Addressing Heroin and Opioid Abuse a Top Priority for Mayor and Health Commissioner

By: Rajani Gudlavalleti, Director, Opioid Overdose Prevention and Response BCHD & Behavioral Health System Baltimore

One day in 1997, a man woke up in the ER after experiencing a heroin overdose. He was scared and homeless, unsure of how to access services to manage his addiction. Soon after this experience, the man encountered “the nicest people in the world” at a Baltimore City Health Department Needle Exchange Van. The peer recovery staff built a relationship with this man based on shared experiences and successfully encouraged him to go into—and stick with—a treatment program that worked for him.

This April, the same man attended a community meeting of the Mayor’s Heroin Treatment and Prevention Task Force. He told his story about being in treatment and recovery for 15 years, advocating for healthier living with the support of the Needle Exchange Program. By telling stories like these in community spaces, this man and countless others can effectively reduce stigma around people with addiction and create a safer environment for people to seek support and treatment.

Addiction is a chronic, lifelong condition that can kill if not managed well. With a mission to save the lives of our community members, Mayor Stephanie Rawlings-Blake and Health Commissioner Dr. Leana Wen have made addressing heroin and opioid abuse a top priority. In October 2014, the Mayor convened the Heroin Treatment and Prevention Task Force, which aims to study the problem of heroin addiction and to propose solutions for improving access to effective treatment and neighborhood compatibility.

To ensure that we use a community approach to address heroin and opioid abuse, the Health Department and Mayor’s Office recently held two community meetings. The goal of these meetings was to share the work of the Task Force and solicit feedback from community members. Dr. Wen facilitated the meetings and community conversations, much of which focused on the topic of overdose prevention and response, including expanded access to naloxone and increasing capacity for treatment on demand.

Attendees expressed strong support for naloxone expansion, particularly in areas with high rates of overdoses, otherwise known as “hot spots.” Naloxone is a life-saving drug that completely reverses the effects of an opioid overdose. A representative from the Penn North Recovery Center suggested that naloxone be required in every building, like fire extinguishers are. Over the past few months, we have increased naloxone expansion efforts in the city and encouraged providers to make overdose response a priority. As a result, more community members are trained and equipped to reverse overdoses. Just in the past few weeks, more than 10 overdose reversals have been reported, including one by a community member near Lexington Market after they were trained by a street outreach team in the area only days prior.

Many attendees also expressed the need for increased capacity for treatment and recovery services. Judge Ellen Heller, who presides over the city’s drug court, advocated for treatment centers throughout the city to operate 24/7 and accept walk-in clients. These centers would relieve the currently over-taxed treatment system and help to ensure that people at risk of overdose can be offered immediate access to treatment at any time.

Peer recovery specialists and treatment providers in attendance strongly supported these suggestions and emphasized the need for all providers to ensure that patients are appropriately referred to mental and physical health care services. These linkages to other forms of care will greatly improve individuals’ health in recovery.

The Health Department will work with the Task Force to integrate the valuable community feedback into its report; the final recommendations will be released by the Mayor and Health Commissioner in summer 2015.

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