STROKE: Two Patients Tell Their Stories

Stroke Treatment & Recovery

Jim Macaulay knew he was having a stroke. One evening about seven years ago, his right arm suddenly felt numb and he realized his right leg wasn’t responding. “When I tried to curse,” he said, “I found out my speech was slurred.”

Jim was rushed to MedStar St. Mary’s Hospital where test results showed he was having a hemorrhagic stroke. Within a short period of time, he was sent by helicopter to MedStar Washington Hospital Center.

Jim is a regular attendee of the Stroke Survivors’ Support Group, which meets monthly in the Outpatient Pavilion at MedStar St. Mary’s Hospital, as is Mary Ann Hayden of Bushwood, another stroke survivor. “Once I started going, I have never missed a meeting,” she said.

Mary Ann had a hemorrhagic stroke in March 2017. Her son drove her to the MedStar St. Mary’s Hospital Emergency Room.

“Two nurses came out and took me in and there were people all around me doing their jobs,” Mary Ann said. Her blood pressure skyrocketed when she learned about her condition, and the doctor treating her quickly went to work to bring it down so she could be transported to MedStar Washington Hospital Center. “My doctor never left my bedside,” she said.

Both Jim and Mary Ann have had a variety of therapies to overcome the effects of their strokes. Jim regained the ability to drive after several years and is now able to take short hikes, something he loved to do prior to his stroke. Mary Ann was able to host Christmas dinner for her family, preparing much of the meal herself thanks to a tip from a therapist to help her overcome her challenges with short-term memory.

“They taught me to use sticky notes, so I had sticky notes all over the kitchen,” she said. “It helped keep me going. “

“As long as I can stay like this I will be satisfied, I can do pretty much anything I want to,” Mary Ann said. “I’m just a little slow.”

Jim was especially happy to be able to resume driving his speedboat in the Southern Maryland Boat Club’s Leonardtown Regatta.

“This 70-year-old stroke survivor was racing his boat at 60 mph on the water,” said Jim. “I intend to do that as long as I can.”

Therapy Can Help Patients with Aphasia

For Anna Decker, MS, CCC-SLP, speech-language pathologist at MedStar St. Mary’s Hospital, helping people affected by aphasia is a personal mission.

“My mother had a stroke which caused aphasia — a communication deficit that makes it difficult to speak,” Anna said. “She uses a communication app on the iPad to speak for her, which helps her continue to live a full life.”

Aphasia is most often caused by stroke, but, it can also be the result of other traumatic brain injuries. Individuals with aphasia often have difficulty reading, writing, speaking, or understanding language.

“Aphasia is not a loss of intelligence, but a frustrating condition which affects the ability to communicate. Imagine not being able to say what you are thinking,” Anna said. “This is what people with aphasia experience every day.”

Working with a speech-language pathologist can help many patients regain their ability to speak or find other ways to communicate; however, the recovery can be long, and some people never fully regain their normal speech. People with aphasia can live a full and enjoyable life, even with communication difficulties or deficits.

Anna offers the following tips for communicating with someone who has aphasia.

  • KEEP IT SIMPLE. Speak in short, simple sentences.
  • BE PATIENT. Allow plenty of time for a response. Talk with him/her not for him/her
  • BE CREATIVE. Try writing, gesturing, pictures, and communication tools like an iPad.
  • Repeat back what you think he/she is saying.
  • DON’T SHOUT. Hearing is not affected and yelling does not help.
  • ASSUME COMPETENCY. Intelligence and cognition is generally intact and treat it like a language barrier.

Think FAST & Learn More

Don't wait until it's too late.

Inform yourself and your loved ones about the warning signs and symptoms of a stroke, and what to do if you suspect a stroke. Remember: If someone shows any signs of stroke, even if the symptoms go away, call 9-1-1 and note the time when the symptoms first appeared - this information helps healthcare providers determine the best course of treatment. 

Visit MedStarStMarys.org/Stroke and MedStarStMarys.org/Aphasia to learn more about the care and services offered at MedStar St. Mary’s Hospital.

To reach MedStar St. Mary’s Hospital Rehabilitation Services Department, call 301-475-6062.

Designated as a Primary Care Stroke Center

You suspect your loved one is having a stroke and you want to make sure they receive the best care possible. MedStar St. Mary’s Hospital recently received a five-year recertification as a Primary Stroke Center
through the Maryland Institute of Emergency Medical Services Systems (MIEMSS). 

MedStar St. Mary’s:

  • Offers state-of-the-art technology for diagnosis and treatment of patients suspected of having a stroke 
  • Has established protocols on how to treat stroke patients, based on evidence-based practices
  • Has stroke neurologists and neuro-imaging services available 24-hours-a-day to aid in diagnosis and treatment
  • Has access to the Telestroke program with MedStar Washington Hospital Center 

Stroke Survivors' Support Group

Meets the third Tuesday of every month from 5:30 to 6:30 p.m. in Health Connections, located in the Outpatient Pavilion. The group discusses topics related to stroke, recovery, and how to prevent future problems. Caregivers are welcome. Call 301-475-6019 to register for this free support group.

Types of Strokes

ISCHEMIC: Happens when a blood clot blocking an artery feeding the brain causes a portion of the brain to stop functioning.

HEMORRHAGIC: Occurs when blood leaks from a burst blood vessel creating a mass of blood that distorts brain structures and interrupts brain function.

OPIOIDS: The Youngest Victims of a Nationwide Crisis

When an expectant mother arrives at MedStar St. Mary’s Hospital, she will undergo a variety of tests prior to delivering, including a screening for drugs and alcohol. If a mother’s results are positive, her newborn child will also be tested.

“We are seeing episodes of babies testing positive for opioids much more frequently than several years ago,” said Jeanne Hill, MSN, RNC, director of MedStar St. Mary’s Hospital’s Women’s Health & Family Birthing Center. Babies born to drug-addicted mothers are the youngest victims of what continues to be a nationwide crisis and they are not difficult to identify, said Jeanne. “They have a high-pitched cry, they can’t calm themselves down, they have tremors, they often have diarrhea and tensed muscles,” she said. “It is just heartbreaking.”

MedStar St. Mary’s Hospital is among 30 birthing centers in Maryland joining forces with the Maryland Patient Safety Care Center to standardize care for babies suffering neonatal abstinence syndrome. As part of the hospital’s efforts, mothers are presented with information about how and where to get help with substance abuse. Although Jeanne feels their work is making a difference, there is still plenty to be done.

Fighting the Addiction 

“We need every single person in the community to recognize addiction is an illness, it is a brain disease and it requires an evidenced-based approach to treatment,” said Meenakshi G. Brewster, MD, MPH, St. Mary’s County Health Officer. The Health Department, MedStar St. Mary’s Hospital and Sheriff’s Department are among the many community organizations coming together to offer a comprehensive response to this epidemic. “It is a challenge like we have never seen before in the treatment community,” said Kathleen O’Brien, PhD, chief executive officer of Walden, which provides crisis, behavioral health, trauma, and recovery services to Southern Maryland. “Certainly, here, historically most of our treatment was related to alcohol and a mixture of some other drugs, but prior to about six years ago, we weren’t seeing opioids or heroin as a presenting problem. Now, that is about 70 percent of the primary substance abuse cases coming through our doors.”

Harry Gill, MD, PhD, medical director of Behavioral Health for MedStar St. Mary’s Hospital and president of Axis Healthcare Group, says he believes the opioid epidemic has gotten worse due to the prevalence of more lethal synthetic opioids. “Most patients have co-occurring disorders − they have a psychiatric disorder and addiction,” said Dr. Gill. “Going through substance abuse treatment provides temporary relief, but if the psychiatric condition is not treated, relapse is highly likely.”

Dr. Gill said many people who turn to opioids also have anxiety, depression, and post-traumatic stress disorders, all of which are treatable. In his work with the hospital, Dr. Gill is called in for psychiatric consultations with patients suspected of intentionally overdosing on opioids. These patients are typically discharged to outpatient substance abuse programs such as those provided by Walden, but often need treatment for co-occurring disorders. Support from their family and their community also plays a large role in the recovery process. “Family support is critical because it is such an isolating illness, such an isolating disorder that re-engaging with the world and, in particular, the people who love you unconditionally is a critical component of recovery,” said Dr. Gill.

Changing the Conversation

Winning the battle against opioid addiction means making sure those fighting their addictions know that assistance is available and they can receive help to access it. In addition, the community as a whole needs to accept that addiction is a disease, not a choice or a moral weakness, said Dr. O’Brien, and that treatment works and recovery is possible. “This disease doesn’t affect others, it affects all of us, and we all could possibly be afflicted by this disease,” said Dr. O’Brien. “In all my years in doing this, people think it’s the other who gets impacted, but we are all vulnerable.”

WHERE TO FIND HELP

Call the Maryland Crisis Hotline
at 1-800-422-0009 or visit
MedStarStMarys.org/Opioids
for information and links.

Note: This article concludes a four-part series on the opioid epidemic in our community. 

Update Following Shooting at Great Mills High School

UPDATE at 3:30 P.M.: The 14-year-old male patient remains in good condition after receiving a gunshot wound to the thigh.


Leonardtown, Maryland (11:39 A.M.) – We are currently treating one patient, a 14-year-old male, following a shooting at Great Mills High School. At approximately 8:15 a.m., MedStar St. Mary’s Hospital received word that patients were en route following the shooting. We first received two patients, one of whom, a 16-year-old female, we stabilized and transferred to UM Prince George’s Hospital Center.   

The 14-year-old male is in good condition.

Elective surgeries that had been postponed earlier have resumed.

The safety of our patients and associates are our highest priority. MedStar St. Mary’s is a full-service hospital delivering emergency, acute inpatient, and outpatient care. We will share additional details as they become available. More information will also be shared by St. Mary’s County Public Schools and the St. Mary’s County Sheriff’s Office, when possible.

About MedStar St. Mary’s Hospital
MedStar St. Mary's Hospital (MSMH) is a full-service community hospital, delivering state-of-the-art emergency, acute inpatient and outpatient care in Leonardtown, Maryland. Nestled in a waterside community, MedStar St. Mary's provides advanced technology with a dedication to excellence in all services provided. The not-for-profit hospital has been named among the nation’s Top 100 Hospitals™ and is an eight time recipient of the prestigious Delmarva Medicare Excellence Award. In addition, MSMH received the Maryland Performance Excellence award at the Platinum level in 2014 – the highest in the state. Our staff is committed to providing quality and compassionate medical care for all patients by coupling innovation with our outstanding team of Medical Staff members, associates and volunteers. Visit MedStarStMarys.org to learn more.

Contact: Holly Meyer
Phone: 301-475-6010
Email: [email protected]

Valley Lee Couple Shares Story of Recovery and the Importance of CPR

‘It Came On With No Warning’

Gloria and Francis Bean were walking on July 4 — a typical sticky summer day, like many in Southern Maryland — when, without warning, Francis went into cardiac arrest.

They’d just completed a walk around Francis’ brother’s farm: a pleasant routine for the Valley Lee couple. Francis typically joins his wife for an hour before Gloria completes another 30 minutes on her own.

The two stood chatting on Independence Day when, as Gloria recalls, Francis suddenly collapsed, grasping at his wife’s shirt as he fell. He was not breathing.

“There were no warning signs,” Francis says. “You know how, with heart attacks or cardiac events, there are symptoms or warnings? There were none.”

Gloria has spent 36 years as a registered nurse at MedStar St. Mary’s Hospital, but this patient in sudden distress was her husband. They were just a five-minute walk from their own home, but it might as well have been miles. “We didn’t take our cell phones,” she says.

Driven by adrenaline, Gloria began cardiopulmonary resuscitation (CPR): the technique of administering chest compressions and giving breaths to assist a person who has stopped breathing or is experiencing a cardiac event. CPR restores oxygenated blood flow to the vital organs by pumping blood through the body, and/or giving breaths to oxygenate the blood being pumped.

“I was probably out there for 15 minutes,” Gloria says, “but then I really thought I needed to get help.”

She sprinted to find her brother-in-law and call 911, then returned to continue CPR. It took an additional 10 minutes of mouth-to-mouth before first responders could arrive.

“You’ve never been so happy to see anyone in your life,” Gloria says.

Members of the Second District Fire Department and Rescue Squad — where Francis has also volunteered — revived him using a defibrillator. He was then transported to the Emergency Department at MedStar St. Mary’s, where he was seen by Dr. Daniel Geary, medical director of the Emergency Department, and the emergency staff before being flown to MedStar Washington Hospital Center.

The Cardiac Catheterization Lab at the MedStar Heart & Vascular Institute determined Francis had a 100 percent blockage in one artery. Surgery was required to clear it and place a stent to keep the artery open. Francis was able to be discharged after just two days with a LifeVest — a wearable defibrillator — providing protection and peace of mind while he recovered at home.

Three months later, Francis smiles at his wife of 35 years. The pair has four grown children and three grandchildren. How grateful they are that Gloria was by Francis’ side that day.

“It’s so important that CPR was started immediately. Your chances of recovery drop with every minute until help arrives,” he says.

Francis started a supervised exercise program at the Grace Anne Dorney Pulmonary & Cardiac Rehabilitation Center at MedStar St. Mary’s, where his vital signs are monitored during low-impact routines. The intensity of his workouts has been gradually increased to safely return him to an active lifestyle.

The couple advocates strongly that everyone take a CPR course to be able to assist others in a crisis. At least 10 of the Beans’ family members have become certified since July.

“You never know when you’re going to need CPR,” says Gloria. “You think the skills aren’t going to come back to you, but they do. You never know whose life you’re going to save — it could be your loved one.”

Today, the Beans are back to walking again: an hour around the farm and home again.

“But we take a cell phone now,” Gloria smiles.

To learn more about cardiac and pulmonary rehabilitation, visit MedStarStMarys.org/GraceAnneDorney.

For CPR class availability and other opportunities at MedStar St. Mary’s, go to MedStarStMarys.org/Calendar.

Code Brown LIFTED

Code Brown Lifted as of 8:05 p.m. on March 3


Leonardtown, Maryland (March 3, 2018) - Due to inclement weather, a CODE BROWN is in effect for our hospital as of 4:50 p.m. on Friday, March 3, 2018. For patients with scheduled appointments, tests, or surgeries, please use your best judgment when traveling. Patients, to reschedule an appointment or procedure, contact the appropriate department directly. As a reminder, MedStar St. Mary's Hospital and Emergency Department is OPEN 24/7. 

Remember, do not travel to the hospital if you do not have reliable transportation or feel it is unsafe. If you or a loved one is experiencing an emergency, please call 9-1-1 immediately.

For non-emergency medical needs, please consider using MedStar eVisit, a video-based care option offering access to board-certified medical professionals 24/7. After registering, patients can have a secure virtual consultation for a non-emergency medical issue within minutes through your computer or mobile device. Each visit costs only $49 or less* and insurance is not required. Learn more and enroll here.

Quick numbers:

Associates, CODE BROWN drivers are available during severe weather for individuals who need help traveling to the hospital. Please call 301-475-6226 or 240-434-7008.

Surviving Sepsis: Two Local Women Share Their Stories

Lucky To Be Alive

In mid-August, Jennifer’s husband drove her to the Emergency Department (ED) of MedStar St. Mary’s Hospital where she was diagnosed with sepsis, a deadly infection that can lead to tissue damage, organ failure and all too often, death.

“There was a point when I was in the Emergency Department and I remember feeling like I was not going to make it out of there. I have never felt so sick in all of my life,” said Jennifer, 49, who survived a battle with breast cancer 13 years ago.

A few days before she was admitted to the hospital, she noticed an infected, ingrown hair on her leg. She treated it and thought nothing more of it, but that small infection would lead to much bigger problems. Still recovering from a flu-like illness the previous week, she started to feel sicker over the weekend and stayed home from work Monday.

“I could not get out of bed,” Jennifer, a California, Md., resident said. “I stayed in bed all day Monday, and that’s not like me.” Tuesday, Jennifer went to work, but her symptoms worsened and she began having chills and uncontrollable shaking. Her coworkers called her husband who drove her to the hospital.

“The ED was full, but by the time my husband got back from parking the car, I was in a room and they were hooking up IVs,” Jennifer said.

When Jennifer arrived in the ED and was being triaged, the nurse recognized her symptoms and a Code Sepsis was called. In September 2016, MedStar St. Mary’s Hospital instituted the Code Sepsis, a treatment protocol designed to quickly diagnosis sepsis patients so that life-saving medications can be started. Antibiotics are effective in battling sepsis, but because the infection spreads rapidly delayed treatment increases the risk of death. 

“My doctor said it would take a lot of time for my body to recover,” she said. “And he told my husband, if I had stayed home by myself, my husband probably would have come home to find me in a coma or dead.”

Although it has taken several months for Jennifer to regain her strength, she has made a full recovery. For Cheryl Douglas, of Chevy Chase, the outcome was very different.

Education Can Save Lives

In 2006, Cheryl, who had recently retired, returned home one afternoon and suddenly started feeling ill like she had the flu. She sat in an ED for hours waiting to be seen. Two months later, she woke up from a coma with no recollection of what had happened.

While she was unconscious, her husband, Paul, and her doctors had to make the painful decision to amputate her hands and feet to save her life. It has taken years of physical therapy and relearning basic life skills such as walking and cooking, but Cheryl has regained her independence. She loves to cook and travel with her husband and is determined to help others survive sepsis. 

 “Two hundred and fifty thousand people die each year in this country due to this totally treatable health condition,” said Paul, who with Cheryl recently shared their story at the Southern Maryland Sepsis Collaborative hosted by MedStar St. Mary’s Hospital.

“Paul and I had never heard of sepsis and we had no idea what to do,” said Cheryl. “If people know the symptoms, they are more likely to go to the doctor.”

Cheryl and Paul believe that education of healthcare workers and the public is the key to reducing sepsis deaths. “We could save so many lives in such a relatively easy way,” said Paul.

Visit MedStarStMarys.org/Sepsis to learn more. 

Know The Signs and Symptoms of Sepsis

S ► Shivering, fever, or very cold

E ► Extreme pain or discomfort

P ► Pale, discolored, clammy or sweaty skin

S ► Sleepy, confusion or disorientation

I ►" I feel like I might die."

S ► Shortness of breath

Live Q&A Jan. 23 with Sports Medicine Specialists to Address Keeping Young Players Safe

Leonardtown, Maryland (Jan. 2, 2018) – A free presentation on preventing, diagnosing and treating sports injuries in children and young adults will be held 6:30-8 p.m. Tuesday, Jan. 23, in the auditorium of Leonardtown High School.  

“Protecting Your Student Athlete,” an informative talk geared toward parents, will be led by Emmanuel Atiemo, MD, and Christian Glaser, DO. The physicians will discuss preventing and treating common sports injuries like concussions, fractures, tears, strains and more, accompanied by engaging question-and-answer sessions with attendees.

Dr. Atiemo, a board-certified orthopedic surgeon and sports medicine specialist with MedStar Orthopaedic Institute, has extensive athletic team experience as a team physician for the Baltimore Ravens and Washington Nationals, among others. A graduate of the Morehouse School of Medicine in Atlanta, Dr. Atiemo completed his residency at Temple University Hospital and fellowship at MedStar Union Memorial Hospital in Baltimore.

Dr. Glaser is a board-certified internal and sports medicine specialist with the MedStar Medical Group at Charlotte Hall. He is a team doctor for the Maryland Jockey Club. A graduate of the Philadelphia College of Osteopathic Medicine, Dr. Glaser completed his residency at Crozer-Chester Medical Center and his fellowship at Thomas Jefferson University Hospital in Philadelphia.

 

Contact

Holly Meyer, Director
Marketing, PR & Philanthropy
301-475-6010
[email protected]

 

 Making Strides Against Sepsis

Sepsis can be deadly, but it doesn’t have to be. For the past year, MedStar St. Mary’s has increased efforts to recognize sepsis early and treat it quickly to ensure the condition doesn’t cost someone their life.

“Since we began our sepsis protocol, we have seen a dramatic decrease in sepsis mortality,” said Jennifer Alvey, BSN, RN, director of the Intensive Care Center (ICC), Respiratory Therapy and Three Central.

Last September, MedStar St. Mary’s began calling a Code Sepsis for patients who are showing signs of developing the deadly condition. Once the code is called, a sepsis response team — Intensive Care Center and Emergency Department staff, a respiratory therapist and the patient’s primary nurse — reviews the patient’s medical chart and any trends in their vital signs to help identify the source of the infection. A pharmacist is also consulted to make sure the proper medications are being given.

According to the Maryland Hospital Association (MHA), sepsis is among the top 10 most common and potentially preventable complications across Maryland hospitals, and it is also a leading cause of mortality and readmission. Continually rising sepsis rates spurred the MHA to partner with the Maryland Patient Safety Commission to create an 18-month collaborative of 11 Maryland hospitals to work toward reducing hospital sepsis mortality.

MedStar St. Mary’s participated in the state program and is helping to take the efforts to the next level by partnering with other regional hospitals to establish a Southern Maryland Collaborative, which will hold its first meeting in the Education & Simulation Center Sept. 19.

“Maryland has taken a really hard stance on sepsis,” Jennifer said. “Next, we will be working to help educate long-term care facilities about the early warning signs. A lot of patients from these places already have it by the time they get here and by then it’s too late.”

How You Can Help Prevent Infections

  • Follow infection control requirements (e.g., hand hygiene) and ensure patients receive recommended vaccines (e.g., flu and pneumococcal).
  • Educate patients and their families. Stress the need to prevent infections, manage chronic conditions, and seek care if signs of severe infection or sepsis are present.
  • Think sepsis. Know sepsis signs and symptoms to identify and treat patients early.
  • Act fast. If sepsis is suspected, order tests to determine if an infection is present, where it is, and what caused it. Start antibiotics and other medical care immediately. Document antibiotic dose, duration, and purpose.
  • Check patient progress frequently. Reassess antibiotic therapy 24-48 hours or sooner to change therapy as needed. Be sure the antibiotic type, dose, and duration are correct.
    Source: Centers for Disease Control and Prevention

Learn more about Sepsis on our website. 

Partners in the Southern Maryland Sepsis Collaborative

Purpose of Collaborative

  • Offer education
  • Facilitate networking
  • Establish joint problem solving

St. Mary’s County Not Immune to Devastating Effects of Opioid Epidemic

An Epidemic Hits Home

This is the third in a four-part series on the opioid epidemic in our community.

As an Emergency Medical resident with MedStar Georgetown University Hospital, Eric Kiechle, MD, was prepared to treat patients coming to the D.C. hospital who had overdosed on opioids or heroin. But during a rural emergency medical rotation at MedStar St. Mary’s Hospital, a ride along with the Lexington Park Volunteer Rescue Squad gave him a different perspective. 

“Walking into a home where people are overdosing really put things in perspective for me,” Eric said. “I could see that the opioid and heroin epidemic has hit the area pretty hard. Obviously, I see it in D.C., but seeing it here was eye-opening to me.” 

Just as in other areas of the country, St. Mary’s County continues to deal with the impact of the opioid and heroin crisis. In June, St. Mary’s saw its first overdose from the powerful drug carfentanil, a synthetic opioid 10,000 times stronger than morphine and 100 times more potent than fentanyl.

In the first half of 2017, the St. Mary’s County Sheriff’s Office has responded to 14 overdose deaths all linked to the use of — or a combination of — heroin, cocaine, fentanyl and/or carfentanil. “On the law enforcement front, we are going after the drug dealers, and if we can identify a dealer in a fatal overdose, we’re going to work with the State’s Attorney’s Office to hold those dealers responsible,” said Capt. Eric Sweeney, Vice/Narcotics. “Our approach to the opioid epidemic is comprehensive: we are investigating, we are arresting, and we are educating.”

The sheriff’s office works closely with the St. Mary’s County Health Department, MedStar St. Mary’s Hospital, St. Mary’s County Public Schools, the Young Marines, and other county organizations to host prevention programs. Its headquarters in Leonardtown is also a collection site for unwanted medications through an anonymous 24/7 drop-box program. 

This initiative ensures proper disposal of medications, so they never enter the streets and minimizes the opportunity for an individual to become a target of crime by having unused medications in their home. Additionally, every September the Sheriff’s Office collects medications directly from the homebound who otherwise may not have the opportunity to dispose of their unused medications.

Every deputy at the sheriff’s office is equipped with and trained to use naloxone (Narcan). The sheriff’s office responded to 106 nonlethal opioid overdoses in the first half of 2017 and administered 99 doses of Narcan to 50 recipients. In 2016, only 49 doses of Narcan were administered by deputies.

“What we see on the streets is that this epidemic does not discriminate — it impacts all ages, genders, backgrounds, and
races. This is a nationwide problem and St. Mary’s County is not immune,” said Sheriff Tim Cameron. “If you have a family member or friend struggling with addiction, please get them help. It’s a horrible epidemic, and the help is out there.”

Visit MedStarStMarys.org/Opioids for more information on lifesaving resources and information.

A Prescription for Change: Combating Maryland’s Opioid Epidemic

Drug Monitoring Program May Help Curb Opioid Epidemic

This is the second in a four-part series on the opioid epidemic in our community.

When you hear the words State of Emergency your thoughts naturally turn to natural disasters, not drugs. But on March 1, Gov. Larry Hogan declared a State of Emergency in Maryland in response to the heroin, opioid and fentanyl crisis devastating communities throughout the state and the country. 

“Our community has not gone untouched by this crisis,” said Jeremy Tucker, DO, medical director of the Emergency Department at MedStar St. Mary’s Hospital. “The sad truth is that we encounter the effects of this every day in our Emergency Department. The number of people we have coming to us seeking prescription pain medication and the number of overdoses we see continues to rise. The drugs available on the street are stronger, more addictive and deadlier than ever before.” 

Heroin and the new kid on the street, fentanyl, are cheaper more readily available alternatives to illegally obtained prescription opioids, and become the drug of choice for many when access to prescription opioids runs out. According to statistics from the Maryland Department of Health and Mental Hygiene, in some areas of the state approximately one in 10 people are addicted to heroin. 

“We are not just talking about prescription opioids,” said Meenakshi G. Brewster, MD, MPH, St. Mary’s County Health Officer. “Certainly, when this all started, it was probably the most prominent feature, but now a major factor is heroin and fentanyl.”

According to Dr. Brewster, fentanyl is 50 to 100 times stronger than morphine and incredibly more potent than other prescription opioids and heroin. “Sadly, people buying and selling drugs on the street may not be aware that fentanyl is cut into the medication or the drug they are selling or buying,” said Dr. Brewster. “Even non-opioids, like Xanax, we are now sometimes finding have opioids like fentanyl cut into them and people are overdosing because it is incredibly powerful, they haven’t built up a tolerance and their bodies are overwhelmed.”

Helping to Curb Over-prescribing 

One way Maryland hopes to combat the opioid epidemic is with the Maryland Prescription Drug Monitoring Program (PDMP). Officials are counting on it to become the first line of defense and help reduce over-prescribing of prescription pain medications as well as doctor shopping for multiple narcotic prescriptions. 

The PDMP was created to support providers and their patients in the safe and effective use of prescription drugs. Pharmacists and practitioners authorized to prescribe controlled dangerous substances must be registered with the PDMP by July, and by July 2018 prescribers will be required to query and review their patient’s PDMP data prior to prescribing an opioid or benodiazephine, and repeat that query every 90 days thereafter as long as they continue to prescribe opioids.

“The new drug monitoring program will be a tremendous benefit to help reduce the risk of over-prescribing opioids,” said Dr. Tucker. “The PDMP will allow us to make more informed decisions about whether or not to prescribe narcotics to patients to control their pain. Earlier identification of a patient who might be at risk of abusing opioids gives us the opportunity to help that individual find the treatment they need which ultimately could save their life.”

Visit MedStarStMarys.org/Opioids for more information on lifesaving resources and information.