Howard County appears to have found a way to significantly reduce in its number of fatal opioid-related overdose deaths even as those deaths grew around the state.
But the county’s success with death rates though came with a troubling trend: Even as fatal overdoses fell, the number of non-fatal overdoses the county tracks rose.
The county chalks up the decline in overdose deaths to the overdose reversal drug naloxone, also sold as the brand-name drug Narcan.
“I can say what helps us address the reduction in fatalities is the way in which we are making Narcan, or naloxone, available, the way we are making sure that every entity in the county that could respond to an individual in an overdose with Narcan,” said Carl DeLorenzo, director of policy and programs for Howard County. “That, we believe, has played a significant factor in helping reduce overdose fatalities.”
Around the state, local jurisdictions have been struggling to contain the deadly opioid epidemic. The powerful synthetic opioid fentanyl has been blamed for many of the deaths.
Last year, the state’s overall overdose numbers grew again, continuing an 8-year trend. However, preliminary numbers for the first quarter of 2019 released Tuesday showed a decline from the first quarter of 2018.
In the year’s first quarter, 515 people statewide died from opioid-related overdose deaths, down more than 14% from last year’s 4th quarter, when 601 people died. The decline is across all categories of opioid use, including a decline in deaths due to fentanyl.
Steve Schuh, executive director of the state’s Opioid Operational Command Center, warned that despite the first quarter’s strong trend, the epidemic is still ongoing.
” … the heroin and opioid crisis in Maryland is by no means over,” he wrote in the report. “The number of opioid-related fatalities in Maryland continues near all-time highs. We remain in the midst of a public health crisis of unprecedented magnitude.”
In Howard County, the rate of that decline between 2017 and 2018 depends on what numbers you look at. The county’s data suggests a drop from 52 deaths in 2017 to 37 deaths last year, a decline of nearly 29%.
State data suggest the number of deaths dropped from 47 to 37 over that same period, a decline of more than 21%. That decline continued in the preliminary first-quarter numbers released Wednesday, which showed a decline from 10 deaths in the first last year to 8 deaths in the first quarter this year.
While fatal overdoses have declined, non-fatal overdoses in Howard County have moved in the opposite direction. They were up to 188 last year, up from 171 in 2017, a nearly 10% increase.
Those numbers only include police responses to overdoses. The availability of naloxone means an overdose can happen without any sort of response from emergency services.
That can be an issue, said Mike Gimbel, a former director of Baltimore County’s Bureau of Substance Abuse, a recovering addict and a consultant at Maryland Addiction Recovery Center in Towson.
“The only reason they didn’t die was because someone used Narcan to bring them back,” he said. “We’re not getting better and solving the addiction problem. We’re just getting better at bringing people back.”
Gimbel has been critical of state and local leaders for not providing more funding for treatment.
“They’re not really helping people in terms of treatment,” he said.
Howard County hopes it is on the way to providing more treatment resources for its residents.
It currently offers 24/7 walk-in services at Grassroots, the county’s crisis center.
The county is also working on a partnership with a private treatment center to open up a Howard County location that would include a certain number of beds reserved for Howard residents.
“We have drastically increased our number of outpatient treatment providers,” DeLorenzo said. “We know that getting someone into treatment urgently is a challenge, and we don’t have any residential treatment beds in the county.”
Questions on numbers
The conflicts between Howard County’s data, the state’s data and data from other sources raise questions about how effective the response to the opioid epidemic can be when officials often deal with incomplete or inconsistent data.
The state’s data makes a determination of whether a death was “unintentional,” excluding cases like suicide and homicide from the overall numbers it releases quarterly.
Howard County’s numbers come from the police department itself, leading to some differences in the data.
Despite the inconsistencies, the county is confident that it has what it needs to address the epidemic, DeLorenzo said.
“We have the data that we need,” he said. “We always want more data, but we have sufficient data to guide our investments.”
But Gimbel worries that emphasis is being placed on the wrong numbers, with statewide and local data emphasizing overdose deaths.
“Politically it looks good,” he said. “The reality is most overdose deaths are accidental. No one wants to die. They just want to get really high.”
Daily Record government affairs reporter Bryan P. Sears contributed to this report.