Under pressure to do more, Bowser declares public emergency on opioids

Mayor Muriel E. Bowser on Monday declared a public emergency over the opioid crisis, answering critics who say substance abuse should command more attention from the District government as overdose deaths rise.

The order, which is effective immediately, directs city agencies to use a shared overdose-tracking system so outreach teams can respond to hot spots more effectively, and it suspends some contracting rules to more quickly provide services.

Public scrutiny has increased on the District’s strategies to combat serious substance abuse, which city officials say tax hospital emergency departments, the criminal justice system and law enforcement. Opioid overdose deaths recorded by the city so far this year are on pace to surpass last year’s record of 461.

“We have too many people dying in our city related to fentanyl overdoses most specifically,” Bowser said during a news conference focused on health emergencies for opioids as well as juvenile crime.

The D.C. Council passed a nonbinding resolution last week urging Bowser to declare the public health emergency, which the mayor said she would consider if the order would allow concrete changes to alleviate suffering in the District. On Monday, she said the order’s terms could jump-start work of the newly formed Opioid Abatement Advisory Commission, which must recommend how the city should spend an anticipated $80 million from an opioid lawsuit settlement.

How deeply did prescription opioid pills flood your county? See here.

“We believe that the contracting vehicle will allow us to move — we hope — more quickly,” she said, adding that the faster the commission prioritizes investments, the sooner the order can be invoked.

But some advocates questioned the scope and effectiveness of the emergency order, which is effective for at least 15 days and does not come with funding or on-the-ground services, such as housing, transportation and employment opportunities.

Some said they would like to see District officials go further, adopting strategies such as treatment on demand with no waiting period, overdose prevention centers and drug-checking equipment beyond fentanyl test strips.

“The most important thing is these types of declarations need to come with funding and services that could be immediately stood up. If we say it’s a crisis, we need to respond as if it’s a crisis,” said Emily Kaltenbach, senior director of state advocacy and criminal legal reform at the Drug Policy Alliance, which advocates for decriminalizing drug use. “We need to think beyond the strategies that may have seemed realistic five years ago.”

The District joins at least six states in declaring an emergency because of the opioid crisis, including Virginia and Maryland, which made the move in 2016 and 2017, respectively, according to the Network for Public Health Law.

Ciana Creighton, the District’s interim deputy mayor for health and human services, said during the news conference that opioid use is a driving cause of a decrease in life expectancy recorded in the United States for the first time in a century.

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In D.C., older Black men in Wards 5, 7 and 8 were hit hardest as fentanyl surged into the drug supply, according to city data. Last year, about a third of people who died from an opioid overdose in the District had a history of seeking treatment, city data show.

Connecting residents to treatment is one goal of the District’s first stabilization center, which since opening two weeks ago has served 139 people, about two-thirds of whom were transported by fire and emergency services personnel, said Robert Holman, the medical director of DC Fire and EMS. More than 60 percent were using alcohol and more than 20 percent opioids, he said, noting that the overdose antidote naloxone has been administered at the center.

“You don’t take people that need to sleep and put them under bright lights and give them lots of noise; you put them in a quiet space,” Holman said. “And that’s going to help them connect because they’re not so irritated with really mission-driven specialized-care providers, and that’s key.”

Opioid overdose deaths more than doubled in the five years since 2018 when the Bowser administration announced Live.Long.DC., a strategic plan intended to prevent and treat overdoses with harm-reduction techniques such as naloxone and fentanyl test strips.

The forthcoming third version of the plan is under review by the mayor’s office, but some members of the Opioid Abatement Advisory Commission say the District must rethink its approach with a focus on peer support and direct services, such as housing.

At a meeting last week, Edwin C. Chapman, a physician specializing in addiction medicine, pressed fellow commissioners to say if they considered opioid use an emergency in the District, eliciting abstentions from agency heads who work for Bowser.

“There are people at the table who are muzzled,” Chapman said during the meeting. “They won’t say what needs to be said. If I don’t raise hell about this every day, then I should throw my license away. I’m out on Benning Road for a reason.”

D.C. Council member Christina Henderson (I-At Large), chair of the council’s health committee, called the order a “good first step” that will be helpful when the commission, of which she is a member, begins to make funding decisions.

The data-sharing piece is intended to reveal in real time places where the District can deploy outreach teams. However, Henderson said, council hearings on the issue show the need for a coordinated action plan.

Health Alliance Network founder Ambrose Lane Jr., who has clamored for a public health emergency since an April news conference outside the District government building, had hoped such an order would allocate $50 million for infrastructure, create residential and youth treatment centers, and identify 500 jobs for people in recovery.

Still, he hoped to thank Bowser after the announcement, saying, “It’s a start.”

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