A voice for the voiceless in Maryland’s overdose crisis
By Carolyn Thangawng
The writer is medical director for Recovery Centers of America Capital Region.
Earlier this year, I attended the Community Overdose Action Town Hall Series in Charles County. Maryland’s Office of Overdose Response held town halls across the state to hear from the community about ways to address the overdose crisis.
As an addiction medicine physician and medical director of Recovery Centers of America Capital Region, an addiction treatment center in Waldorf, I welcomed the opportunity to provide my perspective on addressing substance use disorder (SUD) and overdose in the state.
One of the most important things to understand about addiction is that it is not an individual disease. Addiction often carries collateral damage affecting family, housing, mental health and employment. Children in particular are greatly affected by addiction in the household.
Addiction and mental illness often occur together. Social determinants of health, racial disparities and treatment access are exacerbating factors. It is logical, therefore, that the criminal justice system represents the foremost referral source to addiction treatment.
Given this landscape, my testimony focused on ways I believe we can make a difference in reducing the impact of SUD on the county level and in Maryland more broadly. Although there are no easy solutions to this multi-pronged problem, I’m resharing my ideas here, including areas I believe are critically in need of funding now.
Addressing mental illness: Mental Illness and addiction are largely co-occurring. Legislation is needed to allow emergency medical services to take a patient to the closest hospital with psychiatric beds, rather than the closest hospital, which may not have onsite psychiatric services or beds.
Mobile crisis teams: These teams consist of mental health professionals dispatched to provide immediate assessment and treatment to people experiencing a psychiatric emergency. They go to the individual and provide services where the person is located. Teams work with crisis intervention agencies, shelters and others to help patients find treatment and/or shelter.
Low-barrier mobile buprenorphine vans: Also known as street medicine, these readily accessible units park in high-need communities and are staffed with nurse practitioners or physicians who can treat opioid use disorder. They initiate Buprenorphine, which can reduce relapse by 50% and refer patients to local primary care for follow-up.
Supporting children: When we talk about the opioid epidemic, we must talk about the trauma epidemic experienced by the children of those who struggle with addiction. We need to establish evidence-based resiliency and coping/emotional regulation curriculum starting in elementary school.
Funding for treatment of incarcerated individuals: The No. 1 cause of post-release fatality is overdose due to loss of tolerance when medication-assisted treatment (MAT) is not provided to incarcerated individuals. Under new Maryland law, the State Opioid Use Disorder Examination and Treatment Act, jails must provide all forms of medication-assisted treatment. Funding – not as grants but as line items in the state budget – is desperately needed to staff jails to expand treatment access. Funds are also needed for releasing incarcerated individuals to be transported to their community MAT appointment.
I’m pleased the state of Maryland has opened a forum where addiction treatment experts and those affected by the overdose epidemic can share ideas. The dialogue must continue. I invite my fellow Marylanders to join me in being a voice for the voiceless.
It’s time to put words into action. As state officials and legislators consider ways to put the opioid settlement payments to the best use, I ask that they remember the important feedback shared during the town halls and commit to funding these programs. Especially in the correctional setting when resources are spread thin, it’s essential that financial support for these programs is built into correctional budgets, rather than solely as time-limited grant opportunities.
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