Every month, Tina Johnson’s family changes the numbers on a billboard outside the Frederick County Adult Detention Center.
Those big, black numbers represent the number of overdoses, fatal and nonfatal, that occurred in Frederick County. In 2021, the county experienced 198 nonfatal overdoses plus 43 fatal, according to police data provided by Maryland Heroin Awareness Advocates (MHAA). That’s fewer than in years past, but for Johnson and other recovery awareness advocates, one is too many.
Johnson, of Frederick, lost her son Raymond “Coop” Cooper and her brother Tyler Rakich to overdoses within less than two months of each other in 2018. Rakich was 28 when he died, and Cooper was 27.
“They were extremely close,” she recalled, more like brothers than an uncle and nephew.
When Rakich died, Cooper felt more lost than before.
Johnson grieves still, but she doesn’t do it sitting down. She sponsors people in recovery and is the Frederick County representative for MHAA. She encourages people in need to reach out to her through the organization. Johnson has been in recovery herself, or as she puts it, a “productive member of society” for 15 years.
When she updates the overdose numbers, she does so in the shadow of the building where she was once an inmate.
Roughly 15-plus years ago when she was at the detention center, Johnson says she was lucky to get into an outpatient recovery program offered at the time. She remembers there being 12 slots for women, much fewer than what was available for the men.
“I just remember being like, ‘Thank God I was chosen,’” she said.
Now, Johnson has made it her mission to help others. She has a message for those who use drugs.
“One is too many, and a thousand is never enough,” she said, as in, one dose takes it too far, and one thousand doses could never be enough once you’re hooked.
It’s painful for Johnson to see the overdose numbers climb month after month, but when it came time for the update Wednesday, she had supporters by her side.
“We are here to help with compassion,” said Carin Miller, president of MHAA and peer recovery support specialist with the Maryland Center of Excellence on Problem Gambling.
Sean Nicholson, director of community and business relations for The Orenda Center of Wellness, also provided a helping hand. Orenda, an addiction treatment center, provided funding for a new banner on the sign.
An active advocate and local resident, Nicholson has come to know many in the Frederick County recovery community.
“A lot of my friends are in this number,” he said, staring at the billboard. “It’s getting harder and harder to absorb the loss.”
Though important for visibility, the sign does not capture every loss. Deaths related to drug use can also take form in sepsis or endocarditis, Miller acknowledged, not only overdoses. And when people cross county lines for hospital care and die elsewhere, their fatal overdose isn’t necessarily recorded in the same place they obtained the drugs, like with Johnson’s brother.
What’s more, some overdoses go unreported entirely if people don’t seek medical treatment after being revived.
“We don’t have a perfect system,” Nicholson said. “It’s unfortunate that an overdose board has to be displayed on a major road for there to be an elevated conversation for the needs of people who struggle every day with multiple substances. ... We’ve lost so many, and that brings us to why we’re here today at the board.”
The sign that faces Md. 85 came to be in 2017. In the first quarter of that year, Frederick County experienced overdoses from heroin or an opioid, on average, every single day, according to Margaret Nusbaum, chief of staff for the county executive. Every week and a half, someone overdosed and died. A tranquilizer called carfentanil that is 10,000 times more potent than morphine and 5,000 times more potent than heroin reached Frederick, causing one of the first three deaths in the state from this drug, Nusbaum said. Advocates and members of the county executive’s Heroin Consortium called for increased awareness, and the overdose billboard was erected.
Advocates have seen mixed results over the past half-decade. Nonfatal overdoses have been on the downturn since 2016 locally, but the amount of fatal overdoses has risen and fallen over the years. In 2020, there were 216 nonfatal, opioid-related overdoses and 59 fatal in Frederick County, according to data provided by Miller, representing a decline of about 12.4 percent in total overdoses compared to 2021. In 2019, there were 245 nonfatal overdoses and 49 fatal.
Nusbaum views the nonfatal overdose decline with “dubious optimism,” she wrote in a recent email. “Frederick County’s trends are going in the opposite direction of the national trend during the pandemic,” Nusbaum wrote.
Overdoses reached a new high nationwide during the pandemic. The Centers for Disease Control and Prevention estimated that 100,300 Americans died of drug overdoses from May 2020 to April 2021, the Associated Press reported.
“Contributing factors for the [Frederick County] decline in overdose and overdose deaths may be related to the extensive efforts to reach people in the community using partnerships in innovative ways,” Nusbaum said.
A short walk from the overdose sign is Mountain Manor at Marcies Choice, an addiction treatment center on the second floor of the Frederick County Work Release Center that opened its doors last year, Nusbaum noted. And in 2020, the fire and health departments launched a program that put peer recovery specialists and emergency medical service providers on the road together to respond to overdoses in a more holistic way.
The opioid overdose reversal medication naloxone, also known as Narcan, has also flooded the community. Nusbaum also pointed out the county funded expanding Mobile Crisis Services to a 24/7 model, grew the Walk-In Behavioral Health Crisis Center and also established enhanced coordination with crisis service partners through the Coordinated Crisis System Workgroup.
Despite these and other advancements, the opioid epidemic continues, and so does the work of people like Miller, Johnson and Nicholson.
When Johnson lost her son and brother, people told her in the beginning it would be OK. The pain would go away.
“It just gets different,” she said.
She thinks of her brother as a child playing with Tonka toys, then growing up to learn the trade of construction. And even though he was the baby of the family, he was the protector.
Coop, meanwhile, wanted to be a mixed martial arts fighter and was known to do backflips. He was a positive thinker and never held a grudge.
Johnson looks at her grandson Calin, Coop’s child, and is reminded of her son.
“Pain doesn’t go away,” Johnson said. “But [for] someone like me, it just drives me to do more, to be a part of it.”