Recommendations From Baltimore's Heroin Task Force

Members of the Task Force underneath the new banner, Dr. Wen at the podium.

Like many large US cities, Baltimore sees far too many of its residents die from heroin overdose. But it is also a city that tries to lead the curve and address the problem. Just a few days ago, under a banner touting "Dontdie.org, Mayor Stephanie Rawlings-Blake released the recommendations of the MAYOR'S HEROIN TREATMENT & PREVENTION TASK FORCE REPORT. Other speakers at the press conference, besides the mayor, included Health Commissioner Dr. Leana Wen, Rep. Elijah Cummings and representatives from various treatment and recovery resources.

David Z., who spoke about his experiences in heroin recovery for more than ten years, was probably the most compelling speaker. His thanks went primarily to the kindness of a stranger and the City's NEEDLE EXCHANGE PROGRAM. Currently, David has been clean for fifteen years.


These are the recommendations of the Task Force:

1. Develop dashboard for ongoing monitoring to obtain real-time data for number of people with substance use disorders, near-fatal and fatal overdoses, and capacity for treatment.

2. Implement citywide heroin overdose plan to save lives of our citizens. This plan includes developing targeted treatment and preventive interventions for those at highest risk for overdose and ensuring widespread dissemination of the opioid antidote naloxone.

3. Develop a centralized, easy-to-access intake that is 24/7, with immediate access to an addiction counselor or social worker, and publicize to all (including emergency departments, emergency personnel, peer networks, and community members).

4. Increase data-driven, high impact options for treatment. This includes universal case management and access to treatment for most vulnerable individuals in the city such as inmates and the recently incarcerated, as well as increasin availability of evidence-based treatment, such as buprenorphine.

5. Ensure treatment on demand. This includes work towards a 24/7 "no wrong door" treatment center for addiction and full capacity for treatment in both intensive inpatient and low-intensity outpatient settings.

6. Develop voluntary certification and review for substance use providers based on core standards of care. This includes a pilot to test and refine best practice standards with key volunteer providers in Baltimore City.

7. Facilitate an ongoing partnership and collaboration among key stakeholders to pilot programs, test economic incentives, and discuss integration with state/federal systems of care.

8. Develop standardized good neighbor agreement and establish best practices for substance use disorder providers and community members (including such issues as loitering, cleanliness, security, community advisory committee, and voluntary agreements).

9. Coordinate efforts with treatment providers and law enforcement. This includes preventing targeted drug sales to vulnerable individuals undergoing addiction treatment; working collaboratively to obtain help for people with behavioral disorders; and increasing support for Drug Treatment Courts and other diversion programs.

10. Implement comprehensive strategy to educate and inform residents, businesses, and other key stakeholders about substance addiction to help reduce fear and combat stigma. This includes launching a campaign to educate citizens that addiction is a chronic disease and to encourage individuals to seek treatment.

When Rep. Cummings reached the podium, he brought up the most recent issue that has come up for municipalities and governmental agencies. The price of naloxone suddenly rose from $97 to $370 per unit. This cost increase would reduce access to this vital drug, which is needed to save lives from the dangerous effects of an overdose, He has promised an investigation into this occurrence, along with a pathway to reduce the costs, again, through his congressional work.

Mayor Stephanie Rawlings-Blake at the podium.

Certainly, the provisions of this recommendation reflect state-of-the-art in treatment and is multi-faceted. It comes at a time that deaths from heroin overdoses have risen drastically, and promises to be life-saving to those who have become vulnerable to heroin addiction.

Rep. Elijah Cummings speaking about increased costs of naloxone.

Thanks to this blog post from B'healthy B'altimore, authored by Sarah Ceponis, Kelleigh Eastman, and Wes Williams: https://bhealthyinbmore.wordpress.com/2015/07/16/dont-die-baltimores-heroin-task-force-unveils-recommendations/.

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