Overdose and Prevention
Baltimore City
Legislative Breakfast 2014
Mishka Terplan MD MPH FACOG Diplomate ABAM
Medical Director, Behavioral Health System Baltimore
Overdose in the US
CDC 2011
Overdose in the US
What is an opioid overdose?
• Opioid overdose happens when a toxic amount of
an opioid – alone or mixed with other substance
(alcohol, opioid, etc) – overwhelms the body’s
ability to handle it.
• Many opioid-related overdoses result from mixing
prescription painkillers or heroin with
benzodiazepines, cocaine, and/or alcohol.
What Leads to
Overdose Death?
• Respiratory Failure – lack of sufficient oxygen in the
blood
• Vital organs- like the heart and brain- start to fail
• Leads to unconsciousness, coma, death
Surviving an opioid overdose =
BEATHING and OXYGEN
Maryland
• Increase in total overdose deaths
in MD
• 7% increase 2012-2013
• Heroin
– Increased 18% 2012-13
– Increased 88% 2011-13
Baltimore City
Number of Overdose Deaths per Year Baltimore City
2007
289
2008
184
2009
239
2010
172
2011
167
2012
225
2013
246
Baltimore City
• Most of the deaths involve an opioid – either heroin
or a prescription opioid
• Therefore these deaths could have been prevented
with naloxone – a medication that reverses opioid
overdose
• BHSB along with BCHD are working to ensure that
Baltimore residents have access to naloxone – so
that no one dies unnecessarily of overdose.
Naloxone (Narcan)
Overdose Prevention: Naloxone
• Anyone with a license can prescribe naloxone to a
person who is at risk for opioid overdose
– Co-prescribing
• Naloxone can also be prescribed to people who may
be near someone experiencing an overdose
– Similar to an Epi-pen
Baltimore City Overdose Education and
Naloxone Training
• Staying Alive
– Over 10 years over 200 documented reversals (lives saved)
– Works closely with Baltimore City Needle Exchange
• 2014 Maryland’s Overdose Response Program
regulations went into effect
– BHSB
– Baltimore Student Harm Reduction Coalition
Naloxone
• How to make overdose education and naloxone
more accessible:
– Allowing health care providers to prescribe and
dispense under standing orders
– Encouraging co-prescribing
– Providing civil immunity to people who administer
naloxone
2015
• Additional efforts that will help prevent overdose
deaths:
– Encourage people to call 911 (and provide protection for
those that do)
– Support the Baltimore City Needle Exchange
• Overdose prevention
• Prevention of HIV Hepatitis
Thank You
Mishka Terplan
[email protected]