Sadly, we lost nearly 3,000 Marylanders in 2020 to overdose, and according to 1st quarter reports from 2021, we experienced a 5.7 per cent increase in 2021. The ONLY cause (or excuse) offered is a correlation with the COVID-19 pandemic. Those of us ‘in the trenches’ know that this over-simplification is simply not accurate. There are MANY reasons, other than COVID, why Maryland is ranked THIRD in the nation for overdose deaths.
A nationally heralded team was formed to recommend a list of strategies to end addiction. After months of deliberating, this panel of stellar experts had only ONE SINGLE suggestion –MEASURE OUTCOMES. We do not know what works unless we measure the results of what we currently do. Unfortunately, Maryland’s drug policy is not based on rational and evidence-based outcomes –it is often based on who has the most money to finance the best lobbying campaigns. This is not because our elected officials are motivated by profit or are heartless to the cries and pleas of constituents –it is because the lobbyists have million-dollar campaigns to support their interests –namely profit margins –and they are highly paid to be highly believable. What we need in 2022 is a progressive drug policy platform that supports:
TREATMENT REFORM
Our Treatment System MUST Reflect Science-Based Drug Scheduling: “Treatment for opioid dependence, as well as healthcare policy designed to address the epidemic proportions of suffering individuals, have been monopolized by an industry with enough capital to create brilliant marketing and promotion strategies that have created a $1.4 billion opioid addiction treatment industry in the U.S. as of 2014” (Manalo, 2017).
Due to a lack of equally proportional funding for high profile marketing and lobbying strategies, other equally viable or promising alternative medications, like ibogaine, kratom, medical cannabis, ketamine, amino acid therapy, have either struggled to gain a foothold in the treatment arena or remain virtually unheard of. Other evidence-based therapies, like brain stimulation, meditation, and hypnotherapy remain financially out of reach for most individuals who suffer from SUD, because these evidence-based therapies are not Medicaid reimbursable. Impacted individuals must fly to other countries to get some of these treatments or order medications from other countries to find a cure for their treatable brain disorder –addiction. In the meantime, Maryland continues to schedule these drugs as having “no medical value” despite the plethora of international research to the contrary. This is simply unconscionable given the degree to which addiction is devastating our families and communities across Maryland and hemorrhaging our hard-earned tax dollars in a futile attempt to meet the burgeoning capacity needs of our overwhelmed healthcare and justice systems.
For instance, while ibogaine is currently not legal in the United States, it is currently used to treat opioid addiction in other countries, including Canada and Mexico. While only 9 of the 28 countries presently in the European Union have similar classifications as the U.S., it is unregulated (neither officially approved nor illegal) in much of the rest of the world. New Zealand, Brazil, and South Africa have classified ibogaine as a pharmaceutical substance and restrict its use to licensed medical practitioners. This has led Americans who struggle with addiction to seek out international clinics or underground providers to receive this evidence-based treatment.
The Maryland legislature has the power to change drug classifications –to at least allow researchers to purchase the drugs and study them. Sadly, the pharmaceutical industry representatives show up to kill these bills each and every time they are brought up in the Maryland legislature –with biased studies and unscientific arguments. Drug scheduling in Maryland needs to change to reflect scientific advances –not profit motives.
HB674 (2020) altered the lists of substances designated as controlled dangerous substances under drug scheduling classifications under the Maryland Controlled Dangerous Substances Act. We need a similar bill to alter drug classifications in 2022. Ibogaine, cannabis, kratom, ketamine, and other substances are all currently scheduled as having “no medical value”, while substances like Xanax (aka xanny bars on ‘the street’) are currently scheduled as having “no abuse potential”.
Our Treatment System MUST Ensure That ALL Paths to Recovery are Available: In addition to failing to support advancements in the treatment of addiction, including the aforementioned medications and other progressive therapies, Maryland policy makers have all but eradicated Abstinence-Based Residential Treatment (ABRT) from the options available to recovering individuals, in favor of pharmaceutical options, despite the literally 70 years of reputable studies showing slightly higher success rates on average for Abstinence-Based Residential Treatment –particularly when it lasts longer than six months and in conjunction with mental health therapies. They have done this by funding ONLY treatment providers, programs, recovery residences, that cater to the pharmaceutical industry solutions –thereby removing options and limiting choices for consumers of addiction services.
Our Treatment System MUST Reflect a “Continuum” of Care: Many times, individuals who have been diagnosed with a chronic, potentially life-threatening, Substance-Use Disorder do not get the services they need in order to recover. Assessments for these patients often show that they need and qualify for long-term in-patient (residential) treatment, housing, on-going mental health or psychiatric services, medication maintenance, family stabilization services and/or counseling, vocational training, educational services, legal services, and/or other wrap-around services –yet far too many are being discharged with no plan for how or where to access these services. Many patients are not even aware that this is exactly what their discharge plan from a regulated Maryland treatment provider is supposed to encompass. They often rely on a treatment provider to devise an appropriate discharge plan –only to discover they are being discharged to “nowhere” after it is too late for them to do anything about it. All too often they are simply left to figure out their “next level of care” plans on their own. Unless the patient receives the services that are necessary for their recovery –THEY ARE UNLIKELY TO RECOVER! Simply put, EFFECTIVE DISCHARGE PLANNING IS A MATTER OF LIFE AND DEATH! There have been numerous bills introduced during the past five years –HB515 (2017), HB852 (2019), HB1171 (2019), HB29 (2021), attempting to correct problems with the ‘Continuum’ of care, that have not yet passed.
Warm Regards and Hope for Recovery in the New Year,
Lisa Lowe