Photo via Wikimedia Commons

As fatal overdoses continue to climb in Maryland, heroin’s contribution to the epidemic is diminishing as its more potent cousin, fentanyl, assumes a larger role, data show.

Just over 1,700 people in Maryland died of accidental drug or alcohol overdoses in the first nine months of 2017, according to new figures published today by the Maryland Department of Health. About 88 percent (1,501) of those deaths were opioid-related, a nearly identical proportion to the same period in 2016. But around 69 percent of the deaths in 2017 were fentanyl-related, up sharply from 49 percent for the same nine-month stretch one year earlier.

Fatal heroin overdoses actually declined by nearly 50, the first such drop for that period in seven years, though deaths from fentanyl – a drug estimated to be 50 times stronger – and carfentanil – an even stronger synthetic animal tranquilizer being cut with street drugs, with deadly results – accounted for more deaths than ever before, as drug traffickers and suppliers are cutting more heroin sold on streets with even more potent substances. (The state only began tracking carfentanil-related deaths in 2017, but the drug was connected to 57 deadly overdoses through from January through September 2017.)

Heroin-related deaths actually decreased through three quarters of 2017 actually fell for the first time in seven years. Graph via Maryland Department of Health.
Fentanyl-related deaths continued to climb in the first nine months of 2017, accounting for 1,173 of the state’s 1,705 fatal overdoses. Graph via Maryland Department of Health.
Fentanyl-related deaths continued to climb in the first nine months of 2017, accounting for 1,173 of the state’s 1,705 fatal overdoses. Graph via Maryland Department of Health.

Use of cocaine in combination with opioids is also a growing factor in the opioid epidemic. Data show cocaine-related deaths climbed by 47 percent from 2016.

“The Department issued a warning against fentanyl in 2016 and I want to reiterate the dangers of it and other synthetic drugs, which are the leading cause of overdose deaths in Maryland,” said Maryland Health Secretary Robert R. Neall in a statement. “We implore Marylanders who are grappling with substance use disorders and are taking illicit substances to seek treatment immediately, and for others to take advantage of the standing order for naloxone by learning how to administer it and carry it with them.”

Baltimore continues to contribute heavily to the spiraling problem. The city accounted for 574 overdose deaths in that nine-month period, equal to a third. Baltimore County was the second-largest contributor with 271 fatal overdoses.

“Based on the numbers that were just released, it’s likely that Baltimore City and Maryland have had more overdose deaths in 2017 than any other point in our history,” Baltimore City Health Commissioner Dr. Leana Wen told Baltimore Fishbowl on Friday. “And what’s terrifying about this is that we have not even seen the peak of the epidemic yet. We don’t know how much worse this is going to get, we just know that it’s going to get worse.”

Maryland officials are at battle with the epidemic. Gov. Larry Hogan called a state of emergency in the spring, and established the so-called Opioid Operational Command Center to better mobilize against localized overdose outbreaks.

In June, the state issued a standing order to allow pharmacies to dispense naloxone, a life-saving antidote to overdoses, to anyone at risk or who can help someone at risk of an overdose. Under another order issued by Wen, all of the city’s pharmacies are now selling naloxone over the counter, regardless of whether they’ve received training.

Wen said naloxone and on-demand treatment are proven methods to fight the onslaught of drug overdoses in Baltimore, but the city needs more federal and state resources–funding included–to expand use of those tools.

“We have a solution, but we just lack the resources to get there. We’re doing everything that we can in Baltimore City on a shoestring budget,” she said. “We know that we have already saved thousands of lives, but how many more thousands of lives [would] we [be] able to save if only we had the resources to do so?”

This story has been updated with comment from Baltimore City Health Commissioner Dr. Leana Wen.

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Ethan McLeod

Ethan McLeod is a freelance reporter in Baltimore. He previously worked as an editor for the Baltimore Business Journal and Baltimore Fishbowl. His work has appeared in Bloomberg CityLab, Next City and...