Substance Use

SUBSTANCE USE 

Baltimore City disproportionately experiences negative ramifications of the statewide and national opioid epidemic. The disproportionate effects of the Crack Cocaine Epidemic, War on Drugs, Heroin, and the rise of Fentanyl in Baltimore City in comparison with other Maryland jurisdictions further amplify this. Addiction is a chronic disease that changes the chemistry of the brain. Whether it be in the workplace, in the community, or at home, those who suffer from addiction should be treated with dignity and respect. When people with addiction are stigmatized and rejected, it contributes to the struggles of dealing with SUD.

People use drugs for various reasons, including peer pressure, social norms, self-medication, and coping, which are just the tip of the iceberg. Developing a substance use disorder depends on various factors, which include your biology, route of administration, effects of the drug, metabolism, gender, and environment. Multiple behaviors can signify a potential addiction; however, addiction has no distinct look. Each person presents different symptoms. Some of the behaviors to look at include if a person has been visiting multiple doctors for prescriptions, has suddenly shifting moods, has social withdrawal, has unexplained financial problems, has trouble staying awake, falls asleep at inappropriate times, has poor motor skills and coordination, and loss of appetite and these things were not previously issues for the person. Opioid use disorder can develop in as little as five days. Substance use disorder may develop as immediately as after the first use, depending on the substance and other factors.

WHAT ARE OPIOIDS?

Opioids are a classification of drugs that are directly obtained from the poppy plant. Opioids are highly addictive due to opioid receptors in our brains. They block pain signals sent from the brain to the body and use the receptors to release dopamine in large amounts as a supplement for the pain. However, there are side effects to using opioids repeatedly. One of these side effects is developing a dependence on them. Addiction or substance use disorder is a disease, just like diabetes or hypertension, which has to be managed daily. No one chooses to have a substance use disorder.

Prolonged drug use impacts brain function and can cause changes in temperament and behavior. These changes can cause problems like mood swings, memory loss, cognitive decline, and issues making decisions.

There are three different classifications of opioids: opiates, semi-synthetic opioids, and synthetic opioids. Opiates include Opium, Morphine, and Codeine. Semi-synthetic opioids include Heroin, Hydrocodone, Hydromorphone, Oxycodone and Buprenorphine. Synthetic opioids include Fentanyl, Methadone, and Tramadol. Each category of opioids has a different level of strength. Opioids also can come in many forms: pills and capsules, powders, tablets, or liquids. They can also be taken in many ways.

WHAT IS FENTANYL?

Fentanyl is a powerful synthetic opiate similar to but more potent than morphine. It is typically used to treat patients with severe pain or to manage pain after surgery. It is also sometimes used to treat people with chronic pain who are physically tolerant to opiates. When prescribed by a physician, fentanyl is often administered by injection, transdermal patch, or in a lozenge form. The type of fentanyl-associated overdoses was produced in laboratories and mixed or substituted for heroin in a powder form. Fentanyl is 50 to 100 times more potent than morphine. Two milligrams of fentanyl – (equivalent to six or seven grains of salt) is enough to kill someone. 

HOW CAN I HELP?

Addiction is a chronic disease that changes the chemistry of the brain. Whether it be in the workplace, in the community, or at home, those who suffer from addiction should be treated with dignity and respect. When people with addiction are stigmatized and rejected, it contributes to the struggles of dealing with SUD. How can you help? First, acknowledge addiction is a disease, not a moral failing or something to be ashamed about. Learning about the disease, its implications, & how it impacts one life can help you understand addiction better. Talking about addiction and showing compassion helps humanize the disease and shows that recovery is possible. People need support and help in a non-judgmental manner so those who do seek recovery can have continued support even if they do relapse. Know the facts, and educate yourself and others about substance use disorder and how it may impact individuals and communities. Be aware of your attitudes and behavior towards addiction, as well as the language you use. Prioritizing the experiences of people living with addiction is essential to combating stigma in Baltimore City. 

Drug Use-Related Data Sources

Below are several reports on substance abuse and drug treatment in Baltimore City:

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