January 30, 2021

Credit: Herald Mail-Media, Julie E. Greene

No matter what report officials look at, the number of opioid-related overdoses in Washington County was up significantly last year.

The COVID-19 pandemic has exacerbated the opioid epidemic on several fronts, said Vicki Sterling, director of behavioral health services for the Washington County Health Department.

Fewer outreach events are held and not as many participate as previously when those events do occur, Sterling said.

The stressors that lead to new or continued drug use also have increased.

Many who were in recovery lost their jobs, can’t find in-person support meetings and have difficulty with the isolation that can stem from keeping their social distance, Sterling said. Maybe they can’t see their therapist anymore or are doing telehealth appointments, which are great but don’t provide the connection some people need, she added.

Behavioral health, law enforcement and health care officials are meeting in early February to strategize what more they can do to curb the growing number of overdoses.

One possibility Sterling said she’s already considering is temporarily pulling some of her division’s peer-support specialists from other duties to help with street outreach. That could include reassigning specialists who now help pregnant addicts and aid other community providers.

Such a move could increase street outreach efforts from two to three times a week to daily, Sterling said.

During street outreach, peer-support specialists — recovered addicts trained to help others — walk around known hot spots to see if addicts need help such as Narcan or are ready to seek treatment, she said.

Grim numbers

Of the 469 heroin- or fentanyl-related overdoses the Washington County Narcotics Task Force reported for the county in 2020, 72 were fatal. That compares to 60 of 328 overdoses being fatal in 2019.

In both years, the majority of fatal overdoses occurred in Hagerstown.

Those statistics don’t include other opioid-related overdoses, such as methadone (two in 2020) and suboxone (four). There were 39 overdoses involving pills in 2020, but the report doesn’t list how many were opioids. Sterling said the pills could have include illicitly manufactured, or homemade.

According to the third-quarter report from the Maryland Opioid Operational Command Center, 78 opioid-related deaths were tied to Washington County just from January to September 2020. That’s a 37% increase over the 57 fatalities reported for that nine-month period in 2019.

There’s long been a difference between the state and county overdose reports. The state includes data from the state medical examiner’s office, so if a Washington County resident dies in another county, that shows up in the Washington County data, Sterling said.

Washington County Sheriff Doug Mullendore reiterated Thursday that he thinks the local task force figures are more accurate because the state figures include some duplication. He also said it doesn’t make sense to attribute resident overdoses to Washington County if the local resident overdosed elsewhere.

There were 468 heroin- or fentanyl-related overdoses in Washington County in 2020, according to the regional heroin program coordinator for the Office of National Drug Control Policy. The report does not account for all overdoses because there are some the group will never hear about, and some toxicology reports haven’t been released yet, Coordinator Jessica Swanson said in an email. Overdoses included in the report were documented by police or emergency medical services runs reported to the coordinator’s office.

Sterling said she believes the extended moratorium on evictions has been a factor in overdoses, though she had no direct evidence of that.

Some people enter treatment because they are being evicted or lost a job, Sterling said. Those aren’t as strong motivators now because there’s an extended moratorium on evictions, and people are getting unemployment assistance, she said.

While Community Rescue Service Assistant Chief Robert Buck said he doesn’t have evidence that stimulus checks are tied to overdoses, he finds the spike when those checks are issued too coincidental.

CRS went from getting three to four overdose calls a day to 15 or more during the weeks both stimulus checks were issued, Buck said.

Sterling said it wouldn’t surprise her if some of those stimulus checks were spent on drugs. Having money can be a trigger for an addict to seek a score, and $600 is a lot of money to someone using drugs, she said.

CRS started a pilot program in October aimed at reducing repeat ambulance calls and referring patients to other health and social resources to improve their situations. The program targets opioid overdose patients the ambulance crews treat, but who refuse to be taken to the hospital for further care.

Sterling said 11 people were referred through the program from October through December.

That’s progress, but Sterling had hoped for more referrals.

Part of the problem is the patients are transient, so there’s no fixed address or phone number to help them with follow-up, according to Sterling and Buck.

Another issue is educating ambulance crew members, Buck said. With Washington County COVID-19 metrics trending downward, Buck said he’s hoping training will increase soon.

Providing help

While local officials prepare to strategize, Congressman David Trone, D-6th, introduced two bipartisan bills last week related to the opioid crisis.

One reintroduces the proposed Family Support Services for Addiction Act. The House passed the bill last year, but Trone said then-Senate Majority Leader Mitch McConnell, R-Ky., didn’t “take it up” for consideration. Trone said he believes new Senate Majority Leader Chuck Schumer, D-N.Y., will.

The bill would create a grant program to help nonprofits that provide family support services for addiction treatment, according to a release from Trone’s office.

The other bill Trone introduced was the Preventing Mental and Behavioral Health Crises During Emergencies Act. The legislation would create a joint task force to dig into the details of the mental health tragedy that was already gripping the nation and was made three times worse by the pandemic, Trone said in a phone interview.

Sterling said most people who use drugs also have a mental health diagnosis.

The proposed task force would look for solutions and help give lawmakers information about where money needs to be invested to help address suicides, depression and anxiety, Trone said.

“We need to spend some money on things that really help people and not spend money on BS,” Trone said.