By: Sarah Ceponis, Kelleigh Eastman, and Wes Williams

On Monday afternoon, under a billboard reading “DONTDIE.ORG”, Mayor Stephanie Rawlings-Blake announced the release and recommendations of the Mayor’s Heroin Treatment & Prevention Task Force report. Speakers at the press conference included the Mayor, Health Commissioner Dr. Leana Wen, Rep. Elijah Cummings and representatives of the recovery and treatment communities.  But it was David Z, in recovery for more than a decade, who captured both the audience’s attention and the meaning of the event by sharing the story of his struggle with addiction and path to recovery.

Remembering back to when he was homeless and addicted to heroin, David Z. said he credits his recovery to two things: the kindness of a stranger and Baltimore’s Needle Exchange Program.

David began using heroin by snorting it, thinking that he was less likely to get addicted that way; a myth, he says, that no one talks about. Soon, David found himself panhandling for $10 a day, just to get his next hit. Eventually, he ended up shooting heroin. One day he was sleeping on an old mattress behind a house and noticed a woman inside the house looking down to him. He quickly moved from that spot thinking she was going to call the police and he was going to be in trouble. Later, he saw that woman who was looking at him from her apartment window again and to his surprise she said to him, “You know, I see you’re struggling. I see you have some issues. Maybe I can help you”. This was a turning point for David– he realized that someone cared. Someone wanted him to help him get clean.

While David kept using on and off over the next year, he eventually found himself at the Health Department’s Needle Exchange van, which provides drug users with clean syringes in exchange for dirty ones. After visiting, a worker at the van told him he could find treatment if he came back early the next day. David knew he wanted to break his cycle of drug abuse, and was back bright and early, and first in line to that same van the next day. He soon enrolled in a medically-assisted treatment program, and a new stage of his life began.

David is now 15 years clean and recently began volunteering in the very same needle exchange van he once visited as an addict. He is hoping to connect other substance users with the same help he received.

Although David’s story is one that highlights the success of support and treatment for opioid addiction, many in Baltimore still struggle with the disease. The Task Force estimates that nearly 19,000 people in Baltimore have used heroin within the past year.  Last year, 303 people died from drug and alcohol overdose, more than the number of people who died from homicide in our city, and the number of heroin-related overdose deaths increased from 150 in 2013 to 192 in 2014.

The Task Force report released on Monday highlights key ways in which Baltimore City can combat this problem, including on-demand 24/7 access to treatment services and reducing the fear and stigma around substance addiction. Dr. Wen noted that some of the Task Force recommendations, such as implementing a citywide overdose plan and “hotspotting” to target areas of need, are so important and so urgent that Baltimore has already begun to implement them.

Other advocates for reducing opioid addiction and overdose death in the city attending Monday’s press conference included Dr. Samuel Ross, CEO of Bon Secours Baltimore Health System  and Bern McBride, CEO of Behavioral Health System Baltimore –co-chairs of the Task Force; Councilman Robert Curran and Councilman Carl Stokes; Interim Baltimore Police Department Commissioner Kevin Davis; Karen Reese, Executive Director/CEO of Man Alive, Inc.;Carlos Hardy, CEO of Maryland Recovery Organization Connecting Communities (M-ROCCC); and Edgar Wiggins of Baltimore Crisis Response.

Rep. Cummings highlighted a significant challenge that Baltimore and other jurisdictions are facing – the price of naloxone has risen from $97 to $370 per unit, and how this rise in cost significantly reduces access to the drug and will result in many residents being unable to receive the life-saving drug that safely reverses an overdose.

The billboard also served as a visual for another one of the Task Force recommendations – launching a public education campaign about the dangers of overdose, the availability of naloxone training, reducing the stigma of drug addiction and encouraging treatment. This outreach campaign, unveiled on Monday, includes billboards, bus shelter ads, and a newwebsite.

Below are the Task Force recommendations:

1. Develop dashboard for ongoing monitoring to obtain real-time data for number of people with substance use disorders, near-fatal and fatal overdoses, and capacity for treatment.
2. Implement citywide heroin overdose plan to save lives of our citizens. This plan includes developing targeted treatment and preventive interventions for those at highest risk for overdose and ensuring widespread dissemination of the opioid antidote, naloxone.
3. Develop a centralized, easy-to-access intake that is 24/7, with immediate access to an addiction counselor or social worker, and publicize to all (including emergency departments, emergency personnel, peer networks, and community members).
4. Increase data-driven, high-impact options for treatment. This includes universal case management and access to treatment for most vulnerable individuals in the city such as inmates and the recently incarcerated, as well as increasing availability of evidence-based treatment, such as buprenorphine.
5. Ensure treatment on demand. This includes work towards a 24/7, “no wrong door” treatment center for addiction and full capacity for treatment in both intensive inpatient and low-intensity outpatient settings.
6. Develop voluntary certification and review for substance use providers based on core standards of care. this includes a pilot to test and refine best practice standards with key volunteer providers in Baltimore City
7. Facilitate an ongoing partnership and collaboration among key stakeholders to pilot programs, test economic incentives, and discuss integration with state/federal systems of care.
8. Develop standardized good neighbor agreement and establish best practices for substance use disorder providers and community members (including issues such as loitering, cleanliness, security, community advisory committee, and voluntary agreements).
9. Coordinate efforts with treatment providers and law enforcement. This includes preventing targeted drug sales to vulnerable individuals undergoing addiction treatment; working collaboratively to obtain help for people with behavioral health disorders; and increasing support for Drug Treatment Courts and other diversion programs.
10. Implement comprehensive strategy to educate and inform residents, businesses, and other key stakeholders about substance addiction to help reduce fear and combat stigma. This includes launching a campaign to educate citizens that addiction is a chronic disease and to encourage individuals to see treatment.