FREDERICK, Md. — The candidates forum had the feel of a group-therapy session at times, as three of six Democrats running for an open congressional seat shared stories of close relatives who overdosed on opioids.
A brother-in-law. A nephew. A father.
"In the next 10 years with opioids, there will be probably a million people dead," Total Wine co-founder David Trone said Wednesday night at a Hood College forum focused on health care and opioids.
Drug addiction has emerged as a central issue in the race to replace outgoing Rep. John Delaney (D-Md.), as candidates nursing personal loss find common ground with the residents they seek to represent on Capitol Hill.
Wherever he goes, Trone asks audiences if they have been affected by the scourge of opioid abuse. Typically more than half the hands go up. Wednesday's forum was no different.
Pediatrician Nadia Hashimi, who will compete with Trone and four other Democrats in the June 26 primary, talked to voters at the forum about caring for jittery, addicted newborns. Patients at her husband's neurology practice sometimes "lose" their prescriptions and request more powerful painkillers, she said later in an interview.
Andrew Duck, a retired intelligence officer also seeking the nomination, learned how to administer the overdose-reversal drug Narcan after a treatment provider told him addicts often repeat rehab two, three and four times before it sticks.
"I made a personal commitment that if I'm in that situation I want to be able to keep a patient alive," Duck said at the forum, explaining why he always carries Narcan with him.
Years of spiking overdose rates have spurred action on opioids at all levels of government. President Trump declared a public health emergency. Gov. Larry Hogan (R), whose cousin died of an overdose, boosted funding, and Maryland's legislature passed a package of laws.
But the six Democrats and two Republicans vying for their parties' nomination to represent Maryland's 6th District say Congress can — and should — do more.
Republican front-runner Amie Hoeber, a defense contractor who challenged Delaney in 2016, agreed with other candidates that more federal funding is needed. She said a young man in her family overdosed about 20 years ago and recovered only after inpatient treatment.
"I still tear up when I talk about it," she said. "You don't lose those memories."
Trone, who ran in a neighboring congressional district in 2016, says it will take $100 billion over 10 years "just to scratch the surface of the problem."
He wants the government to negotiate lower prices for overdose reversal drugs, expand K-12 prevention programs, rewrite guidelines for opioid prescribers and make it easier for doctors to prescribe medically assisted treatment, according to a detailed 12-point plan on his website.
"It's talk, talk, talk and now we have Kellyanne Conway who's talking about it. But where's the money?" Trone said in an interview, referring to the White House adviser whom Trump named to lead White House efforts in the opioid crisis.
Trone's passion is born from years of trying to steer his opioid-addicted nephew through arrests and rehab stints. All appeared well when Ian, 24, celebrated Christmas 2016 with Trone and his family. Days later, after visiting a bar near his North Carolina halfway house, he began using drugs again and ended up dying alone.
"We thought he was going to be able to do it," Trone said, his eyes brimming with tears. "He had been clean for probably 30 or 36 months, so we had made awesome progress, but . . . it's fleeting."
Until earlier this month, the field of candidates included a recovering addict, Republican Matthew Mossburg, who made opioids the centerpiece of his platform. Mossburg quit the race to focus full-time on advocating for better addiction treatment.
The 6th District includes rural counties of Allegany, Garrett and Washington — where a total of 53 people died of opioid overdoses during the first half of 2016, according to the latest numbers from the state health department — and parts of Montgomery and Frederick counties, where there were 77 deaths.
Statewide, there were 1,029 opioid-related deaths in the first half of 2017, up from 873 compared to the same period in 2016 and 508 in 2015. The numbers are highest in Baltimore City, which saw 358 opioid-related deaths in the first half of 2017.
Just over one-third of Marylanders say they have a family member or close friend addicted to prescription pain pills or heroin, according to a March Washington Post-University of Maryland poll.
State GOP-sponsored surveys in parts of the 6th District identify health care and tax relief, followed by jobs and growth, as the top concerns for voters — not opioids. But candidates say addiction is fueled by inadequate health care and a lack of job opportunities.
"It's a symptom of what happens when people lose hope," state Sen. Roger Manno (D-Montgomery) said in an interview.
That sense of despair was on display last month at the opening of the first medical marijuana dispensary in Western Maryland as users lined up for hours to buy an alternative to potent painkillers.
A 60-year-old woman with joint problems, who has taken fentanyl and hydrocodone, said she was already using marijuana to alleviate sharp, radiating pain that makes it hard to stand or sit for extended periods.
"I just want to be normal again . . . and to get off the opioids, even though they help," said the woman, who asked that her name not be published. "I will not be a vegetable smoking marijuana, but with pain medications, some of them make you feel so comatose you don't want to get out of bed and function."
Republican candidate Lisa Lloyd, a nurse practitioner who says her family has also been touched by addiction, proposes after-school apprenticeships to better occupy young people. "To be free of addiction, there has to be something else in their life," she said.
Democratic candidate Chris Hearsey, an aerospace executive, was 12 years old when his father overdosed on Percocet in front of him. "He just collapsed," Hearsey said in an interview.
As a child, he constantly heard about the war on drugs, but at the same time watched his father and uncle, both police officers, drink and take pills to cope with stress and pain.
Del. Aruna Miller (D-Montgomery) said her brother-in-law, 55, died four months ago of an opioid addiction that no one knew he had "until it was too late."
"This is something that we as a society need to be able to embrace as a public health issue," she said at the forum. "This is a disease. There shouldn't be a stigma associated with it."
Clay Stamp, a longtime paramedic and emergency manager who Gov. Hogan put in charge of Maryland's opioid command center, agreed.
"In my 30 years of doing this," he said, "I've never had a crisis where there's such a propensity of people wanting to put their heads in the sand."
It took a national education and awareness campaign to reduce smoking, Stamp said. "And that's what it's going to take for this — and it's going to take money."
Fenit Nirappil contributed to this report.