Maryland Governor Larry Hogan presented his plan to address heroin addiction in Maryland yesterday. Unlike some of his more conservative counterparts, Gov. Hogan clearly stated that heroin addiction — like all addiction — is a disease, and that people with the disease need to be helped:
“”This used to be considered an urban problem, but it’s not anymore,” he said. All over the state, he said, local officials told him heroin had become their No. 1 problem. The governor said he felt a personal connection because a cousin died of an overdose a couple of years ago.
“I know the kind of devastation it can cause for families and communities, but still I was shocked by how widespread this problem had become,” he said.
Hogan said heroin was both a law enforcement problem and a health issue. “This is a disease, and we will not be able to just arrest our way out of that crisis,” he said.”
His plan includes forming a commission to look at how to combat the heroin epidemic, and half a million dollars in federal money. He doesn’t plan on any state money to be used, however. That, and a couple of other aspects of his proposal were the subject of criticism:
“Some were unimpressed by the governor’s plan.
“This is the biggest joke I’ve ever heard in my life,” said Mike Gimbel, a former drug user who served as director of Baltimore County’s substance abuse office. “We need long-term, residential drug-free treatment in the state of Maryland. We’ve never had it. There are people out there who need it immediately.”
Del. Kirill Reznik, a Montgomery County Democrat, said the task force duplicates the Alcohol and Drug Abuse Council he has served on since it was created by O’Malley in 2007. Reznik said the council has already identified what the state needs — more treatment beds and more preventive education programs starting as early as elementary school.”
Personally, I wouldn’t call it a joke. It’s a big step for a Republican Governor to even begin the discussion of drug addiction being addressed by measures other than jail time. For too long we’ve been throwing addicts away into prisons that spit them back out into the community in worst shape more often than not. At the same time, I agree that Gov. Hogan’s plan falls short of what is needed if we are to truly address this “emergency.”
That is my problem with politicians wanting to take on public health problems. They seem to call things emergencies then not act like they’re real emergencies most of the time. Heroin addiction has increased dramatically because of opiate prescription drug abuse. People abusing opiates find that they cannot afford them after a while, or they end up on databases that prevents physicians and pharmacies from prescribing and dispensing opiates to them. So they go in search of a cheaper source of opiates in heroin. With it, the untreated addict is at greater risk of a whole host of co-morbid conditions from their heroin abuse.
I really wish that Gov. Hogan would have issued a request to the state’s board of health to review the prescribing practices of physicians and other providers who prescribe opiates in large numbers. I wish he would have directed the state attorney general’s office to look into pharmacies that dispense abnormally large numbers of prescriptions for opiates. He could have asked the state superintendent of schools to look into curricula that could curb the use of drugs in general by children and young adults, like Delegate Reznik suggested. The state health department could do a descriptive epidemiology using the latest tools available to find out who is most at risk of addiction, where they are getting their drugs from, and what kinds of outcomes we’re seeing in the state. As Mr. Gimbel said, the governor could also help guide legislation that orders heroin users to undergo treatment instead of going to jail. That treatment could be done at any of the closed-down facilities that could be retrofitted to be drug rehab facilities, like Mr. Gimbel suggested.
In essence, this problem needs to be attacked from all sides, just like any other public health emergency should. While there is an intention to do this, and a lot of good things were said, everything to be done will still be discussed in a task force, so God only knows how long before action happens.
René F. Najera, DrPH
I'm a Doctor of Public Health, having studied at the Johns Hopkins University Bloomberg School of Public Health.
All opinions are my own and in no way represent anyone else or any of the organizations for which I work.
About History of Vaccines: I am the editor of the History of Vaccines site, a project of the College of Physicians of Philadelphia. Please read the About page on the site for more information.
About Epidemiological: I am the sole contributor to Epidemiological, my personal blog to discuss all sorts of issues. It also has an About page you should check out.