The city has spent more than $1 million on its 15-month-old program. The state has spent $5 million to support Baltimore's program, start others elsewhere in Maryland and to cover the Medicaid costs of Suboxone.
The House of Delegates' Health and Government Operations Committee will hold a briefing Jan. 24 on the drug that will feature presentations from Sharfstein and Dr. Peter Luongo, director of the state's Alcohol and Drug Abuse Administration.
Some lawmakers said they want to hear how the state is planning to minimize diversion of the state-financed medication.
"The drug should not have been introduced as a matter of policy without having considered those questions [about misuse]," said Del. Richard B. Weldon Jr., a Republican representing Frederick and Washington counties.
He said the state should provide basic protections when taxpayer money is being spent to deliver the drug to addicts. The existence of street sales of the drug should have led the state Department of Health and Mental Hygiene to require the medical examiner to routinely test for it in overdose deaths, he said.
"To ignore that is irresponsible on the part of the state," he said. "We have performance measurements in other places where there is no potential harm for individuals."
Del. Patrick L. McDonough, a Republican representing Baltimore and Harford counties, agreed.
"Do you need a tragedy or an audit two years later to tell us there is a problem?" McDonough said.
Del. B. Daniel Riley, a Democrat representing Cecil and Harford counties, said the state should systematically track urine tests of patients to make sure they are taking their Suboxone.
If Suboxone is not present, it is highly likely that partients are selling it, said Dr. J. Ramsay Farah, president of the Maryland Society of Addiction Medicine.
Farah said the problem in Maryland might not be as pronounced as other states where the per-capita use is higher, but that those problems will increase as the state expands its supply.
"Right now, everyone is happy because the right people are getting the drug," he said. "As more people get it, you will see more of the wrong people getting it."
The directors of four clinics in Baltimore's buprenorphine initiative told The Sun that many addicts come to them having first tried the pill on the street. Police say Suboxone's presence is becoming more noticeable.
