Baltimore health clinic offers naloxone training to combat opioid epidemic

Health officials in Baltimore are preparing to offer training programs and free distribution of the overdose-reversal drug naloxone to mark International Overdose Awareness Day on Thursday.

The Baltimore City Department of Health will able to distribute naloxone thanks to extra state funding that has helped increase the agency’s supply, city health officials said. The department had faced a shortage of naloxone kits in June, with only 4,000 units to last until May 2018.

Mark O’Brien, director of opioid overdose prevention and treatment, said the department is open to training any organization in the use of naloxone but encourages those who can to purchase the overdose-reversal drug and not deplete the Health Department’s supply.

“We really do have to prioritize who we provide naloxone to — to our highest-risk residents — and among our highest-risk residents are needle exchange clients,” Mr. O’Brien said, adding that the department has turned away methadone clinics, homeless shelters and federally qualified health care centers seeking free naloxone.

For 23 years, Baltimore has conducted a needle exchange program in areas with the highest prevalence of overdoses and addiction. Since 2004, it has provided naloxone training to everyone who has approached its mobile health units to exchange needles. The result: More than 500 overdose reversals were reported in 2016.

Still, Baltimore — Maryland’s largest city — witnessed 454 overdose deaths related to heroin, 419 related to fentanyl and 113 related to other opioids last year.

In the first three months of 2017, the city recorded 176 deaths related to drugs and alcohol, compared to 113 similar deaths during the same period last year.

Mr. O’Brien said the Health Department is working to secure a grant to scale up its outreach and treatment efforts.

“Those programs have been effective, but they’re not on the scale that we need to get people into treatment,” he said.

Baltimore Health Commissioner Leana Wen has advocated for the wide availability of naloxone, for health insurance to expand coverage for addiction treatment centers, and for treatment of addiction and mental health remaining within the essential benefits put in place under Obamacare.

“There should also be coverage for other wraparound services that are critical for treating addiction, such as supportive housing and reimbursement for peer recovery specialists,” Dr. Wen wrote in an open letter to President Trump following his announcement earlier this month proclaiming the opioid epidemic a national emergency.

“Block grants are helpful but cannot be depended on for treatment of such a widespread disease. No other disease is treated through grants alone,” she said.

Mr. O’Brien said that since 2015 his team has helped train 25,000 people to administer the overdose-reversal drug and has distributed 21,000 kits containing naloxone, which is delivered as a nasal spray or an injection. He said that private citizens have been responsible for saving at least 1,200 lives of people during that period.

“These are 1,200 lives saved by everyday people in our community who have been able to reverse overdoses in their friends, family members, neighbors and in some cases just strangers that they’ve run into in the city,” he said.

In addition to Thursday’s training programs, the Health Department will hold an open mic night at a local coffee shop to encourage those who are addicted to drugs or affected by the opioid crisis to share their experiences.

“We’re in public health, and a lot of times we get really hung up on the numbers and the data. But the really important thing to me is that we’re talking about people’s parents, people’s children, our friends and our neighbors, who are dying in really unprecedented numbers because of opioid use and opioid overdose,” Mr. O’Brien said.

“We’re hoping it can really be a cathartic way for us to remember residents who we’ve lost and talk about ways that we can improve the health of people in our city,” he said.

International Overdose Awareness Day was started in Australia in 2001 to commemorate those who had died from an overdose.