Alcohol and drug addiction have been significant public health concerns in Maryland for the past couple of decades. Since the middle of the 1990s, opioid abuse, in particular, has grown, as have the resulting health consequences.
Currently, Maryland’s drug overdose death rate is one of the worst in the United States.
According to the Maryland Department of Health and Mental Hygiene, the number of heroin-related deaths tripled between 2011 and 2015, increasing from 247 deaths to 748 deaths.
Since the early 2000s, the use of heroin and opioids for recreational purposes has increased significantly. At the same time, the rate of fatal overdoses related to drug and alcohol abuse also began to climb.
State officials recall a shift in conversation around 2006 and 2007 related to the increasing numbers of overdoses deaths caused by opiate painkillers. Initially, people that succumbed to fatal overdoses were primarily young, white, and from middle to upper economic classes. With time, however, the trend spread to include people from nearly all demographics and socioeconomic groups.
The rate of overdose deaths continues to be a serious threat in Maryland.
Fentanyl, a synthetic opioid that is 50 to 100 times more potent than morphine, is being blamed for the most recent spike in overdose deaths in Maryland. Fentanyl-related deaths doubled in the first six months of 2016 compared to the previous year. Treatment facilities in Maryland report that many of their patients were completely unaware that their drugs, including heroin and prescription pills, were laced with fentanyl, making it an incredibly dangerous substance.
As the opioid overdose epidemic continues to take lives across the country, residents of Maryland are also being impacted by opioid abuse. As of February 2018, Maryland was among the top five states in the country with the highest rates of opioid-related fatal overdoses.
Since 1999, Maryland has been above the national average for opioid-related overdose deaths. At 1.5 to 3 times the national average for fatal overdoses caused by opioid use, Maryland has an opioid overdose epidemic of its own.
In 2016, the rate of opioid-related deaths across the country was 13.3 deaths per 100,000 people. In Maryland, that number was a staggering 30 deaths per 100,000 people.
These deaths are related to the use of heroin, prescription opioids, and synthetic opioids. Synthetic opioids, most of which are fentanyl, are estimated to have caused 650 of the 1,821 overdose deaths in Maryland in 2016.
Heroin and prescription opioids have also been contributing to the rates of fatal overdoses. From 2012 to 2016, heroin was associated with an increase of 173 to 650 deaths. Prescription opioids were linked with an increase of 52 to 812 deaths.
Although the rates of opioid-related overdoses in Maryland have consistently been above the national average since 1999, the rates of opioid prescriptions written in Maryland is lower than the national average.
In 2015, there were 65.6 prescriptions per 100,000 people written in Maryland compared to the national average of 70 prescriptions per 100,000 people. Additionally, there was a 7.3 percent decline in opioid prescriptions being written in Maryland from 2013 to 2015.
The increasing rates of opioid overdoses despite decreasing rates of opioid prescriptions filled indicate a rise in production and consumption of illicitly manufactured opioids. Synthetic opioids are the leading cause of opioid-related deaths in Maryland, and this trend illustrates people’s desire for more potent and more affordable opioid drugs.
While opioid abuse is the greatest recreational drug use concern right now in Maryland, other prescription drugs are also being misused.
According to Maryland’s Behavioral Health Administration, prescription drug abuse — which includes abuse of opioids, stimulants, anti-anxiety medications, and antidepressants — is impacting the health and welfare of people across Maryland.
Maryland has witnessed many consequences of the abuse of the above medications.
Between 2007 and 2012, over 40 percent of drug-related overdoses involved one or more prescription opioids. During this same time period, admission to state-sponsored treatment programs for prescription drug addictions increased 110 percent. Admissions specifically related to prescription opioid abuse increased 116 percent, while admissions for prescription benzodiazepine abuse increased 138 percent.
At a national level, prescription drug abuse creates significant health and economic burdens. In 2008, for every fatal prescription drug overdose, there were 10 admissions to substance abuse treatment programs, 32 visits to emergency rooms for substance misuse, 130 people who reported abusing or being dependent on prescription drugs, and 825 people who reported using prescription medications for nonmedical reasons.
Excessive alcohol use is another public health concern in Maryland.
According to the 2013 Prevention Status Report provided by the US Centers for Disease Control and Prevention (CDC), excessive alcohol use is a major public health problem in Maryland as well as across the country. In the United States, excessive alcohol use is responsible for approximately 88,000 deaths every year. In 2013, 1,318 people died in Maryland due to excessive drinking, which cost the state over $4 billion.
In Maryland, binge drinking — defined as more than five drinks at a time for men and four drinks at a time for women — is a problem among adults. Eighteen percent of adults in Maryland reported binge drinking in 2013 compared to 18.3 percent of adults nationally. For adults in Maryland who did binge drink, they reported consuming an average of 7.3 drinks per occasion.
The CDC explains that binge drinking is a serious, but preventable, problem. It is the most common, most expensive, and most deadly type of alcohol abuse in the United States.
Although most people who binge drink are not dependent on alcohol, binge drinking can indicate an alcohol use disorder. In addition to the risk of addiction, binge drinking exposes people to various health problems.
The Maryland State Drug and Alcohol Abuse Council was established in 2008 to address growing public health concerns caused by drug and alcohol abuse. The council is made up of various professionals and citizens who all wish to eradicate issues of substance abuse in the state.
In response to the growing heroin and opioid crisis caused by drug abuse throughout Maryland, the governor’s Heroin and Opioid Emergency Task Force was formed in 2015. The task force aims to help individuals and families who have been devastated by the opioid epidemic.
The task force focuses on:
For people struggling with any type of substance use disorder, including addictions to alcohol, prescription drugs, and illicit substances, there are many treatment options available.
According to the National Institute on Drug Abuse (NIDA), addiction is a chronic brain disease that requires a multifaceted approach to treatment. Treatment must begin with individualized treatment planning that is based around individual needs and goals for treatment.
It may not be possible for every treatment facility to provide all of the above services, but they should at least have the capacity to make appropriate referrals to outside providers. Through the above services, treatment programs are able to assist individuals through detoxification and then address behaviors related to substance abuse in therapy.
NIDA notes that behavioral therapy is essential for maintaining long-term sobriety and positive treatment outcomes. Detoxification that is not reinforced by therapy does very little to promote recovery long term.
Additionally, effective addiction treatment meets all the needs of the individual, which includes behavioral and mental health.
If you are in search of addiction treatment options in Maryland, there are many treatment facilities available across the state that offer all levels of treatment services. Whether you are in search of an outpatient, residential, detox, short-term, or long-term program, there is one out there able to meet your unique treatment needs.
A great resource for locating treatment options near you is the Substance Abuse and Mental Health Service Association’s (SAMHSA) online Behavioral Health Treatment Services Locator. All your information is kept secure and anonymous as you search by location through SAMHSA’s database of treatment facilities.
SAMHSA’s free National Helpline (1-800-662-HELP) provides free treatment referrals and information. It is available 24 hours a day, 7 days a week.
October (2018). Alcohol and Public Health: Binge Drinking. US Centers for Disease Control and Prevention. Retrieved February 2019 from https://www.cdc.gov/alcohol/fact-sheets/binge-drinking.htm
Heroin and Opioid Emergency Task Force. Office of Lt. Governor Boyd K. Rutherford. Retrieved February 2019 from https://governor.maryland.gov/ltgovernor/home/heroin-and-opioid-emergency-task-force/
(December 2016). Maryland’s Heroin and Opioid Crisis Reaches an All-Time High. Capital News Service. Retrieved February 2019 from https://wtop.com/maryland/2016/12/marylands-heroin-and-opioid-crisis-reaches-an-all-time-high/
(February 2018). Maryland Opioid Summary. National Institute on Drug Abuse. Retrieved February 2018 from https://www.drugabuse.gov/drugs-abuse/opioids/opioid-summaries-by-state/maryland-opioid-summary
Prescription Drug Abuse. Maryland Department of Health: Behavioral Health Administration. Retrieved February 2019 from https://bha.health.maryland.gov/pdmp/Pages/Prescription-Drug-Abuse.aspx
(2013). Prevention Status Report 2013: Maryland. US Centers for Disease Control and Prevention. Retrieved February 2019 from https://www.cdc.gov/psr/2013/alcohol/2013/md-alcohol.pdf
State Drug and Alcohol Abuse Council. Maryland Department of Health: Behavioral Health Administration. Retrieved February 2019 from https://bha.health.maryland.gov/State%20Drug%20and%20Alcohol%20Abuse%20Council/sitepages/home.aspx
(January 2019). Treatment Approaches for Drug Addiction. National Institute on Drug Abuse. Retrieved February 2019 from https://www.drugabuse.gov/publications/drugfacts/treatment-approaches-drug-addiction