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Progress made on opioid crisis, but state must do more

Progress made on opioid crisis, but state must do more

The death rate per 100,000 New Yorkers of all opioid drugs doubled in just five years

On the website of the Renaissance Funeral Home and Cremation on Six Forks Road in Raleigh, N.C., is a photo of a handsome young man with a thick head of wavy auburn hair, bright green eyes and a soft smile.

Underneath the photo are tabs inviting visitors to the website to “Send Beautiful Flowers” or “Share a Memory.”

His name was Caleb Mehlman and he had just turned 19 years old.

His mother described him as her best friend, “big-hearted, charismatic and smart.” 

A freshman at East Carolina University, Caleb died on Dec. 19 from a lethal combination of Xanax, methadone and alcohol while celebrating his birthday.

According to local newspaper reports, he first started experimenting with opioids in ninth grade, hanging out at a friend’s house the first time he took Xanax.

They were careful to avoid the so-called “hard drugs,” like heroin and crack. To the boys, one newspaper reported, these prescription drugs seemed harmless.

Mehlman can serve as a cautionary tale for the opioid crisis, both in this country and here in New York.

The opioid epidemic isn’t just resigned to the inner cities. It’s no longer an urban problem that middle America could conveniently turn its back on. It’s not happening to our kids, we once thought. It’s those people and those people’s kids. Why should we care?

Here in New York, like in North Carolina and the rest of the country, the problem is far-reaching and growing.

Visit the state Health Department’s website and you’ll find an entire page — www.health.ny.gov/statistics/opioid/#i_one — devoted to reports and statistics highlighting the extent of the problem.

One chart, contained in the Health Department’s Opioid Annual Report, dated October 2017, illustrates just how quickly the problem has escalated in just the past few years.

The chart lists the rates of overdose deaths involving all opioids, heroin, and opioid pain relievers in the state for the years 2010 and 2015. The chart shows that the death rate per 100,000 New Yorkers of all opioid drugs doubled in just five years. For heroin, the death rate in 2015 was five times the rate of 2010.

The rate of deaths from pain relievers increased 40 percent in that short time period.

Each county in the state has its own page in the report, and each has its own frightening statistics that include death rates, hospitalization rates and emergency room visits due to overdoses.

Combating the problem isn’t easy. It can’t be traced to a single source, nor is there a single solution.

State Sen. George Amedore, who co-chairs the Senate’s Task for on Heroin and Opioid Addiction, said the state has made headway on addressing both the causes of and treatment for opioid abuse.

A few years ago, he said in an interview on Friday, the state only spent about $50 million fighting the problem.

Today, that number has risen to $260 million. That money helps fund services needed to treat addictions, set up in-patient and out-patient services, and invest in prevention and public education efforts.

In March, as part of the state’s $168 billion budget, lawmakers approved a surcharge on pharmaceutical companies to help cover New York’s costs for state-funded drug and alcohol treatment programs. Rather than go directly into the state’s general fund, the money will be deposited into a stewardship fund to support the state’s alcoholism and substance-abuse programs.

Such taxes have met with opposition, primarily from drug manufacturers, because they claim the cost will be passed on to elderly patients and those in severe pain, possibly making the drugs they need unaffordable and unavailable. But if we don’t find a way to pay to fight the problem now, the costs will only increase over time.

With more funding dedicated to the problem, Amedore said, the state has made great progress in recovery services, peer-to-peer advocacy and establishing family navigators, people who help those recovering addicts avoid recidivism and remain in a sober state.

He said legislatively, the state has also closed some gaps in the continuum of care. For instance, he said, insurance companies can no longer deny insurance coverage for overdoses. He said overdose victims were often being released shortly after getting treatment. Once back on the streets without the full complement of services, many people return to drugs.

Amedore said jail-based services are essential to treating the problem statewide, as half of the people incarcerated in New York are there due to some kind of substance abuse disorder.

Some people believe treating addicts while in prison is rewarding them for committing crimes. But Amedore said providing treatment to these individuals while they’re incarcerated helps reduce recidivism and therefore the level of crime, helps build the workforce and helps relieve the burden on the social services system and on taxpayers who have to pay to deal with people who can’t stay off the drugs.

Lawmakers, he said, also have to go after the sources of the drugs.

Amedore is cosponsoring a bill that would establishco-prescribing guidelines that would allow medical professionals to identify patients most at-risk of becoming addicted to pain killers and prescribing alternative drugs for chronic or acute pain.

He also says the state needs to regulate so-called “sober-living homes,” which are group homes or halfway houses where addicts go to get off drugs. Many of these facilities become drug dens, allowing addicts to revert back to their addictions. So they need to be regulated.

Amedore’s bill (S902/A6210) would create a sober-home task force designed to establish best practices for these homes to ensure the most appropriate and effective environment for people recovering from chemical dependencies.

Another bill to address the source of the problem, dubbed Laree’s Law (S2761/A3398), would allow prosecutors to charge large, illicit-drug suppliers with homicide if a person overdoses on heroin or an opiate-controlled substance that was sold to them by that dealer.

Some drug dealers create more dangerous situations for unsuspecting addicts, for instance, by lacing heroin with fentanyl to make it more potent and potentially lethal.

Under the bill — named after Colonie teenager Laree Lincoln, who died of a heroin overdose in 2013 — dealers could face up to 15 to 25 years in prison.

The bill passed the Senate in March but is stuck in committee in the Assembly.

Amedore said the goal of this legislation isn’t to go after small dealers and co-users who share drugs. These individuals, he said, should be targeted for treatment and recovery resources. It’s the large-volume drug dealers whose actions lead unsuspecting addicts to overdose who should be punished more severely.

There are other bills pending in the Legislature that relate to such issues as access to care for opioid abuse, alternative prescriptions, allowing medical marijuana to be used for certain opioid addictions, reporting requirements, labeling of prescription opioids and timely access to medical care.

While New York has taken great strides in combating the problem, there’s still much more it needs to do. Lawmakers need to consider all of these bills for the potential benefits they could provide.

For people like Caleb Mehlman and the scores of others victimized by the scourge of opioids, more state action can’t come soon enough.

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