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by Jo R. Martin2:30 pmJan 27, 20170

Too few, not too many, drug treatment slots, Baltimore tells state

Maryland accepts city’s data on need as heroin crisis spirals

Above: The Mayor’s Heroin Treatment and Prevention Task Force releases a report, 2015. (baltimorecity.gov)

Last September, the state of Maryland released a report saying Baltimore had excess drug treatment capacity, enough to handle an additional 3,000 addicts.

This set off alarm bells for city health officials, for whom the “Opioid Treatment Programs in Maryland Needs Assessment Report” meant more than a bureaucratic battle over data:

At stake is funding for public treatment of nearly 25,000 opioid abusers in Baltimore, including an estimated 18,916 heroin addicts.

When the report appeared, Behavioral Health System Baltimore (BHSB), the nonprofit agency that oversees the city’s public substance abuse treatment services, initiated its own study.

Yesterday, peace was declared, when the state accepted the city agency’s conclusion that 7,300 more addicts need medically assisted treatment than the city can handle.

The state agreed to use the new data in applying for and distributing treatment funding.

“We are accepting Baltimore City’s calculation,” said Christopher Garrett, spokesman for the Maryland Department of Health and Mental Hygiene.

“The city used a different formula, one whose focus was more city-specific than the Behavioral Health Administration’s statewide considerations,” Garrett said.

Another BHSB official explained that the difference in outcomes reflects the difference in asking the questions.

“Our study puts BHA’s results into context, with an additional focus on opioid treatment programs and buprenorphine providers,” said Adrienne Breidenstine, the BHSB vice president of policy and communications.

Most Recipients from City

In compiling its report, the city used existing information on consumer demand gathered by the Baltimore Mayor’s Heroin Treatment and Prevention Task Force and the Hilltop Institute at the University of Maryland Baltimore County.

Breidenstine explained that her organization also surveyed providers to find service gaps that was not part of the state report.

She also stressed that 92% of individuals requesting services are Baltimore residents, a statistic that repudiates a common assumption that a large number of addicts from surrounding counties come to the city for treatment.

“This report reinforces what we see every day on the front lines of public health. . . an indisputable need to improve access to treatment,” said Baltimore Health Commissioner Dr. Leana Wen.

State Response to Epidemic

The rising rate of heroin use in Maryland has alarmed officials statewide.

Last year, the Maryland General Assembly enacted legislation to increase the number of practitioners certified to prescribe buprenorphine and methadone.

Although controversial, medically assisted treatment with buprenorphine and methadone increasingly is used to support opioid detox and treatment. In the detox phase, antidepressants, sedatives, blood pressure medication, and anti-inflammatory/pain drugs may be included.

During treatment, individual and group counseling, 12-step and other support programs, and social services are added.

Earlier this week, Gov. Larry Hogan and Lt. Gov. Boyd Rutherford announced a series of initiatives to bolster Maryland’s response to the epidemic, including tightening the limits on doctors’ ability to prescribe opioids that can lead to addiction.

Data from the Maryland Department of Health and Mental Hygiene provide a snapshot of the problem:

• From January to September 2016, Maryland recorded 1,468 unintentional intoxication deaths.

• During that period, Baltimore had the highest number of unintentional intoxication deaths – 481. Compared to 190 for the same period in 2015, it represented a 153% increase.

• Multiple causes for 2016 unintentional intoxication deaths statewide: heroin 918, fentanyl 738, alcohol 387 and cocaine 254. (Because overdose may involve multiple substances, individual numbers do not equal the total number of persons who died.)

• Published studies estimate each active addict affects between seven and 10 other individuals.

Jo R. Martin is a Baltimore native and journalist covering the complexities of the addiction epidemic. In March, she will launch Addiction News Network, an online independent journalism service for Maryland communities.

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