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Opioids

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At a time when budgets will be extremely tight amid the gradual economic recovery caused by the virus-induced economic shutdown, investing in organizations that help people deal with mental health problems and substance abuse now could save considerably more money later.

That’s the argument Family and Children’s Association Chief Executive Officer Dr. Jeffrey Reynolds makes, particularly as Suffolk and Nassau County Executives Steve Bellone (D) and Laura Curran (D) urge more federal aid for Long Islanders.

“When you have untreated mental health and substance abuse disorders, the county will pay for that one way or the other,” Reynolds said in an interview. “The question is: do you want to pay for it upfront or on the back end,” with the loss of life from drug overdoses.

Jeffrey Reynolds, the CEO of the Family and Children’s Association. Photo from FCA website

Throughout Long Island, Reynolds, who had previously been the Executive Director of the Long Island Council on Alcoholism and Drug Dependence, said the emphasis on basic needs among families has increased, particularly as the number of unemployed in the area has approached 200,000.

Many of the unemployed are “involved in low wage jobs to begin with” and are living “at the margins,” so there is a need for food, rental assistance, and housing, he said. The basic needs have increased significantly.

The transition to telehealth has been effective for those with mild or moderate challenges and, in some ways, is even easier than walking into a church basement or going to a center. The first step, which is often the hardest in entering any kind of treatment program, involves fewer logistical challenges and allows people to remain anonymous.

At the same time, however, some of these virtual efforts are problematic for those who are dealing with a significant level of impairment.

People who have a more acute mental health condition are “less likely to engage via telehealth” and the same holds true for people with severe substance abuse, Reynolds said. “A virtual session is not the same as seeing them in person and groups are not the same as they were before.”

FCA has seen an increased demand for services for people who were anxious or depressed. Fear or a lack of control brought on by the virus is bringing some of these symptoms to the surface.

“Across the board, we are seeing an increased demand for services,” Reynolds said. “There is now space in which we’re not seeing that request.”

The virus has made health care disparities more visible. The numbers of illnesses and fatalities in Brentwood, for example, are 12 times higher than in Garden City. That relates to preexisting conditions like obesity and diabetes, but also to the crowded living conditions in Brentwood.

The combination of the business closings such as gyms, restaurants, movie theaters, and other enterprises creates anxiety and impacts family structure and family functioning, Reynolds said.

Long Island has had to cope with previous recessions and downturns from disasters like Superstorm Sandy, but this is “even deeper. I imagine we’re going to see the ripple effects for a decade to come.”

Reynolds is concerned about people returning to their normal lives at some point, without addressing underlying problems in the communities or with other families.

Still, Reynolds feels fortunate to work for an organization that has existed and helped communities and neighborhoods for 135 years. That means the group was around during the Spanish Flu in 1918 and 1919.

“What keeps me going is that we’re always had to do more with less,” Reynolds said. “We found hope in people’s lives where it seems like there isn’t.”

Indeed, the group not only survived the Spanish Flu, but also made it through both World Wars, the Great Depression, 9/11, and numerous natural disasters.

Additionally, on the positive side, the FCA can provide services in a much timelier way. People who call with a drug or alcohol problem can get some help within ten minutes. The current environment provides the equivalent of “treatment on demand,” Reynolds said.

The FCA head urged people to get involved, which could mean volunteering time at a school, offering help to a local charity or checking on an elderly neighbor.

He urged people to dedicate some of the time they spend on social media to helping others.

Reynolds has spoken with numerous people who have alcohol dependency. When they finally get treatment, some of them have said, “If it was that bad, why didn’t anybody say something to me?”

He urged friends and family to care for each other, asking about weight loss or prolonged sleep. He suggested having conversations that go beneath the surface.

Children and families benefit from structure, especially in a challenging environment. Reynolds suggested a regular evening meal time and a consistent time and place for homework.

Ultimately, as the head of a 135-year old organization, Reynolds said people need to believe that “you can get through this,” he said. “Even if it feels like the world is ending, it’s not.”

Suffolk County Executive Steve Bellone. File photo by Alex Petroski

During a press conference July 28 at the Long Island Council on Alcoholism and Drug Dependence, Suffolk County Executive Steve Bellone (D) and Nassau County Executive Laura Curran (D) made the case for what’s at stake for Long Island the day before heading to Washington to urge the congressional delegation to provide financial support for the area.

In the wake of the COVID-19 crisis, which claimed the lives of close to 2,000 Suffolk County residents, Bellone and Curran urged the federal government to appreciate what was at stake as residents continued to deal with the mental health consequences of a deadly virus, job losses, and ongoing fear and uncertainty.

Indeed, the 64-year-old LICADD has had a 20 percent uptick in calls as people grapple with mental health problems and anxiety, Steve Chassman, the executive director of LICADD said.

“Many people have crossed an imaginary line, where the 6 p.m. drink became the 2 p.m. drink,” Chassman said in an interview. For some, that has even developed into an “11 a.m. drink.”

Data from police have shown the number of opioid overdoses, both nonfatal and fatal, have increased dramatically since the start of the pandemic, rolling back almost two years of decreases.

At the press conference, Bellone and Curran said they believe the long road to recovery ahead for Long Islanders requires the ongoing support of services like LICADD and the Hempstead-based Family & Children’s Association.

Bellone said he and Curran were heading to Washington to make it clear “we’re talking about people’s lives and families in crisis.” These type of services, including public safety, public health, social services and mental health, are “even more important today” and will be critical as “we seek to recover from this over the next several years.”

Long Island has been battling an opioid crisis that has wreaked havoc throughout the region. The pandemic has increased the risks from opioids, among other drugs, even as Nassau and Suffolk are “still dealing with the direct impacts.”

Jeffrey Reynolds, the president and CEO of Family & Children’s Association, suggested that it “makes no sense to help save someone’s life from COVID-19 only to have them die from a fatal overdose or suicide.”

He called the current challenges among Long Island’s “darkest hour,” which is “exactly what we are seeing on the ground.”

Reynolds noted that social isolation has strained the mental health of individuals and families. In the last two weeks, Reynolds has seen three overdoses, including one of his former staff members.

Reynolds urged Washington to recognize the need for mental health services is just as critical as the need to protect people from viral infection.

“Nobody in Washington or in Albany, from either side of the aisle, would dare say, for the second, third or fourth wave of COVID that we don’t have enough money” for personal protective equipment. “This is the same. Untreated social anxiety and mental health conditions rank right up there and need our full attention.”

In an interview, Chassman added that residents have also self-medicated through other outlets, including gambling, online spending, emotional eating and sexually acting out.

“These are unhealthy coping mechanisms for fear, anxiety and stress,” Chassman said.

Reynolds offered support to the county executives as they head to Washington.

Turning to Bellone and Curran, Reynolds said, “You have our voice and our good wishes as you go forward” to make sure “these vital services” remain available to Long Islanders.

Fireworks in Port Jefferson for Independence Day 2019. Photo by David Ackerman

As the county prepares for a Fourth of July following a painful spring, county officials and health care providers reminded residents to remain safe during fireworks displays and to continue to follow health guidelines.

Steve Sandoval, Associate Professor of Surgery and Medical Director of the Suffolk County Volunteer Firefighters Burn Center at Stony Brook University Hospital, urged residents to be cautious around fireworks and barbecues.

The best way to avoid injuries is to “prevent the burn in the first place with safety tips and precautions to eliminate potential dangers,” Sandoval said in a statement.

The Suffolk County Volunteer Firefighters Burn Center offered 10 tips, which included viewing fireworks used by professionals, not leaving hot coals or fire pits, not using the stove top, fire pit or fireplace when residents are tired or have had alcohol.

“If burned, do you go anywhere but a facility that specializes in burn treatment,” Sandoval said.

The Suffolk County Police Department, meanwhile, warned residents of counterfeit oxycodone. Detectives recently seized pills that bear the markings of 30 mg of oxycodone but that were fentanyl instead, which is 1,000 times more potent than morphine. Ingestion can cause overdose and death. The department warned residents that people buying these pills may not be able to distinguish between the counterfeit pills and prescription oxycodone.

Viral Numbers

After two days without a death related to complications from COVID-19, two residents died in the past 24 hours. The total number of residents who have died from the virus is 1,983.

The number of new infections over the last day was 47, bringing the total to 41,538. Gregson Pigott, the Commissioner of the Suffolk County Department of Health Services, said new infections crossed a whole spectrum of ages and included people in their 20’s.

The county distributed 30,000 pieces of personal protective equipment over the last day.

After the success of drive in movies at the Smithpoint County Park, the county is opening a second site for movies, at the Suffolk County Community College on the Grant Campus in Brentwood. The series will include “Pee Wee’s Big Adventure” July 8, “The Karate Kid” July 9, “Matilda” on the 10th and “Back to the Future” on the 11th. Residents interested in getting free tickets can register through suffolkcountyny.gov/driveinmovies.

Police acquired several million dollars worth of drugs during a seizure of several Suffolk County residents. Photo from DA's office.

Suffolk County district attorney, Tim Sini (D), announced three people in Suffolk and two from New Jersey were indicted in an alleged multimillion dollar drug trafficking ring, with officials saying they seized over a million in cash, 19 kilograms of drugs and numerous guns during the takedown.

Police took millions of dollars in cash from three Suffolk County residents as part of a drug smuggling ring bust. Photo from DA’s office

Sini announced in a press release that James Sosa, 25, of Wading River, Anthony Leonardi, 46, of Coram, and Brian Sullivan, 24, of Lake Grove, and two other individuals from New Jersey allegedly helped purchase and ferry narcotics, including cocaine and heroin, from the West Coast to Long Island partially during the pandemic. The group used residential homes in Lake Grove, Wading River, Port Jefferson Station, Coram, Selden and Brentwood, the DA said.

Sini worked with Suffolk County Police Department, the U.S. Drug Enforcement Administration and the U.S. Postal Service Office of Inspector General.

“The magnitude of this drug distribution ring is enormous; they were responsible for peddling millions of dollars in narcotics on an almost weekly basis,” Sini said in the release. “Not only did this organization continue their illicit operation during the coronavirus pandemic, they were also exploiting the limited availability of certain narcotics during the health crisis to generate even greater profits off their sales.”

The DA, Suffolk police and DEA launched the investigation in May 2019 investigating Sosa, Sullivan and their associates. The group allegedly used multiple methods to get the drugs to the East Coast, including cross-country trips in vehicles and airplanes and even through the mail. Police executed warrants June 27 at locations within the six hamlets, which the DA said resulted in seizing 16 kilograms of cocaine, 2 kilograms of heroin, about $1.5 million in cash, around 4,000 oxycodone pills, nine firearms, along with “numerous luxury vehicles” and equipment the DA said is used for packaging and selling drugs. The police had also seized an additional kilogram of cocaine earlier in the investigation. The cocaine had an estimated street value of $1.6 million and the heroin was worth about $520,000.

Dashawn Jones, 33, of Passaic, New Jersey, was charged with allegedly operating as a major trafficker and first-degree drug possession. Anthony Cyntje, 22, also of Passaic, was charged with first-degree drug possession and was described as being employed as a correction officer in New Jersey.

“This investigation exemplifies how drug traffickers have been impacted by the coronavirus; adapting smuggling methods, transportation routes and money laundering operations to maintain security and social distancing,” said Ray Donovan, New York DEA special agent in charge.

Sosa, who was charged with two counts as a major trafficker, among other counts, was arraigned June 28 with bail set from $7.5 million cash or bond. Sosa’s attorney, Glenn Obedin, a criminal defense lawyer in Central Islip, did not immediately respond to a request for comment.

Sosa, Sullivan and Jones each face 25 years to life in prison if convicted of the top counts, Leonardi 12 1/2 to 25 years and Cyntje 8 1/3 to 25 years, Sini said.

While COVID-19 has become the dominant catastrophe of the moment, other longstanding crises have taken a backseat in the public eye.

Graphic by TBR News Media

The opioid crisis, an epidemic that has taken many more lives over a much longer stretch of time, is seeing a new rash of overdoses since the start of the pandemic.

Data provided by Suffolk County Police shows overdoses have generally increased from the same months last year to this year. In March, police counted a total of 14 fatal overdoses compared to 27 in 2019. There were 108 nonfatal overdoses compared to 93 last year. In April, the numbers jumped wildly from 15 fatal overdoses in 2019 to 30 in 2020. Nonfatal leaped from 67 to 113.

District Attorney Tim Sini’s (D) projections of overdose numbers tell an even more morose tale. With data that includes ODs that weren’t confirmed yet by toxicology reports, seeing a total increase of 19 percent of both fatal and nonfatal overdoses compared to the previous year. Though those numbers include all overdoses, not just related to opioids.

While it may be too soon to determine a specific link between the pandemic and the increase of overdoses, drug counselors and rehabs say they have seen the marked connection between isolation, mental illness and drug dependence. As time goes on and the country faces economic turmoil, some worry the situation may not improve for the rest of the year.

Addiction Relief Shifts to Remote Help

Dr. Carol Carter, the director of the Sunshine Prevention Center in Port Jefferson Station, works especially with youth and parents dealing with mental health and drug-related issues. She said her center quickly had to scramble after the state first started closing down. Since then the center has been hosting most programs over Zoom or in Facebook Live sessions. They have especially tried to focus on appreciating diversity, the issues of isolation and other anxieties. They have done children’s book reading and puppet shows over the internet as well, looking for ways to maintain positivity. They have also connected with families by dropping off care packages and calling families each week.

Sunshine Prevention Center in Port Jefferson Station created a “Blessing Box” for people to take necessary items when they need it and drop it off as a donation. Photo from SPC Facebook

But while such meetings may be a substitute for counseling sessions, Carter said the main difficulty is preventing people from getting on drugs, especially as so many remain cooped up indoors,  many in unstable situations.

“We’ve seen an increase of response hotline, in depression and suicidal ideations,” Carter said. “We’re still collecting data, but we’ve heard of an increase in domestic abuse, an increase in substance use, alcohol abuse, as their way of coping with isolation.”

Director of Drug and Alcohol Counseling Services at the Smithtown Horizons Counseling and Education Center, Matthew Neebe, said it’s hard to gauge if there has been an increase in drug use since the pandemic as the center is not facilitating toxicology screenings. Yet, he added there is “anecdotal” evidence for the pandemic causing and increase in relapses and drug use.

“Two of the biggest risk factors for substance use are social isolation and stress,” he said. “Both are consequences of the stay-at-home orders.”

While the center itself is considered essential, they have continued to operate at a reduced level. However, with most staff working from home, all therapy sessions are done via telehealth. They have been conducting some group sessions virtually, though they have reduced the number of sessions from their regular schedule.

Anthony Rizzuto is the director of provider relations for Seafield, a drug rehab with inpatient facilities in Westhampton and outpatient facilities in Amityville, Medford, Mineola, Patchogue and Riverhead. He said they too have been hearing of the increase in overdoses and the increased use of alcohol and other drugs as more are quarantined at home.

“We know people will turn to drugs or alcohol, and God knows right now we have plenty of stressors — we have people who have lost loved ones, people who have lost their jobs, people who are in financial ruin, some are losing their businesses,” Rizzuto said. “We see an increase right now, and quite honestly I expect a huge increase as this continues going on and after this is over, if this ever happens.”

While there are obvious downsides to telehealth, the push is one that was in the docket for a while, and with the current pandemic, has finally pushed many institutions into taking it seriously, said Dr. Christian Racine, the senior director for clinics for the Family Service League Long Island. The nonprofit social services agency also runs the Diagnostic, Assessment and Stabilization Hub in partnership with Suffolk County.

The benefits, Racine said, include allowing people who may have had mobility issues or other mitigating problems the chance to get into the system. People who call the hotline for the clinic or DASH center are now immediately put into the system, where they can connect with people to understand what the person is going through and what services they should get connected to. It also allows for flexibility in time and location, no longer requiring a person to drive what can be a long distance to start the treatment process. 

FSL’s Mobile Crisis Teams continue to operate, often going to a person’s home to talk through the door or even speak to a person through video chat or phone right on the person’s driveway.

“We didn’t see a drop in services, [but] an increase in services because of flexibility of being able to use telehealth,” Racine said. “People are being frank about increased cravings or relapses.”

Sarah Anker, the legislative chair of the opioid panel, said they too are concerned of increase in opioid overdoses. File photo by Erika Kara

Though there still are several downsides to telehealth. Perhaps the most egregious is for those living in unstable home conditions, where the person on one of the calls may not want others to listen in.

“Even if you get along with the rest of the family, you’re worried about what you’re sharing or you’re hesitant to share certain details,” he said. “Some don’t have the best relationship with their families. It’s absolutely a concern, and we’re very conscious of that.”

While Rizutto acknowledged some of the benefits of telehealth, he said he preferred the in-person meetings where he said “a lot is being said nonverbal.” 

Otherwise, with so many resources shut down, from in-person AA meetings to churches to gyms, “Zoom really played a part to give people something,” Rizutto said. “People are in those meetings who had never been to therapy, before people from all over. It is definitely meeting a need.”

Government and Police Response

Suffolk County Police Chief Stuart Cameron said cops have noticed increased incidents of drug overdoses, though despite the emphasis on social distancing police are still able to administer Narcan, a life-saving drug that halts an opioid overdose. 

But with treatment and prevention as the more important component of substance abuse, the pandemic presents its own unique challenges.

“It’s not just opioids — people are self medicating, people are isolated,” said Suffolk County Legislator Sarah Anker (D-Mount Sinai). Anker is the legislative chair of the Suffolk County Heroin and Opiate Epidemic Advisory Panel.

The trend is troubling, especially compared to Suffolk County’s previous models showing total overdoses are on the decline. In January, Suffolk released a report showing 2019’s projections of opioid-related deaths was 283, compared to 2018’s 380. Those decreased numbers of deaths were attributed, in part, to the greater use and availability of Narcan.

Anker said the numbers have caused real concerns among other members of the opioid advisory panel. In a meeting Friday, May 8, panel members discussed tapping into county forfeiture funding to create public service announcements on mental health and the different places to receive drug treatment. The panel also would look to advocate that the federal government should allow people to use Medicaid funds for teleconferencing, which it currently does not cover.

Suffolk County District Attorney Tim Sini says the issues with overdoses and drugs won’t improve with the ongoing pandemic. Photo by Alex Petroski

Sini said Suffolk County has not seen a decrease in drug-related activity despite the pandemic. This is mostly due to the nature of how drugs enter into Suffolk — smuggled into New York City then is sold wholesale to dealers on the ground, who usually drop it off to peoples’ houses or are picked up at select homes.

“We’re not seeing any drop except for powdered cocaine, but we’re not seeing that same situation with heroin or fentanyl,” the DA said.

Sini said while other crimes like break-ins have declined, the office has allocated more resources to the narcotics bureau, now standing at 13 narcotics prosecutors, which works closely with police to track dealers and prosecute them.

The DA’s office is also planning to roll out a new program that would work with a yet-to-be-named nonprofit and shuttle people in addiction to treatment providers. Sini said there will be more information on that program in the coming weeks.

The initial rise in COVID-19 cases forced the rehab facilities to cut back in bed capacity, especially as hospital-based detoxes turned into beds for COVID patients. Since then, as the number of hospitalizations declined, Rizzuto said now bed supply is better, but of more concern is funding for these facilities.

“Either a state-funded facility, nonprofits or private entities, I think the budget is going to be ravaged and with the lack of being able to collect, they will be looking to cut,” Rizzuto said. “I think they are going to have to cut in many different areas to meet the needs financially. Historically behavioral health is one of the things that gets slashed.” 

Anker said members of the advisory panel have expressed their concerns for many different programs’ funding, especially as New York State reports huge drops in income. Many nonprofit rehabs and centers rely on such funding.

“Drug addiction is not decreasing, it’s increasing and they may be taking away those resources,” Anker said. “We may not hear it now, but we will see repercussions come out as we deal with pandemic.”

Maintaining the breadth of services, from inpatient care to outpatient care to paying for nursing and other medical staff, the rehabs and prevention centers requires a heavy dose of government funding. Racine said restructuring Medicaid could provide a necessary boost of aid.

“The idea of state funding being reduced is really a concern — a lot of services are expensive,” Racine said.

Despite the efforts of both government, for profit and nonprofit organizations, officials said they don’t expect numbers to return to the way they seemed to be heading only a year ago.

“I think it would be very hard to end 2020 on a decline,” Sini said. “We will see an increase in 2020, but we will all be working to bring those numbers down in 2021.”

Kara Hahn in 2017 Photo by Desirée Keegan

Suffolk County Legislator Kara Hahn (D-Setauket) is seeking re-election for her fifth two-year term Nov. 5. Her Republican challenger, John McCormack, of Port Jefferson, is not actively campaigning and was not available for a debate with Hahn at the TBR News Media offices. Therefore, the legislator answered a few questions during a phone interview.

County finances

After receiving the county’s Office of Budget Review’s recent report, she said that even though there are still stresses on the budget, Suffolk is in a better place than it has been in past years.

The legislator said the proposed 2020 operating budget has no new fees and there is no pension amortization for the second straight year. The budget came in $4.8 million under the property tax cap.

“Of course, we’re overly reliant on the sales tax revenue and that was so low for so long, and we’re coming out of that,” she said. “When you are reliant on taxpayer dollars, you always feel pressured to be as tight as you can be, and you want to cut costs at every corner and, of course, we’re doing that.”

Hahn said she is aware that due to the county being reliant on sales tax, from which Suffolk receives approximately $1.6 billion, if a recession hits the county is not properly prepared.

She said a slight increase of the 3 percent hotel/motel tax, which is one of the lowest in the country, would help the budget and at the same time not deter anyone from visiting the area.

When it comes to stimulating the economy, she said it’s important to stay vigilant in the collection of sales tax. It was also helpful that the state allowed Suffolk to collect internet sales tax in 2019, she said, which generated about $10 million additional sales revenue this year and is expected to be $20 million in 2020. She said Suffolk Regional Off-Track Betting Corporation, which oversees Jake’s 58 casino in Islandia, paid off its debt, and its revenue will contribute $25 million to the county budget in 2020.

“We’ve been getting some good revenue sources that have helped to take the pressure off and that’s important,” Hahn said.

Low-nitrogen septic systems

Hahn, chairwoman of the Environment, Planning & Agriculture Committee, has supported the rollout of new low-nitrogen septic systems in the county. The wastewater nitrogen content has a mandated maximum of 19 milligrams per liter.

“This is a long-term, multidecade effort as 360,000 residences are unsewered,” she said. “These homes have to either become sewered or get a new innovative on-site alternate wastewater system. That cannot happen in one year. That cannot happen in 10 years.”

She said to help with the rollout the county has created priority zones, including the Town of Brookhaven’s initiative where new construction within 500 feet of a waterway is required to install the systems. Grants, on both the county and state levels, have been made available for homeowners who choose to replace their cesspools with the new system.

She said it took years for the county’s health department to work on establishing the program to ensure the new systems would work as promised, adding the process for the program also included working with health and science experts along with those who work in the industry. She said she is proud of County Executive Steve Bellone (D) for sticking with the implementation despite the amount of time spent on the issue.

“He stepped up, and it’s happening,” she said. “It might be slow for people who are used to instant gratification but I’m shocked that we’re here where systems are being installed and people are beginning to recognize it, and we’re going to be seeing improvements in water quality because of it.”

Environment

When it comes to the 5-cent minimum fee for plastic bags in stores, Hahn said the program has been successful, with a 70 to 80 percent reduction in the use of the bags. She also sponsored a bill to create a plastic straw ban in restaurants that will take effect in January.

In addition to continuing work on the county’s Blueway Trail, which will create a water path for recreational boating opportunities along Suffolk rivers, lakes, canals and coastlines, she hopes to establish Blue Flag beaches in the county, which will be the first in the United States. The standard was created in Europe, where a beach that flies the Blue Flag has a higher standard when it comes to water quality.

Opioids

Hahn in 2012 sponsored legislation to provide Narcan in police cars. The last two years she has worked with Long Island Council on Alcoholism & Drug Dependence and Stony Brook University to create training for athletic coaches in county middle, junior and high schools to teach them about the signs and symptoms of all forms of addiction. Hahn said she hopes to expand the program to athletic leagues outside of schools and even make it available to dance instructors, music teachers and Scout leaders.

“So that they’re trained to know how to deal with things when they hear it or see it, and know how to help fight and how to prevent — really the key is to prevent addiction,” she said.

District Attorney delivers a special presentation on opioid-related crimes to mayors and other officials from Suffolk County's villages at Lake Grove Village Hall.

Suffolk County Village Officials Association, which represents 32 villages, hosted a special presentation on the opioid crisis Sept. 26 at the Lake Grove Village Hall.

District Attorney Tim Sini (D), Suffolk Police Commissioner Geraldine Hart and Sheriff Errol Toulon Jr. (D) all spoke to the group about how the crisis has fueled a regional surge in illegal firearms seizures and sex trafficking crimes.

Most criminal cases in the county, the officials said, relate to opioid epidemic.

People initially became addicted to prescription painkillers and over time, as demand increased, supply went down, and prices went up. So, people gravitated toward heroin, the DA said, which is more potent and more dangerous. Drug dealers, who realized that money can be made, began cutting their product with the synthetic opioid fentanyl, and more recently with fentanyl variations known as analogs. Fentanyl, Sini said, originates in China and is coming into the United States through the Mexican border. The drug is also being sent into the U.S. over the Canadian border and from China through the U.S. mail.

County officials said they are drilling down as hard as possible. 

Since 2016, the federal government assigned an analyst exclusively to Suffolk County Police Department to examine overdose information with maps and weekly and monthly overdose reports. The mapping system, known as High Intensity Drug Trafficking Areas program, or HIDTA, provides a real-time picture of overdoses. It also helps identify and coordinate candidates for the county’s preventing incarceration via opportunities for treatment program known as PIVOT for short. 

“Everything we do is driven by analytics,” Hart said.

The county has also been using court-sanctioned surveillance methods such as phone tapping and search warrants to crack down on drug crimes. It issued more than 350 narcotics search warrants in 2018 and has eavesdropped on more than 150 phone lines. Consequently, the county has seized greater amounts of certain drugs and illegal firearms. 

The officials said during their presentation that it’s targeting dealers who cause overdoses and charging them with manslaughter. Sini said that through surveillance, he’s learning that tougher manslaughter statutes result in dealers turning away from deadly drugs to instead
peddle nonlethal drugs. 

In 2018, the county also launched a sex trafficking unit that has identified and interviewed more than 200 sex trafficking victims. It has arrested 34 people for 235 counts of sex-trafficking related charges and learned during the interviews how drug traffickers use opioids to addict young women to keep them dependent.

Toulon said that they’re gathering information while the women are in the sheriff’s facility, which is providing other useful information on drug and sex traffickers. 

Victims, while in the sheriff’s facility, are involved in vocational and educational programs and put in touch with nongovernmental organizations that assist with counseling, drug treatment and job training.  A big problem, though, Toulon said, is housing.  

County officials emphasized that human trafficking is happening right here, right now in our communities. It can affect anyone from your neighbor to your niece and nephew. 

Officials are also calling for the use of different terminology for prostitution.  

“It’s a modern-day form of slavery and needs to be called what it is: sex trafficking,” Hart said. The force has historically arrested the women and that was the case, Hart said, but the county’s approach is shifting and officials are now looking at the women as victims.  

Officials are asking people to trust their own  instincts. 

“If you’re at a 7-Eleven and you see an older man in a car with a young woman who looks distressed, call or text us,” the officials said.

The county initiated a Text-a-Tip program. To reach officials, text TIP SUFFOLK to the number 888-777. Residents can confidentially share any information related to illicit or suspicious activity, including drug use or trafficking, Toulon said. 

Paul Tonna, who serves as executive director of the village organization, said in a telephone interview after the event that a group of mayors were previously given a private presentation on the topic in graphic detail. The situation, he said, is horrible. The women are being forced to perform six or seven sex acts a day. He is calling for people such as PTAs and religious groups to sponsor awareness campaigns with officials.

Local villages have resources, Tonna said, such as constabulary that can also become the eyes and ears of county officials. 

“We’re not here to say you need to do more,” Sini said. ”We need to think outside of the box. Because of collective efforts, we can make greater strides.”

Ann Marie Csorny is director of Suffolk County Department of Health Services’ Community Mental Hygiene Services.  The Prevention Resource Center, run by the Family Service League, she said, offers effective tools for those working to prevent drug and alcohol abuse.  Villages and towns, she said, should tap into coalitions that exist or start to build their own coalitions.

“Communities can have a great impact in terms of preventing or reducing drug use, alcohol abuse and related problems when they understand and promote coalition building,” she said. “This can be very exciting in that involved communities promote civic engagement and the building of shared understanding, shared norms, shared values, trust, and cooperation.”

 

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

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 traditional methods of Alcohol Anonymous are helping people overcome addiction to opioids.

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.                

State senators at THRIVE press conference. Photo by Maureen Rossi

Advocates say new budget has wins for people in recovery

By Maureen Rossi

With the opioid epidemic still endemic throughout Suffolk County and beyond, New York State senators are hoping the new state budget will mean more help for those in the throes of addiction.

Measures woven into and passed in the state budget include increasing access for those suffering with substance use disorder to access 28-day inpatient and outpatient programs without prior insurance authorization.  They also include money for a recovery high school start -up and no prior authorization for medication- assisted treatment.  

“These are critical reform measures,” said New York State Sen. Monica Martinez (D-Brentwood). In addition, she touted another reform, which will require emergency rooms to enact screening, brief intervention and referral to treatment for all overdose patients before they are released. For the first time, emergency room doctors will also initiate medically-assisted treatment to overdose patients prior to their release, utilizing drugs like buprenorphine that alleviate the craving for opioids including heroin. 

Long Island advocates rally in Albany for the state to do more about the opioid crisis on LI Lobby Day in March. Photo from Friends of Recovery NY

Martinez was joined by her Democratic colleagues at a press conference in Islandia April 12.  Senators Anna Kaplan (D-Great Neck), James Gaughran (D-Northport), Kevin Thomas (D-Levittown) and Todd Kaminsky (D-Long Beach) gathered at THRIVE Long Island, a community center for people in addiction recovery whose funding was a legislative win three years back.

The Island’s Democrats were joined by stakeholders to celebrate critical initiatives passed in this year’s state budget to combat Long Island’s pernicious opioid epidemic. Those stakeholders include parents of those lost to the epidemic, those in recovery and those in the prevention and addiction field, including the CEO of Family & Children’s Association Jeffrey Reynolds, of Smithtown.

 “There is still much work to be done to combat the opioid epidemic we are seeing here on Long Island,” Martinez added.  She looked to Reynolds to the right of the podium and shared that he was tenacious in getting the Long Island’s senators’ attention as the hours dwindled in budget meetings. “He used social media and tagged every single one of us and let us know what funding was missing in the budget.”

Kaplan said the crisis affects every community, every school and every community.   

“Too many innocent souls have been lost to this disease, they have been failed time and again,” Kaplan said.  “We are done with half-measures — we will do everything we can to help people get into long-term recovery.”  

One such measure included and passed in the budget was the funding of another THRIVE center for Nassau in Hempstead. The doors are scheduled to open next month.

Kaminsky met with some Long Island parents who lost loved ones to the epidemic prior to the budget process. Figures released by the addiction experts on Long Island put that figure at 3,400 since 2010.

“When a parent tells you the story of how they found their child (dead), you want to make sure another parent doesn’t experience that,” said Kaminsky.   

When it came to budget negotiations that lasted around the clock, the state senator said they would not take no for an answer.  

Suffolk County has long been a powerhouse when it comes to shining a light on the opioid epidemic and taking legislative measures to address it. Packages of historic bills have been pushed through statewide by Suffolk County advocates. The county is one of the state’s hardest hit counties and they were the first county in the country to file a lawsuit against Purdue Pharma, the makers of the drug OxyContin.  

Reynolds addressed the senators on behalf of the sixty-plus advocates present.  “ ‘Thank you’ seems insufficient. You promised on campaign trails you would do good for Long Island. Thank you so much for your efforts,” he stated.

However, Reynolds promised that he and the Long Island advocacy movement will always ask the senators to do more. 

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Linda Nuszen, Maryann Natale and Janet D'Agostino, parents who have lost children to opioid addiction, during an event dedicating a new garden at St. Charles Hospital May 18. Photo by Kyle Barr

They say it’s becoming impossible to walk through a crowd and not find at least one person who hasn’t been affected by the opioid crisis. On May 18 a group of more than 50 people, nearly all of whom have lost loved ones, or at least experienced the strain of a loved one having gone through the throws of addiction, gathered at St. Charles Hospital for the unveiling of a new “Remembrance and Reflection Garden” just outside the Infant Jesus Chapel on hospital grounds.

The idea started with Port Jefferson resident Marcia Saddlemire, whose daughter Nicole passed away as a result of opioid addiction in 2015. She said she didn’t want to leave the memory of her daughter as just an opioid addict.

“I was getting angry watching the news, when they say so many died from overdose in Suffolk County this year, I said dammit, she’s not a statistic, she’s a person, she has a name and a life,” Saddlemire said. “All the mothers agree with this, they don’t want to grow up to be addicts. This is not what they wanted from their lives, they had dreams, they had goals.”

Stones dedicated to families affected by opioid addiction in a new garden at St. Charles Hospital. Photo by Kyle Barr

Saddlemire said she didn’t have the connections or know-how to create such a project, so she managed to get in contact with three women — Janet D’Agostino, Maryann Natale and Linda Nuszen — all of whom belong to multiple anti-opioid organizations and support groups. They gathered together to plan and create the new garden.

“We want it to be public — we don’t want to hide it,” said Natale, whose son Anthony died of an overdose. “We want them to know it’s an epidemic. This garden also helps those families who are going through such time with an addict.”

St. Charles Hospital was chosen as the location for the garden because of its existing programs fighting opioid addiction, according to the mothers. The hospital has 40 beds that are allotted for chemical dependency rehabilitation, 10 for supervised detoxification for adults and four for detoxification of adolescents age 12 to 18. Jim O’Connor, the executive vice president of St. Charles Hospital, said administration expects to receive another 10 beds for detoxification services. He said he also expects to develop an outpatient center at the hospital for addicts who need ongoing, comprehensive care in the next several years.

“We are honored that these families have chosen St. Charles Hospital as the site for this very special garden, as St. Charles is committed to hosting hospital programs which combat Suffolk County’s current addiction crisis,” O’Connor said.

Stones dedicated to families who have lost loved ones to opioid addiction in a new garden at St. Charles Hospital. Photo by Kyle Barr

Nearly all work for the project was donated by local businesses. The garden includes stones engraved with the names of victims of opioid addiction and quotes from their families. Ron Dennison and his son Alan from Bohemia-based Long Island Water Jet donated their time to create a heart sign featured in the garden. The sign features large words like “forgiveness” and “understanding” along with small words like “pain” and “fear,” to show positive emotions overcoming the negative.

Dennison’s daughter, Sarah, went through the St. Charles rehab program when she became addicted to opioids. She is out of the program now, and she has a daughter named Serenity.

“When your kids are addicted, you deny it, you deny it, you deny it,” the elder Dennison said as he fought to speak through tears. “And then one day you wake up you say, ‘what is going on here.”

Nuszen and her family founded Look Up for Adam, a foundation dedicated to her son who died from an overdose in 2015. Her organization helps to raise awareness.

“So many people don’t know how to show up for our loved ones,” she said. “So many people don’t know how to be themselves, or how to be here for each other. So now that we can come here and have a place where we’re not isolated — so they come here and know they’re not alone, that there are people who care about them.”