BERLIN – Health officials say cooperative efforts among a variety of local entities are responsible for the recent drop in drug and alcohol deaths.
This month, overdose figures released by the Maryland Department of Health showed a decrease in total drug and alcohol related intoxication deaths in Worcester, Wicomico and Somerset counties. In Worcester County, officials believe a main factor in that 42 percent decline is the commitment of the various organizations involved.
“We all come to the table on a first name basis with each other and we sit down and talk about what everybody’s doing and how we can do this together better,” said Mike Trader, assistant director of behavioral health for the Worcester County Health Department.
According to the figures released last week, Worcester County recorded 11 fewer drug and alcohol deaths between January and September of 2017 than it did during the same period in 2016. The county saw six fewer opioid deaths in 2017 than it did in 2016.
The decline comes despite the fact that Worcester County still lacks resources for those battling addiction. Statewide, behavioral health is in crisis, according to the Maryland Hospital Association. Behavioral health related visits to the emergency room — which include mental health as well as addiction patients — were up 18 percent between 2013 and 2015. Statewide, only 14 percent of psychiatrists are accepting new patients and able to provide those patients with appointments within 45 days.
Atlantic General Hospital (AGH) reports that there is one psychiatrist for roughly every 16,000 people in Worcester County.
“We need psychiatrists to get out of the big cities,” said Michael Franklin, CEO and president of AGH.
Trader agreed. He said he’d visited the University of Maryland in an attempt to interest young psychiatrists in coming to the Lower Shore and had little success.
“I think one of the struggles that we have is how to get psychiatrists to go from what they know — schools and residency programs tend to be in urban areas — how do we get them to come here,” Trader said. “Nationally there’s such a shortage of psychiatrists anyway so they can kind of take their pick where they’d like to go.”
To combat that issue here, psychiatric nurse practitioners are being used to fill the gap.
“What their role tends to be is medication management which is key when it’s a mental health patient,” said Colleen Wareing, AGH’s vice president of patient care services.
Because those dealing with mental health problems and those dealing with addiction are already under stress, individuals known as community health outreach workers have been added to the emergency room at AGH through a partnership with the help department. The workers, also known as care coordinators, know how to navigate the local health system and can connect patients to whatever type of resources they need.
“You’re dealing with a population that’s already in crisis,” Wareing said, adding that patients were often overwhelmed when faced with figuring out the healthcare system.
Franklin agreed.
“If it’s not easy to find it’s not going to be found,” he said. “People are going to give up.”
The care coordinators are trained to deal with mental health patients as well as patients fighting drug or alcohol addiction.
“They see probably more alcohol related emergencies than they do drugs by far,” Wareing said, “and these individuals know all the resources.”
Peer support workers are now among those resources, thanks to a grant the health department received. Wareing said they are individuals who battled addiction themselves and overcame it. They’re able to provide support to the hospital’s patients.
“That peer to peer is really important in establishing trust and getting them into treatment,” Wareing said.
While care coordinators and peer support workers aid those facing addiction now, there are also efforts underway to stop addiction before it starts. Specialists are now helping those with chronic pain, as opposed to just primary care physicians.
“The primary care doctors may not have been the best ones to manage that,” Wareing said. “They were trying to manage it the best they could, sometimes that involved opioids which led to other issues. We’re much more aware of screening for appropriateness of prescriptions now.”
Franklin said the hospital’s pain specialist was working to share his philosophy with patients. He advises them that there’s no way to eliminate all of their chronic pain.
“We’ve got to learn how to help you live with that and adjust to the fact that you are going to have some level of pain,” Franklin said.
He believes the Prescription Drug Monitoring Program will also help decrease opioid addiction. The program, which was created in 2011 but becomes mandatory this year, links pharmacy data throughout the state and requires a physician to review a patient’s prescriptions before prescribing them anything. Franklin said that would prevent an individual from going pharmacy to pharmacy to get prescriptions filled.
“A lot of the weaknesses in the healthcare system that created these places for people to get their hands on medications have gone by the wayside,” he said.
At the same time, awareness of the problem has increased. The state’s focus on the opioid epidemic and efforts of groups like the Worcester County Warriors have put addiction in the spotlight.
“So many people are hearing about the addiction they’re afraid to go on opioids and they’re not asking for them,” Franklin said.
Though fatalities related to drugs and alcohol did drop in 2017, officials say there’s still more work to be done. Wareing said it takes too long to get people into treatment facilities once they decide they want help.
“With addiction you almost have to get wrapped around them and hold onto them until you can get them were they need to go, before they go out and start drinking again, or start using again, because then they’re back into that cycle,” she said.
The Atlantic Club in West Ocean City does offer 24-hour support to those dealing with addiction but that’s not always enough. Wareing says getting people into treatment quickly is vital.
“If they’re ready today and it’s going to be next week (that they can get into treatment) the likelihood they’re going to be there next week is not real high,” she said.
Trader is hopeful the Maryland Helpline, 211, as well as the Life Crisis Center’s 410-749-HELP, will, like the Atlantic Club, provide those in need with some 24-hour support.
While the county continues to need inpatient treatment facilities and recovery beds, officials believe that increased awareness of behavioral health issues will aid in prevention.
“Addiction is an illness and we need to treat it like any other illness,” Wareing said.
Trader agreed.
“It always gets me when people say addiction’s not an illness it’s a choice,” he said. “Do you say to someone with high blood pressure, ‘you have high blood pressure because… you choose to eat poorly and not exercise?’ No. There’s an element of choice but there’s also an illness that comes with it. That’s the way I try to look at it.”
