By Nate Rabner
ANNAPOLIS—The House of Delegates Health and Government Operations Committee heard a bill Tuesday that would create a statewide consortium to combat heroin and opioid abuse.
The 26-member Maryland Opioid Use Disorder Consortium, proposed by Delegate Eric Bromwell, D-Baltimore County, would include representatives from the General Assembly, the Department of Health and Mental Hygiene, the Governor’s Office of Crime Control and Prevention, the Governor’s Office for Children, and the State Police. Deans from Johns Hopkins University; the University of Maryland, Baltimore; and the University of Maryland, College Park; as well as direct care providers; family members of people with opioid use disorders; and someone who is in recovery from opioid abuse would also serve.
“It expands the number and the type of individuals who would need to, in the long term ... be part of a sustained and coordinated effort,” said Dr. Yngvild Olsen, president of the Maryland Society of Addiction Medicine and a director-at-large of the American Society of Addiction Medicine, who testified in support of the bill. She called the consortium “a good investment in really helping to ensure that all the different pieces that are happening around Maryland are coordinated.”
Bromwell’s bill, HB896, cites Colorado as its model. An interdepartmental team in that state in 2013 called for public awareness efforts, “take-back” programs that allow people to conveniently dispose of unused medicine, and increased monitoring of prescriptions to reduce abuse.
Like Colorado, Maryland tracks the flow of prescription drugs—OxyContin, Vicodin, Xanax, Valium, Adderall, Ritalin and others—that contain controlled dangerous substances. Health care providers log their prescriptions via an online system, and pharmacists and other dispensers record the drugs they hand to patients.
Law enforcement officials can use the data to search for people who obtain prescription drugs and sell them illegally.
The crackdown on prescription drug abuse has funneled many addicts to heroin. In 2013, 464 people in Maryland died from unintentional heroin-related overdoses, and 316 died from unintentional prescription opioid-related overdoses, according to the state Department of Health and Mental Hygiene.
“As the overdose fatality rates from prescription opioids has gone down, that there is now ... an increase in the overdose fatality rates from heroin,” Olsen said. She said Maryland’s consortium would expand on the Colorado model by focusing on heroin as well—a matter of “really trying to take a model from a different state and expand it to include all the stakeholders.”
On Feb. 24, Gov. Larry Hogan introduced his own initiative to combat heroin, calling for a task force and an interagency council to unite substance abuse experts, first responders, law enforcement members and other public officials. (http://cnsmaryland.org/2015/02/25/hogan-announces-initiatives-to-combat-states-heroin-and-opioid-crisis/)
Senator Katherine Klausmeier, D-Baltimore County, who is sponsoring a companion bill to Bromwell’s, said the Maryland Opioid Use Disorder Consortium will probably merge with Hogan’s proposed group, as both deal with many of the same agencies.
“We’re all trying to do something to help the situation,” Klausmeier said. “Sometimes the right hand doesn’t know what the left hand is doing.”
She emphasized the need for a practicable plan—and soon—to prevent more deaths.
“I want an action plan as time goes on,” she said. “I don’t want a plan in the end to sit on a shelf and collect dust.”
Bill Would Increase Public Access to Anti-Overdose Drug
The committee also heard a bill aimed at increasing access to naloxone, a drug that can halt an opioid overdose.
In March 2014, the Maryland Department of Health and Mental Hygiene’s Overdose Response Program began training citizens to administer naloxone. Thus far, the program has trained 4,853 people, including 2,306 law enforcement officials, said Rory Murray, a student at the University of Maryland Francis King Carey School of Law, who wrote the bill.
But training must be supervised by a physician or nurse practitioner, and many are hesitant to help because they are worried they could be sued if a trainee administers naloxone incorrectly, proponents said. House Bill 745, sponsored by Bromwell, includes a good Samaritan clause that would allay legal concerns by shielding physicians and nurses who prescribe naloxone for trainees.
Wayne Willoughby, a member of the Maryland Association for Justice, which represents more than 1,300 trial attorneys, opposes the bill. He said the good Samaritan clause is redundant with existing law and would give malpractice immunity to doctors who administer naloxone directly as well as those who prescribe it to citizens.