This final story in WTOP鈥檚 series, , looks ahead to this year’s legislative session and discusses what lawmakers are prepared to do to聽turn the tide of this heroin crisis.
HANOVER, Md. 鈥� The state of Maryland is failing at providing effective opioid abuse treatment, said Mike Gimbel, former Baltimore County drug czar.
鈥淲e鈥檝e not done the right thing so far. Everyone knows it鈥檚 a problem. We don鈥檛 need billboards. We don鈥檛 need PSAs. We don鈥檛 need task forces,鈥� Gimbel said. 鈥淲e need treatment.鈥�
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 state鈥檚 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 of聽drug court eligibility to include people convicted of violent crimes.
Maryland Lt. Gov. Boyd Rutherford told WTOP he expects treatment access to be a priority during the General Assembly session.
鈥淭here needs to be an emphasis on care, particularly quality of care,鈥� he said, but he didn鈥檛 offer specifics. Gov. Larry Hogan聽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 state鈥檚 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 can鈥檛 鈥渁rrest their way鈥� out of this crisis and are taking a more holistic approach.
鈥淚t鈥檚 not like Hollywood,鈥� said Second Lt. James Cox III, a supervisor for the Fairfax County, Virginia, Police Department鈥檚 organized crime and narcotics division. 鈥淒etectives are putting in 14-, 15-, 16-hour days, killing themselves trying to get this drug off the street.鈥�
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.
鈥淒rug treatment can work. People recover from addiction every day. WE BELIEVE YOU CAN DO IT BUT WE CAN鈥橳 DO IT FOR YOU,鈥� the letter reads.
But letters and outreach can only go so far. And Altomare said the state needs massive increases in treatment funding.
鈥淭here aren鈥檛 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,鈥� Altomare said.
Montgomery County State鈥檚 Attorney John McCarthy puts some of the responsibility for inadequate聽treatment squarely on the shoulders of insurance companies. He would like the legislature to rewrite insurance regulations to mandate more coverage.
鈥淵ou 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 it鈥檚 just not sufficient,鈥� 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 didn鈥檛 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 鈥� and because most overdoses occur between midnight and 4 a.m.聽鈥� Cox had to make the difficult decision to cut back.
鈥淚f an addict doesn鈥檛 want help, they鈥檙e not going to get help,鈥� he said.
Instead, Cox鈥檚 latest initiative is working to create a Recovery Call List 鈥� 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.
鈥淪o at 2 o鈥檆lock in the morning, when someone is admitted to Fairfax Hospital for a heroin overdose, a person on this list can reach out and say: 鈥楬ey. I鈥檝e been there. I鈥檝e done that. This is where you can be right now,鈥欌�� he said.
Cox鈥檚 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.
鈥淪he needs to beat the drug first, and then we鈥檒l deal with her in the criminal justice system later. First thing we need to do is keep her alive and get her help,鈥� 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 they鈥檙e not focusing on the right ideas.
鈥淭hey don鈥檛 understand what drives the addict,鈥� 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 鈥渟afe-injection sites.鈥�
Gimbel called these 鈥渋ntellectual pipe dreams鈥� that aren鈥檛 based in reality.
鈥淣othing gets to the root cause of addiction. When I was doing heroin, I didn鈥檛 care if I lived or died. I didn鈥檛 care about police. I didn鈥檛 care about going to jail. I didn鈥檛 care about overdose. I didn鈥檛 care about using a clean or dirty needle.鈥�
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, he聽celebrated his 44th聽year of sobriety.
鈥淚鈥檇 be dead today if I didn鈥檛 have a place to go,鈥� he said. 聽鈥淲e have to get to the inner soul of the person. The work we need to do is on the mental and spiritual side.鈥�
Prison time
As states consider expanding聽treatment-focused programs for drug users, police are also pushing lawmakers to consider increasing聽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 area鈥檚 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 bill聽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 wasn鈥檛 brought to a vote on the House floor.
鈥淭here was a sense that it would unduly affect African-Americans or other minorities in Baltimore City,鈥� Dumais聽said.
A similar bill in Virginia, which聽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.
鈥淚f it leads to death, we should be able to charge them with homicide,鈥� Cox said.
鈥淚鈥檇 like to see a mandatory 20-year sentence,鈥� Altomare said. 鈥淭here鈥檚 nothing non-violent about a heroin dealer who is selling death in the community.鈥�
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. 鈥淥n Monday mornings, we dread seeing on paper how many overdoses we鈥檝e had. Some Mondays, we鈥檙e reeling.鈥�
