Public Hearing - May 9, 2014
1 BEFORE THE NEW YORK STATE SENATE MAJORITY COALITION
JOINT TASK FORCE ON HEROIN AND OPIOID ADDICTION
2 ------------------------------------------------------
3 PUBLIC FORUM: SULLIVAN COUNTY
4 PANEL DISCUSSION ON MONTICELLO'S HEROIN EPIDEMIC
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6
Sullivan County Government Center
7 LOB, 2nd Floor
100 North Street
8 Monticello, New York 12701
9 May 9, 2014
2:00 p.m. to 4:00 p.m.
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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 John J. Bonacic, Forum Moderator
Member of the Joint Task Force
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PANELIST INTRODUCTIONS: PAGE 7
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Izetta Briggs-Bolling
3 Executive Director
The Recovery Center
4
Nolly Climes
5 Program Director
Rehabilitation Support Services
6
James Farrell
7 District Attorney
Sullivan County
8
Dr. Carlos Holden
9 Physician
Catskill Regional Medical Center
10 Also, Medical Director for
Mobile Medic EMS
11
Captain Jamie J. Kaminski
12 Zone Commander
New York State Police, Troop F
13
Peter Laizure
14 Parent
15 Nancy McGraw
Director
16 Sullivan County Public Health Department
17 Nick Roes
Executive Director
18 New Hope Manor
19 Michael Schiff
Sheriff
20 Sullivan County
21 Larry Thomas
District Superintendent
22 Sullivan County BOCES
23 Joseph Todora
Director
24 Sullivan County Community Services
25
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PANELIST INTRODUCTIONS (Continued):
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3 PERSONAL STORY PAGE 11
4 START OF PANELIST PARTICIPATION PAGE 12
5 AUDIENCE PARTICIPATION AND Q&A PAGE 64
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1 SENATOR BONACIC: Can you all hear me?
2 First of all, let me say, good afternoon.
3 I'm Senator Bonacic, and to my left is
4 Senator Boyle who's Chairman of this Senate
5 Task Force, to see what we can do to combat the
6 rising epidemic of heroin use.
7 I want to thank our distinguished panelists
8 that are here today.
9 This is an informal -- an informal meeting.
10 What I would like to do, is I'm going to let
11 Senator Boyle make some preliminary remarks.
12 By the way, there are 17 of these statewide
13 forums. This is Number 11.
14 And at the end of May, under the leadership
15 of Senator Boyle, we hope to put forth some kind of
16 comprehensive package, that might include
17 legislation, that might include some infusion of
18 money to be put in critical areas, to help combat
19 the acceleration of the uses of heroin.
20 After Senator Boyle completes his remarks,
21 I'm just going to ask the panelists to briefly
22 introduce themselves, and then we're going to open
23 it upper with questions to the panelists. They're
24 going to share their experiences.
25 And then we're going to ask the audience if
5
1 you have anything to share or have a question of
2 anyone here.
3 I will tell you that I consider myself a
4 novice when it comes to the subject of heroin or its
5 use, and what is to be done.
6 Quite frankly, I'm here to learn from the
7 experts around this room.
8 So, Senator Boyle, would you like to share
9 some remarks?
10 SENATOR BOYLE: Thank you, Senator.
11 SENATOR BONACIC: Let's make sure your thing
12 is on [adjusts microphone].
13 SENATOR BOYLE: Thank you, Senator, and thank
14 you for hosting this forum; and to this
15 distinguished panelists from Sullivan County and the
16 surrounding areas, and to everyone who came here
17 today to share and to learn.
18 As Senator Bonacic said, this is the eleventh
19 of 17 forums.
20 We're going to be wrapping it up probably
21 next week.
22 And this includes, I'm from Suffolk County
23 out on Long Island, all the way up to
24 Western New York, where one of the upcoming ones is
25 going to be in the Seneca Nation.
6
1 So this is -- this heroin and opioid epidemic
2 is pervasive in all communities, all socioeconomic
3 levels.
4 And, we're learning some more about it in the
5 10, now 11, forums that I've been to.
6 There are some similarities in each one, and
7 something different in each one, and that's what
8 we're trying to take away.
9 What I would suggest is, for our panelists
10 and for the members of the audience, whether you're
11 a treatment provider, prevention expert, a
12 law-enforcement official, or a family member, or an
13 addict themselves, if you are affected negatively,
14 obviously, by this heroin epidemic and you say to
15 yourself on a daily basis, "If I could just change a
16 law or two to make it better, to help fight this
17 epidemic, this is what I would change," that's what
18 we want to hear about today.
19 Or if you know of a program that has been
20 helpful for your family member, that has worked,
21 tell us about it.
22 If there's one that hasn't worked, then say
23 "This is a waste taxpayer money." Let us know about
24 that, too.
25 We're trying to get as many -- as much
7
1 information as possible.
2 The idea for the Task Force, and, obviously,
3 Senator Bonacic is an important member of that
4 Task Force, is to report by June 1st, and then
5 we're going to immediately introduce significant
6 legislation in the days following, and get it passed
7 in this Senate session, and hopefully passed into
8 law, as well, to begin combating this heroin
9 epidemic.
10 I appreciate Senator Bonacic again hosting
11 it.
12 Thank you so much.
13 SENATOR BONACIC: Okay, so why don't we start
14 with Jim Farrell, our good District Attorney from
15 Sullivan County.
16 Jim.
17 DA JAMES FARRELL: Right here.
18 SENATOR BONACIC: Yeah, I can't see too well.
19 SENATOR BOYLE: He's blind.
20 [Laughter.]
21 SENATOR BONACIC: Yeah, no, introduce, just
22 for the --
23 DA JAMES FARRELL: My name is Jim Farrell.
24 I'm the Sullivan County DA. I've been the DA since
25 2010.
8
1 My career in law enforcement started here in
2 Sullivan County in 1995, and as an assistant
3 district attorney. And, then, finally being elected
4 to DA in 2010.
5 I was reelected last year for another
6 4-year term.
7 JAMIE J. KAMINSKI: Jamie Kaminski. I'm the
8 Captain, Zone Commander, for the New York State
9 Police in Troop F, in charge of uniformed troopers
10 in Sullivan County. It's about 60 members.
11 I've been in policing for 27 years.
12 JOSEPH TODORO: I'm Joe Todora. I'm the
13 director of community services for Sullivan County,
14 which is the mental-health director for the county.
15 We also are a provider of OASAS-licensed
16 outpatient mental-health services, and are
17 responsible for developing the local government plan
18 for behavioral-health services to meet the needs of
19 the community.
20 NANCY McGRAW: I'm Nancy McGraw. I'm the
21 public-health director for Sullivan County for the
22 last year, almost.
23 Before that, about eight years as deputy
24 public-health director.
25 And I'm also a licensed clinical social
9
1 worker.
2 And in Public Health, one of our primary
3 missions and goals is to prevent illness and
4 disease.
5 PETER LAIZURE: My name is Peter Laizure.
6 I'm the father of an addict who's experienced all
7 phases of addiction, and tragically lost my son last
8 October.
9 DR. CARLOS HOLDEN: My name is Carlos Holden.
10 I'm a board-certified emergency physician.
11 I'm the medical director of the emergency
12 department at Catskill Regional Medical Center.
13 I'm also the medical director for
14 Mobile Medic EMS.
15 So, I'm involved in both the pre-hospital and
16 in-hospital care for, you know, all emergency
17 medical conditions.
18 SHERIFF MICHAEL SCHIFF: Mike Schiff,
19 Sullivan County Sheriff. Retired from the
20 State Police.
21 With my State Police time, and Sheriff,
22 36 years in law enforcement.
23 NOLLY CLIMES: Nolly Climes from
24 Rehabilitation Support Services. I'm a program
25 director serving both Sullivan and Orange county.
10
1 We provide residential programs for people
2 with a history of mental illness, as well as
3 care-management services.
4 We also have programs to serve families and
5 their children, primarily to prevent placement out
6 of the homes.
7 LAWRENCE THOMAS: I'm Larry Thomas. I'm the
8 district superintendent for the Sullivan County
9 BOCES.
10 I've been the BOCES District Superintendent
11 for about 5 years, but I'm finishing up 40 years in
12 education.
13 NICK ROES: My name is Nick Roes from
14 New Hope Manor in Barryville.
15 We're an all-female residential
16 substance-abuse treatment center, where I've been
17 there for over 25 years now.
18 And I also teach for Brown University, their
19 online addiction courses.
20 IZETTA BRIGGS-BOLLING: Hello, I am
21 Izetta Briggs-Bolling, executive director for
22 The Recovery Center.
23 We provide a comprehensive array of services,
24 from detox services -- [grabs microphone].
25 We provide a comprehensive array of services,
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1 from detox, to scattered-site housing throughout the
2 community, which include residential treatment for
3 men and women, outpatient day treatment services,
4 prevention services, voc ed, and HIV services.
5 SENATOR BONACIC: Okay, let me start, I think
6 I'm going to go to Mr. Pete Laizure.
7 Pete, tell us your story and your experience
8 with your son, please.
9 And before you speak, thank you for your
10 courage --
11 PETER LAIZURE: Thank you.
12 SENATOR BONACIC: -- for you being here to
13 tell your story.
14 I know it's painful every time you have to do
15 this.
16 PETER LAIZURE: Thanks.
17 Thank you.
18 I lost my son Ryan last October, 23 years
19 old.
20 I went with Ryan, from some gateway drugs,
21 alcohol and marijuana, graduating to prescription
22 painkillers.
23 When that got too expensive, moving on to
24 heroin. In the beginning, smoking and sniffing.
25 And when that wasn't good enough, moved on to
12
1 IV-drug use.
2 This went on for four years, in and out of
3 rehab facilities.
4 In the end, you know, 12 hours before he was
5 going to go back into a detox facility and another
6 rehab, he, what we believe tried to do, is get high
7 one more time. And the drug dealer shot him in the
8 head, and a couple days later he passed.
9 SENATOR BONACIC: Thank you, Peter.
10 We have no order in terms of who should speak
11 on the panel.
12 You heard Senator Boyle say we're looking for
13 suggestions.
14 Maybe those that treat heroin addicts, and
15 the programs, could jump in and share some of your
16 experiences with us to help educate us.
17 NICK ROES: I could start.
18 SENATOR BONACIC: Yes, please do.
19 NICK ROES: I see one of the main problems is
20 that there's --
21 SENATOR BONACIC: I would get closer to the
22 mic.
23 NICK ROES: I think one of the main problems
24 is that there's three separate systems that are
25 designed to help the heroin user, and so there's a
13
1 lot of duplication of effort and waste of money, and
2 sometimes the systems work against each other
3 instead of working for each other.
4 So depending on which system the person first
5 presents themself to, if they present themselves,
6 say, to the primary-care physician, they might be
7 treated for falling down the steps, being in a car
8 crash, cirrhosis of the liver, high blood pressure,
9 anemia, a lot of other things, without ever treating
10 the addiction that might be at the basis of that.
11 So that's one of the problems, is that we
12 need a more integrated system of care.
13 And, also, in the substance-abuse treatment
14 side, there's 11 different licenses that they have,
15 so people can't really get continuity of care.
16 There's always changing to a new counselor or
17 something like that.
18 So I think the problem is, we designed the
19 system and the way we fund it on the basis of what
20 we knew 50 years ago.
21 And now that we know better how to help
22 people, we shouldn't keep with the system that was
23 designed before we knew how to help people.
24 So, we need to reimburse for services that
25 are really helpful, and not reimburse for some
14
1 services that aren't helpful.
2 SENATOR BONACIC: Thank you.
3 Maybe someone could talk about the
4 effectiveness of Narcan.
5 I understand that, from the other forums and
6 what I'm reading in the paper, that maybe this
7 particular drug combats a heroin addiction
8 immediately, someone that's going through
9 withdrawals, perhaps it should be carried in a kit
10 by EMS, by police cars.
11 Is it effective?
12 Can anybody share their experiences?
13 DR. CARLOS HOLDEN: Yeah, I'd be happy to
14 address that.
15 Narcan, or the generic name is "naloxone,"
16 has been available for a long time. It's
17 inexpensive.
18 It is very effective in treating opioid
19 overdose.
20 So folks who have -- you know, are not
21 breathing very well because of either heroin or an
22 opiate-pill overdose, Narcan immediately reverses
23 that.
24 It's safe. There's no problem giving to it
25 somebody if they've overdosed on another drug.
15
1 It's widely available.
2 And recently there was an internasal
3 formulation of it. It's, essentially, like a nasal
4 spray, so you don't need any medical training to
5 administer it.
6 It's just like, you know, a nasal spray that
7 you might take for allergies, or something like
8 that.
9 In Richmond County down in Staten Island,
10 they actually have expanded the use of that.
11 They're having, pretty much, every first responder
12 carry it.
13 We do have it available here for our
14 paramedic ambulances, but most of our BLS ambulances
15 don't carry it, nor do law-enforcement officers.
16 I think wider availability of that medicine
17 would be very helpful in terms of, you know, saving
18 lives for acute opiate overdoses.
19 SENATOR BONACIC: Does anyone know the
20 insurance practice, if a person tried heroin, had a
21 withdrawal, and they wanted to access Narcan?
22 Does the insurance company pay right away, or
23 must there be multiple utilizations?
24 DR. CARLOS HOLDEN: Narcan is not really for
25 dependence. It's not for the long-term kind of
16
1 dependence. It's more for an acute overdoes.
2 There is another medicine, the brand name is
3 "Suboxone," that you may be referring to. And that
4 is, you know, more like long-term dependence
5 treatment.
6 And probably some of the other panelists can
7 better address that, that medicine, than I can.
8 SENATOR BOYLE: If I could, Doctor, that's
9 one of the things we're finding in some of the other
10 counties and other forums, is the disparate use of
11 Narcan among -- like, for example, Suffolk County
12 where I am, we hosted one, and I hosted one myself,
13 a Narcan training session for laypeople.
14 You don't have to be a police officer, you
15 don't have to be a first responder.
16 If you take this 40-minute class -- it's not
17 three weeks, it's 40 minutes -- and you get home --
18 come home with a kit.
19 And it will, certainly -- Senator Bonacic
20 will do something similar around here, to get it out
21 as widely as possible.
22 One thing I find, though, and it's
23 interesting, because it depends on what your health
24 commissioner of your county has a different
25 procedure for each county.
17
1 I've gone to several of them, they have
2 different rules.
3 So one of the things we're looking for is to
4 make a unified system to say: This is who can use
5 Narcan and naloxone, and these are not -- you can't.
6 You have to take the class. That's the only
7 thing.
8 Yeah.
9 JOSEPH TODORO: And I do believe it would be
10 very helpful to make it a little wider-spread
11 availability. You know, family members, you know,
12 the treatment facilities ourselves, as well as some
13 of the other public-health facilities.
14 NANCY McGRAW: If I can address some of what
15 we've done so far, in terms of the -- we have a
16 local Sullivan County Prescription Drug-Abuse
17 Prevention Task Force that has been in existence for
18 at least a couple of years, and that's through
19 Public Health, and through a -- sponsored by a grant
20 we have through the State Office of Rural Health.
21 One of our primary goals is to reduce
22 premature mortality in this county, which is one of
23 the highest in the state.
24 And a significant portion of that is due to
25 drug overdose and accidental and intentional
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1 poisonings.
2 So, in terms of the Narcan training, we had
3 worked with our task-force members, which includes
4 many of the people who are sitting on this panel
5 today, as well as some people in the audience, and
6 we sponsored a training at The Recovery Center for
7 27 people. This was last August.
8 So, that was our initial attempt to get these
9 kids, and get the training out there into the
10 community.
11 We are currently working with the
12 Sheriff's Office to identify some training
13 opportunities for law enforcement, as well as with
14 EMS.
15 So that's something that's high on our radar
16 screen right now.
17 SENATOR BOYLE: Now, can you tell me, in
18 terms of the first responders, do volunteer
19 firefighters have Narcan on their trucks? Do you
20 know?
21 UNKNOWN SPEAKER: [Off video.] No, I don't
22 believe so.
23 UNKNOWN SPEAKER: [Off video.] Not yet, no.
24 SENATOR BOYLE: That would be a good place,
25 too, because I'm one. We often to the get scene
19
1 before the ambulance does.
2 SENATOR BONACIC: I have a stupid question,
3 because I told you I'm naive.
4 If there's an acute overdose of heroin, and
5 they take Narcan, is it just gets them through that
6 withdrawal period?
7 Does it diminish, in any way, the addiction?
8 UNKNOWN SPEAKER: [Off video.] No.
9 JOSEPH TODORO: No.
10 SENATOR BONACIC: It does not.
11 JOSEPH TODORO: What it is, is it's a
12 neurotransmitter inhibitor.
13 So, when the Narcan is injected into the
14 individual who is overdosing, what happens is,
15 the -- it blocks the opiate from going into that
16 neurotransmitter.
17 What happens with opiate overdose is that all
18 of your autonomic nervous system shuts down, so you
19 stop breathing, your heart stops.
20 And once the Narcan is injected, it freeze
21 those systems up, and begin to work again.
22 SENATOR BONACIC: So what it does is, it gets
23 them through the withdrawal period.
24 If they use it the time first time, it scares
25 the heck out of them --
20
1 JOSEPH TODORO: No, it doesn't get them
2 through --
3 SENATOR BONACIC: -- and they don't want to
4 use it again?
5 JOSEPH TODORO: It doesn't get them through
6 withdrawal. What it does is, it jump-starts them.
7 SENATOR BONACIC: It jump-starts.
8 JOSEPH TODORO: It brings them back.
9 It doesn't cure addition, it doesn't prohibit
10 addiction. And it's definitely not used in terms of
11 treatment.
12 Treatment, we would look at Suboxone or other
13 type of neural blockers, too. And there are a
14 couple of courses of treatment that's available to
15 that.
16 Right now, the studies show that sometimes
17 Suboxone alone is enough to assist somebody in
18 recovery.
19 But, I think more -- my professional opinion
20 is, more times than not, you should be having that
21 type of a medication used with therapies.
22 SENATOR BOYLE: One question:
23 For those of you who are not familiar with
24 Narcan, I'm a former EMT and I've seen it work, and
25 it is truly a miracle drug.
21
1 You're talking about someone going from the
2 brink of death, not breathing, just about gone, and
3 [snaps fingers] awake, alert, and talking to you a
4 minute later. Literally, a minute later.
5 It's truly amazing.
6 But you're right, it is a short-term thing.
7 It gives them a second chance to get to the
8 hospital, whatever the true medical thing.
9 But you mentioned, on Suboxone, the more
10 longer-term drug.
11 What we're seeing in some areas is that it's
12 almost being used -- now, you can become addicted to
13 Suboxone; correct?
14 JOSEPH TODORO: It doesn't cure the
15 addiction.
16 SENATOR BOYLE: Doesn't cure it.
17 So -- but people are using their Suboxone
18 thing to sell for heroin in some areas.
19 JOSEPH TODORO: Yes.
20 SENATOR BOYLE: So it's a difficult thing.
21 I mean, as you mentioned, Doctor, that -- you
22 need Suboxone with treatment, certainly.
23 And what about VIVITROL? Are you familiar
24 with this --
25 JOSEPH TODORO: Yes, I'm familiar with that,
22
1 too.
2 I think the issue really is -- well, there
3 are a couple of things.
4 One is, you know, if you took all the
5 prescriptions that have been written for opiates,
6 you know, recently in the United States, everybody
7 in the United States would be high for an entire
8 month, 24/7.
9 Okay?
10 So that's how much is out there in terms of
11 the prescription stuff.
12 The other piece is that, you know, this is a
13 disease that's treatable. Period.
14 It's treatable, and we need to remember that.
15 And I think that the real issue for us is
16 access to treatment, and good treatment, as well as
17 prescribing practices.
18 There's no reason in the world for anybody to
19 get a 30-day supply of medication when all they did
20 was strain their back.
21 You know, a 3-day supply, if you must, in
22 terms of an opiate, at most.
23 But, we don't have those types of formularies
24 set up for prescribers at this point in time.
25 DR. CARLOS HOLDEN: Well, actually, we do,
23
1 and that's been a recent, I think, policy success at
2 the state level.
3 We now have something called the
4 "Prescription Monitoring Program."
5 JOSEPH TODORO: "I-STOP."
6 DR. CARLOS HOLDEN: It's mandatory for a
7 prescriber to consult that database and see what
8 other medicines a patient is on before writing a
9 prescription for a controlled substance.
10 This is to eliminate the practice of what's
11 called "doctor shopping," where folks go to one
12 doctor, they get a prescription for a bunch of meds.
13 Then they go down the street to another doctor, tell
14 the same story, get, you know, more meds, and more
15 meds and more meds.
16 So with that statewide law, I think, you
17 know, it's definitely helped deter abuse of the
18 prescription products.
19 Unfortunately, one side effect of that is
20 more folks are, you know, headed towards heroin now.
21 But I definitely think we've made great
22 strides in terms of the prescription-drug abuse
23 problem.
24 One other policy recommendation that I would
25 have, regarding prescription meds, is we know that
24
1 there are some particular formulations of
2 prescription meds that are vulnerable to abuse.
3 Several years ago, when Oxycontin first came
4 out, it was referred to as "hillbilly heroin",
5 because you could crush it, you could snort it.
6 It was just prepared in such a way that it
7 was prone to abuse.
8 The manufacturer of that product subsequently
9 did what I think was a very responsible thing, and
10 chemically modified the drug so that you can't, you
11 know, crush it up and snort it like that, which is
12 really good.
13 Unfortunately, we had a recent FDA approval
14 of a medicine called "Zohydro," against the advice
15 of their own subcommittee that investigated this
16 medicine. And similar to the initial formulation of
17 Oxycontin, it's very, very prone to abuse.
18 There's no -- it's a product that one could
19 crush and -- you know, and consume that way.
20 So I'm worried that we're going to start to
21 see, you know, the same problems that we had with
22 Oxycontin early on.
23 So one recommendation that I would have,
24 if -- you know, for policy, is, if we're going to be
25 marketing long-action prescription opiates, they
25
1 need to have some sort of an abuse-deterrent, you
2 know, formulation inside them, like Oxycontin now
3 has.
4 SENATOR BOYLE: Yeah, that's an excellent
5 point.
6 And I, for the life of me, do not understand
7 the FDA's decision there. Their own advisory board
8 voted 9-to-2 against the idea of this; and, yet,
9 they still allowed it.
10 And I think you're right, we may be seeing
11 some overdoses in this area unless they change their
12 mind very quickly.
13 SENATOR BONACIC: Just, I'd like to get a
14 consensus with the panel.
15 If I used heroin for the first time, am
16 I automatically addicted?
17 Or, it depends on my immune system and my
18 health?
19 Or -- because people say that. They say,
20 "one shot and I could be addicted."
21 Is -- can you share your knowledge on that
22 question?
23 IZETTA BRIGGS-BOLLING: Well, I think that
24 you could be, depending on your brain mechanism,
25 because different substances affect the brain in
26
1 different ways.
2 So, heroin might be the substance that
3 affects your brain. Cocaine could be the substance
4 for someone else.
5 A lot of times it could be -- there are
6 gateway drugs that people progress through, which --
7 I think your name is Peter?
8 PETER LAIZURE: Yes.
9 IZETTA BRIGGS-BOLLING: -- which I wanted to
10 say thank you so much for sharing your story,
11 because you took us through a timeline of a young
12 adolescent who began experimenting with marijuana,
13 and progressed all the way to IV-heroin, and
14 overdosed at the age of 23.
15 And from a community perspective, I think the
16 community needs to understand and recognize and
17 address that the youth of our community are
18 experimenting with these substances.
19 And sometimes we don't want to address it or
20 we don't want to acknowledge it, but the
21 progression -- the progression of the disease of
22 addiction can happen very quickly.
23 So someone can begin at 16, and actually
24 be -- their life be ended at the age of 23, and they
25 have -- their life -- they have experienced the
27
1 entire progression of this disease.
2 So, it depends on the individual.
3 Someone could use one time and become
4 addicted; and someone, their progression could
5 develop over a lifetime; but they still could end up
6 in the same place, which is death at the end.
7 So I really want to impress the importance of
8 community involvement, and us addressing, not only
9 our young people, but also our elderly individuals,
10 who we're seeing a rise in their opiate and
11 prescription use, as well.
12 Because you also expressed a progression from
13 one substance, all the way to heroin, which is, a
14 lot of people begin with prescription, which Joe was
15 talking about.
16 You're prescribed a medication for 30 days
17 for something that you may have only needed
18 3 to 5 days, but, you became physically dependent on
19 the substance and you began to use it more readily.
20 And then the -- a problem was recognized
21 somewhere down the road, and the medication was no
22 longer available. So the next option is heroin,
23 which we -- there's no way to determine what level
24 of drug or substance the person may be injecting or
25 ingesting into their body.
28
1 SENATOR BONACIC: Thank you.
2 NOLLY CLIMES: Just wanted to add, in terms
3 of a recommendation, to keep in mind that --
4 SENATOR BONACIC: Keep close to the mic,
5 Nolly.
6 NOLLY CLIMES: -- Mr. Laizure was talking
7 about his son, that the -- one of the largest
8 increase in heroin use, it seems to be in that age
9 group, 18 to 25.
10 And that we need to -- any recommendations,
11 we need to understand this group, and prioritize
12 their needs, and how to reach them in terms of
13 prevention and education, because this is an age
14 where a lot of decisions are being made in terms of
15 education, career, relationship, life plans, all of
16 which are high risk or interrupted once a person
17 starts to use heroin.
18 So I think that, as we discuss, and there are
19 plans developed, we need to take into account that
20 there is this special population that is really
21 increased the use of heroin; and that's the 18 to
22 25.
23 SENATOR BOYLE: Okay.
24 Why don't we -- if I could just ask a
25 question, for those of you in treatment:
29
1 A typical case we're hearing around the state
2 is, say, a 19-year-old finds himself or herself
3 addicted to heroin or another opiate, and finally
4 says, "I want off, I'm ready to get clean."
5 They get into a detox.
6 And then, from the detox, in most parts of
7 the state, it's a wait to get into rehabilitation, a
8 recovery, a treatment center.
9 The insurance says, No, we're going give you
10 four days, five days.
11 You know, what are you experiencing out here
12 around Sullivan County?
13 JOSEPH TODORO: It's very similar.
14 What we find -- and I think that's the policy
15 issue, really, that we need to grapple with, is
16 access to appropriate levels of treatment.
17 Depending upon your insurer, depending upon
18 your HMO, depending upon -- all of those things are
19 a huge play.
20 And the issue that you're talking about, with
21 a young person who may be able to go into a crisis
22 bed, and, you know -- you know, be somewhat
23 chemically-free, and then needs to go into a 30-day
24 program, or things like that, they're quite often
25 told, not just young people, also, that, No, you
30
1 need to try to kick this on an outpatient basis
2 first.
3 And Izetta will tell you, we have
4 professionals in our offices who can look at
5 somebody, and go: This is not going to work on an
6 outpatient basis.
7 Because it has a lot to do, also, with, you
8 know, the person being in a willing environment,
9 too.
10 You know, so it's not often that you have a
11 drug addict who can go someplace and be safe and
12 away from all those people who have influenced their
13 drug use, too.
14 So that becomes an issue.
15 So, access to treatment is paramount.
16 We don't have enough treatment for
17 adolescents and young people.
18 Because of some of the rules and regulations
19 that, you know, adults can't -- you know, we can
20 treat kids who are 19-plus, but we can't treat them
21 who are, you know, down -- below the age of 18 in
22 certain settings.
23 So, you know, access to treatment.
24 And, you know, quite frankly, through the
25 recession, the prevention budget out of OASAS has
31
1 been cut dramatically.
2 UNKNOWN SPEAKER: [Off video.] Yes.
3 JOSEPH TODORO: We used to have quite a bit
4 of ability to fund community-wide prevention
5 services.
6 Now, not so much.
7 LAWRENCE THOMAS: From the BOCES standpoint,
8 I mean, we have had great relationships and
9 partnerships with county agencies.
10 And one of the things that we have witnessed
11 over the short period of time, is that it's getting
12 harder and harder to have those partnerships, and
13 have some folks from some of those other agencies
14 come into the schools, partially because those
15 individuals aren't even available.
16 And, so, that is a concern for us.
17 I mean, we want to provide prevention
18 services before students even get to the point where
19 they -- where they may be forced to make a decision
20 with regard to heroin.
21 And what we're finding is, it's difficult to
22 have the manpower, to have the service providers --
23 prevention-service providers, even available to
24 bring them into the schools.
25 Some of it is -- some of it is a financial
32
1 issue.
2 Some of it is community acceptance, too, in
3 allowing us to go far enough down into the lower
4 grades.
5 NICK ROES: There's at least a six-week wait
6 to get into our program, and it's really
7 heartbreaking to have to talk to parents whose
8 daughters are really in trouble, and want -- we have
9 to try to place them in shorter-term programs or
10 crisis centers.
11 You feel almost like you're playing God, and
12 it's a really horrible position to be in.
13 UNKNOWN SPEAKER: [Off video.] Yeah, no
14 question.
15 PETER LAIZURE: I would just look to add
16 that, my experience has been that the insurance
17 companies will do that; just give you limited time,
18 and the facilities have to continually call the
19 insurance companies to get more time.
20 30 days is not enough.
21 30 days is not nearly enough for most
22 addicts.
23 This is a very powerful addiction.
24 And you're right -- is it Larry? -- we got to
25 get to these kids before they try it.
33
1 And I'm, you know, in a grassroots group
2 called "Not One More," and we are trying to get into
3 the schools.
4 We have plenty of people ready to volunteer,
5 set up programs, and it's really difficult to get
6 in.
7 SENATOR BONACIC: Yeah, I'd like to touch on
8 that subject.
9 I know that, you know, there's TV ads on
10 smoking. They show the horrific effects if you
11 smoke, what happens to your lungs.
12 I know the State Police used to do -- come to
13 the schools with crushed cars to show what happens
14 if you drink and drive.
15 Do we have, number one, enough instructional
16 material, education material, on the effects of
17 heroin?
18 And, do you think it's an obstacle to get it
19 in the schools as part of an education program?
20 I'm just throwing it out there.
21 PETER LAIZURE: From what I'm hearing from
22 some of the schools, is they don't have the time,
23 and they don't have the money in the budget, to have
24 an ongoing program.
25 They're saying that a one-day assembly is
34
1 just not going to do it. It needs to be a
2 consistent program over and over and over.
3 I understand, you know, the budgeting, but,
4 there are a lot of people who have been affected,
5 who are willing to step up and help up and do some
6 volunteer work for these programs.
7 LAWRENCE THOMAS: Yeah, the one-time shots
8 are just -- are, in fact, that; they're one-time
9 shots.
10 And what we really need is a program that
11 lasts a long period of time.
12 I'm not even just talking about a year.
13 I'm talking about years at different levels,
14 and provides opportunities for students to really
15 process the information that they get, to be placed
16 in -- or have, perhaps, simulations or assignments,
17 where they need to think about, you know, what kind
18 of decisions they're going to make.
19 I mean, these decisions that they make are
20 life skills, life-success decisions, and they
21 certainly relate to whether or not I'm going to
22 become -- I'm going to experiment with heroin, or
23 not.
24 But they need to be placed in these kinds of
25 decision-making opportunities frequently, and
35
1 practice that skill of positive decision-making.
2 SENATOR BONACIC: Do you think paid TV
3 messages are a waste of time, or it's good?
4 LAWRENCE THOMAS: I think that they're good
5 for themselves, but, again, they're a one-time shot.
6 They're a very limited exposure. They don't go deep
7 enough into the content.
8 They don't go deep enough into how it
9 affects, not only you as an individual, but, also,
10 how it affects your family; how does it affect your
11 community?
12 And so, you know, as one layer, okay, but
13 it's just one layer.
14 There needs to be a lot of other layers.
15 SENATOR BONACIC: Thank you, Larry.
16 NANCY McGRAW: I'd like to address, a little
17 bit about, echoing the sentiments that have been
18 said so far, about the need for funding for
19 prevention services.
20 We as a task force have -- among many of
21 these organizations, have pooled our resources for a
22 number of years, and have met with the
23 superintendents, and tried to scrape together
24 materials, have offered volunteer time on our own
25 time, to go in and provide presentations.
36
1 I think what we really need, on the
2 prevention side, is just that; we need more funding.
3 All of our organizations and departments have
4 been cut.
5 Public health has been cut.
6 Mental health has been cut.
7 Law enforcement has been cut.
8 The educational system has been cut in terms
9 of mental-health resources.
10 And I think we really need more funding for
11 prevention resources that are evidence-based.
12 IZETTA BRIGGS-BOLLING: Yes.
13 SENATOR BONACIC: If that happened, would it
14 be -- and it was earmarked for heroin specifically,
15 would there be an assurance that it would be used
16 for that, and not for other things?
17 I mean, let's say we, generically --
18 JOSEPH TODORO: Well, typically, prevention
19 isn't paid by insurance.
20 SENATOR BONACIC: -- gave more money into a
21 budget.
22 JOSEPH TODORO: Prevention is rarely paid by
23 insurance. It's usually --
24 SENATOR BONACIC: No, I don't mean insurance
25 companies.
37
1 I mean --
2 NANCY McGRAW: For the purpose of heroin
3 prevention.
4 SENATOR BONACIC: -- if the State gave more
5 money to public health for this specific purpose of
6 fighting heroin addiction, that it wouldn't be used
7 for pamphlets to go vote, or something.
8 NANCY McGRAW: I -- you know, all of the
9 grants and funding that we have through
10 Public Health is earmarked for specific purposes.
11 SENATOR BONACIC: Okay.
12 NANCY McGRAW: And we have to demonstrate
13 outcomes and evidence-based, you know, reports that
14 we have used it for its intended purpose.
15 And I'm sure, as all of these other
16 organizations do, research on what works.
17 And I think that we need to do more of that.
18 And in terms of preventing, specifically
19 heroin addiction, what Larry was talking about was
20 specific to teaching kids life skills, and teaching
21 them how to cope with making decisions.
22 And that's what leads to, when they're faced
23 with that peer pressure, making the decision not to
24 use heroin, or something else.
25 JOSEPH TODORO: And, Senator, I would warn
38
1 against just going after the heroin addict, because
2 as you've heard today, and many of the stories
3 across the state, it starts with other things.
4 SENATOR BONACIC: Yeah, no, I got that.
5 JOSEPH TODORO: So I think providing
6 prevention efforts and funding to look at, you know,
7 addiction, to try to develop these pro-social skills
8 in our young people, to be able to, you know, resist
9 some of the peer pressure that goes along with being
10 a teenager, or a 20-something, I think that's where
11 your money is well spent.
12 You know, the treatment piece, access to
13 treatment, is critically important, you know.
14 But, if you can separate the toxic agent from
15 the willing host in the enabling environment, you
16 know, you're going to be in a much better place.
17 And prevention dollars help us do that.
18 NOLLY CLIMES: Just wanted to emphasize that
19 there is a direct correlation between reduction of
20 funding on prevention program and the challenges
21 that we face to meet the needs of the people that
22 need the services.
23 So I think that, if through this Task Force,
24 there could be an emphasis to say that, the outcome,
25 the crisis, the challenges, directly relate to what
39
1 has happened in terms of funding for providers that
2 know what to do, but there many other program has
3 been reduced over the last few years.
4 SENATOR BONACIC: There's no question of
5 that.
6 And prevention not only saves lives, it's a
7 lot of bang for the buck --
8 UNKNOWN SPEAKER: [Off video.] Yes.
9 SENATOR BOYLE: -- when you look at the
10 crimes that are committed by addicts to get the
11 money for their drugs, and for putting them in
12 prison.
13 Because, right now, a great percentage of our
14 jail population, statewide, is -- are solely there
15 because of their addictions, no doubt.
16 SENATOR BONACIC: I see last week there was
17 an arrest in New Hampton. A car was stopped, with
18 $12 million worth of heroin.
19 Do you think we need tougher drug laws, you
20 know, legislation, against the people with heavy
21 trafficking in heroin?
22 Or, does anyone on the law-enforcement end
23 want to comment on what they're seeing, whether in
24 prosecution or in arrests?
25 DA JAMES FARRELL: Well, I can address that.
40
1 One of the things that I think's important to
2 note, is that, as Joe said, this is an evolution;
3 and as the parent down on the panel said, as well,
4 there is an evolution.
5 It starts with marijuana. Evolves to the
6 next level; maybe a painkiller, an opiate,
7 hydrocodone, and oxycodone. And then we're into
8 heroin.
9 There really is no difference in the way the
10 drug affects the body between heroin and synthetic.
11 It's a synthetic version of the street-drug
12 heroin. It's what it is.
13 So -- and Sullivan County, New York,
14 "Sullivan County, New York," leads the state in
15 per-capita prescriptions for oxycodone.
16 399 per 1,000 Sullivan County residents have
17 a prescription for oxycodone.
18 Now, what does that also tell you?
19 Now, these people are driving cars.
20 "They're driving cars."
21 And one of the things that's very difficult
22 for law enforcement, extremely difficult for law
23 enforcement, and I think a recommendation that
24 I would urge, is that we have some sort of per se
25 "driving while ability impaired by drugs," just like
41
1 we do with alcohol. We pick a number, .08, that's
2 what it is.
3 Well, when someone's driving under the
4 influence of prescription drugs, you know what they
5 say? "I have a prescription for that. So my doctor
6 told me I could use it."
7 IZETTA BRIGGS-BOLLING: Uh-huh, and they pull
8 it out.
9 DA JAMES FARRELL: Of course, they ignore the
10 label on the bottle that says, "Do not operate heavy
11 machinery." They ignore that.
12 Well, I can do it; I can do it; I can do it.
13 We need to have a per se, because, otherwise,
14 our police -- and when our police come up, they
15 don't smell oxycodone, they don't smell hydrocodone.
16 We have to have a way to enforce that.
17 People are dying on our roads because of it.
18 And when I look at the autopsy reports, what
19 do I see?
20 I see the prescription painkillers.
21 I see the THC.
22 And I see the three words "acute drug
23 intoxication."
24 That's what I see.
25 [Applause.]
42
1 UNKNOWN SPEAKER: [Off video.] Beautiful.
2 DA JAMES FARRELL: So -- and I think the
3 education piece, we're fooling ourselves if we think
4 we can educate these kids, and at the same time,
5 pass laws that legalize marijuana.
6 We cannot do that.
7 We cannot out of one side of our mouth say,
8 "This is bad for you"; but, this is okay.
9 And we've got states that are doing it.
10 And the feds are against it.
11 And I hope the Legislature here in New York
12 remains steadfast, because it is a gateway.
13 And when we see people who are in trouble
14 with the law, people who are imprisoned now because
15 of their actions, what do we see in their
16 presentence reports that are filed with the court?
17 They started with marijuana.
18 It progressed to painkillers.
19 It led to cocaine.
20 It led to heroin.
21 That's what we see.
22 That's what we see.
23 So I think we're kidding ourselves if we send
24 our kids a counterproductive message that one's
25 okay, and one's not.
43
1 I really do.
2 IZETTA BRIGGS-BOLLING: And I'd like to just
3 add that, even though New York State may say no, our
4 youth have access to the world. They have the
5 Internets, they have them on their cell phones.
6 So if it's okay in Colorado, Okay, mom and
7 dad may say that it's not okay, New York State may
8 say it's not okay, but if marijuana is available or
9 any other substance is available, they have -- they
10 already have identified a favorable attitude to, "It
11 must be okay if other states are doing it. New York
12 is just behind the times."
13 DA JAMES FARRELL: And the other thing is,
14 these prescription pills, and when you see kids and
15 you talk to them, and I have, they think they're
16 safe because they're made by big pharma.
17 "Big pharma makes them and they got to be
18 safe. My mom takes them, my dad takes them, my
19 relative takes them. They must be safe. I can take
20 them."
21 IZETTA BRIGGS-BOLLING: Yep. "And it's right
22 in the medicine cabinet, so let me go get one."
23 SENATOR BOYLE: One of the other things we're
24 seeing, and as amazing as it is, someone like me,
25 you know, gray hair, I think of heroin, to 1970s,
44
1 inner city, with the needle.
2 A lot of these kids have never heard of
3 heroin before.
4 They're addicted to the painkiller.
5 They go to their friend in school.
6 Like, on Long Island, for example, because of
7 the I-STOP legislation, that unintended consequence,
8 the price of oxycodone is $30 a pill now in
9 Suffolk County. A bag of heroin is $6.
10 So their friend says to them, Hey, there's a
11 new drug called "heroin." It's a lot cheaper and a
12 lot stronger.
13 They never -- they don't -- they're not from
14 the '70s. You know, they're thinking this is a new
15 thing.
16 And that's what we're seeing.
17 So, prevention and education is going to be
18 key, too.
19 SENATOR BONACIC: Just one thing: I'm going
20 to take something out of order.
21 Lisa Wiles is the superintendent of the
22 Ellenville School District.
23 We had asked her to be on the panel, but she
24 said she could only give us one hour.
25 She has to leave, but she's indicated that
45
1 she would like to speak on the issue of education
2 and heroin.
3 Lisa.
4 LISA WILES: Thank you very much,
5 Senator Bonacic.
6 SENATOR BONACIC: Yeah, come on up.
7 LISA WILES: So, good afternoon, and I really
8 applaud all of you for being here.
9 I just want to talk -- I think that your --
10 I think there's a lot of great ideas coming here.
11 I think there's two issues I see.
12 The first is one definitely prevention, and
13 what best-practice prevention looks like in
14 elementary schools, in middle schools, and
15 high schools.
16 But before I get to that, I want to talk
17 about the access to treatment programs.
18 And I've had -- I see a lot from my position,
19 and I see a lot personally in my county.
20 And, unfortunately, thanks to law enforcement
21 here, I've seen, like, a very big heroin bust in a
22 small sleepy town in Sullivan County called
23 "Woodridge," where I live, four blocks away, that
24 I'm, like, floored that it could happen.
25 So it's all over. It's in Long Island, it's
46
1 in Westchester. My colleagues are talking about it.
2 It's not limited to just heroin. It does
3 start earlier on and move its way up.
4 But, there needs to be better access.
5 I know of a family that had to wait three or
6 four weeks to get into a program; for their daughter
7 to get into a long-term program with an educational
8 component.
9 You know, I worked at New Hope Manor many,
10 many years ago.
11 Those types of programs that tout the skills;
12 teaching, you know, addicts skills to reenter into
13 society so that they have something when they're
14 done.
15 But the prevention piece is huge.
16 So if you have a prevention council, we have
17 one in Ulster County, and we work together to look
18 at best practices that could be used.
19 In the schools we are taxed for time. With
20 Common Core, everyone's worried about testing.
21 You know, these are the basics.
22 I keep saying we have to get back to the
23 basics here.
24 And basics are basics; it's not okay to use
25 drugs, and this is what happens. You know,
47
1 hearing -- hearing definite, you know, experiences.
2 With bullying, you know, we've brought in
3 so -- I'm using that as an example, because we've
4 brought in specialists, we've talked about how to
5 handle this, how to have students understand it, how
6 to react to it.
7 We need to do the same thing with drugs.
8 And it is, sometimes, a dirty little secret.
9 We don't like talking about it.
10 We don't like that, you know, my school has
11 it, your school.
12 All the schools have it.
13 And if anyone tells you they don't have it,
14 they're not being forthcoming.
15 The schools that have -- that are poor, and
16 that are high-needs, have it.
17 And if schools that have all the money in the
18 world have it, maybe it's a different kind of drug.
19 But we need best practices,
20 scientifically-based programs.
21 I don't have the time to go look at what
22 works best.
23 Show us some programs.
24 And then we will need some funding. We're
25 taxed.
48
1 But, we're open to working with volunteers
2 coming into the building, also.
3 So I think on -- I'm not speaking for my
4 colleagues, but I think that we definitely see a
5 need for help, and I think it has to be a
6 collaboration of law enforcement, you know, seeing
7 that end of it, what the consequences are.
8 But before you even get there, you know, what
9 do -- what is somebody who's recovering say about
10 how bad it was to get off of it?
11 I know a family that's really struggling with
12 a heroin-, you know, addicted child, and they could
13 not get off -- she thought they could get off of it
14 herself.
15 It's not -- you cannot -- we can't go there.
16 And there are people, there are kids, dying
17 every day. And people are -- they don't put it in
18 the papers, in the obituaries, because it's shameful
19 to them.
20 And we have to get beyond that if we really
21 want to try to help people and help our kids.
22 And it goes -- I agree wholeheartedly with
23 you, District Attorney Farrell, it's not okay.
24 It's not okay that our kids drink when
25 they're not allowed to drink, and it's not okay to
49
1 condone it.
2 I'm not popular sometimes with my kids and
3 their friends, but, it's just the way it is.
4 And we all have to take a stand on it, but we
5 need some best practices.
6 We set up drop-offs for prescriptions.
7 If you have oxycodone from surgery or
8 something, we have something in Ellenville, I know
9 we have them around the county, too, where you can
10 drop off your prescriptions.
11 But how many people in the county know how
12 important it is not to have it out?
13 More public-service announcements.
14 Our kids in Ellenville are developing them.
15 We have to work collaboratively and come up
16 with you know, better best practices.
17 So I don't want to take your time, but
18 I appreciate it very much, and we're open.
19 I know my colleagues are open.
20 We surely don't want to -- we didn't go into
21 education to watch children suffer.
22 We want them to move ahead as far as they
23 can, you know, in the future.
24 SENATOR BONACIC: Thank you, Lisa.
25 Does anyone from the panel want to conclude
50
1 with any remarks they'd like to share?
2 Because we're going to open it up to the
3 audience, if they have any questions of the panel.
4 PETER LAIZURE: I just had a quote somebody
5 gave me along the way.
6 "Addiction hates awareness, and recovery
7 demands it."
8 SENATOR BONACIC: Beautiful.
9 [Applause.]
10 SENATOR BONACIC: Yes.
11 IZETTA BRIGGS-BOLLING: I just wanted to say,
12 on my way here, an individual came into the crisis
13 unit seeking services.
14 She had been -- this individual had been in
15 withdrawal for seven days.
16 And when I asked, "Why did it take you so
17 long to get here?" it was because there was no
18 transportation.
19 They live at the far end, almost by
20 Pennsylvania, and there was no way for the
21 individual to get to treatment.
22 We do have transportation availability once a
23 person is in a treatment program.
24 But there are people that may be dying, just
25 because they don't have a way to get here, to get to
51
1 the treatment facility in Sullivan County.
2 And I just didn't want this to conclude
3 without addressing the transportation issue.
4 SENATOR BONACIC: Thank you.
5 DR. CARLOS HOLDEN: Yeah, and I think it's
6 impossible to overstate the magnitude of this
7 crisis.
8 Ten years ago, the most common cause of death
9 between the ages of, like, say, 15 to 45, was
10 trauma. You know, that would be traumatic
11 accidents, like car accidents, and stuff like that.
12 We've done better at treating trauma.
13 And this substance-abuse crisis has exploded,
14 so that now the most common cause of death between
15 the ages of 15 and 45 is substance abuse.
16 It's an epidemic. It's killing people right
17 and left.
18 We're seeing it in the emergency department.
19 We're seeing it all around the community.
20 So this is a true public-health crisis, and
21 we appreciate your help in addressing it.
22 NANCY McGRAW: And I'd just like to say one
23 final thing, from a public-health perspective, and
24 the drop-boxes that you mentioned, we have
25 implemented, through the task force,
52
1 three drop-boxes.
2 And if everybody is not aware, they are at
3 their local police stations. 24/7, people can drop
4 off their unwanted prescription medications or any
5 other drugs that you don't want: Fallsbury, Liberty,
6 and Monticello.
7 And the last two Take-Back days alone, we
8 collected over 500 pounds of unwanted medication and
9 getting them out of people's homes.
10 So thanks to law enforcement for transporting
11 them for us to the incinerator.
12 We're making some efforts, but we do need
13 funding for comprehensive prevention strategies for
14 treatment, getting people into treatment, and the
15 elephant in the room, in terms of mental-health
16 resources, that cause people to use drugs in the
17 first place.
18 SENATOR BONACIC: Thank you.
19 Anyone else on the panel?
20 Yes, Sheriff.
21 SHERIFF MICHAEL SCHIFF: First, I'd like to
22 thank both Senators for hosting this.
23 It's a complex problem; it's going to call
24 for complex answers.
25 From law enforcement, I go along with Nancy,
53
1 everyone's budget has been slashed.
2 Law enforcement, nationwide, is having
3 trouble coping with this problem.
4 We have to approach it on every level in a
5 cooperative effort.
6 We need more law enforcement, and we need aid
7 from the feds; from the State, meaning State Police;
8 for more technological aid, whether that be
9 eavesdropping, scoping out areas, doing our
10 intelligence work.
11 And we really have to address the "dealing"
12 problem heavily.
13 That being said, we also have to hit on every
14 one of the other components.
15 We have a D.A.R.E. program. We're going to
16 be trying to expand ours.
17 Hopefully, there will be programs like that
18 in the schools that will start addressing the upper
19 grades.
20 We have not been able to address that from
21 our end. We're going to be working on that this
22 fall.
23 The other problem is getting into, which has
24 been discussed, long-term programs.
25 There aren't too many people anywhere who
54
1 aren't related to or know someone who has a problem
2 with drugs.
3 One of my daughters has a heroin problem.
4 She's an addict, and she happens to be in New Hope.
5 I lived through all the things you've talked
6 about.
7 The short-term programs, just detoxing, not
8 effective.
9 She's finally in New Hope, long-term program.
10 She had been in other programs, where she
11 told me stuff got smuggled in.
12 Not in New Hope. They run a tight ship.
13 I think there may need to be more State
14 monitoring of these programs.
15 But, to take a young person and want them to
16 fail in an outpatient setting, three, four,
17 five times, is courting disaster.
18 You need to go at the problem aggressively,
19 and get them the best help in the beginning.
20 And I think the programs are reversed, so
21 I think we need aid in that end.
22 Another component that I would bring up that
23 wasn't discussed yet here:
24 My daughter was out in California for a
25 while, and she got out of a short-term program. And
55
1 what she found was, after she got out of that
2 program, there was all kinds of support.
3 Young people who met, like in AA or Al-Anon,
4 they got together, they supported each other. They
5 understood their problem in a way that none of us
6 can.
7 And she found that to be very helpful; that
8 the success rate after getting out of a rehab, that
9 made all the difference.
10 She came back to Sullivan County.
11 She went to Ulster County to one meeting,
12 went to a couple here, and found that there were
13 mostly elderly people with alcohol problems. No one
14 she could relate to.
15 And I think we need to work in the schools,
16 but this goes beyond the schools.
17 A lot of these kids are going to be out of
18 school.
19 I think once you get them out of a short-term
20 or a long-term program, the key to success is, once
21 you're back out on the street, who is there to help
22 them?
23 And I think if there's any component we can
24 walk away from this with, that is lacking, it would
25 be that.
56
1 I mean, every aspect of this needs to be
2 beefed up, but, I'm finding, locally, there is
3 nothing. There is no support group.
4 And at the end of the day, anybody can learn
5 to live within the environment of a rehab program or
6 in a medical setting where they're being watched,
7 but when you come out and you're allowed to make
8 those decisions on your own again, you need someone
9 who you can relate to; not somebody who's totally
10 out of your age group and maybe having a totally
11 different problem.
12 So I would advocate, these programs don't
13 seem, in the rural areas, to be put together on
14 their own.
15 There are a lot of dedicated people that do
16 it, but there aren't yet a lot of young people.
17 I think we're going to have to figure out a
18 mechanism, whether through mental health, health
19 services, the schools. I think we have to figure
20 out a mechanism to create that environment.
21 I don't think it's going to do it on its own.
22 So if there's anything I would bring to the
23 table, that would be it.
24 SENATOR BONACIC: Yeah, buddy system, that
25 makes sense.
57
1 DA JAMES FARRELL: Senator, I would also say
2 one other thing --
3 SENATOR BONACIC: Sure.
4 DA JAMES FARRELL: -- I think it's important.
5 And Dr. Holden did a terrific presentation as
6 part of the rural drug task force that we have here
7 against prescription drugs.
8 I think we have to ensure responsible
9 prescribing practices by physicians.
10 If you look at these numbers, and
11 Dr. Galarneau was there, as well, from the hospital,
12 and they're engaged, and we need our physicians to
13 be engaged in this problem, but if you look at the
14 sharp rise in opiate-overdose deaths nationwide --
15 and he brought the maps, and it's nationwide, it's
16 all over -- it parallels the increase with the
17 prescribing patterns of physicians.
18 So I think education, not just to the kids;
19 obviously, we want to get through to them. And as
20 Larry said life skills, life -- and these are
21 life-altering decisions that they're going to make
22 if they decide to get hooked.
23 "Life-altering." It could end their life.
24 But we also need to engage the folks who are
25 prescribing these dangerous drugs, as well; and
58
1 that's our physicians.
2 SENATOR BOYLE: One of the proposals we're
3 looking at is, is -- as part the continuing medical
4 education every doctor has to go through, SBIRT; a
5 program of treating people, screening, figuring out,
6 what is an appropriate opioid.
7 Because we hear it statewide, I mean, it was
8 talked about before, a wisdom tooth taken out, and
9 90 Vicodin is prescribed.
10 It's all crazy.
11 DA JAMES FARRELL: One of the things that
12 Dr. Galarneau said, and he could probably speak
13 better to it, is we treat pain.
14 We treat pain in America now. We don't treat
15 the underlying cause.
16 So we have a bad appendix, it will bust and
17 kill us if we're taking pain medication.
18 Doctor?
19 SENATOR BOYLE: Please, yeah.
20 Go ahead, please, yeah.
21 Do you have a microphone?
22 We just want to get it for the record,
23 though. It needs to be on a microphone to record
24 it.
25 Sorry.
59
1 DR. GERARAD GALARNEAU: I'm Dr. Galarneau.
2 I'm the CEO of Catskill Regional Medical Center.
3 I'm also a practicing urologist.
4 No, I agree; I think it's a shame that it
5 takes a lot of training to be able to prescribe
6 Suboxone and to treat addiction, but it actually
7 takes no training, other than having your doctorate
8 degree, to prescribe Oxycontin and addict people.
9 You know, the treatment of pain, if I -- you
10 know, as a urologist, if someone comes to me with a
11 kidney stone, I can treat them with pain medicine,
12 make them feel great, but I'm not treating the
13 underlying condition.
14 So, for the most part, treating pain with
15 opiates is sort of a cop-out.
16 Other doctors might disagree with me.
17 But you could keep somebody going and
18 actually never diagnose them with anything.
19 So I think that if we worked on -- I mean,
20 the biggest thing, if I had one thing on my wish
21 list, it would be to have very strict educational
22 criteria to be -- to have your DEA to be able to
23 write for a prescription.
24 Because I think a lot of doctors would
25 relinquish that right. I think that would be great.
60
1 Because you could make an argument that the
2 health of this county would be better if no doctor
3 showed up to work tomorrow.
4 [Laughter.]
5 DR. GERARAD GALARNEAU: I mean, that is a
6 provocative thing to say, but, you could make that
7 argument.
8 So, you know, decreasing the ability for
9 physicians to write those pain medicines, in some
10 sort of legislation, and requiring specific criteria
11 before they can, I think that would go a long way.
12 SENATOR BOYLE: What was it you said, the
13 "DEA"? Is that a --
14 JOSEPH TODORO: Your DEA number for -- to be
15 able to write controlled substances --
16 SENATOR BOYLE: Oh, on the scrip? Like --
17 okay.
18 Thank you.
19 SENATOR BONACIC: Thank you, Doctor, very
20 much.
21 SHERIFF MICHAEL SCHIFF: Senator --
22 SENATOR BONACIC: Any of the panel want to
23 share any other thoughts?
24 We'll open it up to the public, but if
25 anybody wants say something --
61
1 SHERIFF MICHAEL SCHIFF: Senator, one other
2 thing I would like to add --
3 SENATOR BONACIC: Sure.
4 SHERIFF MICHAEL SCHIFF: -- I think Jim
5 mentioned it before, we don't want to focus on
6 opiates, we don't want to focus on heroin.
7 This is an ever-changing -- everything we do
8 changes the landscape.
9 And when we went into Afghanistan, the
10 Taliban used to cut your hands off if you grew
11 poppies.
12 Now the Taliban has pushed back, I believe
13 there was a United Nations study, 80 to be
14 90 percent of the heroin coming into this country
15 will be from Afghanistan.
16 When we did the I-STOP, people went from the
17 prescription pills, it became harder to get, more
18 expensive, they went to heroin.
19 If law enforcement changes and we do some
20 other things, and heroin becomes hard to get,
21 becomes expensive, it's like going to a farmers'
22 market. These people are going to buy what's
23 available to them at the farmers' market.
24 And we can't focus on any one type of drug.
25 It's got to be a broad, comprehensive view, because,
62
1 six months from now, heroin may dry up to some
2 extent, and it may be something else that's
3 available.
4 So, if we do earmark, it's just got to be for
5 drug addiction and illegal drugs, and have that
6 broad shotgun approach to what might be.
7 Or like Jim always brings up, synthetic stuff
8 that's not even on the books yet.
9 DA JAMES FARRELL: It is in Sullivan County.
10 SHERIFF MICHAEL SCHIFF: Yes.
11 [Laughter.]
12 NANCY McGRAW: Senator, I would just like to
13 add, in terms of these -- legislation for -- or
14 doing something about all these energy drinks, these
15 5-Hour shots that are available to kids in the
16 grocery store, that's a gateway drug.
17 Do we know what's in those? Kids are using
18 those all the time.
19 So that's part of the issue, as well.
20 And, overprescribing, let's not forget the
21 dentists.
22 I got a 20-day prescription for something
23 I didn't need.
24 So, it happens every day.
25 We have women coming into our clinics with
63
1 newborn babies, who are on Oxycontin and they can't
2 take care of their kids because they had a
3 C-section.
4 They don't need that. They need Tylenol.
5 So, overprescribing, absolutely.
6 JOSEPH TODORO: And I would just like to
7 emphasize that, you know, the way that we tackle
8 addiction, and the way that we prevent things in our
9 community, are a wide and varied thing.
10 You're not going to find one -- you know,
11 "one size fits all" in your attempts to look at
12 this.
13 I think that it would behoove the State to
14 look at the localities, engage the localities, and
15 have the localities say, yes, this is where our
16 efforts should be.
17 You know, at one point in time we were very,
18 very married to our local BOCES to do prevention
19 programs in all of our school districts. And,
20 unfortunately, that got pull away from us.
21 It was not my local decision; understand
22 that, okay, because that becomes the critical mass.
23 You know, if you write something that's in
24 general, and you don't rely on the localities to
25 make a decision in where those resources need to go,
64
1 that's a mistake.
2 DR. CARLOS HOLDEN: Senators, I wanted to
3 thank you very much for inviting me.
4 I, unfortunately, am going to have to excuse
5 myself.
6 But my colleague, Dr. Galarneau, I'm sure,
7 can address any questions that come up regarding the
8 hospital treatment for these.
9 So, thank you very much.
10 SENATOR BOYLE: Well, thank you for being
11 here.
12 DR. CARLOS HOLDEN: I appreciate it.
13 [Applause.]
14 SENATOR BONACIC: I think there's a series of
15 questions that have been given to MJ, so why don't
16 you read the question, MJ.
17 MJ: This question is from Lisa.
18 The question is: What is local law
19 enforcement doing to target underaged drinking and
20 drug use at parties?
21 SENATOR BONACIC: Did they hear the question?
22 MJ: Did you hear the question?
23 DA JAMES FARRELL: Yep.
24 SENATOR BONACIC: Why don't we just respond.
25 DA JAMES FARRELL: We have a local law that
65
1 we passed, that holds people who host these types of
2 parties, with underaged drinking or drug usage
3 occurs, responsible.
4 We have had -- unfortunately, we haven't had
5 that many arrests under the law.
6 We did have one in Fallsburg.
7 But we are actively enforcing the law, should
8 we come across that type of event.
9 Obviously, with prom season and graduation
10 season upon us, those things will become more
11 prevalent.
12 What our local police officers, all of
13 them -- Liberty police, Fallsburg police, our
14 Monticello police, and our Sheriff's Office -- have
15 given us a commitment to enforce that local law;
16 which unlike the state law, which requires the
17 person to provide the alcohol, the local law only
18 requires that the person allow the consumption of it
19 on their premises.
20 So it's a little bit different standard, and
21 that's one of the things that we have in our quiver,
22 so to speak, to combat that.
23 We have to be consistent with our children.
24 And I think sometimes when we get
25 inconsistent, as we have seen in Colorado and in
66
1 other states, it screws things up.
2 And I think we need to be consistent in our
3 message that these things are not okay.
4 We know from studies, with respect to
5 alcohol, and we'll start there, that on the
6 adolescent brain it causes enormous damage.
7 Now, not so much on an adult brain because
8 it's already grown and it's gotten to its position.
9 SENATOR BONACIC: [Unintelligible.]
10 [Laughter.]
11 DA JAMES FARRELL: But on a growing brain,
12 it's life-altering.
13 Again, go back to what Larry is saying about
14 life -- you know, life events, and you're talking
15 about altering your life forever when you consume
16 alcohol, when your brain is growing.
17 So we have to be consistent; we have to have
18 a consistent message.
19 We can't say one's okay, and one's not,
20 because then we confuse them, and we send mixed
21 messages. And I believe that's counterproductive.
22 JOSEPH TODORO: And if I could just add, with
23 regard to the parents who host, the statute that
24 we've passed locally, if you're aware of that stuff
25 is going on, call the police.
67
1 DA JAMES FARRELL: Absolutely.
2 JOSEPH TODORO: Otherwise, you're an enabler.
3 IZETTA BRIGGS-BOLLING: Right.
4 DA JAMES FARRELL: Correct.
5 Correct.
6 [Applause.].
7 SENATOR BONACIC: Lisa, are you satisfied
8 with the answer?
9 If you have a follow-up question, you know,
10 please continue, or else we'll go to the next
11 question.
12 Are you okay?
13 Okay, MJ, the second question.
14 MJ: This is from Cora Edwards.
15 Cora, are you here?
16 Okay.
17 SENATOR BONACIC: Yeah.
18 MJ: Cora asks: How has heroin become so
19 accessible in this area?
20 CORA EDWARDS: [Off video.] "In this era?"
21 MJ: "In this era?"
22 I'm sorry.
23 SENATOR BONACIC: Okay. You know, I didn't
24 hear the question.
25 MJ, could you step in front of the podium and
68
1 you say it louder?
2 MJ: Sure. Sure, yes.
3 "How has heroin become so accessible in this
4 era?"
5 SENATOR BONACIC: Okay.
6 MJ: From Cora.
7 SENATOR BONACIC: All right, thanks, MJ.
8 Does anybody --
9 JOSEPH TODORO: I think it's always been
10 accessible, but I also do believe that it's really
11 the overprescribing that's occurred, you know,
12 across the nation, in terms of managing pain.
13 And once we start to, you know, limit the
14 availability of those pain medications, then
15 heroin's a pretty easy choice for somebody. Instead
16 of a $30 pill, I can get a $6 bag of heroin.
17 And I think that's why it is.
18 And, it's the new flavor, apparently, you
19 know, but, it's really accessible.
20 Just ask, you know, our DA and the
21 State Trooper here, they'll tell you, that they
22 bring it up the Hudson, drop it off in Newburgh, and
23 they've got, you know, both the Thruway and 84 to
24 distribute from.
25 NOLLY CLIMES: It's also the price, that it
69
1 costs less now, and that makes it a lot easier in an
2 alternative choice.
3 SENATOR BONACIC: On something of a macro
4 scale, too, the cartels, the drug cartels, they're
5 evil people, but they're very smart. And they
6 realize that we've got an American generation
7 addicted to opioids, painkillers overprescribed, and
8 say: Well, when they pass these laws to stop the
9 prescription drugs from going, they're going to
10 still be a addicted to opioids, because they're not
11 doing anything about that.
12 And, so, they put heroin out very cheaply.
13 And one important thing is, we used to get
14 the heroin from the Golden Triangle of Afghanistan,
15 stuff like that. Now it's only about 20 percent
16 coming in.
17 Most of it's coming from Mexico; being
18 manufactured and grown in Mexico. So it is a lot
19 cheaper, obviously, just in terms of transportation.
20 They bring it from Mexico, up to
21 New York City, Philadelphia, Newburgh, and out to
22 here.
23 DA JAMES FARRELL: And I think people --
24 SHERIFF MICHAEL SCHIFF: I think, also, on
25 that subject --
70
1 DA JAMES FARRELL: I think people are also
2 using it, they're snorting it, as opposed to using
3 in it needles; whereas, years ago, it was used in a
4 needle.
5 But even now, you have individuals who are
6 not afraid of the needle.
7 You know, AIDS is kind of like, and HIV is
8 kind of like, off the map. We've got great
9 treatment for that. People can live with it for
10 years and years and years, so people are not afraid.
11 SHERIFF MICHAEL SCHIFF: I was going to
12 basically say the same thing.
13 In the '80s, they had to market the heroin to
14 snort it because it was a very negative connotation.
15 If you used the needle, you were an addict.
16 If you didn't use the needle, it was
17 recreational drugs.
18 I'm not seeing any stigma, I don't know think
19 anyone else is, with a needle.
20 It's become so acceptable for someone to have
21 a needle and use it, and I think that's part of the
22 huge change which has put heroin where it is, in
23 addition to the cost.
24 NOLLY CLIMES: I think it is, also, there is
25 a misunderstanding that snorting heroin is safer
71
1 than injecting, when we're talking about the same
2 thing.
3 SENATOR BONACIC: Well, I remember that if
4 you used a needle, you could catch AIDS.
5 NOLLY CLIMES: Right.
6 SENATOR BONACIC: So, you know, you didn't
7 want to try a needle that could be infected, that
8 leads us to AIDS.
9 NOLLY CLIMES: Right.
10 I'm talking about for younger people who
11 think that there is a difference between a pure form
12 of heroin versus a less-pure form, in terms of the
13 drug per se.
14 SENATOR BONACIC: Yeah, okay.
15 Next question, MJ.
16 MJ: "TV media is not allowed to do ads about
17 liquor. In Europe certain products are not allowed
18 to be advertised.
19 "Can we, you, the government, stop ads for
20 pharmaceuticals?"
21 [Laughter.]
22 [Applause.]
23 SENATOR BONACIC: A constitutional issue.
24 SENATOR BOYLE: Yeah, I think there's a
25 constitutional issue there.
72
1 I think -- well, we have seen a change in the
2 advertising.
3 If you watch a typical drug commercial now,
4 the side effects are longer than the normal part of
5 the commercial.
6 So we're coming away, but I think we're going
7 to be constitutionally off-kilter by trying to ban
8 them completely.
9 DA JAMES FARRELL: But I do think that the
10 question raises a good point.
11 I mean, look at smoking in America.
12 Look at how smoking, how everybody came
13 together and drove that down to levels we've never
14 seen before.
15 It's at its low point.
16 And a lot of that was done through
17 legislation, with respect to the big tobacco
18 companies.
19 And I think that maybe if you look at some of
20 the strategies that were used with tobacco, because
21 tobacco kills you, it's addictive, it's highly
22 addictive, may not be as acute, but it certainly has
23 the same end result, we might use some of those
24 strategies in this fight.
25 MJ: I have Alan Sorensen, Legislative
73
1 District 9, who had asked to speak.
2 SENATOR BONACIC: Hi, Alan.
3 Welcome. Thank you for stopping in.
4 ALAN SORENSEN: Thank you, Senator.
5 I just want to follow up on the same topic.
6 In the -- the United States -- there's only
7 two countries in world that allow direct-to-consumer
8 advertising of pharmaceutical products; it's the
9 United States and New Zealand.
10 And in the United States, it wasn't until
11 1997 that there was Congressional legislation that
12 really expanded what pharmaceutical companies could
13 advertise.
14 And to follow up on Jim's point, I think that
15 is the crux of a lot of the problem that our --
16 where children getting addicted to opiates.
17 If you look at the advertisements that
18 they're placed, they're targeted to children.
19 They not only identify the symptoms, but they
20 give, in the advertisement, a list of the symptoms.
21 And at the end of the advertisement, they
22 say: Go see your doctor and tell him you have these
23 symptoms, and he'll give you the drugs that you want
24 him to prescribe.
25 Right? We all see it.
74
1 So, you know, you can watch 10 minutes of CNN
2 and you're seeing pharmaceutical commercial after
3 pharmaceutical commercial for every imaginable
4 symptom out there.
5 If you're having trouble sleeping, take
6 Lunesta.
7 There's a whole variety of other products
8 that are out there.
9 UNKNOWN SPEAKER: [Inaudible.]
10 ALAN SORENSEN: Exactly.
11 And so they're conditioning our children.
12 And I do see this as no different than the
13 attack that the big tobacco companies put on our
14 children back in the '70s and '80s.
15 We did, after people making -- connecting the
16 dots, passed Congressional legislation to prohibit
17 the tobacco companies from targeting our children.
18 And I think the time is long overdue for
19 the -- for our leaders to get after the big pharma
20 to stop targeting our children with these
21 advertisements that are definitely targeted to our
22 children.
23 That is part of the reason that there is such
24 a high rate of addiction in this country.
25 And, you know, when that law passed in 1997,
75
1 the amount of pharmaceutical advertising in this
2 country went from a few hundred million, to over
3 2 billion, within a matter of a year or two, so
4 there's no question that's part of the problem.
5 And I think we need -- I would recommend
6 two actions:
7 One, to pursue legislation that would
8 dramatically limit the ability of pharmaceutical
9 companies to do direct consumer advertising in the
10 United States of America;
11 And, two, that similar to the tobacco
12 settlement, where the big tobacco companies were
13 required to pay into a fund to offset and to help
14 address the high cancer rates as a result of tobacco
15 smoking, that we need someone, whether -- I don't
16 know what group out there, but there's got to be an
17 attorney out there in the U.S. who wants to pursue a
18 class-action settlement, to go after the big
19 pharmaceutical companies who are targeting our
20 children with this direct consumer advertising.
21 And there should be a pharmaceutical
22 tobacco -- or, settlement fund that's set up to help
23 pay for some of these things that our municipalities
24 are having to fund.
25 [Applause.]
76
1 ALAN SORENSEN: So, you know, it's -- I can't
2 help but get emotional about it, because I do think
3 it's an intentional selling of this product to our
4 children, from the time they're born, and watching
5 any advertisements on TV, they're being told that if
6 you have any type of symptom, there's a
7 pharmaceutical "magic pill" to solve your problem,
8 and that's not the message we should be sending to
9 our children.
10 SENATOR BONACIC: Thank you, Alan.
11 ALAN SORENSEN: Thank you.
12 SENATOR BONACIC: I just want to react a
13 little bit.
14 It's an excellent point, Alan. I think it
15 parallels what you said about the smoking industry
16 and tobacco.
17 I think it has to be done on a national
18 level. That's where the pressure has to come.
19 And, you know, special interests that may pay
20 money to try to block something like that in the
21 Congress, but, it's something that has to get
22 traction in every state, with messages sent to the
23 Congressional delegation, to take that point up.
24 It was a good point.
25 Thank you, Alan.
77
1 MJ: I have, next question, is Dr. Salsberg.
2 His question is: How can we expand treatment
3 programs in Sullivan County?
4 SENATOR BONACIC: More money.
5 MJ: Do you want to expand?
6 DR. SALSBERG: Hi, I'm Dr. Salsberg.
7 I have a conflict of interest.
8 I'm the medical director of The Recovery --
9 SENATOR BONACIC: Can you speak louder,
10 please.
11 DR. SALSBERG: I'm Dr. Salsberg.
12 I have a conflict of interest.
13 I'm the medical director of The Recovery
14 Center, one of the treatment programs represented by
15 Ms. Bolling.
16 About a month or two ago, they actually
17 stopped The Recovery Center from taking in patients.
18 Now, The Recovery Center was the last
19 treatment program in the county.
20 The hospital doesn't have a program anymore.
21 I've been doing this for 20 years here.
22 And there's been three or four programs in
23 the county that have just disappeared.
24 So if we want to deal with a program, we need
25 availability here to treat people.
78
1 So I think I'd like to you address that, if
2 there's any funding, or something we can do for
3 this?
4 SENATOR BOYLE: In the most recent budget, we
5 did get another $1.8 million to go towards treatment
6 and prevention.
7 But tell me, did they give -- what's the
8 reason?
9 Was it just funding that they are shutting it
10 down?
11 DR. SALSBERG: Well, they closed The Recovery
12 Center for -- it's back open now.
13 SENATOR BOYLE: Oh, okay.
14 DR. SALSBERG: But there was a few, like,
15 very bureaucrat things, and it put a great strain on
16 our whole county, since this was the last treatment
17 program we had.
18 So instead of, like, talking about it, we
19 need some action, we need some programs here.
20 SENATOR BOYLE: Thank you.
21 SENATOR BONACIC: Thank you.
22 Okay, MJ, next one.
23 MJ: Thank you, sir.
24 Okay, I have Carol Shepherd [ph.] asks: What
25 are the -- the county pays money for people to
79
1 receive treatment outside of the county.
2 "Are there similar plans?"
3 Is that your question?
4 CAROL SHEPHERD [ph.]: [Inaudible.]
5 MJ: Can you stand up?
6 SENATOR BONACIC: Let her come up.
7 MJ: Can you stand up?
8 SENATOR BONACIC: Let her come up and take
9 the mic. Go to the podium.
10 Yeah, and let her come forward.
11 CAROL SHEPHERD [ph.]: I know, I've worked
12 with clients who have a history of heroin addiction.
13 And they're -- they've received methadone. And the
14 county pays a lot of money for these people to be
15 transported down to Newburgh.
16 With the increased problem of heroin
17 addiction in the county, are there going to be any
18 arrangements for them to receive treatment locally?
19 And what are the local options for people,
20 for heroin?
21 I mean, you go to The Recovery Center for
22 alcohol, but what about heroin?
23 JOSEPH TODORO: Well, Carol, at one point,
24 there wasn't an overarching need to really work with
25 opiate addictions, and it was felt that, regionally,
80
1 we could address the folks who were on methadone
2 maintenance with that clinic in Newburgh.
3 As we've seen the increased need for opiate
4 treatment, you know, there are a number of
5 physicians who prescribe Suboxone, which is
6 different, but a similar kind of medication to be
7 used with somebody who has an opiate addiction.
8 I have yet to see somebody come, at least to
9 the Department of Community Services, with a request
10 to open a methadone clinic here.
11 But, I would entertain a request.
12 CAROL SHEPHERD [ph.]: Are there any plans to
13 expand the license at The Recovery Center to deal
14 with folks that are addicted to heroin?
15 IZETTA BRIGGS-BOLLING: We do provide
16 Suboxone treatment for individuals, and we have
17 two different programs.
18 We have the 822, mild-to-moderate withdrawal,
19 and we have a residential crisis unit, where
20 Suboxone treatment is administered.
21 And their residential program has been in
22 existence since about 2007. And the newer one
23 opened in 2013.
24 JOSEPH TODORO: Yeah, and in our outpatient
25 clinic, we now have some treatment groups that are
81
1 working with those people who are on Suboxone
2 maintenance, or trying to come off of Suboxone.
3 So, we've opened that up.
4 We've actually let the prescribers know that
5 that's a service that's available through our clinic
6 at this point.
7 So, yes, we're trying to address some of the
8 local need.
9 SENATOR BOYLE: What's the average length of
10 time your patients stay on Suboxone?
11 JOSEPH TODORO: Again, I think it depends
12 upon the person.
13 But, to detox somebody is usually a week.
14 And some people are able to go that week, and then
15 get into a treatment program and do just fine.
16 The people who are unsuccessful, they may be
17 taking a maintenance dosage of Suboxone for the rest
18 of their life.
19 Because one thing that we do know about this
20 disease of addictions, is that it's chronic; and,
21 so, you live with it.
22 It's like diabetes; you learn to live with
23 it, you learn to manage your recovery from that
24 disease, from the day that you admit that you have
25 that problem, to the day that you die.
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1 SENATOR BONACIC: Okay, MJ?
2 MJ: Jennifer Brian [ph.], did you want to
3 come up and ask your question?
4 JENNIFER BRIAN pph: Hi, my name is
5 Jennifer Brian, and I work for the
6 Mid-Hudson Prevention Resource Center. We're
7 located in Goshen, out of the Alcoholism and
8 Drug-Abuse Council.
9 And what I heard a lot today was about
10 evidence-based programs in schools, and the
11 prevention programs, and things like that, which are
12 phenomenal and fantastic, and we definitely need
13 them.
14 But what I want to ask about is,
15 community-based prevention, which is changing the
16 norms; making it so, that way, the prescription
17 drugs are not something that's considered safe for
18 everybody.
19 And, so, what kind of things can be done in
20 order to support the community coalitions? Which
21 I know they have them in Sullivan County, because we
22 work with them.
23 So what can be done to help support them,
24 both funding- and non-funding-wise, in terms of the
25 government?
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1 And, what kind of things can we, hopefully,
2 see from you guys to help them make that
3 community-based change, that we need to match the
4 evidence-based programs that happens in the schools?
5 IZETTA BRIGGS-BOLLING: Well, The Recovery
6 Center is supportive of your statement, because
7 environmental strategies are very important to
8 making that change occur.
9 And every time an RFP comes out, we have
10 people in the back that are always writing for them.
11 JOSEPH TODORO: The other thing that I'm
12 sure, that we would both invite our community to
13 come out and participate in our planning and
14 implementation of prevention programs in our
15 community.
16 We have attempted to do some community
17 development around that.
18 We had caught fire at one point in time, and
19 had a countywide committee, and then we had a few
20 smaller committees in different communities, but, it
21 kind of petered out, as did some of the funding.
22 But, you know, we would both invite the
23 community to come out.
24 If you're interested, if you want to
25 participate, if -- you know, then come -- you know,
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1 give Izetta a call, and we'll get you participating.
2 JENNIFER BRIAN pph: Thank you for those
3 answers, but I also want to know, maybe from the
4 Senators, what kind of things can we see from the
5 federal government and our state government that
6 will help to support these initiatives that are
7 really necessary in order to make this change?
8 SENATOR BOYLE: Well, that's exactly one of
9 the things we're looking for in these forums.
10 As I say, we did put a few million dollars
11 in, and we'll probably be putting more in, towards
12 prevention and treatment; primarily, towards
13 prevention, and to see which one are base.
14 Of the 17 forums, we've heard some very good
15 programs. We've heard some not-so-good programs.
16 So, we will have answers for you in a couple
17 weeks on that.
18 JENNIFER BRIAN pph: Thank you.
19 SENATOR BONACIC: Thank you.
20 MJ?
21 MJ: Speaker? Come, sir.
22 Dr. Thomas.
23 DR. THOMAS: Hi, good afternoon, everybody.
24 SENATOR BONACIC: Good afternoon, Doc.
25 DR. THOMAS: I'm not an expert, but I've been
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1 prescribing Suboxone and dealing with addiction for
2 the last 12 years.
3 SENATOR BONACIC: I don't think we can hear
4 that you well, Doctor. You've got to speak louder.
5 DR. THOMAS: I'm not an expert, but I've been
6 a physician for almost 40 years, and the last
7 12 years I've been dealing with addiction.
8 And it's very -- probably the best
9 satisfaction, as a physician, is when a parent comes
10 to you and hugs you, and tells you, "Thank you for
11 giving me back my son."
12 I've been able to turn some lives in my life,
13 and it's very sad when some -- [unintelligible]
14 anybody over 40 years old -- below 40 years old,
15 because I'm going to be 70 soon. And, they come in
16 with a good intention of getting rid of this
17 disease.
18 We write the prescription for the medication.
19 We do what we call an "induction," so that we
20 know how much Suboxone he needs.
21 We know how much he needs, we write a
22 prescription.
23 The insurance company says "no."
24 So I go to the pharmacy and I write a
25 prescription for 120 Oxycontins, oxycodones, and
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1 they immediately approve it.
2 And I have here proof of it:
3 The letters of denial;
4 With the prescription for the oxycodone,
5 signed by me, for 120 tablets;
6 And the receipt from the pharmacy for the
7 120 tablets of oxycodone.
8 So, I think that New York State is giving
9 money to drug dealers, because these are drug
10 dealers, these insurance companies.
11 [Applause.]
12 DR. THOMAS: These insurance companies have
13 been contracted to run Medicaid in this state, and
14 this is a shame.
15 And this is at least one every week. Every
16 single week.
17 Yesterday I had another one. One week
18 waiting for the approval. Still, they didn't have
19 it.
20 I called them and I said: Let me speak with
21 the medical director. Who's your medical director?
22 No name, no telephone number.
23 I even left them my cell phone number,
24 because the medical director was going to call me.
25 So before they closed the pharmacy, I went to
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1 the pharmacy, I called them again.
2 "Oh, still it's not approved."
3 So I wrote a prescription for 120 Percocets.
4 Immediately approved.
5 So I call them back and I say, "You don't
6 want to give the medication? You already gave the
7 120 Percocets just a while ago."
8 In 10 minutes they called me, "The medication
9 has been approved," because I told them, "This is
10 going to be in the newspapers tomorrow morning."
11 So, I think New York State has to do
12 something with all these insurance companies,
13 because we're trying to solve a problem, and they
14 are creating the problem.
15 That's one of the things that I wanted to
16 say.
17 The other thing, I got some of the questions
18 and things that they say here.
19 Opiate addiction is a chronic disease, and
20 it's categorized as a "chronic disease."
21 Diabetes mellitus is a chronic disease.
22 Hypertension is a chronic disease.
23 We have some physicians here. Which of you
24 take the insulin off a diabetic because it's
25 expensive?
88
1 It's a crime.
2 They are doing this with our patients, with
3 our [unintelligible] patients.
4 And in my practice, my experience, they come
5 in dirty, not shaved, nothing. Arrogance.
6 And the next day, they are a completely
7 different person.
8 And I'm very, very proud of all of them.
9 We also have another problem that we are
10 going to talk about here, at least what we calling
11 in medicine, "endorphin deficiency syndrome."
12 I believe that everybody remembers from
13 high school what word "endorphins."
14 It's a substance that we have in our brains
15 that make us happy.
16 Okay?
17 The word "endorphins" is a compound word.
18 "Endo," that means built by our own body.
19 And we are left with morphine.
20 So we have, our body produces morphine.
21 So some kids are never happy. If you have
22 low endorphin, you're never happy.
23 And these kids have been diagnosed of
24 depression. They go to the psychiatrist, and they
25 give them one medication.
89
1 No results.
2 Add -- increase the dosage.
3 No results.
4 Give another medication. No results.
5 Because they're not treating the problem that
6 the kid has.
7 And usually this kid is in his house, his
8 mother is always telling him, "Pick up your room."
9 He never picks it.
10 The father tells him, "Mow the lawn."
11 He doesn't mow it.
12 He goes to the dentist, he gets some Vicodin
13 or some kind of with codeine.
14 The mother tells him, "Pick up your room,"
15 and in 5 minutes, the room is picked up, because he
16 had a morphine substance a little bit more in his
17 brain now. Now he is functioning normal.
18 Then when we sit at the table at night with
19 him, we as parents tell him: Why can't you be like
20 this? You see how nice it was today? I just asked
21 you and you did it right away. Why can't you be
22 like this?
23 And then this kid says: Wow, when I take
24 this pill, I get along better with my dad and my
25 mom. I get along better with my teacher in school.
90
1 I perform better.
2 And it's true, he's doing everything better.
3 So he needs a boost on his endorphin.
4 So Suboxone is going to give him that boost
5 because he needs morphine-like substance.
6 But then we have, what are we going give him?
7 Heroin? Morphine? Oxycodone?
8 What are we going to give him?
9 We have to give him the safest one. That's
10 the only alternative we have now.
11 It's the only alternative we have, or he's
12 going to live, like, depressed all his life.
13 It's the same thing as if, you don't produce
14 insulin, you're diabetic. And you need some
15 insulin.
16 So if you don't have endorphin, you need to
17 have some endorphin.
18 That's why this is a disease, and that's the
19 way to treat it.
20 I'm talking about Suboxone and the insurance
21 companies.
22 They are forcing us to lower the dosage on
23 the patients and to get them off the Suboxone.
24 We have to make prior authorizations for the
25 Suboxone. And on the prior authorizations, I have
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1 to write when I'm going to lower his dosage, and
2 when I'm going to get him off the medication, like
3 if you're telling me, "Your diabetic patient, when
4 are you going to lower the insulin, and when are you
5 going to get right of -- get him off the insulin?"
6 It's the same thing.
7 SENATOR BOYLE: Doctor, could I just ask you,
8 your license, you started with 30 Suboxone patients,
9 and then you can go to 100 after a year? Is that
10 correct?
11 DR. THOMAS: Yes, sir.
12 SENATOR BOYLE: You're at 100 now?
13 DR. THOMAS: Not yet.
14 SENATOR BOYLE: Not yet. Okay, okay.
15 DR. THOMAS: I'm very choosy.
16 They come to play games, they don't fit in my
17 practice.
18 SENATOR BOYLE: Okay.
19 Well, thank you very much.
20 SENATOR BONACIC: Doctor, we're not here to
21 cut you short, but we have others that we have to
22 get through.
23 So if you could conclude, we would appreciate
24 it.
25 DR. THOMAS: Okay, so, I just want to make
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1 sure that everybody understands that this is a
2 disease, and that the insurance companies are not
3 helping us.
4 They want these kids in the narcotics,
5 because Suboxone is $8 a dose, and the oxycodone is
6 5 cents a dose. And we cannot [unintelligible]
7 economics against health.
8 Okay?
9 Health is first.
10 Thank you.
11 SENATOR BONACIC: Thank you, Doctor.
12 [Applause.]
13 IZETTA BRIGGS-BOLLING: I just quickly wanted
14 to say that Suboxone used to be -- you could get it,
15 across the board, with Medicaid.
16 Now Medicaid clients are all required to be
17 in an HMO. And different HMOs, it will take much
18 longer for clients that are in need of Suboxone to
19 get it. And sometimes it can take up to a week,
20 which is what he was saying.
21 SENATOR BONACIC: Okay, MJ?
22 MJ: I have a comment here from
23 Dr. Roux [ph.], and I'll just start it briefly.
24 We do have an event coming up in a little
25 while, so we'll ask any comments to be as condensed
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1 as they can.
2 "With the gravity and the extent of the
3 epidemic, what are your thoughts on in-service
4 trainings for judges and other legal professionals?"
5 Is that the general consense [ph.] of the
6 question?
7 MR. ROUX [ph.]: [Not using a microphone.]
8 I'll keep it short.
9 First, I just wanted to say I'm a doctor, and
10 I don't want to pretend to be.
11 MJ: I'm sorry.
12 MR. ROUX [ph.]: That's okay.
13 I'm a licensed mental-health counselor, and a
14 credentialed alcoholism- and substance-abuse
15 counselor, in private practice in Monticello.
16 The only other partner I have in the practice
17 is my wife, Carmen Roux [ph.], who's the office
18 manager.
19 We have a very busy day, though, all day
20 long. There is no shortage of people who are
21 seeking treatment.
22 I want to thank the Senators and the State of
23 New York for their interest in the panel
24 discussions, and all the panelists.
25 I heard very little disagreement from among
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1 the panelists on hardly any point, which I think is
2 notable.
3 What I wanted to point out, though, to
4 emphasize, to accentuate, is the access-to-treatment
5 issue.
6 The last speaker spoke at length about the
7 access to Suboxone.
8 And, Joe Todora, I really appreciated what
9 you pointed out, that some people need a detox
10 protocol to get off of heroin.
11 Suboxone works wonderfully for that.
12 Some people need to stay on it for years or
13 for life.
14 And it's approved by the FDA for maintenance.
15 If it's prescribed by a medical doctor,
16 there's nothing wrong with that.
17 It's a health-care decision, and it should be
18 left between the medical doctor and the patient.
19 And that's a point that was raised in my
20 question, is that I get concerned sometimes, when
21 I see the criminal justice system expressing
22 reservations about the medical care that people are
23 receiving from their doctors who prescribe, for
24 example, Suboxone. Maybe methadone, as well.
25 I see people who are on probation, people who
95
1 are on parole, who are told they have to get off of
2 that. Or when they're sentenced, are told that they
3 must stop taking their Suboxone because that would
4 be a violation of the terms of their sentence.
5 I think that needs some -- a careful look.
6 And I would respectfully suggest that
7 consideration be given to training judges and
8 law enforcement, in terms of the people who
9 supervise the officers of the court who supervise
10 people under the direction of the judges.
11 Biopsychosocial treatment, counseling, is
12 limited in some ways.
13 And I think this is a law that could be
14 addressed. I think it would come under the
15 social-service law.
16 If someone has SSI or SSD, their managed-care
17 Medicaid does not cover any sort of substance-abuse
18 treatment.
19 It reverts to straight Medicaid. It's called
20 a "carved-out benefit."
21 What that means is, that the most disabled
22 people, the people who are most in need of help,
23 because of their mental-health condition or their
24 concurrent physical disabilities that have qualified
25 them for SSI or SSD, have the hardest time finding
96
1 providers who can give them treatment.
2 I cannot be reimbursed by Hudson Health or
3 Fidelis if a person has SSI or SSD. And I know that
4 it's not just me in my licensed capacity.
5 It really makes it much more difficult
6 because of that carved-out provision.
7 I would like to see that eliminated. I would
8 like to see the disease of addiction treated like --
9 treated by managed-care Medicaid treated like any
10 other disease.
11 Getting approval for levels care is also a
12 big issue that's been mentioned -- a big problem
13 that's been mentioned here.
14 We need to have what's called "failed
15 attempts at outpatient."
16 Multiple failed attempts at outpatient
17 treatment for heroin addiction can be fatal.
18 And, also, I wanted to emphasize, I think the
19 point that's been made, is that there's too much of
20 a sharp line drawn between mental health and
21 substance-abuse treatment.
22 There's -- and when you look -- when I see a
23 person, I see a person; I see a human being; I see a
24 whole package.
25 I don't see half of you is an addict and half
97
1 of you is bipolar, and today I'm going to treat the
2 bipolar half, and come back next week and we'll talk
3 about heroin.
4 It needs to be treated together.
5 And I'm not suggesting that OMH and OASAS
6 should be merged.
7 I retired from OASAS in October, and I've
8 been full-time in the private -- Office of
9 Alcoholism and Substance Abuse Services. I've been
10 in private practice full-time since then.
11 But I do think that the two agencies need to
12 blur their boundaries a bit. And, respectfully, the
13 local clinics, work more hand in hand.
14 We need to treat people as people, and not as
15 diagnoses.
16 Thank you.
17 SENATOR BONACIC: Thank you very much.
18 SENATOR BOYLE: Thank you very much.
19 [Applause.]
20 MJ: I have our next comment from
21 Deborah Fuchs Nadu [ph.].
22 Is Deborah here?
23 I'll ask if you can keep them, if you can, as
24 brief as possible.
25 DEBORAH FUCHS NADU [ph.]: It's very hard for
98
1 me, but I'll try.
2 Hi, thanks.
3 Thanks for being here today, and I want to
4 thank everybody for what they've presented.
5 I have a lot of colleagues on this panel, and
6 people, that we have worked on this for the last
7 25 to 30 years, so I'm having some what have a
8 deja vu moment.
9 I'm thinking back, and, Joe, you will
10 remember this, and I don't know who else was here
11 with us:
12 We sat in this room, maybe not with the
13 Senators, but with Steve Lungen [ph.],
14 Frank La Budda [ph.], and a lot of old names, and
15 had drug task-force committees -- in 1985?
16 JOSEPH TODORO: Yeah, I'd say.
17 DEBORAH FUCHS NADU [ph.]: Yeah.
18 -- addressing some of the same issues.
19 The drug of choice this week might be
20 different, but we have addressed the same issues.
21 We had a very, very strong prevention
22 presence in this county. And I can speak to that
23 because I was that presence.
24 I was, in my previous life, before I became
25 the clinical director of BOCES, I was the director
99
1 of prevention services, and worked with all the
2 community agencies that worked really hard on a
3 shoestring, and with all the school districts, to
4 provide prevention programming.
5 So I've heard lots of great things today, but
6 it's the same old story for me. I've heard the same
7 things over and over again.
8 We were minimally funded in this county back
9 in 1985.
10 We started on a $30,000 grant to provide
11 services to all the schools and work with the
12 community.
13 10, 15 years later, it was 45,000, Joe?
14 46,000? And then it was pulled away.
15 "It was pulled away."
16 We talk about what works in prevention?
17 We've known that for years.
18 I've been a prevention researcher for the
19 last 25 years.
20 And they -- all you have to go is to the
21 federal websites and you will see what works in
22 prevention.
23 We can Google those things.
24 Same kinds of things that work in drug
25 prevention, by the way, work for violence
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1 prevention, work for bullying prevention, work
2 for -- prevention is prevention.
3 Somebody coined it with "life skills"
4 earlier?
5 That's what we're teaching: people to be
6 people.
7 Yes, we're torn between what happens,
8 Common Core in education, time constraints for what
9 comes first, but we miss -- we've missed many
10 opportunities.
11 And I'm trying to rush, but I have a couple
12 more points. Sorry.
13 So we do know what works. We've been looking
14 at that for years. We've been promoting that for
15 years.
16 We do know -- not to disrespect anybody in
17 what they're doing -- crash-cars do not work.
18 Those of us that read the research know that.
19 It's a nice addition to things, but they do
20 not work.
21 There are comprehensive programs and
22 strategies.
23 It's a science, folks.
24 We've been out there and we've been doing
25 this work.
101
1 I just want to address a couple of things.
2 In the 1970s and 1980s --
3 You can chop me off in a second.
4 In the 1970s and 1980s, you could get a bag
5 of heroin for $10.
6 It's an old story. It's nothing new.
7 You take away one thing.
8 We had methadone.
9 We're talking about Suboxone?
10 How long has methadone been around?
11 JOSEPH TODORO: Oh, how long's heroin been
12 around?
13 DEBORAH FUCHS NADU [ph.]: Yeah, okay.
14 So, thank you.
15 So it's there.
16 It's, what are we going to do about it?
17 The answers are out there.
18 And this community, this county, had worked
19 very, very hard with The Recovery Center, with
20 New Hope, with the schools, with law enforcement,
21 with Public Health, with community services.
22 We have had many different prevention task
23 forces.
24 Now we need the fiscal support to have that
25 happen again for us.
102
1 Thank you.
2 SENATOR BOYLE: Thank you.
3 [Applause.]
4 MJ: I have Eric Alleva [ph.], who said he
5 had a lot to say, but I have asked him to keep it to
6 the fine points.
7 Okay, sir?
8 ERIC ALLEVA [ph.]: My name's Eric Alleva.
9 I've been a drug addict for 53 years.
10 I'm 65 years old.
11 UNKNOWN SPEAKER: Hold it up. We can't hear
12 you.
13 ERIC ALLEVA [ph.]: I've been a drug addict
14 for 53 years.
15 I'm 65 years old.
16 Back in, I don't know, my chronologic clock
17 is broke, so back, I guess it was in '70s, the State
18 Police, the Sheriff's Department, and myself were
19 successful in arresting 23 -- we got arrested and
20 convicted 23 drug dealers.
21 I can stand here with an open face and tell
22 you that because, hopefully, nobody in this room is
23 going to recognize me, since that was in the '70s.
24 Why can't, from the beginning, there's the
25 arrest. Whether it's in the Sheriff's Department's
103
1 car or in the State Police car, it's an arrest on a
2 drug dealer.
3 Why can't that picture be posted in Fallsburg
4 on their screen? In Monticello on their screen?
5 Why can't that picture be printed out and
6 that police officer take that picture home?
7 He may know that person, whether that person
8 be a male or a female, and say, Wow, I recognize
9 that person. That person was just arrested in drugs
10 this afternoon.
11 That may be a help. That may be a key to
12 opening the door, to finding out where that person
13 got the drugs and stop that.
14 It's very easy.
15 You go to High Street, the same street that,
16 in the '70s, is still selling drugs today.
17 The same street.
18 And it's now, it's not called "Moon Manor,"
19 but the same place. Moon Manor, is the same -- not
20 the same apartment, but the same place is still
21 selling drugs today.
22 And you want to know why the insurance
23 companies won't pay?
24 It's because the amount of -- they ratio to
25 how many failures and successes.
104
1 Here's the insurance company willing to put
2 out money, but how many failures do you have?
3 You see, when I was in recovery, when I was
4 in the Veritas Villa, two men are walking down the
5 street and these church bells go off, and the bells
6 ringing, ringing, and ringing, and the other guy
7 says: Listen, I didn't hear what you were saying.
8 I was listening to those bells, those stupid bells.
9 And the guy said, What stupid bells? I was
10 listening to the music. It was beautiful music.
11 See, one guy heard the music; the other guy
12 heard the noise.
13 The police officers themselves can determine,
14 they can see the difference, between the guy's who's
15 got an attitude, who doesn't want help, who just
16 wants to -- who just needs -- thank God, there's a
17 jail for him; and the people that need help, because
18 there are people.
19 And if you can be more selective in picking
20 the people that really need the help, and put those
21 people in a program, then maybe the insurance
22 companies will say, Wow, look at the amount of
23 success we've got in the programs.
24 And whether you're a good parent or a bad
25 parent, you can't take responsibility for having a
105
1 good kid.
2 I've got five good kids, and I was never a
3 good parent.
4 And you can be a lousy parent and have great
5 kids.
6 And you can be greatest parent and have
7 miserable kids.
8 It's, just, that's the way God made us.
9 SENATOR BONACIC: Okay. I want to thank you
10 for your comments.
11 We have three more speakers.
12 We're going to ask that they limit their
13 remarks to two minutes.
14 We have to be out of here by four.
15 Our panelists have obligations, and so do we.
16 And there's going to be a County State of the State,
17 I understand, here after we leave.
18 So, MJ, you have the next speaker?
19 Okay, yes.
20 Go ahead, tell us your name.
21 CAROL RYAN: Hi.
22 Is this working?
23 Yes.
24 My name is Carol Ryan. I'm the past
25 public-health director before Nancy McGraw.
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1 I just retired in July.
2 So, we're very instrumental in starting the
3 Prescription Drug-Abuse Task Force in this county.
4 And I'm also personally affected by a family
5 member that's been impacted by mental-health and
6 substance-abuse issues.
7 So I see this from two perspectives.
8 I just have a couple of suggestions. I'm not
9 going to be long-winded.
10 But in thinking about this, I think the
11 I-STOP law was a great start, but it did have
12 unintended consequences.
13 One thing, it's driving people to heroin, as
14 you heard.
15 And I think that there were some things that
16 need to be set in place, along with the I-STOP law,
17 that you might want to consider.
18 Maybe some of these exist and I just don't
19 know it.
20 I think that when people get turned away, at
21 that moment, from getting a prescription, there's a
22 big lack in what happens then, and there needs to be
23 some kind of support system set up.
24 I mean, there should be, maybe -- you know
25 how we have the I-Quit line for smoking? "New York
107
1 Quits?" -- we should have a line like that for
2 addicts.
3 We should have a 24-hour hotline, I think,
4 for addicts; but not just for addicts, for
5 counseling.
6 It should be three-prong.
7 I would suggest that, one, it be for the
8 addicts, and you should have trained mental-health
9 and addiction-treatment personnel on it, not
10 operators.
11 Okay?
12 Also, it can serve the pharmacists who are
13 dealing with some of these people.
14 And they're also dealing -- you haven't heard
15 from anybody, this huge amount of increased
16 robberies and violent crimes against -- in
17 pharmacies.
18 So, to help the pharmacists know how to deal
19 with addicts who show up, and it's something they
20 have no idea what to do with.
21 And, also, to help to be a consultation for
22 physicians.
23 I also think that hotline, the person serving
24 on it, the people should have access to an
25 up-to-date database of available treatment beds
108
1 right now, so that -- because, right now, what
2 I think happens, unless it's changed, is they're
3 calling around, maybe from the emergency room, or
4 wherever, place after place after place, trying to
5 find a bed.
6 There's -- I don't think there's any
7 available, uhm -- a consolidated database where you
8 can just call and say, I've got somebody here.
9 The doctor can call. He looks on I-STOP. He
10 can't prescribe this kid Percodan [sic], or this
11 adult.
12 The person, they break down, they say, "Okay,
13 I'm an addict. I need help. What do I do now?"
14 what does that doctor do?
15 There is nothing.
16 So if they could pick up the phone and say,
17 Where's a bed?
18 Pick up, call this hotline, say, "Where's a
19 bed right now? I have somebody who needs help."
20 That does not exist.
21 Okay?
22 So I suggest that there be something like
23 that.
24 I also suggest required training in addiction
25 recognition and screening for all physicians, nurse
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1 practitioners, and physician assistants, maybe in
2 conjunction with renewing their licenses; just like
3 we have now child-abuse training that's required.
4 This should be required, so you can stop this
5 problem at the beginning where it often starts,
6 which is when writing the prescription.
7 And then, not just in recognizing addiction,
8 but training, and what kind of interventions that
9 they can suggest for these patients who show up and
10 need help, because these people are sick.
11 They're not criminals.
12 They become criminals when they are desperate
13 and they have to find ways to get drugs.
14 And two more things, that's all.
15 More affordable substance-abuse treatment
16 facilities.
17 If you put money into that, you're going to
18 lower prison costs.
19 People go to prison because they commit
20 crimes, because they need drugs.
21 And the last thing is: Please, please, do
22 something to require insurance companies to cover
23 immediate inpatient admission, rather than requiring
24 a failed trial as an outpatient first, which is
25 dangerous and unrealistic.
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1 [Applause.]
2 SENATOR BONACIC: I want to thank you very
3 much.
4 They were very excellent suggestions.
5 Thank you.
6 UNKNOWN SPEAKER: [Off video.] There is an
7 OASAS helpline that operates 24/7, that maybe is a
8 resource people should know about.
9 I'm sorry I don't have the number, but they
10 would have access into where beds are available.
11 MJ: Okay, next?
12 KITTY VETTER: Kitty Vetter.
13 I am a nurse by career, an R.N., and I dealt
14 with health issues like this for a long time.
15 And I'm presently one of the County
16 legislators.
17 I would strongly support what Alan is
18 suggesting as far as prevention.
19 Prevention is the main modality in any kind
20 of nursing intervention.
21 So I would suggest to you, as the legislators
22 of our state, to move forward to stop the present
23 form of pharmaceuticals that are out there in the
24 media, that are out there on the TV.
25 We stopped Joe Camel many years ago.
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1 We can stop this now, and I think that's the
2 main way to go.
3 Endomorphins are a reality.
4 The other thing is encouraging kids to
5 exercise.
6 I don't mean doing jumping jacks.
7 Anybody who did anything with a runner's
8 high, which is kicking in your own Endomorphins,
9 kids are not being physically active so they are
10 being depressed, because they don't have the
11 physical activity. And many of the schools are
12 slowing down on that.
13 So physical activity for the children, and
14 stopping the commercials on the TV.
15 SENATOR BONACIC: Thank you, Kitty.
16 [Applause.]
17 KITTY VETTER: You're welcome.
18 SENATOR BONACIC: The last speaker is who,
19 MJ?
20 MJ: We have time for one more?
21 Laurie Rotolo [ph.].
22 Is Laurie here?
23 LAURIE ROTOLO [ph.]: Thank you.
24 Hi, my name is Laurie Rotolo.
25 I work with Ulster Prevention Council in
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1 Ulster County.
2 I also am a part of the prescription-drug
3 task force.
4 And we are working really strongly with the
5 medical community on prescribing practices.
6 One of our -- one of our physicians in
7 Ulster County is starting a prescription for
8 wellness, which is something that they're trying to
9 institute in their clinics as an alternative to --
10 as an alternative to prescription -- for
11 painkillers, to -- just to piggyback on what the
12 person before me just said, to encourage more
13 proactive, health-oriented exercise and alternative
14 medicines.
15 And so my other question is: What can we do
16 to support alternative insurance coverage for
17 alternative treatment for people with addictions and
18 other problems as an alternative to the medication?
19 And, also, to also say about the prescription
20 drugs that the pharmaceutical companies, I agree
21 with everything that was said about the
22 pharmaceutical companies.
23 In Ulster County, we did get a $6,000 check
24 from a pharmaceutical company, in terms -- so that
25 we could purchase more medication drop-boxes.
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1 And, so, we're recommending that everyone
2 reach out to your pharmaceutical companies and ask
3 them to help clean up the mess by making sure that
4 these medication boxes are installed all over the
5 sheriffs and police stations and -- in all the
6 counties.
7 That basically was it.
8 SENATOR BONACIC: Thank you very much.
9 I think we're going to conclude this forum.
10 Do you have another person that would like to
11 say something?
12 MJ: Can we fit one in, Senator?
13 SENATOR BONACIC: Yeah, sure. Go ahead.
14 Come up on.
15 MJ: Priscilla, come on up.
16 Thank you, Priscilla.
17 PRISCILLA BASSETT: Priscilla Bassett from
18 the Sullivan County SLAC, which is the
19 Senior Legislative Action Committee.
20 I was up in Albany on Tuesday and I picked up
21 the "Legislative Gazette."
22 The headline on the second page, and the
23 whole page, said, "Senate Dems Unveil Bill Package
24 To Fight Heroin Epidemic."
25 There was also reference to something in the
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1 Senate, a single bill that was mentioned.
2 I just want to urge the Legislature to set
3 aside these problems of cooperation between the
4 Senate and the Assembly, between the Democrats and
5 the --
6 Oh, I don't know what that other Democratic
7 group is called.
8 [Laughter.]
9 PRISCILLA BASSETT: I don't mean to make a
10 joke.
11 -- between the Democrats and the Republicans.
12 These laws -- these proposed laws,
13 legislations, are vital to moving ahead.
14 And I hope that you can all work together in
15 the spirit that we're all here today, to do
16 something as quickly and as sensibly as possible.
17 Good debate, yes.
18 But action, too.
19 SENATOR BONACIC: Thank you, Priscilla.
20 [Applause.]
21 SENATOR BOYLE: Without a doubt, this is a
22 non-partisan issue.
23 We're here to save lives.
24 And I don't think you were forgetting the
25 Republicans.
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1 It was the IDC, the Independent Democratic
2 Conference, which is the other group.
3 But we have members of that on our -- of the
4 IDC on our task force.
5 And I read the proposals by the Senate --
6 regular Senate Democrats, and they got very good
7 ideas, and we're definitely going to incorporate
8 whatever we can.
9 We're going to work together on it.
10 SENATOR BONACIC: Do you want to close?
11 SENATOR BOYLE: I'd like to thank, certainly,
12 Senator Bonacic for hosting this great forum.
13 We got wonderful ideas.
14 Our panelists, thank you so much for all your
15 unsights.
16 And for the audience members who
17 participated, and those who came to listen and
18 learn, I appreciate it very much.
19 Realize that this is not the end.
20 If you come up sometime tonight and you say,
21 "Oh, I forgot to say something," contact my office.
22 It's, "Senator Boyle," just Google it. And
23 we've got staff people working on this till -- for
24 the next couple weeks, and thereafter, as well.
25 And I would like just to mention, in closing,
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1 that we do realize, and one of the things I really
2 want to get out of these 17 forums, is the stigma
3 involved.
4 We have so many people that are ashamed about
5 talking about family members that are addicted or
6 themselves being addicted, and we still heard such
7 courageous stories here today.
8 It's not a shame.
9 We're going to get rid of the stigma.
10 This is a perfect start, and to learn that,
11 when someone walks up to you and they say, "Oh, my
12 child has cancer," the reaction you'll have, we want
13 to have it so, when you walk up and say, My child is
14 a drug addict, or heroin addict, you're going to
15 have that same exact reaction.
16 And we're going to work together to end this
17 heroin epidemic.
18 Thank you so much for allowing me to be here.
19 [Applause.]
20 SENATOR BONACIC: Again, to everyone that's
21 here -- our panelists, our audience -- government
22 does not have a magic cure for the problems that
23 we're facing with heroin.
24 One of the things that I thought was very
25 helpful, is that the flavor of the drug may change
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1 from one decade to the other, and that point was
2 made over and over again.
3 We need everyone involved: government,
4 community, the experts, law enforcement.
5 We must cure this epidemic as best we can.
6 And as Senator Boyle said, everybody in
7 Albany, both sides of the aisle -- three sides of
8 the aisle, want to attack this problem, because it
9 pervades every area of our society, regardless of
10 our race, regardless of our economic strata.
11 So thank you for coming, and you will keep
12 your eye on this.
13 We're going to work very hard to get this
14 done before the end of session, and that's the third
15 week in June.
16 Thank you all for coming.
17 [Applause.]
18 (Whereupon, at approximately 3:56 p.m.,
19 the forum held before the New York State Joint
20 Task Force on Heroin and Opioid Addiction
21 concluded, and adjourned.)
22
23 ---oOo---
24
25