Matt Maciarello: We’re working to address the opioid epidemic

Heroin Stock Photo 3

There is truly not a day that goes by that those of us involved in public safety do not have our minds on the opioid-heroin epidemic.

There were 46 overdoses reported in our county in March, a number which represents the highest number of overdoses recorded so far in Wicomico in one month—so in no way is this a “Mission Accomplished” letter.

I do hope, however, that this letter generates awareness and discussion and provides the community with some information about what our stakeholders are doing to address this historic challenge.

While I cannot list herein each and every action that has been taken, as there has been an incredible devotion of time and resources by many in our community, I can inform you about some of the major steps our county has taken to address this problem.   

At the behest of our county executive, Wicomico County was one of the first counties in the state to create a county plan of action.  The long term goal in that plan includes a move toward “treatment on demand” for the addicted, along with the use of peer support counselors for the continuity of care and support that is going to be required to keep the severely addicted on a path toward recovery.

This county plan had components that were adopted and referenced by the State Emergency Task Force which provided recommendations to all counties on how to best manage the opioid crisis.  Indeed, Wicomico was among the first counties to have a Fatality Review Board and Prescription Drug Task Force.

Members from law enforcement and the health care community participated for years on these boards and have gradually learned better ways to connect the addicted with treatment and to educate providers on better practices for prescribing pain medications.

For years, our county did not know the scope of our problem. The greatest barrier to our understanding was that overdose data was contained in multiple areas around the county.  Some data on overdoses could be found at PRMC, some at the health department, some was held by law enforcement, etc., but nobody was collecting the data and making it useful for the stakeholders.

As one of his first acts as county executive, Bob Culver approved the creation of a County Heroin Reduction Strategist whose job it was to know everything related to opioid and heroin addiction in our county. Additionally, this person was tasked with studying strategies utilized by other communities, so that Wicomico County could adopt only the best practices.

After the creation of this position, much has been accomplished — the first, and most important, is probably the enhancement of information sharing among the stakeholders.

That data that was once fragmented and scattered across the county is now shared in real time. Of course the numbers we are seeing are shocking, and the toll is tragic, but knowing the true scope of the problem will help the stakeholders make sound and supported policy decisions.  Also, the communication between law enforcement and the health department and other stakeholders involved in managing this crisis is at an all-time high.

One of the wins that has resulted from this synergy between the health department, law enforcement, and other stakeholders is the COAT initiative.  COAT stands for Community Outreach Addiction Team and it is a leap forward toward addressing addiction proactively in our community.

Mayor Jake Day and County Executive Culver have expedited the creation of a team which will try to help addicts before they wind up in either the criminal justice system or the emergency room.  The COAT team will use peer counselors to connect with addicts when and where they need that help with the ultimate goal of leading the addicted to a better way and a better life.

Much is also happening at our local detention center.

It should be no surprise that many in that facility are addicted to opioids, including heroin.  The Warden has been in constant communication with our office, with law enforcement and with the health department.

WCDC is joining many of the jails and prisons nationwide which are starting a Vivitrol program. Vivitrol is a drug that treats opioid addiction to reduce rates of addiction and incarceration.  It is no substitute for the psychological work of recovery, but it does assist the addict during those most dangerous days when they are most likely to relapse, and, consequently, to overdose.

The Health Department is coordinating with the detention center to ensure that those released from WCDC have the option of continuity of care.

We were also very close to restarting residential drug treatment in our local jail. The health department has agreed to provide staffing for this proven approach to getting people off of drugs and out of the criminal justice system for good.

We have experienced funding setbacks, however, but we are undaunted in our commitment to ensuring that we provide effective and efficient treatment that will ultimately save lives and precious financial resources.

Treatment is cheaper than investigation, prosecution, and incarceration, and we are closer to providing the incarcerated with treatment that should make a real difference in our community.

Law enforcement investigations are as robust as ever.  We have a Narcotics Task Force that works closely with state and federal officers on large-scale drug investigations.  Law enforcement is committed to identifying and arresting distributors of narcotics at all levels.

Our local investigations, arrests, and prosecutions are well publicized.  We have a track record of vigorous prosecution of those who are committed to poisoning our community.  All of our large scale drug operations are done with the assistance of the Maryland State Police and federal law enforcement such as the DEA.

Those cases often allow for spin-off investigations that have resulted in the identification, prosecution and arrest of other dealers around the state and as far away as California and Texas.  The synergy and data sharing between local, state and federal officers is at an all-time high and we are resolved to hold dealers of narcotics accountable for their crimes against our community.

Lastly, we are trying to address the demand side of the equation by reaching out to our teens about the insidious nature of prescription drugs.

I have gone to the scene of many overdoses and I have spoken with users and their families.  While there are many ways people become addicted to heroin, with great frequency, addicts explain that they started by abusing prescription drugs.

Many admit that they started in middle and high school and they moved to heroin as prescriptions became harder to obtain. Law enforcement in Wicomico County have sponsored an art and film competition for high school age children.

Information about this competition can be found on the County’s website.  Here we are trying to get teens to teach other teens about the nature of prescription opioids and how abuse of pills leads to a lifetime of addiction, incarceration, and potentially, death.

The entry fee for this competition is awareness, parent and child must watch a video.  Several scholarships will be awarded to the winners so I hope, if you have teens in your household, that you will encourage them to participate.   

I have lost both friends and family to addiction.  As a prosecutor I have witnessed how addiction tears at the fabric of our community and our quality of life.  I can assure you that I, along with Sheriff Lewis, Chief Duncan, our Health Officer Lori Brewster, County Executive Bob Culver, and Mayor Jake Day, are working, day after day, and with united resolve, to guide our county through this historic crisis.


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