Increased Coordination Ensures Effective Collaboration at State and Local Levels
ANNAPOLIS, MD — In the months since Governor Larry Hogan declared of a State of Emergency to combat the heroin and opioid crisis and activated the Opioid Operational Command Center, Maryland state agencies have been working together to address the epidemic impacting communities across the state. Today, the Maryland Department of Health and Mental Hygiene released its annual report for 2016 overdose data, which showed that opioid-related deaths reached a horrific number last year.
“We are working together furiously to save the lives of thousands of Marylanders,” said Clay Stamp, executive director of the Opioid Operational Command Center. “Today’s sobering statistics mean that the mobilization of state agencies and fostering of better collaboration at both the state and local level is critical.”
Operating under a heightened sense of urgency, state agencies have implemented the following initiatives, policies, and programs since the governor’s State of Emergency declaration on March 1, 2017:
Department of Health and Mental Hygiene
• Received a waiver from the federal Centers for Medicare and Medicaid Services that will expand Medicaid reimbursement to include adult residential substance use disorder treatment, beginning on July 1, 2017. The Department is phasing in such additional services as residential substance-use disorder services for pregnant women with children, drug-exposed newborns, individuals involved with the child welfare system and 8-507 treatment services in January 2018; it will incorporate halfway houses in January 2019.
• Provided guidance to prescribers in efforts to help them manage patients’ chronic pain without resorting to prescription opioids through Continuing Medical Education and the Prescription Drug Monitoring Program (PDMP). Maryland’s PDMP allows providers and pharmacists access to their patients’ history of prescribed medications so that they can make an informed decision about prescribing a controlled and dangerous substance.
• Connecting overdose survivors in hospital emergency departments to community peer recovery specialists, who assist them in enrolling in substance-use disorder treatment and obtaining support services through the Overdose Survivors Outreach Project. To date, 53 percent of those referred to treatment through the community peers have enrolled in treatment.
• Held training sessions for nearly 100 Department of Health and Mental Hygiene employees on opioid crisis and response, including what to do if someone is overdosing and how to use Naloxone.
• For more on how the Department of Health and Mental Hygiene has worked to combat the heroin and opioid epidemic, read the full press release.
Department of Human Resources
• Working with local health department officials through its local Departments of Social Services to ensure that those seeking social services are also offered addiction help.
Department of Juvenile Services
• Equipped all secure detention and treatment centers with naloxone kits to respond to possible overdoses within the facility.
• Trained all medical and nursing staff who work with the youth populations within the agency’s secure detention and treatment centers on the proper administration of Naloxone in the event of an overdose.
• Planning to equip all of its 33 community offices throughout the state with naloxone kits.
Department of Public Safety and Correctional Services
• Conducting study with the Friend Research Institute in Baltimore to provide Vivitrol, which halts cravings for opioids, to exiting inmates. The first dose is administered before leaving prison and then, they are linked to a community provider for subsequent doses.
Governor’s Office of Crime Control & Prevention
• Funded $62,958 in Naloxone Program Awards distributed to nine different sheriff/police departments throughout Maryland to fight against overdose deaths.
• Coordinated meetings with the Division of Parole and Probation training staff to identify the potential for integration of evidence-based intervention techniques.
Maryland Emergency Management Agency
• Led coordination of the state agencies that make up the Opioid Operational Command Center, which is located at Maryland Emergency Management Agency’s facilities within the State Emergency Operations Center.
• Supporting local emergency management offices that are facilitating local actions to combat the heroin and opioid crisis.
Maryland Higher Education Commission
• Summarized substance abuse education and outreach on college campuses and identified campuses that have specific policies related to the administration of naloxone.
Maryland Institute for Emergency Medical Services Systems
• Designed and produced double-sided card for emergency medical services providers to give to patients/and or family members that are treated and released.
• Provided emergency medical services and emergency department education on the opioid problem in continuing education programs statewide.
Maryland Insurance Administration
• Partnering with substance use treatment providers and insurance carriers to identify barriers and challenges in order to ease consumers’ access and admission to treatment programs and facilities, as well as to help them navigate the insurance related landscape.
Maryland State Department of Education
• Supporting community efforts through local school systems, while preparing to implement enhanced drug awareness education in compliance with recently passed legislation.
Maryland State Police
• Culminated an eight-month investigation with the indictments of more than 30 people for their involvement in a cross-border, multi-state opioid distribution ring, with the assistance of multiple police departments. For more information, read the full press release.
• Expanded its drug collection efforts in an effort to provide citizens more assistance in efforts to curb opioid abuse. All 23 Maryland State Police barracks are now 24 hours-a-day, seven days-a-week drop-off locations for unused prescription medications. For more information, read the full press release.
“The Governor’s Office of Crime Control & Prevention is attacking this crisis by utilizing data-driven decision models,” said executive director Glenn Fueston. “We are dedicated to the Justice Reinvestment Act that Governor Hogan signed into law, and my hope is that these comprehensive reforms will ensure that drug users are able to access the help and resources they need, while those that are trafficking this poison to our citizens are held accountable."
The Opioid Operational Command Center, which recently debuted its Before It’s Too Late web portal, a one-stop shop for individuals, families, educators, and health care professionals to get the educational resources they need to prevent this epidemic from spreading, has also worked to:
• Engage the Maryland Hospital Association to ensure a standard discharge protocol for non-fatal overdoses is implemented in all Maryland emergency departments—a number of hospitals have already done this.
• Coordinate with federal agencies, such as the Drug Enforcement Agency (DEA), Substance Abuse and Mental Health Services Administration (SAMSA), Centers for Disease Control and Prevention (CDC), and the High Intensity Drug Trafficking Areas (HIDTA) program.
• Provide real-time alerts at the state and local level, such as recently rapidly notifying all health, human service, and law enforcement partners throughout the state of the risk posed by the introduction of carfentanil into Maryland.
• Compile best practices from local partners all across the state to highlight what is working, identify what isn’t, and fill the gaps. For example, in Anne Arundel County, Safe Stations have been established in fire stations that are open 24 hours a day, seven days a week, to serve as resource centers for people addicted to drugs who want help. Also, the Baltimore Police Department developed LEAD (Law Enforcement Assisted Diversion), which redirects some minor drug offenders to treatment and other support services.
• Set up Opioid Intervention Teams within each local jurisdiction and supporting ideas and innovation at the local level.
"With the leadership of the Opioid Operational Command Center, we’re bringing consistency and continuity to the efforts being made at the local level," said St. Mary’s County Sheriff Tim Cameron, who serves as president of the Maryland Sheriff’s Association and as a member of the Governor’s Emergency Management Advisory Council. "It allows us to see a real picture of the challenges we’re all facing statewide and to anticipate those challenges as they evolve."
In May, Governor Hogan signed into law a strong legislative package giving the state additional tools to respond to the heroin and opioid crisis:
• The administration’s 2017 Heroin and Opioid Prevention, Treatment, and Enforcement Initiative legislation, which includes the Prescriber Limits Act of 2017 (HB 1432) that requires health care providers to prescribe the lowest effective dose of an opioid, and the Distribution of Opioids Resulting in Death Act (SB 539), which allows prosecutors to seek an additional 10 years for drug dealers who knowingly sell fentanyl and its analogs, including carfentanil.
• The Heroin and Opioid Prevention Effort (HOPE) and Treatment Act of 2017 (HB 1329/SB 967), a bipartisan omnibus bill that contains provisions to improve patient education, increase treatment services, and includes the administration’s Overdose Prevention Act, which enables all citizens to access life-saving naloxone.
• The Start Talking Maryland Act (HB 1082/SB 1060), which will increase school and community-based education and awareness efforts to continue to bring attention to the crisis and to equip our state’s youth with knowledge about the deadly consequences of opioids.
The Opioid Operational Command Center facilitates collaboration between state and local public health, human services, education, and public safety entities to combat the heroin and opioid crisis and its deadly impact on Maryland communities. Before It’s Too Late is the state’s effort to bring awareness to this epidemic—and to mobilize resources for effective prevention, treatment, and recovery.
Marylanders grappling with a substance use disorder can find help atBeforeItsTooLateMD.org and 1-800-422-0009, the state crisis hotline.