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Bills call for dramatic shift in Md. drug policy

Legislation focuses on treatment and safe, supervised drug use for addicts

Delegate Dan Morhaim.

Delegate Dan Morhaim.

A Baltimore County lawmaker is introducing legislation that will dramatically change how the state responds to people who are addicted to heroin and other drugs.

The package of four bills, sponsored by Del. Dan K. Morhaim will shift state policies to focus less on criminal punishment and more on both addiction treatment and allowing safe, supervised drug use for addicts who haven’t responded to previous treatment attempts.

The goal, said Morhaim, is harm reduction – cutting down on fatal overdoses, disease, and crime associated with the drug trade. While some drug offenders do belong in the justice system, others can be helped in ways that benefit the rest of society, he said.

“I think it’s a very rational shift in thinking,” said Morhaim, a Democrat. “The [decades-long] War on Drugs has not worked.”

Morhaim said he recognizes that the ideas are controversial and that they aren’t bills he would have thought of introducing a decade ago.

The nonprofit Drug Policy Alliance, a national organization that advocates treatment for drug use rather than incarceration, worked with Morhaim to draft the legislation.

The first of the proposed bills requires acute-care hospitals to provide addiction treatment counseling on demand and to establish arrangements to transfer patients to detox or rehabilitation programs when appropriate. The Maryland Health Services Cost Review Commission, which sets the rates for the state’s hospitals, would be required to make sure the programs were funded, according to the alliance.

Another bill decriminalizes possession of small amounts of drugs — enough for personal use — so those users are kept out of the criminal justice system. This bill follows a national trend of marijuana decriminalization and is modeled on a policy adopted fifteen years ago in Portugal; since then, that country has seen drops in drug trafficking, overdose deaths and incidence of sexually-transmitted diseases, according to the alliance.

Two new programs

The other two bills call for programs that don’t currently exist in the United States, said Lindsay LaSalle, staff attorney for the alliance.

One allows local health departments or community-based health organizations to create safe-consumption programs, where people can consume controlled substances in a safe place with sterile equipment and be connected with treatment and medical services.

Similar programs have met with success in Europe, Canada, and Australia, and have kept people from using drugs — and leaving needles behind — in public places, LaSalle said.

A 2012 report from the International Drug Policy Consortium found that “drug consumption rooms” in those countries led to decreases in overdose deaths, reductions in new HIV infections, and thousands of referrals to health and social services.

Stigmas regarding addiction, as well as concern that the programs could be seen to encourage drug use, have kept them from being adopted in the United States, LaSalle said.

The final bill calls for the creation of a pilot program for poly-morphone-assisted treatment — in which addicts for whom other treatment options have been unsuccessful are given pharmaceutical-grade heroin or other opioids under medical supervision in a special clinic.

This kind of treatment program targets “the most hardcore addicted individuals,” who put the greatest strain on public resources such as emergency-room visits and overdose treatment, LaSalle said.

By providing drugs in a clinical setting, it would cut down on illicit drug use on the streets, make sure drugs weren’t mixed with dangerous additives such as fentanyl, and eliminate the need for patients to engage in crime to fund their addictions, she said.

“It’s really a paradigm shift in how we engage people who use drugs,” LaSalle said.

The University of Maryland Department of Psychiatry has expressed interest in establishing pilot programs for the safe-consumption poly-morphone-assisted treatments, and the Johns Hopkins Bloomberg School of Public Health has agreed to provide data collection and analysis, according to the alliance.

The legislative package has earned the support of the Baltimore Student Harm Reduction Coalition, a student-run nonprofit that has fought for overdose-prevention programs and expanded syringe access, among other causes.

“These drug policy reforms will provide a long overdue restructuring of how we deal with substance abuse in Maryland,” Mark Sine, the coalition’s executive director, said in a statement.