Frederick, Maryland, has a history that dates back to America’s earliest colonial days, but the scourge of the opioid epidemic hangs like a cloud over the city’s future.
Even as local government celebrates successful community outreach programs to change the landscape of drug abuse in the area, the arrival of stronger and deadlier opioids is forcing law enforcement and criminal justice bodies to react.
The state of Maryland has greatly suffered in the opioid epidemic, with overdoses now accounting for the most deaths in the state alongside heart attacks, cancer, and strokes.
In Frederick County, the Frederick News Post explains that the form the epidemic takes is prescription drug abuse, often leading to heroin abuse. The problem is not limited to opioids. In 2015, for example, several teenagers at a local high school were hospitalized after overdosing on Ambien and Adderall. The medications were distributed by a 15-year-old student.
In 2013, the state’s Office of Population Health Improvement reported that across Frederick County, 18 percent of high school students said they took prescription drugs recreationally, which is higher than the average for Maryland (15.2 percent). Almost 30 percent of the high school students surveyed said they either received or distributed illegal drugs on school property.
A sergeant in the Frederick County Sheriff’s Office Narcotics Unit said that his office had seen a rise in abuse of nonprescribed drugs, and off-label use of prescription medication goes “hand in hand” with heroin abuse.
Law enforcement in Frederick and its county are more concerned about heroin than they are prescription drug abuse, but note that both are behind Governor Larry Hogan’s February 2017 declaration of a state of emergency due to opioid overdoses.
In Frederick, heroin has become the primary drug of abuse. It is cheaper and easier to get than prescription drugs.
In many cases, heroin is the culmination of prescription medication abuse. As the government tightens restriction on who can get access to drugs like OxyContin and Vicodin, and as those and other prescription opioids are reformulated to be harder to abuse, desperate people turn to heroin to stave off withdrawal sickness and to try and recapture the high of their first use.
Prescription drug abuse is still a “rampant” problem, writes The Frederick News Post, but because of government and law enforcement interventions, it does not occupy the place in the public health epidemic that it did years ago.
But the explosion of overprescription in the 1990s and early 2000s created a black market that will never go away. Police officers conducting routine traffic stops in and around Frederick still find people distributing illegally obtained prescription drugs.
There are some silver linings. The Maryland Department of Health and Mental Hygiene found that Frederick County deaths as a result of prescription opioid overdoses declined from 21 in 2011 to 14 in 2013.
How is the problem being addressed? Local law enforcement agencies have organized educational and outreach events at schools and community centers. They have put together drug disposal events, where people can turn in their old and unwanted prescription medications instead of sharing them with friends and family or flushing them down the toilet, which is damaging to the environment. Drop-off boxes have also been placed around Frederick County.
Having such outreach measures is key because people tend to forget that they have unused pill bottles in their medicine cabinets, which is where children often find them. An officer with the Frederick Police Department suggested that the numbers of prescription drug abuse might be underreported because residents might have completely forgotten about their old prescriptions, and they might be oblivious to their misuse.
The program is working. FPD reports almost 1,000 pounds of properly disposed of medication at each event, with people dropping off everything from Schedule II prescription medication to over-the-counter drugs to even pet medications. It might seem like overkill, but police are happy that people are responding. The wide reach of the drop-off events is effective at bringing down the trend of casually taking drugs.
But the police know that the road to turning back the tide of the opioid epidemic is a long, hard one. Talking to local radio, the Frederick County Sheriff’s Office clarified that their goals are more damage control than complete eradication of the illicit opioid market.
One of the biggest problems facing the Frederick area is that it is on the infamous “Heroin Highway,” the corridor along Interstates 70 and 81. The stretch begins in Baltimore and connects Maryland, West Virginia, and Virginia, and it puts Frederick in the middle of the opioid trade that runs throughout the region.
On Route 85, which drug users take to go from Frederick to Baltimore to get heroin and diverted prescription opioids, a giant billboard keeps tally of the number of opioid overdoses and deaths.
The issue became so serious in Frederick County that the U.S. Drug Enforcement Administration (DEA) had to conduct a number of closures of pill mills in the area. While this had a short-term effect in curbing the spread of illegal medication, it leads to an “explosion of heroin use,” as patients and traffickers made the journey from the Frederick area to Baltimore to stock up on their contraband.
The DEA identified Baltimore as a “high-intensity drug trafficking area,” leading to the allocation of more resources to combat the black market trade originating in the biggest city in the state.
Two decades ago, no one would think of doing the Frederick-Baltimore drive that often, but new infrastructure improvements have led to people doing that commute every day — “down in Baltimore the morning, and be back two hours later,” in the words of one FPD officer.
What are the police doing to fight back? In addition to carrying out more interceptions and arrests, law enforcement has started carrying Naloxone, an opioid overdose reversal drug that works through nasal administration. One dose can revive a patient long enough to be seen by medical personnel.
The county government offers regular free training sessions for members of the public to learn how to use Narcan properly. Police and public health officials hope that by literally saving lives with Narcan, people will be inspired to seek long-term treatment and deprive the drug runners of another customer.
But there is general acknowledgment that for every step forward, the black market pushes back. Even as the local government feels like they have a handle on the heroin crisis, the spread of synthetic opioids, like fentanyl, has raised more alarms. In the first nine months of 2015, two people died from fentanyl overdoses in Frederick County. The following year, there were 28 deaths attributed to the opioid that is at least 50 times more powerful than heroin.
The Frederick News Post writes that with the distribution of fentanyl in the area, the opioid crisis is getting deadlier. In 2017, there were 17.5 fatal opioid overdoses in the county; in the first three months of 2018, the amount went up to 20.9 percent. The county sheriff noted that of the 51 lethal overdoses in 2017, fentanyl was used in 41 percent.
Now, there are concerns that dealers are spreading carfentanil in the area. The synthetic opioid was originally produced as an elephant tranquilizer, and it is over 100 times more powerful than fentanyl itself.
In January 2019, Frederick County prosecutors charged a 23-year-old woman with felony negligent manslaughter for selling carfentanil to a man who was one of the 2017 overdose deaths. The unusual and controversial move was praised as a way of the government finding a balance between smarter ways to curb the overdose epidemic and punishing people who represent a direct threat to public health and safety.
It suggests that Frederick’s fight against opioids has taken a newer and more complicated turn.
(April 2017). Opioid, Heroin Overdoses Reach 'Crisis Level' In Md. EMS1. from https://www.ems1.com/opioids/articles/232736048-Opioid-heroin-overdoses-reach-crisis-level-in-Md/
(March 2017). Maryland Governor Declares State Of Emergency For Opioid Crisis. The Washington Post. from https://www.washingtonpost.com/local/md-politics/hogan-declares-opioid-state-of-emergency/2017/03/01/5c22fcfa-fe2f-11e6-99b4-9e613afeb09f_story.html?noredirect=on&utm_term=.b2758404cce3
Overdose Prevention in Maryland. Maryland Department of Health. from https://bha.health.maryland.gov/OVERDOSE_PREVENTION/Documents/2014.12.18%20-%20OD%203rd%20quarter%202014_posted%20online.pdf
(August 2008). Adults Commonly Share Prescription Drugs With Friends And Family. Medpage Today. from https://www.medpagetoday.com/productalert/prescriptions/10673
(July/August 2012). Can You Flush Your old Drugs Down The Toilet? Mother Jones. from https://www.motherjones.com/environment/2012/08/prescription-drug-disposal/
(June 2017). How Powerful New Synthetic Opioids Are Devastating Maryland’s “Heroin Highway.” WaMu 88.5. from https://wamu.org/story/17/06/01/spike-deadly-synthetic-opioids-rock-western-maryland/
(February 2016). Heroin Highway: Part 1 'Baltimore,' Let's Start At The Beginning. WJLA. from https://wjla.com/features/hooked-on-heroin/heroin-highway-part-1-baltimore-lets-start-at-the-beginning
(March 2017). HIDTA’s Overdose Detection Mapping Application Program (ODMAP) and HIDTA Heroin Response Strategy. National Drug Early Warning System. from https://ndews.umd.edu/resources/hidta%e2%80%99s-overdose-detection-mapping-application-program-odmap-and-hidta-heroin-response
Frederick Police Department. (2014, July 1) General Order. Overdose Response Program. Retrieved from https://www.cityoffrederickmd.gov/DocumentCenter/View/6506/590—Overdose-Response-Program?bidId=
(November 2018). What You Need To Know About Fentanyl. CNN. from https://www.cnn.com/2016/05/10/health/fentanyl-opioid-explainer/index.html
(January 2019). Frederick Co. Prosecutors Charge Alleged Drug Dealer With Manslaughter In Overdose Case. WUSA9. from https://www.wusa9.com/article/news/frederick-co-prosecutors-charge-alleged-drug-dealer-with-manslaughter-in-overdose-case/65-227d24f9-21f6-4aa7-ac3a-5a0842a5bd73