Safe Station saga reflects challenges facing Md. counties

In the midst of a deadly opioid epidemic in Maryland, Anne Arundel County’s Safe Station program has been a light in the dark, helping to connect over 830 people to resources and treatment opportunities since its launch in April 2017.

Just across the Chesapeake Bay, Talbot County has launched a similar program at its 911 center and at the St. Michael’s Police Department. But as of last week, neither of Talbot’s two facilities has had a single visitor, says the county’s emergency services director.

The contrasting experience of the two counties’ Safe Station projects illustrates some of the challenges that local governments are experiencing in battling the opioid crisis. Officials are developing programs on the fly – what works in one locale might fail in another, depending on the availability of staff, other services and the nature of the local population.

The stakes are high. The state is banking on local governments to be a critical player in the campaign. Some $4 million of the state’s overall $10 million budget for anti-opioid programs is going directly to local jurisdictions.

Besides concepts like Safe Station, counties are trying a host of approaches, said Clay Stamp, executive director of Maryland’s Opioid Operational Command Center and Gov. Larry Hogan’s point person in the fight against opioids.

One county may be hiring peer recovery specialists to interact with people who have addiction. Another might have a public awareness program, such as an art competition. Some counties are expanding crisis response by hiring staff to do follow-ups on non-fatal overdoses and reach out to people with a peer recovery specialist, Stamp said.

“We are encouraging creativity, we are identifying promising practices, and we are offering a platform for (counties) to share, but we are also doing statewide roll-out of certain programs,” he said.

Programs like this are important, Stamp said, because local jurisdictions are the first line of defense in responding to and managing the crisis.

“The local level is where the communities are, at the state level we can’t fix things largely, but we can empower people at the local jurisdictions by giving them resources to touch their communities.”

‘Saving lives every day’

In Anne Arundel county, officials decided to implement the Safe Station at all of the county’s police and fire stations.

“For Anne Arundel County (Safe Stations) have been a relatively cost-effective measure that is saving lives every day,” said county spokesman Owen McEvoy. “The cost intake side is negligible. Once you get someone in the fire station, connecting them to crisis response teams is relatively cheap.”

This is because firefighters have a lot of downtime between fires, so teams of medical and safety officers who are already trained and ready to help are readily available to help assess people who are or have been using opioids.

Once a substance abuser visits a Safe Station, he or she can be connected to treatment options. Of those who visit fire and police stations, 81 percent pursue treatment at a 60 percent rate of completion, said McEvoy.

The effectiveness of the program is one of the reasons why the rate of overdose deaths in the county have slowed. Every year, officials had been seeing 50-100 percent increases in the number of deaths, a rate that has slowed since 2017.

The program is particularly useful in urban or densely populated suburban areas where residents can walk to a police or fire station, he added, noting that some 15-20 percent of the cases are coming from Baltimore County neighborhoods where residents can walk across the county line and seek help.“The county executive thinks that any county in Maryland can do this and should do this,” he said.

‘Just another tool’

Though Talbot County’s crisis response model is similar to Anne Arundel’s in connecting addicts to treatment at the stations, officials were challenged with replicating the program to fit the county’s unique needs, said Brian LeCates, director of Talbot County Emergency Services.

For instance, firehouses in Talbot County are not staffed 24 hours a day because the county’s departments are entirely volunteer. Anne Arundel, by contrast, has professional firefighters.

Talbot County also doesn’t have as large of a drug issue, LeCates said, because there isn’t the same volume of substance abusers.

In 2016, there were 10 prescription opioid or fentanyl-related deaths in Talbot County, compared to 146 deaths in Anne Arundel County, according to an annual report by the state’s Behavioral Health Administration.

“It’s just another tool in the toolbox,” said LeCates of the Safe Station program. “Through continued ads and word of mouth we hope people will feel comfortable coming to one of these Safe Stations to get help.”

The county plans to equip EMS responders with information about the program to hand out when they respond to overdoses, LeCates said.

Fredia Wadley, the Talbot County health officer, said that opioid users also might be reluctant to use the St. Michael’s police station out of fears they may be arrested for outstanding warrants or other issues.

Ultimately, Stamp said, officials will look at local programs to develop the state’s response model. Programs such as Safe Stations, like many others across the state, have performance measures put in place to measure their success.

“It’s tough to measure success because different programs do different things,” said Stamp. “Not only are all counties different, but the impact is different as well and we need to respect that.”

This article is part of The Daily Record's special edition examining Maryland's response to the opioid crisis

Read articles in the series:
Attorney addiction | Local government litigation | Outpatient treatment | County programs | A mother's message | For-profit treatment | When to prosecute? | When to prescribe? | Employers' best practices | Rural communities' response | Opioid chief interview

Read commentary:
Maryland's courts | MSBA Lawyer Assistance Program | Using data | The good, the bad and the ugly