Coronavirus Pandemic Interrupts Progress Seen in 2019; State Response Includes Inter-Agency Coordination Plan and Enhanced Services for Vulnerable Communities
Annapolis, MD – The Opioid Operational Command Center (OOCC) and the Maryland Department of Health (MDH) have released their 2020 Annual Report on the opioid crisis in Maryland. The report includes preliminary data detailing increases in opioid- and other substance-related fatalities amid the coronavirus pandemic. The state’s efforts to respond to the increased number of fatalities include continued inter-agency coordination, development of initiatives targeting gaps in treatment, and enhanced recovery services for vulnerable communities.
According to MDH’s Vital Statistics Administration, there were 2,773 unintentional intoxication deaths involving all types of drugs and alcohol in Maryland between January and December of 2020. This figure represents a 16.6 percent increase from 2019, when there were 2,379 such fatalities. Officials believe that the coronavirus pandemic has contributed greatly to these increases. Across the country, COVID-19 has disrupted treatment and recovery support systems and has led to economic stress, despair, and uncertainty, especially among vulnerable populations.
“This has been a challenging year for us all, and Americans suffering from substance use disorder have been particularly hard hit by the pandemic,” said Governor Larry Hogan. “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.”
Opioids were involved in 90.1 percent of all substance use-related intoxication fatalities in 2020, a higher annual proportion of such deaths than at any other time during the opioid crisis. There were a total of 2,499 opioid-related fatalities last year, an increase of 18.7 percent from 2019. This increase was largely driven by the growing prevalence of fentanyl, which was involved in 93.1 percent of all opioid-related deaths, a historic high. 2,326 overdose deaths involved fentanyl in 2020, an increase of 20.7 percent.There was also an increase in deaths involving prescription opioids for the first time since 2016. There were 445 fatalities reported, a 20.6 percent increase compared to 369 reported in the prior year. Heroin was the only major substance category that saw a decrease. Heroin-related deaths decreased by 25.2 percent, a continuation of a trend that began in 2017.
The OOCC’s report includes data on opioid-related overdose deaths by age, race and ethnicity, and gender. While data show that opioid-related fatalities increased across all demographic groups in 2020, Black Marylanders have seen a disproportionate share of such fatalities in recent years. This year, the new Racial Disparities Task Force began its work to promote equitable health outcomes by investigating contributing factors and proposing solutions to eliminate racial disparities related to overdose fatalities in the Black community. The task force is operating under the guidance of the Inter-Agency Heroin and Opioid Coordinating Council, which is chaired by Lt. Governor Boyd Rutherford.
“Many factors can lead to disparate health outcomes, including stigma, education, poverty, and trauma. Marylanders of any race, age, or gender can find themselves without access to needed treatment as a result,” said Lt. Governor Rutherford. “Collecting data that shows us some groups are at a significant risk of dying as a result of substance use disorder is a first step. We must respond with action. The Racial Disparities Task Force will help us determine what must be done to address this epidemic and the needs of those communities.”
To address health inequities among Maryland’s minority communities, Governor Hogan and Lt. Governor Rutherford have committed to support the Center for Urban Health Equity housed at Morgan State University (MSU). Under Governor Hogan’s proposed budget for fiscal year 2022, MSU will receive $3.5 million to sustain the center’s work into the future. The center will develop innovative methods to address health disparities by training researchers and engaging underserved communities to identify and solve a variety of health issues, including substance use. Members of the state disparity workgroup will partner with members of the center to address disparities in substance misuse fatalities.
The 2020 Annual Report also provides an overview of the Inter-Agency Opioid Coordination Plan, which details goals and strategies to advance Governor Hogan’s policy priorities of Prevention & Education, Enforcement & Public Safety, and Treatment & Recovery. The Coordination Plan identifies nine goals with accompanying strategies and tactics to combat opioid misuse. New this year are six priority projects, including:
- Enhancing state infrastructure to respond to adverse childhood experiences (ACEs)
- Establishing a comprehensive crisis response system
- Utilizing data to inform policy and programmatic decisions
- Expanding recovery residences
- Coordinating care, including care for substance-exposed newborns and transportation for individuals seeking treatment
- Ensuring wraparound services for justice-involved individuals
“At this time last year, we saw a decline in statewide overdose fatalities. It was the first time in over a decade that we could report seeing that modest, but vital, first step,” said Steve Schuh, executive director of the OOCC. “Our ability to capture the detailed data outlined in the report helps us to identify where we succeeded in the past, when we can retrace our steps, and how we can improve our responses.”
Litigation at the state and national levels is expected to help to support Maryland’s fight against opioid misuse in the coming years. In late 2021, Maryland is slated to receive a $12 million settlement from a lawsuit brought against consulting firm McKinsey & Co. by a coalition of states affected by the opioid crisis. The funds from this and other settlements will be used to support programs designed to mitigate the effects of the opioid crisis on Marylanders.
“A measure of justice is served when a company that played a role in perpetuating the national opioid epidemic is held accountable,” said Schuh, “The Opioid Operational Command Center looks forward to working with our partners across the state to ensure that the funding received from opioid-related litigation is used to help rebuild the lives and communities affected by years of irresponsible corporate action.”
“We have been deliberate in working closely with state partners and local behavioral health leadership – including through our new Opioid Overdose Prevention Strategy Team and Clinical Advisory Team,” said BHA Deputy Secretary Dr. Aliya Jones, who co-chairs the Racial Disparities Task Force. "We saw that COVID-19 was creating a perfect storm for people with substance use disorder amid the opioid crisis and that we needed to adapt our usual ways of operating if we were going to be able to meet this moment."
The 2020 Annual Report can be found here. The 2021 Inter-Agency Opioid Coordination Plan can be found here.
Before It’s Too Late is the state’s effort to bring awareness to the opioid and substance use crisis and to mobilize resources for effective prevention, enforcement, and treatment. Marylanders struggling with a substance use disorder can find help at BeforeItsTooLate.Maryland.gov; through our state's crisis hotline, Call 211, Press 1; or by texting their ZIP code to 898-211.
