Saving Lives and Treating Addiction in Baltim ore City Mark O’Brien Director of Opioid Overdose Prevention and Treatm ent Evan Behrle Special Assistant to the Health Com m issioner @Bmore_Healthy Catherine E. Pugh @DrLeanaWen Mayor, Baltimore City BaltimoreHealth Leana Wen, M.D., M.Sc. health.baltim orecity.gov Commissioner of Health, Baltimore City
About the Baltim ore City Ba ltimo re City He a lth De pa rtme nt Health Departm ent City agency w ith culture of startup • History • Funding & structure Health not healthcare • 20-yr difference in life expectancy • Education • Crime • Jobs
Overdose Epidem ic in Maryland Drug and Alcohol Drug a nd Alcohol Overdose Deaths Dea ths in Ma ry la nd in Maryland 2500 • 799 in 2012 2000 • 858 in 2013 1500 • 1041 in 2014 • 1259 in 2015 1000 • 2089 in 2016 (about 500 90% involve opioids) 0 2012 2013 2014 2015 2016
Overdose Epidem ic in Baltim ore City Drug and Alcohol Drug a nd Alcohol Dea ths in Ba ltim ore Overdose Deaths City in Baltim ore 450 400 • 225 in 2012 350 • 246 in 2013 300 250 • 305 in 2014 200 • 393 in 2015 150 100 • 694 in 2016 50 0 2012 2013 2014 2015
Fentanyl is on the Rise Deadly synthetic Fenta ny l a nd Other opioid that is Ov erd ose Dea ths dozens of tim es 800 stronger than 700 m orphine and 600 heroin 500 • 4 deaths in 2012 400 • 12 deaths in 2013 300 200 • 72 deaths in 2014 100 • 120 deaths in 2015 0 2012 2013 2014 2015 2016 • 419 deaths in 2016 Other Overdoses Fentanyl-Related
Baltim ore’s Three Prong Strategy • Saving lives with naloxone • Public Education • Access to treatment
Naloxone Distribution • 25,000 people trained • 21,000 kits distributed • 950 lives saved
Don’t Die Cam paign • Public health campaign focused on the dangers of opioids and opportunity to learn to save a life with naloxone • Bus stops, buses, billboards, and metro stations • Posters in libraries, SUD providers, and other settings • Website with online naloxone training
Prescriber Education •Judicious prescribing of opioids •Co-prescribing naloxone •Avoiding combinations of opioids and benzodiazepines
Why Treat Addiction? • 2 1 ,0 0 0 + in Baltimore City use heroin • Evidence-based treatment exists: • Medication-assisted treatment (methadone, buprenorphine) & psychosocial counseling • But only 1 in 1 0 get it • Treatment cuts mortality in half & reduces crim e • For every 100 methadone patients/ year, 57 fewer break-ins, 12 fewer burglaries, 56 fewer car thefts • World Health Organization: Every $1 spent on treatment saves $ 1 2
Expanding Treatm ent Access • Buprenorphine Expansion Plan • 24/ 7 Crisis, Information, and Referral Line • Stabilization Center • Overdose Survivors Outreach Program • Work Group on Treatment Access and Neighborhood Relations
Work Group on Drug Treatm ent Access and Neighborhood Relations Co-chairs: • Don Fry, Greater Baltimore Committee • Bill McCarthy, Catholic Charities • Dr. Leana W en, Baltimore City Health Department Mem bers: • Gabe Auteri, Baltimore City Health Department • Tony Brow n, Charles Village Benefits District • John Bullock , City Council • Pam ela Davis , Baltimore Police Department • Andy Frank, Johns Hopkins University • Matt Gallagher, Goldseker Foundation • Nancy Jordan-How ard , Baltimore Development Corporation • Jon Laria, Ballard Spahr LLP • J. R. Lee, Southwest Partnership • Alan Mlinarchik, Central Baltimore Partnership • Dr. Sam Ross , Bon Secours Health System • Vickie W alters , IBR/ REACH Health Services • Crista Taylor , Behavioral Health System Baltimore
Work Group on Drug Treatm ent Access and Neighborhood Relations Objectives : 1. Engage partners in conducting a comprehensive, strategic city- level planning process , including questions around siting, certifications, and transportation; 2. Propose community-wide financial and regulatory incentive m echanism s to ensure construction of neighborhood-friendly drug treatment centers; 3. Pursue legislative and regulatory efforts to support first two goals, with intention of creating a best practice m odel to address issue on state and national levels.
What’s Next? BCHD convened a city-wide Fentanyl Task Force to make recommendations and assess capacity for a city-wide response: • 23 city and state agencies and organizations • City agencies from police and fire to Mayor’s Office of Neighborhoods and the Convention Center • Other partners including substance use treatment system and hospitals
Citywide Fentanyl Task Force Goals: • Develop a public health messaging campaign focused on dangers of Fentanyl • Train all Baltimore City agency frontline workers to administer naloxone • Implement a real-time overdose spike awareness and rapid response system
Overdose Spike Detection and Rapid Response Real-Tim e Alerts and Rapid Response • Daily updates from EMS on non-fatal overdoses • Detect spikes in overdose in census tracts • Alert the public and ask people to warn others It’s all about reacting quickly! • Re-deploy Overdose Education and Naloxone Distribution resources
Public Policy Advocacy • Eliminating the naloxone training requirement • Requiring co-prescribing of naloxone • Development of a Statewide “Hub and Spokes” Buprenorphine Treatment System • Requiring Emergency Departments to Screen for Addictions and Offer Buprenorphine Induction • Requiring the State’s Jails and Prisons to Provide Medication Assisted Treatment
Partnering with GBC How can w e w ork together? • In-kind support with opioid work • Change your insurance coverage to protect employees • Host us for a talk and naloxone training with your employees
For More Inform ation Websites • Health.baltimorecity.gov • www.dontdie.org Email and Twitter • Mark.Obrien@bhsbaltimore.org • @marklobrien Baltimore 24/ 7 Crisis, Information, and Referral Hotline • (410) 433-5175
Thank You! Questions?
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