This story was originally published by Mobtown Mag.
The rate at which Baltimoreans are dying of overdoses finally seems to be slowing, mirroring a nationwide trend that has offered hope amid a devastating crisis.
There were 566 fatal overdose deaths in Baltimore as of September, according to preliminary data from the Maryland Department of Health. That puts the city on track to end the year with fewer than 800 deaths, marking a notable decline compared to recent years.
The last time the city saw less than 800 deaths was in 2017, which preceded a pandemic-era surge in fatalities as fentanyl rocked the drug market.
“It seems like overdoses are significantly lower this year than last year or other recent years, particularly since the COVID-19 pandemic,” said Kenny Feder, assistant research professor at the Johns Hopkins Bloomberg School of Public Health’s Department of Mental Health. “And it’s not just a Baltimore phenomenon.”
The decline in fatal overdose rates has been mostly experienced in the eastern U.S., Feder said. Last year, the country’s fatal overdose numbers decreased for the first time in five years, though Baltimore’s increased by nearly 6% — marking a death toll of more than 1,000.
Now, however, Baltimore seems to be catching up to the trend as the decline becomes more significant.
The rebound comes after a “tragically high” surge in deaths that was worse than experts could have expected, Feder said. Deaths in Baltimore peaked in 2021, when the state reported 1,079 deaths.
Three years later, although the numbers are still relatively high — particularly in comparison to pre-pandemic levels — the new data shows the death rates may have reached their limits, Feder said.
The recent decline in Baltimore and beyond more definitively indicates that harm reduction initiatives are working.
The recent decline in Baltimore and beyond more definitively indicates that harm reduction initiatives are working.
Cities such as Baltimore have perhaps most importantly ramped up the distribution of naloxone, an opioid antagonist that is at the crux of strategies to prevent fatal overdoses.
Emergency service personnel administered the life-saving drug, which reverses overdoses, more than 1,600 times in Baltimore this year, according to the state health department.
Locally, city officials have teamed up with local harm reduction organizations to augment their efforts, with both parties offering syringe service programs, or SSPs, as well as other resources. In tandem, they aim to reduce overdoses, prevent the spread of diseases such as HIV and help individuals access treatment.
“The thing is, those strategies are effective,” Fedder said. “They were effective before overdoses went up as the saturation of fentanyl went up, and we need more of them. It’s really positive we’re seeing overdoses going down, and those strategies are still saving lives.”
It’s important to note that the data indicating “significant” decreases in death rates is preliminary, so numbers will likely grow as cases are confirmed, said Michael Coury, spokesman for the state’s Office of Overdose Response.
Still, the data is still encouraging and indicative of a downward trend. And that comes after a concerted push by the state and local governments to tackle the crisis.
“Far too many people in Maryland continue to lose their lives every day to preventable overdoses, and Maryland is working to increase access to care for people with substance use disorders in every corner of the state,” Coury said. “We’re continuing to expand access to crisis services, for example, by investing over $100 million to expand mobile crisis services and crisis stabilization centers.”
Earlier this year, Gov. Wes Moore signed a budget that included a 14% increase in funding for substance use disorder services alone. In total, $1.4 billion was allocated for addiction and mental health services.
Earlier this year, Gov. Wes Moore signed a budget that included a 14% increase in funding for substance use disorder services alone. In total, $1.4 billion was allocated for addiction and mental health services.
Mayor Brandon Scott’s signed budget buffs up services even more, including a 44% increase in funding for mental health and substance abuse programs.
The result has been a “robust” harm reduction infrastructure in Baltimore. Statewide, programming is also up, with a majority of countries having SSPs and programs offering fentanyl test strips.
The investments reflect a dedication to drive overdose deaths down. But that’s not to say that experts and public officials expect this year’s downward trend to remain consistent, as numerous roadblocks remain.
“We cannot afford to be complacent in our efforts to save lives,” Coury said.
In addition to the stigma surrounding drug use itself, barriers to treatment and life-saving medications still exist, whether it be because they’re illegal or not done in practice.
Overdose prevention centers, which permit people to use drugs in-house alongside medical professionals, are largely illegal in the U.S. This comes despite the fact they have been proven to significantly reduce overdose deaths.
And, even though pandemic-era laws made it easier to prescribe and distribute life-saving medications such as methadone and buprenorphine, many still go without access.
That is particularly true among minority groups, who are hardest hit by health disparities. That fact is manifested in Baltimore’s death toll, as a majority of deaths are Black residents. Data shows that deaths are most concentrated in the city’s “Black Butterfly.”
All of this is compounded by the fact that the drug supply has become increasingly dangerous with the proliferation of xylazine, a tranquilizer that’s often mixed with fentanyl and is resistant to naloxone. Nitazenes, a stronger form of synthetic opioids, have also become more prevalent.
“This is a major emerging threat to all people who use drugs,” Feder said, adding it’s unclear how they will impact death rates in the future.
The data showing declining overdoses locally places the city at a key juncture in the overdose crisis — and in its mission to address it.
The crisis has killed more than 8,000 Baltimore residents in the past decade, and the city’s death rate remains the highest in the nation, coming in at 144.4 deaths per 100,000 people, based on 2020 U.S. Census data.
The crisis has killed more than 8,000 Baltimore residents in the past decade, and the city’s death rate remains the highest in the nation, coming in at 144.4 deaths per 100,000 people, based on 2020 U.S. Census data.
That quadruples Maryland’s average while dwarfing the death rates of other counties.
And, for Baltimore to end the year with less than 800 overdose deaths, its death rate would have to remain steady, despite some studies showing an increase in fatalities during colder months.
However, as winter approaches, the city is also in hot pursuit of funds to continue to drive numbers down through litigation against opioid manufacturers and distributors over their role in the crisis.
The Baltimore City Health Department declined to comment, citing the litigation.
Baltimore is slated to receive more than $400 million from five settlements, more than $100 million of which has been earmarked for opioid remediation efforts. Ongoing litigation against McKesson and Censora, formerly called AmerisourceBergen, could bring in significantly more.
The windfall of funds will drastically bolster funding for overdose prevention initiatives and other harm reduction measures, officials have said. That comes on top of historical investments already included in the state and city’s most recent budgets.
Although not much has been said beyond that as officials look to prevent hurting their chances in court, they’ve expressed confidence in putting funds through a governance structure to ensure it’s used most effectively.
Officials are now waiting to see just how much money they can obtain to fill their war chest against the crisis. And the city will have to wait to see whether the trend of declining overdoses is sustained.
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