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Medical school follows new approach to opioid curriculum.

At Stony Brook University Renaissance School of Medicine, a new generation of doctors and dentists are involved in a novel approach to managing the opioid epidemic. The training includes instruction from reformed narcotic users, who act as teachers.

A 25-year-old woman recently explained to the first-year students how she became addicted to opioids at the age of 15, when a friend came over with Vicodin prescribed by a dentist after a tooth extraction.

Addiction, she said, is like having a deep itch inside that desperately needs to be scratched.

“There was nothing that could stand between me and getting high,” said the young woman, who wants to remain anonymous. “Most of the time it was my only goal for the day. At $40 a pill, I quickly switched to heroin which costs $10.” 

The university’s Assistant Dean for Clinical Education Dr. Lisa Strano-Paul, who helped coordinate the session, said that “patients as teachers” is widely practiced in medical education. This is the first year reformed narcotic users are participating in the program.

“People’s stories will stick with these medical students for the rest of their lives,” she said. “Seeing such an articulate woman describe her experiences was impactful.”

Gerard Fischer, a doctor of dental surgery candidate from St. James, took part in the patient-as-teacher session on narcotics.

“You learn empathy, a quality people want to see in someone practicing medicine,“ Fischer said. “People don’t choose to become addicted to narcotics. So, you want to understand.”

After working in dental offices over the last several years, he’s noticed that habits for prescribing painkillers are changing.

“Dental pain is notoriously uncomfortable because it’s in your face and head,” he said. “No one wants a patient to suffer.” Pain management, though, requires walking a fine line, he added, saying, “Patient awareness is increasing, so many of them now prefer to take ibuprofen and acetaminophen rather than a prescription narcotic, which could be a reasonable approach.”

Hearing the young woman tell her story, he said, will undoubtedly influence his decision-making when he becomes a practicing dentist. 

An estimated 180 medical and dental students attended the training last month. Overall, Strano-Paul said she’s getting positive feedback from the medical students about the session. 

The woman who overcame addiction and shared her insights with the medical professionals, also found the experience rewarding. 

We respect her request to remain anonymous and are grateful that she has decided to share her story with TBR News Media. For the rest of this article, we shall refer to her as “Claire.” 

Faith, hope and charity

“I told the doctors that recovery has nothing to do with science,” Claire said. “They just looked at me.”

Claire was addicted to drugs and alcohol for seven years and went to rehab 10 times over the course of five years. 

“I did some crazy things, I jumped out of a car while it was moving,” Claire said, shaking her head in profound disbelief.

She leapt from the vehicle, she said, the moment she learned that her family was on their way to a rehab facility. Fortunately, she was unharmed and has now been off pain pills and drugs for close to six years. She no longer drinks alcohol.

“Yes, it is possible to recover from addiction,” Claire said. 

People with addiction issues feel empty inside, Claire explained, while gently planting her fist in her sternum. She said that once her counselor convinced her to pray for help and guidance, she was able to recover.

“Somehow praying opens you up,” she said. 

Claire was raised Catholic and attended Catholic high school but says that she’s not a religious person. 

“I said to my counselor, “How do I pray, if I don’t believe or know if there’s a God?” 

She came to terms with her spirituality by appreciating the awe of nature. She now prays regularly. Recovery, she said, is miraculous.

Alcoholics Anonymous’ 12-step regimen, first published in 1939 in the post-Depression era, outlines coping strategies for better managing life. Claire swears by the “big book,” as it’s commonly called. She carefully read the first 165 pages with a counselor and has highlighted passages that taught her how to overcome addictions to opioids and alcohol. Being honest, foregoing selfishness, praying regularly and finding ways to help others have become reliable sources of her strength.

Spirituality is the common thread Claire finds among the many people she now knows who have recovered from addiction.

The Big Book, Alcohol Anonymous’s 8 decades old textbook, offers coping strategies and a model for living.

Medication-assisted therapy

Personally, Claire recommends abstinence over treating addiction medically with prescription drugs such as buprenorphine. The drug, approved by the U.S. Food & Drug Administration since 2002, is a slow-release opioid that suppresses symptoms of withdrawal. When combined with behavior therapy, the federal government recommends it as treatment for addiction. Medication alone, though, is not viewed as sufficient. The ultimate goal of medication-assisted therapy, as described on the U.S. Department of Health & Human Services website on the topic, is a holistic approach to full recovery, which includes the ability to live a self-directed life.

“Medication-assisted therapy should not be discounted,” Strano-Paul said. “It improves the outcome and enables people to hold jobs and addresses criminal behavior tendencies.”

While the assistant dean is not involved with that aspect of the curriculum, the topic is covered somewhat in the clerkship phase of medical education during sessions on pain management and when medical students are involved in more advanced work in the medical training, she said. 

The field, though, is specialized.

The federal government requires additional certification before a medical practitioner can prescribe buprenorphine. Once certified, doctors and their medical offices are further restricted to initially prescribe the medicine to only 30 patients annually. Critics say no other medications have government-mandated patient limits on lifesaving treatment. 

The Substance Abuse and Mental Health Services Administration, a division of the U.S. Department of Health & Human Services, considers the therapy to be “misunderstood” and “greatly underused.” 

In New York state, 111,391 medical practitioners are registered with the U.S. Drug Enforcement Administration to prescribe opioids and narcotics. Only 6,908 New York practitioners to date are permitted to prescribe opioids for addiction treatment as at Aug. 31.

Strano-Paul for instance, pointed out that she can prescribe opioids, but is prohibited from prescribing the opioid-based drug used for addiction therapy. 

The narcotics education program is still evolving, Strano-Paul said. 

New medical student training now also includes certification for Narcan, the nasal spray antidote that revives opioid overdose victims. 

“It saves lives,” Strano-Paul said. 

In Suffolk County in 2017, 424 people died from an opioid overdose, which was 41 percent higher than the state average, according to a study titled “The Staggering Cost of Long Island’s Opioid Crisis.” The county is aware of 238 potentially lifesaving overdose reversals as of June 30 attributed to Narcan this year alone. Since 2012, Narcan has helped to save the lives of 3,864 people in the county. 

As for Claire, now a mother, she delivered her children through C-section. In the hospital, she was offered prescription opioids for pain. 

“No one will ever see me again, if you give me those pills,” she said.                

Port Jefferson Village constables Brent Broere and James Murdocco. Photo by Alex Petroski

Port Jefferson code officers James Murdocco and Brent Broere are quick thinkers and a dynamic team, and thanks to their efforts, a young man who suffered a drug overdose is alive today.

Despite being delayed by a passing train in late December, when the constables arrived at the scene of a parked car on Belle Terre Road, they sprung into action. Broere had prepared a Narcan dose, the drug used to reverse the effects of an opioid-related overdose, on the way. When the pair arrived at the parking lot of Fairfield at Port Jefferson apartment complex, Murdocco took the syringe and raced to the car.

“This young man regained his life directly in front of everyone.”

— Eyewitness

“He’s pretty much done,” Murdocco recalled thinking that Dec. 22 night when he saw the victim behind the already opened driver’s seat door, whose head was leaning back against the headrest. He said the female passenger was “worked up,” and even tried hitting the victim’s chest in an effort to spark a sign of life. Murdocco climbed in the car, straddling the unresponsive victim next to the girl who was letting out harrowing screams at the comatose man, hoping for a response.

“He was actually purple,” a witness said of the victim. “The situation heightened when no pulse was noted for some time. This incident brought fear to my family — especially during the holiday season. My young ones were in shock.”

Murdocco administered the first dose of Narcan in the victim’s nostril, but it had little effect. Broere loaded up a second, stronger dose and his partner tried the other nostril, completely emptying the syringe in one shot. The victim responded so well he was able to exit the car and put on his own jacket.

“This young man regained his life directly in front of everyone,” the witness wrote in a letter to Port Jefferson Village, discussing the buzz it stirred and pleading for proclamations to recognize the officers’ heroic efforts. “This truly was a holiday blessing. Although a tragedy, these officers saved a tragedy from becoming a parent’s worse nightmare.”

The constables were honored by Port Jefferson Village during a Jan. 3 board meeting for their actions that night. Code officers Michael Hanley and John Vinicombe, who arrived on the scene after Murdocco and Broere, were also recognized.

According to Murdocco, the officers are able to hear 911 calls made in the Port Jeff area, and are encouraged to respond to calls requiring immediate aid, oftentimes faster than Suffolk County police officers. He and his partner were in their patrol car when they heard the call, and planned to make their way to the scene, briefly waiting on the south side of the Long Island Rail Road tracks on Main Street as a train went through. While they waited, they encountered a  county police officer who was also headed to the scene, but who did not have the equipment or training to administer Narcan. Village constables are not required to undergo Narcan training, but they are encouraged to do so, and luckily, Murdocco and Broere voluntarily took the course on their own time.

“The chief and the deputy chief and the mayor did a really good job by pairing me and Jimmy up together.”

— Brent Broere

“These two officers were absolutely incredible,” the eyewitness said. “The officer that jumped into the car acted so fast that he had no protective gloves, and was exposed with the young man’s blood. Several neighbors asked to assist, yet he declined, and was able to clean out all of the areas exposed.”

According to accounts from both officers and an eyewitness, the scene was emotional and tense. Murdocco, who works in a state detention center in addition to his duties in Port Jeff, used the word “gruesome” to describe what he saw.

Broere, a Northport High School graduate and Marine Corps veteran in a scout sniper platoon, had been deployed on multiple combat tours and was awarded a Purple Heart after being shot through both of his legs. He returned to Long Island about six months ago after spending eight years in North Carolina working in various law enforcement capacities.

“The chief and the deputy chief and the mayor did a really good job by pairing me and Jimmy up together,” Broere said. “We’re a good match. As partners, we kind of know what the other one is thinking before he has to say it. In a situation like that seconds count.”

Port Jeff Village officials honor code officers, Michael Hanley, third from left, Brent Broere, James Murdocco and John Vinicombe, far right, for saving a life using Narcan. Photo by Alex Petroski

When Port Jefferson Village code officers James Murdocco, Michael Hanley, Brent Broere and John Vinicombe arrived for their shifts Dec. 22, little did they know they would each play a vital role in saving a life.

The four constables were honored by the Port Jefferson Village mayor and board of trustees during a public meeting Jan. 3 for the roles they played in resuscitating with Narcan an unresponsive victim. Narcan is used to block the effects of opioid drugs and to reverse overdoses.

“On Dec. 22, 2017, officer James Murdocco responded to a call at the Fairfield Apartment complex and upon arrival, officers found an unconscious man in a vehicle,” the proclamation honoring Murdocco read in part. Hanley, Broere and Vinicombe were also each given matching proclamations. “All four officers, while working together, cleared the scene and administered two doses of Narcan to the patient which resulted in bringing him back to life. The actions of these officers are well deserving of an official recognition and are positive role models in the community as these officers are not merely giving out tickets, but are there to save lives also. Therefore as the Mayor of Port Jefferson Village, I do hereby recognize James Murdocco, on this 3rd day of January, 2018 for your act of heroism and many years of public service. You are truly a valuable asset to our community and we appreciate and applaud you.”

According to code Chief Wally Tomaszewski, when the officers arrived on the scene the victim’s skin was a shade of purple, and as far as he was concerned he thought the man was dead. He said the actions of the officers were heroic and saved a life.

Mayor Margot Garant was visibly moved emotionally while presenting the officers with the proclamations. She thanked them for their service and dedication to the community.

Tomaszewski indicated this was not the first time members of his constabulary were called into action to save a life using Narcan, and that Port Jeff code officers are encouraged to undergo Narcan training on their own time should it be needed in the line of duty.

Murdocco and Vinicombe were honored by the board in 2016 after they responded to an opioid overdose at the Islandwide Taxi stand near the Port Jefferson Long Island Rail Road station. Garant said when honoring them during a February 2016 meeting that the officers were told the young victim was dead, and they found no pulse or respiration. Murdocco and Vinicombe each administered the anti-overdose medication Narcan and Murdocco performed CPR.

Tomaszewski also indicated the importance in code officers receiving Narcan training because in situations involving overdoses time is of the essence, and they are able to be on the scene of an incident faster in most cases than Suffolk County police. Tomazewski encouraged all members of the public to undergo Narcan training to be ready in the case of an emergency.

Christina Loeffler, the co-owner of Rely RX Pharmacy & Medical Supplies in St. James, works at one of the few non-major pharmacies in the county participating in the program to give low to no cost Narcan to those with prescription health insurance coverage. Photo by Kyle Barr

By Kyle Barr

The opioid crisis on Long Island has left devastation in its wake, and as opioid-related deaths rise every year, New York State has created an additional, more affordable way to combat it. To deal with the rash of overdoses as a result of addiction, New York State made it easier for people with prescription insurance to afford Naloxone, a common overdose reversal medication.

On Aug. 7, New York Gov. Andrew Cuomo (D) announced starting Aug. 9 that people with prescription health insurance coverage would be able to receive Naloxone, which is commonly referred to as Narcan, for a copay of up to $40. New York is the first state to offer the drug for such a low cost in pharmacies.

Narcan kit are now available for low to no cost at many New York pharmacies. File photo by Rohma Abbas

“The vast majority of folks who have health insurance with prescription coverage will be able to receive Naloxone through this program for free,” said Ben Rosen, a spokesperson for the New York State Department of Health.

Before the change, the average shelf cost of Narcan, which is administered nasally, was $125 without prescription with an average national copay of $10. People on Medicaid and Medicare paid between $1 and $3, Rosen said.

This action on part of the state comes at a critical time. Over 300 people from Suffolk County died from opioid-related deaths in 2016, according to county medical examiner records. On Aug. 10, President Donald Trump (R) declared the opioid issue a national emergency, meaning that there is now more pressure on Congress to pass legislation to deal with the crisis, as well as a push to supply more funds to states, police departments and health services to help deal with the problem.

The drug is available in over 3,000 pharmacies across New York and well over 100 pharmacies in Suffolk County. This includes all major pharmacies like CVS Health, Walgreens and Rite Aid, but also includes a few local pharmacies that already participate in the state Aids Drug Assistance Program and Elderly Pharmaceutical Insurance Coverage and Medicaid, according to Kathy Febraio, the executive director of the Pharmacists Society of the State of New York, a not-for-profit pharmacists advocacy group.

The program is only available for people who either have Medicare, Medicaid or health insurance with prescription coverage. Otherwise, officials said that those who lack insurance who need access can get it through a number of free Narcan training courses.

“We think that anything that can have an affect on this crisis is a good thing,” Febraio said. “This will certainly help. We need anything that will get Naloxone into the hands of those who need it.”

While Suffolk County Legislator and Presiding Officer DuWayne Gregory (D-Amityville) likes the idea of additional access to Narcan, he is skeptical about whether those who get it know how to properly administer it.

Narcan kits are now available for low to no cost at many New York pharmacies, like at Rely RX Pharmacy & Medical Supplies in St. James. Photo by Kyle Barr

“You don’t need a PHD to know how to use it, but there is some training that would help people be more comfortable, such as how to properly use it in an emergency situation and how to store it so that it is accessible while making sure children can’t get their hands on it,” he said. “Unfortunately the epidemic is so wide spread. Everyone knows someone who is affected.”

Christina Loeffler, the co-owner of Rely RX Pharmacy & Medical Supplies in St. James, one of the few non-major pharmacies in the county participating in the program, said though the business has not yet received many calls for Narcan, the state requires pharmacists to demonstrate how to use it.

“You have to counsel the patient and show them how to use it,” she said. “We were showed videos, we were given kits to practice on before we were certified to do it. I feel like it’s a good thing that they’re doing it.”

The county currently provides numerous Narcan training courses for locals, where they receive training and free supplies of the life-saving drug. Suffolk County Legislator Sarah Anker (D-Mount Sinai) said that she will be co-hosting a free Narcan training course Oct. 5 at Rocky Point High School with support from the North Shore Youth Council.

“They absolutely need to be trained,” she said. “Narcan is almost a miracle drug — it brings people back from death. However, people need to know what they’re doing so that it is administered correctly.”

Check on the New York State Department of Health website’s opioid overdose directories section for a full list of participating pharmacies.

The use of Narcan is demonstrated on a dummy during a training class. File photo by Elana Glowatz

By Jill Webb

For five years the Suffolk County Department of Health’s Opioid Overdose Prevention Project has been doing their part to help community members save lives. To commemorate the project’s fifth anniversary an Opioid Overdose Prevention class was held July 31 at the William J. Lindsay County Complex in Hauppauge.

The class trained participants in the essential steps to handling an opioid overdose: recognizing the overdose, administering intranasal Narcan, and what to do while the Emergency Medical Service teams are en-route. These training procedures meet the New York State Department of Health requirements, and at completion of the course, students received a certificate along with an emergency resuscitation kit, which contains the Narcan Nasal Spray.

Narcan, also known as Naloxone, is administered to reverse an opioid overdose, and has saved many lives. Before the project was put into place, only advanced Emergency Medical Services providers could administer Narcan to overdose victims.

“The No. 1 incentive is to receive a free Narcan kit,” Dr. Gregson Pigott, EMS medical director and clinical director of the Opioid Overdose Prevention Program, said. “That’s really the draw.”

He said the class appeals to many people in the field, such as nurses or treatment professionals.

AnnMarie Csorny, director of the department of health’s community mental hygiene services, said another motivation to take the class is “to be better informed, and to have a kit available on you that you would be able to use should you see someone. It doesn’t always have to be your loved one, it could be someone in the community.”

Starting in 2012, the department of health services’ division of emergency medical services has held more than 278 classes. Within this time, approximately 9,000 participants have learned how to recognize an opioid overdose and administer Narcan. Since its start, Narcan has saved the lives of over 3,000 individuals.

Those who have been trained in administering Narcan include EMTs, school district staff and opioid users themselves. The program has developed from how to handle an overdose into adding a discussion of opioid addiction.

“Initially it was just about recognizing signs and symptoms of overdose, how Naloxone is packaged, what it does, what it doesn’t do, what to expect when you administer it, and how to get a refill,” Pigott said.
Now, the program integrates treatment aspects along with prevention techniques.

“I don’t wanna say we just give them Narcan and say, ‘OK here’s how to give it out.’ Pigott said. “I’d like to give them a little bit more background on the epidemic and how we got to where we are, and resources. You have a lot of parents in there who are anxious that they have a son or daughter who is hooked on this stuff. They don’t just want Narcan, they want help for their son or daughter.”

Taking it a step further, in 2016 the county health department started to work with local hospitals to get Narcan kits to those who are at risk of an opioid overdose. They also help educate them along with their families on the risk factors, signs, and symptoms of an opioid overdose.

Suffolk County also operates, with the help of the Long Island Council on Alcoholism and Drug Dependence, a 24/7 substance abuse hotline at 631-979-1700. The line was established in April 2016 for crises, and has received 1,217 calls as of May 31.

On the Opioid Overdose Prevention Program’s impact, Csorny believes it’s a start to tackling a huge issue.

“I think it’s certainly opened the discussion of lines of communication,” Csorny said. “It has, I believe, empowered people to get the support they need and to talk about the things that are not there.”

While the program has educated hundreds of people, and saves many lives, Pigott knows more needs to be done in handling the opioid epidemic.

“I’m realizing that Narcan isn’t the answer,” Pigott said. “It’s a nice thing to say, ‘Hey I got a save, this person was turning blue, not breathing, and then I squirted the stuff up the nose and we got them back.’ But then on the backside of that, the person wakes up and they’re like, ‘Ugh, what just happened to me?’ and then all of a sudden withdrawal kicks in.”

Pigott said after the withdrawal kicks in the users will decide to get treatment or not to, and if they chose the latter they will most likely start using again — administrating Narcan isn’t going to change that.
“That’s the biggest problem we have: it’s a quick fix, and you’re really not fixing anything,” Pigott said. “It’s much more complicated than just giving out Narcan.”

The next step in handling the opioid epidemic, according to Pigott, is getting better treatment options. He said most of the county’s treatment programs are abstinence-based; detox programs in learning how to be drug-free.

“It might be effective at the time but once you’re out of the program it’s easy to get tempted, easy to relapse,” Pigott said. “I think treatment needs to be addressed more and I think there needs to be more options for people.”

Suffolk County Legislator Sarah Anker speaks during a press conference July 25 about creating a permanent panel to address the ever-growing opioid crisis. Photo by Kyle Barr

By Kyle Barr

Following another year of rising opioid use and overdoses, Suffolk County officials announced legislation that would create a new permanent advisory panel to try to address the issue.

“We have lost people from this [problem],” Suffolk County Legislator Sarah Anker (D-Mount Sinai) said during a July 25 press conference. “Children have died, adults have died and we’re here to do more.”

The panel would have 24 members, including representatives from health and science groups, members of law enforcement, hospital employees and individuals from the Legislature’s Committees on Health, Education and Human Services and would focus on prevention, education, law enforcement and drug rehabilitation across the county, Anker said. The panel is planned to be broken up into sub-committees, which would tackle a specific area.

“This is an issue that needs all hands on deck,” Suffolk County Police Commissioner Tim Sini said. “We are not going to arrest ourselves out of this — this is a public health issue [of historic proportion], but law enforcement plays a critical role.”

Over 300 people from Suffolk County died from opioid-related overdosess in 2016, according to county medical examiner records. Sini said that in 2016, the police administered Narcan, a nasal spray used as emergency treatment to reverse the effects of an opioid overdose, in Suffolk County over 700 times.

A 2010 bill saw the creation of a similar advisory panel with 13 members, many of whom are members of the new proposed panel. The original, impermanent panel ended five years ago, but had made 48 recommendations to the legislature focused mainly on prevention education, treatment and recovery. Two recommendations from this committee that were put in effect were the Ugly Truth videos shown in public schools, and countywide public Narcan training.

Though proud of the work they did on that panel, members agreed the situation has worsened since it was disbanded.

“[Seven] years ago we stood here and announced the initial panel — I had the privilege of co-chairing that group — a lot of the things we recommended actually happened, some things didn’t,” said Dr. Jeffrey Reynolds, chief executive officer of the Family and Children’s Association. “Regardless, the problem hasn’t gotten any better, and in fact, it’s gotten progressively worse. Some of the gaps in prevention, access to treatment, recovery and law enforcement haven’t yet been filled. For us to have an ongoing opportunity to have a dialogue together — to brainstorm some new solution to disrupt the patterns here — is very, very valuable.”

On the education side, Islip School District Superintendent of Schools Susan Schnebel said at the press conference that education has to begin at a very young age.

“It’s important that schools take hold of what happens in the beginning,” she said. “That includes educating students at a very early age, educating the parents to know what’s there, what are the repercussions, what is the law. That needs to happen with a 5 or 6-year-old.”

Executive director of the North Shore Youth Council Janene Gentile, and member of the proposed panel, feels that the advisory panel is an important step. She said she hopes that it will be able to do more in helping prevent people, especially young people, from using opioids in the first place, and hopefully help those exiting rehab.

“Implementing a family component when they are in rehab is really crucial, while they are in rehab and when get out,” Gentile said. “There are other agencies like mine — 28 in Suffolk County. If we can reach out to them they can help with re-entry [into society]. They go on the outside and the triggers that started them on opioids are still there, and they need to have places where there are no drugs. We’ve gone through a lot, but we’ve got to do more — and prevention works.”

File photo.

Suffolk County Police arrested a man for driving while ability impaired by alcohol and drugs after he was rescued from his burning vehicle in Rocky Point April 12.

Corey Tierney was driving a 2003 Hyundai Sonata northbound on County Road 21, about one mile south of Route 25A, when he lost control of his vehicle, which crashed into a wooded area and caught fire. Passing motorists, Claudio Gil and Margaret Ward, pulled an unconscious Tierney from the vehicle.

Rocky Point Fire Department Rescue responded and administered Narcan to Tierney, 21, of Mount Sinai, who regained consciousness and was transported to Stony Brook University Hospital for treatment of non-life-threatening injuries and charged with driving while ability impaired by alcohol and drugs.

Gil, 30, of Mount Sinai, and Ward, 51, of Rocky Point, were not injured.

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A Narcan Training Class will be held at the Farmingville Fire Department, 780 Horseblock Road, Farmingville on Tuesday, Feb. 28 from 6:30 to 7:30 p.m. The training, which meets New York State Department of Health requirements, will enable participants to recognize an opioid overdose, administer intranasal Narcan and take additional steps until EMS arrives. Participants will receive a certificate of completion and an emergency resuscitation kit that includes nasal Narcan. RSVP required before Feb. 20 by calling 631-732-6611, ext. 717.

  • Update: The class is now filled.

Suffolk County Leg. Kara Hahn and recovering alcoholic and addict David Scofield answer questions posed by concerned parents at a past Three Village Drug & Alcohol Awareness meeting. File photo by Donna Newman

Heroin addiction can still be seen as a closely guarded secret in North Shore communities, but a couple of Three Village residents are doing their part to try to change that.

About 20 people were present Jan. 22 at the Bates House in Setauket for an informational meeting geared to help the loved ones of those battling heroin addiction. The addicts themselves were not present, but parents, grandparents, siblings, friends and other loved ones were, with the hope of gaining a greater understanding for how to combat the problem.

The gathering was a joint venture of both the public and private sectors, initiated by Lise Hintze, manager of the Bates House, a community venue in Frank Melville Memorial Park.

To help a loved one dealing with addiction call Lise Hintze 631-689-7054

“Pretending we don’t have a drug problem [in our community] only hurts the children and perpetuates the problem,” Hintze said. “I have a 19-year-old and a 21-year-old and we’ve been to too many funerals. Parents say ‘not my child, not in our town’ but it’s very real and it’s happening here.” 

Stony Brook resident Dori Scofield, who lost a son to heroin addiction in 2011, established Dan’s Foundation For Recovery in his memory to provide information and resources to others. Old Field resident Dana Miklos also has a son battling addiction and she wants to share what she has learned to empower parents and help them deal with addiction’s many challenges. The two represent the “private” interests.

“One of the reasons I wanted to come out and talk about it is to give parents ways to navigate through this horrible process,” Scofield said. “From being at the hospital when your son or daughter ODs and you know you have to get them into treatment, but you don’t know [how].”

Scofield said she dialed a 1-800 number someone had given her when her son overdosed and said she lucked out when the placement turned out to be a good one. She told the event attendees they need not “reach out to a stranger” as she did. She can help.

Miklos wants to eliminate the stigma that keeps affected families in hiding.

“I want parents to know the three Cs: they didn’t cause it, they can’t cure it, and they can’t control it,” she said. “We become so isolated [dealing with an addicted child] just when we should be talking to other parents, supporting each other.”   

Suffolk County Leg. Kara Hahn (D-Setauket), who has been working to alleviate the community’s drug problem since taking office, also participated in the event.

“In 2012, the first year I was in office, I couldn’t believe this would be something I could work on and change,” Hahn said. “But I wrote legislation that got Narcan — which is an antidote for opioid overdoses — for our police sector cars. Within a matter of days we were saving one, two, three a day. Within two weeks we had an officer who had two saves back to back.”

Hahn said she authored another bill that would make sure there was a follow-up for each person saved. A Narcan reversal saves a life, but does nothing to end the need for the drug and the cravings. The second piece of legislation tasks the health department with reaching out to those saved to attempt to get them into treatment.

A third piece of legislation she wrote provides training for lay people — like the group assembled at the Bates House — to carry and use Narcan. She encouraged all present to be trained and prepared.

The statistics Hahn gave for Narcan saves showed a steady increase over the last five years. In 2012 after passage of the legislation in August, there were 325 saves. Numbers rose year by year to 475 in 2013, 493 in 2014, 542 in 2015 and 681 in 2016 when at least 240 people died of overdoses, according to Hahn.

David Scofield, who has been sober for three years, delivered a message of hope for those in attendance.

“I don’t have the answers,” he said. “I do know how [it is] to be a kid struggling with drug addiction. This thing is killing people. Hundreds of people are dying from heroin addiction every day and you don’t hear about it. That’s just the truth.”

Scofield’s message also included a plea for loved ones of addicts to get past the stigma of addiction and bring the conversation to the community. As long as people hide the cause of death, he said, he believes kids will continue to die.

For information about this support group, call Lise Hintze 631-689-7054.

The Suffolk County Police Department has saved more than 600 lives since 2012 using Narcan to reverse opioid or heroin overdoses. Data from SCPD.Graphic by TBR News Media

Medical professionals, law enforcement and government officials gathered at Stony Brook University this past weekend to have an open and honest dialogue about the growing opioid problem facing the North Shore and the rest of Suffolk County.

The complexity of the problem and how it relates to communities across the county was the topic of the discussion Oct. 1. A common theme among the speakers was opioid addiction should be treated like a legitimate medical crisis and not a moral failing.

Dr. Constantine Ioannou, director of Stony Brook Medical Center’s Adult Inpatient Unit addressed the current opioid crisis in the United States and specifically in Suffolk County during the event.

“This is not the first opioid epidemic in the United States — this is one of many,” Ioannou said. He likened the current state of opioid prescribing and subsequent widespread addiction to a period in the late 1800s when morphine was first developed. He said doctors overprescribed the powerful painkiller and, in turn, opioid dependence skyrocketed.

SCPD Deputy Sheriff Mike Kern speaks about the opioid crisis in Suffolk County. Photo by Alex Petroski
SCPD Deputy Sheriff Mike Kern speaks about the opioid crisis in Suffolk County. Photo by Alex Petroski

The director traced the origin of the current crisis back to two events in 1995. Purdue Pharma, a pharmaceutical company, began marketing OxyContin, its version of the powerful opioid oxycodone, to doctors. In addition the American Pain Society, an organization dedicated to advocating for public policies to reduce pain-related issues, named pain as the fifth vital sign. Like the other four — pulse rate, temperature, respiration rate and blood pressure —  pain would be monitored in patients from then on. Pain was the only one of those five vital signs that is completely subjective and based on what a patient tells a nurse or doctor, Ioannou said.

Those two events, in accordance with nurse ratings and even payment being tied to patient satisfaction and reduction, created an environment of overprescribing, Ioannou said. He also said training of doctors in pain management needs to be addressed — he graduated from medical school in 1985 with “zero” training in pain management.

“There are states in the United States where there are more prescriptions for opiate pain medications than there are people — this is a staggering number,” Ioannou said.

Jermaine Jones, Ph.D., an assistant professor of clinical neurobiology in the Department of Psychiatry at Columbia University, also spoke and reiterated some of what Ioannou said regarding the United States’ views on pain management.

“I’ve had friends from other countries say that unless you come into the E.R. with an arm missing, you’re not going to get a prescription that you could get here for having a root canal,” Jones said. “We make up about 5 percent of the world’s population yet we consume about 80 percent of the prescription opioid [painkillers].”

Jones is involved in a study called Risks and Benefits of Overdose Education and Naloxone Prescribing to Heroin Users and spoke about some of his findings. Naloxone, commonly known by the brand name Narcan, is a drug used to reverse opioid overdoses.

“We’re trying to better understand how to tease apart ways to attenuate what people like about opioids,” Jones said of the five-year study, which is currently in its second year.

Jermaine Jones, Ph.D., an assistant professor of clinical neurobiology in the Department of Psychiatry at Columbia University, was on the opioid discussion panel. Photo by Alex Petroski
Jermaine Jones, Ph.D., an assistant professor of clinical neurobiology in the Department of Psychiatry at Columbia University, was on the opioid discussion panel. Photo by Alex Petroski

He said the study was created to monitor people who are administered naloxone and see if it is being used for the correct purposes. One concern in the creation of an overdose reversal drug is that users will be more confident in their ability to combat an overdose and may decide not to call 911 if that day ever comes. Other potential unintended consequences of naloxone, including how to deal with a user who may be irate after being saved from an overdose and is now “dope sick” and without the expensive drug they just bought, are the focus of the study. They are also researching some potential new medications or existing ones that could work in accordance with opioids to reduce pain, while reducing the effects that lead to addiction.

“We know that detox by itself is actually one of the highest risk factors for opioid overdose because you’re tolerance decreases,” Jones said. “So once someone comes out of a detox program they swear they’re never going to touch this stuff again, but relapse is very, very common. So they use again thinking that if they were using two bags before, they can continue using two bags now that they’ve gotten out, but their physiological tolerance has decreased and people overdose as a result.”

Ioannou indicated he’d like to see changes in treatment options for addicts.

“We treat all addiction by the same model,” he said. “You have a five-day detox, 28-day rehab and you have an after care that is all based on 12 steps. That is the model of care in the United States. We need to realize with a complex disease, you need a complex set of interventions.”

Suffolk County Police Department Deputy Sheriff Mike Kern is an expert in recognizing drug users. He called overdoses the most powerful “advertisement” for drug dealers because it is a clear indication of how strong their product is. He echoed sentiments from both doctors about the dangers of overprescribing and to what it can lead.

“Why can a doctor prescribe an OxyContin to a 16-year-old or a 15-year-old who just had a root canal?” Kern asked. “It just doesn’t make any sense.”