Whether it’s preventing overdoses or drug use itself, the message of National Prevention Week is that taking action now could be the difference between life and death.
The educational initiative aiming to prevent substance abuse and promote positive mental health ends Saturday. Meanwhile, Baltimore is experiencing the highest overdose death rate in the nation, and it continues to climb despite a COVID-era surge subsiding elsewhere.
The week-long initiative advertised by the U.S. Substance Abuse and Mental Health Services Administration hopes to ensure that no more preventable deaths rock communities.
“The reality is that substance use has never been riskier, whether it is someone’s first use or someone with a long-standing substance use disorder,” said Capt. Christopher Jones, director of SAMHSA's Center for Substance Abuse Prevention, in a statement to The Long Haul. “The risk of overdose and other harms is now elevated with any use of an illicit drug, given the potency, lethality, and unpredictability of fentanyl (and other additives such as xylazine) in the illicit drug supply.
“Importantly, these substance use challenges are happening against the backdrop of rising mental health challenges, especially among young people, that are closely linked to substance use and overdose.”
Prevention strategies that SAMHSA advocates for include helping individuals develop problem-solving and conflict-resolution skills; process emotions; create a positive environment and healthy relationships; and participate in healthy activities, Jones said.
It’s also important to recognize that substance abuse does not have a single cause, nor is there just one solution, he added. Factors contributing to addiction include genetics, initiation at a young age as well as physical and emotional abuse.
Urban areas also tend to see more deaths, and other variables include socioeconomic status; race and ethnicity; sexual orientation or gender identity; and access to services and support.
“These dynamic and interrelated challenges mean that we need to approach our substance use prevention work in new and innovative ways (addressing the acute urgency of rising overdose deaths and other substance use-related harms), while remaining laser-focused on addressing the root drivers of substance use at the individual, family, school, community, and society levels,” Jones said. “That is why SAMHSA included preventing substance use and overdose as a key pillar of its Strategic Plan.”
The push for prevention comes as an estimated 107,000 Americans died of drug overdoses last year, a majority of which involved fentanyl, according to data that was released this week by the Centers for Disease Control and Prevention.
While the numbers show that a surge of deaths during the height of the COVID-19 pandemic has abated, including in Maryland, Baltimore is again trending upward.
The city saw 1,039 overdose deaths last year, a 5.1% increase over the year prior. With 177.4 overdose deaths per 100,000 people, Baltimore’s numbers dwarf even those of other cities that make headlines amid the overdose crisis.
To see more local and national overdose death data, take a look at The Long Haul’s Overdose Death Data Dashboard here.
The Baltimore City Health Department declined to comment, citing ongoing litigation against opioid manufacturers.
The state Department of Health, though, said that the reason for such lawsuits — the over-prescription of opioids and manufacturers’ role in the crisis — has also shaped how it approaches prevention.
“For over a decade, Maryland has been working to reduce inappropriate pharmaceutical opioid prescribing and dispensing, a major driver of the opioid addiction and overdose crisis,” said Chase Cook, spokesperson for the health department, in a statement. ”These initiatives include the implementation and ongoing enhancement of the Prescription Drug Monitoring Program and multiple healthcare provider outreach, training, and education programs.”
The role of prescription opioids, paired with the proliferation of fentanyl over the past decade, has prompted the medical community to take a multi-pronged approach to prevent substance abuse.
And, despite efforts to prevent substance use in general, there are still individuals who will use substances regardless, underscoring the importance of harm reduction efforts.
“The most successful approaches to preventing overdoses involve a braided approach within the harm reduction framework,” Cook said. “Providing naloxone distribution and overdose education in the community has been a first line of defense to combat the risk of an overdose if naloxone is easily accessible for the community. Having syringe services helps with the engagement of the population that are more likely at risk for an overdose based on the usage of syringes.”
Baltimore, as well as many other cities in the U.S., have emphasized access to naloxone, which reverses opioid overdoses, and buprenorphine, a drug used to treat opioid use disorders.
Syringe service programs, or SSPs, have also helped ensure drug users have sterile equipment to prevent diseases such as HIV, although their legality differs by state.
In Maryland, Gov. Wes Moore’s budget has emphasized the importance of addiction services. The recently passed state budget includes a record-high $1.4 billion in state aid for mental health and substance abuse services.
Mayor Brandon Scott has also proposed a budget calling for a 44% increase in funding for related services.
The increased investments come at a critical juncture. Although overdose numbers are still high, they have dipped since the height of the pandemic, which exacerbated existing systemic inequalities correlated with drug use.
And there are other reasons to be optimistic and continue to push for prevention, some experts say.
Recent data, for example, shows a precipitous drop in drug use among teens as a sign that prevention efforts are proving effective — although the reliability of teenagers self-reporting drug use has been questioned.
The annual Monitoring the Future survey, conducted in 2023 by researchers at the University of Michigan, surveyed teenagers in 8th, 10th and 12th grades, among other age groups.
It found that 46% of high school seniors said they’d had a drink in the past year, a significant drop from 88% in 1979. In addition, 29% of seniors reported using marijuana in the previous year, down from 51% in 1979.
Drug and alcohol use among Maryland teenagers has decreased over the past two decades, mirroring the nationwide trend, although historical data for Baltimore is unavailable.
Those struggling with substance abuse in the Baltimore area, regardless of their age, can find addiction treatment resources by visiting The Long Haul’s Baltimore Addiction Resources guide.
For those interested in contacting me, I can be reached by email at l.hullinger@longhaul.blog or via Twitter @loganhullinger. Additional information can be found on my portfolio website.
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