Fighting The Opioid Epidemic

According to the Centers for Disease Control, opioid overdoses kill five Americans every hour. In 2016, and again in 2017, more Americans died from opioid-related overdoses than died than in car crashes, by gun violence, during the peak year of the AIDS epidemic, or during the entire Vietnam War. Since 2015, opioid use has spiked in every area of the country, in both men and women, and in all age groups, even children and teenagers. Here in Maryland, Anne Arundel County is third in opioid-related overdoses, behind Baltimore City and Baltimore County.

Opioids bind to areas of the brain that control pain and emotions, increasing the levels of dopamine and producing intense feelings of euphoria. As the brain becomes accustomed to these feelings, more opioids are consumed to result in the same levels of pain relief and euphoria, leading to dependence and addiction. According to the National Institute on Drug Abuse, 21 to 29 percent of patients prescribed opioids misuse them, and 8 to 12 percent develop an opioid disorder. The U.S. consumes 99 percent of the world's hydrocodone and 81 percent of the world's oxycodone, and uses 30 times more opioids than our population requires.

Last year, I joined the House of Delegates opioid workgroup in an effort to combat the opioid crisis. Through the end of March this year, we have reviewed numerous bills and have approved six as of the end of March.

House Bill 1452, which has passed both the House and Senate, requires licensed providers of controlled dangerous substances (CDS) to complete two hours of continuing education on dispensing CDS. House Bill 653, which was cross-filed in and passed the Senate, requires health care providers, before prescribing a CDS, to discuss why the CDS is being prescribed, the risks associated with using it, the dangers of taking opioids with alcohol and other drugs, and alternative treatments.

House Bill 1480, which has passed in the House, requires dispensers of CDS to report any suspicious order of CDS — one that is of unusual size, frequency or pattern — to the Maryland Department of Health (MDH) and the attorney general. House Bill 359, which was cross-filed in and passed the Senate, enables first responders to efficiently report and track specific overdose information so that resources like overdose treatment can be allocated in near real time to respond to particularly potent opioids in specific areas. House Bill 1092, which has passed the House, establishes a behavioral health crisis response grant program with which local behavioral health authorities can submit proposals to MDH to provide behavioral health services in their service areas based specific local needs.

House Bill 922, which I co-sponsored, has passed the House. This legislation establishes a “pill mill” tip line and requires coordination and interpretation of overdose reports. Using the tip line, people will be able to report doctors and other licensed prescribers suspected to be overprescribing CDS. HB 922 also requires state agencies to collect, examine, and share prescription and treatment histories of fatal overdose victims so that factors associated with opioid overdose can be assessed, programs aimed at opioid use and misuse can be assessed, intervention methods for at-risk populations can be identified and assessed, and recommendations for improving and providing statewide prevention can be made. In this way, devoting resources and developing policies related to CDS overdose prevention can be maximized.

The opioid crisis affects all of us, nationally, statewide and locally, not just in lives lost but also in loss of productivity, increases in medical and insurance costs, and the basic human losses of parents unable to care for their children and interact in global society. My fellow delegates and I are trying our best to pursue a policy to combat this insidious epidemic.