Maryland legislators must put aside their partisan differences to target opioid overdoses
As Maryland emerges again from the latest surge of the COVID-19 pandemic, we are left to survey the damage, not just from the Omicron variant but from the whole two-year ordeal. The shuttered businesses, canceled gatherings and closed entertainment venues were bad for everyone, but worse for those suffering with opioid addiction. The isolation wrought by the pandemic, public health practitioners believe, contributed to the worst year for opioid overdoses in Maryland’s history, with over 2,500 fatal overdoses in 2020 alone.
To counter this worrying trend, Gov. Larry Hogan’s administration has introduced the “Statewide Targeted Overdose Prevention (STOP) Act,” which seeks to increase the availability of naloxone, an overdose-reversal medication. This legislation is a significant step in the right direction, and if Maryland legislators are serious about restoring progress against the opioid epidemic, they should partner across party and regional lines to pass the STOP Act.
In essence, the STOP Act would implement a naloxone “take-home kit” program in which paramedics and emergency medical technicians would be authorized to give out several doses of naloxone to individuals at risk of fatal opioid overdose. By 2024, the legislation would also require community services organizations—including outpatient treatment and reentry programs—to develop protocols for dispensing take-home naloxone for their clients. This strategy would effectively reach the state’s most vulnerable residents who may not have ready access to a health care provider or local pharmacy.
Maryland leaders are right to recognize that now is the time to expand access to this life-saving medication. Up until the pandemic, the state was making great progress in fighting overdoses, even bringing incidence rates down for the first time in 2019. But it proved to be a sad story of “one step forward and two steps back,” as 2020 saw a nearly 19 percent increase in overdoses, with a stark 54.9 percent increase in Prince George’s County alone.
Increasing naloxone access is one of the easiest, least controversial policy steps legislators can take to slow and reverse the overdose rate. Naloxone is a medication approved by the Food and Drug Administration that binds to opioid receptors, “blocking the effects of other opioids” and quickly reversing overdose. Studies indicate that its efficacy ranges from 75 to 100 percent effective, with one study from Boston’s Brigham and Women’s Hospital concluding that it reversed 93.5 percent of overdoses, all with minimal, manageable side effects. Furthermore, it is impossible to get high from, become addicted to or overdose on naloxone; in short, for those in active overdose, it is a medical miracle.
In many ways, legislation to increase access through take-home naloxone is simply an extension of work already being done across the state. Good Samaritan laws have been on the books for years to allow both emergency medical services personnel as well as laypeople to administer naloxone to anyone in active overdose. In 2021, the Maryland Department of Health went a step further, signing a two-year standing order allowing anyone to obtain two doses of naloxone from a pharmacist without a doctor’s prescription.
If the STOP Act passes, Maryland would not be the guinea pig: several other jurisdictions have run pilot programs to test this policy, with a meta-analysis determining they reduce fatality to just one in 123 overdoses. A study of a take-home naloxone program in Vermont estimated that the kits prevented at least 279 deaths in 2020 alone. Another pilot program in Howard County found additional benefits in recovery efforts, as patients were more likely to seek out support from addiction recovery specialists when offered a take-home naloxone kit from a family member or friend (5.19 and 3.69 times more likely, respectively).
Despite being evidence-based and uncontroversial, the STOP Act has little bipartisan support. Only two Democrats signed onto the Senate version, which has 13 Republican cosponsors; none have added their names to the House version, which is cosponsored by 22 Republicans. This likely has less to do with policy than with partisanship: the bill has been a key priority of Gov. Hogan’s administration, and his other priorities, particularly on crime, have drawn much criticism from Democratic leaders in the Baltimore and Washington, D.C. suburbs.
But a good idea is a good idea no matter who came up with it, and stalling the STOP Act will do nothing to bring down the all-too-high rate of opioid overdose deaths across the state. Maryland legislators must put aside their differences and make passing the STOP Act top priority for 2022. The lives of countless Marylanders depend on it.
Image credit: mandritoiu
