Baltimore firefighters respond to up to 6,000 opioid overdoses a year, fire official testifies

The Baltimore City Fire Department responds to 3,000 to 6,000 opioid overdoses each year, a top fire official estimated Monday in testimony in support of the city’s ongoing civil lawsuit against two major drug distributors.

James U. Matz, assistant chief of the state Division of Emergency Medical Services, said that estimate only accounts for incidents in which medics are able to revive a patient with naloxone, which quickly reverses the effects of an overdose. He said that estimate almost certainly understates the true number of opioid overdoses because many fatal overdoses are identified only after an autopsy and toxicology screening by the state’s Office of the Chief Medical Examiner.

Matz said the opioid crisis has strained the department’s resources, leading to longer response times to emergencies.

“Overall, it has worsened the health of Baltimore,” said Matz, a nearly 30-year veteran of the fire service who grew up in the city.

Matz’s testimony came on the same day that city attorneys released a statement by Mark Lichtman, who owned and operated Drug City Pharmacy in Dundalk, which was described as the largest independent pharmacy customer for oxycodone, which is distributed by McKesson, one of the companies in the lawsuit. The other is AmerisourceBergen.

The city alleges that McKesson and AmerisourceBergen are among the companies that flooded the Baltimore region with addictive painkillers, creating a new generation of addicts who died in unprecedented numbers as they sought refuge in an illegal drug market rife with deadly fentanyl.

Baltimore’s 2018 lawsuit alleged that the companies’ actions, along with those of opioid manufacturers and pharmacy chains, constituted a public nuisance under state law because they deprived residents of their right to health and safety.

In opening statements last week, a city attorney said McKesson shipped 3 million oxycodone pills to Drug City a year before the company closed the pharmacy in 2012 amid a Drug Enforcement Administration investigation into its opioid dispensing.

Lichtman said McKesson, the supplier of opioids and other medications, never asked him questions or raised concerns as the supplier sent more and more painkillers to his pharmacy.

“They called me and asked if I needed more oxys,” Lichtman said in the statement. “They loved us. I guess they thought they were in trouble now, so they dropped us.”

Lichtman recalled interactions with a salesperson. Instead of any concern, he said, a salesperson “congratulated me for being the best oxy person for McKesson.”

Lawyers for McKesson and AmerisourceBergen have said the companies are not responsible for creating an opioid epidemic that they say is solely due to illicit heroin and fentanyl brought into Baltimore and sold by cartels, gangs and street gangs. Their companies, the lawyers said, merely distributed the drugs to pharmacies so they could fill doctors’ prescriptions.

Matz testified that he, doctors and paramedics have noticed a big change in the type of people affected by the crisis.

In the 1990s, he said, most of the people who overdosed and were treated by the department were middle-aged and many were homeless. Overdose reports, he added, came only from certain parts of the city.

By the mid-2000s, Matz said, overdose patients were getting younger and coming from across Baltimore and beyond the city limits.

“We saw increasing use of opioid pills,” he said.

In the decade that followed, there were “dramatically more” overdoses, Matz said, and people died at higher rates from heroin and fentanyl.

“It’s not just a heroin or fentanyl problem,” Matz said, “it’s an opioid problem.”