Opinion: Baltimore Needs to Take Bold Steps on Opioid Treatment Programs

opioid treatment
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Early in May, north Baltimore’s Mount Vernon-Belvedere Association sent out a city council candidate questionnaire. Because of COVID-19, candidates were asked to submit video responses to the questions.

Many of these questions were on topics you would expect from these neighborhoods, but one really made me stop to consider what they were asking:

It read, “Do you think that the number of treatment, public health, and correctional facilities are too great in the 12th District?”

Here is a paraphrase of my response:

Putting even a local moratorium on opioid treatment programs represents a critical misunderstanding of how addiction works and how treatment works. It’s a stance that, in 2020, should be ridiculed when a politician takes it.

When you have a substance abuse disorder, you’re most likely to use the treatment center closest to where you live because, in all likelihood, you don’t have access to a car or reliable public transportation. Proximity is important.  

So when you say “not in my neighborhood, we want to put it elsewhere,” you’re basically saying “I’m OK with a person seeking life-saving treatment for their disease … as long as it’s not near Eddie’s.” We need to be expanding treatment options, not just in District 12, but also at the state level.

I don’t know whether that was a popular answer, but I do know that it’s the correct answer.

Our city loses in excess of 700 lives every year to overdose. These are 700 very preventable deaths, deaths that aren’t caught up in the politics that often surround violent crime in our city. We should not be able to countenance the idea that someone who is suffering with a disease should be subjected to obstacles that directly impact the efficacy of their treatment just because of the inconvenience of it all.

When Councilman Ryan Dorsey’s campaign for re-election received more than $40,000 from an opioid treatment program service provider, people got angry. Mr. Dorsey returned the money out of a sense of propriety; but perhaps also so that he could stand in defense of what is correct –– greater treatment options, not fewer –– without public cries of “he’s been paid!” Mr. Dorsey recently celebrated another sobriety anniversary, and while I won’t speculate on any aspect of his disease, I can say with some confidence and not a small amount of faith that Mr. Dorsey would defend these expanded options because it is correct.

Recently, in an article in Baltimore Brew, it was revealed that Antonio Glover, a candidate for council in District 13, has drawn criticism for accepting a contribution of more than $30,000 from the same OTP service providers to whom Mr. Dorsey returned money.

We should really be doing some self-examination when we, as a community, cry foul when public health is concerned, but don’t similarly balk when developers, surveillance companies, or media and restaurant tycoons act similarly.

We could and should be doing more to save lives. A cursory search of the Baltimore Health Department’s website reveals another grim superlative: Baltimore is the most deadly city for intoxication fatalities in America. More than double the number of people are killed by a treatable disease in Baltimore than are killed by homicide.

And every single opioid-related death could have been prevented. It is not requisite that you die from an opioid overdose.

The silence of the vacuum where “deafening public outrage” should be is the most unsettling part of all of this. It is an absolute condemnation on us as neighbors and as non-sociopaths that we are complicit in the loss of more than 700 lives every year. Why are we, as a community, OK with this abject dehumanization? Because politicians, the people who are supposed to shape public discourse and craft policy that uplifts the most marginalized don’t want to openly associate with weakness, with need, or with things that our faint veneer of privilege would otherwise allow us to ignore.

Our next mayor and council must work to save these lives.

Starting today, and echoing into the oncoming years, our city must be at the vanguard of saving lives.

We need supervised injection sites. Philadelphia has already done the heavy lifting of going to federal court (and winning!) to establish a precedent. Supervised injection sites, while not explicitly legal under federal law, are implicitly legal, and should not invite federal intervention. No one in Baltimore is more than one degree of separation from someone who is living with substance abuse disorder.

We need our state leaders to adjust the waiver requirements for doctors to get waived to prescribe buprenorphine, so that more primary care physicians can prescribe a multi-day treatment and can be done through mobile clinics, which could potentially obviate the need for more brick-and-mortar treatment facilities. (Methadone, by contrast, is federally regulated to a single day prescription.) Vermont has leveraged this hub-and-spoke model (with hubs treating complex addiction using ongoing care, while spokes continue care in a community setting) to great success.

Many so-called leaders face challenges when those challenges are placed in front of them. Fewer go to those challenges, proactively demanding to be faced. In Baltimore, we have the opportunity to make the bold, life-saving choice of saving lives. But it demands that we do what is correct, whether or not it is popular.

— DAVE HEILKER

The writer is a community organizer and the communications director for Strong Schools Maryland and Baltimoreans for Educational Equity. He is a Democrat running for Baltimore City Council’s 12th District.

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