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Baltimore’s silent crisis: Fatal opioid overdoses 

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Much has been made of Baltimore’s violent crime crisis, especially homicides, which have been above 300 annually since 2015. Unless there is a dramatic shift, the city seems on track to see more than 300 murders again in 2021.

The city’s Police Commissioner and Mayor have pledged that addressing the homicide rate is priority No. 1. The Mayor characterizes it as a public health crisis as well as a crime crisis.

As grim and unacceptable as the homicide statistics are, the city has another ongoing public health crisis that doesn’t draw as much public attention: Fatal opioid-overdoses.

A recent report by the Maryland Opioid Operational Command Center found that last year 2,499 people died of opioid-related overdoses statewide. Of those fatalities, 954, or 38%, occurred in Baltimore, placing the city as the No.1 jurisdiction in Maryland for opioid-related deaths. Fentanyl, a synthetic opioid available by prescription and illegally, contributed to 93% of the deaths, according to state statistics.

Baltimore’s 2020 opioid-overdose fatality figure is more than two-and-a-half times the number of homicides in the city – 335 – in the same year. Yet, individual or collective opioid-related deaths typically don’t make the news.

Opioid-related deaths increased in the city and statewide in 2020, compared to 2019. The state’s Opioid Operational Command Center’s Executive Director, Steven Schuh, told the Baltimore Sun that while more research needs to be done it appears that the COVID-19 pandemic – which has resulted in isolation and stress for many – has “exacerbated the rate of fatal overdoses around the country.”

Baltimore saw a 12.1% increase in opioid-related deaths compared to 2019, while statewide it rose 18.7%. The surge is being seen in other parts of the country as well, according to the Centers for Disease Control and Prevention. It found a 29% increase in overdose deaths from October 2019 through September 2020, compared with the previous 12-month period.

Experts speculate that along with isolation, stress and depression, the pandemic has resulted in opioid-users being unable to access addiction counseling and Buprenorphine, a drug-used to treat addiction, resulting in more deaths.

Meanwhile, there’s no question the pandemic has focused a lot of the city and state’s health resources on tracking and controlling the spread of the coronavirus pandemic, which has killed more than 8,400 Marylanders since March 2020.

Still, it is important that resources be allocated that place a strong focus on addressing the ongoing public health crisis tied to opioid-related overdoses and deaths with the same urgency placed on addressing Baltimore’s violent crime.

Some experts suggest the current opioid crisis is missing the attention it needs and so increasing public awareness through a high-profile education and prevention campaign needs to be funded, perhaps at the national level.

Others have called for Naloxone (Narcan), an overdose-reversing drug, to be provided directly to known substance abusers. (Baltimore was among the first jurisdictions in the U.S. to make Naloxone available to city residents to prevent deaths.)

Other proposed solutions range from investing in more research to developing new addiction treatments to pooling resources to address the social ills that fuel opioid abuse.

Meanwhile, the Greater Baltimore Committee’s Health Care Committee determined in 2018 that employers should play a key role in helping manage opioid use and abuse, particularly among employees and their families.

A 2017 National Safety Council survey found that 71 percent of employers reported the opioid crisis impacts their workers, managers and resources. But only 19 percent said they were “extremely prepared” to deal with employees addicted or abusing opioids.

In response, the GBC developed Best Practices for Employers Managing Opioid Abuse, a set of guidelines to help employers address opioid use and abuse in the workplace to help remedy this public health issue.

Some of the guidelines include:

  • Educate supervisors on the signs of addiction and non-judgmental approaches to encourage available treatment in the context of state and federal law.
  • Require evidence-based, safe prescribing guidelines from Pharmacy Benefit Managers or limit prescriptions without prior approval.
  • Ensure that employee health care plans cover high quality mental health benefits and employee assistance programs.
  • Educate employees on the safe storage of opioids, the danger of mixing drugs and the risks of sharing drugs.

What’s clear is that recent statistics in the city and state should have alarm bells ringing. Many partners, ranging from public sector agencies to private sector companies and other organizations, must join together to raise awareness, increase research and treatment options, prevent addiction and end a public health crisis that is destroying far too many lives, families and careers.

Read the GBC’s Best Practices for Managing Opioid Abuse guide.

Donald C. Fry is President and CEO, of the Greater Baltimore Committee.