This final story in Ā鶹¹ŁĶųās series, , looks ahead to this year’s legislative session and discusses what lawmakers are prepared to do toĀ turn the tide of this heroin crisis.
HANOVER, Md. ā The state of Maryland is failing at providing effective opioid abuse treatment, said Mike Gimbel, former Baltimore County drug czar.
āWeāve not done the right thing so far. Everyone knows itās a problem. We donāt need billboards. We donāt need PSAs. We donāt need task forces,ā Gimbel said. āWe need treatment.ā
Top politicians, including President Barack Obama, agree.
Maryland and Virginia lawmakers are offering proposals to expand access to treatment programs in their states.
Virginia Gov. Terry McAuliffe announced he is seeking more than $31 million to strengthen the stateās mental health system, including $5.3 million to provide medication-assisted treatment and to buy thousands of doses of naloxone, an overdose-reversal medication.
The legislative reforms he introduced will limit opioid prescriptions written in emergency departments to three days. He also supports during free training classes, and the expansion ofĀ drug court eligibility to include people convicted of violent crimes.
Maryland Lt. Gov. Boyd Rutherford told Ā鶹¹ŁĶų he expects treatment access to be a priority during the General Assembly session.
āThere needs to be an emphasis on care, particularly quality of care,ā he said, but he didnāt offer specifics. Gov. Larry HoganĀ has not released a budget yet.
that other bills expected to be introduced include a measure to keep treatment centers open and mandating treatment for anyone who is revived with naloxone.
But there has been an institutional reluctance for states to dedicate taxpayer money to affordable drug treatment centers.
Following the recommendation from the stateās Heroin and Opioid Emergency Task Force, Hogan announced in August that $3 million in state grants would be used to fight the epidemic. The money was allocated to help police track down violent offenders and heroin coordinators to collect data about overdoses. But none of the money went to in-patient treatment centers.
Though the D.C. Council enacted a law, currently under congressional review, expanding access to naloxone, no current bills address treatment.
As state lawmakers grapple with how to address the epidemic, police departments are filling in the gaps with a new treatment-centered attitude. Where lawmakers fail to agree, officers are pulling together to provide in-person resources on the ground every day.
On the front lines
Over the last couple of years, law enforcement agencies have changed their perception about how to best tackle the opioid epidemic. Officials now say they canāt āarrest their wayā out of this crisis and are taking a more holistic approach.
āItās not like Hollywood,ā said Second Lt. James Cox III, a supervisor for the Fairfax County, Virginia, Police Departmentās organized crime and narcotics division. āDetectives are putting in 14-, 15-, 16-hour days, killing themselves trying to get this drug off the street.ā
Every suspected heroin addict arrested in Anne Arundel County, Maryland, receives a letter from Police Chief Tim Altomare, pleading with them to let the department help them on the road to recovery.
āDrug treatment can work. People recover from addiction every day. WE BELIEVE YOU CAN DO IT BUT WE CANāT DO IT FOR YOU,ā the letter reads.
But letters and outreach can only go so far. And Altomare said the state needs massive increases in treatment funding.
āThere arenāt enough treatment beds in the state. That goes hand-in-hand with the treatment beds for mental disorders. About 85 percent of people fighting addiction have a co-occurring emotional health disorder like bipolar disorder or paranoid schizophrenia,ā Altomare said.
Montgomery County Stateās Attorney John McCarthy puts some of the responsibility for inadequateĀ treatment squarely on the shoulders of insurance companies. He would like the legislature to rewrite insurance regulations to mandate more coverage.
āYou need about 18 months of profound treatment to get away from the psychological control of the drug and really beat the addiction. The reality is that we put young people into treatment and itās just not sufficient,ā he said.
In early 2015, Cox and two Fairfax County detectives tried to tackle this crisis in a unique way. They formed a partnership with the Community Services Board to create an informational packet full of addiction recovery resources. The goal was to dispatch a detective to the scene of every heroin overdose and distribute those packets.
But it didnāt work as planned. Out of about 100 overdose cases, Cox said he only knows of one person who sought help. With only two detectives on this task force ā and because most overdoses occur between midnight and 4 a.m.Ā ā Cox had to make the difficult decision to cut back.
āIf an addict doesnāt want help, theyāre not going to get help,ā he said.
Instead, Coxās latest initiative is working to create a Recovery Call List ā a resource for people apprehensive about interacting with the police. On-call civilian volunteers who are currently in recovery would immediately respond to the scene of an overdose.
āSo at 2 oāclock in the morning, when someone is admitted to Fairfax Hospital for a heroin overdose, a person on this list can reach out and say: āHey. Iāve been there. Iāve done that. This is where you can be right now,āā he said.
Coxās team recently arrested a pregnant woman on heroin charges. But instead of taking her to jail that night, they coordinated with the Community Services Board to get her into rehab as she waits for trial.
āShe needs to beat the drug first, and then weāll deal with her in the criminal justice system later. First thing we need to do is keep her alive and get her help,ā Cox said.
An intellectual solution to a psychological problem
Lawmakers will spend several months hashing out how they want to shape their states’ policies on addiction prevention and treatment. But critics say theyāre not focusing on the right ideas.
āThey donāt understand what drives the addict,ā Mike Gimbel said.
In the past two years, failed proposals in Maryland included measures that would provide drug users with clean needles and allow them to get high in hospitals or similar āsafe-injection sites.ā
Gimbel called these āintellectual pipe dreamsā that arenāt based in reality.
āNothing gets to the root cause of addiction. When I was doing heroin, I didnāt care if I lived or died. I didnāt care about police. I didnāt care about going to jail. I didnāt care about overdose. I didnāt care about using a clean or dirty needle.ā
Gimbel went from shooting heroin every day in high school to becoming the director of Baltimore County’s Bureau of Substance Abuse.
When he hit rock bottom, he enrolled in a long-term drug-free treatment facility in California. A few months ago, heĀ celebrated his 44thĀ year of sobriety.
āIād be dead today if I didnāt have a place to go,ā he said. Ā āWe have to get to the inner soul of the person. The work we need to do is on the mental and spiritual side.ā
Prison time
As states consider expandingĀ treatment-focused programs for drug users, police are also pushing lawmakers to consider increasingĀ prison sentences for drug dealers.
In October 2015, Anne Arundel County detectives captured the biggest heroin distribution ring in county history after an eight-month, multi-agency investigation. Nearly $1 million in assets were seized, including three kilograms of heroin, 1.5 kilograms of cocaine and 12 firearms.
The drug kingpin was sentenced to 25 years in prison, and the bust made a big dent in the areaās drug trafficking, but officials knew that void would be filled by new dealers who wanted to infiltrate the market.
In Montgomery County, after one particularly deadly week, State’s Attorney John McCarthy and Maryland Del. Kathleen Dumais drafted legislation in 2015 aimed at cracking down on dealers who sold drugs that caused a fatal overdose.
The billĀ would have allowed judges to sentence such dealers to prison for up to 30 years, and it had widespread support among the law enforcement community. But it wasnāt brought to a vote on the House floor.
āThere was a sense that it would unduly affect African-Americans or other minorities in Baltimore City,ā DumaisĀ said.
A similar bill in Virginia, whichĀ would have increased the maximum penalty to 40 years, also failed that year.
Law enforcement officials urge politicians to reconsider bringing these measures up for a vote this year.
āIf it leads to death, we should be able to charge them with homicide,ā Cox said.
āIād like to see a mandatory 20-year sentence,ā Altomare said. āThereās nothing non-violent about a heroin dealer who is selling death in the community.ā
While lawmakers slog through committee hearings, arguing about language and scrounging for money, the body count rises.
Altomare recalled one weekend last year when three people fatally overdosed in a 24-hour period.
“It really crushed us,” he said. āOn Monday mornings, we dread seeing on paper how many overdoses weāve had. Some Mondays, weāre reeling.ā
