To the heroin addict, nothing matters more than the next fix.
“Not even your own life. And it all started because the doctor said, ‘Take this little pill,’” said Salisbury City Council Vice President Laura Mitchell, sharing how drugs tore apart her family. Her adult son is in jail and Mitchell and her husband are raising his 9-year-old son.
“Nobody is safe from this. Nobody. You’re one accident, injury, illness from being the next victim,” Mitchell told teenagers assembled in the auditorium at Parkside High School last week, before they heard Tony Hoffman speak.
Hoffman is a champion BMX racer, who fought a painful and criminal drug addiction battle. He was in Salisbury to share his story.
Following an injury, Mitchell’s son was prescribed pain pills. “Pretty soon he had to take two or three of those pills. That’s the way those pills work. It’s chemistry. It says, ‘I’m in more pain. I need more pills.’ Even when it should be getting better your brain doesn’t know that,” Mitchell said.
In Wicomico County, from January to April, there were 144 overdoses, said a concerned Lori Brewster, the county’s health officer.
It’s a growing problem.
In 2014, there were 20 overdose deaths.
The peak year for deaths by overdose in Wicomico was 2012, with 21. In 2013 there 17.
During the first nine months of 2015, there were 11.
“We haven’t completed statistics for the full year of 2015, but it looks like we will have 17 to 20. While that looked hopeful, this year, so far, we’ve had a slew of overdoses,” Brewster said.
By comparison, Worcester County had 13 overdose deaths in 2014 and Somerset County had nine. There weren’t any in Dorchester County, but Cecil, a county comparable to Wicomico, had 29.
Those who use drugs aren’t in a particular socio-economic group or educational level. Generally, their heroin problem started with an addiction to prescription drugs, provided, legally, by a doctor. When they couldn’t get more refills, heroin was the next step.
“It really has to do with access to the drug,” Brewster said.
“The individuals who are overdosing are getting older and older. It’s interesting. I look at the average age and it’s inching up,” she said.
In an effort to battle those numbers down, this week, the county kicked off its COAT program.
An acronym for Community Outreach for Addictions Treatment, the pilot program is the successful result of State’s Attorney Matt Maciarello asking city and county leaders for $125,000 in funding for addictions treatment.
Announced at a press conference in April, it is the first anti-drug program of its kind in Maryland, one that joins law enforcement agencies, government officials and Peninsula Regional Medical Center.
“There are no other COAT programs in the state. We haven’t been able to find another one in the country, none that work with law enforcement and takes data from hospitals and areas where there are repeat offenders,” Brewster said.
Plain-clothed police officers will work with peer support counselors. Police won’t be there to arrest drug users, but to help address needs.
“They will be there to guide us to where we need to go and to provide security for our staff,” Brewster said.
“We will be doing outreach in education, going out with law enforcement to areas where we know people are heavy users and responding to overdose cases in the community or at the hospital to try and be that bridge to treatment for those individuals,” Brewster explained.
“We know what happens is, individuals at their low point of an overdose want treatment. They can’t access it at that point. These people in COAT are going to follow them and stay with them until they get treatment,” she said.
Peer counselors who are in recovery will also be involved.
“We are really excited about this program. We know that there are not enough treatment providers around and that’s a nationwide problem, so access to treatment is an issue,” Brewster said.
“When you’re down and out and you want treatment you want it right then. That’s the hard part. We have people who have issues with access due to lack of funds to pay for it. And then we have individuals who really don’t know there is treatment available. They don’t even know what there is.
“It just amazes me that’s where we’re at in life. But it truly is. It’s like people who are not diabetic, who turn diabetic. They don’t know what’s out there for them as far as treatment options. It’s the same with substance abuse,” she said.
The health department will obtain information from law enforcement on overdose cases they respond to, as well as a report from the vital statistics division on the number of overdose deaths.
Brewster explained the Center for Disease Control puts out recommendations related to adequate practice for prescribing medication. There is also a prescription drug monitoring program.
“When we look forward to future years, physicians will be required to go in and access the drug monitoring program to make sure they aren’t dealing with a doctor shopper. Pharmacies have to access the prescription drug monitoring program. It soon is going to be required of physicians. Legislation was just passed to require that,” she said.
“We are training numerous groups of people in the use of naloxone for reversal of an overdose death, so hopefully we won’t have as many deaths. We have people out on the street who are able to administer naloxone, which is a nasal spray,” she said.
Health department officials have been training citizens to administer it, a move Brewster called “really great.’
“We have many people who are carrying naloxone on a daily basis. Administering it cannot hurt somebody. So even if they’re not sure if the individual has overdosed, it won’t hurt,” she said.
The antidote interacts with opiates or any other types of drugs to bring the user out of a close-to-death experience.
Often the cause is heroin laced with fentanyl – a drug used to treat pain in cancer patients. Brewster said drug dealers are getting fentanyl from China and using it to cut heroin. It makes it more potent, and more deadly.
When somebody uses heroin, Brewster said, “They feel great.”
“Then, when they are coming off it and withdrawing they have what I call flu-like symptoms on steroids – nausea, vomiting, sweats, stomach pains. They are the worst pains they ever had. Also what really precipitates people to continue use is, it’s a mind-altering issue. It does tricks to the mind. It’s affecting the whole community. The increase in crime, the increase in pain and suffering to the families,” she said.
Mitchell understands how drugs ravage a family.
When her son couldn’t get pain prescriptions refilled any longer, “Somebody showed up with a little Baggie and said, ‘Here. Try this.’ It was heroin,” Mitchell said.
She was watching a TV commercial about drug addiction when she realized her son was exhibiting symptoms of heroin use, behavior like falling asleep in the middle of a meal and wearing long-sleeved shirts on scorching hot summer days.
“We talked about it … but he’s sitting in jail. He’s been there seven months,” she said.
When Maciarello spoke at the Tony Hoffman event, he said he and other officials were there “because we care about you and because the prescription pill epidemic and heroin epidemic affects everyone.”
Maciarello talked about a friend who died a few months ago from “a bad batch of heroin.”
“I watched my buddy expire on a ventilator over at PRMC,” he said.
He encouraged students to participate in next year’s art contest illustrating dangers of drug use and said $10,000 will be awarded.
Meantime, the problem often keeps Brewster awake at night.
“It certainly does,” she said.
“I’ve said very publicly that one overdose on my watch is one too many. The fact that we’ve got so many more individuals overdosing is a great concern,” she said.
“We as leaders are on the front lines,” Maciarello said.
“Police respond to the overdoses but we deal with the moms and dads and with the community. It has a tremendous impact on our quality of life. We want to let the citizens know everything we’re doing to combat the drug problem,” he said.
“We are very excited about the COAT program,” Brewster said.
“This is where we need to be, boots on the street.”
Reach Susan Canfora at firstname.lastname@example.org.