In spite of the fact that seemingly every media outlet in New York has raised awareness about the epidemic of addiction and overdose related to prescription opioids and heroin, the Office of National Drug Control Policy has identified it as a priority. Although the New York State legislature has taken some limited actions to address this public health crisis, the epidemic continues to ravage our State. Since the passage of I-STOP, a package of bills passed by our state legislators in June 2014 – including legislation to increase access to treatment for people with health insurance, and increased use of Naloxone that has saved hundreds of lives in NYC – have not been enough to reverse this epidemic. New Yorkers continue to die every day. Our continued failure to support a comprehensive continuum of prevention, treatment, and recovery support services has allowed the epidemic to continue causing more addiction, more death, and more pain for individuals, families, and communities throughout New York State and across our country. New York State Must Address Its Prescription Drug and Heroin Addiction and Overdose Epidemic.
The Combat Heroin Media Campaign and legislation signed into law by Governor Cuomo created hope that resources for prevention, treatment, and recovery support services would be increased in the 2015-16 state budget proposal to better address this epidemic. A flat budget proposed for the New York State Office of Alcoholism and Substance Abuse Services, (OASAS), surprised and disappointed family members and substance use disorders services providers who worked so hard to bring attention to the need for more resources.
A flat budget for OASAS fails to address unacceptable waiting lists for adults, a lack of available treatment services for youth and young adults, the need for more prevention professionals in school and community programs, the need for recovery support services, and the need for even more extensive availability of naloxone and other harm reduction efforts. A flat budget for OASAS misses the opportunity for a much more concerted effort to combat the heroin and prescription epidemic AND the even greater consequences of addiction to alcohol that impact people of all ages throughout New York State.
What Must Be Done to Address This Epidemic?
New York State must take actions necessary to strengthen prevention, treatment, and recovery support. The New York Association of Alcoholism and Substance Abuse Providers, (ASAP) has asked our state legislators to:
- Provide additional funding to OASAS to expand school and community-based prevention, treatment, and recovery support services.
- Make treatment available on demand.
- Expand the availability of services specifically designed for adolescents and young adults. An increasing number of 18-26-year-olds (and younger) are being seen in emergency departments for opioid overdoses and need treatment. A full continuum of age appropriate treatment and recovery services must be made available on demand to meet the needs of this population.
- Strengthen prevention services with emphasis on specialized, targeted prevention focused on children, adolescents, young adults, adults, and older persons who are at risk for prescription misuse.
- Implement educational programs for physicians, pharmacists, and other health professionals focused on SBIRT training, assessing risk for addiction, availability of substance use disorders services in their community, and other related topics.
- Incorporate into existing public awareness campaigns information to increase public awareness about New York’s Good Samaritan law and overdose prevention resources (Naloxone, etc.).
- Include OASAS prevention services providers in the implementation of the NYS Department of Health’s prevention agenda
- Establish recovery centers in every New York State county.
- Support use of Certified Addiction Recovery Coaches and Peer Advocates in a variety of services and community settings. Continued emphasis on the importance of peers/recovering persons as a vital part of the substance use disorders services delivery system is important.
- Support increased and ongoing education efforts to ensure widespread access to and use of life saving Naloxone
- Expand availability and access to medication assisted treatment in Opioid Treatment Programs, other treatment programs, and physician practices (Methadone, Suboxone, Vivitrol, etc.) with an emphasis on the vital role that individualized treatment services have in achieving positive health outcomes. Physicians who prescribe addiction medicines should be monitored and required to affiliate/collaborate with an OASAS licensed program to assure a connection with addiction counseling and recovery support services.
- Support an aggressive campaign to expand use of Screening, Brief Intervention, and Referral to Treatment (SBIRT) in emergency departments, community health centers, and other primary care settings so that the 90% of persons with substance use disorders that are not currently accessing treatment are increasingly referred. SBIRT in primary care settings will help persons with problematic use of prescription medications to be identified earlier on and facilitate successful referral to treatment.
- Insist that there be significant expansion of community-based detoxification services, particularly to address persons with a substance use disorder related to prescription opiates and heroin. This would help to increase access to detox, strengthen the connection between detox and engagement in treatment (because most community-based detox services providers will also be treatment services providers), help to reduce unnecessary hospitalizations, and address a major gap in substance use disorder services in NYS.
Resources for prevention, treatment, and recovery support services have not kept pace with the demand for services. Resources have failed to even keep up with inflation, creating a fiscal crisis for some programs, resulting in closure for some. This failure to adequately support the level of services needed to address the prescription opiate and heroin addiction and overdose epidemic is hard to understand given the increasing voice of families who have lost loved ones and the daily coverage of this crisis in the media. It will take a significant advocacy effort to gain the resources and support needed to make prevention, treatment, and recovery support services available on demand.
Our concern and support go out to families that have lost sons and daughters, mothers and fathers, good neighbors and friends to overdose and other tragic consequences related to an addiction to prescription medications, heroin, alcohol and other drugs. With those impacted by addiction and overdose ASAP asks for your voice in the advocacy for services on demand.
We encourage the many dedicated Behavioral Health News readers to join ASAP advocacy efforts. If you are interested in working with us to make services more available and accessible, please contact Kathleen Campbell, ASAP Director of Public Policy at: KCampbell@asapnys.org. If you are interested in becoming a member of ASAP contact Janet Braga, Associate Director, at: JBraga@asapnys.org.