Correction: Earlier versions of this article misstated the date that Nick Hileman died. It was Jan. 6. The article has been corrected.
Anne Arundel County State’s Attorney Wes Adams grew up with an alcoholic father and has spent two years as lead prosecutor of a county hit hard by Maryland’s opioid epidemic. For a decade, he and his wife did what they could to support her brother, Nick Hileman, whose dependence on prescription painkillers had grown into an addiction to heroin.
So when Adams got an unexpected phone call from Hileman’s wife on the morning of Jan. 6, he was pretty sure he knew what he was about to hear.
“He’s dead. He’s in jail. He’s in recovery — those are your three phone calls,” Adams said. “We drew the ‘dead’ call. That’s what happens. For what I do, it’s a hard call to hear.”
Less than three weeks later, Adams (R) stood with Gov. Larry Hogan (R) at Anne Arundel Medical Center to announce a slate of proposals to combat opioid addiction, which is skyrocketing in Maryland and across the country.
Adams told the crowd that he had buried his brother-in-law eight days earlier after a fatal overdose. He talked about how easy it can be for people to become addicted to prescription painkillers, and then move on to heroin in search of a cheaper high. After back surgery four months ago, Adams recalled, his doctor prescribed him 90 opioid pills, even though he reported only moderate pain from the procedure.
“We’re talking about $7,500 worth of street-level narcotics when I walked out of the hospital,” he said. “The only warning they gave me was that I could become constipated. Nobody told me about the addiction level that could result from taking an opioid medication.”
Hileman, a money manager who lived in Arizona, first got hooked on pain medications that were prescribed to him for dental work and back problems.
He started using heroin about two years ago, had recently completed a 28-day inpatient treatment program and was attending regular Narcotics Anonymous meetings, said his sister, Kristin Hileman-Adams.
During the last week of December, Hileman visited family in Maryland with his wife and 2-year-old son. He went to a support-group meeting on the first night and spent the next few days catching up with family, exchanging gifts and touring the Baltimore Aquarium, Hileman-Adams said.
Two days after returning to Arizona, he overdosed in his living room. He was 38 years old.
Hileman-Adams said her brother was a popular guy with a happy disposition who showed almost no signs of a drug problem.
“I’ve come to learn that you can’t tell someone is addicted to opioids,” she said. “You can’t predict it just by looking at them, or by how old or what they do as a career or anything else. It really affects people across the spectrum.”
Adams says Hileman had trouble accessing treatment programs, with his insurance providing only partial coverage for inpatient care, and even then for less than a month. “You don’t change the behavior in 28 days,” he said.
Many experts agree with that idea, saying health departments need to focus most intently on long-term recovery programs. Nancy Rosen-Cohen, executive director of the National Council on Alcoholism and Drug Dependence, said that “prevention and most importantly treatment are the major part of the solution.”
In his first two years in office, Hogan has boosted funding and treatment beds throughout the state, and launched a statewide database to track opioid prescriptions and identify potentially suspicious activity.
Hogan, who also lost a family member to overdose, last week said he would introduce legislation to limit prescriptions for pain medications to a seven-day supply, with limited exceptions, and increase prison terms for drug dealers convicted of opioid sales that result in lethal overdoses.
The governor also signed an executive order establishing a central “command center” to coordinate local and state efforts to combat opioid abuse, and promised a bill that would allow the state to take action against drug prescribers and dispensers based on investigations by licensing boards and federal authorities.
Many treatment advocates want far more money allocated for long-term, residential recovery programs.
“Numbers will continue to rise until the new generation of politicians and health experts understand heroin addiction,” said Mike Gimbel, Baltimore County’s former drug czar and a recovering heroin addict.
Adams has experienced the opioid epidemic from nearly all angles. Aside from his personal loss, he prosecutes drug users for snatching purses, armed robbery and other crimes they commit to feed their habits.
He has seen the caseload for Anne Arundel’s drug court swell in recent years, prompting him to push for a doubling of resources for a program that diverts addicts into supervised treatment. The jurisdiction had 85 overdose deaths related to heroin, and 41 related to prescription opioids, during the first nine months of 2016, both more than double the amount for all of 2015.
“I am all about rehabilitating people, because the more people I can take away from the extreme of crime, it has a multiplying effect — a big effect on community safety,” Adams said. “The complexity of fighting this is at so many levels,” he said. “You can’t just approach it from arresting drug dealers.”
Adams presses state and local elected officials to provide more funding for treatment beds, visits to classrooms to educate students about addiction and helps lead panel discussions for Anne Arundel’s Not My Child public-
He was elected in 2014 after promising to work more closely with police and get tougher with plea agreements, mainly by offering less-generous deals for defendants. He became the first Anne Arundel state’s attorney to authorize a wire tap to infiltrate a drug organization, an effort that led to a 2015 drug bust that included eight criminal indictments and the seizure of nearly $1 million in assets.
Caleb Alexander, a physician and co-director of the Johns Hopkins University Center for Drug Safety and Effectiveness, said Adams’s willingness to share his story of loss, particularly as an authority figure, can help people realize how common opioid addiction has become.
“I commend the state’s attorney for sharing such sensitive and personal and sad news,” he said. “No single story is going to tip the scales and end the epidemic, but this type of disclosure can serve a very important role.”
Adams said he thinks every day about how to use his office to address addiction, especially because he felt powerless to do anything about his father’s alcoholism as a child.
“So much of my time has been tied up with responding to this drug crisis,” he said. “How do I keep the next Hileman family from getting that phone call?”