Dr. Joshua Sharfstein took over the Baltimore City Health Department in 2005 at a time when heroin-related and overdose deaths were on the decline, and one of his main responsibilities under then-Chief Martin O’Malley was was to reduce more.
Sharfstein led a move to expand access to buprenorphine, an opioid drug used to treat heroin withdrawal, and overdose deaths dropped to about 100 in 2009. That’s the year Sharfstein resigned as the city’s health commissioner, having been nominated by former President Barack Obama to lead. US Food and Drug Administration.
From a peak of 312 heroin-related deaths in 1999, Baltimore reached a low of 76 such murders in 2011, as Sharfstein’s attention returned to the city, this time as Maryland’s health secretary. , again under O’Malley, who had been elected governor.
But shortly after he returned to Maryland, Sharfstein testified Thursday in Baltimore Circuit Court, he and other health officials noticed a pattern. Under his leadership, the state health department sent a letter on Dec. 7, 2012, to every physician in Maryland, asking for their help.
“Over the past decade, the growing epidemic of prescription drug abuse has led to a dramatic increase in drug overdose deaths, often associated with prescription opioid analgesics,” read the letter, which was shown in court. “Improved control over these drugs and improved prescribing practices have been implemented to combat this trend.”
While prescription drug deaths were on the decline at the time, heroin deaths were on the rise again, the letter continued.
“One possible explanation is that people who have difficulty finding prescription drugs for non-medical use are turning to heroin.”
Sharfstein was the first person to testify in the long-awaited trial in Baltimore against drug distribution companies McKesson and AmerisourceBergen. The city is suing those same companies for shipping hundreds of millions of prescription painkillers to Baltimore from 2006 to 2019, regardless of the chaos they could cause.
Describing Baltimore’s crisis as “America’s worst opioid epidemic,” the city’s attorney general in opening statements Wednesday accused drug dealers of ignoring “questionable prescriptions ” called by doctors “pill”.
In doing so, Bill Carmody said, the companies created a new generation of addicts, people who died at unprecedented rates when their subscriptions went up. end and turn to an illegal drug market filled with the deadly fentanyl, an even more synthetic opioid. more deadly than heroin.
Sharfstein’s testimony bolstered the city’s case and tested corporate strategies to combat it.
“We were on the right track, until something caught us off guard,” Sharfstein said.
In opening statements, lawyers for McKesson and AmerisourceBergen said their companies dispensed opioids and other drugs to licensed pharmacies that fill prescriptions from doctors. They blamed traffickers, gangs and drug crews for bringing heroin and fentanyl to Baltimore, pointing to crime as the source of the overdose crisis.
As health commissioner, did you look into who was selling illegal drugs?” Timothy C. Hester, McKesson’s attorney, asked Sharfstein.
“Not much,” Sharfstein said.
In his questions, Hester pointed out that the majority of opioid-related deaths included in the health department’s chart breaking down such deaths from 1995 to 2006, were caused by heroin. -have prescription opioids. He also asked if Sharfstein, when he was health secretary, was concerned about doctors prescribing opioids.
“I was concerned about the prescription drug epidemic in Maryland, which included overuse,” said Sharfstein, who currently works at the Johns Hopkins Bloomberg School of Public Health and advises Baltimore Mayor Brandon Scott. with a health plan for a certain period of time.
City attorneys also questioned Sharfstein’s January 31, 2014, health department news alert about a “strong and lethal combination of drugs” found in autopsies. The ad raised the alarm about heroin tainted with fentanyl.
That worried us a lot. … We knew then that there were a lot of people with opioid addiction,” Sharfstein recalled.
The city maintains that the broadcasters’ actions constituted a public nuisance that deprived residents of their right to health and safety. In order for the court to hold the companies liable, Circuit Judge Lawrence P. Fletcher Hill explained to jurors Thursday, the city must prove that “one or both defendants” caused a public nuisance.
To further support its case, the city called Yolanda Cason, of the Public Works Department’s Office of Solid Waste, and Rania Mohamed, of the city’s health department, to testify about their work in trying to keep the city clean in the face of the opioid crisis and helping people caught in the vicious cycle of addiction.
Cason, who has worked in public works for 31 years, said he didn’t see many signs of addiction in Baltimore, but “now you see it everywhere.”
“It’s been very difficult trying to keep the city clean,” said Cason, noting that his team has to respond to soiled mattresses, drug paraphernalia and human waste every day.
He said it’s become such a problem that his facility has had to hire a biohazard waste disposal company and purchase puncture-proof gloves to prevent workers from being poked by used needles.
“In places where you see drug use,” Cason said, “there’s a lot of trash.”
Mohamed, meanwhile, talked about the health department’s syringe services and opioid recovery programs, which have distributed 17.6 million clean syringes in the past 30 years and reversed more than 7,000 overdoses over the years. the last 20, respectively.
He testified about the length of the health center to help people suffering from opioid addiction, including mobile clinics designed to provide them with equipment and treat their wounds, as well as the partnerships that have been made providing them with substance abuse help and resources, such as housing assistance.
“It is very important that we do not ignore and leave people behind because they have a disease,” said Mohamed.
Megan L. Rodgers, McKesson’s attorney, suggested when asked by Mohamed that syringe services are only for illegal drug users. He also confronted Mohamed about the health department’s policy to address the opioid epidemic in Baltimore.
“Shopkeepers aren’t mentioned, are they?” Rodgers asked.
Mohamed replied: “They are not mentioned directly, but that does not mean that there is no connection.”
Originally published:
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