Baltimore’s Response to Opioids

Baltimore City’s Three-Pronged Strategy for Responding to Opioids

  • Saving lives with naloxone
  • Expanding access to addiction treatment
  • Reducing stigma and preventing addiction

A Nationally Recognized Model

Baltimore’s aggressive three-prong strategy for responding to the opioid epidemic has been recognized as one of the strongest in the nation. This aggressive campaign has been lauded by former Director of National Drug Control Policy Michael Botticelli, FDA Commissioner Robert Califf, and U.S. Surgeon General Vivek Murthy and gained national media attention as a model for the country from USA Today, National Public Radio (NPR), CNN, and other outlets.

Saving Lives With Naloxone

In collaboration with partners including Behavioral Health System Baltimore, Health Care for the Homeless, and Baltimore Harm Reduction Coalition, the Baltimore City Health Department and its Community Risk Reduction Services have held over 5,824 naloxone training’s, had 49,626 people trained to respond to an opioid overdose, and distributed over 42,626 naloxone kits for the reversal of opioid overdoses. These efforts have led to over 3173 overdose reversals in the community.

Addiction Treatment Expansion

24/7 Phone Hotline for Behavioral Health Services

The first step to ensuring access to treatment is to make it easy for people to find services and get referrals to treatment. In October 2015, we worked with partners to combine these lines into a single 24/7 hotline to create a more comprehensive resource for the community.

If you or someone you know needs help with substance use or mental health in Baltimore City, call the hotline at 410-433-5175

24/7 Stabilization Center

The most common health concern of frequent users of emergency medical services in Baltimore City is substance use intoxication or mental illness.

In April of 2018 BCHD opened the state’s first stabilization center. The stabilization center will revitalize space at the Hebrew Orphan Asylum in West Baltimore. A pilot center has opened in Tuerk House, which is a substance abuse center. The Stabilization Center provides short-term crisis services for individuals who are intoxicated from drugs or alcohol, links to people with substance use disorders to treatment and recovery support services such as SBIRT, first aid, food, and showers. Clients may only be transported through EMS/EMT services in order to utilize the facility.

Increasing Capacity for Medication-Assisted Treatment for Opioid Use Disorders

In order to address the increasing need for treatment options that work, BCHD has convened dozens of stakeholders to develop and comprehensive opioid prevention and treatment framework including improved access to evidence-based treatment.

  • We have worked with the city’s hospital emergency departments to encourage buprenorphine induction and referrals to treatment following the SBIRT process.
  • BCHD has also launched a mobile treatment van coined The Spot, where buprenorphine is initiated alongside other forms of care access including Hep C and HIV treatment.
  •  In the fall of 2017, we also began a hub and spoke model of treatment through IBR-REACH ensuring that everyone who needs treatment has access to a flexible network of providers to meet their care needs. Patients receive individualized, comprehensive care; all three medications approved by the U.S. Food and Drug Administration for the treatment of opioid use disorder are available. After a patient’s condition has improved, they have the option to continue their treatment at a primary care clinic—a “spoke”—where the treatment for opioid use disorder is integrated into the rest of the medical care.

Levels of Care

People suffering from substance abuse disorder move through America’s hospitals every year, and the services that hospitals do or do not provide to these patients have a significant effect on their morbidity and mortality. As a result, we launched the Levels of Care initiative, which creates a common foundation for how hospitals should be responding to the opioid epidemic.  It is based on a similar initiative in Rhode Island where the number of overdose deaths decreased significantly. This is an initiative that has been developed with active input from hospitals around the city.  A hospital can be ranked level 3, 2, 1 – with Level 1 hospital offering the most comprehensive response.

The protocols in the levels are evidence-based and include recommendations such as:

  • The ability to maintain the capacity to initiate medication-assisted treatment
  • The ability to offer peer recovery support services or similar support services
  • The ability to screen patients that are in hospital campus outpatient clinics for at-risk substance use and substance use disorder (SUD)