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Prevention

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.”

Parents listen to learn ways to discuss depression and suicide prevention with their kids during a seminar at Shoreham Wading River High School Nov. 30. Photo by Kevin Redding

“We need to change the way we think about mental health and teen depression .. .and we can start in our homes by keeping an open and honest communication and letting our kids know that it’s okay to say that they’re not okay.”

Ann Morrison, Long Island director for the American Foundation for Suicide Prevention, addresses parents in the Shoreham Wading River school district during a seminar Nov. 30. Photo by Kevin Redding
Ann Morrison, Long Island director for the American Foundation for Suicide Prevention, addresses parents in the Shoreham Wading River school district during a seminar Nov. 30. Photo by Kevin Redding

That’s what Ann Morrison, Long Island director for the American Foundation for Suicide Prevention, told an audience of parents at a seminar at Shoreham-Wading River High School Nov. 30, to help identify warning signs and risk factors for suicide in teens, understand the role of treatment in reducing risk and open a dialogue with their children about the topic.

The school district was impacted by two separate incidents of suicide in October and November. Both were high school freshmen. The school’s administration has been doing all it can to raise awareness and education for both students and parents alike ever since.

The AFSP gives different versions of the seminar throughout the country. Morrison’s presentation spoke specifically to parents. Those in attendance said it was much needed.

“It’s important with all the things that have been going on here,” Thomas McClintock said. “I know they wanted to address it with the children, but it’s good for the parents too, because a lot of us are in the dark on this type of thing. It’s not something you expect or anticipate in your own child.”

Morrison explained suicide has become the second leading cause of death among youth between the ages 10 and 24 in the U.S. after accidental injuries and yet, she said, “we aren’t really talking about it.”

“That’s where a lot of the issue is,” Morrison said. “We need to be more comfortable talking about one of the leading causes of death and why this is happening and how we can prevent it. This isn’t meant to frighten anybody, but to let you know the scope of the problem.”

According to the National Youth Risk Behavior Survey, conducted by the Centers for Disease Control and Prevention to monitor health risk behaviors that contribute to causes of death for teens, 17 percent of high school students reported having seriously considered attempting suicide in the previous year — 13.6 percent reported having made a plan for a suicide attempt in the previous year, and eight percent reported having attempted suicide one or more times in the last year.

“We need to be more comfortable talking about one of the leading causes of death and why this is happening and how we can prevent it. This isn’t meant to frighten anybody, but to let you know the scope of the problem.”

— Ann Morrison

Morrison said suicide is a mental health issue and marginally preventable.
The thought comes about when multiple factors come together, so it’s not related to just one cause, but underlying risk signals to look out for in teens are out-of-character bouts of depression, anxiety, aggression and agitation.

She said parents must act if they notice drastic changes in their children’s behavior, which might include withdrawal from activities they normally enjoy, isolation from friends or social media, changes in sleep patterns and appetite, unexplained rage, or giving away their prized possessions — something that commonly happens when someone is preparing to commit suicide.

“It can be very easy sometimes to mistake mental health symptoms for typical adolescent behaviors,” she said.

Also listen for statements like “I should go kill myself,” “I have no reason to live” and “everybody would be better off without me.”

Morrison stressed to the parents the key to helping prevent suicide among teens is to have a strong and supportive home, where it’s okay to reach out for help.

“You have to be a role model and let them know that in your home, it’s okay for open communication no matter what it is that they want to talk about,” she said. “We need to not be afraid to reach out and ask them if they’re okay. … Make sure you talk to them in private, [and] not at the dinner table, in front of siblings or handled very nonchalantly. Listen to their story, get them comfortable to talk to you, express care and concern. Don’t dismiss their feelings. What we think is a small problem to them might be a bigger problem in their mind.”

Debra Caputo, counselor at the Long Island Crisis Center, addresses parents in the Shoreham Wading River school district during a seminar Nov. 30. Photo by Kevin Redding
Debra Caputo, counselor at the Long Island Crisis Center, addresses parents in the Shoreham Wading River school district during a seminar Nov. 30. Photo by Kevin Redding

Debra Caputo, who works as a counselor at the Long Island Crisis Center, echoed the importance of listening. As someone who answers crisis calls on the National Suicide Prevention Lifeline, she said just simply listening to someone wrestling with mental health issues is helpful to them.

“When people call, we’re basically just listening and validating their feelings,” she said. “What they’re feeling is real. If we listen non-judgmentally and understand what they’re going through, it can make a world of difference. We want to reassure them they’re not alone and help is available.”

Morrison said that if there’s a true feeling that a child may be at risk or having suicidal thoughts, it’s okay to directly ask them if they are.

“It’s a scary question to ask or think about asking, but we know that when we ask, it opens that conversation,” Morrison said. “And should a child actually have those thoughts, in most cases, they’re going to feel comfortable telling you. Thank them for having the courage to talk to you and contact a mental health professional for an evaluation. Take it seriously. Don’t wait to act. Be calm. Listen to them.”

If you or your child is in crisis, call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255). The hotline is available 24 hours a day.

For more information about the American Foundation for Suicide Prevention and their services, visit afsp.org.

You can watch “More Than Sad,” a film presented by the AFSP that dramatizes four situations of high school depression, at www.afsp.org/our-work/education/more-than-sad/.

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If an ounce of prevention is worth a pound of cure, what should we be preventing?

Well, we all brush our teeth. At least, we do most of the time, assuming we haven’t relaxed under the covers too long on a cold night and haven’t allowed ourselves to drift off to a wonderful, warm place where we don’t have to worry about meetings, tests, social anxiety, or delayed trains the next day.

Did we also floss? That’s a ridiculous question for those of us who have seen the 1992 movie Prelude to a Kiss. At the end of the film, Julius, played by Sydney Walker, has returned to his body after switching with Meg Ryan on her wedding day. An older man, Julius asks if he can give the young couple a piece of advice. “Floss,” he advises sagely.

Okay, so, what else do we prevent? We change the oil in our cars, or maybe a service station does that. They also probably check our brakes, realign our wheels, and check all our other fluids. That’s all good and seems necessary. How often we do that depends on our tradition and our comfort level with our vehicles.

Then, there’s our bodies. Insurance plans seem to cover the cost of an annual physical. The doctor asks us about any changes, takes some samples, and gets back to us, reminding us to eat better, to sleep better and to exercise more often. Those visits can either be a source of great pride, as we walk in noticeably lighter than we were last year, or a source of frustration, as the weight we lost the year before seems to have boomeranged back to us.

For our bodies, we can also take some preventive steps. I recently endured some lower back problems. I always thought the one advantage of being on the shorter side was that I wouldn’t have to worry about the bad backs some of the tall people of the world suffer. Wrong. My lower back was so stiff that climbing out of a car took much longer than it should, while walking down steps or a slight incline caused me to wince.

My chiropractor helped relieve that pain and gave me some back exercises, which I now do semi-regularly. Okay, well, I don’t do them as often as I brush my teeth, but I do take some time to stretch and strengthen my lower back.

When I was young and playing sports, I used to arrive at a field and play baseball, basketball or anything else and immediately start running at top speed. I barely stretched because I couldn’t wait to play.

Fast forward to today and the true weekend warrior in me, who has endured a groin strain and a partial tear of my rotator cuff, requires at least 10 to 15 minutes of stretching.

As with most life lessons, we become more aware of pitfalls and potholes after we’ve fallen into them. My experience with kidney stones means that I barely go a waking hour without drinking a cup of water. When the doctor told me that half of all kidney stone patients return within five years, I immediately decided I wanted to be in the other half, so I’m drinking water constantly.

I’m sure there are other house items we should maintain, like heaters, air conditioners, dishwashers, refrigerators and other appliances. After all, even though so many of those run for long periods of time without needing any service, they probably won’t require anything major if we give them that extra ounce of preventive attention.

Lit luminaires light up the night during the third annual Lights of Hope event in Port Jefferson on Aug. 31. Photo by Nora Milligan

It’s no time to pass the buck.

When it comes to the rising opioid abuse issue coursing through Long Island’s veins, we want to make sure we continue the open dialogue.

As you finish reading this edition, we hope you reflect on how this growing problem affects you, your family, your friends and everyone else around you — we can’t hide from this.

We need to take a more head-on approach to this medical issue, and accept that it is a medical problem, and not as some say a moral failing.

Parents shouldn’t let the stigma attached to drug or substance abuse keep them from talking about it. If we are to learn and grow and recover, we need to be talking. If we hide from the issue, the results will most certainly be fatal.

This is a problem that requires a collaborative effort, including prevention through education and early identification of at-risk people, enforcement with sharper penalties to dealers and prescription writers and improved rehabilitation resources and strategies. And as this issue should reflect, many groups on the North Shore are dedicated to working together to fight this crisis.

A cooperative combination of all of these things can help get Long Island headed in the right direction. Listed below are several resources if you or a loved one is struggling with substance or drug abuse.

• Suffolk County Substance Abuse Hotline: 631-979-1700

• Hope House Ministries: 631-978-0188

• Response of Suffolk County 24-hour hotline: 631-751-7500

• Prevention Resource Center: 631-650-0135

• Phoenix House’s Edward D. Miller substance abuse treatment center: 844-296-9046

• Samaritan Village’s Suffolk Outpatient Treatment Program: 631-351-7112

• St. Charles Hospital rehab program: 631-474-6233

• New York State HOPEline: 1-877-8-HOPENY

Suffolk County Division of Community Mental Hygiene Services: 631-853-8500

Visit http://www.suffolkcountyny.gov/substanceabuse for a downloadable prevention, treatment and recovery services directory, which gives a list of service agencies and treatment centers on Long Island.

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People at an anti-drug forum stay afterward to learn how to use the anti-overdose medication Narcan. Above, someone practices spraying into a dummy’s nostrils. Photo by Elana Glowatz

We’ve been hit with some staggering figures. The Centers for Disease Control and Prevention reported more than 28,000 overdose deaths in 2014 as a result of heroin or opioid abuse, the highest number on record. Last year alone Suffolk County suffered 103 fatal heroin overdoses. Suffolk tallied more heroin-related overdose deaths than any county in New York from 2009 to 2013, according to the New York State Opioid Poisoning, Overdose and Prevention 2015 Report.

Although local and national initiatives have come from all different angles to try to combat the rise in heroin and opioid abuse, we think lawmakers lack focus.

Most recently, U.S. Rep. Lee Zeldin (R-Shirley) endorsed a large legislation package that would review and update guidelines for prescribing opioids and pain medication and require a report to Congress on the availability of substance abuse treatment in the country, among many other provisions. While we applaud any earnest effort to combat the widespread problem, there needs to be more focus from one specific angle: prevention.

With treatment and recovery options across the North Shore and with the rate at which the county is now taking down drug dealers, enforcement and rehabilitation are not our biggest problems. Instead, more needs to be done to deter kids from ever considering to try drugs in the first place. While some schools have begun to work on this, working with police to hold Narcan training sessions and informational forums, students should be seeing more than just numbers and figures, police officers or counselors.

Tracey Budd, of Rocky Point, helped Suffolk County create a public service announcement, “Not My Child,” that has been shown in schools. Budd lost her son to a heroin overdose and her message is powerful. Kids need to see the struggles that addicts and their families go through to help hammer home how dangerous drugs are.

We also urge parents to be more aware and involved. You know your child — look, listen and ask questions. There are signs in mood, behavior, habit and appearance that could warn you that there’s a serious problem. And don’t be afraid to set boundaries or to talk both about drugs and other topics that may seem difficult or awkward. Many people are drawn to drugs because of an underlying emotional issue, but letting a teenager know that nonjudgmental ears are listening could be a solution.

Frederick Douglass once famously said, “It is easier to build strong children than to repair broken men.” Building those stronger children is how we should tackle our country’s growing drug problem.

Stock photo

Huntington Hospital is taking preventative steps to ensure its patients know how to combat the Zika virus.

The World Health Organization declared the Zika virus a “public health emergency of international concern” this week, just days after three Long Island patients tested positive for the virus. The Centers for Disease Control issued a travel alert for anyone going to regions including South America and Latin America, and Huntington Hospital officials said they were making sure to educate their patients about the symptoms and steps to take if diagnosed with the viral infection that is being spread through mosquitoes.

Denise Naval, director of infection, prevention and control at Huntington Hospital, said that while there is currently no treatment for the virus, there are several precautions a person can take to fight off the mosquito-related Zika.

Naval said the virus is closely related to Yellow Fever, the West Nile Virus and the Dengue virus, which are all also spread through mosquito bites. She said the Zika virus is spread from the Aedes mosquito, specifically.

There are two types of Aedes species, Aedes aegypti and Aedes albopictus, but only the former currently carries Zika with it and it is not native to Long Island, she said. It’s most common in tropical areas of the world. The latter does not currently carry the virus and is found in certain parts of the United States, including Long Island, she said.

Naval also said Zika can not only be transmitted from a mosquito to a human, but also vice versa — from a human to a mosquito.

“Only 20 percent of people will get symptoms,” Naval said in a phone interview. “Eighty percent of people infected won’t even know they are.”

According to the CDC, symptoms from the Zika virus include a fever, rash, joint pain, headaches and more.

Once infected, the CDC says patients must get rest, drink fluids to prevent dehydration, and take medicine such as acetaminophen to relieve fever and pain.

New York Gov. Andrew Cuomo recently announced that the New York State Department of Health, in conjunction with the CDC, would offer free blood test screenings for individuals who have traveled to areas where the Zika virus is going on.

“We’re working closely with the CDC and local health departments to address potential cases of Zika Virus, and by offering free testing we are helping to stay ahead of this disease and protect the public health,” Cuomo said in a press release.

Naval said if anyone must travel to the tropic regions, where Zika is a problem, there are some key precautions they can take.

“Make sure to use bug spray with DEET; stay indoors with air conditioning if you can because insects prefer heat; and wear long sleeves and long pants,” she said.

Aside from a warning for all travelers to avoid these tropic areas, there is also an extra precaution for pregnant women, as there is an added risk for a child whose mother has the Zika virus while pregnant.

The baby can be born with microcephaly, a neurodevelopmental disorder where a baby is born with a smaller head than usual, or other neurological and autoimmune complications, officials said.

According to the WHO, in countries like Brazil there has been an increasing body of evidence about the link between Zika virus and microcephaly. This specific brain disorder is linked to seizures, developmental delays in speech and walking, intellectual disabilities, feeding and vision problems, and more, according to the CDC.

John Martin demonstrates how to use intranasal Narcan in Northport. File photo by Rohma Abbas

Northport High School’s Students Against Destructive Decisions will be dedicating more than a week to raising awareness of drug and alcohol abuse by hosting programs to cultivate prevention and support recovery beginning on Thursday.

Known as the Northport-East Northport Recovery, Awareness and Prevention Week, the programs kick off at the Northport American Legion Hall on Oct. 22 at 7 p.m., where families will gather to share their experiences with addiction. The Suffolk County Police Department will also provide Narcan training for the community.

The weekend will feature drug take-back programs at local libraries. The take-back campaign, manned by the village police department, will start at the Northport Public Library on Saturday, Oct. 24, from 10 a.m. to 2 p.m., and continue on Sunday, Oct. 25, from 1 to 5 p.m.

The county police department’s 2nd Precinct will also man a post at the East Northport Public Library on Saturday from 10 a.m. to 2 p.m. Residents are able to participate in an anonymous drug drop-off, available 24 hours a day, seven days a week, at each police precinct, according a press release by the high school’s SADD club.

The club has partnered with the Northport-East Northport Community Drug and Alcohol Task Force, the office of county Legislator William “Doc” Spencer (D-Centerport), the village police and the county police’s 2nd Precinct to host these events.

Darryl St. George, a social studies teacher at Northport-East Northport school district, is a SADD club adviser. He became involved with the cause after losing his brother Corey to a drug overdose.

In an interview this week, St. George said he feels the week’s events, particularly the Narcan training and the drug take-back program, would make a great impact through helping train people in potentially saving lives and by taking drugs off the streets — drugs that put lives at risk.

“I think that this is very meaningful,” St. George said. “I think that this is one of those events that will have very real results.”

Ending on Thursday, Oct. 29, there will be a number of events at the schools in the district and this year, for the first time, programs will take place at elementary school level.

“Of course the message will be delivered in an age-appropriate way, but nevertheless the message will be the same — say ‘no’ to drugs,” he said.

The programs will culminate in a press conference outside the Northport Village Hall, where officials will report the results to the community.

The large numbers behind opioid-related deaths and Narcan saves justifies the need for these kinds of events, St. George said. According to a recent statement from the office of County Executive Steve Bellone (D), there were more than 250 opioid-related deaths in Suffolk County and 493 Narcan saves in 2014.

“This week, specifically, the Narcan training and the drug take-back program give me a renewed sense of hope that we are doing something that will have tangible results,” Tammy Walsh, a SADD adviser said in a statement. “The drugs we are taking off the streets could stop a kid from overdosing or possibly getting addicted. The Narcan training we are providing is empowering people to be in a position to save lives. We are still in this fight.”

For questions about these events, contact St. George at darryl.stgeorge@northport.k12.ny.us.