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Mid Hudson TimesForum seeks solutions to opioid crisis

Forum seeks solutions to opioid crisis

St. Luke’s Cornwall Hospital in Newburgh treated 181 opioid overdoses since April, 2017. “Over 50 percent were from inside the city limits,” said Sgt. Julio Fernandez, a civil operations specialist with the New York National Guard Counterdrug Task Force.

“People say Newburgh has a massive problem,” Fernandez said, but almost 50 percent of those overdoses occurred outside the city. “No, the region has a massive problem. The towns connected to us have a massive problem. Our counties, our state, our nation has a massive problem.”

Opioid overdoses in the cities of Poughkeepsie and Kingston were up in 2016, explained Fernandez, who crunches data on drug use in the Hudson Valley. Opioid overdoses in the cities of Newburgh and Middletown were down, he said. “This epidemic is bouncing from city to city,” Fernandez said.

The sergeant spoke at a forum on the opioid crisis, hosted by New York is State Assemblyman Frank Skartados at the Newburgh Armory Unity Center on Saturday. The forum brought together a panel of scientists and substance-abuse professionals, as well as family members who lost loved ones to opioid use. “We are here to learn,” Skartados said at the event Saturday.

“All of my beliefs about drug use and abuse have been shaken,” said Lauren Mandel, whose son Zane Mandel-Michalak died of an opioid overdose in September. “The system I tried to access for my son failed.”

What the science says
Panelists at the forum agreed, the approach to dealing with the opioid crisis needs to change in the U.S. “We have to understand why people use opioids,” said Dr. Carl Hart, a neuroscientist and Department of Psychology chair at Columbia University.

“Opioids are really good drugs to decrease anxiety. They produce euphoria. They decrease pain, emotional pain, psychological pain… this provides a clue in terms of how we best help people.”

Opioids have been used for a long time, “because they work,” he said. “Why the hysteria?” he asked. “The hysteria helps bring us in the room, so we understand… But, we have to come in the room with some sense, with some logic, some cool headedness.”

“When we hear numbers like, for example, 64,000 deaths, that’s not 64,000 deaths from opioids, that’s everything – anti depressants, acetaminophen, all those overdosing, drug-related deaths are in there.”

Hart was referring to the Centers for Disease Control and Prevention’s reporting of approximately 64,000 drug-overdose deaths in the U.S. in 2016, a 21-percent increase from the previous year. “You separate the opioids and you get about 33,000 (deaths),” he said. “Those are the latest CDC numbers that I have seen.”

Hart provided some other statistics for perspective: Approximately 15,000 to 16,000 Americans die from guns each year, he noted, referring to the latest information on gun deaths from the CDC. Each year in the U.S., there are tens of thousands of deaths from automobile accidents, he said. “Are we talking about banning automobiles in this country?” Hart said. “Of course not… we ask people to wear seatbelts and we have speed limits.”

In countries like Switzerland, where Hart worked for a time, there are treatment center and auxiliary services for opioid addicts including mental health and social services, he said. “They’ve been doing that for more than 20 years in Switzerland and it works,” Hart said, and most people in treatment are able to maintain their jobs and families
Education on how to safely use opioids is essential, he said. Most of the people who die from opioids have used opioids with other sedatives, Hart said. “These other sedatives make it more risky, they increase the risk of respiratory depression,” Hart said.

These sedatives include alcohol, antihistamines like Benadryl, and benzodiazepines such as Xanax or Valium. “You tell people who are using opioids, don’t mix it with another sedative.”

Another important fact is that fentanyl is more potent than heroin, Hart stated. “A smaller amount of the drug is required to produce an effect,” he said. “If someone thinks they have heroin and they take fentanyl in the same amount, in the same dose as heroin, they can die from an overdose.”

When people buy drugs on the street, they often don’t know what the drug contains, Hart explained. “They don’t know the adulterant and fentanyl might be there.”

To counter this, in some European countries, “They have anonymous, discreet drug-checking services,” he said. “We have that (technology) in the United States, but they have not made it available.”

“We must also separate people who are addicted from those who just use drugs,” he added. “The vast majority of people who use opioids are not addicts. They are simply using opioids. We don’t want to lump everyone into the same category. Our help should be tailored to fit their needs.”

“We have the tools to help people with opioid addictions,” said New York State Director of the Drug Policy Alliance Kassandra Frederique, “including methadone, which cuts fatalities by 50 percent,” she said.

Methadone gets a bad rap, she said, because some people see it as another drug and another way to get high. “Why would you give someone you don’t want to be using drugs access to a syringe so they can use drugs?” she asked. “Doesn’t that condone it?”

The reason, in a nutshell, is “harm reduction,” she said. “Meeting people where they’re at and not leaving them there is not being soft,” Frederique said. “It’s being strong – strong enough to put your uncomfortableness aside to focus on the person in front of you.”

While Narcan, or naloxone, can bring a person back from an overdose, syringe-exchange programs can prevent blood-borne illnesses, she said, and importantly offer support to people seeking help.

The criminalization of drug-abuse is making the problem worse, said Jeff Kaufman, a former NYPD police officer and defense attorney who teaches at Riker’s Island. “We’ve had no success on this war on drugs,” said Kaufman, who saw families destroyed when parents became addicted to drugs. Regardless of arrests, “the drugs got more concentrated, the deaths increased,” he said.

“If we attack this in a more concerted, policy-oriented way… to prevent this from (involving) the criminal justice system, not only will treatment be made available more easily, as a society, we’ll be able to deal with this problem in a way that does not stigmatize.”

An ask for services
Cornerstone Family Healthcare Center for recovery Substance Abuse Counselor Vincent Trunzo spoke about Governor Andrew Cuomo’s “Five Point Plan” to combat the opioid crisis in the state.

Plan goals include holding pharmaceutical companies accountable for their role in the opioid epidemic, getting rid of insurance barriers to addiction treatment and recovery services, and adding fentanyl to the state’s list of Schedule-I controlled substances. Cuomo also plans to direct state agencies to carry out policy reforms to increase access to substance-abuse services.

Trunzo called for more funding for medically-assisted treatment programs, such as the methadone treatment program at the Cornerstone Family Healthcare Center for Recovery in Newburgh. “We have over 400 (people) in our program, with a waiting list of over 100 more,” he said. “We’re the only ones in Orange County. There are about six programs around the Hudson Valley and they all have waiting lists.”

Funding is also needed for education on opioids, Trunzo asserted. “And then prevention, it’s so important,” he said.


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