Public Forum: Jefferson County Panel Discussion on Heroin Epidemic in Watertown and Surrounding Counties

1 BEFORE THE NEW YORK STATE SENATE MAJORITY COALITION

JOINT TASK FORCE ON HEROIN AND OPIOID ADDICTION 2 ------------------------------------------------------ 3 PUBLIC FORUM: JEFFERSON COUNTY 4 PANEL DISCUSSION ON HEROIN EPIDEMIC IN WATERTOWN AND

SURROUNDING COUNTIES 5

------------------------------------------------------ 6 7

Dulles State Office Building, 11th Floor 8 317 Washington St.

Watertown, New York 13601 9

April 25, 2014 10 1:00 p.m. to 3:00 p.m. 11 12

PRESENT:13

Senator Patricia Ritchie, Task Force Forum Moderator 14 Member of the Joint Task Force 15

Assemblyman Will Barclay 16

Assemblyman Kenneth Blankenbush 17 18 19 20 21 22 23 24 25 1

SPEAKERS:PAGE QUESTIONS 2

Steve Jennings 8 15 3 Public-Health Planner, Jefferson County

Watertown City Councilman 4

Nichole Smith 18 20 5 Personal Story

Resident of Jefferson County 6

Cindy Intschert 25 30 7 District Attorney

Jefferson County 8

Mark Koester 37 42 9 Personal Story

Resident of Madison County 10

Reuel Todd 47 51 11 Sheriff

Oswego County 12

Adam Bullock, RN 55 57 13 Director of Behavioral Health Services

Canton-Potsdam Hospital 14

Charlie Moehs, M.D. 71 81 15 Occupational Medicine,

Private-Practice Physician 16 Watertown 17 Chelsea Mulchany 87 89

Personal Story 18 Resident of Oswego County 19 Jeanne Weaver 95

Personal Story 20 Resident of Jefferson County 21 Sean O'Brien 109 114

Detective 22 St. Lawrence County

Sheriff's Department 23

Anita Seefried-Brown 117 125 24 Program Director

Jefferson County Alcohol and 25 Substance Abuse Council 1

SPEAKERS (Continued): PAGE QUESTIONS 2

Jim Scordo 129 138 3 Executive Director

Credo Community Center 4

Penny Morley 140 145 5 Prevention Director

Farnham Family Services 6

Cherie Moore 149 7 Personal Story

Louis County 8 9 ---oOo--- 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 1 SENATOR RITCHIE: I want to welcome you to 2 this forum. It's a bipartisan Senate Task Force on 3 Heroin and Opioid Addiction. 4 You need only to look at the daily newspaper 5 to understand the deep interest in this issue and 6 the real cause for concern. 7 In the State Senate, we are very interested 8 in understanding the full scope of the problem and 9 the full range of ideas to help solve it. 10 Today's forum is one of thirteen across 11 New York State, and two being held in the 12 North Country. 13 There was so much interest, not only is one 14 being held in Plattsburgh, the one that covers 15 Jefferson, St. Lawrence, and Oswego county is being 16 held today in Watertown. 17 If there's one thing we know already, the 18 problem has no geographic, regional, or economic 19 boundaries. It's a problem upstate and downstate, 20 urban and rural, affecting children and families. 21 Wealthy, middle-class, and poor families are 22 dealing with this right now. Heroin is touching 23 every single corner of our state. We must find 24 solutions that apply equally across the spectrum. 25 Before we hear from experts, which will 1 include a cross-section of law enforcement, 2 treatment, and, also, from firsthand accounts whose 3 lives have been affected by this, I want to 4 introduce and thank my fellow panelists, 5 Assemblyman Will Barclay and 6 Assemblyman Ken Blankenbush, for being here today. 7 We are here to facilitate the conversation, 8 and to get as much information as we can, on how the 9 problem is impacting our families and our 10 communities. 11 We will hear a lot of numbers and statistics 12 today, but for today's discussion, I want you to 13 remember four: 14 "10"; that's the going rate for a single hit 15 of heroin in some of our communities; 16 "23"; that's the percentage of first-time 17 users who will become addicted to this drug, 18 according to the State Health Department; 19 "87"; that's the number of heroin overdoses 20 reported last year to the Poison Control Center in 21 Syracuse which covers our region. That's nearly 22 8 times the amount from just 5 years ago; 23 And, "414"; that's the number of hits that 24 police right here in Watertown seized from one 25 alleged drug dealer earlier this month. 1 And there's one other number that's very 2 important, and that's the number on the 3 Poison Control Center poster up here. That's the 4 number that every household should have next to 5 their telephone. 6 And, before we start the program, I want to 7 turn it over to the Assemblymen for their comments. 8 Certainly appreciate them both being here 9 today. 10 Assemblyman Barclay. 11 ASSEMBLYMAN BARCLAY: Thank you, Senator, and 12 good afternoon, everyone. 13 I want to thank the Senator for holding this 14 hearing, and inviting me to attend. 15 I think what Senator Ritchie mentioned about 16 this being kind of across, whether it's social 17 status, whether it's geographic area, or whatever 18 else, it really is a problem, and we're seeing it in 19 a lot of rural areas, unfortunately. 20 And, you know, it's unfortunate, because 21 I think sometimes we think we get some drug problem 22 under control, another one seems to pop up, whether 23 it's with, you know, back in the '90s, or '80s, we 24 had the crack cocaine epidemic. And then we moved 25 into -- lately, we've had a lot of synthetic drugs. 1 And now, certainly, this heroin is getting on the 2 radar screen, which is tragic, obviously. 3 So, I think this hearing couldn't be anymore 4 timely, and I'm thrilled to be here, and I look 5 forward to hearing everybody's testimony. 6 SENATOR RITCHIE: Thank you. 7 ASSEMBLYMAN BLANKENBUSH: And, again, thank 8 you for showing up, everyone, today. 9 And, again, thank you to the Senator for 10 having this hearing here today, and inviting me. 11 As the Senator and the Assemblyman have said, 12 this is an important issue. And, it's -- I'm here 13 today to listen to you, to get as many of your facts 14 and stories that we can get together today. 15 And, so, instead of me talking any further, 16 I'm going to just toss it to the Senator and we can 17 get going, so we can hear from you. 18 Thank you. 19 SENATOR RITCHIE: We'll just start with a few 20 ground rules. 21 We certainly appreciate the speakers who are 22 here today. 23 If you could keep your testimony to within 24 five minutes. We have a number of speakers who have 25 asked to testify. 1 We also had numerous calls from people who 2 also wanted to testify. 3 If they want to submit written testimony, or, 4 if we have time at the end, we can see if that's a 5 possibility. 6 Sarah Compo [ph.] will be the timekeeper, who 7 will try to keep us on track. 8 We have a limited amount of time, from one to 9 three, for the hearing. 10 And with that, we'll get started. 11 Our first speaker is from Jefferson County 12 Public Health, and a Watertown City Councilman, 13 Steve Jennings. 14 STEVE JENNINGS: Good afternoon, Senator, and 15 Assemblymen. Thank you. 16 I want to thank Senator Ritchie and the 17 members of the bipartisan Senate Task Force for 18 working to address heroin and opioid addiction in 19 our state, and for investing the time to hear from 20 your constituents about a plague that is slowly 21 decimating our families and communities. 22 I, of course, have lots of statistics, so, 23 get your pen out, Ken. 24 [Laughter.] 25 STEVE JENNINGS: The opioid abuse and 1 overdose epidemic has reached crisis proportions in 2 recent years. 3 A 2012 federal survey on drug use and health 4 reported that the number of people who said they 5 used heroin in the past 12 months rose 79 percent, 6 from 373,000 people in 2007, to 669,000 people in 7 2012. 8 The agency also reported that the number of 9 people dependent on heroin rose 106 percent, from 10 179,000 people in 2007, to 369,000 people in 2011. 11 It is evident that heroin is highly 12 addictive. 13 The National Institutes of Health estimate 14 that approximately 23 percent of individuals who use 15 heroin become dependent. 16 The U.S. Centers for Disease Control report 17 that, in 2010, opioids, including both prescription 18 pain killers and heroin, were responsible for nearly 19 20,000 overdose deaths in this country. 20 And while prescription pain killers continue 21 to account for the majority of opioid overdoses, 22 deaths from heroin overdose increased by 45 percent 23 between 2006 and 2010, fueling concern nationwide 24 that progress in reducing prescription pain-killer 25 misuse is being offset by a dramatic rise in heroin 1 use, and it's attendant social and health 2 consequences, including addiction, hepatitis C, and 3 overdose. 4 Active abuse of prescription opioids and 5 heroin is alive and well in Jefferson County, and as 6 a result, we are clearly seeing increased 7 hepatitis C diagnosis, overdose, and overdose 8 deaths. 9 I want to share with you the impact of what 10 we're experiencing. 11 Hepatitis C, our cases have significantly 12 risen in Jefferson County since 2001. 13 Hepatitis C is a contagious liver disease 14 that ranges in severity, from a mild illness lasting 15 a few weeks, to a serious, chronic lifelong illness 16 that attacks the liver. 17 Most people contract chronic hepatitis C. 18 Unlike hepatitis A and B, there's no vaccine 19 to prevent hepatitis C. 20 Jefferson has seen its chronic hepatitis C 21 cases jump from 1 in 2001, to 59 in 2007, to 67 in 22 2013. 23 Jefferson's rise is not out of line with 24 what's occurring statewide and nationally. 25 The increase can be attributed to more 1 testing, which we in public health are pushing, and 2 it's a good thing, but it's also a result of 3 increased high-risk injection-drug use: the sharing 4 of needles and other drug paraphernalia, and the 5 resulting blood-borne transmission of virus. 6 Treating and managing individuals with 7 chronic hepatitis C is complex and expensive. 8 Many people currently with hepatitis C choose 9 to forego the care that they need due to lack of 10 access to an infectious-disease specialist and the 11 cost for treatment, but this only serves to 12 exacerbate disease, and dramatically increase the 13 cost, and right at the point where they face 14 required medical intervention to live. 15 On the overdose front, there is significant 16 activity in our county. 17 Consider the 2-year time period, 2011 through 18 2012: 19 Fire and emergency management calls indicate 20 698 overdose calls; 21 301 people visited the Samaritan Medical 22 Center Emergency Department, with 30 percent of 23 these people presenting with self-inflicted injury 24 related to overdose or suicide attempt, and 25 25 percent of these individuals presenting with 1 opioid overdose; 2 There were 199 total inpatient hospital stays 3 at Samaritan due to drug overdoses, with 74 percent 4 of these individuals admitted with self-inflicted 5 injury related to overdose or suicide attempt, and 6 38 percent of these stays specifically due to opioid 7 overdose. 8 [Microphone not working at speaker podium.] 9 STEVE JENNINGS: Overdose deaths in Jefferson 10 County, particularly those related to opioids, are 11 on the rise. Overdose deaths spiked 80 percent 12 between 2010 and 2011, and have remained at the 13 highest levels we've ever experienced since. 14 Of the 48 overdose deaths from 2011 to 2013, 15 79 percent had lethal toxicology attributed to 16 opiates, and 50 percent of these were specifically 17 due to heroin or morphine overdose. 18 Morphine is a breakdown product of heroin. 19 Since 2011, drug overdoses have become the 20 leading cause of injury death in Jefferson County. 21 As a City Councilman, the drug and heroin 22 loose in my city, and its impact on neighborhoods, 23 children, and families, is alarming and deeply 24 concerning. 25 Of all Samaritan emergency department and 1 engagement admissions mentioned, 48 percent were 2 residents of the city. Of all the overdose deaths, 3 44 percent were residents who lived in the city. 4 Though the total county population of 5 118,000, only 22 percent are city residents. 6 These program data, compared against 7 population concentration of the city versus the rest 8 of county, underscored that drug use and all its 9 associated activities [inaudible] is most prevalent 10 in the city of Watertown. 11 And, so, a combination of short-term and 12 long-term approaches are needed to combat the drug 13 problem in our communities. 14 And as I alluded to previously, there is 15 great concern of the tightening up of 16 prescription-drug ordering and dispensing, which we 17 support, is having the unintended consequence of 18 increasing heroin use and overdose for those 19 opioid-addicted. 20 Emerging overdose-education and 21 naloxone-distribution programs are working, but 22 currently rely on limited funding and loose policy 23 amid a growing need. 24 Tighter policy and greater availability of 25 target funds now, through public health and 1 prevention, emergency medical service, addiction 2 treatment and recovery services, would hasten the 3 expansion of these programs to meet growing need and 4 demand. 5 Long-term or legislative commitment to invest 6 and maintain support to the opioid-overdose fatality 7 prevention efforts within the State Department of 8 Health, county health, and mental-health departments 9 and community-based organizations, strengthen the 10 ability to deliver ongoing overdose recognition and 11 intervention training and education, and expand 12 access to rescue medication and other 13 evidenced-based strategies, and needed to control 14 the current crisis and mitigate it for our future. 15 To conclude: 16 There's much to be done and no time to lose 17 in the battle against opioid overdose. 18 We need long-range efforts to address the 19 underlying causes and factors which led to this 20 initial rise in prescription-opioid misuse and the 21 resultant growth in heroin use, together with 22 immediate action to avoid additional deaths and 23 tragedies in the short term. 24 Please feel free to contact me if you need 25 more information, and I thank you for your time and 1 attention. 2 SENATOR RITCHIE: Before you go -- 3 [Applause.] 4 SENATOR RITCHIE: -- Steve, do you mind 5 taking a couple of questions before you go? 6 You mentioned rescue medication, and Narcan 7 has been something that we keep hearing over and 8 over again. 9 Can you give us your opinion on Narcan? 10 STEVE JENNINGS: We certainly are supportive 11 of expanding its access and availability in the 12 community. We worked, most previously, on getting 13 it on our basic levels -- basic life-support squad 14 levels. The advanced life support squads are 15 carrying [inaudible]. 16 But -- so that policy was enacted recently. 17 There's a great push to have law enforcement 18 carry it, and I think the Attorney General recently 19 sponsored something in that regard. 20 I think the policy is loose, and I think we 21 need something tighter and broader statewide on 22 naloxone. 23 And, there's great controversy on who should 24 administer it. Some agencies are very much for it; 25 others are not. 1 So, working on that front I think would be a 2 benefit. 3 SENATOR RITCHIE: Do you have any questions? 4 ASSEMBLYMAN BARCLAY: I do. 5 What were the -- you gave us the last 6 statistics, and, I'm sorry, I missed. 7 I think I heard that all -- over all the 8 overdoses you had, 25 percent are related to 9 opioids, or -- I guess -- 10 STEVE JENNINGS: And heroin. 11 ASSEMBLYMAN BARCLAY: -- and heroin. 12 So what does that equal in actual numbers? 13 STEVE JENNINGS: In the numbers? 14 ASSEMBLYMAN BARCLAY: Yeah. 15 STEVE JENNINGS: So, between 2011 and 2013, 16 so we have a total of 48 overdose deaths. 17 38 had a lethal toxicology attributed to 18 opiates; 19 And, 50 percent were specific to heroin and 20 morphine. Of that 50 percent, 6 were heroin, 21 13 were morphine. 22 ASSEMBLYMAN BLANKENBUSH: And then -- I'm 23 sorry, I should know what you do, but, I know you're 24 on the City Council. 25 But are you also involved in the hospital? 1 Or -- 2 STEVE JENNINGS: I'm a public-health planner 3 with the County Health. 4 ASSEMBLYMAN BARCLAY: I apologize. I should 5 know that. I'm sorry. 6 So -- I mean, the general addiction of these 7 things is because people were on prescription drugs, 8 and then moving off of prescription drugs because 9 they can no longer get them, presumably? Is that 10 the case, where they're looking for an alternative? 11 STEVE JENNINGS: Or it's a combination. 12 ASSEMBLYMAN BARCLAY: Or a combination. 13 STEVE JENNINGS: People have, we call it 14 [inaudible]. They have many drugs in their systems 15 when they expire. It's often a combination. 16 ASSEMBLYMAN BARCLAY: And what's responsible 17 for the cheaper price for heroin now? Do you know? 18 STEVE JENNINGS: I don't know. 19 ASSEMBLYMAN BARCLAY: Usually, I would think 20 a lot of demand out there would cause the price to 21 go up. 22 STEVE JENNINGS: I'm sure law enforcement 23 will talk about [inaudible]. 24 They're [inaudible] selling huge quantities, 25 I'll bet. 1 I'm glad we're catching them, but we're 2 probably not catching all of them, though. 3 ASSEMBLYMAN BARCLAY: Thanks. 4 ASSEMBLYMAN BLANKENBUSH: Steve, is there an 5 age bracket that is more -- you know, is it a 6 middle -- 7 STEVE JENNINGS: It tends to be more middle. 8 People have a perception that it's young 9 people, really young people. 10 It tends to be high 20s through young 11 50s, I would say, that's predominantly. 12 If you're asking about deaths, that's what 13 we're seeing in deaths. 14 I think addiction is probably all over the 15 place. 16 SENATOR RITCHIE: Thank you, Steve. 17 STEVE JENNINGS: Thank you, Senator. 18 SENATOR RITCHIE: Next we'll have 19 Nichole Smith from Jefferson County. 20 [Microphone not working at speaker podium.] 21 NICHOLE SMITH: Hi, good afternoon. 22 My name is Nichole. I'm really glad to be 23 here. I'm a little nervous. 24 I came just to share a little bit. 25 I've been in recovery since March 4th of 1 2012. 2 Since that time, I am now enrolled in a 3 [inaudible] program at JCC. I'm working. I'm a 4 single mom. 5 I have been able to restore relationships 6 with family. I practice yoga. I have a sponsor. 7 And, there's just so many things great about 8 recovery that I wish more people could experience. 9 I would like to share everything that I have 10 experienced, with others, to try to help them, and 11 just to speak to someone on the same level and 12 understanding. 13 I did have about 10 years where I was 14 addicted to cocaine and prescription drugs. 15 My son lost his father, at 31 years old, 16 because of addiction. 17 I've lost several friends as well. 18 I lost my son for approximately a year. 19 I have full custody back, raising him on my own. 20 As I said, going to school, working, and just 21 enjoying life, positively, in recovery. 22 And, I'm very grateful. 23 My faith has been a big part of it as well. 24 Everything's different for everybody, but 25 that's been huge for me. 1 So, as I said, I'm just very grateful to be 2 here, so, thank you very much. 3 SENATOR RITCHIE: I want to say how much we 4 appreciate you coming here and sharing that with us. 5 And, if you're comfortable answering a couple 6 of questions? 7 NICHOLE SMITH: Sure, that's fine. 8 SENATOR RITCHIE: Can you tell me how you 9 first got, I guess, the opportunity, or what made 10 you, the first time, try whatever you started with? 11 Well, just so other people can kind of know 12 what happens, that -- I think, pushes somebody the 13 very first time to try it. 14 NICHOLE SMITH: I think a lot of it was due 15 to peer pressure. That's always a big issue. 16 I had unresolved issues dating back to 17 childhood that, you know, I never handled properly. 18 Addiction is a mask. You know, drug use and 19 addiction is a mask. Unresolved issues, feelings, 20 things that never were addressed properly. 21 I have been in counseling, you know, things 22 like that. 23 I was on antidepressants for years upon 24 years. I no longer need to take them today. 25 So that's something that, you know, says 1 a lot about where I'm at in life, and how positively 2 things are going. 3 SENATOR RITCHIE: And what was the turning 4 point to get you to the point that you were seeking 5 help? 6 NICHOLE SMITH: Well, it took me a few times. 7 Most people it does. It doesn't usually happen the 8 first time, unfortunately. 9 I would say that the major turning point was 10 CPS becoming involved, with my son, and, you know, 11 saying, "You can't see your son anymore." 12 That was my bottom. 13 Everybody's is different. 14 Sometimes that's not even enough for certain 15 people, you know. 16 But that was for me, that was it. 17 SENATOR RITCHIE: And was it easy for you to 18 find services when you got to that point? 19 NICHOLE SMITH: Yes, I think so. 20 If you look, it's there, you know, if you 21 really want it. 22 That's what it boils down to: it's there, 23 it's available. 24 SENATOR RITCHIE: Thank you. 25 ASSEMBLYMAN BARCLAY: Thanks for testifying. 1 NICHOLE SMITH: You're welcome. 2 ASSEMBLYMAN BARCLAY: I think it's going to 3 be very helpful for us. 4 But -- and just to follow up a little bit on 5 Senator Ritchie's comments about, yeah, I guess 6 we're trying to hear testimony, what we can do in 7 state government to help people like you, and 8 others, who have been addicted. 9 And maybe you don't know, but, can you 10 explain what kind of roadblocks you might have had 11 that we could change, or take out, that would make 12 recovery easier for people? 13 Obviously, funding is always a big issue. 14 NICHOLE SMITH: Yeah, that's what I was going 15 to say, plus, insurance issues. 16 I know that, financially, I've heard people 17 say they can't afford, you know, to get help that 18 they need. 19 I think maybe any kind of way that -- to put 20 out there, you know, that there is help, any kind 21 of -- just so it's more available for people to see, 22 I think, you know. 23 ASSEMBLYMAN BLANKENBUSH: Do you think -- I'm 24 sorry to interrupt you. 25 Do you think education would have been 1 beneficial to you, like, at an earlier age? 2 I mean, do you feel like that -- I know these 3 are hard questions -- and maybe it would or maybe it 4 wouldn't, it's hard to say, but, would you think 5 that's -- 6 NICHOLE SMITH: A little bit, maybe, yeah. 7 Yeah, a little bit more in the school system, 8 a little bit more education, because, really, people 9 don't understand what it is to be addicted. 10 They don't understand there's a lot of 11 discrimination against addicts. People have to -- 12 decided that they don't change. 13 That's not true. 14 You know, just, yeah, I think a little bit 15 more education. 16 ASSEMBLYMAN BARCLAY: Thank you. 17 ASSEMBLYMAN BLANKENBUSH: Nichole, just one 18 question. 19 NICHOLE SMITH: Sure. 20 ASSEMBLYMAN BLANKENBUSH: You said you were 21 addicted to cocaine for 10 years? 22 NICHOLE SMITH: Uh-huh. 23 ASSEMBLYMAN BLANKENBUSH: 24 Was that the drug you -- was that your drug 25 of choice at first? 1 NICHOLE SMITH: Yes, sir. 2 ASSEMBLYMAN BLANKENBUSH: And was that 3 because of the cost of it, or the availability of 4 it, or -- why -- why, one day, did you say -- 5 NICHOLE SMITH: I kind of just started out as 6 experimenting, which normally is the way it goes. 7 I think it's availability. 8 ASSEMBLYMAN BLANKENBUSH: Okay. 9 SENATOR RITCHIE: I certainly appreciate you 10 coming here today, because your testimony, along 11 with some of the other testimony that we're going to 12 hear from people whose lives have been affected, 13 I think is really what's going to help us find ways 14 to help. 15 And I know when I initially saw the 16 statistics, the one that really jumped out at me, is 17 that almost a quarter of the people who try heroin 18 are addicted from that point. 19 And, if you're a young kid and you're out 20 with your friends, and you try it once, it could 21 affect your life, you know, forever. And that truly 22 was really alarming. 23 So, we appreciate you coming and sharing your 24 story. 25 Thank you. 1 NICHOLE SMITH: You're very welcome. 2 Thank you. 3 [Applause.] 4 SENATOR RITCHIE: Next we have 5 Jefferson County District Attorney Cindy Intschert. 6 DA CINDY INTSCHERT: Good afternoon. 7 First, I would like to express my 8 appreciation to you, Senator Ritchie, also to you 9 Assemblyman Blankenbush and Assemblyman Barclay, and 10 the members of the Joint Task Force, for recognizing 11 and addressing the havoc that is absolutely being 12 wreaked in our communities by the onslaught of 13 heroin, prescription drugs, and other opioids that 14 are flooding our streets. 15 Based on the cross-section of representation 16 that's here today, it's clear that this is a 17 community-wide problem that affects the health and 18 safety of our citizens in a myriad of ways; and as 19 this is not a singular problem, there's no single 20 answer. 21 Again, thank you for seeking out our 22 perspectives on this issue. 23 Let me briefly share with you some of my 24 observations as a prosecutor with the 25 Jefferson County District Attorney's Office for more 1 than 28 years. 2 Although I don't have any statistics in this 3 regard, I have to tell you that I don't recall 4 hearing about heroin cases in my early days as a 5 prosecutor. 6 Those that existed, if any, were definitely 7 the exception, and not the rule. This general trend 8 continued until just a few years ago. 9 In 2007, 3 percent of the drugs seized by the 10 Metro Jeff Narcotics Task Force, by searches or by 11 undercover buy, involved heroin. 12 In 2009, that percentage rose to 10 percent. 13 In 2012, 27 percent; in 2013, 38 percent; and 14 to date, in 2014, approximately 40 percent, of the 15 drug arrests by the task force involved heroin. 16 Particularly noteworthy is the fact that the 17 cost of a bag of heroin, as you've already 18 mentioned, Senator, is less than half of what it was 19 just one year ago, and if that's not an indicator of 20 supply and demand, I don't know what is. 21 Arrests involving prescription drugs, while 22 nowhere near as prevalent, have also seen higher 23 percentage numbers in recent years. 24 The growing prevalence of heroin addiction in 25 Jefferson County is reflected in the defendants who 1 have been referred to Jefferson County's drug court 2 since we began operating in 2002. 3 Drug court is designed to target and to 4 assist those non-violent felony defendants who 5 offend primarily due to drug and/or alcohol misuse 6 and addiction, and for whom standard rehabilitation 7 programs, quite frankly, haven't worked. 8 It's hoped that, through intensive drug 9 treatment, mental-health treatment, and through 10 regular and consistent court contact, these 11 defendants can recover from their addictions, lead 12 drug- and alcohol-free lives, and become law-abiding 13 contributing members of our society. 14 The number of defendants who have 15 participated in drug court over the last six years, 16 for whom heroin is their drug of choice, has, on 17 average, been double the number of heroin defendants 18 that we saw in our early years of operation. 19 You've heard some, you'll hear more today, 20 but the effects that we see from heroin and opiate 21 addiction are absolutely devastating. 22 The intelligence gathered by law enforcement 23 indicates that many addicted defendants are telling 24 us that some of them will do anything for that next 25 fix. 1 They'll steal from their parents, their 2 grandparents, their loved ones, their friends, to 3 get the money for that next high. 4 They shoplift, forge credit card receipts, 5 and burglarize to obtain goods to sell. 6 Young women are prostituting themselves for 7 the drug or for the money to buy it, and they leave 8 their children unattended while they focus on that 9 very next high. 10 Heroin waste, including used needles on the 11 streets and in our recreation areas, is yet another 12 public-safety concern. 13 As you know in our hearing here today, this 14 is a multi-faceted problem without a single answer. 15 The focus on attempting to control the 16 illegal sale of prescription drugs needs to 17 continue. We know that many turn from 18 pharmaceuticals to heroin because heroin is half the 19 cost on the street, and often provides a quicker, 20 more intense high. 21 From the criminal justice side, we're 22 attempting to reduce both the supply and the demand 23 of heroin, opiates, and all other illegal drugs. 24 I don't believe that there's a single elected 25 district attorney who believes that the appropriate 1 answer is to simply lock up everyone who's offended 2 because of a drug problem. Each case needs to be 3 reviewed individually. 4 And while I can't speak for my colleagues, 5 I believe that each of us looks to rehabilitate 6 through the criminal justice system, where 7 appropriate, while still holding people accountable 8 for their criminal actions. 9 That rehabilitation can take different forms 10 and require many different resources, including 11 substance-abuse service providers, mental-health 12 counseling, and when necessary and appropriate, 13 incarceration. 14 Those efforts target the demand for drugs. 15 Our law-enforcement and prosecution 16 community, including the drug task force, also works 17 to reduce the drug supply. 18 There's been a significant relaxation of our 19 drug laws in the last decade, and we continue to 20 work within that framework to take drugs and dealers 21 off the streets. 22 I believe, personally, however, that the 23 available programming for repeat drug dealers, we 24 used to call them "pushers," could be tightened up. 25 Perhaps more resources could be devoted to 1 screening out those dealers who, after conviction, 2 work the system by claiming a non-existent drug 3 problem; and in so doing, tie up the rehabilitation 4 beds, the substance-abuse counselors, and the 5 mental-health workers that are needed by the true 6 addicts. 7 Again, I thank you for your interest in 8 addressing the issues today, and I appreciate the 9 invitation and opportunity. 10 SENATOR RITCHIE: Thank you. 11 Just a couple questions, Cindy. 12 Can you tell us where the local heroin seems 13 to be coming from? Do you know? 14 DA CINDY INTSCHERT: I'd prefer not to get 15 too specific, but would I say south of here, from 16 some of the larger cities coming up north. 17 SENATOR RITCHIE: I know you mentioned 18 earlier how heroin didn't seem to be a problem up 19 until just recently. 20 And I know, until people started calling the 21 office and asking for some help, whether it be 22 law enforcement or, either, someone looking for 23 services, in the past, when I heard of heroin use, 24 I would immediately think it wasn't in the area and 25 it was something that was coming from New York City. 1 So, it is really hard to believe that this 2 problem is so prevalent in the three counties that 3 I represent. 4 And, appreciate all that you are always doing 5 to stay on top of everything. 6 And just one more question, just for my own 7 personal knowledge: Can you just tell me what 8 happens if you suspect someone is using heroin? 9 Just kind of walk me through what happens if 10 one of your -- if an officer pulls over someone, how 11 it ends up on your desk? 12 Is everyone pulled over's case referred 13 immediately to the DA's Office? Or -- 14 DA CINDY INTSCHERT: If someone is pulled 15 over and they have -- the officers have probable 16 cause to search the car, and they make an arrest, 17 that case is referred to the District Attorney's 18 Office. 19 SENATOR RITCHIE: That case is automatically 20 referred? 21 DA CINDY INTSCHERT: Yes. 22 SENATOR RITCHIE: Okay, great. 23 ASSEMBLYMAN BARCLAY: Thanks for your 24 testimony. 25 Just two, I guess, relatively short 1 questions. 2 How is heroin usually ingested? Is it 3 needles, mostly, or is it -- I mean, you can smoke 4 it too; right? 5 Do you know? 6 DA CINDY INTSCHERT: It can be smoked. It's 7 also an injectable drug. 8 I think the general intelligence is that it 9 is -- that it's injected, but it's also being made 10 available in pill form. 11 ASSEMBLYMAN BARCLAY: Right. 12 DA CINDY INTSCHERT: Capsule form, excuse me. 13 ASSEMBLYMAN BARCLAY: Interesting. 14 And then how -- you've mentioned, maybe, 15 stronger laws for those who deal in this drug. 16 Are heroin dealers unique, opposed to other 17 type of drug dealers? 18 Is there a drug dealer that sells whatever 19 you need? 20 Or -- what's your experience with that? 21 And then, I guess, specifically, you know, 22 what kind of -- any idea of what kind of laws to 23 strengthen, that you're looking for against heroin 24 dealers? 25 DA CINDY INTSCHERT: Again, I was referencing 1 those cases where individuals have been convicted 2 and they're headed to prison. 3 ASSEMBLYMAN BARCLAY: Right. 4 DA CINDY INTSCHERT: And when they have an 5 addiction problem and there are programs available 6 in prison, that's rehabilitation. 7 But those individuals that are playing the 8 system and, quite frankly, they consider it the cost 9 doing business: Well, I haven't used up my 10 [unintelligible]. I haven't used my case 11 eligibility. I haven't been to Willard yet. 12 ASSEMBLYMAN BARCLAY: Right. 13 DA CINDY INTSCHERT: That's a concern. 14 That's a concern for those individuals that 15 can truly benefit from those programs. 16 ASSEMBLYMAN BARCLAY: Do you think that's 17 local, or do you think those people are -- I mean -- 18 so what I'm saying, is there a big drug dealer 19 somewhere along that's pushing this off to maybe 20 smaller dealers, and then how it gets up to our area 21 is mostly abusers that also tend to be drug dealers, 22 too? 23 Is that -- 24 DA CINDY INTSCHERT: I'm sorry, with regard 25 to the playing the system? 1 ASSEMBLYMAN BARCLAY: Well, yeah. 2 So, I mean, I would see the ones that are 3 playing the system are either mid-level or 4 high-level dealers. 5 I assume there's -- again, I'm probably 6 saying more than I know. 7 I'm assuming there's dealers out there that 8 are also addicts, and they just happen to be 9 dealing, because they are addicts -- 10 DA CINDY INTSCHERT: Correct. 11 ASSEMBLYMAN BARCLAY: -- and they have to pay 12 for their own habit, I suppose. 13 DA CINDY INTSCHERT: Yes, yes. 14 ASSEMBLYMAN BARCLAY: I mean, is that -- 15 I would also guess, and I don't know this, I guess 16 [unintelligible], that's primarily the type of 17 dealer you have, probably, in our areas, or, no? 18 Maybe not? Or you don't know? 19 DA CINDY INTSCHERT: I think we see both. 20 ASSEMBLYMAN BARCLAY: Okay. All right. 21 DA CINDY INTSCHERT: I think we see both. 22 Thank you. 23 ASSEMBLYMAN BARCLAY: Thanks. 24 SENATOR RITCHIE: Ken? 25 ASSEMBLYMAN BLANKENBUSH: Yes, Cindy, you 1 know, in the news, nationwide, now, we're talking -- 2 you're hearing in the news, where there are going to 3 be some releases from prisons because of judges 4 having mandatory sentencing on addicts that have 5 been put in prison, and that they've been -- there's 6 going to be some leniency. 7 Does -- in New York, is there mandatory 8 sentences if you're convicted of certain 9 drug-related crimes in the state of New York? 10 Or does the judge have the -- does the judge 11 have the availability to look more at, instead of 12 jail, putting them someplace to get help? 13 [Microphone not working at speaker podium.] 14 DA CINDY INTSCHERT: There is considerably 15 more discretion being provided by the judges. 16 And, quite frankly, there are [inaudible] in 17 the system [inaudible] who are trying to craft, you 18 know, the appropriate disposition. 19 There is some mandatory sentences, and much 20 of that was taken away, in what we refer to as the 21 Rockefeller [inaudible.] 22 [Microphone now working at speaker podium.] 23 DA CINDY INTSCHERT: You know, again, I think 24 it's a -- we've spoken of those individuals who 25 deal, who prey on others. Those individuals who are 1 dealing in small amounts which, in turn, preys on 2 others, but it's also done to feed an addiction. 3 So you've got the businessman, if you will, 4 or businesswoman, versus, he or she that may be 5 motivated by their drug problem. 6 And I think that there may -- again, it's a 7 matter of resources, in order to -- you know, to be 8 able to ferret out who's playing the system. It 9 takes time, it takes trained individuals. 10 And I don't know if that's somewhere that the 11 State would like to expend resources or not. 12 SENATOR RITCHIE: Cindy, I just have one last 13 question to follow-up: If there was one thing that 14 the Legislature could do, in your views, to help the 15 situation, what would it be? 16 DA CINDY INTSCHERT: One thing? 17 [Laughter.] 18 SENATOR RITCHIE: Well, if you have more than 19 one thing, that's okay, too. 20 DA CINDY INTSCHERT: Oh, boy. 21 You know, I think -- again, I think laws that 22 permit us to target the actual dealers, and to see 23 that they're not headed toward some of the programs 24 that others can benefit from, and be rehabilitated, 25 and come back out and be contributing members of 1 society, is great. 2 But in order to have those programs work, 3 whether it's with an individual who is on probation, 4 who has voluntarily said, "I have a problem and 5 I need help," our service providers need money and 6 need people. 7 SENATOR RITCHIE: Thank you. 8 DA CINDY INTSCHERT: Thank you. 9 [Applause.] 10 SENATOR RITCHIE: Next will be Mark Koester 11 of Madison County. 12 MARK KOESTER: Senator, good to see you 13 again. Assemblymen. 14 We met a month ago, maybe two, and we chatted 15 briefly about this. 16 So I have the honor of, thus far, spending 17 about $400,000, in 5 rehabs, for my -- one of my 18 sons. It's been an 8-year process. It's pretty 19 devastating to the family. 20 What happens is, in the beginning, you send 21 your son off to rehab with the hope that they're 22 going to get fixed. 23 That typically doesn't happen the first time 24 around. And then -- but they do get sober, they 25 come home, and you have all the hope in the world, 1 and then, some short period of time later, back they 2 go. 3 And, now, you still have that same hope; it's 4 your child. And the worst thing for a parent is to 5 lose a child. 6 So you dig into your pockets, you come 7 together as a family, and you send them back off. 8 Well, for me, that happened four times. 9 On the fourth time, what I was told by all 10 the counselors, is that: You cannot do it again. 11 If your child is going to die, they're going to die. 12 So if they know that you will help them, they will 13 continue. They will continue doing what they're 14 doing. 15 So, I wasn't going to help him. 16 And, about 90 days ago, he overdosed, or 17 should I say, died, four days in a row in an 18 apartment in Utica, at which time the counselors 19 said, "I think he's ready." 20 So, I did it again. 21 He's now in Florida. He is 90 days sober, 22 which is great news. 23 He is finding it hard right now to get back 24 into society, 'cause for 10 years, or 8 years, he's 25 been out of society. 1 So, he also knows that he is $150 away from 2 death. 3 All addicts know that. 4 If he decides, one time, to do anything, 5 he'll be dead in a week. It's that devastating. 6 So one of the questions is: How did he get 7 started? 8 I suspect that will be a question. 9 So 8 years ago, my wife of 30 years had a 10 brain aneurysm and dropped dead in front of me, 11 which was pretty devastating. We didn't have any 12 warning. I didn't, and neither did my kids. 13 And, we live in a small town, and at that 14 time, doctors were prescribing pain killers almost 15 like candy, seriously. 16 My son had a bad back. 17 And in the -- and this is definitely cleaned 18 up -- but in the receiving line in the funeral, the 19 doctors in my town told me and all of my children, 20 whatever we wanted to help us deal with the grief, 21 they would help us with. 22 And, within two months, from my 23 12 1/2-year-old daughter who was taking Ambien, to 24 my 16-year-old son who was taking Xanax, to my next 25 son who generally stayed out of it, to my oldest son 1 who had a bad back and was taking pain killers, 2 I stopped all that. 3 I thought I did. 4 But, at that time, he could get the pain 5 killers easily. He would get two vials a month of 6 180, sell the 180 for 5 bucks apiece, that's how he 7 made a living, and then do the other -- he would 8 take the other. 9 So, from that time, you progress to more and 10 more pain killers, and then you realize that heroin 11 is way cheaper, way easier to get, and feels a whole 12 lot better. 13 And that's the problem we have now. 14 In my little town, just last week, 15 seven teenagers were arrested for heroin. 16 I'll say, less than a month prior to that, 17 three men in their early -- late 20s were arrested 18 for heroin. 19 So, I know this, that if I was going to 20 invest in a sure thing, I would invest in a chain of 21 rehabs. 22 I'm not trying to be funny, but it's very, 23 very serious, as I see it. 24 And so, for me, I believe that we need to 25 look at the laws. 1 If a drug dealer deals heroin, how many 2 people is he going to kill? 3 I mean, this is death. Does it go to 4 manslaughter? 5 I don't know, but it -- literally, you are 6 dealing something, like guns, that will kill. 7 There's no if, ands, or buts about it. 8 And, my son, like I say, was dead more than 9 four times. 10 So, how do you change the laws? I don't 11 know. 12 But, I remember a friend of mine went to 13 China. And if you got caught shoplifting, they 14 would cut your arm off. 15 So guess what? There wasn't a lot of 16 shoplifting in China, in my opinion. 17 So, I don't know what needs to be done 18 law-wise. 19 I do know that we were lucky enough to be 20 able to send my son to good rehabilitation centers; 21 but it was also $400,000. 22 Most people are not going to be able to do 23 that. 24 So, government-subsidized rehabilitation 25 centers, I think are -- I don't even know -- we 1 didn't really look into any, I don't know what that 2 situation is. 3 I got to think our jails are going to be 4 filling up quick, if they're not already full, 5 because it is an epidemic. 6 So that's my story, and, I'm glad to be able 7 to speak about it. 8 And, right now, my son is 90 days sober, so, 9 we're on the path. 10 Thank you. 11 SENATOR RITCHIE: Well, first, I want to say 12 thank you for testifying. 13 I know it must have been difficult, 14 considering what you've gone through. 15 I'm glad to hear that your son is 90 days on 16 his way to a productive life. 17 I know that you mentioned that it's difficult 18 for him now. 19 Is that because, after someone has been, for 20 10 years, kind of out of the ability of getting a 21 job or going to college, is that why it's difficult 22 for him to get back into day-to-day activities? 23 Or -- 24 MARK KOESTER: I think it's probably similar 25 to getting out of jail. And, you get out of jail, 1 and all of a sudden, you're in a whole different 2 environment. 3 So for 10 years you've been lying, or 7 years 4 or 8 years you have been lying, cheating, stealing. 5 There was a lot of times he would just go to 6 the stores, shoplift for enough to go to the pawn 7 shop and get enough for that night. 8 The next day was the same; day in, day out. 9 And he had a wife and three children. 10 So, uhm... 11 Yes. 12 Sorry. I just felt some emotion, and 13 I actually lost my train of thought. 14 SENATOR RITCHIE: So now that he is in a much 15 better place, what can be done for someone like your 16 son, who has gotten over this huge hurdle, to help 17 them continue on this path? 18 What -- does there need to be more services 19 in place to help those that are recovering find 20 jobs, that are something that would, you know, help 21 them remain clean? 22 Is there -- 23 MARK KOESTER: The outpatient aftercare is as 24 critical, or more critical, than getting them sober. 25 You can take an addict, put him into detox, 1 and get him sober in a couple of weeks. 2 You know, in a month, two months, he's a 3 different person. 4 It's the "afterwards" that is critical; which 5 is where he's at right now. 6 I could get a call tomorrow that he's gone. 7 So, we are paying for aftercare, which is 8 counseling three times a week and meetings every 9 day. 10 SENATOR RITCHIE: Just one last question, 11 because it's been four times that he had gone 12 through that previously. 13 Is there something in particular that would 14 trigger him to start over? 15 Or -- I'm just trying to figure out what the 16 best plan of action is; if there's a need for 17 certain services in the community? 18 If -- what makes this time so much different 19 from your son, because he was at the very end, and 20 that's why he's in this place this time? 21 What can we do to help people get to this 22 point before they get to the very end and have to go 23 through what he did? 24 MARK KOESTER: That is a great question, and 25 the answer is: You can't do anything. 1 Once they're hooked, until they get to a 2 bottom, as we discussed. 3 And everybody's bottom is different. 4 His bottom was death. 5 So the key is education in the schools, and 6 to do our best to prevent people starting on it. 7 And, I would say that that's a start, for 8 sure. 9 I really believe that laws for dealers should 10 be hugely tightened. I think we need to look at it 11 differently. They're not drug dealers; they are -- 12 they're murderers. 13 [Applause.] 14 ASSEMBLYMAN BARCLAY: Thanks for testifying 15 here. Your testimony is very powerful. 16 The -- I guess a question I have, I think you 17 hit on it a little bit with Patty's question: 18 But -- so he was in rehab four times. 19 Did he go to the same treatment center all 20 four times? 21 MARK KOESTER: Five rehabs. 22 There was -- the last two have been the 23 same -- no, back up. 24 The last two have been in the same location. 25 Two different rehabs, but several hundred yards 1 apart. 2 ASSEMBLYMAN BARCLAY: Is there any kind of -- 3 I know you said after -- after treatment -- 4 outpatient treatment is more important than the 5 actual treatment, but was there any difference 6 between the treatment centers that you think was 7 more effective? 8 I mean, he went back, obviously, so it 9 couldn't have been all that effective. 10 MARK KOESTER: The treatment centers that he 11 was in, initially, were very strict: Ties to 12 dinner. No smoking. 13 He's very intelligent, and actually 14 brilliant, and, he loves to break the rules. 15 So the treatment centers that worked were the 16 treatment centers that said, "We will help you if 17 you want to be helped." There were no fences, and 18 no particular rules, so you could -- they gave you 19 enough rope to either kill yourself or succeed. 20 ASSEMBLYMAN BARCLAY: And so after he had 21 those four episodes where he overdosed, that's what, 22 as you said, was his bottom, and that's what got him 23 into the -- 24 MARK KOESTER: That was it. 25 ASSEMBLYMAN BARCLAY: And were these all 1 in-state treatment centers, or all over the place? 2 Or, where were they? 3 MARK KOESTER: There was one in-state. Two 4 out of -- and four out-of-state. 5 ASSEMBLYMAN BARCLAY: Okay. Thank you. 6 SENATOR RITCHIE: Thank you very much. 7 MARK KOESTER: Thank you. 8 [Applause.] 9 SENATOR RITCHIE: Next we will hear from the 10 Oswego County Sheriff, Reuel Todd. 11 SHERIFF REUEL TODD: Again, I want to thank 12 Patty -- or, Senator Ritchie for putting this 13 together, and our Assembly people for being here. 14 We have, without even saying it, a huge 15 problem: Heroin is extremely addicting, as 16 everybody knows. 17 It's use in the past two years has more than 18 doubled. 19 And, in 2002, there were about 20 166,000 people, according to the NIJ, addicted. 21 By 2012, it was 335,000, and they say it has 22 more than doubled, and maybe tripled, in the last 23 two years. 24 And I've already been asked by a couple of 25 people what I think, and I believe a retraction of 1 the Rockefeller drug laws, which reduced the 2 penalties for the possession, and especially the, 3 sale of heroin, has greatly enhanced the penalties; 4 or, the ratio of probability of the crime to the 5 punishment. 6 There is no punishment. 7 If someone comes in now and says, "Well, I'm 8 not just a seller, I'm a user," we send them off to 9 a drug rehab, where they pick up more clients. 10 Lack of jobs and lack of punishment all 11 combine to make this a huge problem. 12 A few years ago we had a problem, a really 13 huge problem, with bath salts. Nobody paid a lot 14 attention at first. It wasn't affected by law. It 15 was legalized marijuana. 16 Then young people were getting killed, same 17 as they are now with heroin. They're doing crazy 18 things: Walking in front of cars, trains. Jumping 19 from buildings. 20 There isn't any day, just about, you go by 21 and read the "New York Post," that there isn't 22 somebody that's jumped in front of a subway car down 23 there. 24 It's continued to get worse; more kids have 25 died. 1 We need to do something. 2 We investigated on the bath salts. We 3 changed the laws and we started locking people up. 4 The guy that was importing it from China got, what, 5 16 years down in Utica. 6 16 years, it's not enough, but it was 7 something. I mean, if he got 16 years for every 8 death, for every child that died, I would say it 9 might have been good, because you're right, these 10 drug dealers are murderers. 11 When the most viral YouTubes, the video, come 12 out here in Watertown, where a child brought some of 13 this legal marijuana, or, bath salts, the parent 14 took the law into his own hands, which I don't 15 condone, but, it's hard for me to disagree, went in 16 with a baseball bat and destroyed the shop. 17 That's when everything went viral, and it 18 started to draw a lot of attention. 19 The guy gets arrested for losing his child. 20 Another family from our county, whose son 21 drowned after he used bath salts, went public, 22 demanding legislation. 23 And, I know most of you people supported that 24 legislation. 25 What do you hear about bath salts now? Very, 1 very little, because the law was strengthened. We 2 punished the people, we made it not profitable. 3 As long as it's profitable, they will 4 continue. 5 Every day, according to the NIJ, there are 6 105 people that die from overdoses in this country. 7 "105." 8 But we take the laws and we strengthen 9 things, and take away guns from legal people, but 10 we're not doing anything, really. 11 We're closing prisons. We weakened the law; 12 the Rockefeller drug laws. 13 When you look at what has transpired, the 14 last five years, when they took away the 15 Rockefeller, decreased them, the Rockefeller drug 16 laws and the penalties, and everything else, what 17 has happened with the trade? It has increased 18 dramatically. 19 Look at what we're doing. 20 With all the tax money that I see wasted, it 21 doesn't make sense to me to be weakening the laws 22 and closing prisons. 23 If we have this much drugs, we should have a 24 lot more prisoners, that's all I can tell you. 25 When we save the money -- tax money, we, 1 supposedly, don't take from the people, and we give 2 it back to people to spend on the funerals of their 3 children. 4 I think it's time that we all got viral again 5 and started saving the lives of our loved ones. 6 [Applause.] 7 SHERIFF REUEL TODD: My views. 8 SENATOR RITCHIE: Thank you, Sheriff. 9 What ages do you -- have you been seeing in 10 Oswego County that have been affected? 11 Is it across the board? 12 SHERIFF REUEL TODD: It's pretty much across 13 the board. 14 And, again, these two people, this gentleman 15 over here, and this young lady, that talked, I'm so 16 proud of them, because, I had a very close relative, 17 a brother, that was addicted, and I went through the 18 rehab thing. 19 You have to have a sponsor, and I did it with 20 him, and it's amazing. 21 But I can tell you, neither one of those 22 kids, the first drug they took was heroin or 23 cocaine. 24 Am I right? 25 Alcohol, weed, right on up the line, that's 1 where it starts. 2 It starts, alcohol, at a young age, because 3 alcohol, well, it's better than cocaine; right? 4 It's better for you. 5 We see it in every -- we had a -- Narcan 6 saved a 17-year-old in our county the other day. 7 But, I had a 48-year-old neighbor, two months 8 ago, that died from a heroin overdose. 9 And the thing about it is, what you're 10 putting in your body, you don't know, because when 11 these -- if you get a hot load, which is anything 12 more than 7 percent, at least that's what it was 13 when I worked undercover in '78 and '79, your 14 average dosage of heroin is about 4 percent. 15 Everything else in there is just cut right down, 16 whether it's Drano. 17 You know, same stuff for bath salts. 18 Battery -- all this stuff, they mix in there. 19 Rat poisoning. 20 They don't care what they put in there, but 21 they make more money. 22 But if you get a hot load from somebody that 23 maybe hasn't cut it again, and it goes up -- if you 24 go, from 4, to 7 percent heroin, your heart 25 explodes. It just plain blows apart. The valves 1 and the vessels and everything, they'll just blow 2 apart. 3 So I'm telling you, right from the 4 16-year-old, up to 48-year-old, we're seeing it. 5 SENATOR RITCHIE: I know Assemblyman Barclay 6 touched on this earlier, and I've heard from a 7 number of law-enforcement individuals who believes 8 the I-STOP program has been so successful that it is 9 forcing more people to use heroin. 10 Do you think that's true? 11 SHERIFF REUEL TODD: I believe it is. 12 And, again, that's -- again, the I-STOP 13 program is great. Any program that helps anybody. 14 You know, my brother who, again, went through 15 this, and never give up hope. 16 Because I honestly didn't think then that he 17 would make it through the program. 18 Don't ever give up hope, because you never 19 know. 20 When they finally hit rock bottom, and they 21 realize it, they're either going to die sometimes, 22 and sometimes they do, I'll be honest with you, but, 23 never give up hope. 24 The I -- it helps, but, again, when you can 25 go to mental-health facilities, like he was saying, 1 and get a prescription of 180 pills of quasi drug, 2 of a drug that is -- they give you to help you get 3 through the effects when you don't have that, and 4 they take it out and sell it for 5 or 10 dollars, 5 take the money and buy cocaine or heroin. 6 And heroin is so cheap now, compared to what 7 it was when I worked undercover. And we saw very 8 little. 9 In '78 and '79, we saw very little heroin. 10 It was all weed back then. 11 And now it's -- now they're importing it. 12 It's so much -- if you got a package of 13 heroin that's that big, you're talking thousands and 14 thousands of dollars. 15 You take -- the cost of weed is up, compared 16 to what -- it's kind of reversed itself. 17 A bag of weed is worth, it's about 40 bucks 18 now, and that's what heroin was. And a little pill 19 like that now is five. 20 UNKNOWN SPEAKER: Well, '78 and '79 was a 21 long, long time ago. 22 [Laughter.] 23 SHERIFF REUEL TODD: Well, I don't want to 24 date myself. 25 Yet, I've been in here a long time. 1 ASSEMBLYMAN BARCLAY: I just had a quick 2 question, and I don't know if you can answer it. 3 The DA mentioned that 40 percent of the drug 4 task force, I don't know if they're arrests, or 5 whatever, covered heroin. 6 Do you have any idea where heroin stands in 7 Oswego County, compared to meth or synthetics or any 8 other drug? 9 SHERIFF REUEL TODD: Heroin is picking up 10 very fast in our county. 11 Meth, we've concentrated so much on so many 12 of these meth labs, when, all of a sudden, the price 13 of heroin has dropped so much, people were turning 14 in their neighbors, and stuff, FOR making this. 15 We aren't seeing as much meth now as we are 16 heroin, because it's there, you can get it. 17 ASSEMBLYMAN BLANKENBUSH: Thanks. 18 SENATOR RITCHIE: Thank you, Sheriff. 19 [Applause.] 20 SENATOR RITCHIE: Next we'll have, 21 Adam Bullock, RN, and director of Behavioral Health 22 Services at Canton-Potsdam Hospital. 23 ADAM BULLOCK, RN: I want to thank 24 Senator Ritchie for having me here, and thanks to 25 the Assemblymen as well, and for listening to us 1 about what's going on with heroin. 2 I'm the treatment side of things. 3 Canton-Potsdam Hospital, we have an 4 outpatient clinic for chemical dependency. We have 5 an inpatient detox program. We have an inpatient 6 rehab, and also a behavioral-health clinic; a 7 psychiatric clinic. 8 So, I see folks on all spectrums of the 9 problem, let's say it that way. 10 And what I've given you is kind of showing 11 some of the increase that we're seeing on the 12 treatment side. 13 The blue, and what you'll see first, is 2011. 14 You'll see a doubling, from 2011 to 2012, and 15 then, again, it doubled, from 2012 to 2013, across 16 all of our service lines. 17 That's all -- that's with the heroin use. 18 The next sheet is your opiate percentages. 19 You would think, and with I-STOP and with the 20 increase in heroin, you would see a decrease with 21 the synthetic opioids; however, you're not. 22 You'll see that in that second page, 23 "Opiate Use Percentages." 24 Not until 2013 are you seeing some of the 25 decline in that. Some of it's I-STOP. Some of it's 1 the increase of the availability and the cheapness 2 of heroin. 3 And your last page, you will see, is 4 comparing the quarters, 2014, to give you a snapshot 5 of what's currently going on, to the last two years. 6 You see detox, from '12 to '14, increasing 7 from 16, to 45 percent, of the folks we're seeing. 8 Rehab has gone from 18 percent, to 53 percent. 9 Our outpatient continues to rise as well. 10 But, there's a drastic jump on that last 11 page, kind of showing the fourth quarter. 12 I am open to questions. 13 I just wanted to give you a little bit of 14 what we're seeing. 15 SENATOR RITCHIE: Can you tell me if you 16 believe there's enough facilities or treatment 17 centers here, as far as the increase in the number 18 of heroin users? 19 ADAM BULLOCK, RN: That's an interesting 20 question. 21 There's plenty of beds. 22 Canton-Potsdam Hospital, our rehab, where you 23 would think, and that's kind of you're talking about 24 is that inpatient rehab, or outpatient, our 25 occupancy rate's around 87 percent in our rehab. 1 The reason that you see an epidemic, and you 2 don't see patients in the beds, it doesn't make 3 sense, does it? 4 Through this increase, we've also seen the 5 decrease in payers. We've seen the inability to get 6 patients into treatment facilities. 7 They continue to raise the standard: An 8 individual hasn't failed at outpatient. They 9 haven't failed enough at outpatient. 10 It doesn't matter what the data is. 11 I have a young woman in treatment right now, 12 who is a registered professional nurse, using at 13 work. Showed up at a -- had some other issues, 14 Child Protection involved. 15 Insurer allowed us to have her in treatment 16 for 12 days. 17 We tried to re-review that this morning. 18 The insurance company denied us, and said: 19 Had you -- the doctor from the insurance company 20 said: Had you called up me previously, I wouldn't 21 have given her any days. 22 This is a woman that also has failed at 23 outpatient therapy. 24 This is non-stop, it's every day. It's a 25 battle that we fight. 1 [Applause.] 2 ADAM BULLOCK, RN: Thank you. 3 SENATOR RITCHIE: Can you elaborate on the 4 process of how someone is trying to get help, and 5 seeks out your services, what the insurance company 6 can or cannot do? 7 ADAM BULLOCK, RN: They can deny you access 8 to treatment. 9 SENATOR RITCHIE: And is there any appeal on 10 that? 11 ADAM BULLOCK, RN: No. 12 SENATOR RITCHIE: If somebody comes in and is 13 looking to turn their life around, and to get 14 into -- to have some rehab services, you're telling 15 me that the insurance company can just come back and 16 deny them payment? 17 ADAM BULLOCK, RN: Absolutely. 18 AUDIENCE MEMBER: Absolutely. 19 ADAM BULLOCK, RN: Absolutely. 20 "Amen!"? 21 [Audience members say, "Yes."] 22 ADAM BULLOCK, RN: The biggest problem you 23 have, the insurance company issue is bigger than 24 heroin problem, because you can't get anyone any 25 help. 1 AUDIENCE MEMBER: Emergency room. 2 ADAM BULLOCK, RN: I fought with an insurance 3 company the other day, and I said: You're shooting 4 your own self in the foot. 5 Instead of getting their subscribers the help 6 that they need, they'll continue to pay for 7 emergency room visits, they'll continue to pay for 8 detoxes, they'll continue to pay on these other, and 9 they don't even look at the data. 10 I said: Look at the evidence. 11 But they continue to deny. 12 ASSEMBLYMAN BLANKENBUSH: What do they tell 13 you, the reasons why, the denial? Just that it's 14 not covered? 15 [Microphone not working at speaker podium.] 16 ADAM BULLOCK, RN: Sometimes there's -- 17 theres a coverage, but they're not qualified? 18 ASSEMBLYMAN BLANKENBUSH: I don't get that. 19 Can you explain it? 20 ADAM BULLOCK, RN: Well, say you call us, and 21 you're looking for -- say you're looking for a rehab 22 bed. 23 Sometimes I can't get you in at all. You 24 don't have the benefit, is some of that. 25 But, you do have the benefit, but you don't 1 qualify because: You haven't tried outpatient. 2 You've only failed once at outpatient. You should 3 try to go to an intensive outpatient before you can 4 come to rehab. 5 So, you know, they raise the gradient. 6 And, it does not matter what's going on in 7 your personal life. 8 Then they'll say, Okay -- after you fight 9 with them for an hour, they'll say: Okay, you can 10 come in. We'll give you three days. 11 The counselor doesn't even have time to write 12 a treatment plan in three days, and we have to call 13 the insurance company. We're not even to the bottom 14 of it yet. 15 And they'll give us four more days. 16 What do you do in four more days? You try to 17 collect more data. You try to work. The patient 18 doesn't even have his bags unpacked, because they 19 know that they're going to have to leave. 20 They'll turn around and they'll ask them to 21 leave. 22 I have a pregnant -- a pregnant individual 23 have to leave us after seven days. 24 SENATOR RITCHIE: What's the normal amount of 25 days that is needed for somebody to recover in 1 rehab? 2 ADAM BULLOCK, RN: I'm not able to answer 3 that question. 4 Ideally, you would want at least a 28-stay in 5 the rehab. 6 It depends on the individual's circumstance, 7 socioeconomic status. 8 SENATOR RITCHIE: Well, I understand there's 9 a variable -- 10 ADAM BULLOCK, RN: Yes. 11 SENATOR RITCHIE: -- but when you're talking, 12 3 days, 4 days, and maybe 7 days, that's a far cry 13 from 28 days. 14 So, in the end, they're actually wasting 15 their own money, because they're not giving you 16 enough money to even accomplish anything. 17 ADAM BULLOCK, RN: Exactly, and they don't 18 get that. And that's the argument we continue to 19 use, but, you don't see them buying the logic. 20 14 days is your typical now. 21 The biggest issue that we've seen, is when we 22 started seeing a lot of the managed Medicaid 23 products. 24 You know, there were some individuals that 25 were able to get help. Managed Medicaid stepped in. 1 BHO stepped in. 2 That was one of the worst things that had hit 3 us, was every patient who had had the BHO (the 4 Behavioral Health Organization), we had to call in 5 all that information, we would spend hours. 6 And we continue to spend hours on those 7 individuals now. 8 I see our friends from Samaritan shaking 9 their heads, also. 10 Hours of time. 11 Now, I'm supposed to be with -- have my hands 12 tied, trying to help somebody, and I'm spending all 13 my time on the telephone, fighting with the 14 insurance company. And I can't even begin with 15 their prescriber. 16 It's not mine. This isn't a person that I'm 17 paying for that stay. 18 That's what's happened with the BHO. It's 19 just gotten worse and worse. The fight has gotten 20 harder and harder. The length of time it takes for 21 the insurance companies has gotten longer and more 22 difficult. 23 MARK KOESTER: We didn't get dime one, out 24 five rehabs, from the insurance company. 25 ADAM BULLOCK, RN: It's insane. 1 MARK KOESTER: I wasn't going to fight with 2 them. 3 ADAM BULLOCK, RN: That's right. 4 ASSEMBLYMAN BLANKENBUSH: So it sounds to me 5 like, if you have $400,000, you can get rehab. 6 AUDIENCE MEMBER: I had a friend who had to 7 refinance his house. His son's in rehab right now. 8 He'll be in there for three days, come home, 9 and go right back into it, I'm sure, because that's 10 just enough time to dry him out. 11 SENATOR RITCHIE: Well, there's very few 12 parents who would have those kinds of resources. 13 And we certainly commend you for staying the 14 course with your son. 15 But, what does that mean for, you know, the 16 majority of families who don't have those kind of 17 resources? What happens to their family members? 18 They come in and they stay for three days, 19 and they send them home, and, then, what, they end 20 up at the emergency room? 21 ADAM BULLOCK, RN: Yes. 22 SENATOR RITCHIE: And what happens at the 23 emergency room? They're signed up for outpatient 24 services? 25 ADAM BULLOCK, RN: Nothing. 1 SENATOR RITCHIE: Nothing? 2 They just get them through that small crisis, 3 and then their sent back -- 4 ADAM BULLOCK, RN: We also, at 5 Canton-Potsdam, we have a detox unit. We have 6 seven beds on the detox unit. 7 There's 54 people waiting for beds, with 8 opiate issues, for those 7 beds. 9 While they're waiting, what do they do? 10 The withdrawal symptoms of opiate dependence 11 and opiate withdrawal is: They have nausea, they 12 have vomiting. There's anger. There's chills, 13 there's sweats. They can't eat. They're curled up 14 in a ball waiting, for a bed. 15 They show up at an emergency room, no one is 16 going to give them opiate to take them out of 17 withdrawal. No one wants to give them a benzo, a 18 Valium, or something to keep them at ease. 19 Generally, they'll give them a little bit of 20 clonidine, maybe a couple Valium, and they send them 21 back home. 22 That's exactly what happens, until they 23 finally detox on their own at home. 24 I frequently hear: I detoxed at home, I'm 25 ready to come in. 1 You know, because one of the questions we ask 2 in our rehab, when we do evaluations on the 3 outpatient side: Are you going to detox? When was 4 your last use? 5 SENATOR RITCHIE: So, is that what you're 6 referring to, that they haven't gone through that 7 process first before they're allowed to go to 8 Canton-Potsdam for a rehab, to an actual facility? 9 ADAM BULLOCK, RN: Yeah, if you want to come 10 into rehab, or the facility, we want to make sure 11 that you're able to engage, and you're not going to 12 go into withdrawal. 13 If we put you in a rehab facility, we want to 14 detox you before you come. 15 So, they'll just spend a couple days there. 16 It's a 5-day methadone taper. 17 Or if it's alcohol withdrawal, which is 18 life-threatening, has to be treated before you can 19 engage in treatment. 20 SENATOR RITCHIE: And this is my last 21 question, I promise: 22 Can you tell me, for those that detox, and 23 then they don't actually get to go into like a rehab 24 program, what's the statistics on their success rate 25 after? 1 ADAM BULLOCK, RN: Uhm, I don't have 2 statistics; nor does anybody, you know, success 3 rate. 4 People have lost contact. People are dying. 5 People are moving on to other treatment facilities. 6 There's no data on that. 7 But we continue to see them. 8 You will see, also, I have percentages on 9 re-admission rates that we've had. 10 For the three years, I gave you 11 representation: 623 admissions to our detox. 12 45 percent of them are re-admissions. 13 So, half the people came back, yeah, that 14 were able to. 15 With rehab, over those three years, there 16 were 296 admissions. 17 28 percent were re-admitted; 83 in 18 outpatient. 19 64 percent are coming back into the cycle. 20 SENATOR RITCHIE: I guess I'm going to have 21 to ask you one more question, after that. 22 Those that aren't coming back are -- those 23 that aren't coming back in for rehab the second 24 time, are you assuming that they're able to hold a 25 productive life, and not use the drug again? 1 Or, are they just not coming back because 2 they've given up hope? 3 ADAM BULLOCK, RN: My mind says is that, one, 4 they're incarcerated. Two, they're at another 5 treatment facility. A small percentage are healthy. 6 And the rest of them are no longer with us. 7 SENATOR RITCHIE: That's pretty scary. 8 ADAM BULLOCK, RN: That's the truth. 9 SENATOR RITCHIE: Thank you. 10 [Applause.] 11 ASSEMBLYMAN BARCLAY: Just two questions, I 12 want to follow up: 13 For a detox on heroin, you use, what's it 14 called, "methadone"? 15 ADAM BULLOCK, RN: Use the methadone. 16 ASSEMBLYMAN BARCLAY: And is -- I know with 17 alcohol detox, it is very dangerous during that 18 time, people -- is it the same? 19 Because some drugs there's not a problem 20 with, as far as life-threatening detox. 21 Where does heroin fall in that? Is that more 22 like alcohol -- 23 ADAM BULLOCK, RN: Alcohol withdrawal is 24 life-threatening because of the cardiac instability, 25 seizures that happen. 1 Heroin generally is not life-threatening. 2 The individual feels like they're going to die; 3 generally doesn't. 4 ASSEMBLYMAN BARCLAY: Just the information 5 you gave us, you have percentages here. 6 I assume that's percentages of all drug use? 7 Is that what the "100 percent" is? 8 And then -- 9 ADAM BULLOCK, RN: Yeah, the "100 percent" 10 would be all patients. 11 ASSEMBLYMAN BARCLAY: Admitted patients for 12 drug use? 13 ADAM BULLOCK, RN: Yeah. 14 ASSEMBLYMAN BARCLAY: And, then, is the -- on 15 the last page -- 16 ADAM BULLOCK, RN: No, that's drugs and 17 alcohol, of all our admissions. 18 The percentage was for heroin. 19 ASSEMBLYMAN BARCLAY: Okay, drugs and 20 alcohol. 21 And then, is this the number -- in the last 22 page, you have: "First-quarter heroin-use 23 percentages," and then you have "60" on the 24 left-hand side. 25 Is that the number of admitted, all for drug 1 and alcohol? 2 ADAM BULLOCK, RN: Yeah, we just used "60" as 3 our gauge because it got over the 50. 4 If you look at the second one, "Rehab," the 5 green, was 53. 6 53 percent of our current patients in the 7 last three months, in rehab, were there for heroin. 8 ASSEMBLYMAN BARCLAY: That's the percentage, 9 okay, that makes sense. 10 Then what are we talking -- I guess what I'm 11 ultimately trying to get at: What are we talking 12 about, actual numbers here, versus percentages? 13 ADAM BULLOCK, RN: Well, 600 over the year. 14 You're going to take 300 -- 15 ASSEMBLYMAN BARCLAY: Well, just go with the 16 heroin-usage percentage, first. 17 ADAM BULLOCK, RN: Probably 150 in the last 18 three months, out of 300. 19 ASSEMBLYMAN BARCLAY: Oh, that's the first 20 quarter. 21 ADAM BULLOCK, RN: Yeah. 22 ASSEMBLYMAN BARCLAY: So you're looking at, 23 what -- 24 ADAM BULLOCK, RN: January, February, March. 25 ASSEMBLYMAN BARCLAY: All tole for the year? 1 ADAM BULLOCK, RN: Yes. 2 ASSEMBLYMAN BARCLAY: Wow, holy smokes. 3 ADAM BULLOCK, RN: So about half. 150 out of 4 300, I'd throw it around there. 5 SENATOR RITCHIE: Thank you. 6 [Applause.] 7 SENATOR RITCHIE: Our next testimony will be 8 from Dr. Moehs. 9 Doctor, thank you. 10 DR. CHARLIE MOEHS: Well, thank you for the 11 opportunity to allow me to talk to you today about 12 some thoughts I have about drug addictions. 13 I have practiced in the Watertown area for 14 30 years. I have a private practice in occupational 15 medicine. Worked at the New York State prison in 16 Cape Vincent for 16 years, retiring in 2006. 17 As a specialist in HIV at the prison, I was 18 offered to take a course to allow me to prescribe 19 buprenorphine. Since then, I have become hooked on 20 working with addicted patients, and follow the 21 largest number of patients with opioid addictions on 22 Suboxone in Jefferson County. 23 In addition, I'm involved in inducing 24 patients on buprenorphine, Suboxone, for other 25 hospital services, and my practice performs many 1 drug tests for uses by social services, probation, 2 the courts, and Child Protective Services. 3 We have a large experience with the problem 4 of drug and alcohol problems in this county. 5 I'm a member of the American Society of 6 Addiction Medicine, and I'm on the New York State 7 Chapter's Committee On Public Policy. 8 This area is blessed by two strong outpatient 9 addiction programs: Credo Foundation, and 10 Samaritan Hospital Addictions Services. 11 These programs are open to all potential 12 patients who choose, and the treatment programs are 13 individualized according to the needs of the 14 individual, and attention is given in terms of 15 advice and encouragement, and other issues, such as 16 education, vocational information, living and 17 housing, and other services. 18 Patients need to graduate from the program, 19 and if they fail because of non-attendance or 20 relapse or other issues, they are given the 21 opportunity to re-enroll. 22 Many of these patients benefit from using 23 Suboxone as a means of avoiding cravings for drugs 24 and help them stabilize their outlook on life. 25 In general, the treatment of drug addicts 1 with Suboxone can be short, such as 8 to 12 months, 2 or longer, as the patient struggle with improving 3 their lives and feeling comfortable being off of the 4 Suboxone. 5 Longer treatment is often advisable, as 6 patients require time to develop living skills past 7 their initial addiction program. 8 Continuing with Suboxone allows them to live 9 without cravings and become productive before they 10 come off the medication. 11 Studies are available to review, concerning 12 these approaches. 13 Suboxone itself can be difficult to stop, as 14 patients become physiologically dependent and suffer 15 withdrawals if the medicine is stopped too rapidly. 16 Tapering patients too rapidly or taking the 17 patient off the medication arbitrarily and before 18 they're ready will lead to relapse. 19 In my practice, I have several patients who 20 have been on Suboxone for eight years. Three and 21 four years is an average, and some patients are 22 less, of course. 23 One problem is that, drug addiction tends to 24 be a catch-all phrase and does not describe the 25 severity of the addiction. Many patients begin 1 their addiction in teenage periods, and in some 2 cases, even in preteens. These adolescents are, 3 thus, subject to brain insults as a result of the 4 addiction, that makes overcoming the addiction very 5 difficult. 6 Patients who begin their addiction in their 7 20s might be perhaps easier to treat, but 8 variables, such as family support, education, job 9 opportunities, and the understanding of realistic 10 goals, are needed to go through a program and 11 complete it. 12 Before they can be done with their addictive 13 ways, the patient sometimes needs longer treatment 14 and specialized treatment. 15 The longer the patient is addicted is a 16 factor, as well. 17 I have patients in their 40s and 50s who 18 have been addicted all their lives and are 19 struggling to remain sober. Some have developed 20 characteristics that make them dishonest to 21 themselves and others. They use drugs when they 22 become frustrated, and they lack the ability to deal 23 with life on life's terms. They are anxious, they 24 are fearful, they are depressed, and they are unable 25 to keep a job, unable to avoid a marginal way of 1 living, and they are unable to recognize a life 2 without the support of social services, health care 3 provided by Medicaid, and in all situations, persons 4 addicted are felt to have an illness related to 5 changes in the brain. 6 I have patients who have been raped or abused 7 by family members, who have seen their 8 patients [sic] abuse each other, or whose parents 9 have been in jail, for much of their developing 10 lives. 11 I have a patient who received an apparatus to 12 use cocaine as a birthday gift when they became 13 16 years old. 14 I have a high rate of pregnancy among 15 Suboxone users. 16 I have had a few amazing successes; people 17 who have taken control of their lives, gotten good 18 jobs, and are now successfully living the American 19 dream. 20 I have had several patients who have attended 21 and graduated from Jefferson Community College and 22 are going on to obtain higher degrees. 23 I have a patient who recently obtained a 24 master's degree, and was sought after for a job that 25 is paying over $60,000 a year; and he is just now 1 coming off his Suboxone. 2 I have had many failures: people who have 3 relapsed, people who have been arrested and gone to 4 jail; failed probation, failed the addiction 5 programs. 6 I have patients who lie and use, and continue 7 to struggle. 8 People are fearful about getting off the 9 Suboxone, and since they lack the confidence to make 10 the changes they need, they don't become successful. 11 To improve our treatment here in Watertown, 12 we should have a detox program. 13 Currently, patients need to go to Syracuse or 14 Potsdam. 15 And we heard from that individual in Potsdam. 16 Thank you very much. It was quite 17 illuminating. 18 There is often a wait time of several weeks 19 or a month to get into detox. 20 The truth is, is that when you're ready to 21 make a change, you need to do it when you are ready, 22 or other influences will intervene and the patient 23 gives up. 24 Detox can be outpatient and can be more 25 versatile than the existing inpatient programs. 1 Funding will be needed for this to be in 2 place, and flexibility of the development of the 3 service should exist. 4 Detox optimally will run concurrently with 5 outpatient addiction treatment. 6 We need more Suboxone providers. 7 Not all doctors want to deal with the messy 8 issues of addiction treatment, so there needs to be 9 support and working agreements with existing 10 treatment programs so that longitudinal treatment 11 issues can be dealt with. 12 These issues are programmatic, 13 social-services networking, mental- and 14 behavioral-health coordination, case management, job 15 training, partner and marriage counseling, and a 16 host of services that physicians might not have easy 17 access to. 18 Until we have this, doctors will not become 19 prescribers. 20 If they have a particularly difficult 21 patient, they need to be able to seamlessly transfer 22 that patient to a higher level without simply 23 discharging them from their program. 24 What I'm describing is an integrated help 25 system where prescribers and addiction-treatment 1 providers work together in managing the patient 2 according to their individual needs, until they can 3 be successfully discharged. 4 We need improved mental-health services. 5 70 percent of addicted patients have an 6 additional mental-health diagnosis. 7 Although we have a new mental-health 8 organization in Watertown, it still takes several 9 months for many patients to be seen, and psychiatric 10 services should be part of the hub that I described. 11 Within the hub, long-term root-treatment 12 programs should be available to provide ongoing 13 support while the patient remains on Suboxone. 14 A statewide issue is that, if a patient is on 15 Suboxone and is arrested and put in jail, his or her 16 medication, just as medicine for diabetes, 17 hypertension, and heart disease, needs to be 18 continued. This patient should not be put in jail 19 and forced to undergo the painful rigors of rapid 20 detoxification in a jail cell. That's just 21 inhumane. 22 Lastly, the issue of legalization of 23 marijuana is troublesome to me, and it's troublesome 24 to our task force. 25 It's a known toxic substance for the 1 developing brains of children and adolescents. 2 Brain damage can occur if the current movement for 3 use of marijuana, even for the ill patient, is 4 implemented. 5 At a minimum, stringent regulatory rules will 6 be needed to control its use, and there should be no 7 consideration given to allowing expanded use to 8 become a steppingstone to legalized marijuana in 9 this state. 10 Thank you again for letting me speak to you 11 today. 12 I have one other comment that I wrote down, 13 and that's about the insurance companies, and they 14 certainly have a huge effect on the prescribing of 15 Suboxone. 16 Suboxone, I haven't said much about it. 17 Most people know something about it, but, 18 it's similar to methadone, except it can be given on 19 an outpatient basis, and patients can carry it with 20 them. They don't need to go every day into a 21 methadone program, and, it certainly is helpful. 22 It has some negative effects, it often can be 23 abused, and so on and so forth; and, so, that's an 24 issue. 25 But the insurance companies currently control 1 Suboxone, as it were. 2 So we can prescribe it, but we have to get it 3 approved. And they may not approve the dose that we 4 want. If we are -- they may not approve the dosing 5 mechanism that we have. For example: 6 If somebody is on 16 milligrams, and you want 7 to reduce them down to 12; 8 You might want to change them to a different 9 dosage form, instead of 8-milligram tablets, or 10 strips. 11 But, you're often not allowed to do that. 12 If I have a patient coming down from Suboxone 13 and they're on 8 milligrams, and I want to reduce it 14 by 1 milligram at a time, it's difficult to do that 15 unless I change the dosage for it. 16 Well, they might not approve the particular 17 dosage for them; and, so, I'm telling the patient, 18 Well, you gotta to cut your pill, or you gotta cut 19 your strip. 20 And, you know, how do you judge 1 milligram 21 from an 8-milligram strip? 22 So, the insurance companies have a big say in 23 what's going on. 24 And, we have no idea how long they're going 25 to approve them. In other words, if we have 1 somebody who's on that medication for two years, 2 they very well may say: Well, two years is long 3 enough, we're not going to pay for it anymore. 4 We don't know that. 5 So, thank you again. 6 [Applause.] 7 SENATOR RITCHIE: Doctor, just a couple 8 questions. 9 Do we have enough doctors and nurses and 10 social workers to cover this area? 11 Because I'm always hearing that there's a 12 shortage for doctors in other areas in the counties 13 that I represent. 14 DR. CHARLIE MOEHS: Well, we are pretty well 15 supplied, I would say. 16 Family-practice and primary-care doctors, you 17 always can use more of them. 18 But, I'm the only doctor in practice that 19 prescribes Suboxone. 20 I'm a family physician, I've specialized in 21 that, and I'm particularly interested in addiction 22 problems. 23 We don't have any other primary-care doctors 24 who are prescribing. 25 We have two psychiatrists right now. 1 There are some who are certified, but they're 2 not really involved. 3 And, I can tell you that, from my experience, 4 it's not easy. It's not just a matter of writing a 5 prescription for Suboxone, because they need extra 6 services, they need more help. 7 And, you know, unless you're willing to give 8 it, you're not going to prescribe. 9 SENATOR RITCHIE: You touched upon one of the 10 points that I was kind of trying to understand, 11 because, when somebody gets to the point, like you 12 talked about earlier, when his son got to the point 13 where he realized he wanted help, and then you go to 14 get the services and you're put on a waiting list. 15 DR. CHARLIE MOEHS: Right. 16 SENATOR RITCHIE: By the time you get to 17 that, your circumstances may have changed. 18 So, for how many people are slipping through 19 the cracks, that they're not able to get the 20 services they need at the time they're ready to 21 receive them? 22 DR. CHARLIE MOEHS: Well, I think that that's 23 a hard number to really get at there, but it's a 24 significant number. 25 I mean, I think if there are 50 patients 1 waiting, how many of those eventually drop out, you 2 know? 3 40 percent? 100 percent? 4 AUDIENCE MEMBER: We get dozens of calls 5 every week for Suboxone, and we're at capacity. 6 Dr. Moehs is at capacity. 7 So, you have a number of people who are ready 8 to come forward, but there's no access to the 9 medication support. 10 DR. CHARLIE MOEHS: I have people calling me 11 every day, to try to get into the program. And I'm 12 limited to 100 patients. That's a lot. 13 There are a lot of doctors who will stay with 14 the initial allowed amount, which is 25. 15 SENATOR RITCHIE: You'd think we would be 16 doing all we could to make sure that those 17 individuals who are at the point where they're going 18 to try and get help are able to immediately get 19 treatment while they're in that frame of mind, 20 versus sending them back home waiting for, you 21 know -- 22 DR. CHARLIE MOEHS: Well, some of them might 23 be in a rehab program, and then the rehab program 24 will want to get them on Suboxone. 25 But, if you don't have room, you know, then 1 they go searching around for doctors. And some 2 might drive to Syracuse or elsewhere to try to get 3 on the Suboxone? Or. They buy it on the street, 4 because it has a street value. 5 AUDIENCE MEMBER: Same with heroin, they 6 oversold it. 7 DR. CHARLIE MOEHS: But I think the issue 8 that I'm trying to describe, is that if we have a 9 really well-honed system, where doctors in treatment 10 facilities work closely together, really closely, 11 and that you can pass a patient back and forth, the 12 problem then for the physician of dealing with 13 addiction issues that they might not be capable of 14 doing or they don't totally understand, they can 15 give that patient back to the rehab, so the rehab 16 can work with that patient, and then maybe send them 17 back to that doctor. 18 And there are models in this country where 19 that works very well. 20 Burlington, for example, is one where they 21 have that kind of a hub system, where the 22 mental-health addiction-treatment program is the 23 main entity, and they have a variety of primary-care 24 doctors who simply prescribe the medication. 25 SENATOR RITCHIE: Thank you. 1 ASSEMBLYMAN BARCLAY: Doctor, how do you 2 spell that, subox -- 3 DR. CHARLIE MOEHS: Suboxone, 4 S-U-B-O-X-O-N-E. And the generic name is 5 buprenorphine. Bu-pre-nor-phine. 6 ASSEMBLYMAN BARCLAY: I'm not going to try 7 that. 8 [Laughter.] 9 DR. CHARLIE MOEHS: I'm going to give you a 10 copy of my -- 11 ASSEMBLYMAN BARCLAY: So that is in lieu -- 12 that there's other methadone? Is that a -- 13 DR. CHARLIE MOEHS: Methadone is another 14 similar-type drug, yes. 15 ASSEMBLYMAN BARCLAY: And these drugs -- and 16 I don't know anything about these, so just bear with 17 me. 18 These drugs, one helps you detox, and also 19 keeps you off the addiction? 20 DR. CHARLIE MOEHS: Well, yes, it helps 21 resolve the cravings that you might have for the use 22 of opiates, yes. 23 ASSEMBLYMAN BARCLAY: And what kind of drugs 24 are these? Are they -- 25 DR. CHARLIE MOEHS: They are opioid-like 1 drugs, but they have a limit. Methadone, less so. 2 But Suboxone has a limit that it will work. So, up 3 to 32 milligrams, perhaps, you won't have any 4 further effect. 5 In fact, 16 milligrams is probably the 6 maximum amount. You can't give more, and you can't 7 get higher, or you can't get high at all. 8 Most people who are on Suboxone, and, in 9 fact, not pointing them out, there are a few of my 10 patients here who are on Suboxone, and they'll tell 11 you that it just makes them feel normal, and they 12 function just as normally as anybody else. There is 13 no specific ill-effect of the medication. It 14 doesn't make you high. 15 ASSEMBLYMAN BARCLAY: Great. Thank you. 16 SENATOR RITCHIE: Thank you, Doctor. 17 [Applause.] 18 SENATOR RITCHIE: We are going to take a 19 short break, say, 10 minutes. 20 We're halfway through the testimony; and, so, 21 we'll take a quick break. 22 Thank you. 23 (A recess was taken.) 24 (The forum resumed, as follows:) 25 SENATOR RITCHIE: We're ready to get started 1 now. 2 The next person testifying will be 3 Chelsea Mulchany. 4 Chelsea. 5 CHELSEA MULCHANY: Hi. I just want to say 6 thank you, and, I apologize if I get emotional. 7 I already am. Excuse me. 8 I don't have anything written down. I just 9 have my own life experience with this drug. 10 I don't have good memories. 11 (Audience member offers tissue.) 12 CHELSEA MULCHANY: Thank you. 13 I don't have good experience. 14 In September of 2013, my boyfriend passed 15 away because of a heroin overdose. 16 We lived together for two years, and I tried 17 my hardest to try to get him to stop. 18 Unfortunately, like others have spoke today, 19 a big issue is insurance; not allowing him to stay 20 in a facility prevented him from getting clean, and 21 staying clean. 22 In September, he finally went to a rehab for 23 the second time. He got out because insurance 24 wouldn't let him stay any longer than six days. 25 The day that he got out, he begged me and 1 begged me to try to get him help. 2 He told me how he felt like the devil was 3 inside of him. He could not get the devil out of 4 him. 5 Unfortunately, six days later he passed away 6 at his mother's house, in the bathroom, and his 7 10-year-old niece found him. 8 I don't really know what else to do to try to 9 get it out there that there needs to be more help. 10 The system is broken. It is not effective, 11 whatsoever. 12 In January, we found out my brother was 13 addicted to heroin. 14 Luckily -- well, not luckily, but, it was not 15 at the point where he was injecting. He was only 16 ingesting by sniffing. 17 So what had happened is, we sent him to a 18 rehab facility called "Syracuse Teen Challenge." He 19 was there for 90 days, and he just got out on 20 Monday. 21 He has a wife who is an RN. 22 He himself was in the union, had a good job. 23 Just, got mixed up in the wrong thing, 24 because he was addicted to opiates for 10 years, and 25 it led to, eventually, being addicted to heroin. 1 My father, who owns his own company, is sick. 2 He has autoimmune polyneuropathy, and he also has 3 Lupus. They give him pain pills. He became 4 addicted to the pain pills, and now he is on 5 Suboxone, and he will be for the rest of his life. 6 I really don't know what else to say, other 7 than, there needs to be more options for those who 8 are addicted to drugs, opiates, alcohol, any other 9 drug besides heroin, as well. 10 But, there just needs to be more options to 11 get help, and to stay clean, because it's just not 12 working the way it is now. 13 Really, that's all have I to say. 14 [Applause.] 15 SENATOR RITCHIE: First, I just want to say 16 how much we all appreciate you coming here and 17 telling the story, because if we don't hear, 18 unfortunately, heartbreaking stories like that, it 19 never gets ramped up to the next level to really do 20 something about it. 21 So, appreciate how tough that was for you. 22 CHELSEA MULCHANY: Thank you. 23 SENATOR RITCHIE: And if you, you know, would 24 be willing to answer a few questions? 25 CHELSEA MULCHANY: Sure, yeah. 1 SENATOR RITCHIE: Can you tell me how long 2 your boyfriend struggled with this before that 3 happened? 4 CHELSEA MULCHANY: Well, probably a total of, 5 addiction, in general, about five years. 6 He was captain of his high school football 7 team. He was an All-State champion wrestler. He 8 grew up and lived right outside of Las Vegas, in 9 Henderson, Nevada. 10 It began just partying. You know, the 11 drinking. Recreational drug use turned into 12 addiction to pain pills, which then turned into 13 addiction to heroin. 14 He then decided he wanted to get clean, and 15 he came to live with his mother here on this side of 16 the country. 17 And, the kids that he went to the 18 middle school with are all addicted to opiates and 19 heroin, and, you name it, they have it, they do it. 20 And it just spiraled out of control. 21 The last two months of his life, he was using 22 $700 or more a week of heroin, which is about a 23 bundle to a bundle and a half a day, which I believe 24 is a lot, a day. 25 SENATOR RITCHIE: You talked about the need 1 for more services? 2 CHELSEA MULCHANY: Right. 3 SENATOR RITCHIE: And I understand that he 4 didn't get to stay as long as he needed to the last 5 time. 6 What other problems did you run into when he 7 was trying to look for services? 8 CHELSEA MULCHANY: The prices of rehab 9 facilities. 10 I called the New York State Hotline, to try 11 to get him into a rehab, and they said: 12 Unfortunately, the cheapest rehab that we have 13 available is $14,000 a month. 14 "A month." And that was the cheapest. 15 The most expensive that they could tell me 16 was $50,000 a month. 17 SENATOR RITCHIE: Do you have any questions? 18 ASSEMBLYMAN BARCLAY: I do, thanks. 19 I just want to echo the Senator's words: 20 It's really very good of you to come. And I know 21 it's not an easy thing to do, to relive somebody's 22 bad memories. 23 CHELSEA MULCHANY: Thank you. 24 ASSEMBLYMAN BARCLAY: Can you explain a 25 little bit, and maybe you don't know, or whatever 1 you're willing to testify, where he got the heroin 2 from? 3 CHELSEA MULCHANY: Yeah, sure. 4 I live in Oswego County, in Fulton, New York, 5 where I say, we, as a county, around that area, get 6 drugs; specifically heroin, from Syracuse. 7 Generally, the west side of Syracuse. 8 It's everywhere. 9 You can walk into a supermarket, ask pretty 10 much anybody, they can tell you: 11 Oh, yeah, sure, right over here on this 12 corner; 13 Right behind that school; 14 Right over there behind the teen -- the Boys 15 and Girls Club, right there, right in that alleyway? 16 Yeah, just walk back there. 17 ASSEMBLYMAN BARCLAY: So it's purchased 18 similar ways, you know, my experience, I guess, as 19 seeing it on TV: 20 Where, you're in your car, there's someone on 21 the street. You pull up and say, "I want to buy 22 this"? 23 CHELSEA MULCHANY: Yeah. 24 ASSEMBLYMAN BARCLAY: They either get a 25 runner to come get it, or -- 1 CHELSEA MULCHANY: Uh-huh. 2 ASSEMBLYMAN BARCLAY: Yeah. 3 CHELSEA MULCHANY: Yep. 4 ASSEMBLYMAN BARCLAY: It's not someone's 5 house -- 6 CHELSEA MULCHANY: It's easy. 7 ASSEMBLYMAN BARCLAY: It's easy. 8 CHELSEA MULCHANY: Right. It's incredibly 9 easy to get your hands on. It's shockingly scary 10 how easy it is to get your hands on heroin. 11 ASSEMBLYMAN BARCLAY: That is scary. 12 Thank you. 13 CHELSEA MULCHANY: You're welcome. 14 SENATOR RITCHIE: Assemblyman? 15 ASSEMBLYMAN BARCLAY: Your brother, how old 16 is your brother? 17 CHELSEA MULCHANY: My brother just turned 27. 18 ASSEMBLYMAN BARCLAY: Okay. 19 Now, he was in a teen center, you said? 20 CHELSEA MULCHANY: Well, the name of it is 21 "Syracuse Teen Challenge." It's not just focused to 22 teens. It's focused to, really, any man -- it's a 23 men's community. 24 ASSEMBLYMAN BARCLAY: Now, he was allowed to 25 stay there for 90 days? 1 CHELSEA MULCHANY: Right. 2 They want you to stay there for 14 months. 3 They keep you in Syracuse for about three to 4 four months, and then ship you to Pennsylvania to 5 their other portion of the rehab facility. 6 He has a family. My nephew is almost 7 5 years old. You know, he's got a mortgage. He's 8 married; he's got to support his family. 9 So, after about 90 days, he got out, and -- 10 which was on Monday, and, is back to work. 11 Unfortunately, I, as an individual, don't 12 have a lot of hope that he's going to stay clean. 13 And it's sad, just because there's been so 14 many times where I've saved my boyfriend's life 15 myself. I gave him CPR and brought him back to life 16 about five times myself, because I was too scared to 17 call somebody else for help. 18 ASSEMBLYMAN BARCLAY: Thank you. 19 CHELSEA MULCHANY: You're welcome. 20 SENATOR RITCHIE: Thank you. We do really 21 appreciate you coming, and talking to us today. 22 [Applause.] 23 SENATOR RITCHIE: Just to let everyone know, 24 the Assemblyman will have to leave before we finish. 25 We want everyone to understand that he 1 believes it's important, and has a prior commitment. 2 So, Jeanne Weaver of Jefferson County is the 3 next testimony. 4 JEANNE WEAVER: Thanks for allowing me to be 5 here. 6 I just want to say, begin to say, that this 7 wasn't probably any of my life plan to be standing 8 up here and airing my family's addiction issues, you 9 know, but, obviously, plans change, and I'm here. 10 I hope that some of this experience that 11 I share will help. 12 I personally envision that this growing 13 heroin epidemic is like a black plague that's 14 infecting and destroying our communities, sickening 15 and killing our children and young adults, and has 16 far-reaching consequences. 17 We have a strong family history of addiction. 18 We also have a family history of recovered addicts. 19 My father was a morphine addict. He was a 20 World War II veteran who was very badly wounded, 21 and, addicted to morphine for pain. 22 And, my husband became an alcoholic as a way 23 of medicating a loss of -- in a divorce of his 24 children. 25 And, my son, I am the mother of a heroin 1 addict and alcoholic, who is now currently 61 days 2 sober, finally, at least at this point. 3 I'm also a grateful member of Al-Anon and 4 Nar-Anon, which is family support groups for loved 5 ones of alcoholics and/or drug addicts. Very, very 6 important program for me, because, I was crazy, 7 which, living in an addicted house can make you that 8 way. And these support groups are very helpful. 9 I had a whole laundry list of my family 10 history. 11 Basically, I want to -- I guess I'll touch 12 more on my son's. 13 You know, he was a brilliant, engaging young 14 man; big heart. He was a college graduate, and 15 stonemason. 16 And, like most of us, made some pretty stupid 17 choices, even though he went through all the 18 D.A.R.E. programs, and everything, that was there, 19 you know, as a teenager. 20 Like, we never did any of that stupid stuff 21 as teenagers. 22 And, in time, he found himself a full-blown 23 heroin addict and alcoholic, and, most recently, 24 living in an unfinished cellar in a drug house in a 25 Pittsburgh suburb, which has recently been 1 condemned. 2 And, he also had a little bit of touch with 3 this fentanyl-laced heroin that killed somewhere in 4 the number of about, 23, I think, people OD'd in 5 about a week down there. 6 He had lost everything -- 7 Then, this is about the third time that this 8 has happened. 9 -- his home, his job, his truck, a 10 girlfriend, their baby, and his dog. 11 He was facing two warrants in two different 12 states. 13 He has currently satisfied the legal matters 14 in that -- in the first state, and is working on 15 this now. 16 He's reconnecting with his girlfriend and 17 child, and working on this reconciliation, and is 18 addressing his drug and alcohol problems. 19 He started a new job, as an outpatient rehab. 20 And, through Credo, he attends two or more AA 21 meetings a week, and does not have easy access to 22 NA, which would be really important. 23 There are NA meetings in Watertown, but, 24 outlying areas, there's nothing. 25 And a lot of these people don't have their 1 license anymore, so it's really hard to get there to 2 these meetings. 3 So because of that, we're doing a lot of 4 driving. And some of these meetings and 5 appointments are at least a 70-mile round trip. 6 And he's lucky, because he's got parents that 7 are standing behind him, you know, to help him do 8 this. 9 He wanted to go into inpatient rehab, but was 10 denied by the insurance company. He did not qualify 11 because he had been sober for too many days. 12 That's a big problem. 13 He'd only been -- he'd probably been sober, 14 maybe three weeks. 15 So, the insurance company has renamed his 16 illness a behavioral problem, which pretty much 17 relieves them of paying for inpatient addiction 18 treatment. 19 The fact is, that they do just about what 20 they can to avoid paying for inpatient treatment 21 because it is expensive. And they do, in their 22 contract, say they provide for these things. 23 And they also work pretty diligently in 24 decreasing the time that they spend in inpatient. 25 And I think -- or, you guys have heard this. 1 That is just one of my issues. 2 And the reason for some of this history that 3 I think is important for you guys to know, is that 4 we, just all of us people here now, we're, like, 5 regular working-class Americans, middle-class 6 Americans. 7 We're not the low-life trash that people 8 would think of as a heroin addict or a junky or 9 a dope fiend, and their family members. 10 We -- you can see a stream of BMWs driving 11 into the inner city any day, with all these little 12 yuppies going in to get their fixes. 13 You can see on a Friday night, a line of 14 young teens and young adults at a pharmacy counter, 15 there to pick up their syringes so they can party 16 safely. 17 You'll see a lot of older adults becoming 18 opiate addicts because they are seeking arthritic 19 pain relief. 20 You'll see a local high school lacrosse team 21 with a roster of pill-poppers. And I know that for 22 a fact. 23 These kids nowadays have no respect or fear 24 for heroin like we did. You know, somebody said 25 "heroin," you ran. 1 This is not the way it is now. This is just 2 one of the pieces of equipment to party with at this 3 point in time. 4 So what I want to say is: Heroin has no 5 respect to persons. There's no one that's exempt 6 from this anymore. It's just us; all of us. 7 I wanted to spend a little bit of time with 8 our personal experience, and I know I don't want to 9 run over too much, but: Life is filled with chaos 10 and guilt, fear and panic, insanity, for both the 11 family members and the addict. 12 The addict's loved ones become so enmeshed in 13 covering for, and trying to save their addict, that 14 they lose themselves. 15 We become addicted to the addicts, and we 16 become sick; and then we become sick in -- 17 spiritually, physically. I can say "ill." 18 In a point of desperation, which was 19 relatively close in time, I wrote to Dr. Phil. That 20 tells you how desperate and crazy you can get. 21 [Laughter.] 22 JEANNE WEAVER: And he hasn't called me yet, 23 but, I'm waiting. 24 [Applause.] 25 JEANNE WEAVER: We'll do just about anything, 1 you know. 2 There's -- you know, I want to go through 3 some history of this, but, probably the -- some of 4 it would be that, that he -- even though the strong 5 family history, he very well could have become an 6 addict, you know. But, he was injured in football 7 at 15, was prescribed an opiate for the pain. 8 Ultimately became, you know -- ultimately, continued 9 using some opiate, on some level, right up through 10 the use of heroin. 11 And he said to me, he loved the way that made 12 him feel, and he never stopped using it during these 13 next few years. 14 I think his -- I know his use escalated in 15 college, where you will find a lot of drugs to help 16 along with that. 17 By the time he came home, there was a lot of 18 personality changes. He was testy and unhappy, 19 verbally abusive, among other things. Would not cop 20 to anything but smoking a little weed. Had an anger 21 problem; went to anger management. 22 Over the next couple of years, there was 23 escalating chaos in our house; strange happenings: 24 Crazy friends. Missing money. Missing -- anything 25 that wasn't tied down, that had of any value, would 1 come up missing. 2 And, you know, we were clueless, really, to 3 why this. This didn't look like anything I had ever 4 seen or had any experience with. 5 Finally, after some pretty significant stuff 6 going on, he came and told us about this. 7 And that was just the beginning of our 8 experience of knowing where we were, you know, at 9 with him. 10 He had been -- he did end up going into rehab 11 in about that time, and they -- day two, they were 12 talking discharge plans. 13 Now, this is not -- we're going: What, are 14 you're kidding me? You know, we're expecting at 15 least 30 days here. 16 "Day two." 17 He was out -- sent out on the 15th day, 18 with a pat on the butt, and a "you're cured," and a 19 coin, and a to-do list. 20 You know, it just wasn't -- it wasn't what 21 we -- we tried really hard, working with the 22 insurance company. They just said "no." 23 He had OD'd at least twice. 24 He has common physical issues, mental, you 25 know, stuff that goes along with this, emotional, 1 spiritual, damage from the drugs. He's made suicide 2 threats. 3 And -- and this thing, as I said, I am in 4 much fear for his life. 5 We did everything. 6 We did everything; we do did nothing. We 7 spent money. We enabled. We detached. We removed 8 him from the home. 9 That's really hard, kicking your kid out. 10 Especially one that we feel was sick, you know, it 11 was really difficult. 12 Anyways, I think that's about all I'll say 13 about that. 14 But -- so as I can say, I haven't heard 15 anything from Dr. Phil, yet. 16 [Laughter.] 17 JEANNE WEAVER: Because I'm waiting. 18 This brings me to another -- my next concern 19 is that, you know, after reading and researching 20 much of the physiological effects on drugs on brain 21 chemistry, I'm fully convinced that this is a 22 disease. It's a chronic disease, that with a known 23 caused progression, and outcome, left untreated. 24 Good news is, you can successfully manage 25 drug addiction or alcohol addiction. 1 Problem, herein, and you've heard this: This 2 area, Jefferson tri-county area, is sorely in need 3 of more treatment facilities; particularly, I feel, 4 inpatient. 5 You know, the ones that we have are stretched 6 right to their limits, with a long waiting list. 7 And, the only way you get into these now, of 8 course, if the insurance company blesses you with 9 this, and that doesn't always happen. 10 As, you know, we -- my son was recommended by 11 his physician, by somebody that was -- that's in 12 jail. He spent some time in jail, and they had a 13 process they went through there. 14 That was recommended by her, and the person 15 at Credo; all sent recommendations for rehab, and 16 they said: No. He's been sober too long. 17 So then your choices are with this: 18 Out-of-pocket for fifteen to thirty-five to 19 fifty thousand dollars a month, which we all have in 20 our back pocket; 21 Or, Medicaid, you know. 22 And, he's not on Medicaid. 23 Addicts don't do real well with long waiting 24 periods, because they're in the throes of 25 withdrawal, and, they want -- they're ready. 1 When they're ready, they're ready, and 2 they're not -- their patience is about, like, this 3 long [indicating]. 4 Right? 5 So, anyways, we need more facilities, and 6 outpatient and inpatient treatment; 7 Well-trained professionals who understands 8 that addiction is an illness, and treated 9 accordingly; 10 And insurance companies that are going to be 11 required to cooperate a little bit; 12 And more "Dr. Moehs," because these -- you 13 know, you need these kind of people around to deal 14 with this. 15 Another issue I have is, you know, I haven't 16 had the opportunity to stand beside my son in court; 17 because, many, if not all, eventually find 18 themselves in legal issues. 19 And I certainly don't advocate for the 20 absence of accountability for bad or criminal 21 behavior. 22 What I do feel, is that all the players in 23 the legal system become more cognizant that this 24 disease -- that this is a disease process, and that 25 this disease process leads addicts to take part in 1 criminal activities that they would not have been 2 involved in otherwise had they been sober. 3 Their judgment, to conceptualize actions 4 versus consequences, is dysfunctional due to the 5 brain damage and paramount to the chemicals. 6 And what I would like to see is, is more 7 judges placing more emphasis on treating the illness 8 that causes the bad behavior, combined with some 9 level of accountability, based on the treatment 10 programs. 11 And that is what our judge here recently has 12 done, after quite a bit of talking with him, because 13 he was ready to hang him. 14 And, maybe he should be. At least he was in 15 there, which scared him. 16 You wouldn't send a diabetic to jail without 17 the insulin to manage his illness, where, you know, 18 do you send an addict to jail without something to 19 manage his illness? 20 You know -- so, again, we need to work on a 21 better system to meet the needs of the addicts who 22 break the law, especially the large number of 23 drug-related cases seen in the legal system. It's 24 huge. 25 I would hope we could wait -- would not wait 1 till they're, like, diseased at Stage 4, but, 2 maybe -- where they're committing felonies and 3 really bad stuff. Try to recognize their illnesses 4 at Stage 1, when the legal issues just begin. 5 I guess my final one is directed at -- 6 I shouldn't say "at" physicians, but, it's about the 7 medical field. 8 I've worked in physical therapy for years. 9 We treat pain with, you know, hands-on means. 10 Doctors are required to assess and assist in 11 pain management for their patients, which has led to 12 this overprescribing of opiates, along with the 13 assistance of the pharmaceutical companies. 14 For pain control, many, if not all these 15 patients that are on these opiates, like Oxycontin, 16 or whatever, oxycodone, whatever, become addicted to 17 the medication, you know. And they're taking it 18 because they're supposed to take it. 19 Now, who's responsible for their addictions? 20 Most doctors are not trained, or are not 21 really interested, in treating addiction; not the 22 addiction, you know, they've had a hand in creating. 23 You know, and when there is a doctor who will 24 try to wean them, the patients, off of opiates, 25 they're dropping the amount that they have. 1 So these people need, you know, they're 2 addicted. They're going to go out and find the 3 street drugs to satisfy their cravings, or to keep 4 them from withdrawals, because the withdrawals are 5 pretty nasty, kind of scary. 6 Rapid-Response group is doing, you know, 7 pretty good job dealing with this. 8 But, for you, I would say, the governor of 9 Vermont, and New Jersey, have started doing some 10 pretty good programs for how to deal with the legal 11 issues, and stuff. And I think that would be a 12 model to look at. 13 And I just said, you know, my question would 14 be: Considering all the studies about the brain 15 dysfunction, you know, with drugs and the damage it 16 does, especially with the developing brain, you 17 know, why would a doctor send a 15-year-old home 18 with a prescription for Vicodins? 60 Vicodin 19 tablets, and three refills? 20 He can't have alcohol until he's 21, but he 21 can have Vicodins, you know. 22 And, maybe we should rethink that. 23 I said, maybe a few days of discomfort 24 managed by Tylenol would be better than a lifelong 25 battle with addiction. 1 [Applause.] 2 JEANNE WEAVER: I just want to close by 3 saying: 4 I probably have annoyed a lot of people, but 5 that's too bad, I guess. 6 I'm just real thankful to see that we're 7 starting, you know, you guys are here, and to help 8 fight this battle, and fight for our loved ones, 9 because these are our babies that this is happening 10 to, and they don't know what they're getting into. 11 And I would just say, educate yourself about 12 the disease of addiction. That really will change 13 your mind about this whole thing. 14 [Applause.] 15 JEANNE WEAVER: So, anyways, I'm done. 16 SENATOR RITCHIE: Thank you, and, appreciate 17 your testimony, and appreciate your recommendations, 18 because we're going to forward those on to the full 19 panel. 20 Thank you. 21 [Applause.] 22 SENATOR RITCHIE: Next we have 23 Detective Sean O'Brien from the St. Lawrence County 24 Sheriff's Department. 25 DET. SEAN O'BRIEN: Good afternoon, Senator, 1 Assemblymen. 2 I come before you today as a man that's boots 3 on the ground. 4 I'm assigned to the St. Lawrence County Drug 5 Task Force. 6 My goal, at the end of the day, is to target 7 drug dealers. Not the users, the dealers. 8 And while national statistics are 9 frightening, I have before you local statistics in 10 St. Lawrence County. 11 Heroin, essentially, was non-existent in the 12 law-enforcement side, dealers, before 2012. 13 I take a step back for a second. 14 The oxycodone that we were faced with, 15 preferably, the oxy 80s are CDN; oxy 80s that we 16 were attempting to purchase, was at a -- probably a 17 high in 2010-2011. 18 There was a change in the formula somewhere 19 in that 2011-2012 area. 20 We had a 57.10 decrease in oxycodone-sales 21 cases. 22 Now we have heroin. 23 So as I stated before, the direct result of 24 the oxycodone was the change in the formula, and it 25 was difficult to abuse because could you no longer 1 smoke it or inject it. 2 2013, our heroin cases increased 280 percent. 3 2014, we're on track, at this particular 4 moment, 120 percent above 2013. 5 We have a problem. 6 And, to be quite candid, and not to take 7 anything away from the heroin and opioid addiction, 8 but next year our fear is, it's going to say: 9 Heroin and opiate and meth, because, we need to stay 10 out in front of the curve. 11 This is a result of what's going on. 12 I'm telling you, at least in 13 St. Lawrence County, we have a 500 percent increase 14 in meth. 15 So we're a little slower up north. 16 [Laughter.] 17 DET. SEAN O'BRIEN: We -- the meth -- or, the 18 heroin and -- the heroin is not coming from the 19 north; it's coming from the south. 20 As stated before, the metropolitan -- major 21 metropolitan areas -- Syracuse, Rochester, Buffalo, 22 New York City -- they come to our area. 23 Not only is this scary and frightening 24 numbers regarding drug sales or crimes that were -- 25 or people that are arrested, we have a rise in 1 property crimes. 2 As a few have stated, their children were out 3 stealing, doing what they had to do, to get their 4 fix. 5 So, it's not just about the drugs -- it's -- 6 it is about the drugs, because it causes the 7 children to go out and offend. 8 Much like the oxy problem, if the source is 9 targeted, you will limit the amount available. 10 Period. 11 Therefore, we need to find some different 12 approaches on what we're going to do. 13 Suggestions? 14 Patrolmen interdicting individuals and 15 identifying individuals that are bringing the 16 product into our communities. People aren't growing 17 this in our backyards; people are bringing it to us. 18 Undercover operations need to increased to 19 include controlled buys, to identify the sources 20 that are out of the area. 21 To further accomplish these tasks, 22 multiagency cooperation needs to be established. 23 Now, we do have quite an entourage, if you 24 will, of -- and -- a cross-section of law 25 enforcement on our task force in 1 St. Lawrence County, but, it basically boils down to 2 funding. And, you know, it's all about the money, 3 unfortunately. 4 Sitting here today, our hearts go out to 5 those that have lost their loved ones. It's a 6 tragedy. 7 And I'll be honest, the gentleman that I'm 8 here with today, we were out in the hall at the 9 break, and we said: You know what? This lights a 10 fire under us. 11 So you can rest assured tonight that we will 12 be working our hardest to try to curb this problem. 13 Having said that, a suggestion of mandatory 14 prison sentences that takes the discretion away from 15 the judges may not be a bad idea, similar to the 16 Rockefeller laws, as the Sheriff and the DA spoke of 17 earlier. 18 That pretty much... 19 Drug prices in St. Lawrence County, you folks 20 here speak of $10 a packet of heroin? 21 We pay 35 to 50 dollars per packet. And it 22 wasn't just once. Constant. 23 So, the prices, supply and demand, basic 24 economics, but, to pay for a $50 packet of heroin, 25 you've go to steal that much more out of people's 1 cars, you have to steal that much more out of 2 businesses. 3 And, like I said, next year, our fear is that 4 it's going to be a heroin and opiate and meth 5 addiction. 6 Thank you. 7 [Applause.] 8 SENATOR RITCHIE: Detective, can you tell me 9 where you believe the heroin is coming from, 10 especially if it's at a higher rate than maybe has 11 been said occurs in Jefferson or Oswego county? 12 DET. SEAN O'BRIEN: Like I said, I think it's 13 the -- I would say it's south. It's definitely 14 the -- seems to be the metropolitan areas in those 15 communities. 16 SENATOR RITCHIE: And do you believe that the 17 laws on the books are not tough enough now to keep 18 the drug dealers off the street? 19 DET. SEAN O'BRIEN: That's, the dealers. 20 SENATOR RITCHIE: The dealers, right. 21 DET. SEAN O'BRIEN: Not the abusers. 22 Not the abusers; the dealers. 23 SENATOR RITCHIE: But I -- 24 DET. SEAN O'BRIEN: I mean, if you're caught 25 with a certain quantity of heroin, if you're caught 1 with X amount of packets of heroin; if you're with 2 100 packets of heroin, or 150 packets of heroin, 3 you're not a user; you're a dealer. 4 And this person doesn't need to go to -- you 5 know, and a lot of good businessmen aren't using. 6 They are making money, they're making profit. 7 I mean, if it's 7 or 10 dollars on the 8 streets of Watertown today, it's 35 just 35 miles 9 north. 10 SENATOR RITCHIE: Well, I'm sure everyone 11 who's here today, is sole purpose is to help those 12 people who, unfortunately, got caught up in it, and 13 we want to do our best to make sure that they get 14 put back on the right track, with resources, because 15 of what it's doing to them and their family. 16 But there are some who are dealing, who are 17 making a profit, who, unfortunately, are giving the 18 15-year-old kid the opportunity to get hooked on his 19 first try. 20 And those are the people that we should all 21 be working towards making sure that they're no 22 longer on the street. 23 DET. SEAN O'BRIEN: Absolutely. 24 [Applause.] 25 SENATOR RITCHIE: Just two things: 1 You mentioned not enough resources for the 2 drug task force. 3 If we're looking for some kind of solutions, 4 is that something you think should be part of the 5 talk, that, certain grant funding allowed to be 6 looked at? 7 DET. SEAN O'BRIEN: Absolutely. Absolutely. 8 We -- the drug task force in 9 St. Lawrence County has been organized by the 10 sheriff, Keith Knowlton. 11 And my understanding is, that was his center, 12 and, he knew the drug problem was coming. 13 And here we are many, many years later, and 14 that's where the money needed to be spent. 15 Unfortunately, we're strapped for manpower. 16 We don't have enough manpower. 17 And, people in the community need to 18 understand that the border patrol has a function, 19 that the State Police have a function, the 20 Sheriff's Office has a function. 21 They don't see the St. Lawrence County Drug 22 Task Force members, because we try to blend in. 23 So, we need to reallocate or spend a little 24 more in the undercover operations. 25 And, I understand the constant complaints of: 1 Oh, I've passed X amount of police cars in a 5-mile 2 area. 3 So we need to reallocate money if you want to 4 attack this problem. 5 [Applause.] 6 SENATOR RITCHIE: Do you have any specifics, 7 or could you pass on specifics at a later time, with 8 the number of arrests in the last year? 9 DET. SEAN O'BRIEN: Absolutely. 10 SENATOR RITCHIE: Updated? 11 DET. SEAN O'BRIEN: Absolutely. 12 SENATOR RITCHIE: Thank you, Detective. 13 Assemblyman? 14 ASSEMBLYMAN BARCLAY: (Shakes head.) 15 SENATOR RITCHIE: Thank you. 16 DET. SEAN O'BRIEN: Thank you. 17 Thank you very much. 18 [Applause.] 19 SENATOR RITCHIE: Next speaker is 20 Anita Seefried-Brown, program director at the 21 Jefferson County Alcohol and Substance Abuse 22 Council. 23 ANITA SEEFRIED-BROWN: Good afternoon. 24 And, thank you, Senator Ritchie, and all the 25 members of the New York State Senate Task Force, on 1 giving us the opportunity to speak with you and 2 bring our concerns to you. 3 The Rapid-Response Workgroup is comprised of 4 representatives from various nonprofit, county, 5 state, agencies, as well as concerned citizens, 6 including parents of overdose victims and parents of 7 addicted children. 8 And, we're addressing -- beginning to address 9 the issues of prescription-drug abuse and prevention 10 of overdose deaths in Jefferson County. 11 And as already stated by somebody before, 12 I don't remember who, we do applaud the passing of 13 the I-STOP legislation, or, also called 14 "Internet system," for tracking overprescribing, 15 which is designed to curb the overprescribing of 16 opiate-based medications by physicians and doctor 17 shopping for narcotic medications by patients. 18 The legislation had some unintended 19 consequences. 20 Anecdotally, we know that a number of 21 patients whose narcotic pain prescriptions don't 22 last till the end of the month seek pain relief via 23 heroin use. 24 Others who have used narcotic pain 25 prescriptions non-medically, and used to pay 50 or 1 60 dollars a pill, are now buying heroin for less 2 money and get the same, if not better, euphoric 3 high. 4 While we have made some great strides, the 5 scourge of cheap and very potent heroin has created 6 an incredible crisis in the nation, the state, and 7 right here in Jefferson County. 8 According to one member of the clergy who 9 ministers, in his own words, "To the least among 10 us," he says, "that even heroin dealers warn heroin 11 users about the drug's potency." 12 Can you imagine that? Somebody telling you: 13 Hey, look, this is some really strong stuff. You 14 know, take it easy on it. 15 This reverend has earned the respect and the 16 trust of the drug users, their families, and family 17 members. He is compassionate, and believes in the 18 goodness of users, even when they themselves have 19 abandoned themselves. 20 Drug users may implore him -- even drug users 21 will implore him, even during the deep of night, to 22 come to the aid of a drug user in the throes of an 23 overdose. 24 Some are saved. Others die, becoming yet 25 another sad statistic. 1 According to the Jefferson County 2 Medical Examiner's Office, between 2011 and 2013, 3 48 overdose deaths have occurred. 4 Cynics might say: 48 deaths in 3 years, out 5 of a population of 120,000 residents, while sad, 6 that's not so bad. 7 However, let's examine how many people are 8 projected to be impacted by those 48 overdose deaths 9 while using the Center for Disease Control and 10 Prevention's methodology: 11 One death, according to the CDC, impacts 12 ten persons entering treatment for abuse; 13 32 persons showing up in the emergency room 14 department for a misuse or abuse; 15 130 people who abuse or who are dependent; 16 825 non-medical users. 17 So for one death, there is a total of 18 998 people impacted -- projected to be impacted. 19 So let's look at the 48 deaths in 20 Jefferson County: 21 480 treatment admissions for abuse; 22 1,536 ED visits for misuse or abuse; 23 6,240 people who abuse or who are dependent; 24 39,600 non-medical users; 25 For a total of 47,904 people impacted by only 1 48 deaths. 2 The deceased individuals may have had their 3 struggles with addiction, a chronic, potentially 4 life-threatening disease that affects the individual 5 physically, mentally, spiritually, and emotionally; 6 nevertheless, they were somebody's sons, daughters, 7 and husbands, and fathers. 8 They were loved, and they will be missed, 9 even though they may have put their families through 10 living hell while in the throes of their disease. 11 Addiction creates an obsession for the drug 12 of choice and the compulsion to use it regardless of 13 the known consequences. 14 Heroin and narcotic pain medications have 15 incredible addiction potential. People will lie, 16 cheat, steal, and break the law to feed their 17 addiction. 18 This destructive behavior is a symptom of the 19 disease itself which affects the user's ability to 20 resist wrongdoing and enables them to justify their 21 behavior, and allows them to ignore any feeling of 22 guilt for their actions. 23 Essentially, nothing is off limits when 24 trying to satisfy the need for the next fix. 25 It is easy to see, but not justifiable, why 1 society views addicts as losers, criminals, persons 2 not worthy of our care and concern. 3 But we all know that addiction does not 4 discriminate based on economic status, on your 5 standing in the community, or your level of 6 education. 7 The good news is, that as with many other 8 diseases, addiction can be controlled and treated 9 successfully. 10 While with proper treatment, even coerced 11 treatment such as drug court, many addicts can live 12 full lives in recovery. 13 Many others continue to suffer in silence, 14 afraid to seek treatment and obtain available 15 services they so desperately need and deserve. 16 Reducing stigma will result in individuals 17 seeking and receiving treatment for their disease, 18 enabling them to enjoy full and productive lives. 19 Reducing stigma, treating individuals, and 20 supporting recovery are also associated with 21 dramatic improvements in all areas of life: Family, 22 health, and finance. Higher civil engagements; 23 voting increases significantly. And, dramatic 24 decreases in public-health and safety risks and 25 associated reducing costs. 1 While reducing stigma will lead many addicts 2 to seek treatment, educating clients about available 3 medication-assisted treatment is equally important. 4 Over the years, advances in 5 medication-assisted treatment and recovery, opiate 6 addicts were supported by methadone and Suboxone, 7 drugs designed to ease opiate cravings; however, 8 these medications can easily be diverted on the 9 illegal market. 10 A new, non-addicting, non-divertible 11 medication named "VIVITROL" is on the market. 12 The injectable medication eases cravings for 13 30 days, allowing the person to fully focus on 14 treatment and recovery; however, the drug is still 15 quite expensive, at between 750 and 1,000 bucks per 16 injection. 17 Also, many physicians are reluctant to become 18 VIVITROL-approved providers, citing a lack of 19 interest by clients to use this medication, and also 20 cost factors. 21 Dr. Moehs is one of the very few who is a 22 VIVITROL-approved provider. 23 The Rapid-Response Workgroup has also been 24 working hard to make Narcan, an opiate-reversal 25 drug, widely available. 1 Sometimes we have the notion that only drug 2 addicts, particularly heroin addicts, die from 3 opiate overdoses. 4 Anyone who is using opiate-based substances, 5 illegal, as well as legal ones, are at great risk of 6 experiencing or dying from an overdose. 7 Timely application of Narcan will restore 8 breathing and prevent death. 9 The overdose-prevention rescue kits are 10 relatively inexpensive; anywhere between $12 and 11 $25. 12 The already mentioned minister is eager to 13 attempt Narcan training; and most importantly, he 14 will invite drug users, their friends and family 15 members, to become trained, and to receive Narcan 16 rescue kits, as most overdoses are, in fact, 17 witnessed. 18 Dear Senator Ritchie: Again, we appreciate 19 your interest and your time. 20 Supporting education and awareness-building 21 of addiction as a brain disease, helping us reduce 22 stigma about addiction, helping us distribute Narcan 23 deep and wide into the community, will help to 24 alleviate the drug problem in the community. 25 There is no one single method to begin 1 addressing this issue, as DA Ms. Intschert has 2 already mentioned. 3 It really takes concerted efforts of all 4 sectors of the community to be involved. 5 One we have already talked about: 6 law enforcement. 7 Chief Currier in Messina, for reasons of his 8 own, he really emphasizes compassionate policing; 9 keeping people who are being arrested accountable, 10 but in a compassionate way. 11 People who are users, they already know that 12 they're not living up to their potential. 13 Getting it from the police, as they're being 14 arrested, you know, the sense that they're 15 considered, perhaps, low-lifes, or whatever, the 16 arresting person may communicate verbally or 17 non-verbally, is not productive, and will continue 18 to further disincentivize the individual to help 19 seek treatment that is so desperately needed. 20 [Applause.] 21 SENATOR RITCHIE: Anita, first I want to 22 commend you for being so involved in every issue. 23 You were so helpful on the bath-salts issue. 24 ANITA SEEFRIED-BROWN: Thank you. 25 SENATOR RITCHIE: And you can tell that you 1 don't do it because it's your job, because you do it 2 for the right reasons: because you truly want to 3 help people. 4 And, appreciate you coming here today and 5 talking about it. 6 We've heard from so many people testifying 7 that the insurance is a real issue. 8 When people are at the point where they 9 really need help, and either they're not able to get 10 in, or, once they are there, they're only allowed to 11 stay for a short period of time. 12 Can you tell me what you've seen on your end 13 when it comes to that? 14 ANITA SEEFRIED-BROWN: Well, I work for the 15 Alcohol and Substance Abuse Council, which is a 16 prevention agency, and, we are not treatment. 17 When we deal with clients who are in need of 18 treatment, we will refer them to a higher level of 19 care. 20 So, we send them to Samaritan or to Credo or 21 to another facility in the neighboring counties. 22 So I cannot really speak to the insurance 23 issue directly, I apologize. 24 SENATOR RITCHIE: And do you think there are 25 enough services available right now, considering the 1 huge spike in use? 2 I know there's been talk from the doctor, 3 that he is the only one who provides that one 4 specific drug. 5 And now you're saying that other doctors 6 don't prescribe, what, the injection of this other 7 drug. 8 ANITA SEEFRIED-BROWN: Correct. 9 SENATOR RITCHIE: So, is there something that 10 needs to be done at that level, too, to get either 11 more doctors here who are willing to participate in 12 that, or, to get other doctors more involved, to ask 13 them to be able to prescribe this? 14 ANITA SEEFRIED-BROWN: Last year, 15 Miss Fitzgerald and I worked very hard to -- in 16 organizing a physician-education program, and part 17 of the physician-education program was to entice 18 physicians to become VIVITROL-approved. 19 They don't even -- it doesn't even take a 20 physician to become VIVITROL-approved. A nurse 21 practitioner can also become VIVITROL-approved. 22 I am not exactly clear why physicians are so 23 reluctant to use it. 24 Perhaps there are reimbursement issues 25 involved. 1 Perhaps it is not -- perhaps it is the sense 2 that addicted persons should tough it out, and 3 should attempt to, you know, work the steps, work 4 with their counselors, and don't necessarily want to 5 have the addict, the benefit of a medication that 6 would ease their cravings. 7 I really cannot speak to it cogently. 8 Maybe Miss Fitzgerald would be able, or 9 Mr. Scordo would be able, to give us some insight. 10 I mean, cost of it is certainly an issue. 11 I tend to think, if a business person, a 12 pillar of the community, would come to a private 13 provider and specifically ask for this medication, 14 it is my sense that that person would receive the 15 medication. 16 Number one, the client already knew enough to 17 ask for it; and, secondly, the client has enough 18 money to pay for it, and the doctor doesn't have to 19 wait for reimbursement for this rather expensive 20 medication. 21 Now, that medication actually is also 22 available in pill form and is very inexpensive. 23 The issue with the pill form is, that it has 24 to be taken every single day. And the addict has to 25 make a decision every single day to stay clean and 1 sober that day. 2 The decision to stay clean and sober is taken 3 away from the addict by their 30-day injection. 4 There is no guessing: Well, my friend from 5 Syracuse University is coming up on Friday, so I'm 6 not going to take my medication, which will 7 interfere with a high and be ready to party, and 8 pick up my medication treatment again on Monday. 9 SENATOR RITCHIE: Thank you. 10 ANITA SEEFRIED-BROWN: Thank you. 11 [Applause.] 12 SENATOR RITCHIE: Next we have Jim Scordo, 13 executive director of Credo Community Center. 14 JIM SCORDO: Senator Ritchie, 15 Assemblyman Barclay, thank you very much for the 16 opportunity to come to Watertown, and hear, as we 17 obviously had a very full house with a great deal of 18 interest in this topic. 19 As everyone has stated, and we've heard over 20 and over today, addiction does not discriminate; 21 does not discriminate against race, gender, 22 ethnicity, socioeconomic status, neighborhoods you 23 live in, particularly when you look at the opiate 24 addict. 25 Not unusual that will you see an opiate 1 addict that is -- we've heard individuals that 2 completed high school, that completed college, that 3 were athletes, that had jobs, and, something 4 happened; an injury, a surgery, a medical condition, 5 that required that they were on pain killers for a 6 period of time, and became addicted. 7 Very common. 8 Very common, that that's where that addiction 9 starts for many of those individuals. 10 And there's a fairly high percentage of 11 individuals that become dependent on the opiate 12 prescriptions that will then go on to heroin use. 13 You know, we've heard from, the I-STOP 14 program has done a great job of shutting some of 15 that down. But what that also has done, is the 16 unintended consequences has resulted in people -- 17 the heroin is now more affordable, so they'll switch 18 to the heroin. 19 The addictions to opiates and addictions to 20 heroin is one of the most difficult addictions to 21 treat. 22 I get family members, friends, people who 23 know me, who call and say: I've got a friend, I've 24 got a family member, who's addicted. 25 And I hold my breath and hope that they're 1 not going to tell me it's to opiates or it's to 2 heroin, because that's a very difficult addiction, 3 more difficult than any others that we've seen, to 4 overcome. 5 The triggers: I can see somebody on the 6 right path. And after being in treatment for a 7 period of time, improve their health, put on 8 30 pounds, get their -- everything going back in 9 their life, get a job, have an apartment, and 10 everything going well, and then a trigger, and then 11 something happens where they're drawn back to that 12 addiction. 13 We've heard that over and over here today of 14 different individuals who experienced that. 15 We've seen an increase in individuals who 16 come to seek treatment at Credo, with both the 17 opiates and in the heroin. 18 If we were to look at our residential 19 program, our women's program, OASAS has a criteria, 20 that if they're pregnant or if they're an IV-drug 21 user, they get top priority to come into residential 22 treatment sooner. 23 95 percent of our women who are in our 24 residential program have an opioid addiction, 25 because of that. They take priority over any other 1 addiction, and we have a houseful of them: 2 15 individuals, and 5 of them have their children 3 with them. 4 In our adolescent program, we've got about 5 90 percent who are addicted to either opiates or 6 heroin. 7 When we look at the treatment approach, you 8 know, across the state, and across the nation, we 9 have not had great results. This is a very 10 challenging addiction to try to help someone over 11 overcome. 12 We've taken a look at many different 13 approaches. 14 We found that an individualized treatment 15 approach, a holistic treatment approach, perhaps is 16 the best way to go to try to treat that individual. 17 Medication-assisted therapy, as we heard from 18 Dr. Moehs. 19 And we may need to make sure that we're 20 treating, what was the underlying reason that 21 perhaps led to this addiction? 22 Was it a mental-health issue? 23 Was it a trauma issue, that -- blocking the 24 emotional pain? 25 Was it a physical? 1 Was it a primary care? 2 Was it an old injury? 3 So, we need to make sure, as part of our 4 treatment approaches, that we're dealing, not with 5 just addiction, but we need to deal with their 6 mental illness, we need to make sure we're 7 addressing their primary care, so if there's that 8 injury that needs medication, we can do so, and not 9 put them at risk of falling back into that full 10 addiction with the opiates. 11 You asked a number of the speakers, "what 12 you're recommendations were." 13 I've been in this field long enough, and 14 I don't remember what the epidemic was, whether it 15 was the cocaine that we were facing, or what it was, 16 but not even sure whether it was the '80s or '90s, 17 but we identified a three-prong approach: That, it 18 needs to be a combination of law enforcement, it 19 needs to be prevention, and it needs to be 20 treatment; and we need to focus on all three. 21 We heard the detective from 22 St. Lawrence County talk about they need resources. 23 They absolutely need resources. 24 They need to be able to buckle down on the 25 dealers that are coming into our communities. 1 They're not our local people who are dealing. 2 These are people who are coming in. 3 Read the papers, look at the names there. 4 They're not names that I recognize at all 5 that are from our community or from the 6 North Country. 7 These are people from outside of the area 8 that are coming in here, and, it's a business. 9 It's a business, and they're making money off 10 it. 11 So law enforcement needs some dollars. 12 Prevention needs dollars. 13 Years ago, I remember when the 14 Alcohol Substance Abuse Council was in a good share 15 of the schools, having a student-assistance 16 counselor that was there for all of the students. 17 And if they were in every one of the schools 18 right now, I'm sure that one of the things they 19 would be talking about and doing presentations with 20 students on, and getting families in the audience, 21 they'd be talking about opiates. 22 And Anita could tell you how many schools 23 they were in at one point, and what they're in now. 24 And what's -- it's not that the schools 25 didn't want them. It's that the schools could not 1 afford that. 2 So we need to make sure that we're putting 3 money into prevention and education to prevent this 4 from happening. 5 Despite all those efforts, we're still going 6 to have some who are going to need treatment, and we 7 need to have the full continuum of care. We can't 8 just say, Well, we're going to do this in an 9 outpatient basis. 10 We need to have detox available. 11 We need to have inpatient treatment. 12 We need to have outpatient treatment. 13 We need to have various levels of residential 14 care. 15 We need to have permanent support of housing, 16 apartments, available. 17 We need to have employment vocational 18 services as part of that. 19 Case-management services as part of that 20 treatment. 21 I'm concerned, as we were hearing earlier, 22 about what we're seeing with insurance companies, 23 and they're denying individuals inpatient care. 24 I'm concerned, as we approach a managed-care 25 environment in 2015, what is that going to do? 1 What is that going to to do for people trying 2 to access care? 3 Are we going to be looking at shorter lengths 4 of stays? 5 Are we going to have to continue to send 6 individuals out of state? 7 Why is that happening? Why do people in 8 New York have to go out of state for treatment? 9 That's ridiculous. We should be able to 10 treat those individuals here. 11 I'm concerned that, as we deal with this 12 addiction with opiates, that research will show that 13 longer lengths of staying in treatment produce 14 better outcomes, particularly for the opiate addict. 15 And, are we going to see shorter lengths of 16 stays driven by managed care? 17 Are we going to see that they need to fail 18 two or three or four times in an outpatient before 19 they go inpatient? 20 How many of them are -- before they end up 21 failing that third time, how many of them are going 22 to end up dead? 23 We need to work around that. 24 People who have mental health, to think that, 25 all of these individuals, we're going to be able to 1 treat them on an outpatient basis is not realistic. 2 We need to make sure we have other levels of care. 3 Otherwise, all we're going to do, is we're 4 going to shift the cost. We're going to shift the 5 cost to our local state -- or, our local jails and 6 our state correctional facilities. 7 We need the beds for -- as the detective was 8 talking about, we need those beds for the 9 individuals who are dealers. Those are the 10 individuals that we need to be incarcerating. 11 We don't need to be incarcerating somebody 12 who has an opiate addiction or who has an untreated 13 mental illness. Those individuals deserve the right 14 to have treatment. This is 2014. 15 [Applause.] 16 JIM SCORDO: I'm pleased that, you know, we 17 have representation on this Task Force. I see this 18 as an opportunity. 19 I think New York State Office of Alcohol and 20 Substance Abuse Services is willing to take a look 21 at how we can go about enhancing treatment services. 22 There's a residential redesign committee that 23 meets every Friday. I'm on the conference call 24 every Friday, as they take a look at, as we go 25 towards a managed-care environment, how can we make 1 sure that residential treatment is still an option 2 and still available, and that managed care cannot 3 deny that and say, "We're not going to do that," as 4 it currently happens. 5 As they start working towards the parity 6 laws, making sure that the private insurance 7 companies recognize that addiction and mental 8 illness should be treated very much like somebody 9 who's, if they've got cancer, if they've got heart, 10 if they've got diabetes, if they have primary care, 11 and they need to be treated in a hospital setting, 12 then that's what they need to do. 13 We need to advocate for the same. 14 [Applause.] 15 JIM SCORDO: We'll be happy to be a part in 16 anything we can do to assist you in your efforts, 17 and we look forward to working with you. 18 SENATOR RITCHIE: I know Anita touched on the 19 stigma that goes along with this. 20 Can you tell me, in your opinion, how we need 21 to change that? How do we start to change that? 22 JIM SCORDO: It's an ongoing process. 23 And you would think, in 2014, that we would 24 be past this. This is not 1970, when, you know, 25 addiction and mental illness was, really -- there 1 was a stigma attached to that. 2 We've gone and made great leaps and strides 3 with that, but, it still exists. 4 It still exists, particularly if you're an 5 opiate addict. 6 When we had the whole media thing, they 7 wanted to do a story, Channel 7, I was cautious 8 about putting any one of our individuals who's in 9 recovery from an opiate addicts, in front of the TV 10 and showing their face, when they're trying to get a 11 job in this community, or they're going to JCC, and 12 how they're portrayed as an opiate addict, and what 13 people envision, more so than any other drugs, is 14 that person with a needle stuck in their arm, and a 15 junky, and the stereotype. 16 Now, geez, I got that person employed. 17 Or, the person that comes in, did you know 18 that the person you got sitting behind the counter 19 who waited on me is a junkie and an opiate addict? 20 That's the mentality that still exists, 21 particularly with opiate addiction. 22 It's ongoing education. 23 I come back to my prevention-education piece: 24 We need education. That's important to help 25 overcome that stigma. 1 It's a difficult battle, and it just needs to 2 be ongoing, constantly. 3 SENATOR RITCHIE: Thank you. 4 JIM SCORDO: Thank you very much. 5 [Applause.] 6 SENATOR RITCHIE: We have a couple more 7 speakers. 8 Penny Morley, prevention director at 9 Farnham Family Services. 10 PENNY MORLEY: I don't know, he's kind of a 11 hard act to follow. 12 But, ironically, prevention, I believe is 13 really the key. 14 You talked about earlier, or someone talked 15 about, going into schools and doing education. 16 It's not just education. 17 The student-assistance counseling that he 18 spoke about, we have in Oswego County, and we're in 19 five school districts throughout the county. 20 We used to be in eight. 21 And, it makes a difference to those children, 22 to have a connection with an adult that they can 23 count on, and that can help them with those 24 decision-making skills. 25 One of the people that spoke earlier said, 1 I "didn't know how to deal with my feelings." 2 That's something that our kids aren't being 3 taught necessarily at home, so we need to help them 4 with that. 5 And that's what we do: Help them learn how 6 to cope with their feelings, help them make healthy 7 choices. 8 All those things that, you know, we kind of 9 take for granted sometimes, they're not getting 10 taught. 11 So, that's what we do in our program. 12 Another thing we do is talk about drugs and 13 alcohol. You know, what's not helpful for them to 14 use, those kind of things, starting at very young 15 ages. 16 We're in K through 12 in our schools; and, 17 so, really, you start out with very simplistic 18 things. You know, not putting things in your body 19 that wouldn't be healthy. 20 And then when you get to middle school, 21 talking about drug use, over-the-counter medication, 22 and the actual prescription meds, because that's 23 where we're seeing kids are starting. They're 24 starting in seventh grade. 25 It's not, Oh, they're in high school, they're 1 going to start using someone else's medication. 2 They're bringing it to school, and they're 3 sharing. 4 So that's something we talk about in the 5 schools. 6 And, one of the things that I think is really 7 important, is we need to talk to our, kids because 8 they do listen. 9 And that's something, if I could say one 10 thing to a parent: Talk to your kids. 11 No matter how much they roll their eyes, 12 throw their hands up, say some nasty things, they 13 hear what you have to say, and they will listen, and 14 it will come back to them. 15 It's not the only answer. There is not one 16 answer, but it does help. 17 We also -- the information I gave you at our 18 agency, my director couldn't be here with us today, 19 so, I brought some agency information as well. 20 From 2010, our heroin use of our clients was 21 2 percent, to 2014. 22 Just starting 2014, from January til today -- 23 or, sorry, Monday, 16 percent of our clients are 24 using heroin. 25 That is a huge increase. 1 And, we started seeing a rise in late 2012, 2 early 2013, and we've talked about all the reasons 3 that started. 4 Those unintended consequences, you know, had 5 happened, but we're addressing them now. 6 So, we started an opioid group for the 7 agency, for people that were in treatment. 8 We also have a doc that works with us, that 9 does Suboxone, so he works closely with our staff. 10 I believe there's only two doctors in 11 Oswego County that provides Suboxone treatment. 12 So -- and Oswego County's pretty big, so we 13 have waiting lists, as well. 14 I can get those numbers to you, too, if you 15 want those, because I don't have those off the top 16 of my head, but can I get them. 17 So, the increase in heroin in our city is 18 frightening. 19 The city of Oswego has seen an increase, and 20 Fulton. 21 Ironically, I wish the Sheriff was still 22 here, because our people that are coming into 23 treatment are not reporting heroin use in the 24 outlying areas. They're reporting, still meth. 25 So I'm with the gentleman behind me, we're a 1 little slower over in Oswego County with some of our 2 development, but we are seeing heroin increase in 3 the city areas, so -- from self-report from our 4 clients. 5 So that's the information I have in that 6 regard. 7 I spoke with one of my contacts at 8 Oswego Hospital. I wanted to know how many 9 overdosed people they get in the ER. 10 And she said, you know, she said: Last night 11 we had two. And in the last month we've had 10. 12 I mean, that's Oswego. It's not -- you know, 13 it's not a huge population of people, so we're 14 seeing an increase in heroin, and we're trying to 15 address it in our treatment. And our prevention 16 counselors are addressing it with our youth. 17 And, it really is going to be very important 18 that we have that two-pronged approach that we can 19 do. 20 And it's -- the funding piece is so 21 important, because if we don't have funding, our 22 counselors aren't in the schools. 23 I'm a grant-writing fiend, and, I do my best 24 to get money in, but there's not a lot of money out 25 there. 1 So, one of the other things I wanted to 2 mention, I sat with Mr. Barclay about a week, or 3 two weeks ago, maybe, and I had mentioned this to 4 him: Something we're trying to do is form a 5 coalition for Oswego County, to address drug and 6 alcohol use in adolescents. 7 And, we used to have a coalition for Oswego, 8 but that was many years ago. 9 So, we're trying to get this coalition off 10 the ground so that we can try and apply for some 11 Drug-Free Community funding, so that maybe we can 12 actually address some of the other issues, the more 13 environmental issues, that we see. 14 So... 15 SENATOR RITCHIE: Can you elaborate on the 16 programs that you have at the schools? 17 Is it one counselor per school? Is it 18 full-time? 19 PENNY MORLEY: That's a great question. 20 I actually have three counselors. 21 I have a counselor three days a week at 22 APW High School. Then she goes to 23 Phoenix Elementary -- I'm sorry, Phoenix Middle 24 School, and Phoenix High School. Those are her 25 schools. 1 I have a counselor that covers just the 2 elementary schools in Oswego. She covers all five 3 of them. 4 And, then, another counselor that covers 5 Mexico Middle School, Mexico High School, 6 Oswego High School, and Oswego Middle School. 7 SENATOR RITCHIE: And the counselors, do they 8 go into each class? 9 Are they in an office so the kids can come in 10 and talk to them? 11 How does that work? 12 PENNY MORLEY: The majority of their time is 13 spent with students, either one-on-one or in groups. 14 And, students can self-refer. Students can 15 be referred by a principal, by a teacher, parents 16 call us. 17 They also do classroom presentations, but 18 their main goal is that focused one-on-one or 19 small-group interaction with youth. 20 We use the 4-day developmental assets. 21 I'm not sure if you're familiar with that, 22 but one of those is -- has been hugely studied. 23 I can send you some information on that. 24 But one of the things in there is, if you 25 have one connection with an adult, as a youth, just 1 one, you can be more successful. 2 So, if that one person isn't your parent or a 3 relative or someone close to you, it can be that 4 student-assistance counselor. 5 SENATOR RITCHIE: Do you have any idea how 6 many kids would come to the counselor on their own 7 to speak with them? 8 PENNY MORLEY: Oh, yeah. I have all those 9 stats. I can send you the numbers. 10 Roughly, the students that seek out the 11 counselors usually are at the older ages, and I'd 12 say probably half would actually come on their own. 13 SENATOR RITCHIE: Okay. 14 If you could get me those numbers, that would 15 be helpful -- 16 PENNY MORLEY: Yeah, absolutely. 17 SENATOR RITCHIE: -- you know, as we look to 18 find ways, or look to fund certain programs. 19 This sounds like something that, for those 20 schools that have someone there, they have a great 21 advantage. 22 But for the other schools, that's too bad 23 that they don't have the same counselor there for 24 the kids to reach out to. 25 PENNY MORLEY: We used to be in Fulton City 1 schools, K-12, and the funding dried up probably 2 10 years ago. 3 And people are still are, like, Aren't you 4 coming back to Fulton? Aren't you coming back to 5 Fulton? 6 And it's, just -- it's a money issue. 7 You know, the money, the Drug-Free Schools 8 money that they had no longer exists in the way it 9 did. 10 So, we have to try and find other funding. 11 SENATOR RITCHIE: Thank you. 12 PENNY MORLEY: Thank you. 13 ASSEMBLYMAN BARCLAY: I really have more of a 14 comment more than a question. 15 Although, the numbers that -- I think you 16 told me the numbers that the counselors actually see 17 in the school is probably substantial, if I recall. 18 PENNY MORLEY: Yeah, but I don't want to 19 quote a number and have that on record, and be 20 wrong. 21 ASSEMBLYMAN BARCLAY: Right. 22 PENNY MORLEY: But I can send that to you. 23 ASSEMBLYMAN BARCLAY: Yeah, I don't remember 24 the specifics of who voluntarily goes, versus who's 25 referred -- or who goes on their own, versus... 1 I just want to compliment you. I think you 2 guys are doing, really, a wonderful job, you and 3 your director in Oswego County, and I look forward 4 to working with you on that. 5 I know you've been in touch with my office 6 about the child-care counseling, and we'll 7 definitely help out any way we can. 8 PENNY MORLEY: Excellent. 9 Thank you so much. 10 SENATOR RITCHIE: Thank you. 11 [Applause.] 12 SENATOR RITCHIE: Cherie Moore of Jefferson 13 County. 14 CHERIE MOORE: Hi, I'm Cherie, and I'm 15 actually from Lewis County. 16 I'm a member of the local Al-Anon Family 17 Support Group; a wife, mother of two children, and 18 I have a successful career. 19 Just to let you see a difference in 20 backgrounds: 21 I grew up in a middle-class family with no 22 addicts in my life. 23 My father was a successful insurance agent, 24 and my mother raised us six children. 25 I have been married to my current husband for 1 18 years. My two children grew up in a home with no 2 alcohol, no drugs, or even prescriptions in our 3 home, other than the common antibiotic. 4 We have both worked, and have successful 5 careers, but I am currently dealing with a heroin 6 addict. 7 My daughter has worked in jobs since she was 8 in ninth grade, with the summer youth programs and 9 fast-food restaurants. 10 She took a civil-service exam at 19 years old 11 and obtained a job with the County. She has always 12 been very dependable, reliable, and a hard-worker. 13 She worked overtime, holidays, and whenever 14 she was called in for all her jobs. 15 My daughter has always been very responsible 16 with her bills and has excellent credit even to this 17 day. 18 She has never been in any trouble at all any 19 time, until recently. 20 In 2011, when my daughter was 24, she moved 21 out on her own, with a roommate. This roommate 22 introduced her to heroin and other acquaintances, 23 people, and she started dabbling socially. 24 It was not every day, and she could take it 25 or leave it at first. 1 She was still working, making good money, 2 saving for a new truck, and looking to buy a house. 3 She had a great life ahead of her. 4 Then, in 2012, she met a person that she 5 liked, a male friend. There was a drastic change in 6 her behavior, attitude, and lifestyle. 7 She quit her County job. 8 She was impossible to talk to, get ahold of, 9 or even get any sort of comment from her or 10 commitment for anything. 11 She worked a couple of minimum-wage jobs, but 12 her life was a mess, and she had made mine a mess. 13 I was in constant fear for her life, since 14 I knew this person was abusive, and I was going 15 crazy, trying to figure out what was going on and 16 how to help her. 17 She lived in a camper trailer with no heat, 18 electrical, running water, et cetera. 19 She wasn't raised this way. 20 She would still take a shower daily at a 21 relative's house, but she was not keeping up with 22 the hygiene she normally did. 23 She lost a lot of weight and was not eating 24 properly. 25 During all of this, she maintained jobs and 1 was high-functioning, and kept her bills paid, even 2 though she went through every bit of her savings and 3 took a loan out for more money. 4 I can honestly say, that with all the changes 5 in her life and the downward motion she was in, she 6 never stole from our household or any member of it. 7 This went on until February of 2013. 8 She came to me and her brother, asking for 9 help. She admitted to the drug use, that she was an 10 addict, and knew she needed help. 11 This was the first time I really knew what 12 was going on with the changes in her life. 13 She had only been using steady for less than 14 a year. 15 We were trying to research and figure out 16 help for her, but because she had no insurance -- 17 actually, she was in between, because she was 18 turning 26 and was losing our insurance -- there was 19 nothing available. 20 She was on unemployment which made it too 21 much money. Just not enough for Medicaid. 22 She didn't make a lot of money at her jobs, 23 but, again, that was still too much for Medicaid. 24 She had to move back home. 25 She was laid off from her job and on 1 unemployment. 2 She was really trying to get her life back in 3 order. 4 In May of 2013, she met up with the person 5 that she had been with previously; was in the wrong 6 place at the wrong time. 7 To me, it was good, to some degree, because 8 of some of the outcome, but it is affecting her life 9 for the rest of it, because of the system. 10 She had this person in her car, and they were 11 stopped. My daughter was arrested because it was 12 her car. She had no idea what this person had with 13 them. 14 There was no charges for possession, sales, 15 or driving under the influence. 16 The charges were for manufacturing meth. 17 There was no meth in the car, and nothing 18 mixed together as in manufacturing. 19 There were items in a bag that could be used 20 for meth. My daughter had no idea they were there, 21 and to this day, has no idea how to even make meth. 22 It was not what she had ever been involved in. 23 She spent 45 days in jail, and was appointed 24 a lawyer from the courts; not a public defender. 25 This lawyer visited my daughter one time for 1 less than 10 minutes the whole 45 days she was in. 2 I was the one that informed him she was 3 housed out to Oneida County. He had no clue. 4 I had called him several times, upon my 5 daughter's request -- because, in jail, you have no 6 access to call your lawyer -- asking him to please 7 go meet with her. There were things she wanted to 8 discuss with him, and she had questions. 9 He insisted that she knew what she needed to 10 know, and told me not to call his office again. 11 This is a lawyer being paid by the County to 12 do nothing. 13 How is this a good thing? 14 Well, while in jail, my daughter met with a 15 counselor for pretrial release. She was honest, and 16 admitted her heroin addiction, hoping that she would 17 get help from someone. 18 She was released on pretrial, and in the 19 course of the past year, my daughter has been in 20 two inpatient rehabs. 21 The first one was 28 days; 22 And the second one, it was 6 weeks, only 23 because it was a 3-week program. The jail -- she 24 was sent to jail in between the two rehabs, because 25 the judge decided she needed help, and she was going 1 to sit in jail until she got into the rehab. 2 When she got in the second rehab, it was for 3 three weeks. She had to stay six weeks, because she 4 had to wait for a bed for a halfway house, which 5 they didn't tell her she was going to till after she 6 was in the rehab. 7 In the rehabs that are three weeks, you're 8 sitting there, you're doing the program. When you 9 have to stay longer, you're just repeating the same 10 program. 11 Will it help to repeat? Yes, to some degree, 12 but it also does not help, because you're not 13 getting any extra help. You're not getting anything 14 different. 15 She put herself -- before she went to jail 16 the second time, she was doing outpatient rehab 17 weekly. It was minimum, two days a week. 18 She put herself into extensive outpatient, 19 and she is currently in the halfway house. 20 She still only saw her lawyer one time, 21 except for five minutes before court. 22 And I know this for a fact, because I was 23 with her every time during the whole 2 stints of 24 45 days each. 25 So that was a total of 90 days in jail, she 1 saw her lawyer once. 2 She is currently six months clean. She will 3 be coming home in a couple of weeks. 4 You are probably wondering why I'm giving you 5 all this background? 6 Well, my main concern is stigma with the 7 system itself. 8 These are people that are degree-educated, 9 but not street-educated. They are supposed to be 10 there to help people, are supposed to be -- they're 11 supposed to be there to help and -- to help the 12 people that are innocent -- well, they are supposed 13 to be there to help, and to -- and people are 14 supposed to be innocent until proven guilty. 15 Well, I learned an eye-opening lesson this 16 past year about our so-called "system," and the 17 people that work in it. 18 And this is Jefferson County that all of her 19 legal stuff was in. 20 The lawyer had nothing good to say about my 21 daughter, and he does not even know her. 22 During this whole situation this past year, 23 he did nothing to help her, would not meet with her. 24 Tried to cut deals, and said to her face: I don't 25 care if you go to trial. It is more money for me. 1 He called her "a severe drug addict" in court 2 in front of everyone present that day. 3 He doesn't know what she even does for drugs: 4 how often, how much, or for how long. 5 Another situation with stigma in the system? 6 During one of the outpatient meetings, my 7 daughter met a very nice young man that was there 8 for alcohol abuse. He was mandated by drug court. 9 They struck up a friendship and were really 10 supporting and helping each other. 11 They encouraged each other to go to outside 12 NA and AA meetings. 13 This person was honest with his drug-court 14 counselor and the judge, and let them know about the 15 friendship. 16 The counselor gave him a hard time from then 17 on, telling him that he had to stay away from her; 18 that she was a low-life loser, that she was no good 19 for him. She doesn't have a job, and she is a drug 20 addict that he does not need to be around. 21 This is coming from a person that has no clue 22 about my daughter's history. 23 The judge and the counselor would make 24 comments when he had to report, and were repeatedly 25 asking him if he was still hanging around her. 1 He was told that if he did not drop the 2 friendship, he would not graduate from drug court. 3 The counselor insisted he spend no time with 4 her and that he tell her to get lost. 5 Who are they to judge when a person is good 6 for another person, or not? 7 Who are they to judge my daughter, degrade 8 her character, and call her "a low-life loser," when 9 they have never met her? 10 Do they know her life history or her 11 situation? No. 12 The insurance companies -- again, back to 13 insurance, because it does fall back on them -- 14 they're fighting the treatment of drug addiction. 15 They are trying to say it is behavioral problem. 16 Drug addiction is a disease that affects the 17 brains. 18 Drug can alter important brain areas that are 19 necessary for life-sustaining functions, and can 20 drive the compulsive drug abuse that marks 21 addiction. 22 I talked to my daughter before I came here, 23 and I asked her her opinion; and I asked her, as a 24 drug addict in the system, in the jails, in the 25 rehabs, in the halfway house, what she felt. What 1 she felt that these people need, and she needed. 2 Part of it was, this area has a huge health 3 problem with diseases and hep C due to the 4 uncleanliness of the drug users that have no choice. 5 In all honesty, drug abuse and addiction is 6 so large across the USA, it will never go away. 7 We need to work on making people healthy the 8 right way, and then you will see a difference. 9 The area needs to implement a needle-exchange 10 program. People cannot afford to get clean supplies 11 or dispose of their dirty-needles supplies the safe 12 way. 13 Not to promote the drug use, but to promote 14 safety, to promote health. 15 A needle-exchange program will help protect 16 the public: The little 3-year-old playing in 17 Thompson Park, the grade-school kids out on the 18 playground, et cetera, that don't even realize, when 19 they're picking up something and they're jabbed with 20 a needle, that now, maybe at 8 years old, they're 21 getting hep C from a dirty needle. 22 The needles get thrown out improperly, and 23 anyone that comes in contact with them can be 24 exposed to something. 25 The drug addicts have no access to sharps 1 containers. They have no access to dispose of 2 these. 3 It's going to be there. It's always going to 4 be there, to some degree. 5 To help with that, to me, I looked at both 6 sides, and I said: Well, you're promoting the drug 7 addiction. 8 She said: No, you're helping with the safety 9 of the youth, because these drug addicts will throw 10 their stuff anywhere. They don't care where it is 11 or who gets it. 12 I don't know if you want to hear about my 13 opinion on the legal system, so I'll go on to 14 treatment. 15 Treatment needs to be longer than two to 16 three weeks. Just because they are over the 17 withdrawal, detox does not mean they are better, and 18 now have behavioral issues instead of disease 19 issues. 20 Not everyone should be classified the same. 21 The system needs to treat each addict situation 22 separately. 23 Everybody that talked today mentioned they 24 need to have individual plans. And they really do. 25 Most people are dual-diagnosed with mental 1 health and drug addiction. Some are just addiction. 2 They should not be put together in the same 3 programs, such as outpatient rehabs, halfway houses. 4 They need to be treated differently than each 5 other. 6 Halfway-house people have to follow the same 7 program no matter what the addiction or 8 mental-health problem. 9 Local outpatient programs are the same 10 program, structured the same for everyone, no matter 11 what the issue: drugs, alcohol, mental health. 12 It doesn't work. 13 There needs to be a separate program that 14 deals with the specific problem. 15 Then there's the issue of getting other help 16 if needed. 17 In-patient treatment rehabs or treatment for 18 cravings and withdrawal, there are addicts asking, 19 begging, for help to change their life and get 20 clean. 21 This is exactly what happened to my daughter 22 before she went to jail the second time. 23 She was in extensive outpatient. She was at 24 mental health. She had counselors. She had group 25 counseling. She had individual counseling. 1 She begged everybody to help her with the 2 cravings. 3 Nobody would help her. Nobody would talk to 4 her. Nobody would give her the time of day. 5 In October she got frustrated. She relapsed. 6 She didn't relapse because she wanted to. 7 She relapsed to prove a point, and to try to 8 get some help. 9 That's when the judge put her in jail for 10 another 45 days. 11 They get frustrated and mad, and then they 12 say "To hell with it." 13 No one wants to help or cares that they want 14 to get help. 15 My daughter put herself in the extensive 16 outpatient because the local program wouldn't. 17 The regular program is group two times a week 18 for an hour; one-on-one, one time a week for an 19 hour. 20 Intensive is group four times a week for an 21 hour; one-on-one is every two weeks. 22 She begged everyone for help, and ended up 23 back in jail for another 45 days. 24 Group treatment needs to be structured like 25 NA and AA meetings. And this is coming from an 1 addict that has been through them all. 2 They need to be able to discuss current 3 issues going on in their life and get help with real 4 suggestions; examples of actual experiences, stories 5 of how other addicts handled similar situations or 6 got through it. 7 Right now, they only do State-required work 8 pages. They are all general, and really don't do 9 much to help the addict. 10 She goes -- currently, in the halfway house, 11 she herself is going to an NA or an AA meeting once 12 a day, seven days a week, sometimes twice a day, 13 because she wants to, because that helps her. 14 She goes to the group three times a week 15 because it's mandated. She doesn't get that much 16 help out of it. 17 In jail there is no treatment or help at all. 18 If you are detoxing from heroin, it can last 19 up to a week. They make you suffer. They do 20 nothing for it. 21 There are meds to help with withdrawal, but 22 in jail, no one gets anything. 23 There is practically no counseling in jail. 24 You can sign up, but good luck if you see 25 anyone. 1 My daughter was in for a total of 90 days 2 between the two. She signed up first thing both 3 times, and never once saw anyone. 4 SENATOR RITCHIE: Thank you. 5 CHERIE MOORE: You're welcome. 6 [Applause.] 7 SENATOR RITCHIE: We have one last speaker, 8 Aaron Vortel from ACR. 9 Is Aaron still here? 10 AUDIENCE MEMBER: No, they've left. 11 SENATOR RITCHIE: All right. 12 I guess we're all set. 13 I thank everyone for coming. 14 All the testimony will be forwarded on to the 15 full Senate Task Force. 16 And, I appreciate everybody staying longer 17 than we were supposed to, but the testimony has 18 really been helpful, and, appreciate all your time. 19 Thank you. 20 21 (Whereupon, at approximately 4:04 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 1 ---oOo--- 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25