A Crisis ‘Unlike Anything I’ve Seen’

Jay Schneiderman is the supervisor of the Town of Southampton, but when he took the microphone last week at Stories From Suffolk, a policy discussion forum featuring local and state officials and experts involved in New York’s fight against opioid abuse, the scenario he described was familiar to everyone in the room.

He spoke about the rapid onset of the opioid epidemic, the ways it defies easy solutions, the heartbreaks that seemed to come along almost unabated — especially at first.

“We cherish our small-town life here, and the big issues we face here are typically traffic or weather or beach erosion, loud parties, things like that,” Mr. Schneiderman told the crowd of more than 300 at the Greek Orthodox Church of the Hamptons in Southampton. “But then, suddenly, 19 members of your community in one year [2017] died very preventable deaths in a small town of 60,000 people — 19 lives just whisked away, many of them really young people. And suddenly as a town supervisor and town board you’re faced with grappling with an issue that’s life or death.”

Many of the panelists acknowledged that knowing how to respond to the opioid epidemic can feel daunting, given the gravity, extent, and urgency of the problem. As Mr. Schneiderman noted, even progress like the Town of Southampton’s 70-percent reduction to six deaths by overdose in 2018 seems like only a qualified success because “it’s still six deaths too many.”

“The opioid crisis is unlike anything I’ve seen in my 32-year career,” Suffolk County Police Chief Stuart Cameron said.

Still, a general consensus about some effective policy measures did emerge during the four-hour forum, which was organized by Suffolk County Executive Steve Bellone.

The three panel discussions featured medical providers and community advocates, policymakers and school officials, local law enforcement officers and criminal justice experts, who addressed prevention methods and treatment and recovery options. They also discussed how the legislative and executive branches are tackling the problem locally and across the state.

Everyone agreed that unrelenting, multipronged strategies are necessary.

Another strongly voiced theme was the need for evidence-based policymaking — a hard-won insight learned from what Dr. Jim Malatras, president of the Rockefeller Institute of Government think tank, called “the spaghetti-against-the-wall approach” of years past, which led to resources being poured into programs such as the Just Say No abstinence campaign.

“Ten years later, we found out after tens of millions of dollars it didn’t work,” said Dr. Leslie Marino of Columbia University, a psychiatrist who specializes in substance abuse disorders. “Good policy is informed by good science, which is informed by good data.”

“Let’s find what works, let’s fund what works,” agreed State Senator Peter Harckham of Westchester County, the chairman of the State Senate’s committee on alcoholism and drug abuse.

Many of the experts also expressed strong support for Medically Assisted Treatment programs that involve the use of pharmacotherapy drugs such as methadone, buprenorphine, and Vivitrol to help substance abusers in treatment. “This saves lives,” said Robert A. Kent, chief counsel for the state’s Office of Alcoholism and Substance Abuse Services. 

Reducing barriers to getting treatment is also vital, the panelists said. Some advocated rewriting insurance rules to give patients quicker access to treatment and lower co-pays. They cited the need to set up more hospital beds and facilities for inpatient and outpatient treatment. They spoke about providing more support services such as peer counseling, Recovery High Schools for teens, and transportation to keep people in treatment.

On the South Fork, “To get to a methadone clinic now, a person has to drive to Riverhead every day,” said Dr. Gregson H. Pigott, director of the county’s Office of Minority Health.

Lack of child care help is another problem. “We know the number-one reason women don’t seek treatment is lack of child care,” said Dr. Jeffrey L. Reynolds, who runs the Family and Children’s Association, a 134-year-old organization that cares for Long Island’s most vulnerable people. “We currently have a system designed primarily for men.”

Some panelists emphasized the role that mental illness plays in addiction, saying that too often individuals are treated only for substance abuse disorders, not underlying problems such as depression, anxiety, or bipolar disorder that may have driven them to addiction. “What brings somebody to the point they throw away their lives? Mental illness is, I believe, at the forefront of this,” said Dr. Tomrul Tuzel, a psychiatrist and mental health administrator who has worked extensively in community and prison treatment settings.

Education and prevention efforts (again, preferably with a data-based approach) were also touted as a crucial piece that should include everyone — parents and children, teachers and law enforcement, doctors and other service providers. Dr. Marino lamented how she graduated from medical school within only the last 10 years and yet “I learned nothing about pain management, opioid addiction, or how to treat addiction in general.”

Suffolk County District Attorney Timothy D. Sini drew spirited applause during his keynote address when he said, “We need to keep pushing for evidence-based programs in our schools, K through 12. It’s never too early to start.” 

Anthony Ferrandino, a substance-abuse counselor in the Northport-East Northport School District and chairman of the district’s drug and alcohol task force, agreed but noted that “most school districts don’t have a person assigned to deal with drug and alcohol” problems. He also said that too often “students don’t have a seat at the table” when policy is discussed.

Lars Clemensen, superintendent of the Hampton Bays School District, suggested that vigilance about substance abuse could be modeled on how school shooting awareness has been heightened. “What we’ve learned in school shootings is at least one person knew what was going to happen before it happened,” he said. “Apply that to this epidemic if you see someone you know that needs help. Minimize the bystander effect. Don’t assume someone else is going to try to get a person help.”

Mr. Sini described how the arc of drug use — and therefore the fight against it — has changed over the years, moving from predominately a “pill problem” driven by overprescribed prescription drugs to the increased popularity of heroin use by the start of this decade to, now, the use of heroin and other street drugs (including marijuana) that are often laced with fentanyl, a deadly and highly addictive add-in that users often don’t know they’re ingesting until it’s too late.

One of the many efforts Suffolk County is undertaking is a campaign called One Try and You Could Die to highlight that it’s not only addicts who are perishing from such drug use. Even experimenting with a single dose can be lethal.

“These drugs can take you like this,” Lt. Gov. Kathy Hochul told the crowd, snapping her fingers. She described how she lost a nephew to heroin use 10 years ago.

Mr. Sini also detailed how law enforcement officials and the criminal justice system are approaching the opioid and substance abuse fight. He said the use of tracking technology, wiretapping, and search warrants has been beefed up exponentially since 2016. He detailed how his office has prosecuted dealers for manslaughter when possible, and told a story about a wiretap that caught a drug dealer bragging that the potent drugs he was dealing were causing “mad” casualties. 

Mr. Sini also spoke about intervention efforts designed to get people help at various points of their passage through the criminal justice system, with an emphasis on getting them into treatment rather than incarceration when possible.

Mr. Bellone noted that fatal overdoses declined last year in Nassau and Suffolk Counties for the first time in years. But far more progress is needed.

“We will not stop until the job is done,” he said.