Opioid use, fentanyl deaths in Maryland spike amid pandemic

Preliminary data from 2020 reveals a dramatic increase in deaths linked with opioids in Maryland, particularly fentanyl; health officials blame the pandemic.

The number of unintentional intoxication overdoses — those involving all drugs and alcohol — rose 18.7% to 2,773 in 2020 from 2,379 in 2019, according to data collected by the Maryland Department of Health.

In more than 90% of cases, opioids were detected in bodies postmortem, the highest rate recorded in the state’s history of collecting this data.

While too early to formally determine the extent to which COVID-19 has influenced this increase, experts agree the pandemic is likely to blame for the widespread increase in drug use.

Dr. Aaron Greenblatt, the medical director of the University of Maryland Medical Center Addiction Treatment Programs, said he feels confident the pandemic has affected these statistics.

Pandemic-induced stress, he says, is likely a major factor in drug users’ relapses; but COVID-19 restricted treatment options, too.

“I think that access to treatment—particularly access to psychosocial treatments—was really significantly impacted by COVID…we haven’t had groups,” Greenblatt told Capital News Service.

Outpatient addiction treatment programs are intense, and may typically require patients to visit an office or a clinic to get supervised therapeutic medication dosing up to six days a week.

“Our spaces are not necessarily set up for physical distancing. So all of the adjunctive psychosocial interventions that are important in addiction treatment have been harder for patients to access,” Greenblatt said.

This sentiment was echoed in a December press release by Dr. Robert Redfield, then the Director of the Centers for Disease Control and Prevention.

“The disruption to daily life due to the COVID-19 pandemic has hit those with substance use disorder hard,” Redfield said.

In the same press release, the CDC issued a statement that said the number of drug-related intoxication deaths throughout the U.S. in 2020 was the highest ever recorded during a 12-month period.

As is the case in Maryland, fentanyl was involved in a staggering number of these deaths; between June 2019 and the next 12-month period, overdoses involving fentanyl increased more than 38%, according to the CDC.

During this period more than 97% of U.S. jurisdictions that collect data on synthetic opioids — namely fentanyl — use reported an increase in deaths linked with the substances, according to the CDC.

It is hard to be certain why fentanyl use has increased in so many places, but in Maryland, Greenblatt thinks cost plays an important role.

“When I came to Baltimore in 2014 to do my training, a pill of heroin was, I think, typically $10 maybe $12 sometimes… but now, you know, you can actually get like large pills of street opioids, probably fentanyl, for between $3 and $6,” Greenblatt said.

Maryland runs a variety of relief initiatives in partnership with the Opioid Operational Command Center.

In June, the center released a 10-page COVID-focused strategy.

Its stated goals are grouped into three distinct focus areas: prevention and education, enforcement and public safety, and treatment and recovery.

The first focus area includes promoting public awareness campaigns about substance use disorders amid the COVID-19 pandemic; the second includes expanding Law Enforcement Assisted Diversion (LEAD) programs.

The third area focuses on more concrete resources like promoting healthcare enrollment and expanding peer support programs and recovery housing.

The 2021 Maryland Inter-Agency Opioid Coordination Plan released last month includes information about the COVID-19 pandemic’s effect on opioid use that was not known in June 2020 as well as general guidance.

Among its six new priority projects are expanding care resources for newborns exposed to opioids and “enhancing the state’s infrastructure to respond to adverse childhood experiences,” the plan says.

In April, despite the uptick in opioid-involved overdose deaths, Gov. Larry Hogan, R, vowed the state would continue to fiercely fight the battle against the opioid crisis.

“Our administration will not waver one iota in its efforts to combat the opioid crisis in Maryland. Just as we have made tremendous progress against COVID-19, I am confident that we will work together to reverse the recent trend in opioid-related fatalities,” Hogan said.