Lisa Lowe’s son was just 16 when she tried to get him treatment for heroin addiction.
She began tirelessly seeking treatment for him, having to remain in the state of Maryland because of her insurance’s policies.
She had to take weeks off work, causing her to lose multiple jobs and eventually her house while working to get her son the treatment he needed.
But the answer always remained the same: there was just no room for him.
“I lost so much trying to get the treatment that has been shown to be successful,” Lowe said. “I swore if I ever got to a point where I was not in total crisis that I would spend an equal amount of time in the face of my legislators.”
Lowe’s son finally received treatment when he was 17, admitted to an adult treatment facility because there was no room anywhere else.
Lowe is now the director of the Heroin Action Coalition of Maryland and one of the voices opposing proposed legislation in Maryland that would increase penalties for distributing heroin.
If it passes the Maryland General Assembly, House Bill 222 (and cross-filed Senate Bill 303) would hold heroin distributors responsible for deaths that occur because of the drugs they provided, even if they did not directly give the drug to the victim, by enabling prosecutors to charge them with homicide, according to the bills.
Those sentenced could be jailed for up to 30 years, according to the bills.
Lowe said increasing incarceration will do little to reduce the problem, and the money used for incarceration should be put toward under-funded treatment programs.
“We have put billions into incarceration and it hasn’t done a thing. Policymakers keep saying, ‘We can’t incarcerate our way out of this!’ and then they cut our treatment budget by millions of dollars every year,” Lowe said. “And yet this bill comes and asks for money to incarcerate and everyone is on board.”
Montgomery County State’s Attorney John McCarthy, who helped draft the bill, insists it is to be used in partnership with treatment programs.
“This is not an attempt by anybody to preclude treatment,” McCarthy said. “The shame of it is that the state keeps limiting the amount of treatment you can get under a typical insurance plan, but we need to take a multi-faceted approach.”
Dr. Raymond Crowel, chief of Behavioral Health and Crisis Services for the Montgomery County Department of Health and Human Services, echoed McCarthy’s statement.
“We have to attack this problem on several fronts,” Crowel said.
The bill also includes deaths caused by fentanyl, a synthetic opiate often laced into heroin – the combination of which can be deadly.
“It kills people so quickly that you’ll find bodies with the needle still in the arm,” McCarthy said.
McCarthy said House Bill 222 and Senate Bill 303 are just two pieces of a wave of recent legislation in Maryland aimed at reducing heroin use, a result of the recent spike in heroin-related deaths.
In 2013, 464 people died heroin-related deaths in Maryland, up 88 percent from 2011, according to the Maryland Department of Health and Mental Hygiene. Montgomery County accounted for 28 of them.
Addicts often start out using prescription painkillers, such as oxycodone. The increase in heroin use is a result of addicts switching to heroin when they realize how much cheaper it is, according to the Journal of American Medicine.
“Oxycodone is a $40-$80 pill. You can get a bag of heroin for $10,” McCarthy said.
Dr. Yngvild Olsen, a board member for the Maryland chapter of the National Council on Alcoholism and Drug Dependence, said she worries the bill could remove the focus from the importance of treatment.
“I think it may confuse some of the efforts or some of the discussion around how we really take an approach to people who have opiate use disorder,” Olsen said. “We know that treatment is No. 1 for those people, and this doesn’t make it clear.”
“I think the public and our legislators are sufficiently aware of the scope of the program and the needed solutions that it’s unlikely that anyone will see this as the single solution,” Crowel said.
Of every dollar that federal and state governments spend on substance use, 95.6 cents pays for the aftermath, including incarceration or mortality costs, while 1.9 cents pays for prevention and treatment, according to “Shoveling Up II: The Impact of Substance Abuse on Federal, State and Local Budgets”, a 2009 report by the National Center on Addiction and Substance Abuse (CASA) at Columbia University.
While federal law permits distributors to be held accountable for resulting deaths, according to Montgomery County Delegate Kathleen Dumais, who introduced House Bill 222 in February, the high number of cases makes it difficult to get them through the federal courts.
Lowe said she is concerned that, as written, the bill could allow for addicts who are not large-scale drug dealers, and who were merely providing for a friend, to be charged.
“There are all these kids who, when it’s their turn to buy, purchase heroin and then give it to their friend,” Lowe said. “If that heroin is bad and the friend dies, does that kid who bought that one day deserve to be in jail for 30 years and to be called a murderer? That’s outlandish.”
Dumais said that legislators are willing to add something to the bill that would distinguish dealers from users who are just sharing.
“I’m not looking to prosecute the people distributing to feed their habit or sharing with friends,” Dumais said. “I am looking for the people who are manufacturing to make money. That’s who I want off the streets.”
The bills include a Good Samaritan provision, which would give immunity to anyone who seeks assistance during an overdose.
“The Good Sam clauses in this bill and other legislation will help us to encourage people to get help for persons who might otherwise die from an overdose,” Crowel said.
Olsen said she worried the increased punishment would still deter people from calling for help.
“They tried to make the Good Samaritan provision stronger in the bill and there is a huge amount of fear among people with this disorder. I am concerned this will increase fear and reduce the calling of 911.”
Officials held a hearing for the house bill Feb. 10. A hearing of the senate bill is scheduled for March 4.