Fentanyl Killing More Marylanders Than Heroin: New Overdose Stats

BALTIMORE, MD — Maryland's opioid epidemic continued unabated last year, and the latest fatal overdose count released Friday by state health officials showed that while prescription drug and heroin overdose deaths are down across the state, fentanyl is killing more residents than ever. Fentanyl is a synthetic opioid that is more potent than heroin and contact with just a few grains of the powder can be fatal. More than two-thirds of all overdose deaths through September 2017 involved fentanyl.

The Maryland Department of Health tally of unintentional fatal overdoses through the third quarter of 2017 shows January through September of 2017, there were 1,501 opioid-related deaths in the state, including 1,173 fentanyl-related deaths, from January through September 2017. The largest increases in overdose deaths were related to fentanyl and from cocaine use combined with opioids.

“We implore Marylanders who are grappling with substance use disorders and are taking illicit substances to seek treatment immediately, and for others to take advantage of the standing order for naloxone by learning how to administer it and carry it with them," said Health Secretary Robert R. Neall.

For the first nine months of 2017, the percentage of opioid-related deaths involving fentanyl increased from 56 percent of all opioid-related deaths in 2016 to 78 percent in 2017. "You can get a kilogram of fentanyl for about $3,500 compared to a kilo of heroin, which is running about $60,000," Lt. Jeffrey Kloiber of Maryland State Police said on June 6 while discussing the opioid epidemic on Comcast Newsmakers. He said fentanyl was coming from China.

The number of fatal cocaine overdoses increased 47 percent in the first nine months of 2017, compared to the same time in 2016. Much of this increase is due to fentanyl being combined with cocaine, often without the user's knowledge. Fentanyl was present in 68 percent of the overdoses from January through September last year.

Heroin-related and prescription opioid-related deaths started to show a slight drop in the third quarter of 2017, officials said. The number of heroin-related deaths fell by 56 percent when compared to the same period a year earlier, while prescription opioid-related deaths fell by 11 during the same period.

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The rate of fatal drug and alcohol overdoses in the state continues at an epidemic pace — especially for users of fentanyl and the even more lethal carfentanyl — say state officials, who urged users to get into treatment before it's too late.

State health officials announced two multi-media advertising campaigns to help raise awareness and combat the state’s opioid epidemic. One effort aims to overcome the stigma that prevents people from seeking much-needed treatment.” With the tagline “Less Judgment. More Compassion,” the campaign stresses that opioid addiction is not a moral failing to be judged, but rather a chronic disease that requires treatment. The campaign kicked off this week.

The second campaign, “Talk to Your Doctor,” stresses the importance of speaking candidly with your health care provider when being prescribed an opioid pain medication because the medications can be highly addictive.

Maryland has expanded access to naloxone, a life-saving drug that reverses opioid drug overdoses. On June 1, 2017, Health’s Public Health deputy secretary, Dr. Howard Haft, issued a standing order that allows pharmacies to dispense naloxone to individuals who may be at risk of an overdose or anyone who may be able to help someone who overdoses. This action is authorized through legislation signed by Governor Larry Hogan.

Naloxone safely and effectively reverses an overdose and has a low risk for adverse effects. This simplifies the previous process where it could be dispensed only to those trained and certified under the Maryland Overdose Response Program. Pharmacies play an important role in providing access to naloxone and counseling on how to recognize and respond to an opioid overdose. Fentanyl and carfentanil may require multiple doses of naloxone to be administered to help victims overdosing on those substances.

See the full state report here. Past reports can be found on this page.

SEE ALSO:

• Heroin Fatalities Up 185 Percent: Harford Sheriff
• 16 Opioid Overdoses, 3 Deaths In 24 Hours Across Anne Arundel County
• Maryland Opioid Epidemic: New Laws Tackle Addiction
• Heroin and Opioid Crisis Hits Record High in Maryland
• Heroin Crisis: Desperate Families Wonder If Anyone Cares
• Heroin Epidemic Escalates Across Maryland
• 3 Die from Heroin Overdoses in One Day: Harford Sheriff
• $3M Targeted at Fighting Maryland's Heroin Epidemic
• Heroin Addicts Dealt Hope By County Police Chief
• 'I Really Like Getting High': Anne Arundel Heroin User

On July 1, 2017, three new initiatives to further combat the opioid epidemic went into effect. First, the Maryland Medicaid policies reforming the opioid-prescribing process went into effect. This new police requires prior authorization for all high-dose and long-acting opioids issued to Maryland Medicaid recipients.

The Prescription Drug Monitoring Program went into effect, which allows providers and pharmacists access to their patients' history of such prescribed controlled dangerous substances as prescribed opioids. Prescribers are required, with some exceptions, to query and review their patient's PDMP data prior to prescribing an opioid or benzodiazepine and at least every 90 days thereafter, as long as the course of treatment continues to include prescribing an opioid or benzodiazepine.

Maryland Medicaid also began to reimbursement for federally funded residential substance use treatment. Maryland was the third state in the nation to be granted a waiver from the federal Centers for Medicare and Medicaid Services to provide treatment with federal Medicaid dollars.

State officials said last year that access to the Screening, Brief Intervention and Referral to Treatment program, already in existence in 10 hospitals will soon expand to a total of 15 facilities. The hospitals already involved are: Bon Secours Hospital, Johns Hopkins Bayview Medical Center, MedStar Franklin Square Medical Center, MedStar Good Samaritan Hospital, MedStar Harbor Hospital, MedStar Montgomery Medical Center, MedStar Union Memorial Hospital, Mercy Medical Center, University of Maryland Medical Center, and University of Maryland Medical Center Midtown Campus. The department and command center also are working to implement peer recovery support in all 15 of the hospitals.

Where to Get Help in Maryland

Maryland residents who need help finding substance abuse treatment resources should visit the Department of Health website for links to substance abuse treatment facilities. Or call the Maryland Crisis Hotline, which provides 24/7 support, at 1-800-422-0009. Marylanders grappling with a substance use disorder can find help at BeforeItsTooLateMD.org.

If you know of someone who could use treatment for substance abuse, treatment facilities can be located by location and program characteristics online.

Signs of Overdose:

• Person is not responsive.
• Fingertips or lips turn blue or grey.
• Breathing is slow, shallow or has stopped.
• Person is gurgling or making snoring noises.

What can you do if you see an opioid overdose?

• Call 911.
• If you have naloxone, give the person naloxone and perform rescue breathing.
• If no response after 2-3 minutes, give a second dose of naloxone.
• Do not leave the person alone. Help will arrive.
• If the person starts to breathe or becomes more alert, lay the person in the recovery position; put the person slightly on the left side so that their body is supported by a bent knee with their face turned to the side and bottom arm reaching out to stabilize the position.

Remember the Good Samaritan Law – save a life!

• If you provide help or assist a person experiencing a medical emergency due to alcohol or drugs, you are criminally IMMUNE from being charged, arrested and prosecuted from certain crimes. (Ann. Code Md. CR §1-210)
• The police and the courts believe that saving a life is more important than a charge or an arrest.

How can I lower my risk of overdose?

• Carry naloxone with you at all times and inform others where it is.
• If you haven't used in a while, start slowly. You are at a high risk for overdose after leaving jail, prison or the hospital or after coming out of treatment.
• Avoid mixing substances.
• Be aware that drugs vary widely in purity and strength.
• Don't use alone. If you must use alone, let people know where you are, and never the lock the door.
• Check up on each other.
• Seek treatment.

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