JUDY WOODRUFF: But first: the nation’s opioid crisis.
Overdose deaths are on the rise across the country, in 2015, surpassing gun homicides for the first time. One of the hardest-hit states is Maryland, where the governor today declared a state of emergency to fight the epidemic.
But, for more than a year, the city of Baltimore has been training everyday citizens in how to use a lifesaving antidote, an approach that’s catching on across the country.
NewsHour producer Pamela Kirkland visited Baltimore to find out more.
MAN: Excuse me, sir, are you interested in Narcan training?
PAMELA KIRKLAND: Each week, city health workers hit the streets of Baltimore, handing out an emergency medication that brings users back from the dead.
JOHN HARRIS, Baltimore Health Department: This is the medicine. It reverses overdoses.
PAMELA KIRKLAND: Naloxone, brand name Narcan, comes as a nasal spray or injection, and works by blocking the brain’s opioid receptors.
In a city with 24,000 active heroin users, overdoses, and now increasingly this emergency antidote have become facts of life.
KYRON BANTON, Baltimore Resident: I lost a friend of mine that was — at 25 years old.
KENNETH SADIQ LEIGHTON, Baltimore Resident: I have just seen so many young people getting hooked on the opioids, or better yet, the fentanyl. And it’s definitely a killer.
PAMELA KIRKLAND: In Maryland, deaths from opioids, which include heroin, fentanyl and prescription painkillers, doubled between 2010 and 2015, to just under 1,100 people a year. Meanwhile, heroin fatalities alone more than tripled.
And in just the past three years, deaths in Baltimore from fentanyl, a synthetic opioid far stronger than heroin, are up 20-fold.
DR. LEANA WEN, Baltimore Health Commissioner: We have an epidemic of people, fellow residents in our city, who are dying from opioid overdose.
PAMELA KIRKLAND: In late 2015, Dr. Leana Wen, Baltimore’s health commissioner, and a practicing emergency room physician, issued a standing order for naloxone to all 620,000 city residents.
DR. LEANA WEN: What that means is that, if somebody goes through a very basic training — and we do trainings everywhere, including on street corners, in jails, in public housing, really anywhere that people are — they will immediately get a prescription for naloxone, and even get the medication in hand.
PAMELA KIRKLAND: Just one dose of naloxone can bring someone back. Residents can buy it at a pharmacy, only $1 for Medicaid recipients. And thanks to a 2015 good samaritan law, there’s no risk of prosecution if citizens intervene and the victim dies.
KENNETH SADIQ LEIGHTON: I have used it four times. I keep them in my bag. I always keep them in my bag, at least four or five of them in my bag.
JOHN HARRIS: This is our mobile unit.
PAMELA KIRKLAND: John Harris works on one of the Health Department’s vans which traverse the city offering sexually transmitted infection screenings, clean needle kits and naloxone training.
JOHN HARRIS: Well, we tell people that, once you reverse an overdose, then not to use that.
PAMELA KIRKLAND: He knows what addiction can do to a person, having spent 16 years addicted to heroin. But he sees something different today.
JOHN HARRIS: There was a lot of fentanyl at first that we were hearing about. But now the clients are starting to come with medications that they use on an elephant, tranquilizers being cut with heroin. There are benzodiazepines. We’re hearing about all different types of drugs. It’s really becoming more complicated and dangerous.
PAMELA KIRKLAND: Since January 2015, the Baltimore Health Department says over 20,000 residents have completed naloxone training and at least 800 lives have been saved.
And many more states and municipalities across the country have moved to make naloxone more accessible to the public. But not everyone believes this is the right approach.
MIKE GIMBEL, Maryland Addiction Recovery Center: We are selling it to the public as if it’s the answer. I mean, it’s an amazing drug, no doubt about it, but it doesn’t change the behavior of the addict.
PAMELA KIRKLAND: For 25 years, Mike Gimbel was Baltimore County’s director of substance abuse. Now he’s a consultant for Maryland Addiction Recovery Center, a private treatment facility outside the city. And like John Harris, Gimbel is in recovery.
MIKE GIMBEL: Heroin is the devil. It’s the devil. It makes you do things you would never do you in your life. It took a middle-class, good Jewish kid like me, and had me robing my own parents, carrying a gun.
That’s what heroin does. That’s how powerful heroin is.
PAMELA KIRKLAND: He argues that the city and state are spending too much time and money on Narcan training and outreach, and not enough on long-term recovery.
And as a sign this approach isn’t working, he points to the city’s rising overdose fatalities, up 68 percent for the first three-quarters of 2016 over the same period the year before.
MIKE GIMBEL: Sometimes, by having Narcan so available, it actually reinforces the addict’s behavior. Why should I stop using heroin, when, if I overdose, Narcan’s going to save my life? Where’s the motivation to stop? It’s not there. It’s not there.
So, sometimes, yes — and we don’t want to see people die, but, sometimes, watching someone die and watching what happens with overdose and death wakes up a lot of addicts.
TIMMY HALL, Former Baltimore Police Officer: It’s just a first-responder tool. That’s all it is.
PAMELA KIRKLAND: Timmy Hall was with the Baltimore Police Department for 24 years, where he routinely saw opioid overdoses. He says officers often use Narcan to revive the same drug users over and over again.
TIMMY HALL: A lot of times, they get upset with you when you bring them back, because they feel like you wasted the money they spent. You know, that’s the feeling that they wanted. That wanted that feeling, and you took it away from them.
PAMELA KIRKLAND: But Hall doesn’t see an alternative.
TIMMY HALL: As a police officer, your first job is to protect and serve, you know? And what officer would want to sit there and watch somebody die, if they got the tools to save somebody? So, Narcan, to me, is a great tool. It’s just a first-responder tool.
PAMELA KIRKLAND: The Health Department attributes the continued rise in overdoses and fatalities to a rise in far more powerful drugs hitting the streets.
Dr. Wen says there’s no evidence that denying naloxone to overdose victims helps users end their addictions. Naloxone is just one tool in this fight.
DR. LEANA WEN: We are just treading water if all we’re doing is saving someone’s life right now. We also know that we have to get them the second part, which is access to long-term treatments, that it’s a combination of medications and some treatments, psychosocial treatments, like counseling. And then other services are important too, including housing.
PAMELA KIRKLAND: Of course, those all cost money and political will.
GOV. LARRY HOGAN, R-Md.: Heroin and opioid abuse has been taking lives and tearing apart families.
PAMELA KIRKLAND: Just today, Maryland’s Republican governor, Larry Hogan, announced a state of emergency to deal with the crisis, pledging 50 million additional dollars over five years for enforcement, treatment and prevention.
JOHN HARRIS: It’s got to get better. It’s got to get better. And I believe it will get better. I don’t think perfection exists in anything, but I do believe Baltimore has done a lot of good work, will do some more good work, because we are saving lives.
PAMELA KIRKLAND: Saving some lives amid a growing epidemic.
For the PBS NewsHour, I’m Pamela Kirkland in Baltimore.