Saving Lives and Treating Addiction in Baltim ore City Mark OBrien - - PowerPoint PPT Presentation

Catherine E. Pugh Mayor, Baltimore City Leana Wen, M.D., M.Sc. Commissioner of Health, Baltimore City

@Bmore_Healthy @DrLeanaWen BaltimoreHealth health.baltim orecity.gov

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

City agency w ith culture of startup

• History
• Funding & structure

Health not healthcare

• 20-yr difference in life

expectancy

• Education
• Crime
• Jobs

Ba ltimo re City He a lth De pa rtme nt

About the Baltim ore City Health Departm ent

Overdose Epidem ic in Maryland

Drug and Alcohol Overdose Deaths in Maryland

• 799 in 2012
• 858 in 2013
• 1041 in 2014
• 1259 in 2015
• 2089 in 2016 (about

90% involve

• pioids)

500 1000 1500 2000 2500 2012 2013 2014 2015 2016

Drug a nd Alcohol Dea ths in Ma ry la nd

Overdose Epidem ic in Baltim ore City

50 100 150 200 250 300 350 400 450 2012 2013 2014 2015

Drug a nd Alcohol Dea ths in Ba ltim ore City

Drug and Alcohol Overdose Deaths in Baltim ore

• 225 in 2012
• 246 in 2013
• 305 in 2014
• 393 in 2015
• 694 in 2016

Fentanyl is on the Rise

Deadly synthetic

• pioid that is

dozens of tim es stronger than m orphine and heroin

• 4 deaths in 2012
• 12 deaths in 2013
• 72 deaths in 2014
• 120 deaths in 2015
• 419 deaths in 2016

100 200 300 400 500 600 700 800 2012 2013 2014 2015 2016

Fenta ny l a nd Other Ov erd ose Dea ths

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

• ther settings
• Website with online

naloxone training

Prescriber Education

• Judicious prescribing of
• pioids
• Co-prescribing naloxone
• Avoiding combinations of
• pioids 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
• n 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
• rganizations
• 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
• n non-fatal overdoses
• Detect spikes in
• verdose in census

tracts

• Alert the public and ask

people to warn others

• Re-deploy Overdose

Education and Naloxone Distribution resources

It’s all about reacting quickly!

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?