In their ongoing effort to better understand and inform others of the social, economic, environmental, and political issues facing the United States and the world, the Yates Progressives invited a panel of diverse experience to discuss the rising heroin and opioid drug abuse problem in our region.
Convening at Hunt Country Vineyards Sunday, Nov. 19, the panelists were Penn Yan Police Chief Tom Dunham, Finger Lakes Area Counseling and Recovery Agency (FLACRA) medical advisor Dr. Jane McCaffrey, FLACRA Peer Counsellor Dale Foster, and Yates County Drug Treatment Court volunteers Rich Stewart and Tom Close.
An everyday event
Dunham described some of the elements law enforcement agencies believe have contributed to the problem. The clean needle exchange program, while well-intentioned to decrease the spread of disease, has made things more difficult for police. The increase in intravenous drug use in Yates County has gone “from non-existent to every day,” says Dunham. Penn Yan Police officers responded to heroin overdoses by administering Narcan (an opioid antagonist that reverses the overdose) nine separate times in 2016 – and they are on pace to go past that number in 2017.
Dunham says that most of the heroin and other opioid drugs come from cartels in Mexico, and arrive via Buffalo and Rochester. Far more dangerous than ordinary heroin and the other opiates derived from the poppy plant, are the synthetic opioids such as fentanyl (50 - 100 times stronger than heroin ounce for ounce), carfentanyl (100 to 500 times stronger), and ketamine (over 500 times stronger) which is used as a fast acting elephant tranquilizer. The additives used to cut the drug’s strength, such as cornstarch or even drywall dust, can have their own poisonous effects on the human body when injected into the bloodstream. Dunham says the uncontrolled and unknowable strength of the drugs they buy is often what leads to drug abusers overdosing.
Serious, life-threatening disease
Dr. Jane McCaffrey described the changes in the brain’s nerve receptors for people with a genetic predisposition to drug addiction. When prescribed opiates or opioids for pain, these people experience intense pleasure rather than merely pain relief. As they seek to experience that feeling again, their system develops a tolerance and resists the effect, thus requiring a higher dose. Without that dose, life becomes unbearable, and their fear of withdrawal overwhelms even their fear of death by overdose.
McCaffrey calls drug addiction “a serious, life-threatening, chronic disease,” and says Yates County has the second highest death rate by drugs per capita in New York.
Foster says he came to drug addiction as a somewhat troubled youth from an average family. But youthful drinking and marijuana use was nothing compared to the addiction that began with a prescription for pain medication for a broken jaw.
Foster described his own heroin overdose experience prior to entering recovery. When he overdosed, Foster says, “The people I was with rolled me in a carpet and threw me in a dumpster.” Despite surviving that ordeal, Foster says it took him another 2 1/2 years to decide to get clean. “I was pure evil. I lied, cheated, stole – whatever it took to get high.” Foster says the loss of his marriage and custody of his children is what finally made him change. “I was sick and tired of ruining my life.”
Now with 3 1/2 years of sobriety and his work as a Peer Counsellor, Foster says FLACRA’s new Center of Treatment Innovation (COTI) 24/7 Opioid Response Team will help those in crisis get treatment faster. Last Thursday night, Foster says the team worked with an overdosed drug user trying to get her into a detox center, and successfully got her admitted to the center within 18 hours, rather than the days or even weeks it took to do this in the past. That rapid response can mean the difference between life and death for a drug abuser. “Without treatment,” Foster says, “we would have given her about a month.” That same night, the team responded to two more overdose cases in Ontario County.
“FLACRA is doing our part helping get people’s lives in order,” Foster says, “but we need the community to do their part, too.”
Community involvement is the concept of the Yates County Drug Treatment Court, a statewide judicial diversion program to keep people convicted of non-violent, drug-use crimes out of prisons and into recovery. Rich Stewart, a retired sixth-grade teacher, was trained as a volunteer to conduct drug/alcohol urine and breath testing for the male drug court participants. Stewart described the strong, parental, tough love expectations of the drug court team, made up of court, probation, and law enforcement volunteers. Participants are required to be employed or enrolled in school or both.
“It’s not easy,” says Stewart. “The four phases take over a year, and many relapse during that time. It’s almost expected.”
Sanctions by the court for violating can include extended and expanded probation supervision, and even jail time. But recalling one of the young female participants he knew, Stewart say she was unrecognizable at the time of her graduation from when she was admitted. “She looked like a different person.”
Tom Close, who was recruited as a YCDTC volunteer by Stewart, says he has met some of the nicest people he has ever known among the participants, “often the smartest people in their class.” Saying what a privilege it has been to volunteer, Close adds, “Thank goodness for this program.”
Dunham is part of the YCDTC team and says, “Law enforcement is just a piece of the puzzle. Sometimes, getting arrested is the step it takes.” Foster agreed while sitting next to Dunham, the police officer he says who arrested him and started him on the way to recovery. “It’s pretty crazy to think there could ever be a heroin problem in Penn Yan,” says Dunham, “but it’s been here for years now and doesn’t seem to be going away.”
Responding to questions later in the program, Dunham said the change than made heroin/opioid addiction and the related crimes a problem where they had never been seen before, was the overprescription of opioids by doctors for pain relief.
Dr. McCaffrey joined him in placing the responsibility with the medical profession and the pharmaceutical industry. She described how in the 1990s, pain was made a fifth vital sign for hospitals and doctors. If pain was reported by patients and hospitals did not eliminate it, they would be penalized. Those penalties, combined with the pharmaceutical companies assuring doctors the new opioid drugs were not addictive, led to the far more widespread prescription of opioid pain medications. Once the problem was recognized and the rules of prescription dialed back, those already addicted sought illegal prescription meds. Once the demand and price for pills grew so high, they turned to the cheaper option, heroin and illegally manufactured synthetic opioids. With this new market opened all over America, the addiction crisis found its way to places it had never been before – places like Yates County.