Ban the sale of drug paraphernalia. Tax alcohol to fund substance abuse prevention. Drug-test student athletes. Strengthen social host laws. Sic drug-sniffing dogs on school lockers. Overhaul the substance-abuse rehabilitation sector. Enact better controls over prescription medication. Require health insurance companies to cover rehab bills.
Those are just a few of the 48 recommendations to Suffolk County legislators outlined in a 51-page report issued in December by the Suffolk Heroin and Opiate Advisory Panel following six months of research. The wish list aims to reform prevention, treatment and recovery services overburdened by a heroin epidemic. Now comes the hard part: nudging lawmakers to act on the ideas and fund costlier suggestions while the economy too is in rehab—all before complacency takes hold.
“The reality is that we are in the midst of a crisis,” says Jeffrey Reynolds, chairman of the 12-member panel and executive director of the nonprofit Long Island Council on Alcoholism & Drug Dependence (LICAAD). “We believe the investment is worth it.”
The report is the most exhaustive of its kind to date that looks at improving on the piecemeal approach taken by local officials surprised that heroin now contributes to an estimated 300 deaths annually on LI after being relatively dormant for three decades. Last week the panel gave legislators a short list of proposals to be considered first.
At the top of the list was to take a cue from Nassau County and use asset-forfeiture funds—money seized from criminals during investigations—to pay for the “Too Good for Drugs” program or another so-called “evidence based” curriculum. The panel didn’t mention the HealthSmart and PoliceSmart programs currently taught in Suffolk schools, which experts consider experimental.
Suffolk police last year replaced the old DARE program with PoliceSmart to modernize their school outreach efforts to address current issues kids face. Suffolk County Executive Steve Levy, a PoliceSmart proponent, declined to comment.
Meanwhile, young addicts increasingly turn to crime to fund their habits amid rising HIV/AIDS and Hepatitis C infection rates due to intravenous drug use—not to mention poor sexual decisions made by those under the influence.
HIGH TIME FOR REHAB REFORM
One of the most innovative proposals—creating a cheaper, non-hospital form of detox—also goes to the heart of the reason the panel was created: analyzing whether there are enough beds countywide for those seeking detoxification, especially adolescents. Although that analysis was inconclusive, the panel cleared up a widely held misconception.
“Parents want a place where they can take and leave their child in a secure location where they can step away from the chaos, and the family can resume some sort of organized living for a short period,” Jack Hoffman, vice chair of the panel and a behavior health director at Eastern Long Island Hospital, told the health committee Dec. 16. “That is not what detox services are about.
“Detox services is an acute medical unit where someone is removed medically from a substance, which abrupt cessation of that substance will lead to seizure and death,” he said. The only three substances that require medical detox are alcohol, barbiturates and benzodiazepines, or sedatives such as Klonopin, Xanex and Valium—and even that need depends on the duration of physical dependence and psychological addiction.
Heroin withdrawal, although agonizing, is not deadly. The same goes for withdrawal from commonly abused synthetic opioid-based painkillers such as Oxycodone and Percocet, which are often gateways to heroin.
The panel proposed increasing access to sub-acute adolescent crisis services—two-week stays at inpatient rehab for patients not facing fatal withdrawal symptoms.
But patients who’ve completed the first step of recovery often find access to inpatient centers on LI insufficient, with “only a fraction of current needs being met” for adolescents, the panel said. Less than half seeking outpatient care make it into a program.
“For some reason there is a disconnect” between young people and treatment providers, said Elaine Economopolous, a panel member and director of Smithtown Horizons Counseling and Education Center, an outpatient facility.
With those issues in mind, panelists encourage partnerships between schools and treatment providers to improve access, like a recent proposal to offer Daytop Village counseling services at William Floyd High School.
But considering how controversial that idea has proven, it is unlikely LI schools will take the panel up on another recommendation to create a dedicated “recovery school” where academics coincide with continuing care.
“People are upset and afraid,” says Legis. Kate Browning (WF-Shirley), chair of the health committee, who adds that parents in the neighborhood are worried a high-school-based rehab program would put kids at risk. “The reality is we have a problem.”
LI AND BEYOND
Some recommendations would require state or federal legislation, but a handful of local suggestions have been taken up.
The county legislature last year enacted age limits on the sales of drinking games and banned the sale of canned air—a party favorite for huffing, or getting high on inhalants. Lawmakers also increased fines and clarified jurisdiction in the Social Host law, but the panel said enforcement is lacking. In addition, Suffolk police precincts had permanent anonymous drug drop-off bins installed last summer.
One lawmaker wanted to ban the sale of drug paraphernalia but learned that such products are sold legally as long as retailers say the products are for tobacco use. A drug paraphernalia tax to fund drug prevention was discussed, but not proposed.
Legis. Jack Eddington (I-Medford), who had a career as a teacher, drug counselor and social worker prior to being elected, found the report inspiring for its innovativeness but frustrating because he’s heard it before.
“Parents have to get involved, teachers have to get involved,” he says. “We can’t just legislate our way out of this,” he adds. “Let’s really making an impact or else we’ll be sitting here in another 15 years having the same discussion.”
On the state level, two proposals hit snags when Sens. Craig Johnson (D-Port Washington) and Brian X. Foley (D-Blue Point) were ousted by Republicans last year.
Johnson’s 911 Good Samaritan bill would have given low-level drug offenders a pass when they call police to report an overdose. Foley proposed Denise’s Law, which would have helped parents force kids into treatment. Neither bill has been reintroduced.
Taking it a step further, the panel suggests requiring insurance companies to pay for the full duration of rehab. Such a move would help block the common path of addicts who can’t afford rehab and later are arrested for stealing to fund their next fix.
As one heroin addict’s mother quoted her son to the panel: “Every rock bottom has a trap door.”
TAKING IT TO THE STREETS
Not content to wait for the snail’s pace of legislation, grassroots groups created a “hit list” to lobby school districts to encourage them to improve prevention efforts.
“It’s not a money issue, it’s a no-brainer,” Teri Kroll, coordinator of People United to Stop Heroin on Long Island (PUSH-LI) told the panel while speaking on the need for better prevention in schools.
She added there is limited support. “Unfortunately parents don’t see the need for the awareness,” she said. “They’re in denial.”
Kroll should know. The Copiague mother was once like them.
Her son, Timothy, died in 2009 after he got hooked on Oxycodone and later graduated to heroin, which can be cheaper.
The case is just one of many that highlighted the need for more awareness—especially considering Tim had abstained from drugs until being prescribed painkillers.
In the absence of a countywide policy on evidence-based programs in Suffolk schools, some groups offer training for teachers in the Too Good For Drugs curriculum.
Whether or not the recommendations get adopted, the battle is uphill. LICAAD’s Reynolds recalled another advocate’s analogy in the day-to-day challenges.
“It’s almost as if our kids are swimming in a pretty polluted pond in terms of access to alcohol and access to drugs,” he said. “We pull them out when they get in trouble for a period of time…and then we drop them right back in, and wonder why they begin to have a hard time again.”
Heroin prevention resources: