Public Hearing - May 23, 2014

    


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

       3                  PUBLIC FORUM:  GENESEE COUNTY

       4          PANEL DISCUSSION ON BATAVIA'S HEROIN EPIDEMIC

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

       6
                               Batavia City Hall
       7                       1st Floor Conference Room
                               1 Batavia Center
       8                       Batavia, New York 14020

       9                       May 23, 2014
                               10:00 a.m. to 12:00 p.m.
      10

      11

      12      PRESENT:

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

      16         Senator Michael H. Ranzenhofer, Forum Moderator
                 Member of the Joint Task Force
      17

      18

      19

      20

      21

      22

      23

      24

      25







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       1
              PANELIST INTRODUCTIONS:                       PAGE  6
       2
              Colleen Babcock
       3      Parent & Family Support Coordinator
              Horizon Health Services
       4
              Dr. Bruce Baker
       5      Medical Director
              GCASA
       6
              John Bennett
       7      Executive Director
              GCASA
       8
              Mary Beth Bowen
       9      Chief Nursing Officer and
                 Vice President of Nursing
      10      United Memorial Medical Center

      11      Lisa Glow
              Program Director
      12      Horizon Health Services

      13      Shawn Heubusch
              Chief of Police
      14      Batavia Police Department

      15      Timothy Lynch
              Assistant U.S. Attorney
      16         for the Western District
              Chief of the Narcotics and
      17         Violent Crime Division

      18      Gary Maha
              Sheriff
      19      Genesee County

      20      Donna Sherman
              Substance-Abuse Treatment Program Manager
      21      VA Western New York Health Care

      22      Augusta Welsh
              Director of Community Services
      23      Genesee County Mental Health Services

      24      START OF PANELIST PARTICIPATION               PAGE  7

      25      START OF AUDIENCE PARTICIPATION AND Q&A       PAGE 53







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       1             SENATOR RANZENHOFER:  Good morning,

       2      everybody.

       3                  [Audience replies, "Good morning."]

       4             SENATOR RANZENHOFER:  Much better.

       5      Everybody's awake, that's great.

       6             Before we begin, what I would like to do, and

       7      before we do introductions, I would just like to

       8      introduce Staff Sergeant Dennis Sensbaugh [ph.] who

       9      is with us today, who's going to lead us in the

      10      Pledge of Allegiance.  And, the flag is to my right

      11      here.

      12                  [All present stand and recite, as

      13        follows:]

      14                  "I pledge allegiance to the flag of the

      15        United States of America and to the republic for

      16        which it stands, one nation under God,

      17        indivisible, with liberty and justice for all."

      18             SENATOR RANZENHOFER:  Thank you,

      19      Staff Sergeant Sensbaugh.

      20             My name is Senator Mike Ranzenhofer.  I'm

      21      joined here -- getting a little nod to move this

      22      over, but I'll give it back to you, Tim, when you

      23      speak.

      24             My name is Senator Mike Ranzenhofer.

      25             I'm joined today by Senator Phil Boyle.







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       1             And I want to thank everybody who is here in

       2      the audience and on the panel for joining us today.

       3             I'm going to make a couple of opening

       4      remarks, then I'm going to turn it over to

       5      Senator Boyle.

       6             But before I do, I want to just give a brief

       7      introduction.

       8             Senator Boyle is actually joining us from

       9      Long Island.

      10             And, to talk about his dedication, he was

      11      flying up last night, and he told me that his plane

      12      was delayed and didn't get up here until about

      13      two in the morning.

      14             And, Senator Boyle has traveled the state,

      15      from Montauk to Buffalo, to Watertown, all the

      16      states [sic], conducting 17 hearings.

      17             And I'm very privileged that he is able to

      18      join us today in Genesee County, here in the city of

      19      Batavia, this beautiful city hall.

      20             Senator Boyle is the Chairman of the Senate

      21      Committee on Alcoholism and Drug Abuse, and he is

      22      the Chairman of the Joint Senate Task Force on

      23      Heroin and Opioid Addiction.

      24             And there are two other vice chairs,

      25      Senator Carlucci and Senator Nozzolio.







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       1             But Senator Boyle has really been leading the

       2      effort and leading the charge, and I'm just very

       3      privileged that he found the time to join us today

       4      right before a long holiday weekend, to come up to

       5      our community and listen to this very, very serious

       6      problem.

       7             So what I'd like to do is, I'm going to turn

       8      it over to Senator Boyle for a few remarks.  Then

       9      we'll introduce the panel members that are up here.

      10             And this is a -- you know, more of an

      11      informal than a formal process.

      12             We'll hear from some of the panelists with

      13      respect to law enforcement, what they're seeing out

      14      in the community from; from the treatment

      15      perspective, in terms of what they're seeing; and

      16      then, certainly, you know, we want to hear from the

      17      folks that are on the other side of the dais here,

      18      in terms of their personal stories and what's

      19      happening in their lives.

      20             So, with that, I'd like to turn it over to my

      21      good friend and colleague Senator Phil Boyle.

      22             SENATOR BOYLE:  Thank you, Mike.

      23             I'd like to thank Senator Ranzenhofer for

      24      hosting this opioid forum, and this is the 14th of

      25      what has become 18 forums around the state.







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       1             And as Mike was saying, these are informal.

       2      They're not, technically, hearings.  They're

       3      roundtable discussions, and we'd like to get input.

       4             This is an incredibly distinguished panel,

       5      and I thank you all for participating, and for those

       6      of you in the audience.

       7             However this heroin/opioid epidemic has

       8      affected your life, whether on a professional basis

       9      or a personal basis, we'd like to hear what you

      10      think we can do to fix it.

      11             As I say each time, if you have an idea,

      12      whether your child's addicted or whether you're a

      13      health-care professional for years or a

      14      law-enforcement official, "If I could change a law,

      15      or a couple laws, to create one, or to get rid of

      16      one that isn't working," that's what we're here to

      17      do -- to learn about.

      18             And, Mike, again, I thank you for hosting

      19      this, and I look forward to some good testimony.

      20             SENATOR RANZENHOFER:  Okay, well, great.

      21             On the panel with us today, I'd like to

      22      introduce:

      23             Lisa Glow, who is the program director at

      24      Horizon Health Services;

      25             We have Colleen Babcock, a parent and family







                                                                   7
       1      support coordinator, also at Horizon;

       2             We have Shawn Heubusch, Chief of Police from

       3      the Batavia Police Department.  Thank you for

       4      joining us today;

       5             We have Sheriff Gary Maha from

       6      Genesee County;

       7             We have with us Timothy Lynch,

       8      Assistant U.S. Attorney for the Western District,

       9      who is the chief of the narcotics and violent-crime

      10      division.

      11             We have Mary Beth Bowen, who's the chief

      12      nursing officer and vice president of nursing at

      13      United Memorial Medical Center;

      14             We have John Bennett, who is the

      15      executive director of GCASA;

      16             We have Dr. Bruce Baker, who is the medical

      17      director at GCASA;

      18             We have Augusta Welsh, who's director of

      19      community services at Genesee County Mental Health

      20      Services;

      21             And, also, finally, Donna Sherman,

      22      substance-abuse treatment program manager at the

      23      VA Western New York Health Care.

      24             And I thought what we'd do, and I know it's

      25      done a little bit differently at every hearing, I'm







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       1      going to turn to my good friend and Sheriff of

       2      Genesee County, if you could just give us, you know,

       3      an idea of what you're seeing out in the community.

       4             Obviously, your deputies are, you know, on

       5      the streets, patrolling, you know, every day.

       6             You know, what are they seeing?

       7             What are they reporting to you?

       8             What's happening with respect to heroin use,

       9      and opioid abuse [sic] and abuse.

      10             SHERIFF GARY MAHA:  Thanks, Mike.

      11             Good morning.

      12             First, I'd like to thank Senator Boyle,

      13      Senator Ranzenhofer, and the New York State Senate,

      14      for hosting this event here this morning.  It's an

      15      important event, which affects our community, public

      16      safety, and health of our community.

      17             Genesee County is a small rural county

      18      between two large metropolitan areas, Buffalo and

      19      Rochester.

      20             What we're seeing here in this county, is the

      21      majority of our drugs come out of the city of

      22      Rochester.  That's been the case for several years.

      23             This is not a Genesee County issue, it's not

      24      a state issue.  It's a national issue.

      25             Recently, in the "USA Today" April 17th







                                                                   9
       1      edition, there was a report that America's top

       2      law-enforcement officials reported that heroin and

       3      other opioid addiction is now claiming more lives in

       4      many communities than violent crime and car crashes.

       5             So it is a national concern.

       6             What we're seeing here is heroin being sold

       7      on the streets for, roughly, 10 to 20 dollars for a

       8      bag of heroin.  It's cheaper than prescription pills

       9      being sold on the street.

      10             We've had cases where addicts have gotten the

      11      Suboxone, sold that on the street for

      12      20, 25 dollars, and then turn around and buy heroin

      13      with the proceeds of their sale.

      14             About 50 percent of our drugs being purchased

      15      undercover with undercover buys are now heroin,

      16      according to our local drug task force.

      17             You know, a few years ago, heroin was unheard

      18      of here in Genesee County.  Now it's very prevalent

      19      and very available.

      20             Many of our property crimes -- the

      21      burglaries, larcenies, shoplifting -- they can all

      22      be related to some type of an addiction.

      23             Burglaries, for example, they steal your

      24      flat-screen TV or a firearm which are worth a lot of

      25      money in the city.  45 minutes after they steal it,







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       1      it shows up on the street of Rochester and stuff

       2      goes up their nose.

       3             Local jails, the concern of -- with me, being

       4      a -- the Sheriff who is responsible for the

       5      operation of the county jail, we have seen,

       6      probably, 80 to 85 percent of our inmates addicted

       7      to some sort of substance, whether it be alcohol or

       8      drugs.

       9             We have an opiate-withdrawal protocol in

      10      place, so if somebody does come in the jail and we

      11      know they're addicted to opiate, we have to follow a

      12      certain protocol.

      13             And a couple of my concerns are, you know --

      14      well, I'm going to talk a little bit about the

      15      Narcan program which I know you're familiar with.

      16      It's saved lives out there on an overdose of heroin.

      17             The Genesee County Sheriff's Office is going

      18      to participate in that program.  We've already sent

      19      officers to training.

      20             In Suffolk County alone, and Senator Boyle

      21      probably knows this, that over 200 lives are saved

      22      by the Suffolk County PD using Narcan.

      23             What has helped, in my mind, in my opinion:

      24             Aggressive law enforcement:  Specifically

      25      targeting dealers to help reduce the supply, because







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       1      it boils down to, again, supply and demand; and

       2      tough sentences for dealers, especially those who

       3      deal to our young children.

       4             Drug Take-Back days:  The DEA I know holds

       5      Drug Take-Back days at least once a year throughout

       6      Western New York.  We've seen hundreds of pounds of

       7      prescription drugs being turned in and not available

       8      to those on the street.  Again, trying to reduce the

       9      demand because those drugs are worth money on the

      10      street to the addicts.

      11             Education:  Education to the public,

      12      especially vulnerable populations, alerting them to

      13      the serious threat heroin poses to their health --

      14      health and the health of the community.

      15             And education must be done by local

      16      individuals.  A person who's thinking about getting

      17      involved with drugs is not going to go out on a

      18      national website and look at the pitfalls with

      19      regards to the use of drugs.

      20             Treatment:  This is very important, I think,

      21      because we're in a vicious circle if these people

      22      don't get treated.  We've seen generations of

      23      children being addicted because that's a way of

      24      life.

      25             Treatment has to be affordable.  And many







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       1      times we hear from parents who'd like to get their

       2      children treated, but they can't afford it.

       3             So I think that's a major thing that should

       4      be overcome.

       5             The I-STOP program has helped.  Some of you

       6      are familiar with that.  That's where these addicts

       7      can't do doctor shopping.  If they go to one doctor

       8      to get a Suboxone, they can't go two weeks later to

       9      another one to get more, because they're just

      10      selling this stuff it onto the streets.

      11             So, basically, that's what we're seeing here

      12      in Genesee County, Senator.

      13             SENATOR RANZENHOFER:  Thank you, Sheriff.

      14             Chief, you're -- I mean, are you seeing the

      15      same things in your department?

      16             POLICE CHIEF SHAWN HEUBUSCH:  Ah, yes.

      17             Good morning.  Thank you for having us here

      18      today.

      19             I would echo the Sheriff's sentiments.

      20             We work closely with the Genesee County Drug

      21      Task Force.  That's where we would be provided most

      22      of our information.

      23             I would agree with the Sheriff, this is a

      24      growing problem.  Being between Rochester and

      25      Buffalo, again, we see a lot of our influx from







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       1      Rochester.  We see a lot of little guys set up shop

       2      for a couple days, a week, at a time before we can

       3      crack down on them and send them on their way, but,

       4      it's merely moving them around, so to speak.

       5             I think one of the things that us small rural

       6      area lacks is the resources to really address this

       7      problem on a law-enforcement level.

       8             We have a regional drug task force, as the

       9      Sheriff mentioned, that's comprised of members of

      10      the City of Batavia Police, Genesee County, and the

      11      Leroy Police Department.

      12              Unfortunately, it's a small unit combating a

      13      large problem.

      14             And one of the things that we have seen here

      15      in the city just arising, as the Sheriff mentioned,

      16      is the property crime.  Some violent crime, as well,

      17      has gone up.

      18             We had a series of robberies over this past

      19      winter that took place, that was a direct result of

      20      addiction.

      21             So, I see an increase in that.

      22             The education piece is large.

      23             Again, it's a resource -- a matter of

      24      resources for us.

      25             SENATOR RANZENHOFER:  Okay, and, Tim, keeping







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       1      with the law-enforcement theme, I know you deal with

       2      this issue at the federal level.

       3             What are you seeing on the federal level?

       4             ASST. U.S. ATTY TIMOTHY LYNCH:  Well, first

       5      of all, on behalf of the United States Attorney,

       6      Bill Hochul, you know, I want to thank you for

       7      hosting this forum.  This is an important topic for

       8      the U.S. Attorney.

       9             When he became the U.S. Attorney in 2010, it

      10      was, really, one of his initial initiatives was to

      11      address the growing prescription-pill problem that

      12      he and, you know, obviously, other people around

      13      this community and around the country, had noticed a

      14      growing increase of abuse by our young children,

      15      which, as law enforcement knows, often leads to

      16      heroin abuse.

      17             So, this is an important topic for him, and

      18      I know he wishes he could be here today, but he's in

      19      Rochester attending to another matter.

      20             I think when -- when I look at the problem,

      21      and I agree with the Sheriff's sentiments and the

      22      Chief's sentiments, it's not just an urban problem.

      23             I think a lot of times people thought that,

      24      you know, this is what occurs in the city of

      25      Buffalo, in the city of Rochester.







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       1             When I first started in the office, I handled

       2      terrorism cases for the first five or six years.

       3             But in 2007, I had my first heroin

       4      prosecution, and I hadn't really done a lot of

       5      narcotics cases.

       6             And what struck me most of all, was when I --

       7      when all these individuals went to get sentenced,

       8      the individuals who were using the drugs and selling

       9      them, you know, I noticed that they all began their

      10      abuse with -- or they all began their substance

      11      abuse with the abuse of hydrocodone.

      12             And for me it was eye-opening.  I really

      13      had -- I'd never experienced that, obviously, as --

      14      growing up.  But it struck me that this was the

      15      entryway for these individuals into, obviously, the

      16      harder-core, more serious drug, that -- and the

      17      cheaper drug, unfortunately, heroin, that has

      18      devastated our streets and our communities.

      19             So for us, it's not an urban problem.  It's a

      20      countywide, it's a districtwide problem, and we've

      21      tried to address, in several ways, that problem.

      22             One, in 2011, along with the

      23      State Attorney General, we hosted a

      24      prescription-pill summit at the University of

      25      Buffalo, where we brought together, again, like you







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       1      have today, members of -- across the board; not just

       2      law enforcement, but members of our substance-abuse

       3      community, treatment community, and tried to at

       4      least start to get the message out to everyone about

       5      this growing problem.

       6             And I think it's continued to snowball, not

       7      just here in our district, but across the country,

       8      that, you know, we really need to take efforts to

       9      stop the abuse at the beginning stages.

      10             And I think, certainly, we could arrest

      11      individuals.  That's not going to solve the problem.

      12             I think we have to take it to our -- the

      13      medical community, the doctors, make sure that

      14      they're properly educated.

      15             You know, in -- while they're in medical

      16      school, are they getting sufficient amount of

      17      education pertaining to identifying

      18      prescription-pill abuse, opiate abuse?

      19             And, making sure that they're taking the

      20      necessary steps to do the proper examinations prior

      21      to prescribing these highly addictive drugs.

      22             In our cases, we've noticed doctors who are

      23      just simply not conducting what would be the

      24      required physical examinations prior to prescribing

      25      pills.







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       1             And we had a case, an egregious case, of a

       2      doctor exchanging prescription slips for gas grills,

       3      for paper products.

       4             I mean, it's unbelievable what we've seen.

       5             We've arrested nurses who were taking

       6      prescriptions from individuals who died in their

       7      care.  Getting the unused pills and then selling

       8      them right out of her office.

       9             So, you know, those are the egregious cases.

      10             But even -- notwithstanding those, we know

      11      even prior to the I-STOP program, there was a lot of

      12      doctor shopping.

      13             And I have not -- you know, it's still so

      14      early on, I don't know that we've necessarily seen

      15      the repercussions of it, or -- but I assume, over

      16      the next few years, we'll, hopefully, notice that,

      17      you know, that hasn't taken place.

      18             But that's another avenue, you know, that

      19      we've seen.

      20             The other thing that's really on the rise is

      21      the robberies and the burglaries of pharmacies.

      22             And we've -- in my office, that's one of the

      23      cases now that we regularly, you know, try to take,

      24      so that, hopefully, looking for more harsher

      25      sentences in federal court to, hopefully, obviously,







                                                                   18
       1      deter other individuals from engaging in that kind

       2      of conduct.

       3             So I -- you know, generally speaking, that's

       4      what we've seen.

       5             I'm sure we'll talk about other topics, and

       6      I don't want to talk too much, as lawyers often do.

       7             Okay?

       8             SENATOR RANZENHOFER:  Well, that was a good

       9      segue, Tim, to your comments about talking about the

      10      medical community, and, you know, what we really

      11      need to do on the education side, the prevention

      12      side, the treatment side.

      13             My eyes go over to Lisa Glow and

      14      Colleen Babcock, and, perhaps, you can share some of

      15      your perspective and your stories.

      16             Start with whoever wants to start.

      17             Colleen?

      18             COLLEEN BABCOCK:  Well, actually, Senator,

      19      first, thank you for having me today.

      20             But, although I'm a parent and family support

      21      coordinator for Horizon Health Services, I'm here

      22      today as a parent.

      23             And, if it is okay, I have a statement that

      24      I put together, that I'd like to read.

      25             SENATOR RANZENHOFER:  Absolutely.







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       1             COLLEEN BABCOCK:  Uhm, I am a parent and

       2      family support coordinator for Horizon Health

       3      Services, but before anything else, I'm a parent,

       4      and that's why I'm here today.

       5             I have a wonderful and amazing 23-year-old

       6      son who suffers from addiction disease.

       7             When my journey started with my son

       8      seven years ago, I, like many other parents, had no

       9      idea what I was dealing with.

      10             The thought of addiction was the furthest

      11      thing from my mind, and heroin was even further.

      12             Christopher suffers from a genetic defect

      13      called "neurofibromatosis," and he has

      14      two inoperable tumors in his brain.

      15             Between the ages of 7 and 14, he underwent

      16      several brain surgeries.

      17             As a parent, I couldn't have imagined that

      18      anything could get worse, but there was worse, far

      19      worse.

      20             When he was a junior in high school, things

      21      started to change.  Chris started to experiment with

      22      substances with other kids in school.

      23             As Chris would put it, "From that point on,

      24      there was no turning back."

      25             Doctors believed Chris, having addiction on







                                                                   20
       1      both sides of the family, and introduced to

       2      narcotics at a very young age, was predisposed to

       3      addictions.

       4             Could things have been different if doctors

       5      would have talked to me about that during his

       6      surgeries?

       7             Over the next several years, his addiction

       8      grew, and doctors who prescribed him an array of

       9      controlled substances for disorders he did not have

      10      only fueled that addiction.

      11             By the time Christopher was 19, he had

      12      overdosed twice, and attempted suicide once.

      13             I did not recognize my once happy child.

      14             Trying to access treatment was a nightmare.

      15             Doctors never recommended treatment, nor did

      16      they ever talk to me about addiction.

      17             If you don't know the names of treatment

      18      facilities, how can you possibly find them?

      19             There's no listing in the phone book, and

      20      there was no -- virtually, no help out there.  There

      21      was no communication between doctors and

      22      substance-abuse providers.

      23             By the grace of God, in 2011, Christopher was

      24      in the right place at the right time, and became

      25      eligible for a pilot program being introduced by







                                                                   21
       1      BlueCross and BlueShield for IV-opiate addiction at

       2      Horizon Village Sanborn long-term inpatient

       3      treatment facility, and insurance covered his care

       4      there.

       5             That's when our lives began to change.

       6             As our journey began, I became a sponge for

       7      information, wanting to understand the disease and

       8      learn as much as I could about addiction and

       9      recovery.  And we were in the right place.

      10             Christopher spent six months at

      11      Horizon Village on two separate occasions.

      12             The program at Horizon Village not only saved

      13      Christopher's life, but mine as well.  It helped me

      14      as a parent to understand that this is a disease and

      15      just stopping is not an option.  We needed to work

      16      together.

      17             Christopher has spent three years in recovery

      18      and is still linked with treatment.  He has started

      19      college, and today life is good, but I don't think

      20      that that's a guarantee.  The disease can change

      21      everything tomorrow, and Chris has to work at his

      22      recovery every day, forever.

      23             My son's life was saved because he had access

      24      to treatment.  This is not the case for many others.

      25             I attribute his success to the long-term







                                                                   22
       1      treatment and education he received, education we

       2      both received, at Horizon Village.

       3             His brain was given time to heal, and the

       4      tools and time he needed to learn how to manage this

       5      disease.

       6             Yes, I was the driving force in the

       7      beginning, but now he works at his recovery for

       8      himself.

       9             Unfortunately, not everybody is able to

      10      access these same treatment options.

      11             Insurance companies demand failures first

      12      before they will allow the much needed long-term

      13      treatment programs.  Then when failures are too

      14      many, they deny them treatment because they don't

      15      follow recommendations.

      16             Are we forgetting that we're dealing with

      17      people who are sick?

      18             We do not deny diabetics treatments because

      19      their sugar levels are high again.

      20             Recovery takes time, especially with our

      21      youth whose underdeveloped brains have not matured

      22      yet.  They are taking some of the most strongest

      23      narcotics on the planet known to man, at 20, 30, 40,

      24      even 50 times the recommended dosage and putting

      25      them in their brains.







                                                                   23
       1             How could we even imagine that this can be

       2      fixed in 30, 60, or even 90 days?

       3             Outpatient programs are not working on the

       4      young-adult brain.  28 days is not long enough in

       5      inpatient.  It takes 90 days or more for opiates to

       6      start to leave the system, when education can begin.

       7             We put our young adults into short-term

       8      programs or incarcerate them just long enough to

       9      lower their tolerances without the crucial education

      10      and tools they need to be successful in recovery.

      11             They are going back out onto the streets and

      12      using, in most cases, within hours or days, and many

      13      are dying.

      14             Access to effective medications, such as

      15      Suboxone and methadone, for medically-managed

      16      recovery have waiting lists up to three months.

      17             People are detoxing in treatment facilities

      18      with the use of Suboxone, and then being discharged

      19      to an outpatient with no access to Suboxone, and

      20      just put on another waiting list.

      21             What do you think is happening in that

      22      three-week waiting period?

      23             Today I work as a parent and family support

      24      coordinator, to help families better understand the

      25      seriousness of opioid addiction and the role in







                                                                   24
       1      their recovery, to help them navigate the limited

       2      resources that are available to them, and help

       3      prepare families for the letdowns along the way.

       4             The family needs support as much as the

       5      person suffering from addiction disease.

       6             Recovery is more than just the abstinence of

       7      the drugs.  It's learning to change the behaviors

       8      and use the tools that are given in a long-term

       9      setting, and that takes a long time.

      10             Quite frankly, that's harder; the hardest

      11      part of recovery.

      12             I'm here today as a parent, to help spread

      13      the message that recovery is possible, but we need

      14      to make the resources available and a possibility.

      15             We need everyone to come together to change

      16      the things and make the resources available for

      17      everyone.

      18             Every child should have access to the same

      19      resources.

      20             Today there's a waiting list at every

      21      treatment facility in Western New York.

      22             Horizon Village, a long-term residential

      23      treatment program, has a waiting list of 90 to

      24      120 young adults at any given time; the majority of

      25      our IV-heroin users, 18 to 27 years old.







                                                                   25
       1             Our youth are dying while they're waiting to

       2      get the help they so desperately need.

       3             This is unacceptable, and things have to

       4      change.

       5             Thank you.

       6             SENATOR RANZENHOFER:  Thank you, Colleen,

       7      for, not only your personal story, but your

       8      perspective as -- you know, in your position at

       9      Horizon.

      10             Lisa, your perspective is a little different;

      11      you have a different title.

      12             What do you see over there?

      13             LISA GLOW:  So I am the program director for

      14      our Batavia Horizon Health Services outpatient

      15      clinic.

      16             At this point, over half of our population in

      17      treatment are opiate users.  We've seen a drastic

      18      increase in the number of clients coming in for

      19      treatment using heroin and other opiates.  The

      20      growing demographic being that teens-to-20s age

      21      bracket.

      22             As a result of the drastic increase and the

      23      changing face of addiction, we've had to get

      24      creative with how to treat these clients because, as

      25      Colleen mentioned, so often, we'll make an inpatient







                                                                   26
       1      recommendation for a client, and hear back from the

       2      insurance company that, unfortunately, it's not

       3      medically necessary for them to go inpatient at that

       4      time, or, that they need to fail at the outpatient

       5      level.

       6             SENATOR RANZENHOFER:  Who makes that

       7      determination whether it's medically necessary?

       8             LISA GLOW:  The insurance company.

       9             SENATOR RANZENHOFER:  Okay.

      10             LISA GLOW:  We'll make the referral, and the

      11      insurance company comes back and says "not medically

      12      necessary," or, that they need to fail at outpatient

      13      first.

      14             Unfortunately, what "failing at outpatient"

      15      means, is that client continues to use heroin and

      16      other opiates.  And as we know, overdose is

      17      happening and clients are dying.

      18             We have found some progress.

      19             As a few have mentioned, the I-STOP

      20      legislation has helped.  At least the scrips that

      21      are being written are being written to those that

      22      are using them responsibly.

      23             We've been training clients, family members,

      24      community members; anyone who's interested in being

      25      trained on Narcan.







                                                                   27
       1             If you haven't heard, we -- this coming

       2      Wednesday, May 28th, we're doing a large

       3      community-wide training, numerous times of the day,

       4      open to the public, so that they're able to be

       5      trained on how to recognize an opiate overdose, and

       6      how to effectively respond using the Narcan kit.

       7             Involving family members throughout the

       8      treatment process is imperative.  If we're only

       9      treating the clients, we're only really treating

      10      half of what we could be.

      11             And we've had to develop an opiate-specific

      12      track of treatment in order to really work with this

      13      unique demographic of individuals.

      14             So I'm hopeful that, as a result of forums

      15      like this one, that we'll start to see some changes

      16      in terms of access to care and eliminating barriers

      17      to the clients that really, really need help.

      18             Thank you.

      19             SENATOR RANZENHOFER:  Thanks, Lisa.

      20             Let me just turn to this side.

      21             You know, we've heard a lot about the

      22      law enforcement and the Horizon perspective.

      23             I guess I'll start off with GCASA, because

      24      I'm very familiar with your organization.

      25             Dr. Fisher and John Bennett, why don't you







                                                                   28
       1      share your perspective in terms of what you're

       2      seeing on this particular problem.

       3             JOHN BENNETT:  Thank you.

       4             Thank you for having us here today.

       5             And I certainly want to appreciate the Senate

       6      for convening a lot of these regional forums.

       7             I think, you know, this does a lot to reduce,

       8      or at least take a look at, some of the stigmas

       9      associated with the work that we do.

      10             So what I do is, I took a look at --

      11      Sister's Hospital, back in 2001 and 2002, approached

      12      Genesee County, and I know, uhm -- they were looking

      13      to start a methadone program up here.

      14             So I remember having to look up how many

      15      opiate-treatment patients we had in treatment.  And

      16      that year, I think it was 2001-2002, we had

      17      three opiate-primary patients in treatment.

      18             So, you know, we gave that information back

      19      to the County, the Community Services Board.  And,

      20      eventually, there didn't seem to be a need for

      21      opiate-treatment service -- or, for methadone in

      22      this county.

      23             So we roll the clock, you know, forward to

      24      2014, we had -- we've had 483 admissions that are

      25      opiate-primary since 2008.







                                                                   29
       1             We started our program back in 2006-2007,

       2      when we started prescribing medication-assisted

       3      treatment, buprenorphine, for opiate-treatment

       4      patients.

       5             So, right now, I think, Dr. Baker, we

       6      currently have about 175 active admitted patients

       7      who are opiate-primary.

       8             I echo Lisa's statement, that more than half

       9      of our caseload right now is opiate-primary.

      10             And, again, we've all had to get creative.

      11             I think one of the big -- one of the big

      12      problems for us -- well, I think one of the things

      13      to understand, I mean, the 12-to-25-year-old bracket

      14      is the biggest --

      15             SENATOR RANZENHOFER:  "12" did you say?

      16             JOHN BENNETT:  -- 12- to 25-year old is the

      17      largest-growing number of opiate prescription pain

      18      medicine.  Non-medically used prescription pain

      19      medicine.

      20             And if you look at -- you know, if you've got

      21      a young person, that 12-to-17-year-old group, you

      22      know, they're taking medicine out of their

      23      grandma's, you know, medicine cabinet, and they're

      24      getting together on a Friday night and they're just

      25      having -- they think they're just having fun.  You







                                                                   30
       1      know, they're, like, Let's just take a few pills.

       2             And -- but what we know about opiate is that,

       3      you know, doing that for two or three weeks, and for

       4      some of these kids, you know, they're popping them

       5      every day, thinking this is no big deal.  This is a

       6      prescription medication.  My grandma uses it, my

       7      mother uses it...whatever.

       8             And over a period of time now, they try to

       9      stop using, and now they start to get sick.

      10             So, they're no longer necessarily looking for

      11      that high.  Now they're just, you know, taking a

      12      pill to go -- before they go to school so that they

      13      don't get sick.

      14             And that's how, sometimes, young people

      15      become addicted to these -- you know, these

      16      substances, by just kind of experimenting, playing

      17      around, and then, eventually, they start to -- they

      18      want to get off of them.  They go through

      19      withdrawal, and they continue to use.

      20             I think the I-STOP has been great.  I mean,

      21      it's been a -- so I appreciate, you know, some of

      22      the legislation around that.

      23             I think that the medication take-back has

      24      been wonderful in getting some of the drugs off the

      25      street.  As the Sheriff indicated, though, it's







                                                                   31
       1      caused an increase in price in the prescription

       2      pills on the street, and a decrease in heroin.  And

       3      heroin's become much more prevalent.

       4             I'm disappointed to say that, you know, we

       5      have patients trying to sell heroin sometimes in our

       6      waiting room.

       7             And -- you know, so that's a change for us,

       8      you know, trafficking drugs in our waiting room.  We

       9      didn't have to deal with that, you know, five or

      10      six years ago.  We didn't have to deal with people

      11      saying, you know, If you don't help me today, I'm

      12      going to vomit in your waiting room.

      13             And, so, those are the types of changes in

      14      our treatment system.

      15             Our counselors have to -- you know, they had

      16      to educate themselves.

      17             We've had to do a lot of training on opioid

      18      addiction, because I think, as a field, you know, we

      19      were kind of behind the gun seven, eight years ago.

      20             I think that one of the concerns for me in

      21      this community is that we have very few private

      22      practitioners who prescribe, and so it creates a

      23      backlog in our system.

      24             We have two doctors who work for us.  Each

      25      can prescribe up to 100.







                                                                   32
       1             Right now, we are -- you know, we are really

       2      at a max.  They're both part-time physicians.

       3             We need physicians in our community to take

       4      our patients who are doing well, who have been, you

       5      know, clean for eight months or a year, who are

       6      medication-compliant, who are on low doses of

       7      Suboxone, who will take our patients and not worry

       8      about.

       9             I know some of the fears -- well,

      10      anecdotally, what they've told me was:  I don't want

      11      to get those phone calls at two or three in the

      12      morning.  I don't want to deal with patients in my

      13      waiting room, you know, arguing, frustrated,

      14      vomiting; whatever that is.

      15             And we try to reassure them that the patients

      16      that we're dealing with, that we would refer to you,

      17      are doing well.

      18             But I think, you know, physicians are afraid

      19      to take on this population.

      20             So I think, you know, educating our local

      21      practices is a good thing.

      22             And then I also think that there's a place

      23      for prevention in this.

      24             We -- I don't know of any, and there might

      25      be, but, I talked with my prevention assistant







                                                                   33
       1      director yesterday, and I asked:  Is there any

       2      evidence-based stuff out there right now for

       3      preventing opiate use?

       4             And, so, she was looking into that.  She

       5      didn't think there was.

       6             So I think that, you know, we need some

       7      better prevention tools out there, because

       8      I think -- you know, I think that's where it's at

       9      with the young people, is to try to prevent this

      10      from happening.

      11             And -- and -- and, so, thank you.

      12             SENATOR RANZENHOFER:  Thanks, John.

      13             Dr. Baker, your perspective on the medical

      14      side?

      15             DR. BRUCE BAKER:  I'd like to go over one

      16      thing that you said, in educating medical students,

      17      educating doctors.

      18             Before you do that, they have to -- you

      19      raised, Rochester.  They created something called a

      20      "biopsychosocial concept of medical care."

      21             Well, the "social" part is the part that's a

      22      big problem here.

      23             And as a student or as a practitioner, they

      24      have to get inside their patients' heads and

      25      families and realize what the social situation is.







                                                                   34
       1             I was medical director at Hope Haven for

       2      25 years.  And I see, over the last five, six years,

       3      over half -- a third of my patients had no idea of

       4      what normal social behavior is.

       5             So -- and at GCASA and at the hospital and

       6      Horizons, we put up with an awful lot.  But,

       7      frequently, it just doesn't work because people

       8      can't accept it.

       9             I'd just like to share what some of my

      10      patients have told me over the years.

      11             The relief of pain or good feeling they get

      12      from using opiates is nothing compared to what they

      13      go through with withdrawal.

      14             And, unfortunately, the opiates, once they

      15      get into them -- or, how do they get into them?

      16             There's two main ways.

      17             One is the diversion from legally prescribed

      18      drugs.  Even some older people sell them.  Get more,

      19      they want to sell them, or their kids sell them.

      20             The other, although marijuana is not

      21      universally accepted as a gateway drug, my patients

      22      tell me that, as young people, even teenagers, they

      23      began using marijuana.

      24             Well -- so marijuana is not necessarily

      25      directly responsible for opiates, but, when you







                                                                   35
       1      think about it, they're using marijuana in

       2      association with people who do use the hard drugs.

       3             And, sure, "Well, try this, see how it

       4      works."

       5             Well, once it begins working, they have to

       6      take more and more and more.

       7             And just quickly to say how this

       8      buprenorphine, Suboxone, works, it -- buprenorphine

       9      is an opiate.  And, uhm -- it -- it's accepted as an

      10      opiate by the receptors in the brain which are now

      11      chronically diseased.  They don't work at all well.

      12             But I'm not a scientist.  For some reason,

      13      I don't -- I cannot explain, the buprenorphine

      14      opiate does not require escalation.  We normally

      15      start with a dose of 8 milligrams a day, along with

      16      2 milligrams of the Narcan you mentioned.  And the

      17      reason this is put together is so that they can't

      18      get a buzz by snorting it or injecting it.

      19             We do use something called "Subutex," which

      20      is just buprenorphine, for pregnant ladies, because

      21      we don't want the baby exposed to the naloxone.  We

      22      don't want the baby exposed to the opiate either,

      23      but at least it's a small controlled drug.  And when

      24      the baby is in the hospital, the nurses, the

      25      doctors, the hospitals, they know there's a problem







                                                                   36
       1      and they're prepared to treat any withdrawal, which

       2      is -- in my experience, has been very, very rare.

       3             One time I saw -- I knew that mother was

       4      using lots more drugs.

       5             So as a -- as -- what the Suboxone will do,

       6      it will replace the other opiates.  It will maintain

       7      withdrawal without need for increasing the dose.

       8             All right, now, they've got to get off this.

       9      It's still an opiate.

      10             Well, we're looking forward, probably a year

      11      or two, before they get off.  We gradually decrease

      12      the dosage.

      13             The way we do it, is we'll go from

      14      8 milligrams every other day, to 6 milligrams every

      15      other day, and do that for a period of time.

      16             The receptors in the brain don't realize that

      17      they're getting less because they're gradually being

      18      reset.

      19             The brain never forgets, because you're still

      20      an addictive person.  And so the time they're off

      21      it, hopefully.

      22             Now, unfortunately, some people relapse in

      23      spite of all the help they've gotten.  And many

      24      people have to go through two, three, four times.

      25             But I don't know of any other way we can do







                                                                   37
       1      this.

       2             And I think, in my experience, going back

       3      many years, but just recently with GCASA, I think

       4      it -- I think it's worthwhile trying.

       5             And as far as cost-effectiveness is a

       6      concern, it's a bargain.

       7             SENATOR RANZENHOFER:  Thank you.  And,

       8      Doctor, I appreciate that, the medical perspective.

       9             And you had alluded to, you know, the

      10      hospital setting, and what you're seeing there.

      11             And I'm just going to turn to

      12      Mary Beth Bowen.

      13             What are you seeing in United Memorial

      14      Medical Center with this problem?

      15             What's happening in your emergency room?

      16             What's happening, you know, in the hospital?

      17             MARY BETH BOWEN:  Thank you.

      18             And thank you both for being here today.

      19             It's certainly an important topic for the

      20      community, and a huge consumption of resources.

      21             And, sadly, we don't do a good job medically

      22      treating people and getting them recovered.  And

      23      that's a challenge in the acute-care setting and the

      24      hospital.

      25             We see patients primarily in four venues:







                                                                   38
       1             In the emergency room, and this can be a

       2      variety of people coming in for acute treatment,

       3      overdoses, or alcohol-related.

       4             We started looking and tracking our

       5      statistics after the bath-salts epidemic that we had

       6      in this community a few years ago.  And the work of

       7      this group and other members of the community really

       8      were able to nip that in the butt, but it taught us

       9      some lessons.

      10             And in our ER, from 2013, we saw a total of

      11      62 overdose patients.

      12             Year-to-date this year, we've seen a total of

      13      130.

      14             And, so, there's a significant increase.

      15             That is not just opioids.  That is also

      16      including alcohol.  It could include other

      17      ingestion.  So it's not truly that, but the change

      18      is remarkable.

      19             So the impact is throughput of the ER.

      20             I spoke with the ER physicians, and their

      21      frustrations center around appropriate and easily

      22      accessible treatment options, particularly for the

      23      mentally ill who have a chemical dependency.  That

      24      is a challenge to get people into programs timely.

      25             Other -- on the inpatient side we have







                                                                   39
       1      drug-seekers; people are who addicted who will come

       2      in for treatment.  And we spend a tremendous

       3      resource doing workups to determine whether or not

       4      they have health issues that need to be treated, or

       5      whether they're just -- it's a mechanism and an

       6      access to the substances they require.

       7             Our OB population, we do have a number of

       8      mothers who do come in addicted.  We test every

       9      delivery that comes in for substance.  We probably

      10      have a 25 percent positive rate.

      11             Fortunate for us, we have very good working

      12      relationships with both Children's Hospital in

      13      Buffalo and Strong in Rochester, so we're able, not

      14      only to care for the moms, but also to treat --

      15      transfer the babies to get them treated immediately.

      16             And then our third --

      17             SENATOR BOYLE:  [Unintelligible.]

      18             MARY BETH BOWEN:  25 percent.

      19             SENATOR BOYLE:  Of pregnant or delivering?

      20             MARY BETH BOWEN:  Delivering.

      21             SENATOR BOYLE:  Wow.

      22             MARY BETH BOWEN:  And then the fourth

      23      mechanism where we access, we have the -- a 28-day

      24      program, and it's a challenge.

      25             Access to care, funding for care, delays in







                                                                   40
       1      the admissions, create variables.  And, also,

       2      there's just a failure rate.

       3             We don't have good medical management, and

       4      there's not standing -- I think that John and Lisa

       5      alluded to this, there are not necessarily best

       6      practices out there.  There's not one recipe for

       7      success in doing this.  And it's a challenge,

       8      because the families are tremendously frustrated.

       9      The resources aren't available.

      10             And for the providers, they don't -- they

      11      don't feel successful.  I mean, medical people want

      12      to help and cure people, and this is truly a

      13      challenge.

      14             One other comment that our ER physicians

      15      asked that I make separate, is, uhm -- I said,

      16      "Do you have any other concerns that you'd like me

      17      to bring forward?"

      18             And they said they have concerns around

      19      e-cigarettes.  They see them as another mechanism

      20      for drug delivery in a creative population.

      21             So they wanted to just bring that to the

      22      forefront.

      23             SENATOR RANZENHOFER:  Okay, now you had

      24      touched upon on the mental-health aspect, also, in

      25      combination with the drug aspect.







                                                                   41
       1             So I'm going to ask Augusta Welsh, how are

       2      these -- how are the two related?

       3             I mean, obviously, you're mental-health

       4      services, but, I imagine a large component of that

       5      is also, you know, folks that are at some stage in

       6      their addiction to heroin or prescription medication

       7      or other illegal substances?

       8             AUGUSTA WELSH:  Thank you both, Senators, for

       9      inviting us today.

      10             When we reviewed our system over the past

      11      decade or two, what we found were a couple patterns,

      12      and I think, mainly, there's some other providers

      13      here from the community that I'm sure have seen the

      14      same thing, is that, when mental illness starts in

      15      somebody, usually they aren't aware of it and they

      16      don't know what to do with the symptoms.

      17             So the majority of people who really have not

      18      had the diagnosis of mental illness at that -- at

      19      this time really are trying to work with their own

      20      symptoms in any which way they can.

      21             Well, one of the easiest ways is to

      22      self-medicate with alcohol and with other

      23      substances.  The more readily available they are,

      24      the more you can get them.

      25             We see that, especially now with our younger







                                                                   42
       1      population.

       2             As everyone has attested to, you know, if

       3      you've been around long enough in the field, years

       4      ago, 25 years ago, a heroin user looked very

       5      different than a heroin user looks today.

       6             They were few and far between, but, they were

       7      individuals who had been addicted for years and

       8      years and years, and really had gone through the

       9      whole spectrum of substances and kind of ended at

      10      heroin.

      11             Now we have a couple of programs that

      12      I believe have identified people sooner.  And, a

      13      couple who have jammed people up, like the I-STOP,

      14      for example.

      15             You know, that we -- I can give you cases,

      16      where our psychiatrists have been able to look and

      17      see that somebody has already received a number of

      18      prescriptions for painkillers and opiates from other

      19      docs, so that they won't go in that direction, or,

      20      they will actually adjust some of their medications

      21      so that it doesn't exacerbate the problem.

      22             We also, you know, are fans of the Take-Back

      23      program.

      24             I grew up with a generation of parents who

      25      kept everything.  You know, the cotton balls in the







                                                                   43
       1      bottle, to the tin foils, to everything else.

       2             Well, they also kept drugs.

       3             And when my father passed away, and my mother

       4      was placed in a nursing home, we, literally, were

       5      able to take bushels to be destroyed; to be taken

       6      back.  And many of them were painkillers.

       7             Just as was mentioned before, kids are taking

       8      anything out of cabinets now that are just

       9      prescription, just to see what they will do.

      10             It's, you know, called "fishing," and you can

      11      put it in a nice bowl, and whatever looks like a

      12      pretty color, that's what you're going to ingest.

      13             And if you ingest it with alcohol, as a

      14      solvent, you're going to get the reactions much

      15      stronger, much faster, and it puts these kids at

      16      high risk.

      17             What we find very difficult is, yes, we have

      18      seen our numbers go up.  Our co-morbidity for

      19      substance abuse, and mental illness, in general, has

      20      increased, probably, from 40 to 50 percent over the

      21      last few years.

      22             But what we see, and specific to heroin, is

      23      that heroin and these type of drugs has been the

      24      first time that our psychiatrists have been talking

      25      about, that that exposure, as has been mentioned by







                                                                   44
       1      Dr. Baker and other people, to the young brain

       2      really can lead to mental illness.

       3             We always saw it as the symptoms of mental

       4      illness.  Like I said, were being self-medicated.

       5             What they're saying now is, truly, you have

       6      substances that you're using that can lead to a

       7      mental illness and problems later in life, in

       8      addition to the addiction.

       9             And those have been some of our biggest

      10      concerns.

      11             We'll say to one another at work, Do you know

      12      why you're here?

      13             And it's not that -- or, to another provider,

      14      Why are you here?  Do you realize what you're here

      15      for?

      16             Not that they're questioning anybody going

      17      into early dementia.

      18             What we're saying is, there's a reason that

      19      we're here right now, together; not only in this

      20      panel, but working in coalitions and looking at this

      21      problem.

      22             Because I think this is a really important

      23      time, that we really need to intervene somehow and

      24      stop this, because if we've now made it, as

      25      Sheriff Maha said, so incredibly cheap to put these







                                                                   45
       1      substances on the street, you've opened a gateway to

       2      anybody trying it.

       3             And I believe that, anecdotally, like Narcan,

       4      we have to teach our emergency workers because it's

       5      going to be more prevalent.  We have to teach the

       6      community.

       7             But I'm also wondering:

       8             If you have an adolescent who is

       9      experimenting, what's going to be the impact?

      10             Is that adolescent going to take into

      11      consideration that they may have an out because so

      12      many people have an antidote?

      13             You know, are they going to be more willing

      14      to try it or to experiment if they know about that,

      15      too?

      16             So it's a real tough balance right now for

      17      what's going on in the community.

      18             And when I ask myself, "Why are we here?"

      19      I think Mrs. Babcock put it right on the table, that

      20      we definitely need to come together right at this

      21      moment, because I think it's crucial in what's

      22      happening out there.

      23             SENATOR RANZENHOFER:  Well, thank you.

      24             And I was really kind of astonished to hear

      25      the different paradigm, in terms of the mental







                                                                   46
       1      illness leading to the drug abuse, the drugs

       2      actually cause causing mental illness.

       3             And, you know, on your second point there,

       4      I mean, that's why we're having these hearings, is

       5      we hope, you know, very soon -- I mean, we're -- you

       6      know, we've had some hearings already, and we're

       7      working on legislation, but, very soon, to hope to

       8      announce some solutions, you know, to the problems,

       9      based on what we hear, here, and across the state.

      10             And before we, you know, open it up to

      11      questions and comments from the audience, I'd just

      12      like to turn to Donna Sherman, and just hear your

      13      perspective in terms of what's happening with this

      14      issue, you know, from the VA perspective?

      15             DONNA SHERMAN:  Thanks again for inviting us

      16      here today.  It's a real privilege to be able to get

      17      to speak for our veterans.

      18             I guess we're not -- we are seeing an

      19      increase amongst veterans in opioid abuse and

      20      dependency, but not at quite the same rate as the

      21      community.

      22             In our treatment programs, we're seeing about

      23      a third of our patients with opioid dependence.

      24             When we speak about veterans, I think, in

      25      some ways, veterans can often roll up all kinds of







                                                                   47
       1      concerns into one package.

       2             We hear from some veterans that, when they

       3      were soldiers, that they were injured in combat,

       4      prescribed opioids for the pain so that they could

       5      continue with their deployment.

       6             And sort of unbeknownst to them, becoming

       7      more and more tolerant and dependent on prescription

       8      opioids, returning to the states and finding, you

       9      know, that they really had a habit that was getting

      10      expensive, and resorting to purchasing street heroin

      11      instead.

      12             So I think, with veterans, they present, or

      13      they can, when they're in addiction or

      14      behavioral-health treatment, can present with

      15      certain co-morbidities that can make treatment a

      16      little bit more of a challenge, and needing for it

      17      to be a little bit more tailored.

      18             So an example of some of the complexities can

      19      be:

      20             The diagnosis of PTSD, which is an anxiety

      21      disorder.  And, certainly, opioids can help with

      22      calming some of those symptoms.

      23             Obviously, coming back with pain; so somebody

      24      who's going to be having chronic pain, but, yet, is

      25      also struggling with an addiction, how do we decide







                                                                   48
       1      how we're going to treat that?

       2             Finally, traumatic brain injury can also be a

       3      factor.  And many of our newer veterans coming back

       4      are on the younger side, being in their earlier to

       5      late 20s, and are feeling pretty powerful and not

       6      at risk.  So, maybe being willing to take a little

       7      bit more risk than other groups.

       8             So, we have a comprehensive treatment

       9      programs at VA.  Right now, I have four different

      10      components of our substance-abuse services:

      11             We have a 28-day residential treatment

      12      program;

      13             A standard outpatient treatment program that

      14      branches to all of our CBOC locations.

      15             "CBOC" stands for community-based outpatient

      16      clinic, so we deliver services for SUD through

      17      telehealth there;

      18             We have tobacco-disorder services;

      19             And, finally, a Suboxone program.  We have

      20      two waivered providers.

      21             Right now, we have about 100 cases in our

      22      Suboxone program, and offer a standard outpatient

      23      approach.

      24             I think we also -- there's a number of very,

      25      I think, innovative initiatives that VA, as a whole,







                                                                   49
       1      has undertaken to address this problem.

       2             One of them is the CPRS record, computerized

       3      record.

       4             So, basically, we have records for veterans

       5      over the whole country.  We can see what veterans

       6      are doing in any location; and, so, we're able to

       7      coordinate care, and keep track of what they're

       8      being prescribed, and whether those prescriptions

       9      are appropriate for what their disorders are.

      10             Congress actually tracks our pharmacy

      11      numbers:  How many opioid prescriptions are being

      12      written?  What are the levels of those

      13      prescriptions?

      14             And there are metrics that we're assigned

      15      that we have to make improvements on.

      16             So, in other words, if there are too many

      17      opioid prescriptions being written at too high of

      18      dosage, then there's got to be a process by which we

      19      reduce that.

      20             So, locally, we've got a couple of things

      21      that we're doing.  One of them is the opiate review

      22      board.

      23             This is a physician-provider board, where the

      24      numbers are run on the highest users of prescription

      25      opiates in the facility, and those cases are







                                                                   50
       1      clinically reviewed by a panel of physicians to

       2      determine whether the dosage is appropriate.

       3             All our physicians also participate in

       4      I-STOP.

       5             So, ideally, veterans are being very closely

       6      monitored for their prescriptions, both, within the

       7      VA system, and, are monitored for possible doctor

       8      shopping and pharmacy utilization in the community.

       9             So I think that this is real innovative, and

      10      it's probably not without its flaws, so far.  But --

      11      and I won't say we're perfect, but, we're really

      12      committed to going all out to support our veterans

      13      in their recovery efforts.

      14             Another program that I can talk about a

      15      little bit is our chronic-pain clinic, which is a

      16      place where, okay, so we know that veterans are

      17      going to have pain, and, you know, so what are we

      18      going to do about this?

      19             I mean, legitimate pain is a separate issue

      20      from opioid addiction.

      21             And, so, what we offer in the chronic-pain

      22      program, which is run by a pain-specialist provider

      23      and a licensed pain psychologist with a pain

      24      specialty, really, the pain is assessed there.

      25      Medical -- it has to be medically substantiated, and







                                                                   51
       1      then non-opioid strategies for the management of

       2      pain are taught through that clinic.

       3             So on the prescription side, we really are

       4      doing a lot to assist veterans.

       5             On the treatment side, we've got any number

       6      of services.

       7             We have -- now, many of our veterans who are

       8      involved in opiates are going to have brushes with

       9      the law; and, so, we have a veterans justice

      10      outreach worker, who I think is here today.  His

      11      name is John LaHood [ph.], and he's in the audience.

      12             And he goes around and touches base with all

      13      of our courts, to make sure that we know who our

      14      veterans are and what help they need.  And he helps

      15      link them to our services.

      16             We also have two people on my staff who

      17      interact with the Buffalo Veterans Court and the

      18      Niagara County Veterans Court, to coordinate any

      19      care that we're delivering in substance abuse

      20      directly with that court.

      21             We have a number of services, certainly,

      22      through our OEF, OIF, OND, which is sort of a fancy

      23      way of saying all the new wartime initiatives.  That

      24      kind of captures those three:  Afghanistan, Iraq,

      25      and New Dawn.







                                                                   52
       1             They provide case-management services, and

       2      help veterans get into the care at VA.

       3             We have a huge mental-health clinic in

       4      Buffalo that also branches out to all of our CBOC

       5      locations to deliver mental-health services.

       6             And, of course, our addiction services.

       7             So, I think we're -- we're doing a lot, and

       8      we probably could do more.

       9             Veterans are not immune from addiction,

      10      certainly; but, yet, substance abuse, and opiate use

      11      especially, tends to be highly stigmatized.

      12             And, the desperation, described by

      13      John Bennett earlier, of some addicts, I think

      14      really makes it tough for people to have willingness

      15      to help this population at times.

      16             One of our biggest challenges, and I'm hoping

      17      that other providers are going to agree with me, is

      18      the recruitment, retention, of approved providers

      19      who are willing to work with this population.

      20             It's extremely labor-intensive, and takes a

      21      very, sort of, compassionate, yet tough, personality

      22      to be effective.

      23             Our veterans are strong advocates for

      24      themselves, as well; and, so, you know, we have to

      25      be willing to reach an equalized compromise in our







                                                                   53
       1      decisions with them about treatment.

       2             So, I guess -- you know, I'm based more in

       3      Erie County.  That's where my office is.

       4             We have a community program in Erie County

       5      called "Painkillers Kill More Than Pain."

       6             That's been a really great public-awareness

       7      campaign.  There's been billboards and video.

       8             Certainly, WNED had a short shot that was let

       9      out for view over months, really discussing the

      10      dangers of opioid abuse and dependence.

      11             So, thank you.

      12             SENATOR RANZENHOFER:  Well, thank you, Donna.

      13             I appreciate your comments, and the allusion

      14      to veterans courts, and, you know, the special, you

      15      know, attention that needs to be on that particular

      16      issue.

      17             I know we have some veterans in the audience.

      18      Perhaps we'll hear from them as we, you know, move

      19      into our second hour.

      20             I know there are a number of people here that

      21      would like to speak and share their comments.

      22             I know that our office had been in touch with

      23      one, Amber Mottser [ph.].  I'm not sure if she is

      24      here, or if she feels comfortable speaking.

      25             But, certainly would like to hear from some







                                                                   54
       1      folks that are sitting in the audience, if you want

       2      to share your stories and situations with us, in

       3      terms of, you know, what needs to be done; what your

       4      suggestions are.

       5             Whether it be law enforcement, whether it be

       6      intervention, whether it be treatment, whether it be

       7      education, if you're comfortable, stand up and

       8      speak.

       9             Thank you, Amber.

      10             AMBER MOTTSER [ph.]:  Hello.

      11             SENATOR RANZENHOFER:  Good morning.

      12             AMBER MOTTSER [ph.]:  Thank you for

      13      letting -- or, asking me -- well, having my

      14      counselor at GCASA asking me to come and speak and

      15      share my story.

      16             I'm actually pretty familiar with the format.

      17      I've spoken in Western New York, over in Buffalo, as

      18      a survivor of human trafficking.

      19             Unfortunately, that's where my drug addiction

      20      had taken me.

      21             I first used heroin at 16 years old.

      22             My friends were users of heroin.  I had

      23      already been experimenting with other substances,

      24      and it just came across my path.  And at that point,

      25      honestly, that was my way out from my family home







                                                                   55
       1      life.  I just had a really -- I suffered a lot at

       2      home.  Alcoholic family, and things like that.

       3             And I remember when I told my grandparents,

       4      when I was 20, that I was addicted to heroin, and

       5      they were just shocked, because they hadn't seen it

       6      since Vietnam, you know, and they just were

       7      unfamiliar with it.

       8             And I remember having tears in my eyes and

       9      saying, "This is an epidemic."

      10             Like, the face of heroin addiction has

      11      totally changed.  You know, it's teenage girls in

      12      the suburbs.  It's not, you know, junkies in the

      13      city -- in the inner city anymore.  It's just not

      14      like that.

      15             And I've been through inpatient four times.

      16             One time, it took me all the way down to the

      17      Walter Hoving Home, which is a non-for-profit

      18      Christian organization in New York City -- right

      19      outside of New York City.  And I stayed there for a

      20      month, and I came back, and I collected 11 months

      21      clean.  Went through the GCASA program.

      22             Unfortunately, back in January, I did have a

      23      relapse, because when I -- I think a lot of it had

      24      to do with, when I came back up from New York City,

      25      I decided I didn't need the Suboxone program.  And,







                                                                   56
       1      eventually, it caught up with me, and I relapsed.

       2             But now I'm currently on the Suboxone

       3      program.

       4             I know a lot of people that are really

       5      successful with it.

       6             And I know some people that aren't successful

       7      with it; and reason being for that is, they don't

       8      have long-term care, they don't have long-term

       9      treatments.

      10             It's been my experience that it needs to be a

      11      whole lifestyle change.  It's not just surface

      12      issues, it's not just underlying emotions.  It's the

      13      whole five aspects of wellness: spiritual,

      14      emotional, physical, all of those things, mental,

      15      and caring for those.

      16             That's what I've been doing in my recovery

      17      program, and it's been working pretty well for me.

      18             Currently, I just finished a year at GCC.

      19      I'm going to -- I'm pursuing to be an addictions

      20      counselor.  And, eventually, I'd like to work for a

      21      non-for-profit organization.

      22             I directly correlate with PATH organization

      23      which works out of Buffalo.  We're opening a drop-in

      24      center for human trafficking.

      25             A lot of these young girls -- I don't know if







                                                                   57
       1      you've connected these two points yet, but a lot of

       2      these young girls that are addicted to heroin are

       3      resorting to trafficking themselves on the Internet.

       4             So, I mean, that's a huge issue that we're

       5      looking at over there.

       6             But, I think it's really great that you guys

       7      have brought a light, and really brought an

       8      awareness to the community here, because it has

       9      changed.

      10             I've only lived in Batavia in two years and

      11      I've seen dramatic change, even in the style of the

      12      groups that I attend at GCASA.  And the kind of

      13      people that are coming there are becoming younger

      14      and younger.  And, it's just not who you would

      15      expect.

      16             And I know that there's people in my family

      17      that have been affected by this disease.

      18             People I've gone to high school with have

      19      overdosed and died.

      20             I mean, it's really sad that our young people

      21      are killing themselves.

      22             So, I just want to say thank you, again, for

      23      letting me come up here and just share my

      24      experience.

      25             SENATOR RANZENHOFER:  Okay, let me ask you a







                                                                   58
       1      question.

       2             For you, the 28-day -- you said you relapsed

       3      four times.

       4             Were -- your treatments, 28 days, and then

       5      you had the outpatient, you said that worked for you

       6      to some degree.

       7             But you said that, for others, it must be --

       8      it needs to be a much longer treatment program?

       9             AMBER MOTTSER [ph.]:  Yes, because what I've

      10      noticed, I think, for my benefit, is that I just

      11      don't get along with my family and that background,

      12      so it was easy for me to break away from that

      13      situation.

      14             Other people, what I've noticed, because I do

      15      go and speak at the alumni meeting Wednesday nights

      16      over at Hope Haven, and what I've noticed with

      17      people, is after the 28 days worth of treatment, if

      18      they get that long, because of their -- you know,

      19      the insurance company, they go home and they're back

      20      in the same circumstances, same exact situation,

      21      same exact people.

      22             It's just -- it's a matter of time before it

      23      happens again, whether Suboxone or not.

      24             So, uhm -- I don't know, I think there just

      25      needs to be more done.







                                                                   59
       1             I know for me personally, even when I was

       2      living on the streets, I tried to get into rehab

       3      multiple times.  It took me almost six months to get

       4      into a rehab.

       5             I went to ECMC, Stutzman.  I got denied both

       6      places.

       7             I called Syracuse Behavioral Health for

       8      3 1/2 months.  While being homeless, I could find a

       9      phone every day and try to call, because I really

      10      wanted the help.

      11             And I think that that's a major aspect, too,

      12      is, are these people really wanting help?

      13             And the sad part about it is, that those that

      14      do, is the help and the resources available?

      15             SENATOR RANZENHOFER:  Okay.

      16             AMBER MOTTSER [ph.]:  And sometimes it's not.

      17             SENATOR RANZENHOFER:  Okay, well, thank you.

      18             Thank you very much.

      19             UNKNOWN SPEAKER:  [Not on video.]

      20             Amber, where do you live now?

      21             AMBER MOTTSER [ph.]:  I live here in Batavia.

      22             UNKNOWN SPEAKER:  [Not on video.]

      23             Are you in supportive living?

      24             AMBER MOTTSER [ph.]:  No, I did not go

      25      through the supportive-living program.







                                                                   60
       1             I did spend three months at the

       2      Atwater House.

       3             My personal opinion is, the co-sex thing that

       4      they have going on there, males and females, is not

       5      working.

       6             UNKNOWN SPEAKER:  [Not on video.]

       7             But you did spend three months --

       8             AMBER MOTTSER [ph.]:  Three months there,

       9      yeah.

      10             SENATOR RANZENHOFER:  Are there some other

      11      people that would like to speak?

      12             If you would -- this lady is right in front.

      13             Just -- if you would, just identify who you

      14      are so we know who you are.

      15             CHRISTINA AMABALAY [ph.]:  My name is

      16      Christina Amabalay [ph.], and I'm a

      17      nurse practitioner for Horizon Health Services.

      18             I do work with the chemically-dependent

      19      population.

      20             One of my roles is to meet with people who

      21      are opiate-dependent and discuss their options.

      22             I feel that, as a nurse practitioner, I have

      23      full prescription privileges, which means I can

      24      prescribe any medication on the market, with the

      25      exception of Suboxone.  I can prescribe it off-label







                                                                   61
       1      for pain, but not for the addictions.

       2             This is limiting the access to care and to

       3      medication-assisted treatment which is desperately

       4      needed right now for opiate dependence.

       5             So, when I meet with clients to determine

       6      whether or not they would like to try

       7      medication-assisted treatment, and they're

       8      opiate-dependent, and they're still actively using,

       9      and I say to them, "These are the options that

      10      I think you have.  Suboxone is a great option, but,

      11      we have a six- to eight-week waiting list," and they

      12      look at me and say, "So what am I supposed to do in

      13      the meantime"?

      14             And in the meantime, they either:

      15             Go through that tortuous withdrawal on their

      16      own;

      17             They go to detox where they get a dose of

      18      Suboxone, but then are discharged and don't have a

      19      scrip for Suboxone;

      20             Or they continue to use while they're on the

      21      waiting list for Suboxone.

      22             So it's my feeling that some emergency

      23      legislation is needed, to allow a very important

      24      part of the medical community, which is

      25      nurse practitioners, to prescribe Suboxone.  And







                                                                   62
       1      I think we need it very hastily.

       2             So I would very much appreciate any authority

       3      that you might have to allow this legislation.

       4             SENATOR RANZENHOFER:  Senator Boyle had a

       5      comment.

       6             SENATOR BOYLE:  Yeah, you make an excellent

       7      point, and we've heard that in a number of forums.

       8             The problem is, it's a federally regulated

       9      drug.  And there's a cap on the number of patients

      10      that a doctor can have, but it's all federally

      11      regulated.

      12             I think, as part of this legislative package,

      13      what we're going to do is, is either have a

      14      resolution or some force from New York State

      15      Legislature saying to Congress, Hey, get on the ball

      16      and change this.

      17             But it's a federal situation with Suboxone,

      18      unfortunately.

      19             CHRISTINA AMABALAY [ph.]:  So what is the

      20      next step?

      21             I want to be involved in the next step,

      22      because I feel that there's urgency about this and

      23      it's not being taken care of quickly enough.  And as

      24      a result, people continue to use and overdose, and

      25      die.







                                                                   63
       1             SENATOR BOYLE:  What I would recommend is,

       2      and this sounds corny, but write your Congress

       3      person or contact their office.

       4             We will do, as state legislators, but your

       5      federal representatives, they need to know exactly

       6      what you're saying.

       7             It makes perfect sense, and it should be this

       8      way, but we as state legislators do not have

       9      jurisdiction over Suboxone in particular.

      10             CHRISTINA AMABALAY [ph.]:  Okay.  Thank you.

      11             DR. BRUCE BAKER:  Senator --

      12             SENATOR BOYLE:  Yeah.

      13             DR. BRUCE BAKER:  -- as a practicing

      14      physician, I'd like to say that I think the

      15      nurse practitioner is perhaps better qualified than

      16      the average physician, because the nurse

      17      practitioners are much better -- more aware of the

      18      social problems that people have.

      19             SENATOR RANZENHOFER:  Good, thank you.

      20             DR. BRUCE BAKER:  And I would endorse that

      21      500 percent.

      22             SENATOR RANZENHOFER:  Just 500.

      23                  [Laughter.]

      24             SENATOR RANZENHOFER:  I know there was

      25      another hand in the back.







                                                                   64
       1             Yes, why don't you tell us who you are, and

       2      come to the microphone.

       3             LAURIE CURRIER [ph.]:  My name is

       4      Laurie Currier [ph.], and my daughter is a

       5      recovering heroin addict.  She has been in recovery

       6      for the last two years.

       7             And, everything that everyone had said this

       8      morning makes so much sense as far as not being able

       9      to find the help necessary.

      10             So I'm very glad that you're having this talk

      11      this morning, because I think that, again, the

      12      stigma that goes with heroin addiction, you know,

      13      that they are the castoff people.  That they're not

      14      your child, your sister or brother, your mother or

      15      father.

      16             And, they truly are.

      17             When we sought help for my daughter, we were

      18      told that there was a six-month waiting list.

      19             We were also told by our insurance company

      20      that she needed to fail on the outpatient first.

      21             With heroin addiction, I've discovered that

      22      without an inpatient piece, outpatient is reluctant

      23      to work.

      24             We have gone through the gamut, as a family,

      25      trying to find help.







                                                                   65
       1             So I do think family is a huge piece.

       2             There has been so many roadblocks along the

       3      way.  And even when help was available, it was

       4      limited to 28 days.

       5             There is a link between mental health and

       6      addiction.

       7             And it took my daughter going out of state to

       8      a clinic that dealt with both mental health and drug

       9      addiction, together, in order to help get her on the

      10      right track.

      11             She had -- when I told her I was coming

      12      today, she had said that, you know, the Narcan

      13      program, that, I don't know how much would, as

      14      Augusta had said, be an easy out for addicts.

      15             Maybe for people that were experimenting the

      16      first time, but for the most part, an addict would

      17      rather be left alone and die than take Narcan

      18      because of the painful snap back to reality.

      19             We are a typical middle-class family that

      20      are -- we're very involved in our children, their

      21      education.  Drugs were not abused in our home.

      22             And, yet, I am the parent of an addict.

      23             So that I think there needs to be more out

      24      there, that when you are seeking help, that you can

      25      get the help when you need it.







                                                                   66
       1             That there shouldn't be someone at an

       2      insurance company, sitting behind a desk, saying,

       3      you know, Nope, she doesn't need that treatment;

       4      when, as a parent, and even her physician had said,

       5      and wrote letters, and appeals, saying, yes, she

       6      did.

       7             It took, actually, a government member

       8      telling me, "Drop her off your insurance so that she

       9      can get Medicaid."

      10             And, it was through Medicaid.

      11             And there is a huge connection between

      12      law enforcement and the addicted population.

      13             My daughter did things that she never would

      14      have done otherwise.  Under the influence, anything

      15      was fair game.

      16             I can't thank the Mental-Health Drug Court

      17      here in Batavia enough for the help that they

      18      provided my daughter.

      19             Judge Balbick and Nichole Desmond were

      20      wonderful.

      21             And, that, I think everyone needs to work

      22      together in order to make this a known problem.  Not

      23      hide.

      24             You know, it's very hard to get your children

      25      into a program; and, yet, no one talks about it.







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       1             This is the face of addiction.  You know,

       2      that we are very typical people.

       3             And I sincerely hope that we can give it a

       4      voice, give it a name, get more help in our

       5      community, because it's here, it's big, and people

       6      don't recognize it.

       7             Thank you.

       8             SENATOR RANZENHOFER:  Well, thank you very

       9      much.

      10             I know that Nichole and Judge Balbick do a

      11      very good job.

      12             And we're going to get to a couple of people,

      13      but I just want to throw something out here, 'cause

      14      I hear a lot that you have to fail first before you

      15      get into a longer-term program.

      16             So my question is:  Does the 28-day program

      17      work in some cases, and that's why they make you go

      18      through it first?

      19             I mean, if it fails in 100 percent of the

      20      cases, why would anybody ever do it?

      21             So I don't know if anybody has any thoughts

      22      on that?

      23             I guess we'll take a couple of comments here,

      24      and then we'll go back to some folks in the

      25      audience.







                                                                   68
       1             Donna, and then Colleen.

       2             DONNA SHERMAN:  I think it really comes down

       3      to making individualized assessment of each case

       4      that's coming in.

       5             I think the earlier someone is in the

       6      addictive process, the better chance that a 28-day

       7      program will be adequate.

       8             But, oftentimes, more supports are needed.

       9      And people can really run the gamut in terms of what

      10      their needs are.

      11             You could have someone who has a lot of

      12      psychosocial support, a job, et cetera, and just has

      13      had some chronic pain and became addicted

      14      inadvertently.  And someone like that could

      15      participate in Suboxone for a year, taper off, do a

      16      28-day program, and be fine.

      17             And others who have more psychosocial

      18      deficits, more mental-health or trauma-related

      19      issues, are going to need more and more intensive

      20      services over a longer period of time.

      21             SENATOR RANZENHOFER:  Okay, Colleen, do you

      22      want to comment on that?

      23             COLLEEN BABCOCK:  I do agree with what Donna

      24      says, but I think that, also, with the young-adult

      25      brain, you're dealing with a totally different face







                                                                   69
       1      of addiction.  And the 28-day programs do not work.

       2             I will tell you that the majority of your

       3      young-adult population, 12 to 27, repeat those

       4      programs over and over again, such as Amber.

       5             Why not start with the long-term program,

       6      give them the solid foundation that they need to get

       7      on their feet.  And then, if you have to refresh

       8      down the road with outpatient or 28-day program,

       9      you're at least appropriately targeting that

      10      young-adult brain, giving it time to heal, so that

      11      they can absorb and take in the tools that they need

      12      to be successful.

      13             So, I think we really need to look at

      14      starting with long-term treatment before the 28-day

      15      program.

      16             SENATOR RANZENHOFER:  Right off the bat.

      17             COLLEEN BABCOCK:  Right, exactly.

      18             SENATOR RANZENHOFER:  Okay.  Thank you.

      19             I know there were two women in the front.

      20             MARY BETH BOWEN:  Senator, I would echo that.

      21             I think that our experience with the 28-day,

      22      it's the exception versus the norm.

      23             We have people who have gone through the

      24      program six, seven, eight, nine times, and seen at

      25      that point they have achieved sobriety.







                                                                   70
       1             The other challenges, it's a very difficult

       2      population to follow, because if the patients are

       3      not connected with a GCASA program or another

       4      program, they're home -- they're classified as

       5      "homeless" in our system and we can't access them to

       6      see where they are at.

       7             AUGUSTA WELSH:  Senator, in -- you know, in

       8      our historical addiction programs, we have always

       9      seen that, after somebody went through the 28-day

      10      program, the -- for whatever addiction, they did

      11      best when they had the most supports.  Whether it

      12      was the halfway house, family was involved, they had

      13      resources.

      14             When you have -- you know, we keep talking

      15      about these young adults.

      16             When you have these young adults, they may

      17      still have the chance for the family being intact.

      18             But a lot of times, with the 28-day program,

      19      it is, you -- you, literally -- you know, I'm a

      20      nurse, first and foremost.  You literally have had

      21      changes physi- -- changes the physiology of their

      22      brain.  This is not a quick adjustment.

      23             And, you know, when I was talking before and

      24      I spoke, and it wasn't about Narcan not being a good

      25      thing.







                                                                   71
       1             What I was speaking about is some anecdotal

       2      things that came back through some of our

       3      therapists, that, literally, they have said kids

       4      have wondered about this, you know, saying, Okay,

       5      maybe I'd be more apt to try.

       6             We also have a number of youngful [sic] --

       7      young clients that we see, that are beginning to get

       8      into more of crimes on a minor basis, because some

       9      of their comments have been:

      10             "Well, they won't hold me accountable.  I'm

      11      still a youthful offender."

      12             "They won't hold me accountable" if they're

      13      17 or 18 "because the jail's full."

      14             So they're looking to see how to manipulate

      15      their environment.

      16             But in regard to the treatment of this, the

      17      longer that you have, the more that you can taper

      18      the supports, the better chance you're going to have

      19      the first time out.

      20             And I would definitely defer to Jodie from

      21      Renaissance House, next, to explain that.

      22             SENATOR RANZENHOFER:  We're going to take the

      23      woman in the black, who raised her hand.

      24             Yes, you.

      25             So you want to make a comment?







                                                                   72
       1             AUDIENCE MEMBER:  [Inaudible/no microphone

       2      used.]

       3             SENATOR RANZENHOFER:  Use the microphone.

       4             And then the woman in the gray will go after

       5      her.

       6             And does anybody else -- well, the gentleman

       7      in the back will be next.

       8             SHERRY PLASIC [ph.]:  Well, I just wanted to

       9      tell a little bit about my son Daniel.

      10             My name is Sheryl Plasic [ph.].  I'm here

      11      with my son Dan.  We're from Niagara Falls,

      12      New York.

      13             My son was a veteran.  He came home.  He was

      14      a journeyman plumber.  Bought his own home at 23.

      15      Was doing extremely well.

      16             And, he hurt his back at work, and was

      17      prescribed by a large pain-management facility here

      18      in Western New York, he was prescribed large amounts

      19      of Lortab.

      20             We didn't realize he was addicted until he

      21      came to us and said he wanted to stop taking them

      22      and he couldn't do it on his own.

      23             And we started at ECMC.

      24             We went to Lakeshore.

      25             On to the VA.







                                                                   73
       1             But I think talking about the facilities and

       2      a places for people to go when they are addicted is

       3      so important.  We need more facilities built in our

       4      area.

       5             The one at Horizon, which they're trying to

       6      get going, I can't believe that they even have to

       7      have a problem getting that built.

       8             My son, finally, after begging the VA to get

       9      him in there, he hung himself the first night he was

      10      there.

      11             So I guess, along with what everybody else

      12      has said about the stigma attached to it, and how

      13      the new face of addiction is these days, it is.

      14             This is what the new face of addiction is

      15      [pointing to picture being held up].

      16             I just hope we can get that facility built in

      17      Sanborn because I really think we need more.  A lot

      18      more.

      19             Thank you.

      20             SENATOR RANZENHOFER:  Thank you,

      21      Sheryl [ph.].

      22             I'm very sorry about the loss of your son.

      23             And the braveness that you showed in coming

      24      here today and sharing that with us, I appreciate

      25      that.







                                                                   74
       1             SHERRY PLASIC [ph.]:  [No microphone used.]

       2             Thank you.

       3             We were a big part of getting the I-STOP,

       4      along with Saving Michaels of the World.

       5             And our PSA is on through Painkillers Kill

       6      More Than Pain.  And one of those three are my

       7      husband and I, putting up my son's picture, trying

       8      to educate people about what addiction is.

       9             SENATOR RANZENHOFER:  I remember dealing

      10      with, you know, families like yours, when we were

      11      dealing with the I-STOP program, and, you know, the

      12      tragedies that occurred, you know, that led up to

      13      the implementation of that program.

      14             The woman in the -- well, you know who you

      15      are because you're already standing up.

      16                  [Laughter.]

      17             JODIE ALTMAN:  I do because I'm antsy.

      18             Hi, I'm Jodie Altman.  I'm the director of

      19      the Renaissance Campus in West Seneca, and we're a

      20      62-bed campus for adolescents, ages 12 to 20.

      21             70 percent of our kids are addicted to

      22      heroin, 90 percent to pills.

      23             Our problem is twofold.

      24             The ones that are under 18, there's nowhere

      25      to send them for detox, because people think they







                                                                   75
       1      don't need detox, and so we lose them from

       2      treatment.

       3             Bigger than that, when you talked about

       4      Medicaid, and getting your child off of health

       5      insurance to get them on Medicaid, right now, our

       6      kids are carved out of the managed Medicaid until

       7      2015.

       8             If they are not kept carved out, treatment as

       9      we know it for these 13, 14, 15, 16, and up, kids

      10      will no longer exist, because, then, like the

      11      insurance companies, Medicaid will say, We'll treat

      12      them in 7 days.

      13             You don't treat an addict -- an opiate

      14      addict, and a 12-year-old opiate addict, in 7 days.

      15             So our issue right now, that we need help

      16      from -- from everybody, but also, you know,

      17      specifically from this Committee, is we need to keep

      18      this carve-out.  We need to not allow managed care

      19      to affect our adolescents, or else our program and

      20      programs like us, which there are none in

      21      Western New York, will close.

      22             So that's our issue.

      23             SENATOR RANZENHOFER:  Okay.  Thank you.

      24             I just turned to Senator Boyle.

      25             He said that that's an issue that's come up







                                                                   76
       1      at a number of hearings, this carve-out issue.

       2             Because I wasn't sure if it was a state or

       3      federal.

       4             He said that is an issue that we can deal

       5      with.

       6             SENATOR BOYLE:  We have some input on that.

       7             SENATOR RANZENHOFER:  Okay, great.

       8             There was a gentleman in the back.

       9             And then -- why don't you come on up, and

      10      walk to the microphone.

      11             And then the gentlemen in the black shirt,

      12      with the white, you'll follow him.

      13             Okay.

      14             NICHOLAS BURKE [ph.]:  Yes, my name is

      15      Nicholas Burke [ph.].  I'm the school security

      16      officer for the Batavia City School District.

      17             And I work closely, and I, you know, want to

      18      thank the City of Batavia Police Department, because

      19      I work with them, you know, regularly throughout the

      20      year.

      21             One of the things that I wanted to mention

      22      was, you know, and so far, a lot of people have

      23      mentioned about the treatment and the recovery from

      24      drug addiction.

      25             But I've been in my position at the school







                                                                   77
       1      since 2001.  And I would say, within the last

       2      three or four years, probably since 2010, the

       3      general drug culture at every school in

       4      Genesee County has increased tremendously.  And I'm

       5      not just speaking for Batavia.

       6             I've gone to forums at -- you know, talked to

       7      the officer at BOCES, and at every school, there's

       8      just a significant increase in drug culture.

       9             And I think that we need to try to find a way

      10      to educate kids, as early as elementary school,

      11      middle school, about the dangers of, not only heroin

      12      and opiate addiction, and -- and, you know, the

      13      harder drugs, but, also, you know, marijuana,

      14      et cetera.

      15             Just a brief story:

      16             I coach.  I coach track and field, and

      17      football, for Batavia.

      18             And I was at a track meet this winter, and

      19      I had a girl on the team that I coach, like, you

      20      know, in a public setting, pleading with her mom to

      21      buy her a vape.  An e-cigarette.

      22             And, you know, pleading:  Mom, mom, everyone

      23      is using these e-cigarettes.  You know, all my

      24      friends, they got them.  We -- they vape all the

      25      time.







                                                                   78
       1             And the problem is, is that there's no -- at

       2      this stage, there is very little or no state

       3      regulations on e-cigarettes, but what these kids

       4      have found is, they can take marijuana oil, hemp

       5      oil, which is 90 percent potent, and they can put it

       6      in their vaporizer and they can use it.

       7             And it doesn't smell like pot.  So, like, you

       8      know, when I'm at school, I can't sense it or smell

       9      it when I -- you know, whatever.

      10             You know, and it's very accessible.

      11             And so what we have is, we have these kids

      12      whom, culturally, you know, because of, that's just

      13      the way, you know, it is right now, who think that,

      14      you know, vaporizing, vaping, is okay.

      15             You know, and I think Dr. Baker mentioned

      16      about the correlation between, you know, whether

      17      marijuana is a gateway drug or not.

      18             But -- but I just see this heightened drug

      19      culture in the last few years.  And I think that

      20      that's partly to, you know, explain some of the

      21      increase in the heroin and opiate addictions, and,

      22      you know, the troubles in rehab, et cetera.

      23             So if I could just recommend some -- you

      24      know, one thing, it would be, you know, dealing with

      25      the treatment.  And the rehab is, obviously, a huge







                                                                   79
       1      undertaking and trying to solve that.

       2             But I think that we also, because that's so

       3      difficult, need to focus on the education, and

       4      trying to prevent, and to -- to, you know, lessen

       5      this drug culture before it starts.

       6             You know, this girl that was talking to her

       7      mom is a 97-average student at our school, who's had

       8      zero referrals for discipline.  She's not a bad kid,

       9      and she thinks it's okay.

      10             You know?

      11             The other thing with the vaporizers, as far

      12      as the, uhm, you know, state regulations, or

      13      starting to do this, you know, come up with some

      14      sort of regulations for them.

      15             The nicotine oil that you can buy comes in

      16      flavors.  It smells like cherry, smells like

      17      blueberry.

      18             And, you know, a 5-year-old kid, and, you

      19      know, you can buy them in town.  And, you know,

      20      I see 16-, 15-year-old kids with them, you know,

      21      regularly.

      22             It's nicotine.  You know, it's the equivalent

      23      of putting, I don't know, 100 nicotine patches on

      24      your skin.

      25             And a mom or dad can leave that nicotine oil







                                                                   80
       1      sitting on their table, and it smells like cherry.

       2      And a 5-year-old kid can go and put pick that bottle

       3      up and squirt it in their mouth, and it will kill

       4      them.

       5             You know?

       6             And, so, you know, in regards to, kind of

       7      getting off the subject a little bit, the heroin and

       8      the opiate addiction, and trying to solve that

       9      problem or educate, I think that we need to look at

      10      trying to educate kids, and trying to regulate some

      11      of the things that are the gateway to leading to the

      12      stronger drugs.

      13             So -- so, thank you.

      14             SENATOR BOYLE:  Thank you very much.

      15             SENATOR RANZENHOFER:  Thank you.

      16             Thank you, Nicholas.

      17             The gentleman in the black shirt.

      18             JASON NORTON:  Good morning.

      19             Can you hear me?

      20             Okay.

      21             I'm Jason Norton, and I currently am employed

      22      at the YMCA, and my wife and I co-pastor at

      23      EFF Church in the YMCA.

      24             I didn't think I would come here today and

      25      speak, but there was a short story that I wanted to







                                                                   81
       1      share with you.

       2             I also have a history of drug addiction and

       3      alcoholism, and it sums back many years, and has

       4      crept back into my life later.

       5             I'm sober now, obviously.

       6             But, I came here today to tell a quick story

       7      about my brother.

       8             My younger brother is, as of last night at

       9      10:00, had six days clean, on heroin.

      10             I haven't spoken to him yet today.  He works

      11      the B shift.

      12             He is just now coming to his four days off

      13      with the holiday, and got paid, so I'm hoping that

      14      he maintains his sobriety.

      15             But he himself had trouble trying to get into

      16      GCASA.  And one of the reasons also was, he's

      17      working.  That's one thing he didn't lose yet.

      18             But the whole Suboxone issue, with the

      19      doctors, he couldn't -- you know, you got to see a

      20      certain doctor in order to get the Suboxone.

      21             He's been trying to quit for two months.

      22             You know, unfortunately, we're all busy

      23      people, and we can't walk with people, hand in hand.

      24      I can't be with him 24 hours a day to make sure that

      25      he makes the right choices, or doesn't go hang out







                                                                   82
       1      with somebody that he's been using it with.

       2             And a lot of us know, and we sit around

       3      worrying, like, Well, how they are doing?

       4             But, he himself also had two overdoses.

       5             And another bit of awareness I want to bring

       6      is, he was a marijuana smoker.

       7             I can't remember if he got in trouble with

       8      the law, or how it happened.  He probably ended up

       9      in a program.  But, somebody had prescribed him

      10      Suboxone to get off marijuana.

      11             Because of that, he ended up on street

      12      heroin.  You know, he was an intravenous-user.

      13             And so he's been struggling, and this has

      14      been going on for 20 years.

      15             He was sober.

      16             And, of course, the same story that we've

      17      been hearing here today.

      18             He fell off a motorcycle, got back on pain

      19      pills, which led back to heroin.  For the last

      20      nine months, he's been running, of course, to

      21      Rochester, or wherever he can get it.

      22             So I wanted to just bring an awareness,

      23      I think that the education part, as far as the --

      24      medically, you know, what we're prescribing.

      25             And I just want to echo what I'm hearing, is







                                                                   83
       1      our lack of being able to prescribe the medications

       2      to help people get off the opiates.

       3             But, also, the overprescribing of the opiates

       4      and the heroins and the painkiller -- not heroin,

       5      but the painkillers that is leading to this problem.

       6             And I just wanted to put one more note in

       7      there.

       8             There are -- I think programs are starting to

       9      rise up that maybe some of us are not aware of.

      10             Total Freedom is a faith-based program in

      11      Darien, that is an eight-month program, minimum.

      12             And if the people are willing to work it,

      13      they're pretty strict out there.

      14             They also help them get back on their feet.

      15      They help them get work.  Make them -- you know, get

      16      them to be a better, you know, success in the

      17      community, or whatever, and in society.

      18             So that's just something that I wanted to

      19      throw out there.

      20             But, you know, I think the difficulties and

      21      all the red tape of the insurances and trying to get

      22      into some of these programs, and then, of course,

      23      the prescriptions, and -- I think leads to these

      24      street drugs that, then, people just find themselves

      25      stuck on.







                                                                   84
       1             But, again, addiction crosses all cultural

       2      lines, whether you're making six-figures or sleeping

       3      behind the dumpster at Wendy's.  I mean, it's --

       4      it's in our face.

       5             So, I wanted to say thank you to everybody

       6      that's here, and all of you guys for bringing all

       7      this awareness.

       8             So, thank you very much.

       9             SENATOR RANZENHOFER:  Well, thank you, Jason.

      10             DONNA SHERMAN:  Senator, I wanted to bring to

      11      this group's attention that there is a SAMHSA report

      12      called the "DAWN Report" (Drug-Abuse Warning

      13      Network).

      14             And what it -- there's a report called

      15      "The Drug-Related Mortality."

      16             And what they do is, they track the responses

      17      of participating communities, on the incidence,

      18      causes, and demographics related to drug overdoses.

      19             Not all counties in New York State are

      20      participating in this data-collection effort.

      21             For Buffalo and Niagara, and the last report

      22      was in 2010, and it showed, I think about -- and I'm

      23      going to get the numbers a little bit wrong, but

      24      they're pretty close ballpark -- around

      25      85 drug-related mortality cases.







                                                                   85
       1             In Buffalo-Niagara, 34 of those overdose

       2      deaths occurred in health-care facilities.

       3             I'm really moved by a lot of the parent and

       4      provider testimony that I'm hearing today, because

       5      addiction really causes sorrow in all of us.  And we

       6      struggle when our family members are caught up.

       7             For us at the VA, we -- our heart goes out to

       8      our veterans who served their countries, and came

       9      back to face addiction-related issues on opioids.

      10             We work as hard as we possibly can at VA to

      11      help any veteran who comes to us.

      12             We have no waiting list, and we have capacity

      13      to treat any veteran who has opioid or other drug

      14      problems.

      15             SENATOR RANZENHOFER:  Well, I think the

      16      comment, but for the grace of God, it could be

      17      anybody.  You know, it's not defined by, you know,

      18      where you live, who your family is, you know, how

      19      much you make, what your job is.

      20             I mean, it is just out there everywhere.

      21             And, you know, it could be my family.  It

      22      could be your family.  It could be your nextdoor

      23      neighbor's family.

      24             You just -- you know, you just don't know.

      25             No one is immune from this situation.







                                                                   86
       1             I did see a couple of other people's hands up

       2      there.

       3             Why don't we take a couple of the comments

       4      from here.

       5             John.

       6             JOHN BENNETT:  Yeah, I guess, I -- you know,

       7      I've heard a lot of testimony today, and especially

       8      around the lack of beds in Western New York.

       9             And I want to say that, you know, that

      10      Terence O'Leary, who's the director of Bureau of

      11      Narcotics, was up here last year.  He spoke at the

      12      regional consortium.

      13             He said that New York and -- Western New York

      14      and Long Island were the two trouble spots in

      15      New York.

      16             I think he said that the rates of

      17      prescription medications were seven times that of

      18      the rest of the state, or something like that.  It

      19      was close to that.

      20             So we've known for a while, that

      21      Western New York.

      22             And I do appreciate that we did get 25 new

      23      beds in Western New York, but you can see that

      24      25 beds really has made just -- you know, it's a

      25      drop on the head of a pin.







                                                                   87
       1             And I know Amanda spoke about -- you know, we

       2      run a 17-bed community residence.

       3             We've talked for a long time about having a

       4      male and a female residence.

       5             And so we have a co-ed, because we want to be

       6      able to offer services to women.

       7             It used to be an all-male facility.

       8             And there are struggles with having a co-ed

       9      facility, for staff and for patients.

      10             And it's very difficult, depending on your

      11      background, when you come into a co-ed facility, to

      12      maintain your sobriety in there.

      13             So, I just want to put a -- you know, put a

      14      plug in for beds in this region.

      15             I mean, that's -- it's a huge need in this

      16      region, and we've known it for a while.

      17             So, I mean, the data is out there.

      18             So, that's all.  I just wanted to --

      19             SENATOR RANZENHOFER:  Thanks, John.

      20             COLLEEN BABCOCK:  If I could just interject

      21      on that a moment, we did get approved for the

      22      25 beds, but we don't have them yet.  We're waiting

      23      for the young-adult treatment facility to be built

      24      in Sanborn, which is going --

      25             SENATOR RANZENHOFER:  That was the comment,







                                                                   88
       1      yeah.

       2             COLLEEN BABCOCK:  Yeah.

       3             -- which is going to be -- or is designed to

       4      meet the needs of the young-adult opiate-addicted

       5      brain, 18 to 25.

       6             We drastically need that facility to open.

       7             And it was supposed to start in the fall of

       8      this year.  And I know that it's been pushed off a

       9      little bit more.

      10             But, again, any input that you can have in

      11      getting that moved along would really, really help

      12      our community.

      13             We have, as I said earlier, 90 to 120 young

      14      adults, 18 to 27, waiting on that list to get into

      15      Horizon Village.

      16             SENATOR BOYLE:  Was that a funding issue or a

      17      zoning issue?

      18             Or do you know what the holdup is?

      19             COLLEEN BABCOCK:  I don't know exactly what

      20      the holdup is.

      21             AUGUSTA WELSH:  I think it's a red-tape issue

      22      with people who need to --

      23             SENATOR RANZENHOFER:  Sounds familiar.

      24             AUGUSTA WELSH:  -- with people who need to

      25      approve the facility.







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       1             It's not for lack of wanting to get it going.

       2             SENATOR BOYLE:  By "the people," you talking

       3      about OASAS, on the state level?  Or the --

       4             AUGUSTA WELSH:  [Nods head.]  Uh-huh.

       5             SENATOR BOYLE:  Really?

       6             Okay.

       7             SENATOR RANZENHOFER:  Okay.

       8             Well, that's something that we can easily

       9      take a look at.

      10             SENATOR BOYLE:  Uh-huh.

      11             SENATOR RANZENHOFER:  A couple of ladies, two

      12      or three back there.

      13             We can go for about another, maybe 15,

      14      20 minutes, maybe even a little longer.

      15             But why don't we -- the people that want to

      16      speak, why don't you actually all kind of migrate

      17      over to the microphone.

      18             ROSEMARY CHRISTIAN [ph.]:  Thank you very

      19      much.

      20             I am Rosemary Christian [ph.]

      21             I want to thank you.  This was very

      22      educational to me.

      23             I want to say there are men and women that

      24      have served our country.  Thank you.

      25             But this has happened for years and years.







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       1      Ever since the Vietnam war, my friends have come

       2      back addicted.

       3             Education, we need it, from second grade, on.

       4             We need family structure.  No doubt about it.

       5             I want and I need an answer, as to why our

       6      Governor or this state is possibly going to pass

       7      marijuana?

       8             Tell me, how can we?

       9             SENATOR RANZENHOFER:  Well, I appreciate your

      10      comments.

      11             We're not going to get into a -- you know, a

      12      discussion.

      13             ROSEMARY CHRISTIAN [ph.]:  I'm trying to --

      14             SENATOR RANZENHOFER:  I understand what

      15      you're say.

      16             ROSEMARY CHRISTIAN [ph.]:  But the thing of

      17      it is, here's our state representatives that are

      18      possibly passing it for medical purposes, fine.

      19             But it doesn't lead just to medical purposes.

      20             Look at Colorado and what's happening there.

      21             SENATOR RANZENHOFER:  Yeah, and I understand,

      22      actually, that's an issue that's being discussed

      23      with the Legislature.

      24             And we've had meeting rooms like this filled

      25      with 300 people, saying that their babies need these







                                                                   91
       1      medical oils to cut their seizures from 150 a day,

       2      down to 2.  And they have a very, very compelling

       3      story to tell, also, that they suffer every single

       4      day, watching their kids go through these seizures,

       5      any of which can kill them.

       6             So, it's a complicated issue which is being

       7      discussed right now.

       8             I'm not sure what the resolution of that is

       9      going to be.

      10             You know, I've listened, and I know

      11      Senator Boyle has listened, to both sides of the

      12      story.  And, you know, it's a very, very tough issue

      13      that we are going to be dealing with.  Not the

      14      recreational use of it, but, medical use, and

      15      whether there should be limited medical use for

      16      children, you know, to stop their seizures.

      17             So it's an issue, I appreciate your bringing

      18      that up.  And, again, it's something that's on our

      19      minds every day as we're dealing with this issue, as

      20      well.

      21             ROSEMARY CHRISTIAN [ph.]:  Like I said,

      22      Senator, I can understand the medical issues of it.

      23             But the fact that the recreational, no,

      24      I can't.  And it should have been stopped.

      25             It just, apparently, seems like some of our







                                                                   92
       1      state legislators just don't have the balls to do

       2      anything properly.

       3             Thank you.

       4             SENATOR BOYLE:  We're not going to legalize

       5      marijuana for recreational purposes, I can tell you

       6      that.

       7             SENATOR RANZENHOFER:  That's not going to

       8      happen.

       9             Thank you, Rosemary.

      10             Yes, ma'am.

      11             CINDY B.:  My name is Cindy B., and we lost

      12      our son a year ago to heroin-fentanyl overdose.

      13             I just wanted to speak about three different

      14      things:

      15             One, the education of physicians.  They need

      16      to know conditions, such as ADD, predispose people

      17      to addiction.

      18             The marijuana issue:  My son was out of jail

      19      and clean.  He smoked marijuana with a friend.  It

      20      lowered his inhibitions.  He came home and found

      21      some pills he had stashed, and OD'd.  We did not

      22      have Narcan.  We were able to save him that time.

      23             We have insurance.  It covered any program we

      24      could have got him into.  Fought tooth and nail to

      25      get him in rehab several times.







                                                                   93
       1             Finally, we did get him into a couple

       2      different programs.

       3             Once, again, when he came out, there isn't

       4      the support afterwards.  You come out of rehab and,

       5      there you are.

       6             So, we also had him end up back in jail

       7      again.

       8             And after doing, I believe it was, like,

       9      six months, and he was sober, and he did want rehab.

      10             Unfortunately, he didn't have an active

      11      addiction at that time.

      12             So rehab, at a point in time when he was

      13      clear and level-headed, that may have worked for him

      14      because he was going into it willingly with a clear

      15      mind.

      16             It wasn't an option for him because he didn't

      17      have a current addiction.

      18             So I would like to see laws where, crimes

      19      that are addiction-generated, they have a component,

      20      after jail, where they do have to go to rehab, where

      21      they can learn the skills to continue their lives

      22      drug-free.

      23             Thank you.

      24             SENATOR RANZENHOFER:  Well, thank you, Cindy.

      25             MARY PHILLIPY [ph.]:  Hello, my name is







                                                                   94
       1      Mary Phillipy [ph.].

       2             I'm here is a parent.  I have five sons, two

       3      of which are addicts.

       4             My oldest son Anthony told me his first time

       5      smoking marijuana was when he turned 11, in the

       6      first month of being 11 years old.

       7             By the time he was 15, he was addicted to

       8      heroin.

       9             At the age of 22, he had already had

      10      three overdoses.

      11             I sent him to a rehab.

      12             After five days of calling around and trying

      13      to find anyplace that he could get into in

      14      Western New York, and I ended up taking him to a

      15      place in Louisiana.  It cost me $40,000 of our

      16      life's savings.

      17             He was there for 7 1/2 months.

      18             In the first hour of leaving that bubble, he

      19      was dropped off at the airport, to come home, and

      20      his anxiety hit the roof so much that he went to the

      21      bar with the $10 that they gave him.

      22             So he relapsed within the first hour.

      23             There was no recommendation of any

      24      counseling, except for, that there was an open line

      25      to them forever, if he needed to call.







                                                                   95
       1             Unfortunately, I wasn't -- still wasn't

       2      educated enough to understand fully.  And I feel

       3      I should have been, because I lost my mother to

       4      addiction.  My brother is in the hospital dying

       5      right now from liver disease to his heroin addiction

       6      and alcoholism.

       7             I have an 18-year-old who's addicted to

       8      marijuana and alcohol.

       9             Uhm, the gateway, marijuana, in my eyes, it

      10      is a gateway.  It's just that start of leading up to

      11      more dangerous drugs.

      12             When Anthony relapsed, I did the same thing

      13      that I did the first time, only I -- instead of

      14      calling around Western New York, I drove between

      15      Western New York and Pennsylvania, for 48 hours,

      16      trying to find him a place to go, because he asked

      17      for help again.

      18             Couldn't find a place to go.

      19             I took him home, and his withdrawal was so

      20      overwhelming for him, that he took off.  Stole keys

      21      took off, and he stole a dirt bike from our land.

      22             I had to put him in jail.

      23             I put him in jail.

      24             And while he was in jail, I called the

      25      insurance company, begging them to let him go







                                                                   96
       1      somewhere.

       2             As a result of that, I took him out on his

       3      23rd birthday.  I took him to a 28-day rehab

       4      which, again, was out of state.  Not in state.  It

       5      was in Pennsylvania.

       6             Within a week and a half of him being home,

       7      he relapsed again to alcohol.

       8             Four days ago he tested positive for heroin

       9      and cocaine.

      10             In the past month, he's lost 30 pounds, and

      11      I'm at my wit's end.  I don't know where to go from

      12      there, because there is no place for -- I mean,

      13      there's places to go, but they don't have the help.

      14             28 days doesn't work.

      15             And when you talk about the 28 days and

      16      failing, you have to fail at outpatient before you

      17      even get 28 days.

      18             I had to fight for that over and over and

      19      over again, and by the grace of God, I got him the

      20      28 days; only, now, he's right back in the same

      21      situation he was before, because the drugs are not

      22      the problem for the addict.  Reality is the problem

      23      for the addict.  It's the anxiety.  It's the brain

      24      damage that's caused by the heroin, or the other

      25      drugs done before they get to the heroin.







                                                                   97
       1             He already had a mental disorder, the anxiety

       2      and depression.  And after doing the heroin, now

       3      he's got an added brain disorder: brain damage.

       4             So we do need a huge change.

       5             I brought two readings that he wrote, so that

       6      you can hear from the addict's point of view, from

       7      someone who's in pain.

       8             The first one he wrote in full addiction

       9      while he was high.  And the second one he wrote just

      10      after he entered rehab and he was clean.

      11             "Lord, tell me, will I ever be forgiven for

      12      this life I'm living?

      13             "It's so hard to see the sun from the bottom

      14      of the grave.

      15             "Will my eyes ever perceive Him?

      16             "By demons I have always been driven.  I've

      17      run these tracks for so long, you know I've lost my

      18      way.  I've cut the flesh, the bone, the tendons, but

      19      will I ever find redemption?

      20             "Lost my soul so long ago, how will I carry

      21      on?

      22             "Although my hand the snake has bitten, I no

      23      longer want to be my own victim."

      24             This one he wrote after being clean.

      25             "I'm feeling horribly sick.  I'm sick of all







                                                                   98
       1      these feelings.  They creep up from the floor and

       2      crawl across the ceiling.  They feed upon my soul

       3      and my soul is depleting.

       4             "My wrist forever scarred, my heart forever

       5      bleeding, oh, so long ago I dug my trenches, and now

       6      I don't care much for the body cleanses.

       7             "I can walk a million miles, I may dig a

       8      thousand feet, but will I ever find the happiness

       9      that's right in front of me?

      10             "Oh, so many times I've passed my trials, for

      11      I'm still walking strong at a million miles, but my

      12      feet are blistered raw and they're bloody to the

      13      bone, and every step I take takes me further from my

      14      home.

      15             "Oh, so many times I've drowned my sorrows,

      16      but tonight I wonder if I'll see tomorrow.

      17             "Will the sun refuse to shine?

      18             "Will I open my eyes?

      19             "Will I see the light of day and will I still

      20      feel all of this pain?"

      21             SENATOR RANZENHOFER:  Thank you, Mary, for

      22      sharing that information.

      23             Thank you.

      24             How old is your son?

      25             MARY PHILLIPY [ph.]:  Twenty-three.







                                                                   99
       1             SENATOR RANZENHOFER:  Thank you.

       2             MARY PHILLIPY [ph.]:  Thank you.

       3             JEFFREY GRAY [ph.]:  My name is Jeffrey Gray.

       4      I'm a counselor at GCASA.

       5             And, first, I'd like to thank you, Senators,

       6      for being here for the forum today.

       7             I guess what I've heard is, I don't know if

       8      any new laws are going to help or change.

       9             I think maybe regulation, insurance-company

      10      regulations.

      11             I echo the sentiments of previous speakers

      12      that sometimes it just seems impossible to get

      13      somebody into treatment.  They have to fail at

      14      outpatient.  And sometimes failing for our people

      15      means that they're dead.

      16             I think Mr. Bennett mentioned we need more

      17      Suboxone providers.

      18             I think the regulations with insurance

      19      companies need to change, where we can get somebody

      20      into a long-term residential program, because it

      21      seems to be what works best for opiate people.

      22             I was sitting there, thinking, I remember,

      23      I've been -- I've been with GCASA for a total of

      24      10 years.  And I think the first person that

      25      I encountered that was an opiate addict, was a young







                                                                   100
       1      man, 18 years old, from Warsaw, New York.

       2             And I don't even think I worked at GCASA.

       3      I think I was just doing my internship through

       4      Genesee Community College.

       5             And I was just flabbergasted that this

       6      18-year-old kid from a small little town, Warsaw,

       7      New York, was addicted to heroin.

       8             And I had many conversations with him, trying

       9      to figure out did this -- you know, Where did you

      10      start?  And, you know, how did you end up being

      11      addicted to heroin, from Warsaw?

      12             It wasn't Buffalo or Rochester or

      13      New York City.  It was this tiny little town.

      14             Ten years later, I have to tell you, I'm not

      15      shocked anymore when I have conversations.

      16             And that stinks, that I'm not shocked anymore

      17      that there's 18-year-old kids from small little

      18      hamlets in the middle of nowhere that are addicted

      19      to heroin.

      20             Again, sir, I just echo the statements, that

      21      I think three things that we need are:

      22             Better regulations with insurance companies

      23      so that we can get somebody into long-term care;

      24             More Suboxone providers;

      25             And I think, more beds.  We need more







                                                                   101
       1      long-term residential beds to treat these people.

       2             Thank you.

       3             SENATOR RANZENHOFER:  Thank you, Jeffrey.

       4             MIKE:  Hi, my name is Mike, and I'm an

       5      alcoholic.

       6             Oh, I'm sorry.  Wrong meeting.

       7                  [Laughter.]

       8             AUDIENCE MEMBER:  Hi, Mike.

       9                  [Laughter.]

      10             SENATOR RANZENHOFER:  That was pretty funny.

      11             MIKE:  Just a couple things I want to

      12      mention.

      13             I got straight in 1972 in Buffalo, New York.

      14             And, I had a conversation with a guy who

      15      worked in Gary's profession, and he encouraged me to

      16      get some help.

      17             And I ended up talking to a guy named

      18      Dick Gallagher [ph.].  And Dick Gallagher sent me to

      19      see David Mahoney, who was an attorney.

      20             And David Mahoney put me in front of

      21      Judge Doerr.

      22             And, Judge Doerr sent me to a Presbyterian

      23      minister, who ended up being my therapist.

      24             And all of these people did one thing: they

      25      talked to each other.







                                                                   102
       1             I couldn't lie to one and run to the other

       2      one and lie to them.

       3             In case you don't know it, addicts lie.

       4             And I couldn't play anybody off against

       5      anybody.  Everybody talked.

       6             Law enforcement has a real tough job.  They

       7      have to deal with my relapses.

       8             Treatment providers have a hard job because

       9      they have to find out what's the truth and what's

      10      not the truth.

      11             And it's a difficult job dealing with

      12      addicts.

      13             I just want to emphasize again, I'm a

      14      recovering addict.

      15             Law enforcement has a hard job; a real hard

      16      job.  I wouldn't want their job.

      17             The other thing I want to mention to you,

      18      just briefly, is that I noticed that when we stood

      19      up and faced the flag, we said "under God."  We all

      20      did this morning.

      21             Try to find the "G" word in treatment

      22      anymore.

      23             Try and find it.

      24             You won't see it.

      25             If you read the early literature of







                                                                   103
       1      Alcoholics Anonymous and Narcotics Anonymous, the

       2      "G" word is through the whole book.

       3             If you want to know why relapses are so bad,

       4      go back to the original literature.

       5             Faith has a great deal to do with recovery.

       6             "Faith has a great deal to do with recovery."

       7             I would encourage people -- and by the way

       8      I'm not a pastor.

       9             I would encourage everybody -- law

      10      enforcement, Senators, everybody -- to look at the

      11      early history of the recovery movement in the

      12      United States.  It was faith-based.

      13             Faith has a lot to do with making people

      14      well.

      15             And, once again, we started the meeting today

      16      with "under God."

      17             Thanks a lot, guys.

      18             SENATOR RANZENHOFER:  Thank you, Mike.

      19             A couple of final thoughts from the panel,

      20      and then we'll wrap up.

      21             I know that Senator Boyle has got to catch a

      22      plane.

      23             So, anybody want to add some final thoughts?

      24             Sheriff.

      25             SHERIFF GARY MAHA:  Senator, just a comment







                                                                   104
       1      on the e-cigarettes.

       2             I know one gentleman brought it up.  I think

       3      I heard it from one of the panel people.

       4             I talked to Senator Gallivan about this back

       5      in January because of the concerns we've had on this

       6      same issue with, you know, dealing with

       7      e-cigarettes.  And this is the fad nowadays of young

       8      kids.

       9             If you go into these smoke shops on the

      10      reservation, they have all kinds of flavors of oil

      11      they can vaporize, and they're putting drugs in

      12      there.

      13             So I think there's something there that we

      14      need to address as far as regulation of

      15      e-cigarettes.

      16             SENATOR RANZENHOFER:  Thanks.

      17             Any comments, Doc?

      18             DR. BRUCE BAKER:  I do.

      19             It is difficult to get people in treatment.

      20             But what is very frustrating, is some people

      21      will get right there, but they just -- no matter

      22      what you do, no matter what you say, they refuse

      23      treatment.

      24             And that is one of the most difficult things

      25      to deal with.







                                                                   105
       1             Isn't that right, Mike?

       2             COLLEEN BABCOCK:  I will kind of interject on

       3      that.

       4             My son, my 19-year-old son, didn't go into

       5      treatment willingly.  He did not think he had a

       6      problem.  He thought life was fine.

       7             And I was the driving force behind that for a

       8      long time.  But, we got to a point in our

       9      relationship where we were able to set some clear

      10      boundaries.  And I have never, ever veered from

      11      those boundaries.

      12             And my son's clean today, for three years.

      13      There's been ups and downs, but, somewhere along

      14      that journey something clicked.  Something clicked

      15      with why he was there; why he was working that

      16      recovery; with his faith.  His faith changed and

      17      grew.

      18             You cannot expect -- and I'll say this a

      19      thousand times over.  I'll go to my grave with

      20      it. -- you cannot expect a young adult, especially

      21      in active addiction, to make a rational decision.

      22             As a parent or a support, you need to make

      23      those decisions for them.  And you need to be that

      24      driving force.  And then you need to pray and hope

      25      that something does click, because you're always







                                                                   106
       1      going to have people that are going to choose to

       2      stay in addiction.  They're going to choose to

       3      never, ever change.

       4             That's been through the course of history.

       5             But you're also going to have those success

       6      stories, like my son, who decided that life could be

       7      different.

       8             SENATOR RANZENHOFER:  Thanks, Colleen.

       9             JOHN BENNETT:  Yeah, Colleen, I just want to

      10      say, I mean, I agree with that.

      11             I think that, on a huge level, you know,

      12      people who are coerced into treatment do very well.

      13      In fact, probably do better in long-term care; and,

      14      because, something happens while they're in

      15      treatment.

      16             COLLEEN BABCOCK:  Uh-huh.

      17             JOHN BENNETT:  And that's where the longer

      18      stays help, because it's very difficult to -- you

      19      know, to get it early on.

      20             I mean, we know that denial is part of this

      21      illness; and, so, it is just hugely important to

      22      have people in longer treatment stays.

      23             You know, we're all worried about the whole

      24      redesign, the Medicaid redesign, which I know is

      25      coming.  And I think there's some opportunities for







                                                                   107
       1      us, hopefully.

       2             But we all, we just don't know where that's

       3      going to fall for our patients.

       4             And so, I mean, I know that's been talked

       5      about already today, some of the Medicaid stuff.

       6             And so, hopefully, you know, all of these

       7      types of facilities and types of treatments will

       8      still be available a year or two years or five years

       9      from now, I mean, because it's a continuum of care,

      10      and we need all of them, so...

      11             ASST. U.S. ATTY TIMOTHY LYNCH:  Mike, I just

      12      want to share one story.

      13             You know, at the federal level, we're so

      14      often focused on the major suppliers who bring

      15      heroin into our area, and the doctors, and the

      16      people who divert the drugs.

      17             But in one instance, I had one of the

      18      prosecutors in my office come to me and say:  Hey,

      19      I've got this witness, it's a young girl.  She can

      20      be a vital witness on this case that I have.

      21             It's not somebody we would normally charge,

      22      but, you know, he said to me, "She's got this

      23      serious heroin addiction."

      24             And she couldn't get the resources that were

      25      needed for her to overcome her addiction.







                                                                   108
       1             So we eventually agreed, although we wouldn't

       2      have charged her originally, we charged her just so

       3      we could get her into treatment.

       4             And, you know, it's not something we would

       5      normally want to do, but we really saw it as the

       6      only option.

       7             And, you know, I know from -- I know some

       8      people -- and I haven't heard it here, but some

       9      people look at law enforcement as the problem -- you

      10      know, one of the problems sometimes, or, we're

      11      trying to arrest people, arrest our way out of the

      12      problem.  And I don't think that's the case.

      13             You know, we -- in our system, you know, we

      14      often send a lot of people to treatment programs.

      15             We're not looking to incarcerate, you know,

      16      the individuals who are addicts, but there really

      17      sometimes is that forced or coerced treatment that's

      18      necessary.

      19             So...

      20             COLLEEN BABCOCK:  I commend you.

      21             SENATOR RANZENHOFER:  I think what we'll do

      22      is, I'm going to just have Senator Boyle make a few

      23      comments, and then I'll make comments.

      24             And a number of us will be around for a

      25      while, if there's anybody that wants to come up and







                                                                   109
       1      say anything or talk to us.

       2             Although I know Senator Boyle has a plane to

       3      catch, but I'll be here, and maybe some of the panel

       4      members will, also.

       5             So, Senator.

       6             SENATOR BOYLE:  Thank you,

       7      Senator Ranzenhofer.

       8             And thank all of you.

       9             Just quickly, a comment about what Tim was

      10      saying:  We've heard that around the state, where

      11      parents have actually been put in a position where

      12      they had their children arrested, just because --

      13      just so they could get them the treatment that they

      14      needed.

      15             That is a system that truly needs reform, and

      16      that's exactly what we're going to do here.

      17             I do want to say that, I thank everyone.

      18             The parents who have lost children, and those

      19      that are in recovery, I give you my prayers and best

      20      wishes.

      21             And thank you for sharing your stories,

      22      because this is going to make a difference, from the

      23      panel today, from the audience.

      24             I know we talk about, you come to a thing

      25      like this and you think, Well, maybe a year from







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       1      now, or a couple years from now, it's going to

       2      change.

       3             I can tell you, with technology, that's not

       4      the case, because as we were talking today, I was

       5      texting my staff in Albany about ideas.  And they

       6      ran the ideas by the counsel in the last two hours,

       7      and they actually drafted the bill and sent them

       8      back to me a couple minutes ago.

       9             So we actually have bills that are going to

      10      be introduced next week, based on what was said here

      11      today.

      12             I thank you all.

      13             Mike, I cannot thank you enough.  This was a

      14      wonderful forum.

      15             Appreciate it.

      16             SENATOR RANZENHOFER:  Well, Senator Boyle,

      17      I want to thank you for, you know, traveling here

      18      from Long Island, and, you know, getting here at

      19      two in the morning.

      20             And, you know, I know that you've traveled

      21      extensively across the state, from -- you know, from

      22      Buffalo to Batavia, to Rochester, to Syracuse, to,

      23      you know, all over the state.

      24             And, you know, your advocacy and your

      25      patience in helping to craft solutions to the very







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       1      serious problems that we kind of know about, but you

       2      really don't appreciate until you hear about it, not

       3      only from, you know, the members of the panel that

       4      are up here, with law enforcement and with treatment

       5      and with education.

       6             You know, but for the folks that are sitting

       7      on the other side of the dais, and, you know,

       8      I mean, the courage that you have, and the bravery

       9      that you have, to come up at a public forum and talk

      10      about your -- you know, your personal tragedies and

      11      your personal life stories, I don't know if it's

      12      something that could I do.

      13             So I want to thank each and every one of you

      14      that have come here today and shared that with us.

      15             Because, the objective is to try to do --

      16      from a legislative standpoint, to try to provide,

      17      you know, some benefit, some solutions, to a very

      18      humanistic problem, where, you know, you don't --

      19      you know, is there a law that you can pass that will

      20      make a difference?

      21             Well, hopefully, there is.

      22             But, can a law solve everybody's problems?

      23             Probably not.

      24             But, you know, to listen to what we have

      25      heard here today is going to be helpful.







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       1             You know, I know that Senator Boyle has been

       2      working on the legislation.  It's been a work in

       3      progress.

       4             And, you know, I know we wanted to hear from

       5      everybody here, not only on the panel, but in the

       6      audience, about how it's affected Batavia and

       7      Genesee County, you know, Leroy, Pembroke, you know,

       8      but our local community here.

       9             So, thank you, Senator, for joining us here

      10      today.

      11             Thank you panel members for agreeing to take

      12      time out of your very busy schedules and lives to be

      13      here.

      14             And, again, for everybody that has sat in the

      15      audience, and either spoken or not spoken, you know,

      16      thank you for being here today and sharing your

      17      story with your presence, and then with your words

      18      if you chose to speak.

      19             So, thanks very much.

      20                  [Applause.]

      21                  (Whereupon, at approximately 12:01 p.m.,

      22        the forum held before the New York State Joint

      23        Task Force on Heroin and Opioid Addiction

      24        concluded, and adjourned.)

      25                            ---oOo---