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Opioid

Suffolk County Legislator Steve Stern. File photo by Rohma Abbas

A victory was gained in the fight against opioid abuse this month, as the Suffolk County Legislature unanimously approved a new bill that prohibits the sale and possession of U-47700, a highly addictive synthetic opioid drug.

“We must protect our young people from synthetic opioids like U-47700 that we know lead to addiction, graduation to heroin and potential death.” —Steve Stern

The pink pill contains fentanyl, another addictive and dangerous opioid, and is resistant to treatment with Narcan, a drug used to revive people who have overdosed.

Suffolk County Legislator Steve Stern (D-Dix Hills) created the bill, which passed Oct. 5.

“We must do everything in our power to protect our young people from synthetic opioids like U-47700 that we know lead to addiction, serious health effects, graduation to heroin and potential death,” Stern said in a statement.

Stern’s office said U-47700 was originally developed by the pharmaceutical industry as an alternative to morphine but was never marketed when it was determined to be more than eight times as potent as morphine. The drug is manufactured overseas, mainly in China and is sold at a low cost on the internet, according to the Drug Enforcement Administration.

It can be smoked, snorted or orally ingested and can cause respiratory depression, coma, permanent brain damage and death.  The DEA temporarily listed the drug on Schedule I of the federal Controlled Substances Act in September because of the imminent hazard it presents to public safety.

Schedule I drugs have a high potential for abuse, are not currently accepted for medical use in the U.S. and are deemed unsafe even under medical supervision. Other drugs in the Schedule I list include heroin, LSD and ecstasy.

Many states, including Georgia, Ohio and Wyoming, have banned the drug.

The DEA confirmed at least 15 fatalities from the use of U-47700, and according to news sources, at least 50 deaths nationwide can be linked to the drug.

According to the bill, any person who knowingly violates the law will be guilty of an unclassified misdemeanor punishable by a fine of up to $1,000 and/or up to one year of imprisonment. The law goes into effect immediately after the Office of the Secretary of State files it.

The legislation to prohibit its sale was supported by the entire legislature, as well as Health Commissioner James Tomarken and Police Commissioner Tim Sini.

“I thank my colleagues on the Legislature for joining me in taking meaningful action to protect the health and safety of our communities,” Stern said.

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 https://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.

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.”

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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.

Event attendees learn how to use Narcan to counteract opioid overdoses. Photo by Giselle Barkley

By Giselle Barkley

Parents and students alike walked out of Mount Sinai High School knowing the ugly truth about heroin and opioid use and addiction. But they also walked away with a lesson about Narcan.

Event attendees learn how to use Narcan to counteract opioid overdoses. Photo by Giselle Barkley
Event attendees learn how to use Narcan to counteract opioid overdoses. Photo by Giselle Barkley

The school district held it’s first “The Ugly Truth” presentation on Tuesday in the Mount Sinai High School auditorium. Suffolk County Police Department officer George Lynagh, EMS officer Jason Byron and county Medical Examiner Michael Caplan tackled the origins of heroin and trends among addicts over the years. Suffolk County Legislator Sarah Anker (D-Mount Sinai) and Town of Brookhaven Councilwoman Jane Bonner (C-Rocky Point) also spoke at the event.

But residents didn’t simply learn about heroin on the Island, they also left with their own Narcan kits after Byron led a Narcan training class. According to Sgt. Kathleen Kenneally of the police department’s Community Response Bureau, Narcan, also known as Naloxone, was successfully administered around 530 times since the opiate antidote was introduced to the police department in July 2012.

Narcan, which reverses the effect of heroin or other opiate-based overdoses, can be administered via an injection or nasal spray. Mount Sinai resident Susan Matias said the spray is a friendly option for community members.

“Here, it’s introduced through the nasal passages — there’s no harm done, you’re not afraid of administering a needle and/or sticking yourself in the moment of chaos,” Matias said. “I think that’s why people are more open to partake and participate in the training.”

The nasal spray also makes it easier for people who still have a stigma about drug addicts and users. Byron reminded residents that the face of addicts has evolved and they’re not the only ones in need of drugs like Narcan.

“Sadly, the connotation is, we think people that could have overdosed are dirty when really it doesn’t have to be,” Byron said. “For opiate overdose, it doesn’t mean that it’s someone addicted to heroin. It could be somebody who’s possibly on pain management for cancer, end of life care, hospice care. It’s not the stereotypical — I hate to say it — junkie. That’s not what we’re seeing out there.”

According to Caplan, in the last few years, drug addicts who’ve overdosed on the substance have gotten younger and younger. The rate of opiate overdose deaths has increased by 140 percent since 2000. Synthetic opioids, like fentanyl, are responsible for 80 percent of these death rate increases.

Fentanyl, which some dealers or users will mix with another drug like heroin, is 50 times more potent than heroin and 100 times more potent than morphine. Combining this drug with others can make it difficult when administering Narcan.

“One of the problems with Fentanyl is, because it’s so potent, because it acts so fast, you may need to give multiple doses of Naloxone,” Caplan said.

According to Lynagh, the police department is starting to see higher levels of Fentanyl. He added that in his more than three decades as a police officer, the drug is one of the more addictive drugs he has seen. Lynagh added that heroin was initially introduced to combat morphine addiction.

“We don’t have too many people addicted to morphine now,” Lynagh said. “We have this heroin addiction, so sometimes we mean to do something well or combat a drug or something bad, with something else that’s bad.”

File photo

The path to overcoming opioid addiction will soon be just a phone call away, thanks to a new initiative that the Suffolk County Legislature announced last week.

A new full-service substance abuse hotline will serve as what officials called a lifeline to residents battling drug addiction, which lawmakers have been struggling to address across Long Island for years. To get there, the county teamed up with Stony Brook Medicine and the state’s health department as well as the county’s private and public community partners in the substance abuse field to allow residents to call to get screenings, referrals and follow-ups.

The Long Island Council on Alcoholism and Drug Dependence will operate the 24-hour hotline and direct callers to those resources. Providing a single phone number to call for a myriad of resources and services is key to assisting those who are battling addiction and their families, officials said.

“Like many places in this country, Suffolk County is facing an opioid epidemic of historic proportions,” County Executive Steve Bellone (D) said in a statement. “We need to tackle this epidemic on all fronts — including prevention, treatment and law enforcement.”

Bellone said his administration has made it a top priority to “explore and launch new, evidence-based tools” to help address the region’s fight against heroin and opioid use.

“The creation of a local 24/7 hotline is now another tool in our arsenal to assist those who are battling opioid and heroin addiction and their families,” he said.

The hotline will become live by April, Bellone said, and the Suffolk County health department will provide oversight and analyze data to monitor its effectiveness and identify trends and emerging issues in the community.

“Every second counts to a mother whose son or daughter was found and saved from overdosing,” said Suffolk Legislator Kara Hahn (D-Setauket). The majority leader was the author of several laws credited with preventing more than 1,000 opioid overdoses in Suffolk County since the summer of 2012, including one that gave police access to Narcan, a medicine that stops such overdoses. “And every hour and every day that slips by trying to find quality, affordable, accessible treatment is critical.”

Suffolk County Legislature Presiding Officer DuWayne Gregory (D-Amityville) said the initiative is essential, as heroin deaths in the county have nearly tripled since 2010.

“This alarming data demands our immediate attention,” he said. “A centralized hotline for people in crisis is a critical step toward saving lives, but we must do more. My colleagues and I look forward to our continued work with both the county executive and officials from Nassau County as together we fight to stem Long Island’s heroin epidemic.”

County Legislator William “Doc” Spencer (D-Centerport) echoed the same sentiments and said the area’s substance abuse issue was pervasive and touched the lives of more than those who suffered from addiction.

“This initiative will provide [the] opportunity for addicts to reach out during their time of need and access treatment and support options easily,” he said. “Often, there is a critical and brief period of time when a person sees clarity and makes the decision to seek help. This hotline can be fertile ground for change and recovery as it can quickly link residents to crucial health care services.”

Drug busts are becoming more common in Suffolk County. Above, drugs and other items seized during one such bust. File photo

Overall crime is dropping in the 6th Precinct — but one wouldn’t know that by looking at the number of drug arrests.

Fewer crimes are being reported across the board while heroin arrests have doubled in the last five years, according to Suffolk County Police Department statistics shared at a joint meeting Tuesday night of the Port Jefferson Station/Terryville Civic Association and Comsewogue Community Crime Awareness Committee. Inspector Bill Murphy, the head of the precinct, said those arrests numbered 148 in 2011 but ballooned to 298 last year.

“And that’s just our arrests,” he said, noting that it doesn’t account for all heroin use. “Those are times that we come across it.”

Comsewogue area residents and visitors from neighboring civic associations vented their frustrations about local drug-related crimes and activity at the meeting in the Comsewogue Public Library on Terryville Road as they received the most recent data about police action on the issue. Despite the overall drop in crime, Murphy said drug addicts are still behind many of the reported incidents in the 6th Precinct.

“Unfortunately, a lot of the serious crimes we have are driven by drug abuse: The people addicted to heroin and they’re so addicted to it, they have to get money to go and buy these drugs,” he said. “They’re doing stickups, they’re doing burglaries.”

The police are cracking down on the drug trade, however. Murphy noted that officers had executed search warrants on three “drug houses” in the past week alone. One of them was in Centereach, where he said cops busted a repeat offender and caught him with 4 ounces of cocaine and 2 ounces of heroin.

“He’s going away for a long time,” Murphy said.

But the police activity is not limited to arrests. Officers also attack local drug addiction when they save people from opioid overdoses using Narcan, a medication they carry that stops overdoses of drugs like heroin, Vicodin, OxyContin, Demerol and Percocet.

Officer Will Gibaldi said at the meeting that in the past four weeks alone, they responded to three overdoses in Port Jefferson and one in Port Jefferson Station.

“We do handle a decent amount of them,” the officer said.

Police have been relying on Narcan so much in the few years since they first got access to medication that the department has stopped keeping track of how many lives officers have saved with the overdose antidote.

“We actually stopped giving statistics on it,” Murphy said. “After we broke the ‘500’ mark, there were just so many of them, it was senseless to even bother keeping numbers.”

For residents who are concerned about drug activity in their neighborhoods or want to report it to the police, Gibaldi emphasized that communication with the public is a department priority, saying, “Our door is always open.”

Likewise, Murphy invited people to reach out to him.

“If you contact me with a problem, you will get a response. You will not be ignored.”

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

The Suffolk County Police Department handed out dozens of overdose rescue kits in the Port Jefferson high school on Monday night, at the conclusion of a crowded drug abuse prevention forum geared toward educating parents.

“We have to double-down on prevention,” said Tim Sini, a deputy county commissioner for public safety who has recently been nominated for police commissioner.

People at an anti-drug forum stay afterward to learn how to use the anti-overdose medication Narcan. Above, Jim Laffey assembles a syringe. Photo by Elana Glowatz
People at an anti-drug forum stay afterward to learn how to use the anti-overdose medication Narcan. Above, Jim Laffey assembles a syringe. Photo by Elana Glowatz

He and other officials from the police department, medical examiner’s office and community spoke at the forum to inform parents about the dangers of drug abuse, including how kids get introduced to and hooked on drugs in the first place. Much of the discussion focused on opioid drugs, which include heroin as well as prescription painkillers like Vicodin and Percocet, and on the lifesaving Narcan, an anti-overdose medication that blocks opioid receptors in the brain and can stop an overdose of those types of drugs.

According to Dr. Scott Coyne, the SCPD’s chief surgeon and medical director, in the three years since Suffolk officers have been trained to administer Narcan — the well-known brand name for naloxone — they have used it successfully 435 times.

Attendees who stayed after the forum were able to register in the police department’s public Narcan program and receive a kit with two doses of the medication, which can be sprayed into an overdose victim’s nostrils.

Narcan training classes are coming up
Want to learn how to use Narcan, the medication that stops an opioid overdose in its tracks? Training courses are taking place across Suffolk County over the next couple of months, including in Port Jefferson and in neighboring Centereach.

Narcan, the brand name of naloxone, blocks receptors in the brain to stop overdoses of drugs like heroin, Vicodin, Percocet, OxyContin or Demerol, among others. It can be administered through a nasal spray and will not cause harm if mistakenly given to someone who is not suffering an opioid overdose.

The local training sessions meet state health requirements, according to the Suffolk County Department of Health Services, and will teach trainees to recognize opioid overdoses, to administer Narcan and to take other steps until emergency medical personnel arrive on the scene. All participants will receive a certificate of completion and an emergency kit that includes Narcan.

The first course will be held on Monday, Dec. 14, from 6 to 7:30 p.m. at the county’s Office of Health Education in Hauppauge, at 725 Veterans Highway, Building C928. RSVP to 631-853-4017 or [email protected].

In Centereach, a course will take place on Friday, Jan. 15, from 6:30 to 7:30 p.m. in the Middle Country library at 101 Eastwood Blvd. RSVP before Jan. 11 at [email protected] or at 631-585-9393 ext. 213.

Later that month, Hope House Ministries will host another Narcan training session in its facility at 1 High St. in Port Jefferson, in the Sister Aimee Room. That event, held in conjunction with the Port Jefferson ambulance company, will take place on Thursday, Jan. 28, at 10 a.m. Call 631-928-2377 for more information or register at https://pjvac.enrollware.com/enroll?id=952865.

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Danielle Wisnieski mugshot from SCPD

Police allege a pregnant woman was on drugs when she overturned and crashed her car in Kings Park the night before Thanksgiving.

The 26-year-old, Danielle Wisnieski, who is also 26 weeks pregnant, according to the Suffolk County Police Department, was driving north on Indian Head Road at the time of the crash. Police said she lost control of the vehicle, a 2003 Cadillac Escalade, near the intersection with Old Northport Road and overturned just after 8 p.m.

Paramedics treated her at the scene, police said, and administered Narcan, a medication that is used to block the effects of opioids like heroin and Vicodin and is commonly used to reverse overdoses.

The driver, a Kings Park resident, was transported to Stony Brook University Hospital to be treated for minor injuries. The passenger in her car, a 34-year-old Kings Park resident, was treated for minor injuries as well at Huntington Hospital.

No other cars were involved in the crash.

Wisnieski was arrested and charged with driving while impaired by drugs.

Attorney information for the suspect was not immediately available, and she was scheduled to be arraigned at a later date.

File photo

The issue of drug abuse will be brought to the forefront in a few weeks, as the Port Jefferson Village Board of Trustees dedicates its next meeting to a community discussion on the topic.

That meeting on Dec. 7 is being moved to Earl L. Vandermeulen High School, where school, village and police officials will meet for a forum called The Ugly Truth.

“Although we have all read and heard the headlines about heroin in our neighborhoods and the dangers of easy access to powerful prescription medication, we rarely hear The Ugly Truth behind these headlines,” according to a flyer advertising the joint event.

Suffolk County Police Department officials, including the chief medical examiner and a school resource officer, will tell parents the signs of heroin and prescription drug abuse among teenagers and what can be done about it.

The village trustees will hold their work session meeting at 6 p.m. that day at the high school on Old Post Road, then attend the forum at 7 p.m. in lieu of holding a public comment period at Village Hall as usual. The public comment period will instead be held at the board’s following meeting, on Dec. 21.

Drug addiction and abuse is a topic that hits home in all Long Island communities, but it has been a particular point of friction in Port Jefferson and Port Jefferson Station because of a visible homeless population and the presence of various community services catering to that group, such as a soup kitchen network and a homeless shelter.