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Overdose deaths drop again – baltimoresun.com

Overdose deaths drop again – baltimoresun.com.

Officials credit better outreach and treatment

By Kelly Brewington | kelly.brewington@baltsun.com

July 1, 2009

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Deaths from alcohol and drug overdoses declined for the second straight year in Baltimore and are at their lowest level since 1995, when the city began recording the data, according to a Health Department report released today.

In 2008, 176 people died of a drug overdose in Baltimore, compared with 281 in 2007, a decrease of about one-third.

Baltimore health officials called the figures significant and noted that they come at a time when overdose rates in other cities are climbing. They said increased treatment slots, better outreach to addicts and a five-year-old program that teaches drug abusers how to avoid overdosing themselves have contributed to the decline.

“Short and sweet: Treatment works,” said Gregory Warren, executive director of Baltimore Substance Abuse Systems, the quasi-governmental agency that oversees drug treatment in the city. “There are literally hundreds of people alive today because of what’s happening.”

With the help of a $1.1 million grant from the state Alcohol and Drug Abuse Administration, the city has expanded treatment slots for heroin addicts treated with buprenorphine, which health officials contend is helping decrease overdoses.

Mayor Sheila Dixon credited the increase in treatment and said partnerships between advocates and the health department are helping improve overdose statistics.

“It’s not often that we get a lot of good news when it comes to drugs,” she said in an interview. “It’s something we should be proud about and is due to a lot of hard work on behalf of our addiction counselors and recovery workers.”

While the report signals an important shift, Warren and other drug abuse experts said the city’s decades-long drug problem is still severe and demand for residential treatment slots is so great that most facilities don’t bother keeping waiting lists.

“I think this is a human tragedy that has just been incredibly sad for Baltimore City,” Warren said. “Families have been torn apart. Neighborhoods have seen residents dying on the streets, literally.”

Some 74,000 people needed substance abuse treatment last year, according to state estimates, but Warren’s organization was only able to reach 16,000 of them, he said.

“If you were able to offer substance abuse treatment to more people, we would be able to continue this positive trend,” he said. “Of course, we’d like to get to treatment on demand. But that’s a tall order.”

In the meantime, education and outreach programs can help, said Dr. Christopher Welsh, an addictions psychiatrist at the University of Maryland Medical Center.

Chief among the city’s efforts is a program called Staying Alive, which instructs drug users how to avoid overdose, even arming them with a prescription for Narcan, which can overcome the effects of heroin, oxycodone and other opiates. The program, launched in 2004, is based on a concept of harm reduction. Addicts may never halt their addiction, but the harm of their addiction can be minimized.

When the program began, some critics said it would only help people continue to use, but there has been no evidence that it does, said Welsh.

“A lot of these people get to a point where they do want help; but you can’t get help when you’re dead,” he said. “That’s really the idea behind this. I have seen people who have been revived and it really helped them come to a point where they realized they wanted to get help.”

At a training session yesterday at the offices of Baltimore Behavioral Health in West Baltimore, instructor Nathan Fields showed a mix of clients and staff how to spot the signs of overdose, when to inject Narcan, and how to perform “rescue breathing” on a mannequin named Brad.

At the end of the session, participants received a prescription for Narcan, three syringes, alcohol wipes and a face shield for CPR.

Fields started off by dispelling myths about overdose remedies, such as burning the fingers of a person experiencing overdose, injecting them with salt water and giving them a hard slap to the face.

“Those street remedies are more damaging than the overdose themselves,” he said.

Frankie Wells, 46, of Baltimore, who is a client and a manager at Baltimore Behavioral Health, said the training helps people realize they are not powerless if they encounter someone suffering an overdose.

“Just knowing about this can save a lot of lives,” he said.

Wells, who has been clean for 15 months after using heroin and cocaine for two decades, knows the impact of overdose intimately. His twin sister died of an overdose in 1999, just a week after leaving a treatment program. People are at higher risk for an overdose when the body has not used drugs for a while.

“They found her in a tub of water,” he said. “But God does some things so that someone else can see clearly. I think he wanted me to wake up.”

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