Pubdate: Tue, 07 Jul 2015
Source: Baltimore Sun (MD)
Copyright: 2015 The Baltimore Sun Company
Contact:  http://www.baltimoresun.com/
Details: http://www.mapinc.org/media/37
Author: Meredith Cohn

DEATHS FROM FENTANYL-LACED HEROIN SURGE, SPUR WARNING

Amid a statewide surge in overdoses, Baltimore health officials 
announced a campaign Monday to tell heroin users that the drug they 
buy on the street could contain the much more potent painkiller fentanyl.

The synthetic opiod, which federal officials say is 30 to 50 times 
more powerful than heroin, is blamed in the deaths of hundreds of 
drug users nationwide since 2013. Health, law enforcement and 
counselors began issuing warnings more than a year ago, but have not 
been able to stem overdoses.

In Maryland, fentanyl-related deaths now account for nearly a quarter 
of drug overdose deaths, up from 4 percent two years ago. The 
percentage now eclipses deaths related to cocaine and alcohol, and is 
gaining on prescription drugs.

Baltimore has been hit particularly hard. The 39 deaths in the city 
linked to fentanyl in the first quarter of the year are nearly three 
times the 14 recorded in the same time last year. They account for 
more than half of the 73 fentanyl-related deaths in Maryland during 
the first three months of the year.

"It's unclear why it's happening in Baltimore now, but it is a trend 
throughout the state and country," said Dr. Leana Wen, the city's 
health commissioner. "Our goal is to alert the public, alert 
residents that heroin my be laced with fentanyl."

Baltimore led the state in 2014 with 71 fentanyl-related deaths. 
Baltimore County was second with 36; Anne Arundel County was third with 23.

One of the most recent victims was Crystal Moulden, a 16-year-old 
Glen Burnie girl who was found in a Baltimore alley last month.

Her family said she was a straight-A student and cheerleader until 
she began drinking and smoking marijuana. Eventually, she turned to 
harder drugs, they said.

"It's very concerning, especially when we hear reports about people 
who don't know what they are using," Wen said. "They think they're 
using heroin only.

"[Fentanyl] stops their breathing within a minute or so because it's 
so powerful."

Public health officials say they lack good data on how to effectively 
warn users about the dangers. Baltimore is using trusted workers from 
its needle exchange program, in operation for two decades, to spread 
"lifesaving tips" - rather than a message to quit heroin.

They tell users to avoid drugs that have different colors or 
textures, warn against using drugs when they're alone, and show them 
how to use the overdose medication naloxone. They also can steer 
people to addiction treatment.

"The idea is to keep people alive today so they can make better 
choices tomorrow," Wen said.

Fentanyl, used by cancer patients and those with chronic pain, is 
prescribed legally to millions of Americans each year.

It produces euphoric effects similar to those of heroin but is far 
more powerful, making it particularly dangerous.

Fentanyl overdose deaths surged in 2005 and continued for two years 
until the U.S. Drug Enforcement Administration shut down a single lab 
in Mexico. But cases began climbing again in 2014, particularly in 
the Northeast and California.

Deaths related to fentanyl in Maryland tripled to 185 last year from 
58 in 2013, state data shows. Baltimore made up more than a third of the total.

Heroin deaths in general also are rising, with 578 people succumbing 
last year, up 25 percent from the previous year, and more than double 
the 2010 total.

"Drug incidents and overdoses related to fentanyl are occurring at an 
alarming rate throughout the United States and represent a 
significant threat to public health and safety," DEA Administrator 
Michele M. Leonhart said in March.

Gov. Larry Hogan has formed a task force on heroin that has been 
visiting all corners of the state and expects to send recommendations 
to the governor by year's end.

The Baltimore County Department of Health offers training in the 
overdose medication. In the last year, 331 people have been certified 
to use naloxone.

Baltimore City also has been providing such training. That and the 
new antifentanyl campaign are an extension of the Mayor's Heroin 
Prevention and Treatment Task Force, which is due to issue 
recommendations next week. Wen said health officials didn't want to 
wait for the report.

One Baltimore-based addiction specialist said the warnings are a good 
idea, even if drug users aren't easily dissuaded from risky behavior.

"Although one of the symptoms of addiction is doing things an 
individual would not usually do without the addiction ... the vast 
majority of overdoses are unintentional," said Dr. Yngvild Olsen, 
medical director for the Institutes for Behavior Resources/REACH 
Health Services.

"Most people with addiction do not want to die," she said. "So I 
think a campaign educating users about the dangers of fentanyl and 
reaching out to people to assist them in reducing overdose risk - 
including naloxone and engaging people in treatment - can save lives."
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MAP posted-by: Jay Bergstrom