Opioid and Heroin Overdoses Have Reached ‘Crisis Level’ In Maryland

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When Carin Miller’s son was about 19 years old, he began to abuse heroin by snorting pills, eventually moving on to shooting up. This went on for six years before he got help.

Lucas Miller’s history of drug use started in high school with smoking marijuana. When he moved out of his parents’ house, one of his housemates had access to between 750 to 1,500 pills at any given time between five houses located in Frederick, Maryland.

“My son was addicted to heroin, he’s in recovery by the grace of God since Thanksgiving 2014, I think that’s where we are at,” Miller said.

Opioid overdoses now rank with cancer, strokes and heart attacks among the top killers in Maryland.

State and federal lawmakers have passed legislation aimed at addressing the crisis, although they and public health experts agree the battle will be long.

On April 10, the Maryland General Assembly passed several bills to address this ongoing statewide crisis. The Start Talking Maryland Act, HB1082, and the HOPE Act, HB1329, were both passed.

The HOPE Act would increase access to naloxone, an overdose-reversal drug and would require hospitals to establish a new protocol when discharging patients treated for substance abuse disorders. It also introduced Keep the Door Open, a provision that provides three years of funding to reimburse community health providers. The act also requires the Behavioral Health Administration to establish a crisis treatment center before June 2018.

The Start Talking Maryland Act would require schools to have defined education programs on opioid addiction.

Other opioid related bills passed by the General Assembly were HB1432, which places a restriction on the number of opioid painkillers a doctor can prescribe to a patient per visit, and SB539, a bill that sets new penalties for distributing fentanyl.

The opioid-related legislation have been sent to Maryland Gov. Larry Hogan’s desk for his signature. The governor has until May 30 to either sign or veto the 900 bills passed by the General Assembly; otherwise they automatically become law.

On March 1, Hogan signed an executive order, declaring a state of emergency in response to the heroin, opioids and fentanyl crisis “ravaging communities in Maryland and across the country.”

“We need to treat this crisis the exact same way we would treat any other state emergency,” Hogan said in a statement. “This is about taking an all-hands-on-deck approach so that together we can save the lives of thousands of Marylanders.”

The final numbers for 2016 are expected to show that approximately 2,000 people died from heroin and other opioid overdoses in the state over the last year, about double the number of deaths in 2015.

Additionally, drug overdose deaths rose by 19.2 percent from 2013 to 2014 in Maryland, according to a press release from Sen. Ben Cardin, D-Md.

“There’s no question, no question there has been a spike in opioid overdoses,” Cardin said in an interview with Capital News Service. “Let me indicate the numbers in Maryland are shocking as we are seeing the doubling and tripling over the last couple of years, but the Maryland numbers are typical to what we see all over the country.”

Both Cardin and Sen. Chris Van Hollen backed passage of the 21st Century Cures Act and the Comprehensive Addiction and Recovery Act of 2015 (CARA). Van Hollen was a cosponsor for the 21st Century Cures Act.

“The opioid addiction epidemic is having a devastating impact on communities in Maryland and across the country,” Van Hollen said in a statement for Capital News Service. “I fought to pass the 21st Century Cures Act, which helps states expand programs to treat those suffering from addiction, but we must do much more to prevent substance abuse and to get help to those who need it.”

The 21st Century Cures Act was signed by President Barack Obama in December. It will provide $1 billion over two years for state grants to support opioid abuse prevention and treatment activities. CARA, a bipartisan bill, was signed into law by Obama last July. CARA assists drug-dependent newborns and their parents.

The federal Department of Health and Human Services has just awarded Maryland a $10 million grant under the 21st Century Cures Act.

“These grants are a small but encouraging step toward addressing the opioid crisis,” Rep. John Sarbanes, D-Towson, said in a statement. He was among those who pressed for the funds in the law. “But to make real progress in our effort to combat the epidemic, it’s the responsibility of Congress to provide additional resources to programs, families and communities in Maryland and across America that are working day in and day out to end the crisis.”

Van Hollen said there is more to be done with the crisis, including “protecting the significant investments made by the Affordable Care Act, and ensuring institutions like the National Institute for Drug Abuse at NIH in Maryland and others across the country have the resources necessary to carry out their critical missions.”

On March 29, President Donald Trump signed an executive order creating a presidential commission designed to combat opioid addiction and the opioid crisis nationwide. New Jersey Gov. Chris Christie is leading the commission.

A main reason for the doubling of overdoses for Maryland has been a new street drug, fentanyl, a powerful synthetic opioid that dealers are increasingly blending into regular heroin and selling cheaply.

Fentanyl is coming to the United States from China, and that needs to be stopped, Cardin said. The senator added that there also is work to be done with Mexico to stop heroin from flowing from that country.

“We’ve seen an abuse of using these drugs for pain and an abuse of people selling these drugs on the street and getting people addicted,” Cardin said. “There are things we can do to dry up the supply and help people who have addiction and health issues.”

In response to the rise in drug-related deaths, Hogan announced on March 1 that he has budgeted an additional $10 million per year to combat overdoses over the next five years.

Miller said Hogan’s action would help, but more money is needed from the federal government.

Miller is no stranger to opioid abuse as well. She said her husband, Greg Miller, had been abusing opioids since the late 1990s after he was hit by a drunk driver and had an additional, separate accident at work.

It reached a point where her husband’s withdrawals were so terrible that he almost died after being denied narcotics prescriptions at Frederick Memorial Hospital six years ago, Miller said.

“I was trying to get my husband off the pills, never thinking that my own kids would go on them after they saw the hell that I was put through,” Miller said.

Three years ago, Miller co-founded Maryland Heroin Awareness Advocates (MHAA), a grassroots organization in Frederick. It was founded “out of necessity,” by a group of women from Frederick in order to save their children from the opioid and heroin epidemic, Miller said.

“We have all been affected in some way, a lot of my colleagues have lost their children to overdoses,” said Miller, who is the president of MHAA.

Miller noted that there is not enough education about these drugs in schools. While one of her colleagues is invited into middle and high schools in Carroll County to give presentations, MHAA is “just nipping the bud” at giving presentations in Frederick County, Miller said.

Frederick County is a 40,000-student district with 10 high schools.

“We really give the principals the autonomy to address any issue in their community,” said Mike Maroke, Frederick County Public Schools deputy superintendent. “They determine if this is something be address or not.”

If the Start Talking Maryland Act is signed by Hogan, it would require schools to have opioid education programs, possibly through presentations such as MHAA’s.

After one presentation at a school, Miller handed out index cards to the students, ranging from seventh to twelfth grades, and asked for their feedback. She recalled what happened next: “One little girl came up to me and handed me her card and it said ‘Thank you for coming out and telling us about drugs because I wouldn’t want to lose any friends because my dad died a couple of months ago from a heroin overdose.’”

 

by Jess Nocera

 

Copp Named Emergency Preparedness Manager for UM Shore Regional Health

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University of Maryland Shore Regional Health (UM SRH) has announced that Elizabeth Copp, CHSP, CHEP, has been named Emergency Preparedness Manager effective April 2.

Copp will oversee the organization’s emergency operation plan, as well as facilitate the education of emergency procedures. In addition, she will continue to develop and monitor emergency management exercises across the system to determine the effectiveness of processes and ensure team member preparedness in emergency situations.

“Beth’s thorough knowledge of our facilities in our system and prior experience in the position makes her the ideal choice as Shore Regional Health’s new Emergency Preparedness Manager,” said Tamara Curry,Interim Director for Accreditation and Patient Safety. “She is well respected by her colleagues and we look forward to her beginning her new position.”

Copp began work at UM Shore Medical Center at Chestertown as support services coordinator in 2004. She also worked for Cecil County Public Schools as assistant in facilities for safety before returning to UM SRH. A graduate of University of Baltimore Merrick School of Business, she resides in Millington.

About UM Shore Regional Health: As part of the University of Maryland Medical System (UMMS), University of Maryland Shore Regional Health is the principal provider of comprehensive health care services for more than 170,000 residents of Caroline, Dorchester, Kent, Queen Anne’s and Talbot counties on Maryland’s Eastern Shore. UM Shore Regional Health’s team of more than 2,600 employees, medical staff, board members and volunteers work with various community partners to fulfill the organization’s mission of Creating Healthier Communities Together.

Spy Profile: United Needs & Abilities and the Shore’s Developmentally Challenged Residents

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For an organization that serves over 400 of the most developmentally challenged residents on the Eastern Shore, including Kent and Talbot County, United Needs & Abilities continues to struggle with name recognition. That might be partly due to UNA’s name change in three years ago when it decided that the Epilepsy Association of the Eastern Shore was far to limited in defining their work, but it also may be the result of the stigma that comes when serving those with cerebral palsy, traumatic brain injury, autism, intellectual disabilities, epilepsy and other mental and physical impairments.

Board President Debbie Horner Palmer and Executive Director Michael Dyer want to start changing that mindset. Debbie, who suffers from Epilepsy herself, and who has played a number of leadership roles in the organization over the years, is determined to end this historical blind spot on the Shore by using her own story as a way to focus attention on the needs and aspirations of those with developmental disabilities. Michael, who has worked in management positions at Perdue Farms before taking on the day-to-day management of UNA, is also driven by the same goals as the organization sees new challenges in funding and outreach during a time of governmental austerity.

The Spy sat down with Debbie and Michael to talk about the mission of United Needs & Abilities and its unique role on the Shore at Bullitt House last week.

This video is approximately four minutes in length For more information please go here

Kathy Elliott to Succeed Mary Jo Keefe as Nursing Director for UM SMC

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Kathy Elliott, MSN, NEA-BC, RN

Kathy Elliott, regional director of Professional Nursing Practice/Magnet Program, has been named director of Nursing for University of Maryland Shore Medical Center at Chestertown and will assume the position on June 30, 2017 when current the current nursing director, Mary Jo Keefe, retires. According to Ruth Ann Jones, senior vice president, Patient Care Services and chief nursing officer, UM Shore Regional Health, Elliott will succeed Keefe as nursing director while also retaining her current position.

A member of the Chestertown nursing team since she joined the hospital staff in 1988 as an LPN, Elliott has taken on progressively responsible roles at UM Shore Medical Center at Chestertown and UM Shore Regional Health. In 1990, she earned her RN from Wor-Wic Community College and over the next decade, served on the hospital’s Medical Surgical, Critical Care and Same Day/PACU nursing teams. In 2001 she assumed the role of nurse manager for Same Day Surgery and PACU, and in 2006, was promoted director of Acute Care, overseeing Medical Surgical, Pediatrics, Infusion Clinic, and Same Day Surgery/Post Anesthesia Care.  Along the way, she earned her MSN from Walden University and became certified as a Nurse Executive, Advanced (NEA-BC).

Until 2013, Elliott worked in various director positions at Chestertown and subsequently became Shore Regional Health’s Magnet Program director. In January 2016, she assumed leadership of UM Shore Regional Health’s Professional Practice Development and Magnet Program.

In making the announcement, Jones commented, “Kathy’s leadership in her new role in nursing administration will help UM Shore Regional Health to achieve our mission of Creating Healthier Communities Together, and our vision to be the Region’s Leader in Patient Centered Health Care.

For her part, Elliott is excited to be returning to Chestertown on a more full-time basis. “I feel like I am coming back home, but with much broader knowledge and many excellent contacts and resources that I have gained in the past few years through my Magnet responsibilities. I’m also grateful to have the next few months to work side-by-side with Mary Jo as a transition to assuming the nursing director role.”

As part of the University of Maryland Medical System (UMMS), University of Maryland Shore Regional Health is the principal provider of comprehensive health care services for more than 170,000 residents of Caroline, Dorchester, Kent, Queen Anne’s, and Talbot counties on Maryland’s Eastern Shore. UM Shore Regional Health’s team of more than 2,500 employees, medical staff, board members, and volunteers works with various community partners to fulfill the organization’s mission of Creating Healthier Communities Together.

Homestead Manor Hosts Talk on Early Detection of Alzheimer’s and Dementia

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Homestead Manor will host a lecture by Jennifer L. FitzPatrick in late April on, “Know the 10 Signs: Early Detection Matters Alzheimer’s and Dementia” This presentation is designed for individuals who are interested in learning more about Alzheimer’s and dementia, anyone who is experiencing memory loss or other warning signs that might indicate a problem, and individuals who are worried about a family member or friend presenting possible symptoms.

When: Thursday, April 27, 2017
Where: Homestead Manor, 410 Colonial Drive Denton, Md
Time: 1:00 Pm – 2:00 Pm Presentation, Light Refreshments
Why: Learn More About Alzheimer’S And Dementia
Who: Everyone, Also Social Workers Will Earn Ceu’S

Call Now and RSVP 410-479-2273

 

Recovery: Inaugural Tri-County Prevention Walk set for May 13

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The inaugural tri-county prevention walk is scheduled for 9 a.m. Saturday, May 13 at Church Hill park in Church Hill, and supports efforts at keeping our communities drug- and alcohol-free.

The free walk is a collaborative effort from the prevention offices of Caroline, Kent and Queen Anne’s counties, with the theme, ‘Making a difference – one step at a time.’

“This walk is for anyone who’s had drugs or alcohol affect their lives,” said Annette Duckery, prevention coordinator for Kent County. “We’re working hard to prevent drug use and alcohol abuse in our communities, and this offers everyone the chance to support our efforts.”

The event includes fun for the entire family, with a live DJ, free back packs, snacks and games including corn hole. Registration is available online at Eventbrite.

The walk coincides with National Prevention Week, which is an annual health observance dedicated to increasing public awareness of, and action around, mental and/or substance use disorders. This year’s prevention week is from May 14 until May 20.

“National prevention week offers the perfect opportunity to show our solidarity in the fight against substance use disorders,” said Iris Carter, prevention coordinator for Queen Anne’s County. “With several overdoses in our area each week, we’ve got to come together and support prevention efforts across our region.”

Prevention efforts start young, and can help keep drug use from starting.

“We all can invest in drug and alcohol prevention,” said Melanie Rodriguez, prevention coordinator for Caroline County. “Prevention really IS the best treatment.

For more information on the walk, please contact Duckery at 410-778-7918 for Kent County; Carter at 410-758-1306 ext. 4524 in Queen Anne’s and Rodriguez at 410-479-8164 in Caroline. The Tri-County Prevention Walk is a collaboration between the health department prevention offices of Caroline, Kent and Queen Anne’s Counties. The walk also is supported by SAMHSA and the Maryland Behavioral Health Administration.

Annapolis: Generic Drug Price Gouging could be Penalized In Bill Sent to Hogan

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A prohibition on generic drug price gouging now heads to Gov. Larry Hogan’s desk for signature after the House concurred in Senate amendments Monday morning.

The House voted 137-2 for the bill, HB631, and the Senate approved it on Friday 38-7 with a handful of Republicans joining the Democratic majority. All but a few GOP delegates supported the measure.

The legislation would be the first of its kind in the country to hold drug makers accountable for drastic spikes in prices that can’t be justified. Under the new law, the state Medicaid program will notify the attorney general of a spike in drug prices, who can seek civil penalties of up to $10,000 per violation.

“Generic prescription drugs prices have been like the ‘wild’ west for many Americans” said Vincent DeMarco, president of the Maryland Citizens’ Health Initiative, moments before Friday’s vote. “There’s a new sheriff in town and his name is Attorney General Brian Frosh, who will protect Marylanders from price gouging, and this will also allow future AG’s to protect Marylanders.”

“Frosh will be able to take legal action to stop unconscionable price increases that hurt people without justification when there’s no competition in the market,” DeMarco said.

Subjective judgment

In floor debate Friday, Sen. Robert Cassilly, R-Harford, said the proper way to deal with price controls would be to set up a commission rather than allow the attorney general to make a “subjective” determination on what constitutes price gouging.

“If the state of Maryland wants to establish their own version of the FDA and engage in price controls we ought to do in the proper manner,” Cassilly said. “The proper manner would be set up some proper board or commission…or have it come under some aspect of our state bureaucracy.”

Senate Republican Whip Sen. Stephen Hershey. R-Queen Anne’s, said the law could actually harm competition.

“Generic drugs are one of the only indicators in the delivery of health care where prices are actually going down,” Hershey said prior to passage of the bill. “This bill is going to have a negative effect that could potentially eliminate some of the competition that is in Maryland and that is driving these costs down.”

The legislation was rolled out at a Jan. 10 rally in Annapolis three weeks after Maryland joined 19 other states in a lawsuit against six generic drug makers for market manipulation and anti-competitive behavior.

Frosh said a 2014 survey of pharmacists revealed that 25 “off patent” generic drugs saw price increases of 600% to 2000%.

He said normally prices “plummet” when patents expire and competition becomes “robust.” He said generic drugs have consistently run about 20% of the original patented price.

“What we allege is these companies conspired to fix prices.” Frosh said at the rally.

by Dan Menefee

The Faces of Mental Illness: The Photography of Michael Nye at Chesapeake College

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While it may be true that most people on the Mid-Shore have a very real and distinct impression of the toll of mental illness in our society, it still is hard for many of use to truly understand the profound impact that these conditions has on victims and their families.

A new art exhibition, sponsored by the Mental Health Association of the Eastern Shore in partnership with Chesapeake College in May, might very well help change some of those perceptions using the stunning images and oral narratives of those victims by award winning  photographer Michael Nye.

Some fifty photographs and recorded messages of people who suffer from various forms of mental illness will be on display as part of a major educational effort to remove the stigma and misunderstanding of a growing problem in our communities.

The Spy spoke the Association’s director, Jackie Davis, last week at Bullitt House to talk about the show and the important work of the organization in serving families impacted by mental illness throughout the Shore.

This video is approximately three minutes in length. For more information about  Mental Health Association of the Eastern Shore and their opening reception, please go here 

Annapolis: Maryland Could Expand Options to Treat Addiction Remotely

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A bill that could expand telemedicine to include counseling for substance abuse disorders, which could help thwart the ballooning heroin-opioid epidemic in the state, is advancing in the Maryland General Assembly.

Telemedicine, or the use of virtual tools like video chats to provide health care services, has grown rapidly in recent years. In 2015, about 15 million Americans used telemedicine, a 50 percent increase from 2013, according to the American Telemedicine Association.

Although some health insurance providers do offer telemedicine for the treatment of substance abuse disorder, the bill, sponsored by Delegate Joseline Peña-Melnyk, D-Anne Arundel and Prince George’s, would ensure that this would include counseling for addiction treatment.

“Counseling is a critical component of the recovery process, and works hand in hand with medication-assisted treatment,” wrote the Community Behavioral Health Association of Maryland in testimony in support of the bill. “This bill would help ensure the most efficient use of clinicians who are paneled with commercial (health insurance) carriers by allowing them to deliver counseling services through telehealth.”

There has been a growing push for the the adoption of telemedicine for the treatment of substance abuse disorders, said Yngvild Olsen, the director of a Baltimore outpatient substance use disorder treatment program.

However, some Medicaid regulations have hindered reimbursement of telemedicine for substance-abuse counseling services, Olsen said, adding that if regulations are clarified, Maryland could begin seeing a more widespread adoption of the treatment method.

“This is something that there is a significant amount of interest in because of the lack of behavioral health counseling and other behavioral health services in many areas of the state,” Olsen told the University of Maryland’s Capital News Service.

Opioid-related deaths in Maryland have doubled from 529 in 2011 to 1,089 in 2015, according to the Department of Health and Mental Hygiene.

Pockets in the Eastern Shore and Western Maryland have had trouble attracting enough health care providers to treat the problem there, Olsen said.

Moreover, the U.S. Health Resources and Services Administration has designated parts of Baltimore City and all of Harford County as areas where there is a shortage of health professionals, specifically for mental health.

Although other states have begun adopting a more widespread use of telemedicine for opioid-heroin substance abuse treatment, Maryland has only a few pockets where these services are available, Olsen said.

The first telemedicine program to treat addiction in Maryland started with a partnership between the University of Maryland Medical Center and the Wells House, a Hagerstown, Maryland, drug treatment program.

After one of the Wells House’s doctors retired, the staff were looking for a solution to keep up with the “ever-increasing” demand, said Paul Smith, the telemedicine program coordinator.

So they enlisted the help of University of Maryland Medical Center doctors who remotely meet with patients and prescribe them medication to treat their addictions by video chatting through their television screens, Smith said.

“It’s so versatile,” Smith said. “They can literally plug in here in a matter of seconds.”

Wells House prescribes medication for about 30 to 35 patients per week using this technology on average, Smith said. Since the program’s launch in 2015, the University of Maryland Medical Center has expanded its partnerships to include the Garrett County Health Department to offer similar services there, he added.

Recent studies have shown that telemedicine can be an effective way to treat substance-abuse disorders.

West Virginia University physicians recently conducted a study to determine whether telemedicine could provide similar outcomes as in-person treatment for patients in medication-assisted treatment programs.

Doctors remotely met with 46 patients in 30-minute group sessions to prescribe them buprenorphine, an opioid medication, by videoconferencing, and met with 54 patients face-to-face. Both groups followed these sessions with an in-person hour-long therapy group.

In the telemedicine group, 49 percent achieved 90 consecutive days of abstinence, compared with 37 percent in the in-person group.

Wanhong Zheng, a doctor who worked on the project, said expanding programs like these could be especially helpful for those with substance abuse disorders living in rural areas, where some patients have to drive up to five hours once a week just to go to a clinic.

This lack of treatment availability, one of the many challenges those hoping to treat an opioid addiction face, can be overcome by expanding telemedicine programs, Zheng said.

Maryland’s House of Delegates passed the bill and the state Senate is planning to hold a hearing on it April 4.

By Natalie Schwartz