. Federal agents have arrested several alleged drug dealers in the past year, and an FBI special agent told an audience in Anne Arundel in 2017 that “99 percent of the heroin here comes from Baltimore” (Chen et.al.,2019). Drug and alcohol problems seem to have a significant impact on the city’s fire department. The Baltimore Behavioral Health System wrote in a grant application to expand crisis response services that “approximately 77% of ambulance calls are at least somewhat related to alcohol or drug use.”
The Baltimore City Health Department and government officials and the Center for Disease Control must work closely together to create and implement an action plan to combat the problem. Baltimore’s response to opioid addiction and overdose must rely on three key pillars: overdose prevention, access to treatment, and anti-stigma education.
Expanding access to naloxone, a life-saving opioid overdose reversal medicine that can prevent deaths from opioid drug poisoning, should be a significant priority of the opioid overdose prevention effort. On-demand treatment and long-term recovery services must be made more widely available. To integrate referral services with this gap in mind, the Department of Health and local partners in Baltimore should streamline existing resources and open a 24-hour phone line for patients, family members, and providers (Wen & Rawlings-Blake, 2016). The city should also be given capital funds to construct a “stabilization” facility.
From the following, the first step toward establishing a complete 24-hour community-based ambulance service for those with substance abuse and mental health issues. According to the health department and local partners, residents should be educated about addiction as a chronic condition and encouraged to seek treatment (Wen & Rawlings-Blake, 2016). The campaign could include establishing a website, using social and traditional media, and billboards throughout the city (Baltimore City Health Department, 2016). The city should put drug collection boxes at every police station to eliminate prescription drugs from homes and communities.
State and federal assistance are still required. Although more work, remains to be done, state and federal legislation have aided and strengthened several projects in Baltimore City, including the permanent ordering of naloxone. For example, the cost of various naloxone medications has climbed from 95% to >500% in recent years, limiting local governments ability to purchase the antidote for usage by paramedics and police officers (Gupta et al., 2016). Buprenorphine prescriptions could be made more accessible if the federal government takes action. At all levels of government, a concerted, multilateral effort will be required to implement these reforms.
The Baltimore City Health Department’s motto is that every resident can save a life and that we must save lives today to assure a brighter tomorrow. It is not only a moral argument; every dollar invested in addiction treatment programs saves an additional $4-7 in reduced criminal justice and community expenditures (Wen & Warren, 2018). Baltimore now aspires to be the nation’s recovery capital and a hub for cutting-edge opioid addiction treatment and overdose prevention. This would necessitate increased efforts to prevent inappropriate opioid prescribing in the acute and subacute settings and more comprehensive and prompter treatment of drug and alcohol addiction.
References
Wen L.S., Rawlings-Blake S. (2016) Baltimore Mayor’s Heroin Treatment & Prevention Task Force Report. Baltimore City Health Department. Web.
Q. Chen, M. R. Larochelle, D. T. Weaver, A. P. Lietz, P. P. Mueller, S. Mercaldo, S. E. Wakeman, K. A. Freedberg, T. J. Raphel, A. B. Knudsen, P. V. Pandharipande, and J. Chhatwal. (2019). Prevention of prescription opioid misuse and projected overdose deaths in the United States. JAMA network open, 2(2), e187621-e187621.
Baltimore City Health Department Public Health Officials Urge FDA to Issue Warnings for Dangerous Combination of Medications Amid Prescription Drug Overdose Crisis. (2016). Baltimore City Health Department. Web.
Gupta R, Shah ND, Ross JS. The Rising Price of Naloxone—Risks to Efforts to Stem Overdose Deaths. (2016). N Engl J Med, 375(23):2213–5
Wen, L. S., & Warren, K. E. (2018). Combatting the opioid epidemic: Baltimore’s experience and lessons learned. Journal of public health (Oxford, England), 40(2), pp.107–111. Web.
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