Stemming the tide

January 28, 2008

Deaths among Baltimore residents from drug and alcohol overdoses have been on the decline over the past 12 years, according to a new study by the city's Health Department. But they remain on par with the number of homicides - another reminder of the horrible toll taken by the city's twin addictions, drugs and drug violence.

The most sensible answer is more and more access to treatment, which needs to happen as quickly as possible. In the long run, it saves money and lives.

Although the study shows that the total of 248 intoxication deaths in 1995 wasn't much different from the 244 in 2006, there have been ups and downs. In 1999, overdose deaths peaked at 321, exceeding the city's 305 homicides. Since 1999, there has been progress, but not enough. Most notably, overdose deaths in 2006 were 14 percent higher than in 2005, increasing from 214 to 244. Although preliminary figures for 2007 indicate another decrease, the city's health commissioner, Dr. Joshua M. Sharfstein, is right to say that Baltimore has "a long way to go," since overdose deaths have exceeded homicides in six of the 12 years examined in the study.

While the majority of overdose deaths - 77 percent - were related to heroin, cocaine- and alcohol-related deaths were also prominent. As disturbing is that during the years of the study, methadone-related deaths increased from seven to 61.

The study and its portrait of the powerful hold of intoxicating substances, whether used singly or in combination, underscore the urgency of the city's recent request to the state for $15 million to expand treatment services. One-third of the money would be used for buprenorphine, the synthetic opiate that has had promising results in helping addicts manage recovery from heroin. Despite some evidence of illegal diversion, bupe may be a safer, more effective alternative to methadone in the long run. A 2004 study of bupe treatment among problem heroin addicts in France found that overdose deaths declined by nearly 80 percent over a decade.

Beyond bupe, more addicts should be trained to use Narcan, a drug that can help revive someone who is near death from an overdose. And as the state increases Medicaid eligibility for single adults, more drug counseling and maintenance services for recovering addicts should be provided.

Baltimore's drug trade is deadly. That's why sensible investments to help more users break free and survive could also help reduce the murderous rampage among their suppliers.

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