Public Hearing - May 2, 2014

    


       1      BEFORE THE NEW YORK STATE SENATE MAJORITY COALITION
              JOINT TASK FORCE ON HEROIN AND OPIOID ADDICTION
       2      ------------------------------------------------------

       3                 PUBLIC FORUM:  RICHMOND COUNTY

       4       PANEL DISCUSSION ON STATEN ISLAND'S HEROIN EPIDEMIC

       5      ------------------------------------------------------

       6
                               Jewish Community Center of
       7                       Staten Island Auditorium
                               1297 Arthur Kill Road
       8                       Staten Island, New York 10312

       9                       May 2, 2014
                               1:00 p.m. to 4:00 p.m.
      10

      11

      12      PRESENT:

      13
                 Senator Philip M. Boyle, Task Force Chairman
      14         Chairman of the Senate Committee on Alcoholism and
                 Drug Abuse
      15

      16         Senator Andrew J. Lanza, Task Force Forum Moderator
                 Member of the Joint Task Force
      17
                 Senator Diane J. Savino
      18         Member of the Joint Task Force

      19         Assemblyman Michael Cusick

      20

      21

      22

      23

      24

      25







                                                                   2
       1
              INTRODUCTIONS - ROUNDTABLE PARTICIPANTS:       PAGE 16
       2
              Boris Natzen
       3      Owner
              Nate's Pharmacy
       4
              Dr. Daniel Messina
       5      President and CEO
              Richmond University Medical Center
       6
              Dr. Russell Joffe
       7      Chair of Psychiatry
              Staten Island University Hospital
       8
              Tony Ferreri
       9      President and CEO
              Staten Island University Hospital
      10
              Dr. Hillary Kunins
      11      Acting Executive Director Commissioner
                 for Mental Hygiene
      12      New York City Department of Health
                 and Mental Hygiene
      13
              Diane Arnett
      14      President and CEO
              Community Health Action of Staten Island
      15
              James Fiore
      16      Resident of Dongan Hills, Staten Island
              Resident of Community Health Action
      17         Outpatient, Student of CSI

      18      Candace Crupi
              Barry Crupi
      19      Parents

      20      Brian Hunt
              Parent
      21      Resident of Princes Bay

      22      Luke Nasta
              Executive Director
      23      Camelot Counseling

      24      Jacqueline Fiore
              Executive Director
      25      YMCA Counseling Service







                                                                   3
       1
              SPEAKERS (Continued):                          PAGE
       2
              Adrienne Abbate
       3      Executive Director
              Staten Island Partnership for
       4         Community Wellness, and Project Director
                 for the Tackling Youth Substance Abuse
       5         Initiative.

       6      Gary Butchen
              President and CEO
       7      Bridge Back to Life Center

       8      Edward Delatorre
              Assistant Chief, Commanding Officer of the
       9         Uniformed Force, NYPD, Staten Island

      10      Dominick Dorazio
              Captain
      11      Commanding Officer, Staten Island Narcotics

      12      Karen Varriale
              Assistant District Attorney
      13      Representing Dan Donovan and the
                 Richmond County District Attorney's Office
      14
              James J. Hunt
      15      Acting Special Agent in charge of
                 New York Field Division,
      16      Drug Enforcement Administration

      17
              PERSONAL STORIES                               PAGE 19
      18
              START OF PANELIST PARTICIPATION                PAGE 40
      19
              AUDIENCE PARTICIPATION AND Q&A                 PAGE 52
      20

      21

      22                            ---oOo---

      23

      24

      25







                                                                   4
       1             SENATOR BOYLE:  If everyone could stand just

       2      for the Pledge of Allegiance, please.

       3                  (All present recite, as follows:)

       4                  "I pledge allegiance to the flag of the

       5        United States of America and to the republic for

       6        which it stands, one nation under God,

       7        indivisible, with liberty and justice for all."

       8             SENATOR LANZA:  Good afternoon, everyone.

       9             My name is Andrew Lanza, and I have the

      10      privilege of serving the people of Staten Island in

      11      the New York State Senate.

      12             Before we begin the program, I would just

      13      like to introduce the Chairman.

      14             This is, as you know, we're here to meet as

      15      part of the New York State Senate Task Force on

      16      Heroin and Opioid Addiction.

      17             Senator Phil Boyle from Long Island is the

      18      Chairman of this Task Force, and he's been gracious

      19      enough to come out -- come out here to

      20      Staten Island, from Long Island, today, so let me

      21      first introduce him.

      22                  [Applause.]

      23             SENATOR BOYLE:  Thank you, Senator Lanza.

      24             And I would like -- also like to thank

      25      another member of the Heroin Task Force,







                                                                   5
       1      Senator Savino.  Thank you very much.

       2             And, Assemblyman Cusick and

       3      Assemblywoman Malliotakis, and thank -- welcome --

       4      it's a nice welcome to be here on Staten Island.

       5             And thank you for the Jewish Community Center

       6      for hosting this.

       7             This is the ninth of 17 forums facing this

       8      heroin and opioid epidemic we're looking at across

       9      the state.

      10             What we're specifically asking for -- and we

      11      have a distinguished panel here, and I'm looking

      12      forward to hearing their ideas -- focusing on the

      13      areas of prevention, treatment, and law enforcement.

      14             So we have a panel here that can give -- are,

      15      basically, experts in each of those areas.

      16             And for those of you in the audience, we'll

      17      open it up for questions a little bit later.  You

      18      can write down a question.

      19             And, whether you're a law-enforcement

      20      official, an educator, a treatment provider, a

      21      family member, an addict -- we've had numerous

      22      testimony from each -- to say, "If I had an

      23      opportunity to change a couple laws in

      24      New York State, to help us combat this heroin

      25      epidemic," please give us the ideas.  That's what







                                                                   6
       1      we're looking for.

       2             The Task Force is going to have a report due

       3      June 1st, and we're going to have subsequent

       4      legislation passed in the State Senate; and so we're

       5      looking for ideas.

       6             We're looking for a great exchange of ideas

       7      today.

       8             Thank you, Senator.

       9             SENATOR LANZA:  So, very quickly, we're here

      10      to listen.

      11             Let me just say, no one here needs to --

      12      doesn't know how widespread and devastating this

      13      problem of opioid addiction is, both here in

      14      Staten Island and across the state.

      15             It is a national epidemic.

      16             In a 10-year period, leading up to 2012, in

      17      New York City alone, 10,000 of our neighbors --

      18      brothers and sister, mothers and fathers --

      19      10,000 residents of New York City lost their lives

      20      to opioid addiction and overdose.

      21             "10,000."

      22             When we hear of deaths occurring as a result

      23      of other causes, they're often national debates,

      24      there's discussion from the White House, from the

      25      Attorney General, from every elected official across







                                                                   7
       1      the country.

       2             We don't believe enough is being done to deal

       3      with this problem that is taking so many of our

       4      friends' and neighbors' and family members' lives.

       5             On Staten Island alone, over the last year

       6      and a half, more than 130 people lost their lives.

       7             Just think about that:  130 of our neighbors

       8      lost their lives.

       9             More people died in New York City over the

      10      last 10 years from opioid addiction than did in the

      11      terrorist attacks of 9/11.

      12             This is a situation, this is an epidemic,

      13      that is affecting all of us, every one of us.

      14             The gateway, interestingly enough, to heroin

      15      addiction, as reported by a story in

      16      "The Washington Post," 80 percent of all people who

      17      try heroin first tried a prescription drug.

      18             And, so, the availability and access to those

      19      drugs has really become a gateway to the heroin

      20      epidemic that we now see raging across the state,

      21      the city, and the country.

      22             And so, as Senator Boyle stated, the purpose

      23      here is to bring stakeholders, experts, those who

      24      are affected by this problem, together, so that we

      25      can really begin to turn back the tide of this







                                                                   8
       1      epidemic.

       2             The first step here, and the reason why

       3      Assemblyman Cusick is here -- he's not in the

       4      Senate, although he does live in my district, so

       5      I'll pay attention to whatever signatures he starts

       6      gathering -- but the reason he's here, he sits here,

       7      too, as a government expert in terms of, given the

       8      fact that's wrote the I-STOP Bill in the Assembly.

       9             My good friend and colleague from

      10      Staten Island, also representing parts of Brooklyn,

      11      Senator Savino is a member of this Task Force.  And,

      12      I can't tell you how many conversations we've had

      13      over the last several years, in terms of people we

      14      know, conversations we've had.

      15             This is -- this problem is reaching into

      16      every single neighborhood, every single house, and,

      17      enough is enough.  We've got to do something about

      18      it.

      19             We've got, I think, the right group of people

      20      here on Staten Island who have the expertise, the

      21      commitment, the dedication, and the wisdom to come

      22      together, to really start to turn this thing around.

      23             So with that, I'm going to introduce

      24      Senator Savino.

      25             SENATOR SAVINO:  Thank you, Senator Lanza.







                                                                   9
       1                  [Applause.]

       2             SENATOR SAVINO:  I want to say a special

       3      thank you to Senator Boyle, the Chair of this

       4      substance-abuse committee in the New York State

       5      Senate, and, of course, my colleagues on both sides

       6      of me, Assemblyman Cusick and Senator Lanza.

       7             And then, of course, all of the experts that

       8      are here today, those of you in the audience that

       9      are service providers, those of you who are family

      10      members, those of you in law enforcement, you've

      11      been dealing with this issue for a very long time.

      12             You know, 20 years ago, 25 years ago, when

      13      I was a caseworker working in the city's

      14      child-welfare system, the vast majority of children

      15      that we were taking away from parents were children

      16      born with a positive toxicity.  The majority of them

      17      were born positive tox to cocaine.

      18             The city was in the midst of a crack epidemic

      19      then.

      20             Drug trends come and go.  You know, the drug

      21      of choice that becomes the most abused has a

      22      tendency to go through stages.

      23             But there is one drug that has always been

      24      with us, and one drug that always comes back no

      25      matter what, and that is heroin.







                                                                   10
       1             So last -- two years ago, when we began the

       2      fight to tackle the opioid-abuse and

       3      prescription-drug problem that was led by these

       4      two gentlemen on either side of me who wrote the

       5      I-STOP law, a landmark piece of legislation, you

       6      could almost predict, though, that we would have to

       7      tackle this other issue, because these drugs that

       8      young people are abusing now, those prescription

       9      drugs that Senator Lanza talked about, they are far

      10      more addictive than anyone ever could have imagined.

      11             25 years ago, no one could have imagined a

      12      thing called a "super-opioid."

      13             No one could have seen the level of addiction

      14      that Oxycontin could produce in people.  And that's

      15      what we're fighting against.

      16             We're trying to find a way to restrict those

      17      dangerous drugs, and we're trying to find a way to

      18      prevent the next wave.

      19             Heroin has always been with us, but it's more

      20      dangerous now because of the level of addiction

      21      that's out there, and the young people who have been

      22      exposed to it.

      23             And not just young people, old people, too

      24      who have been exposed it to, because they've been

      25      given a prescription for a drug that no one could







                                                                   11
       1      ever have imagined could be so addictive.

       2             So, this, what we're doing today is so

       3      important:  Not just examining the trends, not just

       4      talking about the effect, but also, trying to come

       5      up with solutions, because this is going to

       6      continue.

       7             Until and -- unless and until we figure out

       8      how to cure addiction, and I really wish those

       9      pharmaceutical companies that spend so much money

      10      researching and developing addictive drugs would

      11      spend a little bit of that money on researching

      12      addiction.

      13                  [Applause.]

      14             SENATOR SAVINO:  Maybe they could come up

      15      with a pill that cures that.

      16             But until they do, our work will not be done.

      17             So I want to thank all of you for coming, and

      18      participating.

      19             And I want to a special shout-out to my good

      20      friend, former

      21      Councilman Dominic M. Riccia, Jr. [ph.], who is here

      22      in the front row.

      23             He and I worked together in Coney Island for

      24      years, where there are several drug programs that

      25      struggled with the issues of addiction.  And heroin







                                                                   12
       1      is prevalent right there, too, so he knows what it's

       2      like to represent people who are trying to fight

       3      against this scourge.

       4             Thank you, everyone.

       5                  [Applause.]

       6             SENATOR BOYLE:  Assemblyman Cusick, would you

       7      like to say a couple of words?

       8             ASSEMBLYMAN CUSICK:  Thank you.

       9             Thank you.

      10             Thank you, Senator Boyle, for coming to

      11      Staten Island.

      12             I just want to welcome Phil.

      13             Phil is a Senator now, but Phil did come from

      14      the State Assembly, so I want to take credit for

      15      Phil being a member of the State Assembly.

      16             I feel a little outnumbered up here.

      17             But, I just want to thank Senator Lanza and

      18      Senator Savino for making sure that this Task Force

      19      had a meeting here on Staten Island, because it's

      20      very important.

      21             Many of the folks in the audience, sitting

      22      out, we know each other's faces and names.  We know

      23      each other from fighting the good fight when it

      24      comes to the epidemic with prescription drugs, with

      25      heroin, with substance abuse.







                                                                   13
       1             And it is a team effort, and it is a

       2      community that has to come together, to make sure

       3      that we can fight this together.

       4             You know, and part of this is, there was

       5      mention of the reason why I'm up here is that, I was

       6      the author in Assembly of the I-STOP legislation,

       7      and teamed up with Senator Lanza to get that passed.

       8             That started with, not as big as this

       9      roundtable, but it started as a roundtable.

      10             It started as a roundtable at the South Shore

      11      YMCA, about, in 2010 or 2011.  And, it was a smaller

      12      group, but it was from discussions of community

      13      groups.  It was from discussions of counselors.  It

      14      was from discussions of medical professionals.  It

      15      was discussions from our law enforcement.

      16             This is an issue that is fought on many

      17      fronts.

      18             You have the enforcement front, you have the

      19      legislative front, and you have the treatment front.

      20             And there are many other fronts to fight this

      21      epidemic.

      22             The -- you think about I-STOP, is that --

      23      the numbers aren't out yet, but, we are very

      24      confident that it is working, and that it is cutting

      25      down on doctor shopping, and that it is cutting down







                                                                   14
       1      on the availability of the prescription drugs.

       2             And I do have to say, that this man sitting

       3      next to me, Mr. Luke Nasta, had said it at our

       4      first roundtable that Andrew and I had at the

       5      South Shore YMCA; he said, that:  You know, we'll be

       6      successful in this, but things with heroin are

       7      still -- they're on the rise as we speak.

       8             And the heroin issue was always there when we

       9      tackled the prescription drug.  And it was all part

      10      of this.

      11             And although we cut down on the -- we focused

      12      on the enforcement and we focused on the doctor

      13      shopping.

      14             We always had in the back of our heads that

      15      the next step would be the treatment, and providing

      16      the proper treatment for those who had this

      17      addiction to heroin.

      18             So I want to just thank you, Senator Lanza,

      19      Senator Savino, and Senator Boyle, for having me as

      20      part of this panel, and I look forward to the

      21      discussions today.

      22             Thank you.

      23             SENATOR LANZA:  And before we turn this

      24      over --

      25             Thank you, Assemblyman.







                                                                   15
       1             Before we turn this back over to the

       2      Chairman, Senator Boyle, let me tell you how this is

       3      going to work today.

       4             We're going to hear from a number of

       5      categories of panelists.  We're going to hear from

       6      some of our neighbors, parents, and even someone

       7      who's fighting addiction.

       8             So, we're going to hear from those who are

       9      personally affected.

      10             We're going to hear from public-health

      11      experts, from both hospitals here, and others, here

      12      on Staten Island.

      13             We're going to from our law enforcement who

      14      are really at the front lines in terms of some of

      15      the aspects of this epidemic.

      16             We're going to hear from, as

      17      Assemblyman Cusick just mentioned, folks like

      18      Luke Nasta, experts on recovery and treatment.

      19             And, finally, there will be a conclusion.

      20             So, Senator Boyle.

      21             SENATOR BOYLE:  Thank you.

      22             SENATOR LANZA:  And I just have to do this,

      23      but, someone who helped work with us on the

      24      I-STOP Bill is here, Former Assemblyman Lou Tobacco.

      25             I want to acknowledge his presence.







                                                                   16
       1                  [Applause.]

       2             SENATOR BOYLE:  Thank you very much, Senator.

       3             And, now, if we could just have the panelists

       4      briefly introduce yourself and where you're from.

       5             We can go around, and we can make statements

       6      a little bit later, but, just, we want to know where

       7      you're from and your current position.

       8             BORIS NATZEN:  Boris Natzen, the owner of

       9      Nate's Pharmacy.

      10             DR. DANIEL J. MESSINA:  Dan Messina,

      11      president and CEO of Richmond University Medical

      12      Center.

      13             DR. RUSSELL JOFFE:  Russell Joffe, chair of

      14      Psychiatry at Staten Island University Hospital.

      15             ANTHONY C. FERRERI:  Tony Ferreri, president

      16      and CEO of Staten Island University Hospital.

      17             DIANE ARNETT:  Diane Arnett, president and

      18      CEO, Community Health Action of Staten Island.

      19             JAMES FIORE, JR.:  James Fiore, resident of

      20      Dongan Hills, Staten Island.  And I'm a resident of

      21      Community Health Action Outpatient, student of CSI.

      22             CANDACE CRUPI:  Candace Crupi.  I'm

      23      Jonathan Crupi's mom.

      24             BARRY CRUPI:  Barry Crupi, Jonathan's father.

      25             BRIAN HUNT:  My name is Brian Hunt, and I'm a







                                                                   17
       1      broken-hearted father.  I'm from Princes Bay.

       2             Two months ago today, I lost my son to a

       3      heroin overdose.

       4             LUKE NASTA:  Luke Nasta, executive director

       5      of Camelot Counseling.

       6                  [Applause.]

       7             JACQUELINE FIORE:  Jackie Fiore, executive

       8      director of the YMCA Counseling Service.

       9                  [Applause.]

      10             ADRIENNE ABBATE:  Adrienne Abbate,

      11      executive director of the Staten Island Partnership

      12      for Community Wellness, and the project director for

      13      the Tackling Youth Substance Abuse Initiative.

      14                  [Applause.]

      15             GARY BUTCHEN:  I'm Gary Butchen, the

      16      president and CEO of Bridge Back To Life Center.

      17             We're a network of outpatient programs here

      18      on Staten Island, Brooklyn, Manhattan, and

      19      Long Island.

      20                  [Applause.]

      21             ASST. CHIEF EDWARD DELATORRE:  Assistant

      22      Chief Edward Delatorre, commanding officer of the

      23      uniformed force, NYPD, Staten Island.

      24             CAPTAIN DOMINICK DORAZIO:  Captain

      25      Dominick Dorazio, commanding officer of







                                                                   18
       1      Staten Island Narcotics.

       2             KAREN VARRIALE:  Karen Varriale,

       3      assistant district attorney, representing Dan

       4      Donovan and the Richmond County DA's Office.

       5             JAMES J. HUNT:  James Hunt.  I'm the acting

       6      special agent in charge of New York Field Division,

       7      Drug Enforcement Administration.

       8             SENATOR BOYLE:  Thank you very much, ladies

       9      and gentlemen, and we look forward to your input.

      10             You know, when we hear a lot about this

      11      heroin epidemic, as Senator Lanza said, it's a

      12      nationwide, and certainly a statewide problem in

      13      New York.

      14             And coming from Long Island myself, we always

      15      heard about a particular area of difficulty in --

      16      with this heroin epidemic, and that was

      17      Staten Island.

      18             We have a big problem on Long Island, but

      19      Staten Island was really a center of the tragedy of

      20      this epidemic.

      21             And, we hear a lot about statistics and

      22      numbers, but, these are human faces behind that

      23      story.  There's losses, there's personal tragedies.

      24             And that's why we asked some family members

      25      to accompany us today, to tell us about their story.







                                                                   19
       1             And I would like to introduce

       2      Mr. Brian Hunt.

       3             BRIAN HUNT:  Thank you.

       4             Like I said, two months ago, I lost my son to

       5      a heroin addiction.  And needless to say, my family

       6      is devastated.

       7             We found out the hard way, the first time my

       8      son overdosed.

       9             And we did what most parents do, is we wanted

      10      to keep it quiet.

      11             And one of the reasons is -- that we're not

      12      hearing a lot about this epidemic, is that a lot of

      13      parents want to turn around and keep it hidden

      14      because they're embarrassed and ashamed.

      15             Now, let me ask a question here:

      16             Who in this audience knows someone that had

      17      passed away from a drug addiction?  Raise your hand.

      18             Keep your hands up, and keep them up high.

      19             I want this panel to look at this, and let

      20      this be the face of what this drug addiction is

      21      doing.

      22             Not me.  I'm a father, that's all.  I'm not

      23      an expert.

      24             But I will tell you --

      25             You can put your hands down.







                                                                   20
       1             I will tell you that this has to be looked at

       2      at three fronts:

       3             The first front is alcohol.

       4             Understand, that this all starts with

       5      alcohol, underaged drinking.  They get the liquor

       6      from the home.  They get the liquor from their

       7      friends.

       8             When the liquor is not available, someone

       9      turns around and says:  Hey, remember when my mom

      10      hurt her back?  The doctor gave her these pills,

      11      they're prescription.  They made my mother feel

      12      great.  It's from the doctor.  Take one.  Take two.

      13             Next thing you know they're addicted to the

      14      pills.

      15             They're available; they're in your medicine

      16      cabinets.  That's where they get them from.

      17             Now they have to go purchase them.

      18             Now you have no more money.  You can't afford

      19      20, 40 dollars a pill.

      20             What do you do?

      21             Someone pretending to be your friend turns

      22      around and says to you:  Hey, I have some heroin.

      23      I do it all the time.  Look at me.

      24             Meanwhile, he doesn't do it.

      25             He says:  Take it.  It's cheap: $5, $10.







                                                                   21
       1             They feel great, but you want to know

       2      something?  Once you put it up your nose or you put

       3      it in your arm, that's it.

       4             I want everyone to go online and look up

       5      "Miss Heroin," M-I-S-S Heroin, and see what that is

       6      all about.

       7             Because, you read that, that's what -- that

       8      was my son, exactly what took place.  And it's a

       9      look into the future.

      10             If you went on vacation, and I said to you,

      11      "Let me give you a look at what that vacation will

      12      turn out to be," and while you're looking, you're

      13      seeing:

      14             You went on vacation, everything was nice.

      15      You got in your hotel.  You got in your car and

      16      you're going to the beach.  And then, all of a

      17      sudden, you saw you got in an accident.  And maybe

      18      some members of your family did not survive.

      19             Would you go on that vacation?  Probably not.

      20             But if you did go on that vacation, guess

      21      what?  You wouldn't go down that road where you had

      22      that accident.  You'd go someplace else.

      23             And what is that?  You have knowledge.

      24             And that's what stops this epidemic, is

      25      knowledge.







                                                                   22
       1             When our children were growing up, when we

       2      sent them off to school, or we sent them to the

       3      park, what did we tell them?

       4             Don't talk to strangers.  Don't take anything

       5      from a stranger.  If someone wants to give you

       6      something, yell, scream, tell someone.  Tell a

       7      teacher, tell a cop, tell the crossing guard, tell a

       8      parent.

       9             Well, that still holds true today for our

      10      older kids, but the problem is, it's not only

      11      strangers.  The people that are doing and selling

      12      drugs could be the people in this front row, the

      13      people in the back row, could be somebody on this

      14      panel.

      15             The people that are doing it are friends and

      16      neighbors, and they are hiding in plain sight.

      17             I can tell you I just found out, four houses

      18      past me, behind me, father and son were selling

      19      drugs.  They're now not around anymore, but they

      20      sold drugs to my son.  That's five houses down.

      21             So we could be a mother, a father, a sister,

      22      a cousin.  It's not your typical guy that you could

      23      point out, He's a drug addict or a junky.

      24             My son wasn't a junky.

      25             My son was a good kid.  He was trying to make







                                                                   23
       1      a way for himself.

       2             Someone pretending to be his friend gave him

       3      something that was bad for him.

       4             And young kids today think everybody's their

       5      friend.

       6             But I can ask this panel and I can ask

       7      everyone here:  I'll bet you, 2-to-1, you can count

       8      your friends on one hand.  True friends.

       9             And as I told the kids at my son's wake,

      10      I said:  Listen, if you're a true friend, and you

      11      see someone in trouble, say something, do something.

      12      If they give you a hard time, go to their parents

      13      and tell the parent.  "Put the people in the know,"

      14      as the kids say.  Let people know about it.

      15             The more people that knew about my son having

      16      an addiction, the less people would invite my son to

      17      a party where there's going be alcohol.

      18             And when my son died, I found out, my son,

      19      30 days before he died, he went to a Super Bowl

      20      party, and had a drink.  And 30 days later my son

      21      overdosed on heroin.

      22             So, I don't want you ever standing here with

      23      me.  I don't even want to be here.  I would rather

      24      go back three months and do something different.

      25             When my son passed, I was not home.







                                                                   24
       1             Had I been home, maybe my son would be alive

       2      today.  But I was taking care of my father-in-law

       3      who was supposedly dying at that point in time.

       4             Unfortunately, he died ten days after that,

       5      so we had a double-whammy in the life.

       6             And I never told him about my son's

       7      addiction.

       8             But, we have to let people know.  We have to

       9      get people help.

      10             My son went to the Y.  They helped him

      11      tremendously.

      12             Adrienne from Tackling Youth Substance Abuse,

      13      I've been to one of their presentations.

      14             Let me tell you something:  Get involved with

      15      these people.

      16             Tackling -- with Adrienne, Tackling Youth

      17      Substance Abuse, they'll teach you how to go out in

      18      the world and talk to people, and explain to people

      19      what this drug addiction is doing to this island.

      20             But you have to get involved.

      21             And you have to be a parent.  Don't -- you

      22      don't want to be my best -- I'm your best friend to

      23      your son or your daughter.

      24             Be a parent, do what you're supposed to:

      25      Protect them, guide them.







                                                                   25
       1             And I will tell you, as far as, if you really

       2      want to know what we need to do, if I know I had a

       3      snake in my house, and it was going to hurt my

       4      family, what's the best way for me to get rid of

       5      that snake?  I'm going to cut its head off.

       6             These people here need to stop the influx of

       7      drugs onto this island.

       8             The people that are selling the drugs, you

       9      need to have a stiffer law.  People selling drugs,

      10      don't slap them on the wrist, become a first-time,

      11      you know, dealer.

      12             A drug dealer and a first-time drug dealer

      13      are the same to me.  If you sell drugs, in my

      14      opinion, you should go to jail forever.

      15             And you know what?  They say we don't have

      16      the room?  You have people sitting on death row for

      17      20 years.  Let's move it along, or build more jails,

      18      but you need to get the people off the street.

      19             We need to let people know on Staten Island,

      20      you sell drugs, eyes are on you.  Someone's going to

      21      say something.

      22             So we need to attack that on three fronts.

      23             The treatment, we need to go back to the

      24      schools.

      25             What happened to having No-Drug Week in







                                                                   26
       1      schools?

       2             These kids are learning about drugs on the

       3      streets.

       4             Get back in, teach these kids what drugs are

       5      about.

       6             The more knowledge you have, the better you

       7      are prepared to turn around and say:  No, sir,

       8      I don't want that.  I'm not taking that.

       9             And understand, the drug dealers and this

      10      epidemic does not care how much money you have,

      11      where you live, or what job you have.  It's going to

      12      affect everybody.

      13             And I'm sure that -- I'm sure if I asked this

      14      panel to raise their hand, they would be able to

      15      tell you, "Yeah, we know someone."

      16             So they're familiar with it.

      17             So we now need these people to put their

      18      heads together, and with you, with your suggestions,

      19      to be able to come up with a plan to, I say, fight

      20      the drugs coming in here.

      21             Arrest the people that are dealing the drugs,

      22      put them in jail for life; get them off the street.

      23             And, educate our children, going forward.

      24             Plus, you need to financially support the

      25      groups that are helping.  Like this young man here,







                                                                   27
       1      and that group in the back, they need to be

       2      supported.

       3             We need to help the people that are in crisis

       4      now.

       5             We can always go back and help the kids that

       6      are young, and make them understand what damage it

       7      does do.

       8             But we need to set -- we need to support the

       9      agencies that help the people with the addiction.

      10             Anybody here quit smoking?  [Raises hand.]

      11             I quit smoking.  Damned hard; right?

      12             Imagine trying to quit heroin.  That's really

      13      hard.

      14             And my son fought that fight.  He went away,

      15      he got treatment.  He was clean for nine months.

      16             I still don't know what caused my son to do

      17      what he did, but at the end of the day, on my son's

      18      death certificate, it says, "acute heroin

      19      intoxication."

      20             And that's my story.

      21             And for the rest of my life, I have to live

      22      without my son.

      23             You know, we have memories.  I can't put my

      24      arms around a memory.

      25             So, this epidemic has taken my son, much like







                                                                   28
       1      the Crupi family.

       2             And I don't want anyone else, and we'll share

       3      in that, we do not want anyone else to share what we

       4      have.  Believe me.

       5             There is a piece of us missing, and people

       6      say, "time heals all wounds."

       7             No, it does not, because, there is a hole in

       8      us.  There is a piece of us gone forever.

       9             Please, if you know something, you see

      10      something, say something.  Step up.

      11             If you're a friend, tell someone, because

      12      people need help.  We cannot -- we cannot put this

      13      underneath the carpet any longer.

      14             I will applaud Senator Lanza for getting --

      15      making it harder to get pills, but if I wanted to be

      16      critical, I would say we should have went after

      17      heroin first, and then go after the pills.

      18             But, they did a magnificent job doing that,

      19      and I applaud everyone.

      20             And I applaud everyone here for coming forth,

      21      to put forth a plan to finally get rid of the

      22      epidemic in Staten Island.

      23             Thank you, and God bless you.

      24                  [Applause.]

      25             SENATOR BOYLE:  Thank you so much,







                                                                   29
       1      Mr. Hunt.  Thank you for sharing your story.

       2             We now hear from Miss Candace Crupi.

       3             CANDACE CRUPI:  And, good afternoon.

       4             I lost Jonathan in Conosco once, when he

       5      was 4, and it took me 20 minutes to find him.

       6             By the time I saw him, I was frantic.

       7      I smacked him on the bottom and told him never to

       8      wander from me again.

       9             And with tears in his eyes, Johnnie looked at

      10      me and said:  Mom, you're making me hit my children.

      11             And I thought that was kind of profound.

      12             He was a happy, loving caring kid.

      13             When he was 7, he wanted to be a priest, but

      14      settled to be an altar boy.

      15             At age 9, the priest asked for volunteers

      16      because there was a shortage of ushers, and the next

      17      week he came to church in his suit to help out.

      18             Jonathan was a high-achiever.  There was so

      19      much he wanted to do.

      20             He always had high grades.  He was a Boy

      21      Scout.  He earned a black belt in karate.  He played

      22      every sport imaginable.  He took music lessons, he

      23      played.

      24             My whole job was just to usher him from place

      25      to place.  My car looked like a changing room.







                                                                   30
       1             Life with Johnnie was always an adventure.

       2             That all stopped the day, when he was in

       3      seventh grade, at the age of 12, he was introduced

       4      to alcohol.  His first experience with liquor put

       5      him in the hospital, where he stayed for three days

       6      because of alcohol poisoning.

       7             That was the beginning of John's addiction.

       8             He quickly got bored of liquor and started

       9      smoking pot.

      10             When that didn't do enough, he started on

      11      pills.

      12             By the time he was 16, he was hopeless --

      13      helplessly addicted to oxycodone.

      14             The only reason he went to heroin was because

      15      he couldn't afford oxycodone anymore.

      16             I can't count the detox, rehab, and

      17      counseling stints he did.

      18             Jonathan was once given a choice of drug

      19      rehab, which he knew would be nine months; or

      20      four months in jail, which he knew would be actually

      21      two months for good behavior.

      22             Well, he chose jail.

      23             We were always told that he wouldn't stop

      24      unless he wants to.  Or, he has to hit bottom before

      25      he'll stop.







                                                                   31
       1             We kicked John out for days or weeks.  He

       2      would go into the woods or sneak in stairwells to

       3      sleep.

       4             How far is bottom?

       5             The problem is, how they -- how can they want

       6      to stop if they can't think straight?

       7             These drugs take over their whole way of

       8      thinking until they just can't think for themselves

       9      anymore.

      10             And in the obituaries, there's a certain age

      11      group, from 17 to 55.  And if you see "died at

      12      home," you know it was either a drug overdose or

      13      just too many years doing drugs.

      14             Everybody knows it, but nobody says anything

      15      because it's taboo.

      16             The families are left behind, feeling alone

      17      and frustrated and embarrassed because of their

      18      loved one's addiction.  And we need to fix this.

      19             You cannot define a person because of their

      20      addiction.  You need to remember them as they were

      21      before the addiction.

      22             Every single person, including my son

      23      Jonathan, started their life out on the good foot.

      24      They were happy, hard working, eager to please

      25      people, that had dreams and ambitions, and loved







                                                                   32
       1      their families, until they met drugs.

       2             I will always be grateful to the many people

       3      who have tried to help John, but, somehow, I think

       4      the approach to treating addiction has to be

       5      different because we're losing too many loved ones.

       6             I think drug rehab should be funded by the

       7      pharmaceutical companies.  They're making ridiculous

       8      amounts of money, and they're reaping all the

       9      benefits but sharing none of our sorrow.

      10             What about the new and stronger oxycodone?

      11             Instead of Percocet or Vicodin, which is a

      12      about a third oxycodone and two-thirds analgesic,

      13      the FDA just okayed a new pill which is 100 percent

      14      oxycodone.

      15             What's wrong with this picture?  What are

      16      they thinking?

      17             The drug companies also came out with the

      18      nasal spray called "naloxone" that can block the

      19      effects of an opioid overdose.  And they're handing

      20      them out and training people to use them, which is

      21      great.

      22             The drug companies are trying to make us

      23      think that they're doing everything they can to

      24      help, which couldn't be farther from the truth,

      25      though.







                                                                   33
       1             I'm afraid it's going to give the families a

       2      false sense of security because, unless you're there

       3      when the person takes the heroin, it only takes a

       4      couple of minutes for the drugs to start working.

       5             Whether it's snorted or shot, it doesn't

       6      matter, both ways are deadly.

       7             Once a drug starts working, their breathing

       8      slows until they stop breathing all together.

       9             The whole process takes no more than

      10      15 minutes before that person dies.

      11             And I know this, because the overdose that

      12      killed Jonathan wasn't his first.

      13             Johnnie had a tattoo on his arm, and I loved

      14      it.  It said:  Every angel has a past, and every sin

      15      has a future.

      16             Let's work at giving these people so

      17      helplessly addicted to these drug a future.

      18             We need to erase the stigma or the

      19      embarrassment and treat these people like the loved

      20      ones that they are, and maybe they'll go for help.

      21             Thank you.

      22                  [Applause.]

      23             BRIAN HUNT:  Can I just interject for a

      24      moment?

      25             Candy said some very potent things.







                                                                   34
       1             And, you know, I want everyone to understand

       2      that drug -- drugs and the addiction is an illness.

       3      It's not a handicap.  And you shouldn't look upon

       4      someone as being deformed in any way.

       5             It's an illness.  Just like every other

       6      illness, just like cancer, it's the same thing, and

       7      it has to be treated.

       8             But I also wanted to say, for Mr. Hunt, and

       9      this board here:

      10             I was just informed the other night, when

      11      I went to the funeral for the John [unintelligible],

      12      the young boy that passed, and nobody knows why he

      13      passed yet, and I was told that there is a new

      14      synthetic drug out there today.  It's in New Jersey,

      15      and the chances are, it's going to be coming here.

      16             It's a little tab that you put on your

      17      finger, and you put it on your tongue or on your

      18      gum.  It's called an "N Bomb."

      19             And you know where the kids were ordering it

      20      from?  Online.

      21             That's been, obviously, stopped, but I'm sure

      22      there's ways of getting it.

      23             So, I think we need to be on the lookout for

      24      that, also.

      25             It's like LSD, and it, just -- you know, it







                                                                   35
       1      gives you hallucinations.

       2             But, I do have -- I do have a website that

       3      will explain to you everything about it, if anybody

       4      wants it.  It's a news reporter and also a police

       5      officer.

       6             And it is killing kids, 15, 16, 17 years old.

       7             Thank you.

       8             SENATOR BOYLE:  Thank you, Mr. Hunt.

       9             And thank you, Mrs. Crupi.

      10             We will now hear from a young man in

      11      recovery, James Fiori, Jr.

      12             James?

      13             JAMES FIORE, JR.:  Good afternoon.

      14             Oh, the mic.  Sorry.

      15             Good afternoon, ladies and gentlemen.

      16             My name is James Fiori.

      17             This afternoon, I'm going to share a part of

      18      my story, struggles, and hope with you all.

      19             I was born January 1, 1992; an ordinary boy

      20      with a middle-class Brooklyn family, who moved to

      21      Staten Island to have a better life for me and my

      22      little sister.

      23             Unfortunately, no matter where I moved, I was

      24      unable to get away from the addictive genes passed

      25      to me from my parents.







                                                                   36
       1             Regardless, Staten Island was my new home,

       2      and I truly enjoyed my childhood, until one fateful

       3      day, when I was about 14 at the time.  Sometimes

       4      I would sneak a cigarette, or a pull the joint with

       5      some friends.

       6             At the time, that was the extent of my drug

       7      use.  Like a lot of my generation, at that young

       8      age, I was experimenting.

       9             Then came the day, for better or worse, that

      10      shaped the rest of my life, and so many more lives

      11      on this island.

      12             I took my first Percocet at about 14.

      13             Excuse me.

      14             I loved the feeling it gave me, and my

      15      addictive genes kicked right in.

      16             My addiction progressed quickly, from taking

      17      a Perc or two, to snorting oxycodone, and Oxycontin,

      18      and needing any opiate just not to be sick.

      19             Very quickly, my life had been consumed by

      20      the horrors of opiate addiction and its dependence.

      21             I was raised a good young man, with respect,

      22      loyalty, and a good set of core values.

      23             When I was using, however, that all went out

      24      the window.

      25             As my tolerance grew, I would do things to







                                                                   37
       1      get pills I would never have dreamed.

       2             I sold all my valuable possessions, and stole

       3      from my parents and friends.

       4             In the end, I lost all of my true friends

       5      because they couldn't bear to see the drug addict

       6      I had become.

       7             This for me was the saddest and most

       8      oppressing point I've yet been in in my young life,

       9      because I knew what I was doing was wrong but my

      10      desire for opioids outweighed my conscience.

      11             Of course, the consequences of my addiction

      12      caught up with me and I was arrested.  I went

      13      through the system, and had a 4-year battle with

      14      courts, lawyers, and prison.

      15             I navigated through the system in order to

      16      keep felony charges off my record that would have

      17      permanently scared my future.

      18             At this time, I would like to thank my

      19      mother, Marie Fiori, for not giving up on me through

      20      these dark years.

      21             When I was released from prison, I was full

      22      of hope, but people, places, and things I couldn't

      23      stay away from.

      24             In a short time, I was back in the grips of

      25      full-blown addiction.







                                                                   38
       1             Thank God, at this time, a few people saw a

       2      light in myself that I thought was extinguished long

       3      ago; mainly, my counselor, Naomi; and the director

       4      of the Community Health Action,

       5      Angela Antonaccio [ph.].

       6             Through their guidance and counseling, I was

       7      encouraged to go on Suboxone, which, at the time,

       8      was the best thing I could have done.

       9             Excuse me.

      10             Since I've been taking my Suboxone as

      11      prescribed, and attending my daily groups at

      12      Community Health Action, I've been able to turn my

      13      life around, and the obsession to use pills and

      14      heroin are now gone.

      15             Now I go to college and outpatient five days

      16      a week.  I'm not perfect, and I still have slip-ups,

      17      but, overall, for the first time in years, I'm truly

      18      happy.

      19             I am now starting toward becoming a counselor

      20      at CSI.

      21             In my story, I want to stress the importance

      22      of Suboxone, with groups, and the willingness to

      23      stop using, as a major factor in the success of my

      24      recovery, thus far.

      25             With all respect, and sincerity, I would dare







                                                                   39
       1      broach one last topic with the ladies and gentlemen

       2      in this room.

       3             It is my firm belief that Suboxone can help

       4      other young people to fight the disease of opiate

       5      addiction and maintain successful clean time, just

       6      as it has helped me.

       7             I humbly ask a policy of Staten Island Task

       8      and Treatment Court clients having to be cut off

       9      Suboxone in order to complete their mandated term of

      10      treatment, to be changed.

      11             I hate to quote statistics, but,

      12      statistically speaking, the highest rate of lasting

      13      sobriety for long-term opiate addicts on Suboxone is

      14      for about two years, coupled with talk therapy.  And

      15      that has a success rate of about 50 percent.

      16             A 50 percent success rate may not seem

      17      significant, but it is significantly higher than any

      18      other modern method of opiate treatment.

      19             It is my firm belief that responsible

      20      individuals who take their medicine, not to get

      21      high, but as a chance to live -- excuse me, but as a

      22      chance to live a sober life, should be able to have

      23      a choice to stay on their medication, with their own

      24      willingness to stop, instead of being prematurely

      25      forced to be taken off of Suboxone before they can







                                                                   40
       1      graduate their mandated terms.

       2             I know policy change is not made easy, but

       3      with hope and education, I believe that this policy

       4      can be improved upon, for the sons, daughters,

       5      fathers, and mothers on our island who are suffering

       6      from this deadly disease of opioid addiction.

       7             In closing, I would like to thank the whole

       8      staff of Community Health Action for supporting me

       9      through both my failures and successes, and for

      10      continuing to be a guiding force and sober-support

      11      network in my life.

      12             I would also like to thank all of the people

      13      on this panel, the mothers, fathers, Senators,

      14      Councilmen, family members; everyone here for

      15      listening to me.

      16             Thank you, and respectfully and sincerely,

      17      James Fiore.

      18                  [Applause.]

      19             SENATOR BOYLE:  Thank you so much, James.

      20             Thank you for having the courage to share

      21      your story, and giving us some good idea, actually,

      22      for some legislation to look at as the panel

      23      progresses.

      24             I would like to now open it up to the

      25      panelists.







                                                                   41
       1             Our first area is going to be on public

       2      health, and the effect that the heroin epidemic and

       3      opioid epidemic is having on our hospitals, on our

       4      treatment facilities.

       5             If we could start with, perhaps,

       6      Dr. Messina, can you tell -- give us a little bit

       7      of your insights from Richmond University Medical

       8      Center?

       9             DR. DANIEL J. MESSINA:  Good afternoon.

      10             Thank you Senator Lanza and Senator Savino

      11      for organizing this critical forum.

      12             Staten Island has surpassed the rest of

      13      New York City, with 10.2 fatal overdoses per 100,000

      14      people.

      15             Heroin deaths were higher in the past years

      16      on our own mid-island and south shore than in any

      17      other neighborhood citywide.

      18             South Beach and Tottenville were in the top

      19      five neighborhoods in New York City.

      20             Thanks to city and state elected officials,

      21      naloxone was introduced, and the internasal drug is

      22      credited for saving lives of heroin overdoses if

      23      administered properly.

      24             The drug is now carried by police officers in

      25      Staten Island neighborhoods as part of a pilot







                                                                   42
       1      program.

       2             As of yesterday, Richmond University Medical

       3      Center's EMTs are all equipped with naloxone and

       4      trained to administer this life-saving medication.

       5             We were the first in the New York City 9/11

       6      system to be fully trained and carrying naloxone, a

       7      step we took to protect our community and stem the

       8      rise of overdoses seen in our borough.

       9             Richmond University Medical Center has made

      10      critical changes to our emergency department

      11      guidelines, to minimize the number of opioid pain

      12      killers prescribed upon discharge.

      13             We have further instilled in our emergency

      14      physicians that no long-acting opioids are to be

      15      utilized unless clearly necessary for proper

      16      treatment.

      17             The new guidelines are part of the

      18      New York City Emergency Department Discharge

      19      Guidelines.  The set of nine guidelines, along with

      20      clinical judgment and expertise, can help reverse

      21      opioid dependence and overdose.

      22             We are currently working with all of our

      23      physicians to implement new prescribing guidelines

      24      within their practices, as well, to minimize legal

      25      access to opioids, since the risk of addiction or







                                                                   43
       1      misuse is so widespread.

       2             Through our participation in the DEA's

       3      Drug Take-Back Program, Richmond University Medical

       4      Center collected more than 300 pounds of unwanted,

       5      expired, and unused prescriptions.

       6             The Joint Senate Task Force is a significant

       7      step towards awareness and action.

       8             My staff at Richmond University Medical

       9      Center looks forward to working with everyone on the

      10      panel, and with you, Senator Lanza, Senator Savino,

      11      to reverse trends and to educate Staten Island

      12      residents.

      13             Despite recent overdoses of high-profile

      14      celebrities in the media -- recently, Philip Seymour

      15      Hoffman, we all read the story -- many residents of

      16      our boroughs believe that heroin addiction cannot

      17      happen in our quiet neighborhood.

      18             It is happening here; just as it's happening

      19      even more dramatically in that quiet little Rutland,

      20      Vermont, neighborhood upstate.

      21             "New York Times" Reporter Kathleen Seeley

      22      described this crisis as a call to arms.

      23             And a recent "Rolling Stone" article

      24      described Vermont at the new face -- as the new face

      25      of heroin addiction.







                                                                   44
       1             Vermont's Governor Pete Shumlin devoted his

       2      entire State Of The State message to what he said

       3      was a full-blown heroin crisis.

       4             It's critical to pay attention to Vermont, as

       5      it paints a picture of the consequences of heroin

       6      addiction in a small community.

       7             Richmond University Medical Center is

       8      committed to being part of the solution: working to

       9      educate borough residents, working with our elected

      10      officials, and acting as a resource in the

      11      development of new policy solutions that will stem

      12      the tide of opioid addiction.

      13             Treatment is available for all those faced

      14      with addiction.

      15             Our Silverstein Clinic and Rehab Center is

      16      available for those 18 and older.  And we have a

      17      24-hour hotline that can be called by anyone.

      18             Again, in Rutland, Vermont, what struck me

      19      was, the director of psychiatric services, a

      20      gentleman by the name of Jeff McKee [ph.], and

      21      I quote him, "There is probably not a person in

      22      Rutland County whose life has not been affected by

      23      opioid addiction in one way or another."

      24             And I think the same applies to us here in

      25      Staten Island.  And I can include myself.







                                                                   45
       1             I've had three of my very close relatives die

       2      of drug overdoses over the last many years,

       3      beginning in 1977, on Mother's Day.  Ten years

       4      later, his brother.  And then, about seven years

       5      ago, my cousin who is a pharmacist.

       6             And, again, like Mr. Brian Hunt just said,

       7      these were great, great kids.

       8             I am unsettled at the epidemic that continues

       9      to build before us; however, I am optimistic, as

      10      I look forward to this panel of experts to devote

      11      the energy and resources needed to save our

      12      residents.

      13             And I look forward, I'm back on my fifth day

      14      from 30 years in New Jersey, and I'm really pleased

      15      to be back in my hometown to, hopefully, help along

      16      the way.  Thank you.

      17                  [Applause.]

      18             SENATOR BOYLE:  Thank you very much, Doctor.

      19             Now, this is not really a hearing.  It's more

      20      of a forum.

      21             So, please, anybody chime in, if you have

      22      something to add, or -- to whatever's being said.

      23             I'd ask the same question of Dr. Kunins,

      24      regarding your experience with --

      25             LUKE NASTA:  if I could just say something?







                                                                   46
       1             SENATOR BOYLE:  Oh, please.

       2             LUKE NASTA:  I just want to applaud you,

       3      Dr. Messina, for talking about how it affected

       4      your own family, because, as long as we get it out

       5      from under the table, and we put it here, we've got

       6      a chance of controlling it and beating it.

       7             And, you know, thank you for leading the way,

       8      and being a role model.

       9             DR. DANIEL J. MESSINA:  Thank you.

      10             And could I could say, again, like Mr. Hunt

      11      mentioned, it sticks with us.

      12             You know, as an only child, those were my

      13      three -- believe it or not, my three closest

      14      cousins, so they were semi-brothers to me when

      15      I grew up.

      16             So it's something, a piece, that will never

      17      go away, and that's missing.

      18                  [Applause.]

      19             DR. HILLARY KUNINS:  Thank you,

      20      Senators Lanza and Savino, and I was very happy to

      21      be able to participate both yesterday at this event

      22      in Manhattan, and today here on Staten Island.

      23             I'm Dr. Hillary Kunins.  I'm the acting

      24      executive deputy commissioner for mental hygiene at

      25      New York City Department of Health and







                                                                   47
       1      Mental Hygiene.

       2             We at the Health Department at the city have

       3      been, as you all know, very concerned and active in

       4      addressing issues of prescription drugs and heroin.

       5             My colleague from RUMC just mentioned,

       6      according to our health-surveillance data, and

       7      nationally, there were 16,000 overdose deaths in

       8      this country.

       9             We see them as preventable.

      10             And, surely, as we hear today, and from our

      11      colleagues, really tragically take the lives of

      12      people mostly way too young to be facing this

      13      serious illness.

      14             In New York City, as you heard, rates of

      15      unintentional overdose deaths have increased

      16      233 percent from opioid analgesics since 2000.

      17             And in the last two years, heroin-overdose

      18      deaths in our city have increased 84 percent.

      19             Staten Island has been hardest hit in terms

      20      of both heroin and opioid analgesics of all of our

      21      boroughs.

      22             I just want to say, also, personally, as a

      23      physician, where I cared for patients both in

      24      primary-care and in addiction-treatment settings for

      25      more than 16 years in the Bronx, caring for people







                                                                   48
       1      with this illness is really one of the most

       2      professionally satisfying parts of my work as a

       3      clinician, and having the ability to see folks

       4      recover.  And some of the tragic losses that I had

       5      the honor of witnessing, and talking to families, is

       6      a really important part of my career as a physician.

       7             And I think I want to share that to say, that

       8      this disease is greatly stigmatized, both the

       9      disease and its treatment.

      10             And by coming out both personally and

      11      professionally to say that this is an important

      12      piece of our work together, I think that this is why

      13      it's really great to hear from families, people

      14      affected, to hear from people in the profession, to

      15      say how important this work is to all of us.

      16             And convening this Task Force in this way is

      17      a terrific opportunity to be able to do that.

      18             I also want to highlight my work and our work

      19      at the Health Department.

      20             In addition to the surveillance that we do,

      21      we are very proud to have been able to participate

      22      in an effort that city and state and federal

      23      colleagues called "Rx Stat," part of the Mayor's

      24      Task Force on Prescription Pain-Killer Abuse started

      25      in the last administration.







                                                                   49
       1             Housed at the Health Department, Rx Stat is a

       2      public-health and public-safety collaboration --

       3      some of our colleagues and collaborators are here

       4      today -- that enables key data around opioid

       5      surveillance in real time.  Multiple and innovative

       6      data sources are used to give a comprehensive view

       7      of the opioid problem in New York City.

       8             Importantly, this collaboration allows us,

       9      across agencies, across state and city, to

      10      coordinate efforts, think of solutions, and act in a

      11      timely fashion.

      12             As you know, the Health Department supports

      13      access to naloxone, which you've already heard

      14      mentioned today.  We support training and naloxone

      15      distribution to laypeople trained as overdose

      16      responsers -- responders.

      17             Since 2009, we are aware of more than

      18      500 overdose reversals conducted by laypeople, and

      19      we know that this is much underreported.

      20             We have also collaborated, as you'll no doubt

      21      hear, with New York City Police Department in a

      22      pilot program here on Staten Island, and we are

      23      aware of three reversals to date.

      24             The Health Department also strongly supports

      25      Senator Hannon's bill that would enable more







                                                                   50
       1      widespread distribution of naloxone, by allowing

       2      trained laypeople, as well as pharmacists, to

       3      dispense naloxone with prescriber authorization.

       4             As you already heard, another key part of our

       5      efforts have been to promote guidelines, both for

       6      emergency department and general-practice settings,

       7      promoting judicious opioid prescribing.

       8             We have also engaged in public awareness by

       9      producing and airing several PSA (or public-service

      10      announcements) on the risks of prescription opioids;

      11      most recently, highlighting two Staten Islanders:

      12      one who tragically lost her son from an opioid

      13      overdose, and another highlighting a gentleman in

      14      recovery.

      15             Finally, and to echo the words you just

      16      heard, there's urgent need for increased awareness

      17      of and access to effective treatment for patients

      18      and New Yorkers with opioid dependence and

      19      addiction.

      20             And as you've heard, like other chronic

      21      health conditions, addiction is treatable.

      22             You heard about the 50 percent success rate.

      23             And I can tell you, in my work in primary

      24      care, 50 percent effective treatment of diabetes and

      25      high blood pressure is a pretty good rate.







                                                                   51
       1             And, so, I want to just say that that's a

       2      pretty good success rate, and we should take every

       3      advantage of it.

       4             Scientific evidence demonstrates that

       5      medication-assisted treatments, such as methadone

       6      and buprenorphine, is the most effective way to

       7      treat opioid addiction, which is a chronic, and can

       8      be a lifelong, illness.

       9             These medicines reduce deaths, drug use,

      10      crime, and help people participate in their

      11      communities, their families, and workplaces.

      12             I will close by reiterating, we firmly

      13      believe these deaths and addiction is preventable,

      14      and moving forward addressing both opioid-analgesic

      15      and heroin-overdose deaths will continue to be a

      16      priority for the City Health Department.

      17             We very much thank the Senate for their focus

      18      on this public-health crisis, and we look forward to

      19      working with you to move forward.

      20             SENATOR BOYLE:  Thank you.

      21                  [Applause.]

      22             SENATOR BOYLE:  I would like to acknowledge

      23      that we've been joined by the Staten Island

      24      representative of Governor Andrew Cuomo, Paul Duffy.

      25             Paul, thank you very much for coming.







                                                                   52
       1                  [Applause.]

       2             ASSEMBLYMAN CUSICK:  Doctor, I just have a

       3      quick question.

       4             In reading the testimony, I see 2012.

       5             Do we have recent statistics on overdose

       6      unintended overdose stats?

       7             DR. HILLARY KUNINS:  So, though we are -- so,

       8      not yet.  We don't have final numbers.

       9             We're hoping by the summer to have compiled

      10      and checked figures.

      11             ASSEMBLYMAN CUSICK:  Okay.  Thank you.

      12             SENATOR BOYLE:  Thank you.

      13             We do have a couple of questions from our

      14      audience.

      15             I would like to add one here, we have from a

      16      parent:  "Are there tips you can offer to help me

      17      identify if my kids are on heroin or oxycodone?"

      18             And I guess, Dr. Joffe, if you could...

      19             DR. RUSSELL JOFFE:  I'm not sure that there's

      20      a specific answer to that.

      21             I don't think it would be -- it would be

      22      nice, but, no.  Neither of those are good options.

      23             So, the important thing is, to have open

      24      communication.

      25             And -- but, I don't think there's a specific







                                                                   53
       1      set of clinical symptoms that are going to

       2      differentiate these addictions.

       3             SENATOR BOYLE:  Thank you.

       4             Yes.

       5             CANDACE CRUPI:  From experience with my own

       6      son, opioid, the pills, the Oxycontin, if they're on

       7      them, they itch a lot.  They're always scratching

       8      their face.

       9             They take the heroin, they're out cold.

      10             There's two -- yeah, that's the difference.

      11             They don't take heroin, then just walk around

      12      and itch around.  They're out cold.

      13             And that's our experience.

      14             BARRY CRUPI:  They nod out a lot.

      15             CANDACE CRUPI:  Yeah, they nod out a lot,

      16      but, they don't scratch their face, and they're not

      17      very itchy.

      18             The pills make them very itchy.

      19             BARRY CRUPI:  And they don't eat when they're

      20      on heroin.

      21             CANDACE CRUPI:  Right, yeah.

      22             BARRY CRUPI:  He never ate when he was on

      23      heroin.

      24             CANDACE CRUPI:  And, yeah, you would know,

      25      too.  Right?







                                                                   54
       1             JAMES FIORE, JR.:  Absolutely.

       2             AUDIENCE MEMBER:  [No microphone used.]

       3      Maybe somebody from the panel [inaudible].

       4             LUKE NASTA:  If I may?

       5             Nobody knows your children better than you

       6      do.  Nobody.  Not their buddies, not whoever hangs

       7      out with them.

       8             As a matter of fact, the ones who know the

       9      best are the siblings.

      10             But nobody knows your children better than

      11      you do.

      12             If you suspect something's wrong, trust your

      13      instinct something's wrong.

      14             Whether we call it Oxycontin, oxycodone,

      15      marijuana, inhalants, pills, heroin, cocaine,

      16      whatever it is, you'll know that there's a problem.

      17      And step up, and step into it, or wind up like these

      18      unfortunate parents here.

      19             AUDIENCE MEMBER:  [No microphone

      20      used/inaudible.]

      21             LUKE NASTA:  No, I'm sorry.

      22             AUDIENCE MEMBER:  [No microphone

      23      used/Inaudible.]

      24             UNKNOWN SPEAKER:  You're right.

      25             You're 100 percent right.







                                                                   55
       1                  [Applause.]

       2             JAMES FIORE, JR.:  Thank you.

       3             I know from my own symptoms, extreme -- if --

       4      you could tell if someone is using oxycodone or

       5      Oxycontin or any powerful opiate, by things, like,

       6      there's mood swings.

       7             In the morning, at night, being extremely

       8      happy because they're high.

       9             And then the next morning, going into temper

      10      tantrums and tirades and punching holes in the

      11      walls.

      12             You can tell that they're not just doing

      13      other things.  Not maybe smoking weed, and whatnot.

      14             You know, if children, which I have done,

      15      I switched -- if I was -- when I was using, to ask

      16      my mother for, "Mom, can, I have $30?  I'm going to

      17      go out to see a movie with a girl."

      18             Or something like that.  And I -- I'd hang

      19      out in the neighborhood with my friends, in the

      20      house.  I don't go anywhere.

      21             You know, she can see, you can tell that

      22      people on any opioid, if their eyes are pinned, if

      23      their pupils are pinned, and not dilated.  You know,

      24      that they get smaller.

      25             And, isolation.







                                                                   56
       1             Isolation, in progressive addiction -- as

       2      addiction progresses, isolation becomes a big part

       3      of it.  You know, what I mean?

       4             And you'll see the crowds of children that

       5      your friends hang out, that -- excuse me, the crowds

       6      that your children hang out with will change.

       7             Slowly, but surely, you'll start to notice

       8      that they're not the kids that are going to school

       9      or playing sports.  They're the kids that are

      10      smoking weed, that are selling weed, that are

      11      selling pills, that are drinking and partying.

      12             You know, with me and myself, I know that

      13      I put my mother through hell.  I know that I stole.

      14             My mother knew, because she noticed her

      15      medication was missing, because my -- both of my

      16      parents worked, you know, two New York City jobs: a

      17      postal mail handler, and, a track layer, my father.

      18             They were both -- they both worked City jobs,

      19      and I stole both their medications.

      20             My mother -- my mother got off hers.  She

      21      chose to get off hers for that reason.

      22             And, uhm -- yeah, you know -- I'm sorry,

      23      that's all I have.  Thank you.

      24             Thank you.

      25                  [Applause.]







                                                                   57
       1             BRIAN HUNT:  If I could just add to what

       2      James said, James obviously lived it; hits the nail

       3      on the head.

       4             And you're right, he's the one we need to

       5      hear from.

       6             But I will tell you, from a person's point of

       7      view, my son, very active, athletic, smart kid.

       8             You know what?  It was there.  We didn't see

       9      it.  We didn't know what we were looking at, what we

      10      were looking for.

      11             But when you find out, what happens is, they

      12      withdraw.  They don't eat.  They lose weight.  They

      13      sleep a lot.  Sometimes they don't sleep at all.

      14             And then you notice, like James said, my son

      15      started to get new friends.

      16             You know, when you get accustomed to seeing

      17      the same group of kids with your son, in and out of

      18      your house, who's there, who's playing, you know,

      19      who's on video games, who's eating dinner with you,

      20      or having a Sunday sauce, or whatever, and then, all

      21      of a sudden, you meet these new kids, and, "Hey,

      22      dad, this is my friend Tommy."

      23             You know, my son had a -- my son was in a

      24      fraternity with St. John's.  He would introduce

      25      me:  Hey, dad, this is my friend Tommy.  He's going







                                                                   58
       1      to be joining us.

       2             "Okay, cool."

       3             "And this is my friend John."

       4             "This is my friend Bill."

       5             All these new people.

       6             And you know what?  They come up very

       7      respectful:  Mr. Hunt, how are you?  Nice meeting

       8      you.  You have a lovely home.

       9             Goes down and sees my son.

      10             How do I know that that wasn't the person

      11      that said:  Here, here's your stuff, in my house?

      12             So there's a bit of disrespect involved in

      13      that.

      14             But you have to look for it.  You have to

      15      really look hard at your kid.

      16             It's not going to jump out and bite you.  You

      17      have to pay attention to it.

      18             And when they start to withdraw, and they

      19      don't want to go away with you, and they don't want

      20      to go someplace, you know, you begin to say:  You

      21      know what?  I don't want to leave them home.

      22             I will tell you, when my son went away for

      23      treatment, went for two months --

      24             AUDIENCE MEMBER:  [No microphone

      25      used/inaudible.]







                                                                   59
       1                  [Microphone handed to audience member.]

       2             AUDIENCE MEMBER:  Jacqueline, you know me.

       3             YMCA didn't help him.

       4             You know me very well.  I put him in there

       5      how many times?

       6             He's 22, I can't help him no more, they say.

       7             He's 22.

       8             Nobody can help me.

       9             I have a petition, I just handed it to you.

      10             I love my son, he's a good kid.  Very

      11      respectful.

      12             He went to Cooper's wake.  That's the day he

      13      almost broke my arm, right after it.  He begged me

      14      for money.

      15             She just lost her son three weeks ago.

      16                  [Another audience member stands.]

      17             AUDIENCE MEMBER:  There's a lot more.

      18             UNKNOWN SPEAKER:  How much?

      19             AUDIENCE MEMBER:  A lot more.

      20             Pinning of the eyes.  They can get big, they

      21      can get small.

      22             Sean's a good kid.

      23             I got three boys.

      24             It's hard.

      25             Heroin is hard.







                                                                   60
       1             Outpatient don't work.  I'm sorry.

       2             Outpatient doesn't work.

       3             Suboxone does not work.

       4             Morphine does not work.

       5             He went to Seguine.  They gave him a drug,

       6      three weeks ago.  What did he do with it?  Sold it.

       7             He went to YMCA, they gave him Suboxone.  He

       8      went on Facebook, "Got Subs for sale.  I got Subs

       9      for sale."

      10             I went back to Y and I said:  Look, Sean's

      11      got Subs for sale.

      12             I showed them his Facebook.  I argued with

      13      that counselor.

      14             And what did the counselor say to me?

      15      "I don't like your attitude."

      16             To me, the mother, "I don't like your

      17      attitude."

      18             I said:  I don't like you.  Do you have

      19      children?

      20             No, I don't have children.

      21             I said:  You don't understand then.  He's my

      22      son.  That's my son.

      23             I want to save his life.  I don't want to

      24      wind up like them.

      25             And I'm very sorry for your loss.  I am.







                                                                   61
       1             I want to save the children.  And they are

       2      children, as far as I'm concerned.  I don't care if

       3      they're 50, they are my children.

       4             And I have a petition.

       5             No matter how old they are, we as parents

       6      have a right to save our children.

       7             I'm asking for that petition.

       8             And, everybody, I have a petition.  If yous

       9      want to sign it, I'll be at the door.

      10             AUDIENCE MEMBER:  [No microphone used.]

      11      For what?  What is it?

      12             AUDIENCE MEMBER:  To change the age, of a

      13      parent to sign their family member into rehab for at

      14      least nine months, until they have the thinking mind

      15      of their own.

      16                  [Applause.]

      17             AUDIENCE MEMBER:  [No microphone

      18      used/inaudible.]

      19             AUDIENCE MEMBER:  Because they cannot think

      20      while they are high.

      21                  [Applause.]

      22             AUDIENCE MEMBER:  They cannot think on their

      23      own while they are high.

      24             AUDIENCE MEMBER:  Can I say something?

      25             My --







                                                                   62
       1             AUDIENCE MEMBER:  I'll be at the door.

       2             AUDIENCE MEMBER:  Excuse me, I'd like to say

       3      something.

       4             My daughter is presently in rehab, and she

       5      has a co-occurring condition.

       6             My daughter had to go to Florida for help,

       7      because she came -- went to the Staten Island Mental

       8      Health.  She refused to go.  She said she was going,

       9      and she -- after three times, you're out the door

      10      and they can't help you anymore.

      11             So I -- my daughter is now in rehab in

      12      Florida.

      13             And this "privacy act" thing that we all know

      14      about, when you're an addict, they're really not --

      15      in my opinion, they're not focused properly in their

      16      heads.  They just care about getting their

      17      substance.

      18             What happens is, my daughter was admitted

      19      into the hospital for psychological problems;

      20      wanting to commit suicide a couple of times.

      21             And the MS came, "Bring her to the psych

      22      ward."

      23             My daughter came out the same night.

      24             Couldn't tell us anything, because my

      25      daughter was 18 years old.  "The privacy act."







                                                                   63
       1             Where is -- where -- as parents, where do we

       2      stand?

       3             Where do people, when these children, not

       4      right in their minds to make their own decisions to

       5      get their -- to get themselves help?

       6             I even went to the courts to get my daughter

       7      that mental -- the right to -- to get her the

       8      mental, I forgot what you call it --

       9             AUDIENCE MEMBER:  [No microphone

      10      used/inaudible.]

      11             AUDIENCE MEMBER:  -- and they awarded it to

      12      me.

      13             But what -- I would have to get the police to

      14      get my daughter in my home, where she was

      15      disappearing, going to crack houses, and what have

      16      you, to get her help during the police -- during

      17      court hours, and have the judge find out if she

      18      really needed psychological help.

      19             I mean, where is the rights, as parents, to

      20      get your kids help without this privacy act?

      21             I mean, they're not -- the addict is not

      22      right in their head.

      23             You want to help your children, but you have

      24      this -- they're not telling you.  They can't tell

      25      you what's going wrong with children, even though







                                                                   64
       1      you know.  You want to know what your child's on.

       2             My daughter -- they told my daughter to sign

       3      the paper.

       4             They couldn't even tell me.

       5             There was a police officer in the hospital

       6      with her.  I couldn't even know what's going on with

       7      my daughter.

       8             It's quite frustrating.

       9             SENATOR BOYLE:  Thank you very much.

      10             And I'll tell you that, we raised a couple of

      11      issues here that I would like to get the panel's

      12      opinion about these.

      13             One is, Suboxone; and, whether it's

      14      methadone, Suboxone, other medication, that addicts

      15      are using while they're going through treatment.

      16             I have gone around the state, and some people

      17      swear by them, that these are -- it's the best way

      18      to recovery.  And others are saying, no, that these

      19      addicted individuals are selling them on the street,

      20      and -- to buy more heroin or become addicted to

      21      them.

      22             So, for the experts on the panel, I would

      23      like to ask your opinion, and what you feel about

      24      that.

      25             Dr. Kunins?







                                                                   65
       1             DR. HILLARY KUNINS:  So, thank you for

       2      telling us both of your stories.  And I know these

       3      raise really complicated issues.

       4             No single treatment works for every person;

       5      I just want to start there.

       6             And -- and because of the severity of

       7      illness, sometimes it takes some time.

       8             And I really respect --

       9             AUDIENCE MEMBER:  [No microphone

      10      used/inaudible.]

      11                  [Multiple audience members speaking at

      12        the same time.]

      13             SENATOR BOYLE:  Hold on.

      14             Let me -- if we could, sir, you'll get a

      15      chance.

      16             SENATOR SAVINO:  Let her finish.

      17             SENATOR BOYLE:  You'll get a chance.

      18             Let's get some information.

      19             DR. HILLARY KUNINS:  I do want to just offer,

      20      that different people's experiences are different.

      21             But we -- but we -- and different intensity

      22      of treatment, outpatient and inpatient, is different

      23      for different people at different times.

      24             We know from the medical literature, and

      25      that's where I come from and can provide some







                                                                   66
       1      insight, is that many, many people do well and are

       2      able to turn around their addiction with the help of

       3      medicines.

       4             That's not to say everybody, and not to say

       5      that outpatient works for all people.

       6             But to -- it's an important part of the

       7      continuum of care and the services.

       8             And for some people who have not been offered

       9      medicine or not been available to take medicine

      10      before, it can change the course of their -- their

      11      course of their road for them.

      12             And, I think we don't want to demonize one

      13      treatment or another.  I think it's important, in

      14      the continuum of care, to make these options

      15      available.

      16             SENATOR BOYLE:  Thank you, Doctor.

      17             SENATOR SAVINO:  I have a question.

      18             And, first, thank you for sharing that; your

      19      personal pain, and the heartbreak.

      20             And I see there's so many of you here who are

      21      feeling this.

      22             But what I hear is, the frustration that

      23      you've been through, attempts at rehab before, with

      24      your children, or your other family members.

      25             And remember, this is not just kids.  This is







                                                                   67
       1      everybody, you know.  There's not a family I know

       2      that hasn't been touched by addiction, including my

       3      own.

       4             But one of the things I'm hearing over and

       5      over, is this new trend of rehab, inpatient rehabs,

       6      which are directed, really, by the insurance

       7      industry that say:  We'll only pay for 28 days of

       8      rehab.

       9             28 days is not enough, particularly because

      10      of the drugs that people are utilizing now.  Many of

      11      them, as Dr. Joffe knows, are also taking

      12      psychotropic medication to deal with other medical

      13      issues that they have.

      14             We have a lot of mentally ill,

      15      chemically-addicted people, and they're

      16      self-medicating if they can't get what they need.

      17             But 28 days is not enough time, and then to

      18      expect them to manage their medication, manage their

      19      psychiatric issues, manage their addiction, and do

      20      it successfully.

      21             I think we're expecting way too much.  There

      22      was a time when rehab was 12 months to 24 months,

      23      and inpatient.

      24                  [Applause.]

      25             SENATOR SAVINO:  And I'm just wondering to







                                                                   68
       1      the service providers, is there some -- is there a

       2      way that you can help us kind of redirect the

       3      insurance industry that these are the things that

       4      they should be paying for?

       5             Dr. Joffe?

       6             BRIAN HUNT:  Well, can I just comment for a

       7      second before that gentleman speaks?

       8             I put my son into the 28-day program,

       9      inpatient.  He had to stay for another month.

      10             My insurance company did not pay for my son

      11      to be in treatment.

      12             SENATOR SAVINO:  At all?

      13             BRIAN HUNT:  At all.

      14             And I'm -- and I'm glad you asked me that

      15      question.  You know why?

      16             Because they told me that my son did not go

      17      into an outpatient program.

      18             But I put my son into a private outpatient

      19      program, where he got personalized care in a

      20      personalized group, that I paid for, that I did not

      21      go through my insurance company for.

      22             And they told me that, outpatient, before my

      23      son could go into inpatient, and it cost me $10,000

      24      a month for treatment, they said to me:  Outpatient

      25      has to fail.







                                                                   69
       1             And I said:  What does that mean?  Go ahead,

       2      tell me what that means.

       3             She said:  Well, it means it doesn't work.

       4             And I said:  Go ahead, tell me what "doesn't

       5      work" means?

       6             My son has to do drugs again.  Right?  He has

       7      to relapse.

       8             What if my son dies?

       9             We're trying to follow the program, and

      10      I have to subject my son to something like that?

      11             My wife sat in this place, originally, when

      12      we went there, and my wife feared for her life while

      13      she was sitting there.

      14             And my wife said:  This is my baby.  I can't

      15      put my baby in here.

      16             People are walking around, and they're

      17      saying:  Come on, you have to be piss test.

      18             And the kid says:  No, I can't.  I did my

      19      shit today.  I'll do it tomorrow.

      20             My wife's not going put my son in a place

      21      like that.  So we paid privately.

      22             Didn't matter.

      23             My son had to fail at outpatient relapse,

      24      take drugs, possibly die, and then the insurance

      25      company said:  You know what?  We'll pay for you.







                                                                   70
       1             But ultimately what happens is, when my son

       2      relapsed, at the end of the day, make no mistake

       3      about it, it cost $30,000 to put my son in the

       4      ground, but my insurance company wouldn't pay shit

       5      to get my son the help that he needed.

       6             And that's amazing.

       7             I know there's people out here, and I've

       8      spoken to them.  They struggle because, you know

       9      what?  They don't have the money, or the coverage.

      10             There has to be a way to get these people,

      11      get the coverage, and get the expenses taken care

      12      of, so you can get the help that you need for your

      13      children.

      14             I know I would pay anything.  I would give my

      15      life for my child.  I would love to change places

      16      with my son right now.

      17             I can't.

      18             But we have to do something with the health

      19      industry, to get people like that help.

      20             This young lady here, and that young lady,

      21      I know -- we know each other, we've spoken before,

      22      and they're suffering.

      23             And it all comes down to dollars and cents.

      24             AUDIENCE MEMBER:  [Speaking without a

      25      microphone.]  It's cost us $60,000 so far.  My







                                                                   71
       1      husband [inaudible] electrical union.  And we're

       2      still paying for my daughter's.  She's in halfway

       3      program right now.

       4             But if we didn't have it, you know, we're

       5      struggling, financially, to pay for my daughter's.

       6             The union offered us a 28-day program.

       7             My daughter didn't even want to go to an

       8      outpatient.  We knew 28 days was not long enough.

       9             So we sent my daughter to a private facility

      10      in Florida, and it cost us $60,000 out of our

      11      pocket.  And we can't get any insurance for it.

      12             So it is very unfortunate for people that

      13      don't have the insurance.

      14             And we love our daughter.  We couldn't put

      15      any dollar amount on it.  And my husband took his

      16      pension, that's how we -- that's how we're paying

      17      for my daughter's care right now, because we love

      18      her and we don't want to lose her.

      19             And Staten Island's very bad here.

      20             Thank you.

      21             SENATOR BOYLE:  Thank you very much.  And you

      22      are not alone in that.  We've heard stories.

      23             Dr. Joffe, you wanted to say something?

      24             DR. RUSSELL JOFFE:  We have a 24-bed unit at

      25      Seguine on Seguine Avenue, with an average stay of







                                                                   72
       1      28 days.  We can't keep people there.

       2             I think we're one of the last inpatient

       3      units.

       4             Most people now have to be treated as

       5      outpatients because there's -- simply, insurance

       6      will not generally approve stays beyond five days.

       7             SENATOR BOYLE:  One of the things we're

       8      seeing --

       9             Excuse me, Senator.

      10             SENATOR SAVINO:  Uh-huh.

      11             CANDACE CRUPI:  Can I say something?

      12             SENATOR BOYLE:  One second.

      13             One of things we're seeing is, there's

      14      obviously legislation there regarding insurance.

      15             And what we've heard at different forums is

      16      the fact that, several different insurance

      17      companies, you talk to ten different insurance

      18      companies, you get ten different definitions of

      19      "medical necessity" of what should be covered under

      20      your insurance plan.

      21             And with -- this Task Force is looking

      22      seriously at trying to have a unified definition of

      23      "medical necessity," in terms of coverage, so

      24      everyone knows exactly what they're going to get and

      25      what they won't get, so they can choose -- you can







                                                                   73
       1      choose your insurance company, and what to -- to see

       2      what kind of treatment will be covered.

       3             Mrs. Crupi.

       4             UNKNOWN SPEAKER:  You want to hear from --

       5      he's been waiting.

       6             CANDACE CRUPI:  I have a question for the

       7      doctor.  I think it's Dr. Russell; right?

       8             DR. RUSSELL JOFFE:  Joffe.

       9             CANDACE CRUPI:  I went to the rehab.  You

      10      can't get in if you're on opioids.  You can --

      11      they'll only take you with the detox.  They only

      12      take you if you are on alcohol or Xanax.

      13             Now, why is that?

      14             If you're on opioids they don't care.

      15             DR. RUSSELL JOFFE:  Because most of opioid

      16      addict -- opioid detox is increasingly becoming an

      17      outpatient procedure because, although it's

      18      extremely unpleasant and difficult, it is not

      19      life-threatening.

      20             Alcohol and benzodiazepine withdrawal is

      21      life-threatening.  You can die from it.

      22             And so, increasingly, the practice in this

      23      country, in this state, is to do that as an

      24      outpatient.  And the insurance companies have

      25      followed suit.







                                                                   74
       1             It's very hard to get insurance approval

       2      because opioid addiction can -- detox, I'm sorry

       3      can, be done as an outpatient.

       4             CANDACE CRUPI:  But they can die of an

       5      overdose.

       6             DR. RUSSELL JOFFE:  And remember, the detox

       7      is a very, very -- detox is a very brief --

       8             BARRY CRUPI:  Kids can't go till after detox.

       9             DR. RUSSELL JOFFE:  What's that?

      10             BARRY CRUPI:  If they wanted to go to

      11      Seguine Avenue to detox, you won't accept them if

      12      they're on heroin or if they're on Oxycontin.

      13             DR. RUSSELL JOFFE:  It's not -- there's no

      14      blanket policy --

      15             BARRY CRUPI:  The only way they're able to

      16      get in is if they drink before they go there.

      17             I mean, that's what they wind up doing.

      18             CANDACE CRUPI:  They have to have alcohol in

      19      their system.

      20             SENATOR BOYLE:  Excuse me.

      21             Sir, okay?

      22             AUDIENCE MEMBER:  I just wanted to say, my

      23      son has an addiction problem, and he's away now.

      24             And I had to call my wife to see if I could

      25      speak first, because there's people I here I know.







                                                                   75
       1             So that goes with the embarrassment issue.

       2             But, he's in a program now called

       3      "Dynamite Youth Center."  It's in Brooklyn.

       4             And, I was told about this by a colleague of

       5      mine a while ago, but I couldn't bring -- I couldn't

       6      see having to put my son away for a year.  You know,

       7      I figured that's like a jail sentence.

       8             But, it's been a progressively difficult

       9      problem with him since he's 16.  Basically, the same

      10      thing: alcohol.

      11             He was in St. Peter's High School.

      12             He went to the -- we put him in the

      13      Army Reserves, the National Guard...everything

      14      eventually failed, and he wound up recently

      15      overdosing.

      16             Fortunately, I was home that night.

      17             He came home 1:00 in the morning, because

      18      I gave him a 1:00 curfew.

      19             He came home, he said he was at his

      20      girlfriend's house.  I checked him, I looked in his

      21      face, he looked good.

      22             He went in his room.

      23             I sleep in the family room.  I don't even

      24      sleep with my wife, because I have to keep an eye on

      25      him; make sure that he don't climb out to window,







                                                                   76
       1      make sure somebody don't come in the window.

       2             But, anyway, I heard a grown about a

       3      half hour later, about 1:30 in the morning, and then

       4      a thud.

       5             So I got up.

       6             You know, usually I'll hear something and

       7      I'll say, Ah, to hell with it.

       8             But this -- this night, I went in, and there

       9      he is on the floor, in his sweat pants, and that's

      10      it.  And he's not breathing.  Totally unresponsive.

      11      I'm slapping his face, trying to bring him to.

      12             He won't come to.

      13             So, you know, I'm an emergency responder, so

      14      my training, finally, after 57 years of life, kicked

      15      in.  And you say you'll always use it when it's your

      16      family member, which happened that night.

      17             So I gave him the breath and the chest

      18      compressions, and revived him.  And then the police

      19      came.

      20             And he went out of second time.  They had to

      21      resume chest compressions.

      22             Make a long story short, we went over to the

      23      South Shore Staten Island University Hospital.

      24      I was in there all night with him, and then they

      25      released him in the morning.







                                                                   77
       1             Now, this was after I already had him in --

       2      I had until a detox -- I tried to get him into

       3      detox, Bayley Seton Hospital.

       4             "He doesn't have a serious enough problem."

       5             I said:  What do you mean?  Who -- who puts

       6      the definition of what the problem is?  I live with

       7      him.  I know he's got a serious enough problem.  You

       8      don't even know him.  You're a physician's

       9      assistant.  Let me talk to the doctor in charge.

      10             They put him on Suboxone for a week.  I had

      11      keep him locked up in my house for a week, to try

      12      the Suboxone.  That didn't work.

      13             I wound up taking him now to Staten Island

      14      again, and they said they had no beds.

      15             So I -- you know, I didn't want to bring him

      16      home again.  I don't want to bring mim back into the

      17      neighborhood.

      18             So I wound up taking to him to a place in

      19      Jersey.  We got him admitted that same day.  It was

      20      like the difference between night and day.

      21             The epicenter of the epidemic is

      22      Staten Island; and, yet, you don't get the response

      23      that you would think would be appropriate with the

      24      epidemic epicenter being here.

      25                  [Applause.]







                                                                   78
       1             AUDIENCE MEMBER:  You have to go someplace

       2      else to get the response that you need.

       3             And now he's in -- he's in the detox for

       4      seven days, maybe, in Jersey.  And, we bring him

       5      some clean clothes one afternoon, and he's gone.

       6             I said:  What do you mean he's gone?

       7             "Well, he was fraternizing with a girl, so we

       8      asked them both to leave."

       9             "Well, where are they?"

      10             "I don't know where they are."

      11             So I had to call the Jersey police, put a

      12      missing person's report out for him.  And,

      13      eventually, tracked him down.  He was at the girl's

      14      grandmother's house.

      15             And I took him right up to the mountains of

      16      Pennsylvania for rehab.

      17             And, he got thrown out of rehab for fighting

      18      with somebody in the rehab up there.

      19             And, you know, ultimately, it wound up to

      20      where he was, basically, dead.

      21             And now, when I'm in Staten Island University

      22      Hospital South Shore, after that whole night,

      23      they're sending him home.

      24             I said:  But how are you going to send him

      25      home?







                                                                   79
       1             "Well, we only treat alcohol here.  We have

       2      an affiliate across the street.  You can bring him

       3      tomorrow morning to the affiliate."

       4             Now, I don't want to bring him tomorrow

       5      morning.  I don't want him back home.  He needs to

       6      be locked up.

       7             You know, he needs -- in that type of

       8      state -- and that's the other issue is, the age.

       9             Well, he's of -- you know, "We can't tell you

      10      anything where he is.  He's of the age, where, you

      11      know, he can do what he wants to do when he wants to

      12      do it, and that's it."

      13             So the problem is -- and the other thing is,

      14      too, with the insurance, I had the same problem with

      15      the insurance company, where they were telling me --

      16      I said:  I need to have him put in at least for

      17      28 days.  He needs help.  He's got to be someplace

      18      and be helped for 28 day, at least.

      19             That's what's in my head.

      20             "That's not the way it is anymore, sir.  We

      21      do it every seven days, we re-evaluate them.  And if

      22      it's medically -- if it's deemed that he no longer

      23      medically needs that type of service, he's

      24      released."

      25             Dynamite Youth Center in Brooklyn, they took







                                                                   80
       1      my son at 23.  They say 23 is the cutoff.

       2             But, he goes away for a year.

       3             "He's upstate now.  You can't have contact

       4      with him for six months.  When he earns the right to

       5      his behavior, he'll be allowed to call you at home."

       6             And, eventually, they let him come home --

       7      after the second six months, he could come home on

       8      the weekends, if he deserves it.

       9             He requests it, we have to agree to it, and

      10      then they'll let him come back, supervised, where

      11      somebody else from the program has to come and stay

      12      in my house with him.

      13             And then in the second year, he's doing

      14      outpatient, going to and from Brooklyn.  He's not

      15      allowed to work.  He's not allowed to do anything

      16      but recover.

      17             And, eventually, you know, if everything goes

      18      according to plan, he can resume his life; go back

      19      to school, get a job.

      20             But that's what people need, something like

      21      that.

      22             I mean, and I -- I feel so bad, because he

      23      almost died, and I didn't want to put him in, away

      24      for a year, when my friend told me about it.

      25             My friend told me, "My son went there.  They







                                                                   81
       1      sent him away for a year."

       2             You know, I didn't think I had to go to that

       3      extreme.  But you do.

       4             And it almost cost him his life.

       5             So, you know, like I say, if some -- if this

       6      is the epicenter of the problem, we need to have the

       7      resources here to help people.

       8                  [Applause.]

       9             SENATOR SAVINO:  I certainly hope that your

      10      son is successful this time.

      11             Again, in listening to the personal stories,

      12      you just reinforce what those in the profession

      13      know:  That you can't make someone get sober that

      14      doesn't want to.

      15             You can take them to rehab every week.  If

      16      they're not willing to participate, they're going to

      17      relapse and relapse and relapse.

      18             The challenge for people like us, and the

      19      service providers and law enforcement, is to help

      20      develop public policies to support families who are

      21      going through this.  Make sure the resources are

      22      there.  Make sure that the treatment programs match

      23      it.

      24             But in the end, we need cooperation from the

      25      addicts, and that's the hardest part.  And I wish we







                                                                   82
       1      could legislate that.

       2             UNKNOWN SPEAKER:  Can I say something?

       3             AUDIENCE MEMBER:  [No microphone

       4      used/inaudible.]

       5             SENATOR BOYLE:  If I could, that is actually

       6      the other issue I was going speak to, is mandated

       7      treatment.

       8             Now, the fact is, in New York State, we don't

       9      even have mandated treatment for minors, forget

      10      about people of age.

      11             And I think that that is one of the areas of

      12      legislation we're looking at, we've heard about.

      13             And we hear stories of kids, 15, 16 years

      14      old, they walked out of treatment and the treatment

      15      provider said:  Oh, we can't stop them.

      16             Well, you should -- you have to be able to

      17      stop them, as parents, to mandate treatment.

      18             For those above age, obviously, we have

      19      Kendra's Law, mandating medicines for those in

      20      psychiatric -- with psychiatric problems who are a

      21      danger to themselves and others.

      22             Well, we may have to look at something like

      23      that for addiction services, as well.

      24             AUDIENCE MEMBER:  [No microphone

      25      used/inaudible.]







                                                                   83
       1                  [Multiple audience members speaking at

       2        the same time.]

       3             SENATOR BOYLE:  I understand.

       4             We have some cards.  If you have something

       5      that you'd like to say, please, our staff person,

       6      right over here, will give you a card, and we can

       7      ask questions.

       8             I'd just like to turn it over, quickly,

       9      unless my colleagues have something else on this

      10      issue, to the law-enforcement aspect of things.

      11             SENATOR LANZA:  And can I just, sort of, a

      12      little more than midway through here, I just want

      13      to -- I just would like to make a comment.

      14             First of all, I think this is very helpful.

      15             And we're here to learn from each other, and

      16      really get a better picture of the problem.

      17             You know, there are two components here:

      18             There's, first, what do we do to stop this

      19      from happening to begin with?

      20             And we want to see whether or not,

      21      legislatively, or otherwise, we can make a run at

      22      making these drugs less available, changing

      23      behavior, more education.

      24             And then, in terms of those who have become

      25      victims of addiction, we want to know -- see what







                                                                   84
       1      more we can do about this.

       2             And I want to say this, and I know this is

       3      very emotional for all of us:

       4             I'm the parent of three young children here

       5      on Staten Island.

       6             And as I went through the research for

       7      I-STOP, together with Assemblyman Cusick, I can't

       8      tell you, every night, I just -- I couldn't sleep.

       9      I was horrified.

      10             And, I'm still in a state of continued fear,

      11      knowing what's happening out there in our schools

      12      and backyards and at parties, all across

      13      Staten Island, and all across the state.

      14             And it's not just Staten Island.  It's a

      15      national epidemic.

      16             But I want to say this:

      17             No one has that one magic solution; no one in

      18      the audience, no one at this panel.

      19             Because if someone did, we wouldn't be here

      20      today.

      21             But the reason we're here, is because

      22      everyone you see on this panel is a piece, a

      23      potential part, of the solution.

      24             And everyone here on the panel has a certain

      25      expertise.







                                                                   85
       1             And everyone here, more importantly, on this

       2      panel, wants to help, and that's why they're giving

       3      their time here.

       4             And that's what this is all about.

       5             And the same from those in the audience.

       6             So this is good, I think, because we're here

       7      to learn from each other.  But this is not about --

       8      in my opinion, this is not about saying who is not

       9      doing something, or who -- because people have

      10      different roles.

      11             And there is not -- this is going to take all

      12      of us, truly, to come together, and come up with a

      13      comprehensive solution so that we can make inroads

      14      to this very devastating problem.

      15             AUDIENCE MEMBER:  [No microphone used.]

      16      I just have one question [inaudible].

      17             I would like to know, what is in place, what

      18      role do you guys play, that is going to [inaudible]

      19      at the source, rather than wait until there's a

      20      problem?

      21             You know, these people are trying desperately

      22      to get help.

      23             What are you guys doing in front of that, to

      24      stop it?

      25             Because these kids are finding it so easily







                                                                   86
       1      available.  And I'm finding it really hard to

       2      believe that nobody is interceding before it gets to

       3      them.

       4             ASST. CHIEF EDWARD DELATORRE:  Okay, from the

       5      NYPD, let me just start with where the problem

       6      appears to have surfaced out here on Staten Island.

       7             We first noticed a dramatic increase in

       8      arrests for pills in 2011.

       9             If you look at 2010, going up to last year,

      10      the arrests we made for people with pills increased

      11      more than tenfold.

      12             The heroin, although a lot of people like to

      13      think that the pills are dropping off and the heroin

      14      is increasing, I know from our narcotics

      15      investigations, that is supported, to some degree.

      16             But, overall, when we look at our overall

      17      arrests here on Staten Island, the heroin arrests

      18      really started to explode last year.

      19             We saw, it doubled in 2012.

      20             But in 2013, we saw a dramatic increase.

      21             And we're watching that trend go into 2014.

      22             So going into 2014, we're seeing a lot more

      23      heroin out there, as well.

      24             But, I can't tell you that we're seeing a big

      25      drop-off in the pills.







                                                                   87
       1             We know it's not as readily available.

       2             We know that the I-STOP, I believe we call

       3      it, program, has really had an impact on our

       4      pharmacies.  Our major cases, you know, we don't

       5      have as many of them as we did before.

       6             But we have two problems now:  We have the

       7      pills and we have heroin, and they're both big

       8      problems.

       9             So now I'm going to work back into what we're

      10      doing about it.

      11             So one of things I know you heard mentioned,

      12      is that we're using the naloxone now.

      13             The naloxone is a spray that, pretty much,

      14      puts on hold the effects of the overdose.  It

      15      doesn't stop it.  It just puts it on hold for a

      16      short period of time so we can get the person to the

      17      hospital.

      18             We did pilot it, starting this year, in the

      19      120 Precinct, which basically services the

      20      North Shore Area.

      21             And in two months' time, we had three saves

      22      that were, what I would call "bona fide saves,"

      23      where the subject or the patient actually stopped

      24      breathing.  And the officers were there in time,

      25      administered the spray.  In most cases, it had to







                                                                   88
       1      administer it twice.  But, it snapped the person

       2      back, they became coherent.  We got them to the

       3      hospital, and they were saved.

       4             We had another incident where we did use it,

       5      but the person was not suffering from an overdose.

       6      It was something else, apparently.  But even in that

       7      case, it seemed to make them a little more alert.

       8             But in all four cases, nobody died on us, so

       9      we did get them medical treatment.

      10             So, right now, we're in the process of

      11      training all the officers on Staten Island, all the

      12      uniformed officers that respond, and the narcotics

      13      officers that deal with the narcotics, you know,

      14      narcotics enforcement directly.

      15             I would suggest that -- and, again, I got to

      16      say this before I go any further:

      17             To the Hunt family, to the Crupi family,

      18      I can't imagine the pain you're living with now.

      19             I'm a father of five.

      20             Right now, I worry about my four-year-old

      21      running into the street.  And we live with these

      22      fears all the time.

      23             I'm not at the point -- my kids are all in

      24      grammar school.  I'm not at the where I have to

      25      worry about drugs.







                                                                   89
       1             But I can see that that worry has to continue

       2      through those years, and you have to look for the

       3      signs.

       4             And I'm learning this here.

       5             You know, I'm taking off my chief hat and

       6      putting on my father hat here, and I can see the

       7      fear that I'm going be living with as my kids become

       8      teenagers.

       9             And to those of you who are living with it

      10      actively now, you know, I wish I had some answer.

      11             I do know that other people that are very

      12      close to me have dealt with it in that very extreme

      13      way.  They've taken large pension loans, and shipped

      14      their children out of state, got them into in-house

      15      treatment for up to a year, then halfway for another

      16      year.  Then let the kids come back to New York for

      17      two to three years.

      18             And when they did come back to New York,

      19      their environment had changed, and they have had

      20      some success in those areas, from what I've seen.

      21             PATRICK TREVOR [ph.]:  Hello, I'm --

      22             UNKNOWN SPEAKER:  [No microphone

      23      used/inaudible.]

      24             ASST. CHIEF EDWARD DELATORRE:  I'm still

      25      working on it.  I am working on it.







                                                                   90
       1             UNKNOWN SPEAKER:  [No microphone

       2      used/inaudible.]

       3             PATRICK TREVOR [ph.]:  -- my name is

       4      Patrick Trevor [ph.].  I'm 21 years old.  And, I

       5      just want to mention that I have 18 months clean

       6      right now.

       7                  [Applause.]

       8             PATRICK TREVOR [ph.]:  I also would like to

       9      say that it is Suboxone-free, it is methadone-free.

      10             UNKNOWN SPEAKER:  Good for you.

      11             PATRICK TREVOR [ph.]:  And I know --

      12      I know --

      13             Thank you.

      14                  [Applause.]

      15             PATRICK TREVOR [ph.]:  Yes, I understand that

      16      that is an option, and that may have worked for you.

      17      But I also know 125 other people, that are my

      18      friends, between the ages of 17 and 25, that are

      19      also doing it.

      20             And I hear so much about the negative here

      21      today, and I wanted to mention a little bit of the

      22      positive.

      23             I'm a member of Dynamite.  It is also known

      24      as "Dynamic Youth Community."

      25             I also have gone to 17 different programs,







                                                                   91
       1      and had to battle with the insurance companies.

       2             And, in the beginning, I can honestly say

       3      I didn't want it.  But at the point when I did want

       4      to achieve sobriety, the insurance companies

       5      wouldn't help me do it.

       6             I would be recommended by a medical official

       7      to go to, say, a three-month program, and the

       8      insurance would pay for two weeks.

       9             Then I would only go for two weeks.

      10             And I never got a fighting chance, until

      11      I found Dynamic Youth Community, which I can

      12      honestly say, for me, a severe heroin addict, was

      13      the best option, and that it is possible.

      14             And I want to give all of the parents here

      15      hope about how possible it is, because I am -- I'm

      16      it.  I'm here with friends that are it.

      17             And I feel your pain, and I agree with you,

      18      I have to say:  That there are other options of how

      19      to do it.  There's so many different things.

      20             Me, I was first introduced to the pills,

      21      I was a lacrosse player, and I shattered my thumb,

      22      and the doctor prescribed me Roxicodone.

      23             Didn't tell me how addictive it was.

      24             What he said was, "You got the good stuff."

      25             So that just shows me, almost, how the doctor







                                                                   92
       1      wasn't even educated on it.

       2             That's 100 percent true.  It's amazing that

       3      he would say that.

       4             After that, a friend showed me:  Oh, you can

       5      sniff these, you can get high.

       6             I enjoyed the feeling.  I thought, Oh, this

       7      can't take a hold of me.

       8             By the time I couldn't afford it, I started

       9      doing heroin, to the point where I was shooting

      10      heroin; where I had lost everything; where I had

      11      gone to jail; where I had stolen from my family.

      12             And then I found Dynamite.

      13             It brings -- it makes me emotional thinking

      14      about how much they have actually helped me.

      15             And how I can't stress how there is other

      16      options, and how funding these programs is what

      17      keeps me alive, and what keeps all these other

      18      children or young adults, living healthy, productive

      19      lives.

      20             Dynamite isn't just a rehabilitation program.

      21      It also taught me how to hold a job, how to be

      22      responsible, how to be a caring person.

      23             AUDIENCE MEMBER:  [No microphone

      24      used/inaudible.]

      25             PATRICK TREVOR [ph.]:  What?







                                                                   93
       1             AUDIENCE MEMBER:  How to speak properly.

       2             PATRICK TREVOR [ph.]:  How to speak properly,

       3      yes, they did teach me that, I've got to say.

       4             How to present myself.

       5             They taught me all of these life lessons that

       6      I actually didn't learn in the 38 programs.

       7             Sure, I learned about the addiction.  And I'm

       8      sure, yes, people do understand it, and they do get

       9      it.

      10             But I learned everything else that comes with

      11      life.  "Everything."

      12             Now I know how to look back at my feelings,

      13      and how to figure out why I wanted to get high.

      14      And, now, how positive a future I have.

      15             And, right now, I'm actually going to bring

      16      up another friend of mine, Michael, who actually

      17      was -- he is one of my peers, and he's doing the

      18      exact same thing as me.

      19                  [Applause.]

      20             MIKE FLYNN:  My name is Mike Flynn.  I'm from

      21      the south shore of Staten Island.  I grew up in

      22      Connorville.

      23             I want to speak on behalf of, even the detox

      24      at the Staten Island University Hospital.

      25             I was not admitted there after having a







                                                                   94
       1      horrible heroin addiction.  "Horrible."

       2             All right?

       3             I overdosed, I think, couple of hours prior

       4      to trying to go there with my mother.  They would

       5      not accept me.

       6             I was told to, basically, go out, drink, or

       7      get loaded up on Xanax, so I would test positive, so

       8      they would take me in.

       9             All right?

      10             So that's what I had to do.

      11             My mother stayed with me in a car in the

      12      parking lot, and telling me to "do whatever you have

      13      to do to get yourself in there."

      14             On behalf of, like, 28-day programs, I worked

      15      for the City at one point and I was sent to

      16      28-day programs that are accessible to the cops,

      17      firemen, all that other stuff.

      18             After --

      19             BRIAN HUNT:  Was that the Villa?

      20             MIKE FLYNN:  -- Malworth [ph.], they call it

      21      "The Farm."  Maybe the cops know it up there.

      22      But -- so I go there.  I was there multiple times

      23      within a 6-month period, basically, after I started

      24      IV'ing drugs.

      25             By the second time I was there, they told me







                                                                   95
       1      that there is no possible way that they could help

       2      me.  They discharged me after two weeks.

       3             They told me that I had an anxiety disorder

       4      and depression, and that I needed to, basically,

       5      leave, and go seek medication and therapy outside

       6      of, you know, what they could do for me.

       7             This was supposed to be, you know, one of the

       8      top rehabilitation centers probably on the

       9      east coast, and this is what was told to me.

      10             So, that's what I did.

      11             Shortly after that, lost my job.  Started

      12      getting arrested for the first time in my life, and

      13      wound up in jail, Rikers Island.

      14             Never thought I would be there.  And I come

      15      from very blue-collar, working-class family.  And

      16      that was never in the cards.

      17             And, that's what happened.

      18             After being there for a month, I was given an

      19      option by the courts to go to, you know, a program

      20      or take a prison sentence.

      21             All I knew was that -- I really had no hope

      22      at that point, but all I knew was that, it was

      23      either I was going to do something or I was going to

      24      die.

      25             I was hopeless.  I was down on my knees, you







                                                                   96
       1      know.  There was times where I just -- I wish that's

       2      what it came to me, because that would have easier

       3      than what I was doing.

       4             And, I wound up at Dynamite.

       5             And I can say, over and year and half later,

       6      life's good again.  Working.  I got probably

       7      60 pounds heavier than I've ever been, you know.

       8      I was, like, my cheeks were sunken in.  I was

       9      like -- you know.

      10             And, just, life's good again.

      11             But it wasn't because of short-term

      12      treatment.  It was because I went away to a

      13      long-term treatment, that I have all these

      14      opportunities that I did now.

      15             When I was 18, I was put on Suboxone, because

      16      that was supposed to be the cure.

      17             The doctor told me:  Take this, and just go

      18      about life.  You know, you go to therapy once in a

      19      while, everything's going to work out.

      20             Yeah, it worked for like two years, and

      21      I achieved a lot.  As soon as I went off of it, back

      22      to drugs, because I didn't know how to deal with

      23      anything.  It was a substitution.

      24             There's ways to go about it.

      25             And what she [indicating] had to say today, a







                                                                   97
       1      lot of other people, the people that experienced it,

       2      they know what they're talking about.

       3             And no offense to anyone up there, but,

       4      unless you lived it, you really can't have, you

       5      know, the right perspective on the matter.

       6                  [Applause.]

       7             BRIAN HUNT:  To that gentleman that just

       8      spoke, I wish I had the opportunity to continue to

       9      experience it.  I wish my son was alive so I can

      10      work with him in getting clean.

      11             I don't have my son anymore, so I don't --

      12      that's a bad thing for me.

      13             My son went to the Villa Veritas upstate in

      14      Kerhonkson, New York.  He went for a 28-day program;

      15      intense program.

      16             He didn't get it.

      17             They wouldn't let him out.  Said you have to

      18      go for another 28 days.

      19             He stayed there for two months.  He finally

      20      got it.

      21             He came out.

      22             You have to go to your meetings.

      23             You had to do 90 meetings in 90 days.  That's

      24      intense.  And you have to work the program.  And you

      25      have to get a sponsor.







                                                                   98
       1             If you don't do that on the 28-day program,

       2      it's not going to work at all.  You can't do it

       3      alone.

       4             You have to go to your programs, you have to

       5      go to your meetings.  You have to have a sponsor;

       6      someone to look after you.

       7             So, God bless you, for you two gentlemen, for

       8      doing what you're doing.

       9             Stay strong, and I hope you live a very long,

      10      prosperous life.

      11                  [Applause.]

      12             BRIAN HUNT:  I wanted to -- can I just, one

      13      thing, I want to get back to this young lady right

      14      here.

      15             UNKNOWN SPEAKER:  I'm sorry.

      16             BRIAN HUNT:  Yeah, I'm sorry.

      17             SENATOR LANZA:  So there was a question to

      18      law enforcement.

      19             Let me -- before we go back there, let me

      20      remind everyone, as I said before, everyone here is

      21      part of the solution, not the entire solution.

      22             With respect to what law enforcement is

      23      doing, we're very fortunate here on Staten Island.

      24             I can speak now as a former prosecutor from

      25      the Manhattan District Attorney's Office,







                                                                   99
       1      I prosecuted hundreds of drug cases.

       2             Law enforcement, they can do two things:

       3             They enforce the laws that we have on the

       4      book, criminally.

       5             And you hear, also, as the chief was saying,

       6      they're now training themselves to deal with, when

       7      they respond as first responders, to save those

       8      lives.

       9             But they're not part of treatment.  They're

      10      not part of the more -- you know, some of the other

      11      things we're talking about here.

      12             And I could also tell you their jobs are made

      13      more difficult by the mixed signals we in society

      14      are sending.

      15             I can't tell you, my work on I-STOP, how many

      16      Staten Islanders called my office, to tell me that

      17      drugs should be legalized.  That this was the wrong

      18      approach.

      19             Many Staten Islanders called to say that, and

      20      e-mailed, to say they ought to be legalized.

      21             As a prosecutor, I can tell you, how many

      22      instances prosecuting drug-sale crimes in Manhattan,

      23      when the criminal justice system would treat them as

      24      if they were shoplifters.

      25             To me, you sell heroin, you're a murderer.







                                                                   100
       1             So it's very difficult, the climate, in which

       2      our law enforcement is operating.

       3             But I'll let them tell you what they're doing

       4      on Staten Island.  And they are being very dynamic

       5      in trying to address this growing crime, from their

       6      perspective, the crime.

       7             ASST. CHIEF EDWARD DELATORRE:  I will.

       8             I will, two seconds.

       9             So what I was saying, then, is now -- so now

      10      we move to the prevention side.

      11             So we have a lot of programs.  Not treatment,

      12      because, he's correct, we don't treat.  But there is

      13      a treatment component to our enforcement, and I'll

      14      get to that in a minute.

      15             On a prevention side, we go after youth, and

      16      we have programs.  We have what we call the

      17      "Youth Police Academy."  It's been in New Dorp High

      18      School.  We're opening up a second one now up on the

      19      north shore here, as well, in Curtis High School,

      20      where we take in about 130, 140 kids.

      21             We have -- that's the YPA (Youth Police

      22      Academy).

      23             We have Law-Enforcement Exploring, which we

      24      engage teenagers, from ages 14 to 21, in every

      25      precinct, including the new 121 now.  They have a







                                                                   101
       1      program there, as well.

       2             We have a Law-Enforcement Exploring Academy,

       3      where we take kids away for a three-week boot camp:

       4      two weeks in Fordham University, and a third week up

       5      in 10-Mile River Campground.

       6             And during this entire time, they're being

       7      mentored and trained by NYPD, DEA, Customs agents,

       8      FBI agents.  The counselors in these programs are

       9      all law-enforcement people.

      10             So we're engaging youth at a younger age,

      11      trying to help mentor, trying to assist parents in

      12      mentoring, and giving them some positive role models

      13      outside of what they're seeing on the street.

      14             We have many, many other programs here.

      15             And Lorraine Marin [ph.] from the Community

      16      Affairs Bureau is standing on the side of the room.

      17             And anybody who wants more information about

      18      it after the meeting, please go over to her.

      19             And if you want your children, your younger

      20      children, in the same families affected right now,

      21      if you have younger children, I would strongly

      22      encourage you to go over and see her, and find out

      23      what programs we have for the younger children, too.

      24             I can tell you, for the younger children, I'm

      25      sure you're aware, they're suffering by seeing the







                                                                   102
       1      older sibling go through this, as well.

       2             Now, I move on to the enforcement aspect.

       3             Captain Dorazio here is going to talk about

       4      what we do with the drug dealers.

       5             Because, obviously, these drug dealers are

       6      selling, they're affecting the lives of hundreds and

       7      hundreds of people.  We finally get them,

       8      something's got to happen.

       9             But the other part is, for the drug users

      10      that we're arresting so many of, as well, on the

      11      island, is Dan Donovan and the DA's Office has this

      12      court, a drug court.

      13             And I -- Karen is here from the DA's Office,

      14      and she'll be able to expand on what the drug court

      15      does to kind of force treatment on many people.

      16             Go ahead, Captain.

      17             CAPTAIN DOMINICK DORAZIO:  Thank you all for

      18      inviting me today.  I appreciate it.

      19             What I wanted to say to you is, obviously --

      20      well, let me start by saying:

      21             I'm not positive I can offer you the answer

      22      that you want, because a lot of what we do, you

      23      know, cannot be discussed in an open forum.  You

      24      know, this is not appropriate time to discuss that.

      25             However, speaking specifically of my unit,







                                                                   103
       1      and the problem that we've discussed here today, and

       2      Dr. Messina accurately described how this problem

       3      has affected -- you know, this problem that we're

       4      talking about today with regards to narcotics, has

       5      affected, primarily, the south shore and

       6      middle island.

       7             Typically, you know, what I could say is

       8      that, the way we allocate our resources, we are much

       9      more dedicated to tackling the problem in that area.

      10             Typically, narcotics, when we prioritize the

      11      allocation of our resources, it is -- we tend to

      12      prioritize the areas that are prone to violence.

      13             And while this is a public-health crisis, the

      14      violence associated, it has not been associated with

      15      pill trade, and even heroin, on the south shore.

      16             However, our union has recognized the

      17      public-health emergency, and we have shifted our

      18      focus, where, without ignoring the areas of

      19      Staten Island that are prone to violence, we're able

      20      to enforce, you know, more aggressively in the areas

      21      that are, you know, being affected by this and may

      22      not be as prone to violence.

      23             The south shore, you know, the Princess Bay

      24      area, you know, even middle island and the

      25      south beach area, these -- you know, which really







                                                                   104
       1      isn't the south shore, but, you know, these areas

       2      that are primarily affected by this.

       3             What my unit does, obviously, we are a very

       4      proactive unit.  We conduct daily enforcement.

       5      We're out there, you know, seven days a week.

       6             And a lot of what we do is responding to the

       7      complaints that you all make.  Sometimes

       8      anonymously, sometimes in writing, sometimes, you

       9      know, however you make -- you know, direct to the

      10      precinct, you know, we respond directly.

      11             Now, when you make these complaints, you may

      12      expect instant gratification.

      13             But the way my unit works, that instant

      14      gratification not possible.

      15             In order to build a strong case, and the

      16      DA's Office could attest to this, you know, we can't

      17      just go out there and say, you know:  There's the

      18      problem, make the arrests, and the problem's solved.

      19             We have to build a case, so, we do more

      20      intense investigations.

      21             We don't just -- you know, we do daily

      22      buy-and-bust enforcement, also.

      23             But, you know, the bulk of what we do, and we

      24      try and do, is try to infiltrate these individuals

      25      and these groups that are selling the stuff, and,







                                                                   105
       1      you know, bring them to justice, so to speak.

       2             But, it doesn't take -- it doesn't take, you

       3      know, a day.  Sometimes it could take weeks,

       4      sometimes it could take, you know, more, to develop

       5      the information that we need to get to where we want

       6      to get.

       7             I will say this:

       8             My unit has -- you know, we talked about the

       9      I-STOP program.  I'm just comparing this year to

      10      last year.

      11             In 2013, compared to 2014, we have seen a

      12      precipitous drop in the amount of pills that are out

      13      there.

      14             You know, 44 percent, obviously, that hasn't

      15      translated across the borough.  Chief Delatorre's,

      16      you know, information is 100 percent accurate.

      17             But in my unit, we've seen a precipitous drop

      18      in the amount of pills.

      19             Unfortunately, that drop has been

      20      commensurate with the increase in heroin.

      21             So, where we see a 46 percent drop in pill

      22      seizures, we're seeing a 44 percent increase in

      23      heroin seizures, from -- you know, from last year to

      24      this year.

      25             And when you go back two years, I mean, it's







                                                                   106
       1      like almost 100 percent, the increase in heroin that

       2      we're seeing.

       3             So, we're effective out there.  We're getting

       4      the heroin that we can, we're getting the pills that

       5      we can.

       6             And just to speak to that I-STOP program,

       7      personally, how I feel about it:

       8             You say, Well, if that I-STOP program is

       9      working, why are we seeing so much heroin?

      10             Well, I would say this:  I would say that

      11      those probably aren't new users.

      12             That -- that the amount of pills that were

      13      available between 2009 and now, you know, you may

      14      have created a whole generation of new users.

      15             Now, to see the effectiveness of I-STOP,

      16      I think you'll see that in the years to come, where

      17      these kids -- and he spoke to it, and the young men

      18      back there spoke to it, I don't think these kids are

      19      going to make the jump to heroin without the pills.

      20             So as the I-STOP program takes effect, so to

      21      speak, and the pills start drying up, the next

      22      generation, so to speak, you know, won't have that

      23      same problem.

      24             That's my own personal opinion on the

      25      effectiveness.  I think it's great program.  And it







                                                                   107
       1      is working.  I mean, we have seen a tremendous

       2      decrease.

       3             I hope I offered you some kind of an answer

       4      there, you know, and -- you know, did the best

       5      I could there.

       6             Thank you.

       7             SENATOR BOYLE:  Thank you very much, Captain.

       8             I'd just like follow up, along those lines,

       9      with the District Attorney's representative, Karen.

      10             Around the different parts of the state, it

      11      seems that we're getting different answers from

      12      different prosecutors' offices.

      13             Are the laws strong enough now?

      14             When you get a case from the law enforcement,

      15      and you have someone dealing with 50 bags, 100 bags,

      16      200 bags, do you say:  Okay, we can give him a

      17      felony as a drug dealer?

      18             Now, obviously, we make the dichotomy between

      19      those people who are selling because of their

      20      addiction themselves, to get their own drugs, or,

      21      those purely dealing drugs.

      22             How do you feel about the current laws?

      23             KAREN VARRIALE:  The current laws, as they

      24      state, have actually reduced the mandatory state

      25      prison sentence for even second-time felony







                                                                   108
       1      offenders.

       2             So the -- what used to happen in the early

       3      days before the Drug Law Reform Act, was that, if

       4      you were facing a second felony offense:

       5             You had to go to state prison;

       6             Or, you could go into our "drug-treatment

       7      alternatives to prison" program:  Do 18 months

       8      inpatient, 6 months outpatient, followed by a

       9      misdemeanor, to avoid your state-prison sentence.

      10             Now you don't have to do that.

      11             Our numbers in that program decreased so much

      12      once they -- when the law was changed.

      13             That being said, we have also created the

      14      Staten Island Treatment Court for first-time felony

      15      offenders; Staten Island Treatment Court for

      16      misdemeanor offenders.  Also, they're outpatient,

      17      mostly, programs.

      18             But if there's a failure, the Court will

      19      either sentence, a punishment, some jail, back to

      20      treatment.  And it changes.

      21             We've also created -- our office has created

      22      a program called "Drug Cap," which is for

      23      first-time, usually, pill offenders; where, you have

      24      to go to a panel similar to this, some law

      25      enforcement, recovery, those grieving a loss, and







                                                                   109
       1      listen to the stories of where you could end up.

       2      It's that future look.

       3             And that's -- will let you get off without a

       4      criminal record so you can still stay with a clean

       5      slate.

       6             But it's not only for drug users -- drug

       7      offenses.  We offer these programs to anyone who has

       8      the addiction, if you qualify.

       9             If you're burglarizing, you know, a

      10      commercial establishment because you need to feed

      11      your addiction, you can still qualify.

      12             The only people who generally don't qualify

      13      are violent offenders.

      14             But back to the generation change in I-STOP,

      15      because, now, we are seeing the heroin, which is

      16      unfortunate, it makes my life a little easier.

      17      I don't have to battle the "I have a prescription"

      18      defense.

      19             You have heroin, it's automatically unlawful

      20      and it's much easier to prosecute.

      21             But, I'll tell you, the judges, as well, and

      22      we as a prosecutor's office, would rather treat the

      23      offender than punishment them, because if you are

      24      truly an addict, you're not going to be any better

      25      after six months in prison or jail.  You need to







                                                                   110
       1      face that problem and deal with it.

       2             So our programs are the first place we go.

       3             And we work hand-in-hand with

       4      Captain Dorazio's unit for those complaints that

       5      I get.  I could make a phone call, and he's on it

       6      the next day.

       7             So we are doing as much as we can at the

       8      front of enforcement, as well, in our

       9      investigations.  We work with them from the

      10      beginning.  We target the areas, and we work every

      11      day with the investigators.

      12             So that's what we're doing.

      13             SENATOR BOYLE:  Thank you very much.

      14             And one final area in law enforcement,

      15      Special Agent Hunt, on Long Island we see the heroin

      16      coming up from the cartels and out to Long Island.

      17             Is it a similar situation here on

      18      Staten Island?  Or do you know, where the big drugs

      19      are coming from, the big numbers?

      20             JAMES J. HUNT:  Yeah, I think it's important

      21      to note that New York is, and always has been, a hub

      22      for heroin distribution in the United States.

      23             20 percent of all DEA seizures of heroin are

      24      here in New York.

      25             What is -- what's been happening in the last







                                                                   111
       1      seven or eight years, that's changed the trafficking

       2      somewhat is, is the Mexican crime groups are

       3      flooding New York with heroin.

       4             In all cities.

       5             The gentleman talked about Vermont before.

       6             It's all over the city.  We're -- we seized

       7      70 kilos of heroin since January 1st here in

       8      New York.  That's an ungodly amount of dope.

       9             It's not putting a dent in them.  They just

      10      have more cars, more trucks, crossing the border.

      11             What we get, we get.

      12             What they get through, hits the streets.

      13             They're trying to create a bigger market for

      14      heroin.

      15             These stories are sad.

      16             I'm sitting here -- what people are going to

      17      understand, you're not going to arrest yourself out

      18      of this problem.

      19             If you're a major drug trafficker here in the

      20      United States, local and federal law enforcement are

      21      very, very effective in catching you.  The federal

      22      and state prisons are filled with bad top-echelon

      23      dope dealers.

      24             You've got a short shelf life:  You're going

      25      to go to jail, or get killed.







                                                                   112
       1             The problem is, there's always going to be

       2      some young punk underneath there that's willing to

       3      take a shot.

       4             So, as law enforcement, we sympathize,

       5      empathize with parents who have gone through this.

       6             There's no lower life than someone who would

       7      sell poison to people.

       8             And, law enforcement is doing what we're

       9      supposed to do: we're locking up those bad guys.

      10             But we're not going be able to save kids.

      11             Parents, prevention, have to do that.  These

      12      kids got to be scared to death to even try it in the

      13      first time.

      14             These crime groups, as sophisticated as they

      15      are, we're catching them.

      16             "Chapo" Guzman, number one guy in the world,

      17      wanted; DEA caught him.

      18             So, they are getting caught, but,

      19      unfortunately, right now, with the Mexican border

      20      proximity to the United States, how porous it is,

      21      they're flooding the market.

      22             So parents, be beware.

      23             The full intent is to get people hooked.

      24             It's cheap.  They're making it themselves

      25      now.  There's labs in Mexico now, where they used to







                                                                   113
       1      get all the time from the South Americans,

       2      Columbians.  They're actually going the poppy in

       3      Mexico.  They can convert it there in Mexico.

       4             So, they're selling kilos of heroin for

       5      $50,000.

       6             30 years ago, when organized crime was

       7      controlling it, it was $200,000 a kilo.

       8             And it's more pure.

       9             So that's what you're dealing with.

      10             We are catching the bad guys, we're doing

      11      everything we can, but, we're not going be able to

      12      arrest ourselves out of this problem.

      13             ASST. CHIEF EDWARD DELATORRE:  You know, if

      14      I can add just one comment?

      15             I think early intervention, obviously, is

      16      probably the best weapon a parent would have.

      17             But, unfortunately, we put all our efforts

      18      into raising these kids, and the last thing we want

      19      to believe is that something's wrong.

      20             And, we get it all the time.

      21             I get calls from people:  Chief, you know, my

      22      kid's a good kid.  They arrested my kid.  The cops

      23      are wrong.  He was just holding it for his friend.

      24      His friend gave it to him.

      25             You know, I get it all the time.







                                                                   114
       1             People on drugs don't always tell the truth.

       2             And the parents have to understand, whether

       3      your son or daughter had the drugs and admitted it,

       4      or was holding it for someone and admitted it, if

       5      they're in that environment with other kids -- and

       6      I heard this said already -- if they're in that

       7      environment, with other kids that had drugs, you

       8      have a problem.  And you better get on it quick.

       9             SENATOR BOYLE:  Thank you very much.

      10             SENATOR LANZA:  A comment, and then questions

      11      from the audience that I have here.

      12             We've talked about the I-STOP a number of

      13      times here, and there's this notion that I think is

      14      floating out there.

      15             I don't want the information to be

      16      misinterpreted.

      17             So there's this notion that because I-STOP is

      18      going to dry up the supply of access -- illicit

      19      access to prescription pills, that, somehow, that is

      20      why people are -- you know, we see heroin addiction

      21      on the increase.

      22             That's partially true, but not for the

      23      reasons why people are saying.

      24             Long before I-STOP came into being and became

      25      law, we saw heroin use increase exponentially every







                                                                   115
       1      year.

       2             And what we learned, and if you listened to

       3      the stories of the young people out there, and what

       4      you've heard, and I quoted the statistic before,

       5      over 80 percent of the people who try heroin for the

       6      first time were already addicted on prescription

       7      drugs.  "Over 80 percent."

       8             So what we learned with this insidious

       9      epidemic of prescription drugs is that, where

      10      there's a certain barrier to entry with heroin,

      11      there are many folks who would never try heroin,

      12      because you have to go to a certain, behind some

      13      building, and deal with a drug dealer on the street.

      14             You would never do it.

      15             We see by the thousands, young people are,

      16      though, willing to try a pill, because it's

      17      happening.

      18             It's given to them by a friend.  It's in your

      19      medicine cabinet.  It was prescribed by a doctor.

      20      It has a nice label on it.  We live in a society

      21      where we think all the solutions are in that bottle.

      22             And, so, that is why so many people, young

      23      people, say:  Why not?  It's safe, I'll do it.

      24             That is the gateway to the heroin, and that's

      25      why we see the heroin explosion.







                                                                   116
       1             So our hope, my point here is, with I-STOP

       2      drying up that supply, that we'll see fewer people

       3      getting involved in the gateway to that -- to the

       4      heroin epidemic.

       5             There are a couple of questions, I'm going to

       6      put them together.

       7             The basic theme here, to law enforcement, is:

       8             People are citing their own experiences,

       9      whether it's at a train station or on the corner,

      10      they see all the signs of the drug trade on the

      11      street.

      12             They know you're doing a good job.

      13             I can tell you, they're doing an incredible

      14      job.

      15             Their question, though, is a question I have

      16      as well:  Do you have enough resources here on

      17      Staten Island, in law enforcement, to tackle the

      18      problem that we have on the streets?

      19             UNKNOWN SPEAKER:  Should we all say "no" at

      20      the same time?

      21             CAPTAIN DOMINICK DORAZIO:  I mean, with the

      22      state of the department as it is right now,

      23      I believe that we do have enough resources.  I mean,

      24      we are able to handle our workload, you know, pretty

      25      effectively.







                                                                   117
       1             Obviously, you know, more personnel is

       2      welcome.

       3             I mean -- and I think that goes for the --

       4      I'm sure the Chief could attest to that, as far as

       5      the patrol borough goes, as far as the narcotics

       6      borough goes.

       7             Yes, obviously, more personnel would make us

       8      more effective, but I do think that we are able to

       9      handle our workload with our current personnel.

      10             SENATOR LANZA:  There's a question from Fern.

      11             Fern, why don't you -- Fern, why don't you --

      12      let's hear from you, instead of me reading this.

      13             Introduce yourself, tell everyone who you

      14      are.

      15             FERN ZAGOR:  Can I take back my card?

      16      Because I forgot what I wrote.

      17                  [Laughter.]

      18             FERN ZAGOR:  Thank you for this opportunity.

      19             I'm Fern Zagor.  I'm the president and CEO of

      20      the Staten Island Mental Health Society.

      21             I'm also one of the co-founders of the

      22      Tackling Youth Substance Abuse Initiative, and very

      23      proud of the work that we do.

      24             Staten Island Mental Health has a licensed

      25      substance-abuse program, and we treat youth through







                                                                   118
       1      our teen center, about 200 substance-abusing youth,

       2      and their families, every year.

       3             But what we've learned is that, youth

       4      beginning to experiment with alcohol and drugs, they

       5      don't come to us, and they're not going to come us,

       6      no matter how often they're referred to us.

       7             They don't seek our help.

       8             They need help on their own turf in their own

       9      communities.

      10             Current regulations don't allow this.

      11             We can only provide early-intervention

      12      programs and treatment services at licensed

      13      locations.  Makes it very difficult.

      14             We know that if we reach out to the kids in

      15      their community, we have a chance of engaging them

      16      early on in their youth -- in their use, and perhaps

      17      preventing them from increasing and becoming

      18      addicts.

      19             Licensing doesn't allow it, regulations don't

      20      allow it, funding doesn't allow that.

      21             Prevention services are usually

      22      group-education approaches offered primarily in

      23      school settings.  This has limited, if any, effect

      24      on youth in the community who are already using or

      25      on the road to abuse.  They kind of laugh it off.







                                                                   119
       1      You know, they're hearing things in the school.

       2             It affects kids.

       3             You know, there are kids that they're going

       4      to grab early on, and they may learn, and that will

       5      prevent them from using, and they're learning those

       6      coping skills.

       7             But those kids who are already experimenting,

       8      that doesn't touch them.

       9             So, again, we need those early-intervention

      10      approaches that engage kids, one-on-one, in small

      11      groups, in their community.

      12             The regulations have to allow that, the

      13      funding has to allow that.

      14             We've done some of that work with

      15      private-foundation money, and we know that it can

      16      work at least for some.

      17             Now, the public, the State, needs to be able

      18      to follow suit and provide us with those kind of

      19      prevention dollars.

      20             Thank you.

      21                  [Applause.]

      22             SENATOR LANZA:  Michael, over here.

      23             Thanks, Fern.

      24             CAROL:  [Speaking without microphone.]

      25             My name is Carol.  I'm a recovering







                                                                   120
       1      alcoholic, and I'm a teacher.

       2             SENATOR BOYLE:  Can you just -- it's for the

       3      recording that we need the microphone.

       4             CAROL:  Oh, okay.

       5             SENATOR BOYLE:  Thank you.

       6             CAROL:  And I was admonished for discussing

       7      drug prevention in an eighth-grade class.

       8             Talking to the kids about senioritis, and,

       9      how, when they would leave -- you know, when you

      10      come to school as kindergarten, you're adorable.

      11      You're the bottom, everybody thinks you're so cute.

      12             You get to fifth grade, you're the top

      13      banana.

      14             You go to junior high, you get squished like

      15      a bug again.

      16             You go to the eighth grade, you're the top

      17      banana again.

      18             Then you go to high school, you're squished

      19      like a bug.

      20             My daughter found pot at IS-75, which

      21      I doubled my rent to get her to IS-75.

      22             Pot was the gateway drug for her.

      23             Xanax, she got at Tottenville High School.

      24             So it was the best schools.  It didn't matter

      25      which shore: south shore or north shore.







                                                                   121
       1             And, I took her to Dynamite on Coney Island,

       2      and I knew they will wouldn't take her.  They told

       3      her she wasn't enough of an addict because she

       4      didn't use heroin or cocaine.

       5             And, I have to tell you, treatment court

       6      helped, and TASK helped.

       7             And I don't know, is TASK still here?

       8             Because --

       9                  [Multiple people say "Yes."]

      10             CAROL:  Okay.

      11             Because I was very involved with them.

      12             It took her three years to graduate from

      13      treatment court.  Three years for a one-year

      14      program.

      15             She went upstate, she went to Daytop,

      16      Forest Avenue.  All of it, it didn't mean anything.

      17             She loves pot.

      18             Thank God, no pills.  Scared the hell out of

      19      her, but she thinks pot is the be-all, end-all.

      20             And so does Cuomo.

      21             I mean, we're hearing about legalizing it.

      22                  [Laughter.]

      23             CAROL:  You know, I was a certified drug

      24      counselor before I was a teacher.  State certified.

      25      I was a SPARK counselor for 8 years at







                                                                   122
       1      Lincoln High School.  So I know all about this

       2      stuff.

       3             And I have 38 years sober.

       4                  [Applause.]

       5             CAROL:  My daughter grew up in a 12-step

       6      household.  It didn't matter.

       7             What mattered is what happened in school.

       8             Not what happened in my drug cabinet, in this

       9      drug cabinet, in the neighbor.

      10             It was what was at school.

      11             You want to feel better, at Tottenville,

      12      there's a corner that they call the

      13      "90-Degree Angle."  Right across the street, and

      14      they smoke dope.

      15             And it was called "dope" in my day.  Pot was

      16      call "dope" because it made you dopey; because it

      17      killed your brain cells.

      18             And these kids, when they see it legalized on

      19      TV, and they see these people, look what they look

      20      like.  "Oh, yeah man, it's now legal."

      21             They look like a bunch of bums.

      22             You don't see them well-dressed, saying,

      23      "Oh, now it's legal."

      24                  [Laughter.]

      25             CAROL:  What I'm saying is, I was written up.







                                                                   123
       1             I'm a sub, I'm an ATR; one of those traveling

       2      teachers, at a junior high, as a sub.  Didn't have

       3      time to do the regular busy work-lesson plan.

       4             Talked to the kids about respect for each

       5      other.  About, as the world gives to you, that's

       6      what you get back.  Talked to them about senioritis.

       7      About how, if kids fail, they want you to fail.

       8      They want to pull you down with, stick with the

       9      winners.

      10             And I was admonished for non-professional

      11      behavior, at a junior high right here on

      12      Staten Island.

      13             So I just -- I just came, and I ran from

      14      school as soon as it was out, to get here.

      15             I really appreciate that you're doing this.

      16             You have no idea that I'm a fan of yours,

      17      Senator Lanza.

      18                  [Laughter.]

      19                  [Applause.]

      20             CAROL:  Well, I know Susan very well.

      21             I know your sister, and your wife.

      22                  [Laughter.]

      23             CAROL:  But, truly, prevention is the

      24      schools.

      25                  [Applause.]







                                                                   124
       1             CAROL:  All these treatment facilities,

       2      they're not going to go unless there's prevention

       3      from kindergarten, on up.

       4             You want to talk about getting them ready for

       5      college in kindergarten?  That's a joke.

       6             Get them ready to be drug-free in

       7      kindergarten.

       8                  [Applause.]

       9             SENATOR BOYLE:  Thank you.

      10             UNKNOWN SPEAKER:  I would like to say

      11      something.

      12             SENATOR BOYLE:  You do bring up a good point.

      13             And all of us in Albany are fans of

      14      Senator Lanza, as well.

      15                  [Laughter.]

      16             SENATOR BOYLE:  And I'm not going tell your

      17      daughter that you added her as a pot-smoker in front

      18      of all of these law-enforcement officials.

      19                  [Laughter.]

      20             SENATOR BOYLE:  But you answered a good

      21      question about the age.  Appropriate age prevention.

      22             And I'll ask the panelists up here:  Do --

      23      anybody have an idea of what is age-appropriate?

      24             Yeah, James.

      25             JAMES FIORE, JR.:  I would like to speak.







                                                                   125
       1             I know that, in my neighborhood, on the

       2      south shore, in Annandale, and in many

       3      neighborhoods, when we were growing up, there were

       4      two things that we would -- well, we never said we

       5      would do drugs.

       6             But there's two things that we would never,

       7      ever could conceive, and that is cocaine and heroin.

       8             And what -- and I heard a woman ask, What can

       9      be done for children at a young age, to prevent

      10      this?

      11             Prescription opiates need to be looked at as

      12      heroin, as crack, because that's what they are.  It

      13      is synthetic heroin.

      14                  [Applause.]

      15             JAMES FIORE, JR.:  Thank you.

      16             And at young ages, these pills need to be put

      17      on this same category as these drugs.

      18             Because I know that no kid in my

      19      neighborhood, at the age that I took my first

      20      Percocet, would take a bag of Coke or a bag of dope.

      21             And, you know, I hate to be so blunt.

      22             And, you know, I want to say one more thing:

      23             You know, regarding Suboxone, it doesn't work

      24      for everyone.  It worked for me.

      25             And, you know, long-term treatment may work







                                                                   126
       1      for some people, and outpatient may work for some

       2      people, but there's a saying in recovery, and I'm

       3      sure everyone's familiar with it:  You can lead a

       4      horse to water but you can't make it drink.

       5             You know.

       6                  [Applause.]

       7             SENATOR BOYLE:  Thank you very much.

       8             Mic over here.

       9             ANN:  Hi, my name is Ann.

      10             And, the very first thing I want to say is,

      11      I'm extremely grateful for everyone in this room,

      12      for all the humanity in this room, your interest in

      13      this disease.

      14             Candace, I want to thank you; all the

      15      parents; everybody that's sharing their story.

      16             But when I read your son's obituary, it blew

      17      me out of the water, because I always wondered if

      18      I would have the courage to say that.

      19             Whenever I read those kids that are -- "died

      20      at home," I know what it is, and I don't want to be

      21      that parent.

      22             I don't know, today I'm not, but I don't know

      23      what tomorrow is going to bring.

      24             I thought that was amazing courage, and it's

      25      the first step --







                                                                   127
       1                  [Applause.]

       2             ANN:  -- not just all of us to say we have to

       3      remove the stigma.  But, anybody who says, it's very

       4      difficult for me to say, my son is in recovery.

       5      Totally, it was not in the script.  Just, it was

       6      impossible to happen to us, and it did.

       7             And everybody can talk about it, but when you

       8      put it in the paper, it was right out there for

       9      everyone:  This is a fact.  This is life.  This is

      10      what's going on.

      11             I thank you.

      12             Thank you.

      13             CANDACE CRUPI:  You're welcome.

      14             If more kids would see it, they'd be afraid,

      15      maybe.

      16             ANN:  I'm sorry?

      17             CANDACE CRUPI:  I said, more kids should see

      18      it, maybe they'd be more afraid.

      19             ANN:  That was the thing.

      20             When I went to high school, they gave us one

      21      tip:  Go to heroin, there's no coming back.

      22             And when my son was given Suboxone, he says

      23      to me:  Do you know that's the same thing they give

      24      to people on heroin?

      25             I was, like, What?  You don't know this?







                                                                   128
       1             He's 29 years old.  How did he miss this day

       2      in school?  I don't know.

       3             But, anyway, it's a family disease, it's a

       4      community disease.

       5             And the thing that I'm struggling with today,

       6      and I would like to leave today, maybe the medical

       7      people could help me, is, my family members are on

       8      board some days, and not on board other days.

       9             And, when they get frustrated, and they're

      10      busy with their own lives, they say:  He chose to do

      11      it.  It's not a disease.  He can stop if he wants

      12      to.

      13             And every day I have to remind myself, and

      14      I have to be extremely patient:  Patience beyond

      15      patience.

      16             And, I need the phrase or the words to say to

      17      them, "It is a disease."

      18             Sometimes I say, you know, your brother has

      19      cancer.  And some days he believes me, and some days

      20      he doesn't.

      21             I need the words to convince people, this is

      22      a disease.

      23             That's what I'm asking you.

      24                  [Applause.]

      25             UNKNOWN SPEAKER:  Hi, I'd like to just offer







                                                                   129
       1      a response to you.

       2             And I think one of the biggest things that we

       3      need to do is education, because, without education,

       4      there's no understanding.

       5             So, maybe what you could impart to your

       6      family and friends, is really providing them with

       7      education that we give in programs, that you can get

       8      on the Internet, that you can get in any of the

       9      agencies here.

      10             But education and prevention are really what

      11      we need to do as a community.

      12             SENATOR LANZA:  Doctor?

      13             DR. HILLARY KUNINS:  Thank you for that

      14      question.

      15             I can just share with you what I've used in

      16      my own practice, and in my own personal life, which

      17      is, some of you heard this yesterday, is I find the

      18      analogy of diabetes very useful in speaking to

      19      people.

      20             You wouldn't ask a diabetic to stop his or

      21      her treatment with insulin, you wouldn't ask a

      22      diabetic to start eating chocolate cake, and expect

      23      it to go just fine.

      24             It's just the same thing:  It's a processing

      25      problem in the body.







                                                                   130
       1             In this case, it's a substance, a drug, and

       2      not sugar, but it's not that much different.

       3             LUKE NASTA:  As far as answering the question

       4      about:  Where do you go for information?  How do you

       5      get support?

       6             Programs like the YMCA Counseling Service,

       7      Camelot.

       8             I'm not sure who else has family

       9      associations.

      10             But -- and it doesn't cost -- there's no fee

      11      involved.  They're weekly meetings, and you're there

      12      with other family members who are going through the

      13      struggle.

      14             And you get educated, and you get support,

      15      and you get the ammunition that you need to deal

      16      with the problem in your home.

      17             JACQUELINE FIORE:  And there's programs

      18      available for kids, too.

      19             I mean, we talk all the time about this being

      20      a family disease.

      21             And it's often the brothers and sisters and

      22      the little ones that are suffering in silence, and

      23      they want to be good, so that they don't have to be

      24      a problem for mom or dad like their brother or

      25      sister.  Or, they're crying out for attention by







                                                                   131
       1      being, you know, bad, quote/unquote.

       2             So there's programs out there for the kids,

       3      who can help them to find the words to express what

       4      they're feeling.  And, also, to arm them with coping

       5      skills so that they can combat life on life's terms

       6      later on in their own lives, and don't have to

       7      travel down the road of their siblings.

       8             SENATOR BOYLE:  I would say, just before

       9      coming here, I got a chance to tour YMCA, and the

      10      Little Steps Program for the younger siblings was

      11      very impressive.

      12             DIANA DULCHE pph:  Hi, my name is

      13      Diana Dulche [ph].

      14             I started my journey because I wanted to help

      15      myself heal.  Not through drugs or any of that.

      16             But I had ailments that I was told that

      17      I needed operations, and I helped myself heal.

      18      I had fourth-stage spondylolisthesis.

      19             But my point is, we're given something, and

      20      people say, you can't be cured, you know, unless you

      21      get an operation.

      22             Which, I don't believe in, and, I healed

      23      myself.

      24             When I was 37, I had fourth-stage

      25      spondylolisthesis.  I used to get out of bed like a







                                                                   132
       1      90-year-old woman.

       2             So how I healed myself was, you know, getting

       3      my core strong.

       4             So this is my point, is:  I started educating

       5      as a holistic health practitioner.  And I wanted to

       6      open up a wellness center.

       7             And I said:  The body could always heal.  No

       8      matter what you do, you can always heal it.

       9             And, you know, lo and behold, I was hit upon

      10      with my son.  He had the addiction to the opiates,

      11      because he had a knee operation, and he got addicted

      12      to the opiates.

      13             And so, me, as studying as a holistic

      14      practitioner I wanted to open up a wellness center,

      15      "Feel great, one, two, three," because I believed

      16      the body could heal.

      17             And if you give it the right stuff, it can

      18      heal.  You have to get to the root.

      19             Because no matter -- you can't heal with

      20      drugs.  You can't heal drugs with drugs.  You have

      21      to let the body heal itself.

      22             So, you have to use alternative methods.  You

      23      have to use meditation.  You have to use -- get deep

      24      within yourself.  You need to talk to a

      25      hypnotherapist.  You need to do whatever you need to







                                                                   133
       1      do with this.

       2             But I don't feel that any one particular

       3      thing could help.

       4             But, if you try to meditate, or add -- add

       5      these different things into society, to help, and

       6      not look at it as an alternative method, because

       7      these are things that God gave us, so they should be

       8      the first method.

       9             The way that people are eating, the

      10      nutrition, sometimes it causes the neurotransmitters

      11      to not be functioning properly.

      12             Dehydration is actually one of the top causes

      13      of the neurotransmitters not being proper.

      14             So what do people do?  What do the kids do?

      15             They try to go for drugs that are going to

      16      help the neurotransmitters get leveled.

      17             So this is -- we're not looking in the right

      18      direction.

      19             We're not looking in the right direction.

      20             We have to heal ourselves, from the root,

      21      from the beginning, and, less drugs, and try to help

      22      each other.

      23             Thank you.

      24                  [Applause.]

      25             SENATOR BOYLE:  Mic.







                                                                   134
       1             ROBERTA THOMAS:  My name is Roberta Thomas.

       2      I'm a retired mental-health nurse.

       3             I've worked with patients with substance

       4      abuse in the course of my career, over 40 years.

       5             And I also work with the Port Richmond

       6      Community Emergency Response Team.

       7             So I'm interested in knowing how I could

       8      learn or be certified to provide emergency care if

       9      we come upon someone who has an overdose.

      10             But before you get into answering that

      11      question, I just wanted to state that education is

      12      the most important thing, but I think we start way

      13      too late.

      14             We need to start the way we start with our

      15      children about smoking and how terrible it is for

      16      them.  We need to start in the fifth and

      17      sixth grade.  Teach them before they come across

      18      people who are offering them things, before this

      19      stage.  Make them aware that how dangerous it is,

      20      early on.

      21             Don't wait till junior high and high school,

      22      because that's when they want to do what everyone

      23      else is doing.

      24             They lose their independence.

      25             They want to say:  Oh, I want to be with the







                                                                   135
       1      group, so I'm going to do whatever they're doing no

       2      matter how dangerous it is.

       3             Get them before that stage.

       4             And the other thing is, we talk about victims

       5      all the time:  What we're going to do to the

       6      victims, and we're going to put them in jail, we're

       7      going to put them in rehab.

       8             What about these suppliers?

       9             Not just the dealers.  The ones above the

      10      dealers that are bringing this crap into this

      11      country, into our state, into our community,

      12      destroying us, all our children.

      13             This has to stop.

      14             And we need to get to the suppliers.

      15             I know that it goes on and on.  You say,

      16      Well, we arrest this one, we arrest that one, and

      17      they still put many more coming along.

      18             But what's the real root of this?

      19             Those crops that they're growing in whatever

      20      country they're growing it in, and bringing it over

      21      here, this could be stopped.

      22             If we can stop terrorists, we have to be able

      23      to stop this.  This is a terror on our community.

      24             And that's all I have to say.

      25             Just tell me about where I can get help in







                                                                   136
       1      getting certified.

       2                  [Applause.]

       3             ADRIENNE ABBATE:  So I just wanted to speak

       4      quickly to this idea of education, and what age we

       5      should start talking to kids.

       6             Okay, the research shows that prevention

       7      should begin in the earliest grades.  And, what we

       8      should be focusing on a lot is on life skills, and

       9      how to develop coping mechanisms, and how to deal

      10      with issues that are going to come along later in

      11      life.

      12             And these programs have been shown to reduce

      13      substance abuse in youth, as teenagers, and above.

      14             And, then, chose also to play a part on other

      15      interrelated social issues, such as bullying and

      16      suicide.

      17             And, it's all interrelated.

      18             So I know that the State Health Department is

      19      overburdened, and that we spend so much time

      20      preparing our kids, as you mentioned, to be

      21      college-ready.

      22             But we need to make a case that a mentally

      23      healthy child is going to be a high-performing

      24      child, so this really has to be a message that we

      25      start early on.







                                                                   137
       1             And I want I want to defer to Chazie [ph.] to

       2      talk about, there was a question specifically about

       3      how to become a Narcan responder.

       4             And we have partners in the community who are

       5      going out and training members.

       6                  [Applause.]

       7             DIANE ARNETT:  So, uhm, Community Health

       8      Action of Staten Island is one of the main agencies

       9      on Staten Island that's actually certified as an

      10      opioid-overdose prevention trainer.

      11             And, so, we've been actually doing

      12      presentations in the community, but you can also

      13      call us.  I'm going to have to look at my staff

      14      about what number to call.

      15             So, we do both group trainings for people

      16      to -- and we train people, how to do -- how to

      17      recognize an overdose, and then how to reverse an

      18      overdose using in naloxone, which is a nasal spray

      19      which actually will bring somebody out of an

      20      overdose.

      21             In the last week, I think we trained -- 50,

      22      80 -- about 100 -- 75 to 100 people.

      23             Both, we had a training at our office, and we

      24      had our training at Our Lady Star of the Sea, with a

      25      support group for parents and family members who are







                                                                   138
       1      affected by this issue.

       2             So, I mean, people can come up and ask us

       3      later.  Some of my staff are here.

       4             We can actually -- we can do it for

       5      individuals, if individuals come to our office.

       6             Or, if you have a group of people that want

       7      to get this information, we can bring our staff to

       8      do the training.

       9             And it's very quick.  It's not -- this is not

      10      a 3-hour training.  It's 45 minutes, at best.

      11             We'll train you, and then we actually supply

      12      people with the kits, to be able to do the overdose.

      13             The same things that the NYPD is using and

      14      that EMS uses.

      15             SENATOR BOYLE:  We also did a training in my

      16      office, with my staff, Stevie and Krista here.  We

      17      had over 150 people doing it.

      18             It is -- as a former EMT, I have seen Narcan

      19      work, and it is a miracle drug.  It gives people the

      20      second chance that they need, to get into recovery,

      21      and save lives, without a doubt.

      22             And as was mentioned before, there's been

      23      hundreds of lives saved here.

      24             We also -- Senator Savino and Senator Lanza

      25      and Assemblyman Cusick are going to be hosting a







                                                                   139
       1      training here on Staten Island, so I urge all of you

       2      to attend.  As was said, it's less than an hour, and

       3      you'll be certified, you'll get a kit.

       4             And, I hope you never have to use it, but if

       5      you do need it, it will save a life.

       6             AUDIENCE MEMBER:  [No microphone used.]

       7      Can I say something?

       8             SENATOR BOYLE:  Yes.

       9             AUDIENCE MEMBER:  [No microphone used.]

      10             [Inaudible] put these commercials on smoking,

      11      and showing people's lungs.

      12             What about showing something -- on more

      13      advertisements on television?

      14             That's what most people will see.

      15             BRIAN HUNT:  Go back to the --

      16             AUDIENCE MEMBER:  [Inaudible.]

      17             BRIAN HUNT:  What they should do is go back

      18      to the fried egg.  "This is your brain on drugs."

      19             It says it all.

      20             AUDIENCE MEMBER:  [No microphone used.]

      21      Yeah, I mean, really, there should be more

      22      advertisements.  This is such a critical situation

      23      [inaudible] that shows really what we have, and

      24      maybe it would scare the children.

      25             [Inaudible.]







                                                                   140
       1             AUDIENCE MEMBER:  [Inaudible.]

       2             THOMAS:  Hi, my name is Thomas, and I'm

       3      coming up on two years clean in about two days, on

       4      May 4th.

       5                  [Applause.]

       6             THOMAS:  And for me, I think a long program

       7      is definitely necessary, because, I'm coming up on

       8      two years, I'm still in the program in Dynamite with

       9      them.  And, you know, sometimes I still need help,

      10      and I still go through hard times.

      11             So I think a long-term program is definitely

      12      necessary.

      13             Even earlier in my program, when I was about

      14      six months, you know, I still hadn't really made a

      15      decision completely.

      16             And it was months into the program, and I was

      17      just coming up to making the decision of, "What do

      18      I really want to do, and, you know, can I really do

      19      it?"  And the doubts were coming.

      20             So, I think it's definitely necessary to be

      21      in a program for a long time, away from home, with a

      22      bunch of people.

      23             You know, I was, like -- I was living there

      24      for 13 months.

      25             And, you know, now that I look back on it, it







                                                                   141
       1      was a great experience.

       2             But, a little bit of my history:

       3             I started using when I was 12.  And, when

       4      I was 12, I smoked pot for the first time, and

       5      drank, and then I was mixing both.  And then, before

       6      that year ended, I was doing morphine and fentanyl,

       7      at 12 years old.

       8             And, you know, it just took over completely.

       9      You know, I didn't have a care in the world.

      10             And I think, you know, something you guys

      11      were talking about before was:  How could you

      12      realize if your kid's doing drugs?

      13             Personally, my personal experience, I think

      14      it's really obvious.

      15             At least in my case it was.  It took me over

      16      completely.

      17             I didn't care about my mom, my dad, my

      18      sister.  I stole jewelry.  I was, you know, acting

      19      up in the house.

      20             It was bad.  It was really bad.

      21             I just think that the options are good.  You

      22      know, there's all different ways of doing this.

      23             My way was long-term.

      24             I was doing heroin, LSD, when I was 17, 18,

      25      all the time.







                                                                   142
       1             And, you know, I think that long-term for me

       2      was necessary, but I think there's all different

       3      paths in life for people who have addiction.

       4             You know, I think -- I didn't use Suboxone,

       5      but, I've seen people use Suboxone, and then come

       6      off of it and do fine.

       7             You know, so, I definitely respect the

       8      different paths that everybody takes.

       9             And, you know, I just -- I think we have to

      10      work, really, as a team.  No, like, one person can

      11      do this.  This finger shouldn't really be pointed at

      12      one person.

      13             You know, I think it's just a good thing that

      14      we're all here together, trying to figure this out,

      15      you know.

      16             And, thank you, and I hope everybody has a

      17      good day.

      18                  [Applause.]

      19             SENATOR BOYLE:  Thank you very much, and good

      20      luck in your recovery.

      21             We've got one more?

      22             Okay, let me just get some comments from --

      23      we've got people from the treatment and recovery.

      24             Gary, or somebody else, in recovery, would

      25      you like to --







                                                                   143
       1             JACQUELINE FIORE:  I wanted to say, the point

       2      that Tom brings up is huge.

       3             We know, and the research tells us, that a

       4      whole -- having somebody go through the entire

       5      continuum of care is going to be what works the

       6      best.

       7             Starting with a long-term intensive program,

       8      and dropping down in intensity to a long-term

       9      outpatient program, is really what is needed in

      10      order to bring somebody with the severe level of

      11      addiction into recovery.

      12             And, as treatment providers, unfortunately,

      13      we're just as frustrated as families at times,

      14      because, what we know is going to work for somebody,

      15      sometimes they can't see, sometimes the insurance

      16      company can't see, sometimes the family member can't

      17      see.

      18             And we have to sit back and watch them travel

      19      down a road that we don't want to see them travel

      20      down.

      21             And, we're sitting here today because we want

      22      to be a part of the solution, along with you guys,

      23      and we don't know all of the answers.

      24             We need to hear you guys speak as openly and

      25      honestly as you did today, because that's going to







                                                                   144
       1      be what helps us to make change.

       2             We are speaking to these people every day

       3      that we have the opportunity.

       4             But, until they hear the real-life stories,

       5      and the courage that you guys have had to share

       6      those, is so impactful.

       7             And I hope that you know that the time that

       8      you spent here today is really going be what helps

       9      us to make a change.

      10             We need the power brought back into the

      11      treatment-provider's hands.

      12             We need to be able to tell insurance

      13      companies:  It doesn't matter what you think is

      14      going to work.  We know what's going to work.  This

      15      is what our tool has told us.

      16             And that's what we need.

      17                  [Applause.]

      18             ADRIENNE ABBATE:  Thank you.

      19             GARY BUTCHEN:  Can I just build on that for a

      20      moment?

      21             I mean, in listening to all the frustration

      22      and all the stories that have been expressed today,

      23      I know from my dealings with the managed-care

      24      companies, that their whole intent is the cost

      25      shift.







                                                                   145
       1             So, the gentleman who paid out of pocket, the

       2      time woman who drained her pension fund, the people

       3      who go to Florida or Texas, that's an intentional

       4      manipulation by the insurance companies, by the

       5      managed-care folks, to cost-shift either onto the

       6      State of New York, because when you go to Camelot or

       7      Daytop or Dynamite, those programs are through

       8      net-deficit funding, through the State.  The

       9      insurance companies, none of them, A through Z, pay

      10      for that level of care.

      11             So what I've been advocating for, and

      12      attending these meetings, and meeting with the

      13      Assemblymen and some of the Senators, is the

      14      access-to-care bills.

      15             I think defining "medical necessity" in

      16      New York State will force the insurance companies to

      17      abide by the rules, whether it's through enforcement

      18      through DFS or any of the other branches.

      19             I heard the frustration about getting into a

      20      detox, getting into an outpatient.

      21             I run an outpatient network.  I didn't set it

      22      up to fail.

      23             My staff are all doctors, psychologists,

      24      nurses, counselors.  We didn't go to school so we

      25      could sit across from somebody and say "Fail so that







                                                                   146
       1      you can get to a higher"...

       2             We're not a conduit.

       3             But, I understand the language that's being

       4      spoken to families.  I understand the frustration

       5      that people are dealing with.

       6             And when someone sits across from me, and

       7      their family has finally got them in my door and

       8      they desperately want to go to a higher level of

       9      care, and the insurance company says, "Fail," their

      10      intent is to fail.

      11             It's a horribly frustrating situation.

      12             New York State is so regulated.

      13             I understand -- I don't agree,

      14      I understand -- why someone can't get into an

      15      inpatient detox.  I understand why they can't get

      16      into a rehab.

      17             But when they go to New Jersey, they cross

      18      the bridge, that program isn't in-network with any

      19      insurance company.

      20             So what they're doing is, they're billing the

      21      hell out of your out-of-network benefit.  You're

      22      getting hit with deductibles, your copays, and all

      23      your other bills.  And you're draining your pension

      24      funds.

      25             They'll take you today, because they don't







                                                                   147
       1      have to worry about managed care or insurance, as

       2      long as you're willing to put up your life savings.

       3             You send them down to Florida, it's the same

       4      thing.  They have what they call the

       5      "Florida model," which is all based on

       6      out-of-network benefits.

       7             They drain your inpatient, your outpatient;

       8      your left, your right, your up, your down.

       9             You come back to your community where you

      10      live, you can't afford to come into a community

      11      provider.

      12             So whatever we can do as treatment providers,

      13      whatever I can do as an advocate, to try to get

      14      access-to-care bills passed in some way, some form,

      15      that defines "medical necessity."

      16             I think it's all about the cost shift, and it

      17      would help a lot of the frustrations that you've

      18      heard here today.

      19                  [Applause.]

      20             SENATOR BOYLE:  Thank you very much.

      21             Luke, would you like to say something?

      22             LUKE NASTA:  I mean, Senator Boyle, you're in

      23      the right place on Staten Island, where this is an

      24      ongoing funeral here.  A week doesn't go by where we

      25      don't hear about 19-, 23-year-olds, that say







                                                                   148
       1      "Good night," and come out of their parent's

       2      bedrooms feet first.

       3             That's the reality.

       4             That's the reality of Staten Island.

       5             There's many things, many things, that we

       6      need to do here.

       7             For one thing, the Staten Island community

       8      needs to embrace the problem; that is, own the

       9      problem, and, embrace and own the solution; so that

      10      when the YMCA or Camelot or Daytop wants to open a

      11      counseling service on New Dorp Lane, that we're not

      12      tarred and feathered and run out of the community.

      13                  [Applause.]

      14             LUKE NASTA:  That's going to take a major

      15      change.

      16             And if we're going to confront and control

      17      this epidemic, we're going to need to have, us, the

      18      solution, available, and visible, throughout the

      19      community.  And more people will come for help.

      20             Now, the gentleman over here, about -- you

      21      know, Camelot has 45 beds on Staten Island, and

      22      it's, pretty much, we're full.  But, given the

      23      nature of the population, it's an unstable

      24      population, so the beds keep opening up.

      25             But for the most part, you know, we can get







                                                                   149
       1      you a bed in a couple of days, or immediately.

       2             And probably within two months, we're going

       3      to open another 24-bed facility in the Port Richmond

       4      section.

       5                  [Applause.]

       6             LUKE NASTA:  That's nice, but that took me

       7      40 years to do that, you know.

       8             And in that -- in that story is part of the

       9      problem, why we're in the situation we're in today,

      10      because we've been denying the extent of problem.

      11      We've been resisting.

      12             The first time -- our 45-bed facility is on

      13      the grounds of the Sea View Hospital Campus.

      14             The first time I went there, to propose using

      15      one of the 75 vacant buildings that The City Health

      16      and Hospitals Corporation controlled, was 1977.

      17             And we opened up two years ago.

      18                  [Applause.]

      19             LUKE NASTA:  But at the rate of 50 to

      20      70 people dying a year, how many could we have

      21      possibly saved?

      22             Now, and to address the criticism of, you

      23      know, the YMCA or Camelot, or Suboxone, the research

      24      indicates, "five attempts," five attempts --

      25             Doesn't want me to say "attempts."







                                                                   150
       1                  [Laughter.]

       2             LUKE NASTA:  -- five attempts at treatment

       3      before a patient stabilizes, before it works.

       4             That's the average: five attempts.

       5             So, we don't have a silver bullet.

       6             We don't pretend to have a silver bullet to

       7      slay the monster.

       8             What we do have is commitment.

       9             We've got commitment.  We'll stay with you.

      10      We'll take you back.  We'll -- we're the medics on

      11      the battlefield.  We'll bring you in no matter what

      12      condition you're in, and we'll try to -- we'll try

      13      to restore you.

      14             We have no control over the war, because

      15      you're going back out there again.  But we'll be

      16      there for you.

      17             And if it isn't Camelot, it will be the YMCA,

      18      it will be -- it will be somebody.

      19             But we need, we need support.

      20             Now, I have a suggestion for Senator Boyle,

      21      who's doing a fantastic job in addressing this for

      22      New York State.

      23             And --

      24                  [Applause.]

      25             LUKE NASTA:  -- what I would suggest is --







                                                                   151
       1      and I have been at this a long time, and I listened

       2      to a lot of government double-talk.  And it's a

       3      disgrace that the Governor of the state of New York

       4      has not acknowledged this problem yet.

       5             Meanwhile, border states, like Vermont and

       6      Massachusetts, their governors have declared a state

       7      of public-health emergency.

       8             I haven't heard anything from our Governor.

       9             Okay, that's enough about him.

      10             But what -- and, so, "his office," his office

      11      is the state of -- is the Office of Alcoholism and

      12      Substance Abuse Services.  They consistently say

      13      there are empty beds now.

      14             That's a truth, there are empty beds, because

      15      the system that was in place, because we couldn't

      16      open up smaller operations, which would be more

      17      effective, they just kept giving more money for more

      18      beds to single organizations, so that you have

      19      250-bed treatment programs.

      20             Okay, those beds are not full on an ongoing

      21      basis.

      22             What I would suggest to Senator Boyle, is to

      23      identify, have the State identify, those beds in the

      24      large programs that are vacant for, whatever, 30,

      25      60 days.  Take that money, and dedicate it to







                                                                   152
       1      opening new, smaller programs, throughout

       2      Staten Island, throughout the state.

       3             It will be more effective as a treatment

       4      program, and, it will be more visible; so,

       5      therefore, it will be, also, approaching the whole

       6      stigma problem, if there are more programs like

       7      this.

       8             And it doesn't necessarily have to cost the

       9      State a lot more money to do that.

      10             Early intervention, all right, how do we do

      11      prevention?

      12             I'm not real popular with a lot of people.

      13             That's okay.

      14             SENATOR SAVINO:  We love you.

      15             LUKE NASTA:  Not always.

      16                  [Laughter.]

      17             LUKE NASTA:  The New York City Board of

      18      Education is negligent on this issue.

      19             Where is the last place --

      20                  [Applause.]

      21             LUKE NASTA:  -- the last place that kids are

      22      required to be, by law?  School.  High school.

      23             They're required, by law, up until, what,

      24      maybe age 16, when they could be signed out, to be

      25      there.







                                                                   153
       1             So, why, when we have them in the place where

       2      they're required to be, by law, don't we do

       3      assessments of the -- and the entire enrollment,

       4      four times a year -- by an independent group, by the

       5      way, to do assessments so that there's no conflict

       6      of interest there -- that would identify these

       7      problems at a very early stage?

       8             And how can you do that?  There's simple

       9      indicators.

      10             As some of the parents said, when you notice

      11      there's a change in your son's or daughter's

      12      friends.

      13             Okay, it's not going to -- that's not going

      14      to show up in school.

      15             But what will up in school is:  Truancy.  You

      16      know, erratic attendance records.  A shift in

      17      achievements.

      18             There are indicators, they're simple

      19      indicators, that then -- that would flag that kid.

      20      And that team could assess that identified child,

      21      and find some problems out, and intervene early.

      22             And maybe you find out that it isn't the

      23      child that's got the problem, but the problem is in

      24      the family.

      25             AUDIENCE MEMBER:  [No microphone used.]







                                                                   154
       1             [Inaudible] in high school, [inaudible]

       2      graduated with almost a 90-something average.

       3             [Inaudible.]

       4             He's 20 years old now.

       5             So I'm just going say to you, that they

       6      should start in younger grades.  Kindergarten.

       7      Maybe -- maybe middle school.

       8             UNKNOWN SPEAKER:  Too late.  [Inaudible.]

       9                  [Multiple audience members speaking at

      10        the same time.]

      11             SENATOR BOYLE:  Hold on.  Let --

      12             AUDIENCE MEMBER:  [No microphone

      13      used/inaudible.]

      14             AUDIENCE MEMBER:  [No microphone used.]

      15             [Inaudible.]  Like the fried eggs, there is a

      16      commercial, every day, about 25 a day, Partnership

      17      For A Drug-Free.  [Unintelligible] stories, share

      18      your recovery, share your disease, people talking

      19      about their children, talking about themselves.

      20      It's on constantly on the air, all day.

      21             AUDIENCE MEMBER:  [No microphone used.]

      22      But it is not enough.  They should show, really,

      23      what happens.  Show somebody almost dead.  Show

      24      them --

      25             SENATOR BOYLE:  Thank you very much.







                                                                   155
       1             We're just limited on a couple more minutes.

       2             Mr. Ferrari, if you would like to...?

       3             ANTHONY C. FERRERI:  Thank you.

       4             And, Mr. Hunt, Mr. and Mrs. Crupi, my

       5      condolences.

       6             James, thank you for your great courage in

       7      coming here today.

       8             And I do really appreciate what you've said

       9      to all of us here today, and it's a very, very

      10      important message.

      11             Like Dan and the others, I was asked to come

      12      with a prepared statement.  That statement's been

      13      submitted.  It's filled with statistics about what's

      14      happened to our community.

      15             And at this point, there's really no point in

      16      reading this into the record, because I think we've

      17      covered all of these statistics, and the epidemic

      18      that we see.

      19             I'm grateful to Mr. Hunt and to the Crupis,

      20      because, they share; they've put a face on

      21      statistics.

      22             And, in fact, for those of us who work in

      23      hospitals, and see what's going on in our emergency

      24      rooms, we see those faces each and every day.

      25             And it's truly an epidemic.







                                                                   156
       1             I think a lot of this comes down to something

       2      that may be more simple, to ally that factor in our

       3      issues today, but more difficult to solve; and that

       4      is resources.

       5             And, I've listened to Gary and Diane, to

       6      Luke, to Fern, and the others that are here today;

       7      those who are not-for-profit private organizations,

       8      that struggle every day to meet the needs of this

       9      community.

      10             And the fact of the matter is, that

      11      Staten Island continues to be the forgotten borough.

      12             And, when you take a look at the issues in

      13      health and Staten Island, it's no surprise that we

      14      lead the five boroughs in addiction.

      15             We also lead the five boroughs in cancer,

      16      lung disease, heart disease, obesity, diabetes, and

      17      mortality.

      18             And this is the borough with the highest

      19      median income in the city of New York.

      20             The fact of the matter is, that the City of

      21      New York, for every dollar of health care it spends,

      22      it spends one-half of one penny on Staten Island.

      23             And, I know that I've been saying this for

      24      the 11 years that I've been the president of

      25      Staten Island University Hospital, but, The Health







                                                                   157
       1      and Hospitals Corporation has no presence in our

       2      community.  No real presence in our community.

       3             The hundreds of thousands of clinic visits

       4      that are provided to the people of this borough who

       5      cannot afford to pay for their care, are provided by

       6      Richmond University Medical Center in Staten Island

       7      University Hospital.

       8             We need resources.

       9             We need resources for prevention, and we need

      10      resources for cure.

      11             And that's my message for today.

      12             Thank you.

      13                  [Applause.]

      14             SENATOR BOYLE:  Boris, would you like to say

      15      something?

      16             BORIS NATZEN:  Assemblyman, thank you for

      17      inviting me today; Senators and Assemblymen.

      18             So I want to say, first, thank you for the

      19      I-STOP program.  It was a tremendous -- it's

      20      tremendous for the pharmacies.  It prevent -- it

      21      alleviated us from becoming police officers, because

      22      that's what was happening in the beginning of this

      23      crisis.

      24             And, it's a tremendous asset for us.  It

      25      helps tremendously.  I think that it's -- I can say,







                                                                   158
       1      it probably knocked it down by 80 to 90 percent from

       2      what we see.

       3             I came to the realization of this epidemic

       4      when we got held up at one of my locations on

       5      Staten Island.

       6             You know, right on the corner, 10 a.m. in the

       7      morning, customers in the store.  Two guys walked

       8      in, young kids walked in, with a gun, and put it to

       9      my pharmacist's head, and asked for the -- for --

      10      not for money, which, you know, you would think they

      11      would ask for, but they asked for oxycodone.  You

      12      know, they ran out of the store.

      13             Came back a month later and asked for it

      14      again.  Did not receive it, because we didn't have

      15      any in stock.  We don't -- we didn't keep it after

      16      that.

      17             And then they came back again, the third

      18      time, but at that time, we already had

      19      police officers in the store.

      20             So, for them to be so blatant.  And, again,

      21      all -- every time they came, it was always during

      22      the day, 10 a.m., 11 a.m.

      23             So, you know, it is an epidemic, and it's

      24      tremendous.

      25             And I applaud everyone here for coming out







                                                                   159
       1      and making sure that our voices are heard.

       2             And, also -- I want to mention, also, you

       3      know, we've spoken about insurance companies.

       4             You know, there's a mail-order issue that we

       5      have in the state, and, where they mail these

       6      controlled substances, they drop them on the

       7      doorstep.  There's 360 pills sitting on somebody's

       8      doorstep.

       9             So that's an issue that I want to address,

      10      with mail-order.

      11             I also want to address the issue of, you

      12      know, the I-STOP program, correlating with

      13      New Jersey.  I think that's a tremendous thing that

      14      we need, because New Jersey's not too far away, and

      15      they can get the prescriptions, go there, pick them

      16      up, and come here and be here within 15 minutes.

      17             So, we want to make sure that we're able to

      18      see if they get them filled in New Jersey, as well.

      19             That would be a tremendous help.

      20             Also, I wanted to mention:

      21             So, some of you guys here might go to a

      22      pharmacy and get a prescription for Nexium, and they

      23      tell you, you know, it's prior authorization, you

      24      can't get it.  And, you go crazy trying to get this

      25      medication.







                                                                   160
       1             And Nexium is a stomach medicine.

       2             And, why can't we do that for these

       3      controlled substances, make it difficult?

       4             The insurances make it very difficult for you

       5      to get the medicine.

       6             Why can't the community make it very

       7      difficult to get them?

       8             You need authorizations, prior

       9      authorizations.  Limit the quantities.  Right?

      10             I know the education with the doctors have

      11      been tremendous, because you could tell how they're

      12      writing now; that it's helping and it's working.

      13             But I think that that's a tremendous thing,

      14      that if we put into -- we can put into law, or

      15      however you want to do it, but limit the quantities.

      16      Have the patient come back in two weeks to get it

      17      again if they're a cancer patient or a hospice, or,

      18      depending on the diagnosis, obviously.

      19             But if -- limit the quantities that are in --

      20      on people's shelves in their house.

      21             So, I mean -- again, so, Suboxone, right,

      22      some of the patients that have come to us, I've

      23      known them for many years, being on Staten Island,

      24      and I speak to a lot of them.

      25             And, you know, the ones that I know







                                                                   161
       1      personally, from interacting with them, they -- the

       2      Suboxone is a tremendous help.

       3             So, you know, some patients it helps, some

       4      patients it doesn't.

       5             But, from the ones that I've spoken to, it

       6      definitely relieves them from the -- from this --

       7      from this epidemic.

       8             So, I appreciate it, again, and thank you

       9      all.

      10                  [Applause.]

      11             ASSEMBLYMAN CUSICK:  Of course, I just want

      12      to thank you, too.

      13             With the I-STOP, we depended a lot on the

      14      pharmacists and the pharmacies, in drafting up the

      15      legislation.

      16             But I just wanted to mention one thing that

      17      you had brought up:  That we as legislators have

      18      brought up to the Staten Island District Attorney,

      19      and actually had an announcement, and we put in a

      20      request to the New York State Department of Health

      21      to have a linkage.

      22             We can link our system to New Jersey, to

      23      Pennsylvania, to other states.  There just needs to

      24      be a consent of each state to do that.

      25             So, I just want you to know that we have, the







                                                                   162
       1      legislators up here, and the District Attorney here

       2      in Staten Island, have put in that request to the

       3      New York State Department of Health to do that.

       4             SENATOR BOYLE:  Thank you, Mike.

       5             I would like thank everyone for coming today:

       6             To the panelists, to the audience, we had a

       7      great exchange of ideas;

       8             Mr. Hunt, the Crupis, and James, thank you

       9      for sharing your story;

      10             And to my colleagues, Senator Lanza,

      11      Senator Savino, and Assemblyman Cusick.

      12             We're going to take what you gave us today,

      13      and it's going to be part of upcoming legislation.

      14             That, I can promise you.

      15             We're going to be -- oh, yeah.

      16             We have some information on the back -- on

      17      the outside, if you want to take it on your way out.

      18             And, remember to try and get trained for

      19      Narcan, if you have not done so already.

      20             I can tell you that, this is a -- obviously,

      21      a non-partisan issue.  We have, members of each

      22      party here, and each house of the State Legislature.

      23             We are here to end this heroin epidemic, and

      24      with the ideas and information you gave us today,

      25      the passion that you expressed.







                                                                   163
       1             And this was, I would say, out of the nine

       2      forums I've been to, this was the most passionate;

       3      and I thank you.

       4             And I understand that Staten Island is the

       5      epicenter of this epidemic, and this is where we're

       6      going to begin the fight, and we're going to win it,

       7      very soon, with new legislation.

       8             Thank you so much.

       9                  [Applause.]

      10

      11                  (Whereupon, at approximately 3:51 p.m.,

      12        the forum held before the New York State Joint

      13        Task Force on Heroin and Opioid Addiction

      14        concluded, and adjourned.)

      15                            ---oOo---

      16

      17

      18

      19

      20

      21

      22

      23

      24

      25