Report details more than 2,000 deaths from overdoses last year
Baltimore, MD (June 8, 2017) – The Department of
Health and Mental Hygiene today released the 2016 Drug- and Alcohol-Related
Intoxication Deaths in Maryland Report. The report found that 2,089 people died
from overdoses last year, a 66 percent increase from 2015’s data. The largest
surge was seen in residents 55 and older.
overdose crisis in Maryland is driven by a number of factors, and we’re
committed to employing numerous approaches to reverse this grim tide,” said
Health and Mental Hygiene Secretary Dennis R. Schrader. “We want the deaths to
cease, and we need those who use drugs to seek help before they feel compelled
to use again.” Marylanders can find treatment resources at MdDestinationRecovery.org, BeforeItsTooLateMD.org, and the state crisis hotline, 1-800-422-0009.
annual report describes trends in the number of unintentional drug- and
alcohol-related intoxication deaths, commonly referred to as fatal overdoses,
occurring in Maryland between 2007 and 2016. Fighting substance-use disorder
and the opioid epidemic in Maryland has been a major priority of Governor Larry
Hogan’s administration. Earlier this year, he declared a state of emergency in
Maryland to raise awareness of the crisis and to rally resources with increased
urgency. He also formed the Opioid Operational Command Center to cut red tape
and enable state and local agencies coordinate and share information more
continuation of this epidemic is the impetus for our daily work to better
coordinate state and local emergency and health resources to save lives,” said
Clay Stamp, who leads the command center.
findings from the report, posted at https://goo.gl/zh35WC, include:
The increase in the number of drug- and
alcohol-related intoxication deaths between 2015 and 2016 is the largest
single-year increase that has been recorded in Maryland. The number of
intoxication deaths has more than tripled since 2010.
The increase in fatal overdoses has been
most rapid among individuals 55 and older. The number of deaths among this age
group increased five-fold between 2010 and 2016, from 86 to 424.
· Eighty-nine percent of all intoxication
deaths that occurred in Maryland in 2016 were opioid-related.
Opioid-related deaths include deaths related to heroin, prescription opioids,
fentanyl. The number of opioid-related deaths increased by 70 percent between 2015
and 2016, and has nearly quadrupled since 2010. Non-opioid-related drug deaths
have also been increasing, but at a slower rate. Large increases in the number
of heroin and fentanyl-related deaths were largely responsible for the overall
rise in opioid-related deaths. Between 2015 and 2016 the number of
heroin-related deaths increased by 62 percent (from 748 to 1,212), and the
number of fentanyl-related deaths more than tripled (from 340 to 1,119). The
number of prescription-opioid related deaths increased by 19 percent (from 351
to 418); many of these deaths occurred in combination with heroin and/or
Carfentanil, a drug even deadlier
than fentanyl, has recently begun to contribute to the fatal overdose tally.
The department’s Office of the Chief Medical Examiner has begun including
screens for carfentanil during that office’s autopsy exams.
Health and Mental Hygiene continues
to collaborate 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
implemented several major initiatives to combat the opioid overdose epidemic:
1. Reimbursement for federally funded residential substance use
treatment, beginning on July 1. Maryland Medicaid was the third state in the nation to be
granted a waiver from the federal Centers for Medicare and Medicaid Services to
provide these services with federal Medicaid dollars. Since receiving this
waiver, the state has been actively engaging with the provider community about
the implementation of this effort through several public forums including the
Medicaid Advisory Committee, Engagement with local health officers and their
substance use partners, legislative hearings, and the Behavioral Health
Advisory Council. The expansion, solidified in the program’s federally approved
waiver, will enable providers to receive previously denied federal Medicaid
reimbursement, an obstacle that contributed to the opioid crisis here. Maryland
Medicaid – backed by Maryland Gov. Larry Hogan – applied for a waiver (or an exception) from that federal
restriction, to be able to win treatment options for more Marylanders.
The IMD Waiver will expand Medicaid reimbursement to include adult
residential substance use disorder treatment July 1, 2017. The Department is
phasing in such additional services as residential substance-use disorder
services for pregnant women with children, drug-exposed newborns, individuals
involved with the child welfare system and 8-507 treatment services January
2018; it will incorporate halfway houses in January 2019.
partnership with all eight of its HealthChoice managed care organizations, the Maryland Medicaid program also is working
to reduce opioid misuse, dependence, overdose and death in both Medicaid
fee-for-service and HealthChoice managed care programs. This amplifies
Medicaid’s urging of providers to:
non-opioids as first-line treatment for chronic pain,
naloxone to patients who meet certain risk factors;
thorough substance use disorder screening prior to prescribing opioids;
patients to treatment that are identified as having a substance use disorder;
the Department’s Prescription Drug Monitoring Program for all Controlled
Dangerous Substance prescriptions.
month, Medicaid implemented a payment policy for community-based
Medication Assisted Treatment (MAT) – a clinical intervention that combines
the use of medications and reimbursement rate to include a $63
per-week-per-patient bundle for methadone maintenance, and the ability for
Opioid Treatment Programs (OTP) to bill for outpatient counseling separately,
as clinically necessary.
has expanded access to naloxone,
a life-saving drug that reverses opioid drug overdoses. On June 1, 2017, Health
and Mental Hygiene’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
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.
Good Samaritan Law
provides protection from arrest, as well as prosecution, for certain specific
crimes and expands the charges from which people assisting in an emergency overdose
situation – such as administering naloxone – are immune.
opioid addiction often has its roots in prescribed medication, Health and
Mental Hygiene continues to provide guidance to prescribers in efforts to
help them manage patients’ chronic pain without resorting to prescription
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. By reviewing the patient’s
prescription history, prescribers can make an informed decision about
prescribing a controlled and dangerous substance.
increase the early identification of those at risk for substance use disorder, the
Department has been employing 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 in 53 community primary care centers and
ten hospitals in 15 jurisdictions across Maryland with the expectation of
screening at least 90,000 individuals.
who die from overdoses often have histories of admission to hospitals’
emergency departments for nonfatal overdoses, the department also has been
working to intervene after Marylanders survive an overdose. The Overdose
Survivors Outreach Project connects overdose survivors in hospital emergency
departments with community peer recovery specialists, who assist them in
enrolling in substance-use disorder treatment and obtaining support services.
Peers are working within select emergency departments and in communities across
the state to assist substance users and their families with engaging in recovery.
This project started in the fall, 2016, at four hospitals. To date, 53 percent
of those referred to treatment through the community peers have enrolled in
who need help finding substance-use-disorder treatment resources should visit MdDestinationRecovery.org, BeforeItsTooLateMD.org, 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 substance use disorder and overdose in Maryland, see http://goo.gl/KvEzQw. If you know of someone in need of treatment for a
substance use disorder, treatment facilities can be located by location and
program characteristics on our page at http://goo.gl/rbGF6S.
201 W. Preston Street, Baltimore, MD 21201-2399
(410) 767-6500 or 1-877-463-3464