Public Forum: Cayuga County Panel Discussion on Auburn'S Heroin Epidemic

1 BEFORE THE NEW YORK STATE SENATE MAJORITY COALITION

JOINT TASK FORCE ON HEROIN AND OPIOID ADDICTION 2 ------------------------------------------------------ 3 PUBLIC FORUM: CAYUGA COUNTY 4 PANEL DISCUSSION ON AUBURN'S HEROIN EPIDEMIC 5 ------------------------------------------------------ 6

Auburn City Hall Chambers 7 24 South Street

Auburn, New York 13021 8

May 8, 2014 9 1:00 p.m. to 3:00 p.m. 10 11

PRESENT:12 13 Senator Philip M. Boyle, Task Force Chairman

Chairman of the Senate Committee on Alcoholism and 14 Drug Abuse 15

Senator Michael Nozzolio, Task Force Forum Moderator 16 Member of the Joint Task Force 17 Senator Thomas O'Mara

Member of the Joint Task Force 18

Senator David Valesky 19 Member of the Joint Task Force 20 Assemblyman Gary Finch 21 22 23 24 25 1

PANELIST INTRODUCTIONS - FRONT TABLE PAGE 11 2

John Riccio 3 Chief Medical Officer

Auburn Community Hospital 4

Shakeel Usmani 5 Physician, Internal Medicine

and Emergency Medicine 6 Auburn Community Hospital 7 Ray Bizzari

Director 8 Cayuga County Mental Health Office 9 Kevin Hares

Executive Director 10 Confidential Help for Alcohol and Drugs, Inc. 11 Jon Budelmann

District Attorney 12 Cayuga County 13 David Gould

Sheriff 14 Cayuga County 15 Michael McKeon

Judge 16 Presiding over felony and misdemeanor drug courts

Auburn City Court 17

Brian Neagle 18 Police Chief

Auburn Police Department 19 20

PERSONAL STORIES PAGE 14 21

START OF PANELIST PARTICIPATION, PAGE 20 22 INCLUDING EXPERTS IN THE AUDIENCE 23 AUDIENCE PARTICIPATION AND Q&A PAGE 50 24 25 ---oOo--- 1 SENATOR NOZZOLIO: Good afternoon, ladies and 2 gentlemen. 3 I'd like to call the meeting of the 4 New York State Senate Heroin Task Force to order. 5 It's extremely an honor to be -- please come 6 in, Doctor. 7 It's an honor for me to be here, and to sit 8 with my colleagues who have worked tirelessly across 9 the state over this last month. 10 Senator Boyle and I, for instance, were in 11 Manhattan a week ago today, to take testimony on 12 this very pervasive, yet extremely important issue. 13 Before I welcome my colleagues, I want to 14 indicate to them who we have in this audience. 15 It is a tremendous group of people who are 16 understanding of this problem, who have been dealing 17 with those who have been addicted to heroin. 18 We have a wonderful contingent of medical 19 professionals, law-enforcement professionals, 20 provider professionals, who understand this issue 21 extremely well. 22 And whether it's an emergency responder or a 23 member of Sheriff Gould's task force or other 24 law-enforcement officials, medical professionals, 25 they will help us provide appropriate insights into 1 this problem. 2 Senators with me today have been involved in 3 the Task Force deliberations, but I wanted to have 4 them understand the impact of this very serious 5 problem in a small city like Auburn, surrounded by a 6 rural area; that heroin addiction is not just 7 centered in the inner cities anymore. 8 And with that, I'd like to first let 9 individuals know that this is not a public hearing. 10 It is not a place to just stand and give 11 five minutes, ten minutes of testimony. 12 This is a place, a forum, to interchange 13 ideas and experiences, and, it will be freewheeling. 14 We'll try to manage it. 15 We want everyone to be able to voice their 16 opinions and provide us insights. 17 But other than our first testifier, and 18 I think you will understand why we asked this 19 individual to testify -- I'll explain that a little 20 later -- it will be freewheeling throughout that. 21 And with that, let me thank the person who 22 had to travel here the furthest, our Chairman of the 23 Task Force, Senator Phil Boyle. 24 Senator Boyle, thank you very, very much. 25 Along with him is -- to his right, is 1 Senator Tom O'Mara, represents much of the 2 Southern Tier, the central Southern Tier, and the 3 central Southern Finger Lakes; 4 And, of course, David Valesky, who, for many 5 years, represented a portion of Cayuga County, and 6 is an important member of our review panel. 7 Two Senators who could not be here today, 8 I need to mention them: 9 Senator John DeFrancisco, who had intended to 10 be here. He also represents a portion of 11 Cayuga County. He could not be. 12 And, Senator Jim Seward, who had to attend a 13 funeral of a military hero who was slain in the past 14 few days in Afghanistan. 15 They extend their wishes and thanks for your 16 participation. 17 I'd also like to thank Mayor Quill. 18 Thank you, Mayor, for the courtesies that you 19 have extended the Task Force. 20 This is a lovely chamber, and thank you for 21 allowing us to use your facility. 22 The Mayor has a meeting later, a City Council 23 meeting later today, so, unless we wrap up by an 24 appointed hour, we will be evicted. 25 Right, Mayor? Is that the -- 1 [Laughter.] 2 SENATOR NOZZOLIO: With that, Chairman Boyle. 3 SENATOR BOYLE: Thank you, Senator Nozzolio. 4 I appreciate your hosting this forum. 5 And Mayor, as well, thank you so much; my 6 colleagues in the Senate. 7 We have been traveling around the state. 8 I represent Suffolk County on Long Island, 9 and all the way up to Buffalo and Western New York, 10 and this heroin epidemic is a statewide epidemic, 11 and it's a crisis. 12 I'm pleased to be here in Auburn. 13 Actually, I've been to Auburn many times, but 14 it was years ago. 15 For those of you who remember former 16 Congressman Frank Horton, I was his legislative 17 director in Washington, so I came to Auburn quite a 18 bit. 19 At that time, I didn't have any gray hair, 20 and Mike was an Assemblyman, so that was a while 21 ago. 22 But I wish I was here under different 23 circumstances. 24 And, today, these forums, as Senator Nozzolio 25 said, they're open. 1 We want answers from our panelists. 2 Certainly, we have a distinguished panel here. 3 And, from people in the audience who have 4 experienced the heroin epidemic in many different 5 ways, whether a personal crisis, through 6 law enforcement, or treatment, we want to hear what 7 you have to say. 8 And the question I always put is, "If you 9 could change a law or two to make this epidemic less 10 stressful on you, get treatment that needs to be 11 provided, and, law enforcement, what laws we can 12 change to put the bad guys away that are dealing 13 these drugs?" that's what we want to hear about. 14 Or, if you know of a law that's there, and 15 you don't think it's good, we need to get rid of it, 16 we'd like to hear that, as well. 17 So, Senator, thank you so much for hosting, 18 and we look forward to a good discussion. 19 SENATOR NOZZOLIO: Thank you. 20 Senator O'Mara? Senator Valesky? 21 SENATOR BOYLE: Senator O'Mara? 22 SENATOR O'MARA: Good afternoon. 23 My name is Tom O'Mara, and I am from the 24 Southern Tier, as Senator Nozzolio mentioned, just 25 south of the Senator's district, spanning the 1 southern Finger Lakes, and the Southern Tier along 2 the Pennsylvania border, from Ithaca to Hornell, 3 including Penn Yan, Elmira, and Corning. So, it's a 4 five-county district. 5 We have issues with the heroin problems 6 across the district. 7 I myself have a background in 8 law enforcement, having been a former district 9 attorney in Chemung County, as well as an assistant 10 district attorney in Manhattan. 11 So, my experience in the criminal justice 12 area is wide, and I look with great interest on the 13 input that we're getting at these forums across the 14 state. 15 You know, Phil -- or Mike mentioned that 16 Senator Seward couldn't be here today with us, 17 unfortunately, for that incident. 18 But I was in his district just a week and a 19 half ago, in Oneonta, for one of these forums. And 20 we're doing the forums across the state. 21 So I thank Senator Boyle and 22 Senator Nozzolio, Senator Valesky, for your 23 leadership on this issue. 24 And, my pleasure to be here in Auburn with 25 you today. 1 SENATOR VALESKY: Thank you, Mike, very much. 2 And I'm very pleased to be here, and pleased 3 to be back, just as a personal aside. 4 As Senator Nozzolio indicated, I had the 5 great opportunity and honor to represent part of the 6 city of Auburn and a number of towns in 7 Cayuga County before the last round of 8 redistricting, so it's very, very nice to be home, 9 and appreciate being here again. 10 I want to acknowledge Assemblyman Gary Finch 11 who just joined us, as well, and will participate. 12 One other thing I would add, as I certainly 13 thank Senator Boyle for traveling around the state, 14 I believe this is one of 17 Task Force meetings, so 15 that's a lot of traveling. 16 And I might add, that we are still in our 17 legislative session. 18 So, I don't know how he spends any time at 19 home these days, but we appreciate his -- the 20 generosity of his time in leading these efforts. 21 And the final point: 22 You all know Senator Nozzolio as being, 23 perhaps, your representative, depending on where you 24 live here in the Finger Lakes. 25 But, you may or may not be aware that he has, 1 just this last legislative term, been chairing the 2 Codes Committee in the State Senate. 3 And the reason why that is significant, this 4 process will lead to -- these Task Force forums will 5 lead to a package of bills that we intend to take up 6 in the State Senate prior to the conclusion of the 7 legislative session. 8 And Senator Nozzolio, as the head of the 9 Codes Committee, will certainly play a very 10 significant leadership role in that. 11 So we appreciate that, as well. 12 Thank you very much. 13 SENATOR NOZZOLIO: Thank you, Senator. 14 And as you indicated, we've been joined by 15 Assemblyman Gary Finch. 16 Assemblyman Finch, we squeezed in a chair for 17 you next to Chief Neagle, and I think that's a good 18 place for you to be. 19 [Laughter.] 20 ASSEMBLYMAN FINCH: [Inaudible.] 21 SENATOR NOZZOLIO: But we greatly appreciate 22 your participation, Assemblyman Finch, and you bring 23 a unique perspective here. 24 Just at the table, I'd like everyone to note, 25 on your left, my right, are professionals in the 1 health and mental-health field. 2 I'd like them to introduce themselves. 3 On my left, your right, are representatives 4 of law enforcement who are here, and they have a 5 very unique perspective, that we will be extracting 6 information from them, both sides, in the upcoming 7 minutes. 8 Also, there are a number of law-enforcement 9 officials who are seated in the front row here to my 10 left: 11 The District Attorney from Seneca County, 12 Barry Porsch; 13 The Sheriff of Ontario County, Phil Povero; 14 The Sheriff of Seneca County, Jack Stenberg; 15 Other law-enforcement officials; 16 That I will ask them to introduce themselves 17 during the course of this meeting. 18 But, thank you all for spending time. 19 If I could just ask you, beginning with the 20 gentleman on my far right, just introduce yourself 21 and your organization for everyone to know. 22 DR. JOHN RICCIO: My name is John Riccio. 23 I'm a physician. I'm the chief medical officer at 24 Auburn Community Hospital. 25 I am a pathologist by trade. 1 I'm the laboratory director, and I've been at 2 Auburn Community Hospital for 15 years. About 3 10 years before that in Syracuse. 4 I brought with me a real doctor, 5 Dr. Shakeel Usmani [ph.], who's an important lead 6 physician in our new emergency medicine group at the 7 hospital. He's board certified in emergency 8 medicine. 9 Shakeel. 10 DR. SHAKEEL USMANI [ph.]: My name is 11 Shakeel Usmani. 12 I graduated in 2008 from New York City. 13 I did internal medicine and emergency medicine. 14 I'm practicing ER for the last five years 15 now; for the last two years at Auburn Community 16 Hospital. 17 So if you have any -- 18 SENATOR NOZZOLIO: Thank you, Doctor. 19 We really appreciate your participation. 20 Ray. 21 RAY BIZZARI: I'm Ray Bizzari. I'm the 22 director out at County Mental-Health Center. 23 We have some oversight responsibilities for 24 things like this. 25 KEVIN HARES: Kevin Hares, the director of 1 the CHAD office (Confidential Help for Alcohol and 2 Drugs), the local outpatient. 3 I've been there 37 years, so I have a fairly 4 extensively opinion on this. 5 SENATOR NOZZOLIO: Jon. 6 DA JON BUDELMANN: Jon Budelmann, 7 Cayuga County District Attorney. 8 I have one of my assistants, 9 Diana Anstedt [ph.], who's been working with drug 10 courts since it started here in our county. 11 I think Nate Darlin [ph.], another ADA of the 12 drug court is here, as well. 13 We handle the prosecution of drug offenders, 14 as well as some of the complications from drug 15 overdose, and cases along those lines. 16 SENATOR NOZZOLIO: Thank you, Jon. 17 Sheriff. 18 SHERIFF DAVID GOULD: Dave Gould, 19 Cayuga County Sheriff. 20 I have my Undersheriff, Jim Stole [ph.], in 21 the back. 22 We have a heroin task force out of our 23 Cayuga County Sheriff's Office, and I'm sure that 24 we'll get into that a little later. 25 But thank you for coming. 1 JUDGE MICHAEL McKEON: I'm 2 Judge Michael McKeon, Auburn City Court Judge. 3 I preside over both the felony and misdemeanor drug 4 court in Cayuga County. 5 POLICE CHIEF BRIAN NEAGLE: I'm Brian Neagle. 6 I'm the Police Chief here in the city of Auburn. 7 SENATOR NOZZOLIO: Thank you all very much. 8 We first would like to set the table, talking 9 about the nature of the problem, the scope of the 10 problem, in the Finger Lakes region. 11 That this is a very sad day, because it's a 12 sad anniversary date, of the death of a young woman 13 from Auburn, Jessica Gentile. 14 And that our first testifier, on behalf of 15 Jessica's family, is Kevin Jones. 16 Thank you, Kevin. 17 Please come to the podium. 18 And, Kevin, I know with you is Jessica's mom. 19 KEVIN JONES: Yes, this is Michele Gentile. 20 This is Jessica Gentile. 21 She graduated magna cum laude from 22 Cortland University. 23 She was a good writer. She was brilliant. 24 She was witty. She had every reason in the world to 25 live. 1 She died by heroin overdose on May 8th of 2 last year. 3 And, the gentleman that she was with didn't 4 notify 911, and didn't tell anybody. You know, he 5 waited three hours before he actually notified 911. 6 And if he had known about the Good Samaritan 7 Law, there's a Good Samaritan Law that states that 8 if you -- if you dial 911 for a medical emergency, 9 then you're not liable for prosecution whatsoever. 10 So, if he had known about that law. 11 We have this fantastic law that can save 12 lives, but nobody even knows about it. 13 So that would be one thing I would like to 14 add as a law to be changed, is put some funds 15 towards notifying people that the Good Samaritan Law 16 exists, and, you know, maybe we can save some lives 17 with that. 18 We tried to get Jessica treatment. 19 She was -- she started out -- she graduated, 20 she was unable to find a job. She was depressed for 21 a little while. 22 And she got to the point where she was so 23 depressed that we entered her into the 24 behavioral-health unit at the hospital. 25 Dr. Syed [ph.] recommended that she go to 1 intensive outpatient treatment because they 2 discovered marijuana in her system. 3 She had no opiates at that point. 4 And once they -- they recommended that. 5 And then she went to CHAD. There's a 6 two-week waiting period before you even get an 7 intake at CHAD. 8 There's almost a nine-month period before you 9 can get into a rehab around here. 10 And if you don't have the proper insurance, 11 there's only one rehab that you can go to in 12 New York State, and that's Dick Van Dyke, because 13 that's the only one that will accept you without 14 insurance. 15 That's another thing I'd like to -- law 16 I would like to address, is we don't have enough 17 rehabs in the area. 18 And -- okay. 19 And then the next part is, we went, and CHAD 20 recommended the same thing, you know, intensive 21 outpatient. 22 We got a letter from the insurance company, 23 OASAS, saying that, "We don't think they need that." 24 And so she never got the chance. 25 They offered -- CHAD offered us, to pay $75 a 1 day, 3 days a week, for as long as it took, which 2 would have been at least 6 months. 3 And I offered to trade in my retirement fund 4 to take care of that, but Jessica wouldn't have us 5 do that. 6 And, she died shortly after that. 7 So, the insurance companies overrode what a 8 doctor said, they overrode what a drug professional 9 said. And, they're just not doing their part. 10 And I understand this takes money. 11 I understand it takes a lot of money for 12 treatment and things like that, but we're paying for 13 it in our jails, we're paying for it in our prisons, 14 we're paying for it in our hospitals, anyways. 15 So -- so I would like some funds for that 16 type of stuff. 17 And, you know, you guys are doing a great 18 job. 19 I've seen more about heroin over the past 20 year than I've ever seen in my life. 21 And we're really thankful for this 22 Task Force. 23 And, you know, we're never going to be over 24 the loss of Jessica, but nobody has to suffer like 25 we did. 1 Would you like to? 2 MICHELE GENTILE: Yes, I would just like to 3 say a few words. 4 I, as her mother, I never, ever, would like a 5 mother to have to go through what we've endured this 6 last year. 7 Last year at this time we were in the ER 8 finding the news out. 9 But, I mean, we will do whatever we can to 10 help. 11 I want to do that in her name, because as a 12 mother, that is your job, to take care of your 13 children. 14 And you feel look a failure. 15 We didn't find out until the night before, 16 that she was using heroin. 17 She called me at work to tell me that 18 somebody was going to say that she was using heroin, 19 and it clicked in. 20 And I said, "I think you are." 21 So we -- my sister texted her and said, 22 "You're going to rehab tomorrow." 23 And she said, "Okay." 24 And then she went and had her last hurrah. 25 But -- so we, literally, found out the night 1 before, what the behaviors were, her distance. She 2 was definitely acting different. She was never, 3 ever home. 4 A couple posts on Instagram that my family 5 sent me came at, like, eleven at night, and she 6 totally looked torn up. 7 And I was, like: I know she smokes pot, but 8 this just can't be normal. 9 And I, like, texted her and yelled at her. 10 I said, "What are you doing?" 11 And, I mean, she definitely denied it. 12 She was always against it. 13 That fooled me. 14 So there's -- I think we need, definitely, 15 prevention. We need more rehabs. 16 And we definitely need Narcan, immediately, 17 here in Cayuga County to at least save lives. 18 That's just the Band-Aid to save their life, 19 which would be -- that's the blessing. 20 But, we also need, we definitely need it. 21 And I think the rehab for this is, 22 definitely, it's not 20 days, it's not 30 days. 23 It's longer. 24 And there needs to be, definitely, intensive 25 outpatient. 1 This drug is way too addicting. 2 And that's all I -- and thank you for having 3 us speak. 4 We appreciate that. 5 [Applause.] 6 SENATOR NOZZOLIO: Kevin and Michele, we wish 7 to thank you for your courage, and for coming here 8 to share what I know must be an anguished memory. 9 You've given us wonderful suggestions. 10 Kevin and I have talked a few times already. 11 We will continue our dialogue. 12 And I hope you can, Kevin, particularly 13 Michele, if you could stay throughout the forum to 14 help us in this focus. 15 But thank you very much. 16 I think this is as good a time as any to ask 17 our law-enforcement officials and providers to help 18 the Task Force understand what you're seeing each 19 and every day, and, the nature and extent of the 20 problem, as you see it, here in the central 21 Finger Lakes. 22 And let's start out with Jon and 23 Sheriff Budelmann. 24 Jon, Sheriff Gould and you are, I know, very 25 much involved with this. 1 Would you start, at least giving us an 2 outline. 3 SHERIFF DAVID GOULD: Thank you, Senator, 4 I will start. 5 We do have a task force, I mentioned this 6 earlier, the Sheriff's Department in Cayuga County. 7 It's made up of several members: uniformed members 8 and plain-clothes detectives. 9 We do intervention. 10 We stop cars, legally stop cars, when we can, 11 and, certainly, our main focus is to search for 12 heroin and ask about heroin. 13 We've made numerous arrests and received 14 numerous tips since we started. 15 We actually started back in February. 16 The Undersheriff came up with this great 17 idea, and ran it by me, and we certainly both 18 agreed, and we talked to our membership. 19 And I think it's been very successful, 20 working hand-in-hand with the Finger Lakes Drug Task 21 Force with Auburn PD. 22 Several of those cases were turned over to 23 our task force. Some of those names were already 24 known; others were not. 25 We have had numerous investigations. 1 Our NARCTIP: We have a NARCTIP, 2 N-A-R-C-T-I-P, line that rings right into the 3 Sheriff's Department with tips. It is anonymous. 4 We receive several, several tips, with family 5 members not wanting their names known to other 6 family members, neighbors, co-workers, telling us 7 about this terrible, terrible heroin epidemic. 8 And it is. 9 As the Senator said, it truly is. 10 Those tips have turned in a lot of arrests, a 11 lot of investigations, a lot of helping. 12 I'm certainly not going to take, you know, 13 Ray's thunder over and CHAD's thunder over. They 14 will certainly talk about the help, but these 15 individuals truly, truly do need help. 16 A lot of times they're coming to our jail 17 and -- for crimes that they committed to get money 18 to buy this heroin, even though it is very, very 19 inexpensive. And I'm sure someone else will go into 20 that. 21 But, they're sitting in our jail, coming down 22 from heroin, which is an awful, awful, awful thing 23 to watch, and to do. 24 It's very addictive and very hard to come off 25 of. 1 SENATOR NOZZOLIO: Sheriff and 2 Mr. District Attorney, what growth? 3 You say "numerous." 4 What is the extent of the growth of these 5 cases in our area, David? 6 SHERIFF DAVID GOULD: That's hard to 7 determine, Mr. Senator, because we haven't anything 8 to compare from the past. 9 This kind of hit us starting a year ago, 10 I think, and it just -- it came on so quickly. 11 When some of us were growing up years and 12 years ago, heroin was used by a very few amount of 13 people, and we thought that was the terrible thing 14 back then. 15 And now it's used by so many because of the 16 cost and the availability. 17 It's just -- it's unbelievable how available 18 it is. 19 SENATOR NOZZOLIO: Are the sheriffs from 20 Ontario County and Seneca County and the 21 Police Chief from Seneca Falls, are you seeing 22 growth, as well, in this area of cases? 23 UNKNOWN SPEAKER: [No microphone used.] 24 Absolutely. 25 Yes, absolutely. 1 And like Dave said, a year ago, a year and a 2 half ago, they were doing the Coke, and they were 3 doing the things of that nature. 4 Now it's the majority of our [inaudible]. 5 SENATOR NOZZOLIO: Yes, Chief. 6 POLICE CHIEF BRIAN NEAGLE: In 2010, the drug 7 task force -- the Finger Lakes Drug Task Force, at 8 that time, they had 2 heroin buys that year. 9 In 2011, it went to 9 heroin buys. 10 In 2012, we went up to 31 buys of heroin. 11 And back down -- in 2013, it went down to 12 18 buys. But what happened there was, in February 13 of 2013, we had a sting -- well, not a sting -- we 14 had a roundup, where we arrested 13 heroin dealers 15 in the area. 16 Obviously, that took a big -- big -- put a 17 big dent into the sales. 18 But as of this year, we're up to about 11, as 19 far as buys. 20 So, you know, you probably say, on an 21 average, we're probably going to at least reach 22 where we were last year. 23 So it's -- we've seen a steady increase since 24 2010. 25 SENATOR NOZZOLIO: What has the prosecution 1 been, though, Jon? 2 DA JON BUDELMANN: Thank you, Senator. 3 I've been prosecuting drug crimes here in 4 Cayuga County since '95, and for most of that time, 5 cocaine has been our primary problem. 6 In the last five years or so, we've seen a 7 rise in the prescription drugs. 8 And as the Chief has put out the statistics, 9 I would say that heroin used to be about 2 percent 10 of our cases, maybe less. 11 We do probably 100 to 150 drug cases a year, 12 and 2 or 3 or 5, at the most, per year were heroin. 13 It was kind of an outlier. 14 Within the last year and a half, two years, 15 as you've heard, it's exponentially grown. 16 I would estimate it's probably higher than 17 the 31 cases, countywide, but those are controlled 18 buys, versus, possession, where a car is stopped or 19 a house is searched and drugs are picked up. 20 I estimate it's closer to 40 percent of our 21 illegal-drug cases now. 22 I think there are a couple of factors, if 23 I might, that lend to that, one of which, is we saw 24 a rise the prescription drugs, particularly the 25 opiate painkillers became quite a problem. 1 We'd see scrips for 180 oxycodone pills per 2 month, and, it's getting on the street. And then, 3 all of a sudden, that sort of dried up. 4 The physicians aren't writing those scrips 5 anymore, and now there's a pure, inexpensive heroin, 6 another opiate, on the market that's taken over. 7 My recollection, when I was young, was the 8 vision of a heroin addict who's some person -- a 9 homeless person in a gutter with a needle. 10 And that's just not the case. 11 It crosses all socioeconomic lines now, as we 12 see from Jessica's case, and many others. 13 And we're seeing headlines. 14 This was in "The Post" the other day. 15 Five overdoses in a 24-hour period, one of which 16 resulted in the death of a young woman. 17 And that's not an unusual headline anymore, 18 which is frightening. 19 So it's really, in the last year and a half 20 or so, come on full bore. 21 I think some of the things we're doing, like 22 your discussions, are bringing attention to it, and 23 I think that's actually cutting down on the number 24 of people. 25 I think people are remembering just how 1 lethal and dangerous heroin can be. 2 SENATOR NOZZOLIO: We'll come back to 3 law enforcement, and I'd also like the Chief from 4 Seneca Falls, and Barry Porsch from Seneca County, 5 also, to be part of the discussions, and think about 6 the tools you need. 7 I'd also like a report to the Task Force from 8 Judge McKeon, to talk about the drug court and other 9 items of judicial review. 10 But let's go -- we'll come back to that. 11 Let's go to the direct health focus with 12 hospital, mental health, and immediate provision of 13 services. 14 Doctor. 15 DR. JOHN RICCIO: Thank you very much, 16 Senator. 17 The District Attorney has made some very, 18 very good points that mirror our experience here in 19 Cayuga County on the health-care side, as well. 20 Historically, most heroin came from 21 Afghanistan. But, we had that war going on over 22 there, which, to some degree, disrupted the supply 23 chain, which is probably a good thing. 24 But, unfortunately, in nature, whenever 25 there's a void, it rapidly fills. 1 And in this case, the area that filled it was 2 Mexico, unfortunately. 3 Mexico is now the number two producer of 4 heroin in the world. 5 And, obviously, you just have to look at a 6 map, Mexico is much closer to the United States than 7 Afghanistan is. 8 So it's flooded the illicit market with 9 cheap, variable-grade heroin, which is cut with all 10 sorts of substances. And it's a nightmare for the 11 people taking care of these folks. 12 Here in Cayuga County, at our hospital, we 13 were able to go back and look at our overdose 14 numbers back into 1989. 15 We've always had overdoses of all sorts of 16 drugs, of course, but we really didn't start seeing 17 heroin until the mid to late '90s. 18 It increased until about, 2006, it peaked at 19 about one a month, and then it went back down. 20 But in the last three years, it has risen 21 again beyond that peak. 22 The first quarter of this year, we've seen 23 five or six heroin overdoses. 24 That puts us on track to see twenty five this 25 year if that progresses and continues the way it has 1 been, which is an outrageous number for a small 2 hospital. 3 And it's -- 4 SENATOR NOZZOLIO: And, Doctor, thank you. 5 And just to put that in perspective: 6 The Task Force heard last week from the 7 New York County, Manhattan health-care providers. 8 They said about 500, was it, of overdoses per 9 year for a city of 8 million people. 10 Here for a city of 30,000 people, you do the 11 math, but it's as a proportional problem here as it 12 is anywhere. 13 DR. JOHN RICCIO: Exactly. 14 And, you know, we're fully equipped to handle 15 these overdoses in the ER, but one of the biggest 16 problems is, getting the patient from the point of 17 where it happened to the ER. 18 And, you know, how much time does that take? 19 What condition is the patient in? 20 When were they reported? 21 How were they found? 22 These are the things that save lives. 23 You know, if you find a patient and he's too 24 far gone, it doesn't matter how good our ER is and 25 how good our providers are, it's too late. 1 Heroin is a very, very powerful opioid, of 2 course, and it suppresses -- it's a depressant -- 3 and it suppresses respirations, and that's how it 4 kills. 5 Simply, it depresses respirations. 6 There's a respiratory center in the brain 7 stem, and heroin causes a depression of our urge to 8 breathe. 9 When we sleep, obviously, we breathe. 10 When we pass out, we breathe. 11 But under the influence of heroin, we stop 12 breathing. 13 Slowly, but surely, we stop breathing, and 14 that's how you die from a heroin overdose. 15 The long-term effects, of course, are much 16 more difficult, including things like endocarditis, 17 which is an infection inside the heart. 18 That can be from the different chemicals and 19 powders and things that they use to cut the heroin. 20 New users, of course, do not have tolerance, 21 so they get the euphoric effects of heroin rather 22 quickly. 23 But every time you use heroin, your tolerance 24 goes up and up and up; you need more and more from a 25 source that you have no idea what the purity of the 1 heroin is; What is the concentration of the heroin? 2 What is it cut with? 3 So, it causes all sorts of complications and 4 all sorts of difficulties. 5 Once the patient gets into the ER, of course, 6 we can do significant treatment and, most times, 7 save their lives. 8 SENATOR NOZZOLIO: Is the availability of the 9 antidote now pretty regular among our hospitals in 10 the upstate area? 11 DR. SHAKEEL USMANI [ph.]: Yes, we do have. 12 We have -- when the patient presents to ER 13 with any opiates, narcotics, overdose, it's 14 sometimes quite serious, a very serious medical 15 condition, because as the doctor -- as Dr. Riccio 16 mentioned, it primarily suppresses your CNS and 17 respiratory center. There's no drive to breathe. 18 If the body lacks oxygen, it affects most 19 multi organs of the body. 20 SENATOR NOZZOLIO: One of the measures that 21 was enacted this week, in response to, I believe, 22 the energy put into this issue over the last few 23 months, and Senator Boyle might want to comment on 24 it, but it's the -- and my colleagues -- the measure 25 passed both the Assembly and the Senate, to make it 1 as a prescription basis, the antidote. 2 DR. SHAKEEL USMANI [ph.]: Right. 3 DR. JOHN RICCIO: One of the things, from the 4 point of view of the physicians and the health-care 5 providers is: Can we get help to these patients 6 quicker? 7 Some states have done just that, by putting 8 Narcan, which is an antagonist drug, which you 9 probably -- most of you are probably familiar with, 10 in the hands of first responders, including 11 police officers and EMT providers. 12 Narcan is a wonderful drug in terms of 13 combating this. 14 However, it's short-acting, but it does work 15 immediately for opioid-induced coma. 16 It's remarkable. 17 If you've not seen it, patients come in, 18 they're completely obliterated. 19 You give them Narcan, they wake right up. 20 It is short-lived, however. The half-life of 21 Narcan is about one hour. 22 There are some newer preparations that have 23 longer half-lives. 24 But the good thing about this drug is that, 25 you almost can't go wrong giving it, because it only 1 works against opioid substances. 2 It won't work against other drugs, and it has 3 few, if any, side effects. 4 So, the police officer or the EMT provider 5 who actually administers Narcan at the scene, if 6 they were able to do that, really can't go wrong 7 doing it, because if they give it in error, there's 8 no side effect, nothing goes wrong. 9 We just keep working on the patient and find 10 out exactly what it was they did take. 11 SENATOR NOZZOLIO: Are there any other 12 comments from our health-care-provider table? 13 Ray, any insights you can provide in terms of 14 the scope of the problem here in Cayuga County and 15 central Finger Lakes? 16 RAY BIZZARI: Yes, thanks, Senator. 17 SENATOR NOZZOLIO: Pull the microphone in. 18 RAY BIZZARI: [Microphone turned off.] 19 So, you know, Jim Stole was mentioned earlier 20 by Dave. He's the chair of the drug and alcohol 21 subcommittee. 22 We have these planning responsibilities, and 23 we're supposed to design a system that meets -- 24 SENATOR NOZZOLIO: Ray, excuse me. 25 Please, the microphone didn't pick up. 1 RAY BIZZARI: We're supposed to design a 2 system that meets everybody's needs, and the 3 subcommittees and the community services boards are 4 the planning parts of this. 5 So, when Jim chaired -- Jim chaired this. 6 And, so, the agencies that provide treatment 7 report to the subcommittee, and then there's 8 legislative appointees that talk about this. 9 So we first started talking about 10 synthetic-marijuana use, and this was something that 11 was very concerning in the community. And there's 12 such a tremendous amount of abuse of this particular 13 drug. 14 And so we did some stuff with the drug task 15 force, we did some stuff with the agencies, and that 16 sort of led us into some other sorts of 17 conversations, and we wound our way towards 18 prescription-drug abuse and heroin abuse. 19 And, you know, I-STOP is program that was 20 sort of implemented as a law, that doctors and 21 pharmacies have to sort of look up to see -- people 22 doctor shop. They got a lot of medication from a 23 lot of different places. 24 That got shut down. 25 I think -- we think that's what drove a lot 1 of people towards heroin. It's cheaper, it's more 2 available. 3 You have a real hard time, you know, finding 4 narcotics nowadays, unless you buy them on the 5 streets. 6 So, I hear from people in a number of 7 different ways. 8 I get a lot of calls from families that talk 9 about their kids, adult children, parents who are 10 older who have become addicted, and they look for us 11 to do some sort of -- some sort of help, because 12 we're able to do certain things on the mental-health 13 side. 14 We don't have any of these tools on the 15 [unintelligible]. We can't order people, compel 16 people, in their treatment, and that sort of stuff. 17 So we hear from families, and that's pretty 18 disturbing. 19 We did some surveys in the schools last year, 20 where we asked kids about what they think about drug 21 abuse and alcohol abuse and bullying. 22 And you would be shocked to know that there's 23 a significant percentage of kids who think that 24 prescription-drug abuse isn't a bad thing because 25 they're prescribed. 1 So we have to change the way -- we've got 2 kids who are growing up, who are thinking, this 3 isn't such a bad thing. 4 You've got folks who've moved off of 5 prescription painkillers, into heroin, both in their 6 20s and 30s. 7 And we have them as older folk, as well, too. 8 So I think that -- that's what we see. 9 It's very disturbing. 10 These guys were at the subcommittee 11 yesterday, with some other folks, and told their 12 stories. Heartbreaking stuff. 13 I appreciate that you're putting this sort of 14 conversation together for communities, because we 15 are not -- and Kevin can really talk about this 16 because he's on the front lines -- but we are not 17 equipped. 18 We're far from being equipped to do what 19 really needs -- even to begin to do what really 20 needs to be done in this area. 21 So, that's the beginning of that. 22 SENATOR NOZZOLIO: Ray, Assemblyman Finch had 23 a question. 24 ASSEMBLYMAN FINCH: [Not using a microphone.] 25 Ray, there's a movement in this country to 1 legalize marijuana. 2 It was mentioned earlier that that may play a 3 part in this whole process. 4 I'd like to get your opinion about legalizing 5 marijuana, medically speaking, or otherwise. 6 And if it does, in fact, have an effect, is 7 it a gateway drug? 8 Is this something that we should be very 9 concerned about, or is this something that is a 10 non-issue? 11 Would you address that for me, please? 12 RAY BIZZARI: I think that we should do a 13 much better job of talking to kids in elementary and 14 middle school about alcohol abuse. 15 That's the drug that folks -- like, when you 16 look at what kids talk about, things that they're 17 exposed to, that's what they talk about. 18 Alcohol is a great dis-inhibiter of folks. 19 They tend to do things that they wouldn't do if they 20 weren't intoxicated. 21 So, I mean, I don't really -- the 22 medical-marijuana thing and treatment, and all that, 23 it's better for doctors to decide, I think, before 24 we have that conversation about whether or not 25 marijuana gets legalized. 1 We have to do something in the schools 2 around. 3 [Unintelligible] communities restricting 4 access to alcohol and tobacco, and those kinds of 5 things, because you take a look at everybody and 6 that's sort of where they start. 7 ASSEMBLYMAN FINCH: [Not using a microphone.] 8 Thank you, Ray. 9 Could we just redirect that question to the 10 doctor? [Inaudible.] 11 DR. JOHN RICCIO: I must be honest, I don't 12 have a real strong opinion about that. 13 There are -- there are studies out there that 14 you can quote either way, saying that: 15 Yes, it is an entry -- cannabinoids, or 16 marijuana, are an entry point for illicit use of 17 other stronger drugs. 18 And then there's probably just as many 19 studies saying that that's not true. 20 I think that THC and cannabinoids are kind of 21 a different class of drugs. They're not quite as 22 dangerous as what we see in the opioids, and 23 specifically heroin. 24 Whether or not they're as addictive, once 25 again, you can get opinions on both sides, but 1 they're certainly not as dangerous. 2 They don't suppress respirations. They don't 3 kill like heroin kills. 4 SENATOR NOZZOLIO: Kevin. 5 KEVIN HARES: Okay. 6 No. 7 SENATOR NOZZOLIO: I'm not asking you to 8 answer Assemblyman Finch's question. 9 I think what -- we're here to talk about 10 heroine. 11 And it -- just as an aside, I agree with the 12 doctor very much. 13 Senator Boyle and I were in New York last 14 week. We asked a recovering addict -- a heroin 15 addict, 20-year-old young man, prime of his life, 16 strong, getting away from it -- we asked him why he 17 did what he did. Why did he fall off into that use? 18 And he said, "Marijuana." 19 Now, I'm sure there are 10,000 stories from 20 each individual who does become addicted. 21 And that's really -- our focus here is -- 22 will be on the prevention part, as well, but before 23 that, Kevin, could you just give us a scope of the 24 problem from what you have to deal with? 25 Explain your organization, and briefly give 1 us your unsights into where we are. 2 KEVIN HARES: Senator, we're a licensed 3 outpatient agency; have been for over 40 years. 4 What we've seen is, in my tenure there, 5 1 in 100 admissions, maybe 5, 6 years ago might have 6 been a heroin base. 7 Now, 1 out of every 2 is. 8 You know, and one of the big things that we 9 all have to wrestle with, that clearly is -- those 10 who work in the field, and many of them are here, 11 will, you know, applaud this -- but, our attitudes 12 have to change. 13 We do not accept treatment. 14 We do not accept recovery. 15 We do not see it as a positive. 16 We need to look at it as a health condition, 17 as a disease, and provide the proper treatment for 18 it. 19 I feel like we're second-class citizens when 20 it comes to funding, and we've kind of been left to 21 run a business, to provide the service, and the 22 State aid, since I started, has decreased quite 23 enormously over the years. 24 And what we're dealing with is, in my 25 opinion, and I guess this is where I'm really angry, 1 I have over 37 years of experience, but I have 2 someone in an insurance agency telling me when 3 somebody should go someplace and how severe their 4 problem is. 5 I didn't know that not getting -- you know, 6 not knowing what I know, and getting people to want 7 to get help, and then being told "no" on another 8 line, and saying to you: Well, you can talk to our 9 doctor. 10 I've not won a doctor's argument in 25 years. 11 Okay? 12 But what it boils down to is, we have 13 dismantled the system that worked. We have taken 14 away long-term rehab, which was spoken to here. 15 You need the ability to put people in the 16 programs that could last up to a year, because some 17 people's disease is that strong. 18 You need immediate access. 19 SENATOR NOZZOLIO: Kevin, let me just have 20 you emphasize that part. 21 In your experience, which I know is 22 considerable, what would you recommend? 23 I know it's individual, but, what is a 24 minimum stay? 25 KEVIN HARES: If you want to look at a system 1 of care, with opiates especially, and heroin, the 2 first step is, is let's remove ourselves from the 3 argument that there is no over -- you know, no detox 4 from heroin. 5 Everybody I talk to that has a heroin 6 addiction is afraid of the withdrawal. 7 So what is our problem in putting them in a 8 setting in which they can withdraw safely and feel 9 like there's somebody supporting them? 10 So that's detox, okay, or something similar 11 to that. 12 The second step is, I used to be able to put 13 people from detox straight into inpatient. 14 I can't to that now. 15 You have to fail like 16 different things 16 before you can even go there. 17 People die in between. 18 The big thing is that, you could go from 19 detox to inpatient. 20 If that does not work, then you should go to 21 long-term care. 22 If inpatient does hit the bell, come back to 23 us for intensive outpatient. 24 But, clearly, the system is not functioning 25 well because we're not being allowed to run our 1 system. 2 And I think the thing that's hugely important 3 is, I've seen a trend to try to save money in 4 health care. 5 I cannot imagine what you're spending on the 6 other side of this that is in law enforcement, 7 prosecution. 8 I mean, those folks would like to be out of 9 business in this, I guarantee you that. 10 But I think it's time that we step up and 11 really start to get angry, and tell the insurance 12 companies -- you know, I'm going to get in a lot of 13 trouble for this -- but, to let us make the call. 14 I don't get any money to send somebody to 15 rehab. There's no vested interest in me to send 16 somebody away. 17 What it is, is, when that level of care is 18 necessary, it should be accessible and it should be 19 quick. 20 When somebody talked about going inpatient, 21 to be able to get somebody inpatient in one day is a 22 miracle. 23 It's an average of three failed outpatients 24 and six months of waiting. 25 So it's -- I've got white hair now, that 1 I don't know if it's my age or this drug, but, 2 clearly, we have to respond, because this is where 3 you guys hold the keys, to me, because treatment 4 works, but we're handicapped. 5 And if anybody's handicapped, you know that 6 you can't do all that you need to do. 7 And then I think the best way to also look at 8 it is, and there's the other hat, prevention. 9 We have to get out to the communities. 10 We have to have a vehicle to talk to parents. 11 We have to have a vehicle to educate this 12 crowd, and more, to -- so families can know what 13 their daughters or sons might be messing around 14 with. 15 And, clearly, we don't have that. 16 And, you know, the smaller the county, the 17 less resources you're going to have. 18 SENATOR NOZZOLIO: And we're finding, again, 19 that the Task Force is hitting it on three levels: 20 The first and foremost is the prevention; 21 The second is the treatment; 22 And, thirdly, is appropriate prosecution, and 23 dealing with the law enforcement. 24 I'm going put you all on hold. 25 I want everybody to think of questions to ask 1 members of the panel, but before we do that, I just 2 want one more speaker. 3 He's one of my favorite EMTs. 4 He's very shy. He doesn't like to speak very 5 much, but I'm going to ask Lon Furcano [ph.] to come 6 up. 7 And Lon has extensive experience in this 8 endeavor. 9 I'd like him just to tell us what it's like 10 on the front lines as you respond to emergencies, 11 Lon. 12 LON FURCANO [ph.]: First, I'd like to offer 13 my condolences to Jessica's family. I share in your 14 grief. I worked on Jessica that morning. 15 So she's with me as well, and all of us who 16 were there. 17 I hope you listen to what Kevin just said, 18 because he hit the nail right on the head. 19 Drug addiction, and the treatment of drug 20 addiction, labors under the stigma of drug 21 addiction, as though those who are addicted to drugs 22 are somehow bad people; they're evil in some way, 23 they're criminals. 24 They're not. 25 They're somebody's mother, somebody's 1 daughter, somebody's son. 2 In the old days, when we would come to an 3 unconscious young person, the first thing we would 4 try to rule out was a drug or alcohol overdose. 5 If we came to an unconscious older person, 6 we'd be looking for a heart attack or a stroke. 7 Today, every unconscious person we come to, 8 the very first thing we look for is a drug overdose. 9 60-, 65-year-old people with fentanyl patches 10 stuck on the roof of their mouth, overdosing from 11 prescription medications. 12 Young people who got addicted with 13 prescription medications, and as has been pointed 14 out now, turned to heroin to avoid their morbid fear 15 of withdrawal. 16 And there are drugs and people who can help 17 them. 18 We have a wonderful physician in our 19 community, Dr. Donelo [ph.], who does this every 20 day, working with CHAD and other agencies, trying to 21 help people. 22 The treatment works. 23 The piece that's really missing, from my 24 perspective, is outreach. 25 People -- these people are sick. They have 1 an illness. They don't think straight. They're 2 living in a different reality than you and I. 3 And someone has to go out there, in many 4 cases, and get them, and hang on to them, and bring 5 them in, and help them get into the system, and 6 advocate for them; because, one part of our system 7 is trying to help them, and the other part of our 8 system is trying to put them in jail. 9 So, you know, there's a conflict there. 10 And we need -- back in the old days, I was 11 funded by New York State as a street-worker. 12 "Worker," not "walker." 13 It makes a difference. 14 [Laughter.] 15 LON FURCANO [ph.]: My job was -- back when 16 the Rockefeller drug laws went into effect, was to 17 go behind schools, go into alleys, engage street 18 gangs; find where the drugs were coming from, and 19 get those kids to come in to a drop-in center, where 20 they could begin to be treated, where they could 21 begin to get counseling, begin to get support 22 services. 23 And I was at risk for being arrested just to 24 be with them in those days. 25 If you were standing in the crowd, you were a 1 criminal. 2 So, we've come a long way from that, but 3 there's no outreach going on. 4 Somebody has to go -- when a family says, 5 "You know, I think something's wrong" with my 6 daughter, or my son, someone who knows what's going 7 on needs to go out there, find them on the streets, 8 because, by now, they probably don't have a driver's 9 license anymore, probably lost their job, probably 10 committing petty crimes for their habit. They're 11 not thinking straight. 12 You know, it gets very complicated, and we 13 don't have a mechanism to reach out there, grab onto 14 those people -- those good people, family people -- 15 and bring them in so people like Kevin can fix them. 16 SENATOR NOZZOLIO: Lon, tell us about the 17 types of response. 18 I had -- we had an EMT talk to us this week 19 from Ithaca; just our neighbor to the south, 20 27,000 people, a city smaller than Auburn. 21 I asked him how many antidotes did he have to 22 give recently? 23 He said, within the last month, he had 24 four calls where the patient was ready to expire. 25 Four in April. 1 And, what type of levels are we seeing here 2 in Cayuga County? 3 LON FURCANO [ph.]: We're treating several of 4 those a week. 5 SENATOR NOZZOLIO: Several. 6 LON FURCANO [ph.]: But I want to make a 7 point that we bypassed, which is, there are a lot 8 more people who are functioning, that they haven't 9 reached that acute overdose point. 10 They're out there, on the streets, in 11 families, in homes, who are a walking army of this 12 close [indicating] to overdosing. 13 They're addicted, they're using the drugs. 14 And it's just -- when a miscalculation 15 happens, that's when we see them in the acute phase. 16 When they stop breathing, someone calls us. 17 We go in, we use Narcan. 18 We've had Narcan for 35 years. 19 It works, as the doctor pointed out, that 20 fast [snaps fingers]. 21 But we're using it every day, and it's not 22 just heroin. It's opioids of all kinds. And we're 23 giving this stuff out like candy, like no one should 24 ever have a pain again in their life. 25 A little pain's good for you. 1 Those of you who are elected officials know 2 that. 3 [Laughter.] 4 SENATOR NOZZOLIO: Lon, thank you very much. 5 LON FURCANO [ph.]: Thanks for the 6 opportunity, Senator. 7 SENATOR NOZZOLIO: Very good to see you 8 again. 9 LON FURCANO [ph.]: Thank you. 10 [Applause.] 11 SENATOR NOZZOLIO: We have about an hour. 12 We'd like to open up the forum to questions: 13 questions of the people up here, questions of your 14 own selves, in terms of providers. 15 Who wants to begin? 16 You know, the only thing that we ask, there's 17 some ground rules. 18 You have to come up to the podium, because 19 those are the only two places that have microphones. 20 You might have to knock that camera out of 21 there to do so. 22 And, state your name and where you're from. 23 That's it. 24 Come on up. 25 SUPERSTAR: So, god, I'm doing this 1 keynote-speaking thing tonight, and I hope to God 2 audience doesn't as spriteful [ph.] and scary as you 3 guys. 4 Oh, my God. 5 So, my name is Superstar. 6 Some of you have heard of my work. 7 I've legally changed my name to raise 8 awareness to addiction issues; right? 9 And I travel the country. 10 I'm kind of in a different and unique 11 position, because I get to see the heroin epidemic 12 in every state across the country. 13 That's my main gig. 14 I travel, right, and influence teens to open 15 up and engage in crucial conversations with their 16 parents or with the people in the schools that they 17 trust. 18 But the pattern that I'm seeing, I'd have to 19 be a dimwit to not know what this pattern is, is 20 that the teens in school feel like no one really 21 cares about them. 22 They feel like -- many of those teens would 23 rather be in school than even go home at night 24 because of what's going on in their homes. 25 Right? 1 So as I travel to the schools in 2 Upstate New York here, I think what's been crucial, 3 and what's been helping others -- 4 SENATOR NOZZOLIO: Excuse me, Mr. Superstar? 5 SUPERSTAR: Yeah. 6 You can call me Mr. Star. 7 [Laughter.] 8 SENATOR NOZZOLIO: We want to make this 9 available to everybody. 10 SUPERSTAR: I know, I agree. 11 I love to talk. 12 SENATOR NOZZOLIO: So we would love you to 13 ask your question. 14 SUPERSTAR: Yeah, here's my question: 15 Is there any possible way that -- teens that 16 don't feel safe going up to adults in the community 17 and ratting out their friends who are the drug 18 dealers, is there anything that we could do to get 19 into the schools, to put up a banner, an 800 number, 20 that says: Hey, here, call this number to safely 21 rat out your friend who's a dealer? 22 Something like that. 23 SENATOR NOZZOLIO: I guess that's a question 24 to our district attorneys. 25 DA JON BUDELMANN: Well, certainly, we would 1 encourage, and the school resource officers have 2 been great in this regard, of nurturing a 3 relationship with the students and law enforcement. 4 There are tip lines, like the Sheriff's tip 5 line, where they could anonymously report those. 6 I think we're fitting into the big part of 7 education, the outreach, reaching the younger 8 people, letting them know what options are out 9 there. 10 But we would certainly love to have them help 11 us stop the distribution of narcotics in our 12 communities, absolutely. 13 MARGIE TABER: I'd just like to add one 14 thing -- 15 SENATOR NOZZOLIO: Your name? 16 MARGIE TABER: I'm Margie Taber, and I work 17 with Monroe County Youth and Family Partnership, and 18 the Rock Star Superstar project. 19 The one thing that we see consistently is, 20 these kids are dying -- young kids; seventh, eighth, 21 ninth, tenth, eleventh grade -- to talk to somebody, 22 to have crucial conversations, to open up. 23 So the people that have advocated and spoken 24 out about the outreach and the prevention, I can 25 just say, from our perspective, and that sometimes 1 the kids -- we need to focus on creating 2 opportunities for these kids to be heard. 3 And we just see it. 4 And I don't have the magic answer for it, but 5 I just know, too many people are dying. 6 And it's sad. 7 Anyway. 8 SENATOR NOZZOLIO: The points are raised 9 about, certainly, education. 10 And, I know all the law-enforcement officers 11 here have been very involved with the D.A.R.E. 12 programs, the education programs. 13 We're trying -- we've heard those programs 14 being praised, and vilified, during the course of 15 these discussions; and either that they've worked or 16 they haven't. 17 And that -- in terms of those types of 18 prevention. 19 And I guess this is as good a time as any, 20 also to talk about diversion. 21 And, Judge McKeon, in terms of your drug 22 experience with the drug courts, what are we seeing 23 that as a -- is it a positive situation? 24 Where are we with those types of 25 deliberations? 1 And, if there are necessary tools that are 2 omitted, what should we look to replace them with? 3 JUDGE MICHAEL McKEON: Thank you, Senator. 4 I've been running the Auburn City 5 Drug-Treatment Court since 2003. And when we first 6 started out in our first couple years, our 7 population, in terms of heroin, opiate, was 8 2 percent. 9 It is now 50 percent of our population that 10 comes into our drug courts: opiates and heroin 11 users. 12 And, it's a huge jump. And, really, in the 13 last two or three years, this has really happened. 14 And that's what we're seeing. 15 I'd echo what Kevin said; one of our big 16 frustrations is the inability to get people into 17 inpatient, running through the hoops that the 18 insurance companies put us through. 19 And sometimes it's -- you know, it's to the 20 detriment to the person in the program, that there's 21 not an access, quickly, to inpatient treatment. 22 It's a long, involved process, and we've had 23 people waiting months and months. And sometimes we 24 lose people in the program because of it. 25 So that's a significant problem. 1 The lack of long-term-care facilities in 2 New York is a significant problem. 3 There are very few long-term programs. And 4 that's doubly difficult to get someone admitted and 5 paid for by insurance in a long-term-care program. 6 I think what can be lost in the process here, 7 in terms of, again, looking at numbers, is the 8 mental-health side of all this. 9 I mean, probably 70 percent of all people who 10 are opiate and heroin users have mental illness; 11 co-occurring disorders. 12 And there's a lack of inpatient programs for 13 co-occurring disorders. 14 It's very rare that the person who's addicted 15 to opiates and heroin does not also have some mental 16 health involved with it, and you need to treat both 17 at the same time. 18 It's an ongoing controversy, I know, but, 19 there's a lack of those facilities in New York, 20 which impacts everyone who is involved with this 21 population. 22 Again, it's frustrating, where I'll issue an 23 order for the person to go into inpatient, and, you 24 know, they simply ignore it. 25 Again, I'm not trying to blame the insurance 1 companies for all of the ills, but, treatment does 2 work, as has been said time and time again. 3 And good treatment, consistent treatment, 4 does work. And we've had great successes in the 5 drug court with opiates- and heroin-addicted 6 individuals; though, they are probably our toughest 7 population to deal with, and, involve a lot of 8 intensive work to get someone into recovery. 9 It's a long process. 10 And, again, the person who's addicted doesn't 11 think of the consequences of what their actions that 12 they take. 13 They're just thinking about the next fix. 14 And so, again, I echo everybody, in terms of, 15 we need more treatment in New York. 16 We need more beds available. 17 There's a lack of medical detox beds, which 18 is another big issue. 19 There are very few of them in New York, or at 20 least in this area. 21 Crisis centers, again, used for people who 22 are addicted, for a short period of time, before 23 they move into, you know, the program, a shortness 24 of those facilities in New York, as well, especially 25 in this community, and surrounding counties in the 1 Finger Lakes. 2 So, I think we would have a much better 3 success rate. 4 And, we do have a very good success rate for 5 people in drug courts. They do work. A very 6 inexpensive alternative to incarceration. 7 But I think we'd do a better job, and would 8 be more successful, if we were able to get people 9 into the programs that CHAD recommends, quicker, and 10 to the right program that will effectively address 11 the needs of that particular client. 12 SENATOR BOYLE: Your Honor, a quick question: 13 On -- for the patients that come in front of 14 you, and defendants, do you have a rule against any 15 other drugs: Suboxone, or anything like that? 16 Because some counties seem -- county court 17 drug courts seem to have that rule, and others 18 don't. 19 JUDGE MICHAEL McKEON: We don't. 20 SENATOR BOYLE: You don't. 21 JUDGE MICHAEL McKEON: We allow people to go 22 on Suboxone, yes, we do. 23 And we allow people to be in a methadone 24 clinic, as well. 25 SENATOR BOYLE: And one quick question for 1 the District Attorney: How you make a decision. 2 We've heard different stories from different 3 counties about who gets to go to drug court. 4 Obviously, we want to get the bad guys, the 5 true drug dealers, out of there. And those that are 6 maybe selling to support their habit, and treat them 7 in a different way. 8 DA JON BUDELMANN: Thank you for the 9 question, Senator. 10 I always believed that there was a two-part 11 approach that needed to be followed. 12 The first was, to prosecute drug dealers; to 13 limit the supply of the drugs into our community, to 14 limit the number of addicts we're creating, by doing 15 that. 16 The second part was the treatment. 17 You needed the resources there to try to 18 treat addicts to reduce the demand. 19 I think there's a third part that Lon Furcano 20 has mentioned, and I think we've heard it here from 21 Superstar here, as well, which is, we need to 22 educate before we get the addicts. 23 That stigma that was there when I was a young 24 man, about the needle in the arm, isn't there 25 anymore. It's been glamorized, or somehow otherwise 1 made. 2 And it figures into a big-picture question 3 versus small question. 4 Obviously, treatment costs a lot of money, 5 but drugs are the locomotive that drive our crime 6 train. 7 There's -- the offenses that are caught, that 8 are committed by the drug dealers: violent offenses, 9 guns, assaults, shootings. 10 There are offenses committed by addicts, to 11 try to get money to buy drugs: the theft, the fraud, 12 the identity theft. 13 There are offenses that are committed while 14 people are under the influences of these substances. 15 And, you're right, we have to investigate 16 them with our police. 17 We have to prosecute them. 18 We defend most of them as indigent 19 defendants. 20 Our courts are consumed. 21 Our jails are consumed. 22 So, if we can spend some of the money that we 23 would otherwise have to spend to do all of that, to 24 try to treat people and reduce the human suffering, 25 I think that would go a long way. 1 In terms of the issues that are -- in 2 responding to your question, I apologize, Senator 3 for delaying on it -- we look at who is a -- what 4 I would call a "true drug dealer." 5 And I haven't done this for 20 years, I've 6 sort of classified people: 7 You have for-profit drug dealers. People 8 that are, essentially, doing it as a lifestyle, as a 9 money-maker, as a way of getting access to young 10 women, or whatever it is that their motivation is. 11 Then we have people, what I call 12 "addict-dealers," or "facilitators," are more likely 13 a good description of them. Someone that is 14 addicted themselves, and rather than stealing to 15 support their addiction, they are turning to dealing 16 to support their adduction. They are spreading the 17 misery that the dealers are, but they also have 18 somewhat of an excuse. I guess it's not just purely 19 profit-driven. 20 What I would call a "true dealer" should not 21 be in a drug court, should not be in a diversion. 22 Should be in prison, where they belong. 23 Someone that is an addict, dealer, 24 facilitator dealer, more of a middleman, that's 25 where we get into the kind of critical questions. 1 Someone that's a low level, that's kind of -- 2 doesn't even hold themselves to drugs. They have to 3 take the money from the addict, to go meet the 4 dealer, get the drugs, go back to the addict, that's 5 a low-level person. 6 They're suffering probably as much as the 7 addict. That's a person that we might want to put 8 into a drug court, in a community-supervision 9 situation. 10 Someone that has, you know, 50 doses of 11 heroin on them, even if they're an addict, I still 12 think they need to go to prison. 13 So that's sort of the way I'm looking at it. 14 I'm trying to classify them in the seriousness of 15 their dealing. 16 But one of the things that we've sort of 17 turned the clocks back, as you know, the prison 18 population has gone down about 20,000 in the last 19 8 or so years. And a lot of that has to do with the 20 drug-law changes. 21 We had the Paterson drug laws of 2009, which, 22 one, removed mandatory prison. 23 We had a -- prosecutors had the discretion to 24 require a plea to a sale third that would require 25 prison. 1 Now, that is not a required sentence for 2 that. 3 So, if we thought someone belonged in prison, 4 we would require the plea or trial on a sale third. 5 Now, we can't force that. 6 If we didn't think they deserved prison, we 7 could reduce the charge and get away from mandatory 8 prison. 9 The second part of that is what we call 10 "diversion," which, essentially, pulls the 11 prosecution, the law enforcement, out of the 12 equation. 13 It puts it entirely in the courts' hands, 14 which I think is a violation of the separation of 15 powers, but it's another situation. We haven't 16 gotten into an appeals on that yet. 17 That I have a real issue with, because, the 18 Court, as an arbiter, is not supposed to be 19 investigating, or talking to one side versus the 20 other. And it's, essentially, pulling it right out 21 of our hands. 22 So, again, my two-part, now three-part 23 approach, is prosecution and treatment. 24 If we're taking away the prosecution, we're 25 going to end up back where we were in the 1 Rockefeller Era when we got the Rockefeller drug 2 laws, which is, the number of addicts is going to go 3 sky high, and we're going to be working decades to 4 try to bring that number down, and the amount of 5 human suffering that's going to happen because of 6 that is incalculable. 7 So, I don't know if that answered your 8 question, round about? 9 SUPERSTAR: We're going step down over here. 10 All right? 11 SENATOR O'MARA: Well, I was going to get -- 12 I wanted to get a question for you, so I'm glad 13 you're still standing up there. 14 SUPERSTAR: Oh, okay. Good. 15 SENATOR O'MARA: You mentioned you traveled 16 in different states, and, you work in Monroe County, 17 and about programs in schools, to provide an outlet 18 for those that might want to, so-called, narc on 19 somebody to do that. 20 What have you seen, in your experience, that 21 has been productive, or has worked, in areas that 22 you've seen? 23 MARGIE TABER: Well, I think when we travel, 24 this topic, it's across the United States. 25 We hear it from rural communities. 1 I know I'm preaching to the choir here. 2 But I think one of the things that we see is, 3 there's so many layers with this. 4 And when we go into a school, and Superstar 5 does his presentation, it opens the door for 6 conversations. 7 And then what we try to do is align the 8 providers and the school people that are working, to 9 piggyback and be there to engage in the 10 conversations, and help kind of disseminate the kids 11 to the appropriate people so that the conversations 12 can continue to increase awareness. 13 It's -- you know, it's not just going in, 14 giving a message, and going on our way and saying, 15 Okay, it's over with. 16 We all have to work together, and we have to 17 collaborate. 18 So -- you know, and there's just so many 19 layers to this that's affecting kids and families, 20 that it's just crazy. 21 So I think, for me, it's all of us coming 22 together, pooling our strength, and building upon 23 opportunities to engage kids in conversations. 24 We were just in a school in Saratoga County 25 last week. Thirty kids came up afterwards, each of 1 them with different topics of things they wanted to 2 talk about, from, I'm worried about my brother who's 3 in the military in Afghanistan, and his drinking, 4 to, what's going on in the homes. 5 And it just keeps speaking to me that these 6 kids need opportunities. 7 They're crying out in so many ways, to be 8 able to talk. 9 And whether they're not seeing what's there 10 in front of them, I don't know. 11 But -- 12 SENATOR O'MARA: How are your programs 13 funded, to allow you to go around and do this? 14 MARGIE TABER: It depends. 15 When we go into a school, sometimes 16 coalitions pay for them, sometimes. 17 We were just in Seneca County a year and a 18 half ago. We were in all the schools in 19 Seneca County, and that was funded by their 20 coalition. The council provided some funding. 21 Sometimes the schools cover it themselves. 22 And with us, it's about collaborating 23 wherever we're going, to partner -- 24 SENATOR NOZZOLIO: Excuse me. 25 MARGIE TABER: I'm sorry. 1 SENATOR NOZZOLIO: What do you mean by 2 "coalition"? 3 When you say "coalition," who -- 4 MARGIE TABER: The coalition might be a group 5 of, whether it's providers, prevention 6 organizations. Stop DWI programs. 7 SENATOR NOZZOLIO: You were in Seneca County. 8 That was kind of a combination of a different -- of 9 a number of different sources of funding? 10 AUDIENCE MEMBER: [Inaudible.] 11 SENATOR NOZZOLIO: Please. 12 MARGIE TABER: Substance-abuse coalitions. 13 I'm sorry. 14 AUDIENCE MEMBER: [Not using a microphone.] 15 Seneca County Substance-Abuse Coalition, about 16 65 providers are working on it [inaudible]. 17 SENATOR NOZZOLIO: They come together and do 18 this sort of educational outreach, I mean, I think 19 that's great. 20 It's something we need to look at, in terms 21 of how we can maybe help structure this better, to 22 keep these types of educational programs going. 23 Thank you very much. 24 MARGIE TABER: Thank you. 25 SENATOR NOZZOLIO: Appreciate your work. 1 [Applause.] 2 SUPERSTAR: Narcan did save my life. 3 I just wanted to let you guys know that. 4 [Unintelligible]. Narcan saved my life. 5 You know what? Pot also led me straight to 6 heroin. 7 I just wanted to add that. 8 Thanks. 9 SENATOR NOZZOLIO: Thank you. 10 [Applause.] 11 SENATOR NOZZOLIO: While we've got 12 Seneca County, I just want to hit -- I didn't -- is 13 Ms. Wilkinson here from Tompkins County? 14 I didn't want to miss -- she's in the -- a 15 district attorney there. 16 Okay. 17 So, Barry, same types of things that Jon has, 18 you have east, west, of here? 19 DA BARRY PORSCH: Do you want me to stand up 20 here, Senator? 21 SENATOR NOZZOLIO: Sure. 22 DA BARRY PORSCH: Same type of things that 23 Jon mentioned, and also Sheriff Gould mentioned. 24 We really were able to crack down on 25 prescription-drug abuse, and from what I see, it 1 just shifted everybody to heroin. And from what 2 I understand, heroin is cheaper than the pills. 3 We have an epidemic in Seneca County. 4 And I know my sheriff, Sheriff Stenberg, he 5 can talk on that a little bit more, but we have 6 quite a few overdoses recently on heroin. 7 We're one of the smallest counties in the 8 state, and we have an epidemic in our county with 9 regards to heroin. 10 I was in a town court last week. I had 11 four felony hearings in one morning. 12 All four defendants, none of them were 13 charged with heroin possession. They were all 14 heroin addicts, though, and they were committing 15 other crimes. That's why they were there. 16 So it's more than just possession of drugs or 17 selling drugs. It's all the other crimes that go 18 with it, and it's really swamped our court system, 19 too. 20 And I also work in drug court in 21 Seneca County. 22 And like Kevin said, a lot of those people 23 need inpatient treatment. 24 It's just not available, unfortunately, 25 because they don't have insurance. They're not 1 working. And, they come from family -- broken 2 families, a lot of them, so they don't have access 3 to that. 4 We probably could use more of that. 5 We really don't have an option there. 6 But I'll speak -- the Assemblyman mentioned 7 about marijuana. I'll speak on that; I have an 8 opinion on that. 9 And I'd like to tell the Governor, we do not 10 need to legalize marijuana in the state. Even 11 medical marijuana, that's a joke. 12 You go out there in California and where 13 that's been enacted, that's the same thing as 14 legalizing marijuana. 15 We're trying to stop one drug. We don't need 16 to legalize another one. 17 And people who use heroin also use marijuana. 18 The people who sell heroin, sell marijuana. 19 Those cartels in Mexico that are importing 20 heroin, they're importing marijuana in this country. 21 We can't legalize it in New York. 22 Thank you. 23 [Applause.] 24 SENATOR BOYLE: Can I just follow up with a 25 question? 1 I think the debate that's going on in Albany 2 now about medical marijuana is not a California 3 model. It's more like a New Jersey, very 4 restrictive. 5 We're never going to see a California model 6 here. 7 Regarding -- and please tell me, from your 8 county, and I hear from different counties: How do 9 you prosecute the dealers with the amount of heroin 10 they have? 11 I mean, we have a case -- I have a bill now 12 that says, 50 bags, and that's a felony. Okay? 13 We have cases on Long Island, where, 14 literally, had 800 bags, and they were a 15 misdemeanor. 16 I mean -- and, yet, I talk to DAs upstate 17 and they say: No, we've got plenty of -- 18 Are the laws strict enough now? Or, is it 19 just an enforcement matter? 20 How do you feel about that? 21 DA BARRY PORSCH: I believe it's strict 22 enough. 23 Everybody that gets arrested in Seneca County 24 either possessing or selling heroin, it's a felony, 25 they get prosecuted as a felony. I don't reduce any 1 to a misdemeanor. 2 It doesn't mean, because they're convicted of 3 a felony, they're going to state prison. 4 Very few people actually go to state prison, 5 in Seneca County. 6 All these people that are selling heroine are 7 also users. 8 We don't have any cities in Seneca County. 9 The people that are selling heroin, they're 10 almost all users. They go to Rochester, get their 11 heroin, they come back. They use half of it, they 12 sell the other half so they can keep they are habit 13 going. 14 We don't have any of the dealers that you 15 have in the cities. 16 SENATOR NOZZOLIO: Barry -- Chief Peenstra 17 and Sheriff Stenberg here, what type of additions do 18 you have to offer, Sheriff and Chief, about what 19 smaller units of law enforcement have to deal with 20 in this [unintelligible]? 21 SHERIFF JACK STENBERG: We have a couple of 22 issues. 23 First of all, a check through our 911 system, 24 dealing with overdoses that were reported through 25 them, this year alone we've had seven, of which 1 three have died. 2 That's just in Seneca County, and that's just 3 ones we know about that have gone through 4 law-enforcement system. 5 Unknown how many may have gone directly to 6 hospitals, what have you. 7 What you're talking -- what Barry was talking 8 about, some of our interdictions for heroin, where 9 we know people are going to Rochester, where we stop 10 them on the way back, many, many times we've got 11 people that come back from Rochester with 100 bags, 12 and 20 of them will be tore open and used by the 13 driver of the car. 14 If he gets down to 40 or 50, he's going to 15 have enough to sell, to make enough money to go out 16 and buy another 100, and, again, like what we've 17 already been saying, take care of himself. 18 Another issue, as the Sheriff and the other 19 sheriffs I know will agree with me: 20 A crisis that we have is, people need to 21 understand, our jails are not a dumping grounds for 22 addicts and mental-health people. 23 I started 1968. 24 We had a fantastic facility, Willard State 25 Hospital, in our county. 1 We took people to Willard that needed to go 2 to Willard. 3 Today those people are in my jail. 4 It's wrong every way in the world you can 5 look at it. 6 They can't function in jail. 7 They're not getting any better in jail. 8 They're not getting treatment they need. 9 They're committing crimes, and they don't 10 even have a concept of what they're doing. 11 That's got to turn around. 12 We are not -- we are not the least bit 13 qualified to take care of overdoses, take care of 14 people detoxing, coming down off heroin or any other 15 drug, including alcohol. 16 But we're tasked with that because we're the 17 only facility available to put these people. 18 That's, in our opinion, I know sheriffs 19 across the state, that's a crisis situation that 20 needs to be addressed some way or another. 21 SENATOR NOZZOLIO: Thank you, Sheriff. 22 Thank you, Chief. 23 [Applause.] 24 SENATOR NOZZOLIO: Thank you, Barry. 25 Yes. Ladies first. 1 TERRI WASILENKO: Hi. I'm Terri Wasilenko 2 from the National Alliance on Mental Illness here in 3 Cayuga County. 4 You know, we've been talking about many 5 pieces of the puzzle. 6 My belief, and my question is, since 7 mental illness and addiction goes hand in hand, 8 where's our funding for dual-diagnosis programs? 9 You know, I have tons of -- 10 [Applause.] 11 TERRI WASILENKO: Thank you. 12 -- I have things to leave for Senators to 13 read, but, you know -- so, I guess that's my 14 question: Where us our money to help these 15 individuals recover their lives? 16 Anybody want to start? 17 [Laughter.] 18 SENATOR O'MARA: Well, I'd like to -- well, 19 where's the money? There's a lot of people asking 20 that question all over the state, for a variety of 21 different reasons. 22 And that's part of the reason for these task 23 forces, is to figure out where to put the money as 24 it may become available. 25 I guess what I'd like to ask, I've been 1 thinking about it here, from yourself, as well as 2 the other providers here, and law enforcement, 3 probably the sheriffs in particular, the 4 differential between the cost of incarceration 5 versus the cost of treatment on a 6-month to year 6 basis, if we can kind quantify where we're spending 7 our money. 8 TERRI WASILENKO: Well, I think our money 9 needs to be spent in treatment. 10 SENATOR O'MARA: No, I understand your 11 perspective, but what's the cost? 12 What are we -- I know there's a societal 13 cost. 14 That's not what I'm talking about. 15 I'm talking about the actual dollars and 16 cents of jail versus treatment that might actually 17 work. 18 DA JON BUDELMANN: Senator, if I might 19 respond? 20 SENATOR O'MARA: Yes. 21 DA JON BUDELMANN: We talked about kind of 22 the global picture. 23 You have to look at the big picture on these 24 things. 25 Thing like drug court are extremely 1 expensive, per person, to supervise in the 2 community. 3 The trick is, and the answer here, lies in 4 not the daily cost to incarcerate someone versus 5 treat them with a number professionals, but the 6 long-term cost. 7 If we get them so their addiction is under 8 control and they're not suffering, we don't have to 9 continue to incarcerate them. 10 If we just continue to incarcerate them, we 11 will always have to incarcerate them because we 12 won't be hitting their addiction. 13 So it's a short-term cost that's exceeding 14 the short-term cost to incarcerate, but it's a 15 long-term cost to incarcerate that grossly exceeds. 16 Also, as Sheriff Stenberg pointed out, it's 17 not the right place for them. 18 We have no other place for them right now to 19 prevent them from committing other crimes, killing 20 other people on the roads, and so on, creating other 21 addicts, spreading the poison. 22 At the same point, it's not the appropriate 23 place for them. 24 There's a better place, we just need to reach 25 it. 1 SENATOR O'MARA: Don't perceive from my 2 question that I'm suggesting that we choose jail 3 over treatment. 4 That's not the point of my question. 5 I'm just trying to get an idea of what the 6 actual -- how much more expensive it is to -- 7 SENATOR NOZZOLIO: And I think -- if I may, 8 I think it's a very good question, a very relevant 9 question. And, Sheriff Stenberg mentioned Willard. 10 Now, all of you who may or may not be 11 familiar with Willard, was a psych center for many 12 years, that it was closed under the past 13 Governor Cuomo. 14 I predate all the Senators here. 15 We converted that. 16 I was Chairman of the Crime -- Victims Crime 17 and Corrections Committee. 18 We created the first drug-treatment prison in 19 the history of the state, where someone incarcerated 20 would actually get treatment, would get it in a very 21 expedited way. It was a 90-day, in effect, 22 intensive program to be effective. 23 And Terri's so right, that it is a terrible 24 choice. 25 Unfortunately, I believe that we've seen that 1 path turn, and so that Willard is not as effective 2 as it could be, in part, because there is a 3 reluctance to sentence the appropriate individual. 4 They might be dealing, sort of the model Jon 5 said, and the District Attorney in the discussion 6 has veto power -- not Jon has veto power -- every 7 district attorney in the state can decide whether to 8 send an inmate, or potential inmate, to Willard, 9 but, they've been reluctant to do so for a variety 10 of reasons. 11 And a very important question, one we're 12 searching for, we're searching for answers of 13 questions of, "What's effective?" What will 14 prevent? 15 I mean, I like Mr. Superstar. 16 I like the kind of, maybe, different, less 17 structured-type programs that make sense and are 18 relevant to young people. 19 That's a first step, and we're trying to 20 figure out what we can help these coalitions, to put 21 the cost together, how we can do that in an 22 appropriate way. 23 More ideas about prevention? 24 Anybody else want to talk about prevention? 25 Sir. 1 Thank you, Terri. 2 TERRI WASILENKO: Thank you. 3 BRAD FINN: Thank you. 4 My name is Brad Finn. My profession is 5 prevention, and I work in Onondaga County, but 6 collaborated a lot with Cayuga County on an ongoing 7 basis. 8 I have three succinct questions, not to take 9 any more time than necessary question. 10 Question Number 1: Certainly, on the 11 treatment side, I know we have these wonderful 12 Narcan kits out there. 13 Why don't we pass some type of legislation 14 that requires that every one of these kits have 15 information for family members and for the addict, 16 about where they can get some help, whether that is 17 formal treatment or 12-steps. 18 We get a lot of calls from parents who want 19 to know "What can we do?" and those parents are very 20 concerned. 21 When we bring someone back from death with 22 one of these kits, that's wonderful. 23 But why don't we have something in those kits 24 that's required for the family member, loved ones, 25 as well as the addicted person? 1 I want to back it up a little bit more. 2 We talked about intervention; early 3 intervention. 4 Why don't we look at a model that's been 5 proven through SAMHSA. 6 It's an evidence-based model called "SBIRT" 7 (Screening Brief Intervention Referral To 8 Treatment). 9 And this model, which is engaged by all the 10 medical community, it's a real quick, down-and-dirty 11 screening. And if a screen pops up the potential or 12 possibility of an addiction, a brief intervention is 13 done right there. 14 The beauty of SBIRT is that, if a physician's 15 office, a clinic, a hospital-based service, uses 16 this, they can bill for SBIRT. 17 And last week, on Thursday, my colleagues met 18 with Senator Valesky and talked about this issue. 19 And to back it up one more, my third question 20 is: We talked about coalitions. 21 Coalitions are an extremely important answer 22 to communities. 23 Coalitions: Why don't we put money to fund a 24 position to coordinate counties. 25 We all work together, but we need one central 1 mass to help lead communities when we come across 2 issues like this. 3 That way, we have a system in place, because 4 once we knock down this demon, there's another one 5 that's going to pop up. 6 And if we have built coalitions, 7 solution-based in communities, we will have an 8 opportunity to address the next issue, as well. 9 Thank you. 10 SENATOR BOYLE: Thank you very much. 11 It's -- 12 [Applause.] 13 SENATOR BOYLE: Those are excellent 14 suggestions. 15 And the Narcan thing, that's a great idea. 16 We're definitely going to take you -- follow 17 you up on that. 18 As far as SBIRT, I actually have legislation 19 now, a bill, that would mandate, as part of the 20 continuing medical education for physicians, to do 21 SBIRT training. 22 SENATOR NOZZOLIO: Who else wants to talk 23 about prevention or treatment? 24 Yes. 25 ERICA TURNER: Good afternoon. 1 My name is Erica Turner, and I work with 2 AIT Laboratories, which is a forensics laboratory in 3 Indianapolis, Indiana. 4 We have recently worked with the Indiana 5 legislators to create the bitter-pill policy, 6 which -- in regards to how prescribers are writing 7 these prescriptions for opiates and for narcotics. 8 What does the State have in place to monitor 9 those prescriptions once they leave the door? 10 I understand that we have the 11 prescription-drug monitoring program, the 12 New York State I-STOP, but there are loopholes with 13 that, as well. 14 From what I understand, methadone clinics do 15 not have to log the methadone prescriptions that are 16 going in through there. 17 So, if that patient were to show up in their 18 primary-care physician's office with back pain, neck 19 pain, leg pain, they could be getting an opiate on 20 top of that. 21 So I wonder, has there been any attention 22 paid to how New York State can crack down on 23 prescribers that are writing these narcotics, and 24 how they plan to monitor those narcotics once they 25 leave the doors? 1 SENATOR NOZZOLIO: Certainly, I-STOP was the 2 first step. 3 We are deliberating what, if any, 4 recommendations we should make about changing 5 I-STOP. 6 That's something that's certainly on the 7 table: changing it, helping it, expanding it. 8 One thing we heard last week in New York City 9 was mind-boggling -- and I'd like it if any county 10 has any idea -- that adding insult to injury in this 11 problem, is the fact that your tax dollars, through 12 Medicaid, are being used by unscrupulous people to, 13 basically, pay people in homeless shelters to use 14 their Medicaid card, take it to getting a phony 15 prescription, and doing this thousands and thousands 16 and thousands of times, hundreds times, anyway, in 17 the city. 18 The pharmacies are being fraudulently -- 19 there are fraudulent pharmacies, in the city of 20 New York, particularly. 21 There are fraudulent individuals who are 22 using the Medicaid system to gain. 23 And this is where it gets real: What could 24 treatment and prevention do with a billion dollars a 25 year? 1 "A billion dollars a year," that's the money 2 that's being stolen from our taxpayers now in this 3 process. 4 Law enforcement informed us last week -- and 5 it was mind-boggling to me, Mr. Chairman -- it was 6 mind-boggling on how the organized crime is, 7 basically, taking over the Medicaid system, on 8 taking, particularly Oxycontin, those opiates, and 9 taking them and setting up a whole new on-the-street 10 market for these products. 11 And it's not the small dealer. 12 You know, even though the small dealer has 13 debts, it starts in taking a multi-billion-dollar 14 theft from the taxpayers of the state. 15 SENATOR BOYLE: And that was only two cases. 16 We had two cases, of a billion dollars; 17 $500 million each. 18 ERICA TURNER: I believe that. 19 I work throughout New York State, and I go 20 into many addiction centers. 21 I have New York State in its entirety as my 22 territory, but I also have the state of Vermont, and 23 Vermont is going through the same thing. 24 How does the State get involved to help? 25 And I encourage you all, if you get a moment, 1 to check out last month's issue of "Rolling Stone" 2 magazine. 3 They had an amazing article about heroin 4 addiction and opioid addiction, and how law 5 enforcement and state regulations, and even the side 6 of the addict, all played into this article. 7 It's really a great article. 8 SENATOR NOZZOLIO: Thank you very much. 9 ERICA TURNER: Thank you. 10 SENATOR NOZZOLIO: Other questions? 11 Keep them coming. 12 SENATOR BOYLE: I just recognize 13 Maryann Marshall. 14 SENATOR NOZZOLIO: Maryann Marshall? Is she 15 here? 16 MARYANN MARSHALL: Good afternoon. 17 My name is Maryann Marshall, and I'm from 18 Rochester, New York, and I just wanted to share my 19 brief story with you. 20 My son Jonathan [ph.], who is 26 years old, 21 is a heroin addict. This happened six years prior, 22 and he has devastated and attacked our whole family. 23 There's no drug there out on the streets 24 that's more deadly than heroin. 25 We have to come up with an action plan that 1 will encompass us all to try and combat this growing 2 epidemic that is destroying and killing off our 3 family members. 4 The addiction has engulfed my son's whole 5 life. It's all about the drug, and how to get it, 6 and get the money to support the habit. 7 These addicts will turn to stealing and 8 robbing from their families, and committing crimes 9 out to the streets. 10 While my son has taken the route of 11 committing petty larcenies, and has landed himself 12 in our local jail several times. 13 And each and every time he goes to jail, and 14 I try to get him rehab help, it's like hitting a 15 brick wall, because he'll lose his insurance, and, 16 we have to start the whole process over once he's 17 gone to jail. 18 And the last time, he spent nine months in 19 jail, and got out and overdosed within a week. 20 So, obviously, jail isn't the way to go with 21 this. 22 We need long-term -- I have to agree with 23 Kevin, long-term addiction centers that can nourish 24 these people back to their self. 25 Okay? 1 It just destroys their whole life. 2 And, we have no funding for this. 3 The detox in the jail I feel is inhumane, 4 because they'll throw them in jail, they have 5 nothing to help them come off of this, and it's a 6 very dangerous situation. 7 They can go into a coma. 8 They can have seizures. 9 They can go into cardiac arrest. 10 So we really have to come together and, you 11 know, try to get long-term rehab for these addicts 12 and bring them back to their normal self. 13 SENATOR NOZZOLIO: Even in Monroe County it's 14 difficult to find providers giving any kind of 15 assistance. 16 MARYANN MARSHALL: Monroe County I feel is 17 the worst. We can't -- and these judges are not 18 going with the drug courts. 19 You know, some of them are against -- I live 20 in Greece, New York, and the judges out there are 21 not for the drug courts. 22 SENATOR NOZZOLIO: Well, thank you very 23 much -- 24 MARYANN MARSHALL: Thank you. 25 SENATOR NOZZOLIO: -- for presenting this. 1 [Applause.] 2 Jon. 3 DA JON BUDELMANN: Thank you, Senator. 4 You touched on a point with the prescription 5 fraud, the Medicaid fraud, that we've seen here 6 locally, and it's where I mentioned the 7 180 oxycodones a month. 8 The statistics are something like, less 9 30 percent of the people who prescribed those types 10 of drugs are actually using them when they are 11 blood-tested or drug-tested for that. 12 Perhaps that would be an important part of a 13 monitoring, to require drug tests, to make sure that 14 they're actually using what they're being given for 15 free at taxpayer expense, that is then ending up on 16 the market causing overdoses, causing sales, 17 causing -- and attack the problem kind of in a smart 18 way. 19 The other point, if I could make one, I think 20 the -- excellent: Trying to reach the young people 21 in whatever way we can reach them is I think what we 22 have to do. 23 Whether it's D.A.R.E., which I thought was 24 very successful, but, whether it's young people, 25 like Superstar, going out and talking to them at 1 their level, Lon going into alleys and finding where 2 they are to try to reach them. 3 Outreach. 4 But, the ounce of prevention is worth pounds 5 of cure. 6 Whether it be incarceration or the heavy cost 7 of treatment, if we can avoid that misery, if we can 8 avoid the loss of life, and the consumption of 9 resources, by spending a little bit up front to 10 avoid it, I think we'd be very smart to do that. 11 And I know we're not talking about 12 legalization of marijuana or other drugs here this 13 morning, but I think we are, because the message 14 that's sent is important. 15 The young people are watching, they're 16 looking, they're listening. 17 If we legalize certain drugs, we had the 18 synthetic marijuana, and what they called 19 "bath salts," which was another synthetic-drug 20 problem a few years ago, and the young people are 21 using it. 22 They were bringing it to school. 23 They thought, Well, if it's legal, it's safe. 24 We can use it. 25 And it couldn't be further from the truth. 1 Prescription drugs, well, if doctors give 2 them out, it must be safe. 3 Not so, unless it's prescribed for them under 4 medical supervision. 5 So, too, if you say, "Well, marijuana is 6 legal," the number of people legally using marijuana 7 is going to go through the roof, particularly young 8 people. 9 And the heroin addiction has hit our young 10 people, ages 18 to 25, the hardest. 11 That's who's getting hit, that's who's 12 overdosing, that's who's dying. That's who we 13 really have to worry about. 14 And I think it all plays into the same 15 message, which is: They're not safe drugs. Whether 16 you want to call it a gateway drug, or you want to 17 date yourself, it's a progressive. 18 You start with smoking something like 19 marijuana, which is an illegal, illicit substance. 20 You then move to smoking or snorting something like 21 heroin. 22 And it's not a huge -- once you've decided 23 you're going to start down illegal drugs, and 24 smoking things other than, you know, nothing, you're 25 taking a step. 1 And if we say it's okay to take this step, 2 we're sending a very strong message to young people. 3 And I would be very surprised to hear that 4 our numbers of other drug use don't go through the 5 roof, also. 6 SENATOR NOZZOLIO: Thank you, Jon. 7 Nelson. 8 NELSON ACQUILANO: My name is 9 Nelson Acquilano. I'm the director of the Council 10 on Alcoholism and Addictions of the Finger Lakes. 11 We serve the five-county central Finger Lakes 12 region of Ontario, Wayne, Seneca, Schuyler, and 13 Yates counties. 14 We are designated by the State as a 15 prevention agency, so we do go into the schools. 16 Last year we had over 7,500 prevention 17 activities, over 1,000 classroom presentations. 18 And I wanted to say, what I passed out to you 19 is about 20 recommendations on this issue. 20 I'm only going on cover three, and I would 21 like to just -- I'll phrase it in the form off a 22 question. 23 The first one, though, is -- well, before 24 I begin, I want to say, my observation of this is, 25 I think we're on the beginning of the epidemic of 1 heroin. 2 I'm seeing things in the community, and 3 nationally, that's saying that this is the start of 4 that epidemic. And if we don't jump on it right 5 away, we're going to be back here in two or 6 three years, or talking about putting more people in 7 prison, and it's just going to absolutely destroy 8 us. 9 So, number one, I want to say thank you; 10 thank you for this critical thing. 11 And I have much gratitude for all of you, and 12 for everything you've done to bring this to light. 13 I'm going to skip over my preliminary 14 remarks, but I just wanted to say, out of all the 15 recommendations, there's three. 16 Okay? 17 The first one, we talked about, is the 18 budget. 19 Now, with the consolidation of DSAS and DAAA, 20 we lost at least a third of our funding. 21 Then in 1995, Governor Pataki cut us another 22 10 percent to drug abuse. 23 And then we were held stagnant. 24 And then when Governor Cuomo came in, he cut 25 us another 10 percent. 1 So what's going on with all these cuts? 2 We have been held so low, we haven't had time 3 and energy and resources to do what we need to do to 4 address all of these problems. 5 Margie talked about youth-counseling 6 services. 7 I have a school-based youth-counseling 8 program in Yates County and in Schuyler County, all 9 right, but youth-counseling services are dying out 10 throughout the state. 11 The other one, Brad mentioned SBIRT. 12 We had a program and it was highly 13 successful. It was called "HIS" 14 (Hospital Intervention Services). 15 It was great. 16 It lost its funding, and it died out. 17 Hospital-based, and it died out throughout 18 the state. 19 This budget is the number one thing that we 20 do have to address, and I have some statistics in 21 there to look at it. 22 But, please, it is budget. 23 Without the resources, there is very little 24 that the community, treatment especially, when you 25 have long waiting lists and you can't hire more 1 counselors, we can't respond. 2 The second item I want to talk about is the 3 health-insurance coverage. 4 Do you know the best resource we had in the 5 Finger Lakes was the detoxification program at 6 Geneva General Hospital? 7 They treated over 10,000 addicts over a 8 25-year period. 9 But guess what? Health insurance killed that 10 program. 11 Okay? 12 You have to -- oh, "not medically necessary," 13 I think that's the term that they use now. 14 So I would support legislation that gives the 15 directive back to the physician or the health-care 16 provider that makes the recommendation for 17 treatment. 18 Take it away from health-insurance companies 19 because it's a conflict of interest. 20 And my board of directors has asked me to 21 come here and to tell you, we need that detox 22 program at Geneva General Hospital, Finger Lakes 23 Health. 24 We need that program back, but it's not going 25 to happen. 1 SENATOR NOZZOLIO: Excuse me, Nelson. 2 Is there, at Auburn Community Hospital, any 3 type of similar program? 4 DR. JOHN RICCIO: No, we don't have a 5 program. 6 I mean, it sounds like it would be perfect 7 for some of the initiatives that we're looking at 8 with the community. 9 We're working with Mr. Bizzari, and a few of 10 the other people in the community, as well. 11 The only thing we have right now in Auburn, 12 to my knowledge, is CHAD, which is remarkable, and 13 it's worked quite well, but it is limited. 14 SENATOR NOZZOLIO: Thank you. 15 NELSON ACQUILANO: And then the third one, 16 and this is going to be the challenge, all right? -- 17 councils on alcoholism often receive calls for help 18 from parents, or from a husband regarding the wife, 19 the wife regarding the husband, and they don't want 20 to come in for help. They don't want to accept a 21 referral. 22 So, did you know 38 states have some form of 23 a civil commitment, an involuntary commitment, into 24 treatment? 25 38 states have some form of that. 1 Okay? 2 Florida has the Marchman Act. 3 Other states I think have the Casey Act, or 4 perhaps a variation of the Baker Act. 5 What I would propose is legislation that 6 would not -- not criminal, okay. And sometimes 7 I tell people, have them arrested. 8 We get them, unfortunately, into the criminal 9 justice system where they will get treatment, go 10 through a drug court, and so forth, but that then 11 turns a person who has a disease into a criminal. 12 I don't want to do that anymore. 13 Let's have a civil commitment for people and 14 help them to get the treatment they can. 15 If you do believe it's a disease, a disease 16 of insanity, where your cognitive faculties are 17 affected, then this will help. 18 So please review that. 19 If there's anything else I can do -- 20 SENATOR NOZZOLIO: Excellent points, Nelson. 21 Thank you very much. 22 [Applause.] 23 SENATOR BOYLE: Nelson, really quickly, those 24 are excellent points. And thank you for all your 25 suggestions. 1 Maybe we just take your cover off and put 2 ours on it and we'll say it's our ideas. 3 [Laughter.] 4 SENATOR BOYLE: But in terms of 5 "medical necessity," that's definitely part of the 6 legislation we're looking at. 7 And the civil confinement, it's a tough 8 issue, obviously, but we have cases on Long Island 9 and upstate, we've talked to, treatment providers 10 advising families how to have their children 11 arrested just so they get off the streets. 12 It's not a great system. 13 We need to change it, without a doubt. 14 SENATOR NOZZOLIO: Other questions? 15 Yes. 16 TERRI WHITT [ph.]: Hello, gentlemen. 17 My name is Terri Whitt [ph.], and I'm the 18 central region prevention resource director. 19 And I just want to piggyback on something 20 that Brad had said, and also what one of the 21 gentlemen up here said, regarding an ounce of 22 prevention is worth a pound of cure. 23 I just wanted you to be aware that the State, 24 through OASAS, already has prevention resource 25 centers. We're regionalized across the state. 1 And our mission is really to mentor and to 2 guide community coalitions. 3 We use data-driven, so it's based on local 4 data. 5 We use a prevention planning process, a 6 strategic plan, so that there is a good, solid, 7 logical roadway to run on. 8 We use environmental strategies, so they're 9 population-level changes, such as in regulations, 10 laws, things of that nature. 11 Other environmental strategies might be, 12 I think we were talking about social norms; changing 13 the way that the community thinks about drugs and 14 their perception of harm. 15 And, finally, in implementing the strategies, 16 it takes the whole community. 17 We use all the sectors of the community, and 18 they actually evaluate the results. 19 And these are implemented throughout the 20 state, but there's very little funding for this. 21 And as Brad mentioned, if we had a key person 22 in the different communities and counties, that 23 would be relatively little money spent on 24 prevention, so that, down the road, we don't have 25 these stories of heartache, and the money that is 1 spent in time and resources and money. 2 SENATOR NOZZOLIO: Thank you. 3 Thank you very much. 4 [Applause.] 5 SENATOR NOZZOLIO: The Senators have to get 6 on the road in a few minutes. We have no more than 7 ten. 8 Let's start with Sheriff Povero, and then 9 just flip your question as fast as possible, and 10 we'll get them on the road. 11 Sheriff. 12 SHERIFF PHIL POVERO: Thank you, Senator. 13 Thank you for the opportunity to be here 14 today, and thank you all for taking time out to 15 listen to these -- this great information. 16 And I don't want to be repetitive. Just 17 would like to take a minute to, perhaps, amplify 18 some of the points that we've heard, and some of the 19 issues that we're seeing in Ontario County, and 20 specifically within the Ontario County Sheriff's 21 Office. 22 Within the past month, our emergency 23 911 dispatchers have, literally, saved the lives of 24 four persons that have overdosed on heroin. 25 Our dispatchers receive calls throughout the 1 evening from people that, fortunately, you know, 2 whether they're aware of the Good Samaritan Law, or 3 not, are calling. 4 And that, as an aside, is something that 5 I agree needs to be publicized more; that that 6 program, that that law, is out there and people need 7 to call. 8 But the callers call in. 9 The story is, basically, that, my boyfriend, 10 girlfriend, my friend, there's a needle sticking out 11 of his or her leg, they've overdosed. 12 And we are very fortunate in the county that, 13 in recent years, we purchased emergency medical 14 dispatch information, which our dispatchers are 15 trained on, and which is readily available; is there 16 next to them on the phone. 17 SENATOR NOZZOLIO: Excuse me, Sheriff. 18 Is that the way it is in Cayuga County, too? 19 SHERIFF DAVID GOULD: That's under the 20 different direction of the sheriff. 21 SENATOR NOZZOLIO: You do -- do not -- you 22 911 -- 23 Is our 911 director here? 24 SHERIFF DAVID GOULD: I believe she's here. 25 SENATOR NOZZOLIO: But it's similar in 1 Cayuga County as in Ontario. 2 Thank you. 3 Excuse me, Sheriff. 4 SHERIFF PHIL POVERO: That's all right. 5 And this program is out there. It's 6 available from several vendors. 7 They were able to give CPR instructions. 8 And, again, as we go on, a lot of this 9 discussion reverts back to funding. 10 But, again, as a particular suggestion, you 11 know, looking at 911 centers in our state, seeing if 12 our dispatchers are trained in emergency-medical 13 dispatching. 14 And if not, perhaps making sure that funding 15 is available so that those localities, 16 municipalities, can purchase this equipment so their 17 dispatchers, as ours have, can save lives over the 18 telephone. 19 As we speak, the chiefs and the sheriffs that 20 are here with me are colleagues, also on our 21 Finger Lakes Law Enforcement Academy, which I know 22 the Senator is aware of. 23 And at this time, we're very fortunate to 24 have the Department of Criminal Justice Services 25 from the state come to our training facility in 1 Canandaigua. 2 And we're hosting the entire region right 3 now, as we speak, with a trained -- the trainer 4 session on police administering Narcan. 5 These individual trainers will go back to 6 their police departments. 7 And we've reached out from as far away as 8 Oswego, to Batavia, to Elmira, and go back and train 9 their officers on the proper use of Narcan. 10 My request on this is that, this type of 11 training not only continue, but there are no 12 programs now -- there are programs now out there 13 available, making the Narcan available to 14 law enforcement. 15 We appreciate that. 16 We need that to continue at low cost, if not 17 no cost. 18 It's been working well, as has been pointed 19 out from the emergency-medical community for years. 20 On Long Island, and in Rensselaer County, 21 law enforcement has been experimenting with this 22 and -- 23 SENATOR NOZZOLIO: State Police just have -- 24 excuse me again, Sheriff. 25 Do you have -- our two counties represented, 1 do you have -- three counties, I'm sorry. 2 Do either of the three counties have any 3 funding for those antidote kits? 4 SHERIFF DAVID GOULD: Yes, Senator. 5 We have already received a grant and got 6 accepted, so we will be training very soon, and all 7 our deputies will have them. 8 SENATOR NOZZOLIO: How about Seneca County? 9 SHERIFF JACK STENBERG: [Speaking without a 10 microphone/inaudible.] 11 SENATOR NOZZOLIO: Sheriff Povero? 12 SHERIFF PHIL POVERO: Yes, sir, we've applied 13 with the State, and our grant is in. 14 SENATOR NOZZOLIO: The pool of funds are out 15 there, but you're still waiting, whether or not you 16 receive them? 17 SHERIFF DAVID GOULD: We've already received 18 it. We will be training very quickly. 19 SHERIFF PHIL POVERO: So that training is 20 going on now. We're very grateful that the State 21 has brought that to our area, one of the first to 22 provide it regionally, and we're grateful for that. 23 On the topic of going back to, as 24 Mr. Superstar and others have mentioned, about 25 children and students relating to people, there are 1 many adults and role models in our school system 2 today that I'm sure, if were driven to it and were 3 committed to it, and had the passion to work with 4 children, I know that we would find our children 5 would be eager to confide in them. 6 The -- that individual in that program that's 7 particularly passionate to me, is the 8 school-resource-officer program. 9 Again, there's a lot of -- some misconception 10 about the role of the school-resource-officer 11 program as primarily a law-enforcement official. 12 It really needs to be clarified that that 13 role is often dwarfed by the other roles of, not 14 only teacher, but counselor. 15 And in schools where we have school resource 16 officers, we can vouch, as can our district 17 attorneys, of the numerous disclosures that are made 18 to trained police officers that student build 19 positive rapports in, for the purpose of, you know, 20 reporting suspicious incidents, or just coming and 21 talking about being a victim of something, either in 22 school or out of school. 23 It's a tremendous program. 24 I've been around a long time, seen a lot of 25 law-enforcement programs come and go. 1 This one is truly successful, and it's 2 something that is universally accepted, but the 3 question continues to be: That's great, but who's 4 going to pay for it? 5 And that's just my suggestion for that. 6 Final, on the sheriffs' side, as operators of 7 our jails, and we've pointed out we're seeing so 8 many of the issues, in April of this year, we 9 admitted 198 persons to the Ontario County Jail. 10 In interviewing these people in subsequent 11 medical discussions with them, that they're 12 admitting, 118 have some sort of substance-abuse 13 issue that they're involved in their lives. 14 13 actually admitted a they were heroin addicts that 15 were being admitted. 16 So the -- my whole point is to say that, the 17 heroin issue, from a sheriffs' standpoint, is 18 impacting our entire operation. 19 And, collectively, we are trying to do what 20 we can. And we appreciate your efforts to hear our 21 concerns. 22 Thank you. 23 SENATOR NOZZOLIO: Thank you, Sheriff. 24 [Applause.] 25 PASTOR DALE ANDREWS: My name is 1 Dale Andrews. I'm a pastor from Geneva. 2 I come at this at a different angle. 3 Obviously, you know, there's a government. 4 You know, you feel it's a government problem, you 5 feel it's a law-enforcement problem, and you feel 6 it's a health problem. 7 And all of you are correct. 8 But I see it as a church problem. 9 What I have experienced, I work at the 10 Seneca County Jail. I go out and do some ministry 11 there. 12 What I've learned from that experience, and 13 I've asked the question -- I like to know what the 14 root of problems are. 15 That's one reason why I feel it's a church 16 problem, and this is my opinion: 17 I don't see them as drug addicts. 18 I don't see them as alcoholics. 19 It's a sin addiction, is what it is; and, so, 20 I go at it with that angle, and I'm able to reach 21 in. 22 But I've asked the question: Why are you on 23 these drugs? What is it that's causing this? 24 And the root of the problem really is, for 25 the vast majority of them, it's a coping issue. 1 They don't know how to cope with the things 2 that they've had to deal with in life. 3 And so when we're talking about our school 4 programs and counseling, and things like that, 5 really what these young children need, and young 6 adults, and different ones, they've lost loved ones, 7 they're from broken homes, their parents are addicts 8 or in jail. Many of them have been abused. 9 And the vast majority have told me 10 personally, the reason why they've turned to that is 11 because it's how they hide their pain. It's how 12 they've learned to cope. 13 And, so, as we're counseling to them as young 14 people, keep that in mind. 15 You know, they need a positive role model. 16 They need somebody that's going to love them, 17 and show them how to respond when life gets hard, 18 because it gets hard for all of us. 19 Now, on the prevention side of it, I can 20 encourage the whole room here -- there's 100 people 21 here. 22 I'm assuming I'm not the only person that 23 goes to church. 24 Right? [Raises hand.] 25 [Laughter.] 1 PASTOR DALE ANDREWS: I feel it's safe to 2 assume. 3 My church, last September, started what's 4 a -- "Celebrate Recovery Program." It's 12-step 5 Christ-centered recovery program. 6 12-step programs work. 7 And what I would ask every person in this 8 room to do, is go back to your community, find a 9 church. 10 If there is no church in your community 11 offering a Christ-centered 12-step program, start 12 one. 13 You be the catalyst. Take part in it. 14 We're all asking, you know, these gentlemen 15 up here, you know, What are you going to do for us? 16 Well, what are we going to do for them? 17 Okay? 18 So we can all take part. 19 It costs my church less than $500 to start 20 this program. 21 What church can't afford $500 to reach out to 22 the community? 23 Amen? 24 So, anyway, I thank you. 25 SENATOR NOZZOLIO: Thank you. 1 [Applause.] 2 PASTOR DALE ANDREWS: I'm sorry, one more 3 thing, and this is just an observation again. 4 When it comes to funding and money and 5 programs that's going on, and this is just a 6 personal opinion, I know of a -- there's a 7 clean-needle program that takes place, helping 8 heroin addicts get their clean needles. 9 And what I've seen and I have experienced, 10 and I've had testimony also from people that take 11 part in that program, really what that is, is a 12 substitute for the heroin. 13 And, so, rather than helping them in a 14 program to get them off the heroin, they're just 15 substituting that addiction for another. 16 And, so, if we could look into that 17 particular clean-needle program and find out, you 18 know, would our money be better spent, perhaps, at 19 CHAD or someplace where they're actually getting off 20 of these things, versus just substituting. 21 Thank you. 22 [Applause.] 23 JACKIE MORELLE [ph.]: Hi. My name is 24 Jackie Morelle [ph.], and I'm a credentialed 25 alcohol- and substance-abuse counselor, and I am a 1 counselor over at CHAD. 2 We run into the problem all the time. 3 We have opiate users and heroin users coming 4 in every single day. 5 I'm sure Kevin gets a call two, three times a 6 day of what parents, family, friends, can do with 7 these people. 8 And, unfortunately, when they come in, 9 they'll say, You know, I'm using this much, I'm 10 using a bundle a day. 11 And, we have no place to send them. 12 There's not enough detox programs. 13 There's SBH [unintelligible] over in Syracuse 14 and SBH in Rochester, and they have long waiting 15 lists. And for people who don't have insurance, 16 that's costly. 17 So the first place to get these people who 18 want the help immediately is detox, and we just 19 don't have them. 20 And then, when they're in detox, a lot of 21 times they come back to the community, where, now, 22 they're coming back to where they were, and they 23 don't have the coping skills and the tools that they 24 need to be able to stabilize themselves back in that 25 community so soon. 1 So, then, for detox programs to be able to 2 refer them to the inpatient programs where they are 3 able to stabilize, and get -- and educate themselves 4 and gather the tools and the coping skills they need 5 to be able to come back home if that's where they 6 choose to go. 7 So I guess, on the treatment side, we're 8 seeing a lot of frustrations with getting the heroin 9 users, opiate users, into detox first, because 10 inpatient programs won't take them because they need 11 to go to detox first, so we get the runaround. 12 Okay? 13 Well, you can't take them, and they can't get 14 to detox because there's such a long wait list, and 15 then we lose them. 16 So that's like the frustration we have. 17 We use Van Dyke often. And a lot of times 18 Suzanne's, like, Well, they have to go to detox -- 19 SENATOR NOZZOLIO: Is Van Dyke full? 20 JACKIE MORELLE [ph.]: Yeah, they're full. 21 And they only -- they have very few female 22 beds. That's the thing that we run into a lot. 23 There's not many inpatient programs that have 24 many women beds available. 25 A lot of them are for the men. 1 So we'll call Van Dyke to try to get a client 2 in there, and they can't take them because they need 3 detox first. 4 And we don't have the resources to send these 5 people to detox because there's not enough of them 6 out there. 7 SENATOR NOZZOLIO: The Chairman and I are 8 just bouncing an idea around. 9 What about taking the assets seized from the 10 criminals who are fraudulently taking taxpayers' 11 dollars through illegal sale and distribution of 12 Vicodin and other -- Oxycontin, rather, and other 13 prescription medicines or other drugs themselves, 14 heroin itself, raw heroin, and taking that and 15 seizing it to use for treatment? 16 It would be a treatment facilities, either to 17 help the coalitions, to help Dick Van Dyke, expand, 18 and other types of drug-treatment providers to have 19 places to go. 20 CHAD doesn't have a place to go. It direct 21 people to go there. Right? It's that kind of a 22 deal? 23 Okay. 24 So the thing is to have, as you indicated, 25 having places to go, and for treatment. 1 And I don't think it's been fully explored. 2 We will explore it, to see if we can do it, 3 but, to take that seizure and use it for treatment. 4 Yes. 5 Wait, wait. 6 Sheriff. 7 UNKNOWN SPEAKER: [Not using a microphone.] 8 (Unintelligible) think it's 40 percent of the 9 seizures. 10 UNKNOWN SPEAKER: To OASAS already. 11 SENATOR NOZZOLIO: And the fact is, that 12 40 percent going to the general fund, it is taxpayer 13 money. 14 But let's take a portion of that, if not all 15 of it, and use it for treatment. 16 That would, in fact, stop the supply chain, 17 wouldn't it? 18 Yes, Miss. 19 Thank you very much. 20 [Applause.] 21 ELIZABETH TOOMEY: Hi. My name is 22 Elizabeth Toomey, and I work for Prevention Network 23 in Onondaga County. 24 But I have been blessed, the last 3 years out 25 of 15, to be working with youth across Onondaga, 1 Cayuga, and Oswego counties. 2 One of the things that I have seen in the 3 last 15 years is the shrinkage of dollars for 4 youth -- direct youth services in the community 5 level, not at the school-based level, because we go 6 into schools. But, at the community level where 7 kids want to be engaged after school, we're not 8 seeing that. Those dollars have shrank. 9 And, kids really want a place, a safe place, 10 that they can come, they can talk and have a voice. 11 And I just urge you to look at those -- look 12 at prevention, because if we have young people who 13 are resilient and learn these life skills when 14 they're the 18- and 25-year-olds that are headed off 15 to college, and more into that drug culture, that if 16 they have the skills they need, we can prevent them 17 from this. 18 So, the prevention dollars is where we 19 really -- along with the treatment dollars, is where 20 we need to be looking to build successful young 21 people. 22 SENATOR NOZZOLIO: Thank you very much. 23 [Applause.] 24 SENATOR NOZZOLIO: As Speaker, I just want to 25 remind everyone that the Chairman has to get on the 1 road by 3:00, so, let's focus. 2 PASTOR FLOYD MARSH: I'll be brief. 3 My name is Pastor Floyd Marsh. I'm the 4 pastor of the Harvest Field Baptist Church in 5 Fayette, New York. 6 And I appreciate this time that you've given 7 to me today, to just -- I'm not going to share my 8 personal story, but our home has been hit with the 9 heroin-addiction problem. 10 And our son, 23, is going through an 11 addiction program right now. 12 He was arrested and placed in the 13 Seneca County Jail. 14 And, actually, the young lady Caitlin [ph.] 15 that works there intervened, and she diagnosed him 16 with the heroin addiction. And then he was sent 17 from there to Dick Van Dyke. 18 And from Dick Van Dyke, after he completed 19 that program, he went to CARS, which is 20 Cayuga Addiction Recovery Services. 21 But my point that I want to make, and he's 22 doing real well, but he's now faced with long-term 23 prison because of the crime that he's been 24 implicated in committing. 25 But what I wanted to address was the fact 1 that he was homeschooled. He was raised in a home 2 where there wasn't any alcohol whatsoever, no 3 cigarettes, no R-rated movies. Just a little bit of 4 dancing between myself and my wife. 5 But this is such a pervasive problem. 6 And I was just -- when Alex was arrested, and 7 I went to the police department in Seneca Falls, 8 I was dumbfounded to begin with that he was even 9 implicated in a crime. 10 And then when I was there, the police officer 11 encouraged him to share with me that he had a heroin 12 addiction. 13 So it was like a double whammy that evening. 14 And we've been devastated ever since. 15 In fact, there hasn't been a day that hasn't 16 gone by that we've wept for our son. 17 And this problem is so pervasive. 18 And, I look at it on a grand scale. 19 We've been looking at locally, which we need 20 to have local programs to take care of this heroin 21 epidemic and the opioids. 22 In fact, Alex, he began with the prescription 23 opioids, and then he was introduced to the heroin 24 after that, and his downward spiral was rapid. 25 It was only a matter of months before he was 1 arrested as a result of his heroin addiction. 2 But I see this as a greater problem that we 3 have. 4 In fact, early on in the discussion, it was 5 said that a majority of the heroin is making its way 6 across the Mexican border. 7 Not only that, but what I've read, 25 percent 8 is coming from Afghanistan. Another 75 percent is 9 coming across the Mexican border. 10 What we need to do, as a state, is encourage 11 the federal government to do something about our 12 borders to protect us from the heroin. 13 And if we could reduce the amount that is 14 coming across the borders, maybe we could reduce the 15 problem locally, as well. 16 [Applause.] 17 PASTOR FLOYD MARSH: Normally people say 18 "Amen" after that. 19 [Laughter.] 20 PASTOR FLOYD MARSH: But in all seriousness, 21 I was reading an article after -- because I was 22 dumbfounded that my son would be a heroin addict. 23 I was dumbfounded that he would be implicated 24 in a crime and be arrested. 25 We were just flabbergasted. 1 So I began doing some research, and I found 2 that, with that 25 percent that is coming from 3 Afghanistan, I started looking into how terrorism is 4 actually supported. And it's through the drugs. 5 And our government, and I can't remember the 6 year, but our government gave the Afghani government 7 $250 million to build a hydroelectric plant. 8 What have they used that hydroelectric plant 9 for? To irrigate their poppy fields. 10 Not only that, but we allow the borders to be 11 open for the Mexican cartels to bring the drugs 12 across. 13 In fact, I was reading an article that was in 14 the "New York Times," I believe, and one of the 15 sheriffs said: "There's a very, very big opposition 16 to calling these organizations what they really are, 17 'narco terrorists.'" 18 He said, "When you label them as 19 'narco terrorists,' we can pursue and target them 20 under the Patriot Act. 21 "This is one of the major things that we need 22 to do because of the level of sophistication they 23 have. 24 "We have a saying on the border, 'If it gets 25 by us today, it's going to be your problem 1 tomorrow.'" 2 And it's our problem today, right at this 3 moment. 4 And I believe that our honorable Senators, 5 State Senators, our State Legislature, needs to 6 solicit our national government to do something 7 about this problem. 8 [Applause.] 9 PASTOR FLOYD MARSH: Because, personally, 10 it's my problem. 11 And if it could be my problem, it could be 12 anyone's problem. 13 We need to do something. 14 Not just talk, but we need to do something as 15 a country. 16 Thank you. 17 SENATOR NOZZOLIO: Thank you, Floyd. 18 [Applause.] 19 SENATOR NOZZOLIO: We -- I apologize. 20 I put everybody on notice, 3:00. 21 I think this will be our last word. 22 TIMOTHY DONAVAN: Thank you, Senator. 23 My name is Timothy Donovan, local resident. 24 I am a community advocate. 25 I want to share about the walk, but, first, 1 I want to echo -- first, we do have a meeting in 2 Auburn. It's a spiritual meeting. 3 It's every Saturday morning at 4 St. Mary's Church over here on Clark Street. It's a 5 12-step program, and they got two wonderful 6 facilitators, and the numbers have grown. 7 And they've been -- they're there. 8 Something's driving them there. 9 It's the word. 10 I tried to share with that, but they're 11 coming. And it's a wonderful 12-step program. 12 I just wanted to share what the pastor said. 13 You know, I do meetings. 14 I'm in recovery. I'm a recovering alcoholic. 15 And I see it as a spiritual program. That's 16 what's kept me sober. 17 I do meetings at the jail on Tuesday and 18 Thursday nights. I try to provide a meeting for the 19 inmates at the county jail. 20 And I do go into -- I'll just say a pod 21 example, the women's pod, and, we'll bring up a 22 topic, and usually family comes up. 23 And I have to share what he said. 24 They are hurting. They don't know how to 25 cope. They're in such pain. 1 They tell me, "We can't wait to get out there 2 and use again." 3 They share about their broken homes. 4 The messages we see on TV -- 5 SENATOR NOZZOLIO: Do you have an event 6 coming up, that you had mentioned to me? 7 TIMOTHY DONAVAN: Yes, yes. 8 SENATOR NOZZOLIO: Would you let people know 9 about it. 10 TIMOTHY DONAVAN: Yes. 11 I just had to share to that: spirituality can 12 help. 13 Thank you. 14 I'm so glad some of the families are here. 15 A few other families are here that lost some loved 16 ones. 17 I'm just happy to note, we are having a 18 Community Suicide-Awareness Memory Walk. 19 It will be here Saturday, June 7th, at 20 12 noon. 21 We're going to kick it off here at the 22 Auburn City Hall steps, and it will proceed down 23 West Genesee Street, cross over, come back. We're 24 going to go around downtown. 25 It's an awareness walk. 1 And awareness is critical to one's community. 2 There are a lot of individuals out there that 3 don't know what's going on in our community, and no 4 fault of their own. 5 But, I just want to make the announcement: 6 This will be one of the shirts. 7 We have some other creativity things planned. 8 And I invite you, Senator, and everybody to 9 come back and walk with us on that day, as, again, 10 awareness is critical. 11 And this is in memory, if I can say, of 12 Jessica, Christopher Wilkes [ph.], Trish Maharve 13 [ph.], and Christopher Sosci [ph.]. 14 So, thank you. 15 SENATOR NOZZOLIO: Thank you very much. 16 [Applause.] 17 SENATOR NOZZOLIO: Senator O'Mara. 18 SENATOR O'MARA: Yes, we're on closing 19 remarks. 20 Thank you very much for being here today, and 21 sharing with us this information. 22 I just wanted to close by saying, those of 23 you that are from the southern Finger Lakes area, 24 like Pastor Marsh, I believe you said you're from 25 Bath, we are having a similar forum to this next 1 Friday in Elmira, at Elmira College, from ten to 2 noon. 3 And, certainly, notices are going out about 4 that. Had some great coverage in the local 5 newspapers down that way today. 6 And I'm looking forward to input from that 7 region, as well. 8 But thank you for your input today. 9 SENATOR BOYLE: Thank you, Senator. 10 And thank you, Senator Valesky and 11 Senator Nozzolio, for hosting this forum, and for 12 all the panelists and for all of the input. 13 It was just what we needed: the type of 14 information, the suggestions, and recommendations. 15 I can tell you, without a doubt, we've got 16 some good ideas today. 17 It's going to be in our final report. 18 It's going to be in legislation, which is 19 going to be passed. 20 And, for Jessica, and all the other victims, 21 we're going to make sure that this epidemic is 22 brought under control. 23 Thanks so much. 24 Thanks for allowing me to be here. 25 [Applause.] 1 SENATOR NOZZOLIO: I just want to thank 2 everyone for being here. You did a marvelous job. 3 We have great input. 4 You stimulated a number of ideas. 5 I wish we could be here two hours longer. 6 But, we certainly have our doors, our ears, 7 our e-mails, open to any suggestion that you may 8 have, that you'd like to follow up through. My 9 contact information is available. 10 And that if you'd like to share with any of 11 the other Senators, as well, I'd be glad to do so. 12 I want to thank our panel for their 13 participation. You've really made this an excellent 14 forum. Thank you very much for being here. 15 Last, but certainly not least, I want to 16 thank Michele and Kevin for your courage and your 17 support. 18 And, we have a lot of work to do, and you 19 just made us more incentive to do so. 20 Thank you very, very much. 21 [Applause.] 22 (Whereupon, at approximately 3:03 p.m., 23 the forum held before the New York State Joint 24 Task Force on Heroin and Opioid Addiction 25 concluded, and adjourned.)