Public Forum: Genesee County Panel Discussion on Batavia'S Heroin Epidemic

PANELIST INTRODUCTIONS:PAGE 6 2

Colleen Babcock 3 Parent & Family Support Coordinator

Horizon Health Services 4

Dr. Bruce Baker 5 Medical Director

GCASA 6

John Bennett 7 Executive Director

GCASA 8

Mary Beth Bowen 9 Chief Nursing Officer and

Vice President of Nursing 10 United Memorial Medical Center 11 Lisa Glow

Program Director 12 Horizon Health Services 13 Shawn Heubusch

Chief of Police 14 Batavia Police Department 15 Timothy Lynch

Assistant U.S. Attorney 16 for the Western District

Chief of the Narcotics and 17 Violent Crime Division 18 Gary Maha

Sheriff 19 Genesee County 20 Donna Sherman

Substance-Abuse Treatment Program Manager 21 VA Western New York Health Care 22 Augusta Welsh

Director of Community Services 23 Genesee County Mental Health Services 24 START OF PANELIST PARTICIPATION PAGE 7 25 START OF AUDIENCE PARTICIPATION AND Q&A PAGE 53 1 SENATOR RANZENHOFER: Good morning, 2 everybody. 3 [Audience replies, "Good morning."] 4 SENATOR RANZENHOFER: Much better. 5 Everybody's awake, that's great. 6 Before we begin, what I would like to do, and 7 before we do introductions, I would just like to 8 introduce Staff Sergeant Dennis Sensbaugh [ph.] who 9 is with us today, who's going to lead us in the 10 Pledge of Allegiance. And, the flag is to my right 11 here. 12 [All present stand and recite, as 13 follows:] 14 "I pledge allegiance to the flag of the 15 United States of America and to the republic for 16 which it stands, one nation under God, 17 indivisible, with liberty and justice for all." 18 SENATOR RANZENHOFER: Thank you, 19 Staff Sergeant Sensbaugh. 20 My name is Senator Mike Ranzenhofer. I'm 21 joined here -- getting a little nod to move this 22 over, but I'll give it back to you, Tim, when you 23 speak. 24 My name is Senator Mike Ranzenhofer. 25 I'm joined today by Senator Phil Boyle. 1 And I want to thank everybody who is here in 2 the audience and on the panel for joining us today. 3 I'm going to make a couple of opening 4 remarks, then I'm going to turn it over to 5 Senator Boyle. 6 But before I do, I want to just give a brief 7 introduction. 8 Senator Boyle is actually joining us from 9 Long Island. 10 And, to talk about his dedication, he was 11 flying up last night, and he told me that his plane 12 was delayed and didn't get up here until about 13 two in the morning. 14 And, Senator Boyle has traveled the state, 15 from Montauk to Buffalo, to Watertown, all the 16 states [sic], conducting 17 hearings. 17 And I'm very privileged that he is able to 18 join us today in Genesee County, here in the city of 19 Batavia, this beautiful city hall. 20 Senator Boyle is the Chairman of the Senate 21 Committee on Alcoholism and Drug Abuse, and he is 22 the Chairman of the Joint Senate Task Force on 23 Heroin and Opioid Addiction. 24 And there are two other vice chairs, 25 Senator Carlucci and Senator Nozzolio. 1 But Senator Boyle has really been leading the 2 effort and leading the charge, and I'm just very 3 privileged that he found the time to join us today 4 right before a long holiday weekend, to come up to 5 our community and listen to this very, very serious 6 problem. 7 So what I'd like to do is, I'm going to turn 8 it over to Senator Boyle for a few remarks. Then 9 we'll introduce the panel members that are up here. 10 And this is a -- you know, more of an 11 informal than a formal process. 12 We'll hear from some of the panelists with 13 respect to law enforcement, what they're seeing out 14 in the community from; from the treatment 15 perspective, in terms of what they're seeing; and 16 then, certainly, you know, we want to hear from the 17 folks that are on the other side of the dais here, 18 in terms of their personal stories and what's 19 happening in their lives. 20 So, with that, I'd like to turn it over to my 21 good friend and colleague Senator Phil Boyle. 22 SENATOR BOYLE: Thank you, Mike. 23 I'd like to thank Senator Ranzenhofer for 24 hosting this opioid forum, and this is the 14th of 25 what has become 18 forums around the state. 1 And as Mike was saying, these are informal. 2 They're not, technically, hearings. They're 3 roundtable discussions, and we'd like to get input. 4 This is an incredibly distinguished panel, 5 and I thank you all for participating, and for those 6 of you in the audience. 7 However this heroin/opioid epidemic has 8 affected your life, whether on a professional basis 9 or a personal basis, we'd like to hear what you 10 think we can do to fix it. 11 As I say each time, if you have an idea, 12 whether your child's addicted or whether you're a 13 health-care professional for years or a 14 law-enforcement official, "If I could change a law, 15 or a couple laws, to create one, or to get rid of 16 one that isn't working," that's what we're here to 17 do -- to learn about. 18 And, Mike, again, I thank you for hosting 19 this, and I look forward to some good testimony. 20 SENATOR RANZENHOFER: Okay, well, great. 21 On the panel with us today, I'd like to 22 introduce: 23 Lisa Glow, who is the program director at 24 Horizon Health Services; 25 We have Colleen Babcock, a parent and family 1 support coordinator, also at Horizon; 2 We have Shawn Heubusch, Chief of Police from 3 the Batavia Police Department. Thank you for 4 joining us today; 5 We have Sheriff Gary Maha from 6 Genesee County; 7 We have with us Timothy Lynch, 8 Assistant U.S. Attorney for the Western District, 9 who is the chief of the narcotics and violent-crime 10 division. 11 We have Mary Beth Bowen, who's the chief 12 nursing officer and vice president of nursing at 13 United Memorial Medical Center; 14 We have John Bennett, who is the 15 executive director of GCASA; 16 We have Dr. Bruce Baker, who is the medical 17 director at GCASA; 18 We have Augusta Welsh, who's director of 19 community services at Genesee County Mental Health 20 Services; 21 And, also, finally, Donna Sherman, 22 substance-abuse treatment program manager at the 23 VA Western New York Health Care. 24 And I thought what we'd do, and I know it's 25 done a little bit differently at every hearing, I'm 1 going to turn to my good friend and Sheriff of 2 Genesee County, if you could just give us, you know, 3 an idea of what you're seeing out in the community. 4 Obviously, your deputies are, you know, on 5 the streets, patrolling, you know, every day. 6 You know, what are they seeing? 7 What are they reporting to you? 8 What's happening with respect to heroin use, 9 and opioid abuse [sic] and abuse. 10 SHERIFF GARY MAHA: Thanks, Mike. 11 Good morning. 12 First, I'd like to thank Senator Boyle, 13 Senator Ranzenhofer, and the New York State Senate, 14 for hosting this event here this morning. It's an 15 important event, which affects our community, public 16 safety, and health of our community. 17 Genesee County is a small rural county 18 between two large metropolitan areas, Buffalo and 19 Rochester. 20 What we're seeing here in this county, is the 21 majority of our drugs come out of the city of 22 Rochester. That's been the case for several years. 23 This is not a Genesee County issue, it's not 24 a state issue. It's a national issue. 25 Recently, in the "USA Today" April 17th 1 edition, there was a report that America's top 2 law-enforcement officials reported that heroin and 3 other opioid addiction is now claiming more lives in 4 many communities than violent crime and car crashes. 5 So it is a national concern. 6 What we're seeing here is heroin being sold 7 on the streets for, roughly, 10 to 20 dollars for a 8 bag of heroin. It's cheaper than prescription pills 9 being sold on the street. 10 We've had cases where addicts have gotten the 11 Suboxone, sold that on the street for 12 20, 25 dollars, and then turn around and buy heroin 13 with the proceeds of their sale. 14 About 50 percent of our drugs being purchased 15 undercover with undercover buys are now heroin, 16 according to our local drug task force. 17 You know, a few years ago, heroin was unheard 18 of here in Genesee County. Now it's very prevalent 19 and very available. 20 Many of our property crimes -- the 21 burglaries, larcenies, shoplifting -- they can all 22 be related to some type of an addiction. 23 Burglaries, for example, they steal your 24 flat-screen TV or a firearm which are worth a lot of 25 money in the city. 45 minutes after they steal it, 1 it shows up on the street of Rochester and stuff 2 goes up their nose. 3 Local jails, the concern of -- with me, being 4 a -- the Sheriff who is responsible for the 5 operation of the county jail, we have seen, 6 probably, 80 to 85 percent of our inmates addicted 7 to some sort of substance, whether it be alcohol or 8 drugs. 9 We have an opiate-withdrawal protocol in 10 place, so if somebody does come in the jail and we 11 know they're addicted to opiate, we have to follow a 12 certain protocol. 13 And a couple of my concerns are, you know -- 14 well, I'm going to talk a little bit about the 15 Narcan program which I know you're familiar with. 16 It's saved lives out there on an overdose of heroin. 17 The Genesee County Sheriff's Office is going 18 to participate in that program. We've already sent 19 officers to training. 20 In Suffolk County alone, and Senator Boyle 21 probably knows this, that over 200 lives are saved 22 by the Suffolk County PD using Narcan. 23 What has helped, in my mind, in my opinion: 24 Aggressive law enforcement: Specifically 25 targeting dealers to help reduce the supply, because 1 it boils down to, again, supply and demand; and 2 tough sentences for dealers, especially those who 3 deal to our young children. 4 Drug Take-Back days: The DEA I know holds 5 Drug Take-Back days at least once a year throughout 6 Western New York. We've seen hundreds of pounds of 7 prescription drugs being turned in and not available 8 to those on the street. Again, trying to reduce the 9 demand because those drugs are worth money on the 10 street to the addicts. 11 Education: Education to the public, 12 especially vulnerable populations, alerting them to 13 the serious threat heroin poses to their health -- 14 health and the health of the community. 15 And education must be done by local 16 individuals. A person who's thinking about getting 17 involved with drugs is not going to go out on a 18 national website and look at the pitfalls with 19 regards to the use of drugs. 20 Treatment: This is very important, I think, 21 because we're in a vicious circle if these people 22 don't get treated. We've seen generations of 23 children being addicted because that's a way of 24 life. 25 Treatment has to be affordable. And many 1 times we hear from parents who'd like to get their 2 children treated, but they can't afford it. 3 So I think that's a major thing that should 4 be overcome. 5 The I-STOP program has helped. Some of you 6 are familiar with that. That's where these addicts 7 can't do doctor shopping. If they go to one doctor 8 to get a Suboxone, they can't go two weeks later to 9 another one to get more, because they're just 10 selling this stuff it onto the streets. 11 So, basically, that's what we're seeing here 12 in Genesee County, Senator. 13 SENATOR RANZENHOFER: Thank you, Sheriff. 14 Chief, you're -- I mean, are you seeing the 15 same things in your department? 16 POLICE CHIEF SHAWN HEUBUSCH: Ah, yes. 17 Good morning. Thank you for having us here 18 today. 19 I would echo the Sheriff's sentiments. 20 We work closely with the Genesee County Drug 21 Task Force. That's where we would be provided most 22 of our information. 23 I would agree with the Sheriff, this is a 24 growing problem. Being between Rochester and 25 Buffalo, again, we see a lot of our influx from 1 Rochester. We see a lot of little guys set up shop 2 for a couple days, a week, at a time before we can 3 crack down on them and send them on their way, but, 4 it's merely moving them around, so to speak. 5 I think one of the things that us small rural 6 area lacks is the resources to really address this 7 problem on a law-enforcement level. 8 We have a regional drug task force, as the 9 Sheriff mentioned, that's comprised of members of 10 the City of Batavia Police, Genesee County, and the 11 Leroy Police Department. 12 Unfortunately, it's a small unit combating a 13 large problem. 14 And one of the things that we have seen here 15 in the city just arising, as the Sheriff mentioned, 16 is the property crime. Some violent crime, as well, 17 has gone up. 18 We had a series of robberies over this past 19 winter that took place, that was a direct result of 20 addiction. 21 So, I see an increase in that. 22 The education piece is large. 23 Again, it's a resource -- a matter of 24 resources for us. 25 SENATOR RANZENHOFER: Okay, and, Tim, keeping 1 with the law-enforcement theme, I know you deal with 2 this issue at the federal level. 3 What are you seeing on the federal level? 4 ASST. U.S. ATTY TIMOTHY LYNCH: Well, first 5 of all, on behalf of the United States Attorney, 6 Bill Hochul, you know, I want to thank you for 7 hosting this forum. This is an important topic for 8 the U.S. Attorney. 9 When he became the U.S. Attorney in 2010, it 10 was, really, one of his initial initiatives was to 11 address the growing prescription-pill problem that 12 he and, you know, obviously, other people around 13 this community and around the country, had noticed a 14 growing increase of abuse by our young children, 15 which, as law enforcement knows, often leads to 16 heroin abuse. 17 So, this is an important topic for him, and 18 I know he wishes he could be here today, but he's in 19 Rochester attending to another matter. 20 I think when -- when I look at the problem, 21 and I agree with the Sheriff's sentiments and the 22 Chief's sentiments, it's not just an urban problem. 23 I think a lot of times people thought that, 24 you know, this is what occurs in the city of 25 Buffalo, in the city of Rochester. 1 When I first started in the office, I handled 2 terrorism cases for the first five or six years. 3 But in 2007, I had my first heroin 4 prosecution, and I hadn't really done a lot of 5 narcotics cases. 6 And what struck me most of all, was when I -- 7 when all these individuals went to get sentenced, 8 the individuals who were using the drugs and selling 9 them, you know, I noticed that they all began their 10 abuse with -- or they all began their substance 11 abuse with the abuse of hydrocodone. 12 And for me it was eye-opening. I really 13 had -- I'd never experienced that, obviously, as -- 14 growing up. But it struck me that this was the 15 entryway for these individuals into, obviously, the 16 harder-core, more serious drug, that -- and the 17 cheaper drug, unfortunately, heroin, that has 18 devastated our streets and our communities. 19 So for us, it's not an urban problem. It's a 20 countywide, it's a districtwide problem, and we've 21 tried to address, in several ways, that problem. 22 One, in 2011, along with the 23 State Attorney General, we hosted a 24 prescription-pill summit at the University of 25 Buffalo, where we brought together, again, like you 1 have today, members of -- across the board; not just 2 law enforcement, but members of our substance-abuse 3 community, treatment community, and tried to at 4 least start to get the message out to everyone about 5 this growing problem. 6 And I think it's continued to snowball, not 7 just here in our district, but across the country, 8 that, you know, we really need to take efforts to 9 stop the abuse at the beginning stages. 10 And I think, certainly, we could arrest 11 individuals. That's not going to solve the problem. 12 I think we have to take it to our -- the 13 medical community, the doctors, make sure that 14 they're properly educated. 15 You know, in -- while they're in medical 16 school, are they getting sufficient amount of 17 education pertaining to identifying 18 prescription-pill abuse, opiate abuse? 19 And, making sure that they're taking the 20 necessary steps to do the proper examinations prior 21 to prescribing these highly addictive drugs. 22 In our cases, we've noticed doctors who are 23 just simply not conducting what would be the 24 required physical examinations prior to prescribing 25 pills. 1 And we had a case, an egregious case, of a 2 doctor exchanging prescription slips for gas grills, 3 for paper products. 4 I mean, it's unbelievable what we've seen. 5 We've arrested nurses who were taking 6 prescriptions from individuals who died in their 7 care. Getting the unused pills and then selling 8 them right out of her office. 9 So, you know, those are the egregious cases. 10 But even -- notwithstanding those, we know 11 even prior to the I-STOP program, there was a lot of 12 doctor shopping. 13 And I have not -- you know, it's still so 14 early on, I don't know that we've necessarily seen 15 the repercussions of it, or -- but I assume, over 16 the next few years, we'll, hopefully, notice that, 17 you know, that hasn't taken place. 18 But that's another avenue, you know, that 19 we've seen. 20 The other thing that's really on the rise is 21 the robberies and the burglaries of pharmacies. 22 And we've -- in my office, that's one of the 23 cases now that we regularly, you know, try to take, 24 so that, hopefully, looking for more harsher 25 sentences in federal court to, hopefully, obviously, 1 deter other individuals from engaging in that kind 2 of conduct. 3 So I -- you know, generally speaking, that's 4 what we've seen. 5 I'm sure we'll talk about other topics, and 6 I don't want to talk too much, as lawyers often do. 7 Okay? 8 SENATOR RANZENHOFER: Well, that was a good 9 segue, Tim, to your comments about talking about the 10 medical community, and, you know, what we really 11 need to do on the education side, the prevention 12 side, the treatment side. 13 My eyes go over to Lisa Glow and 14 Colleen Babcock, and, perhaps, you can share some of 15 your perspective and your stories. 16 Start with whoever wants to start. 17 Colleen? 18 COLLEEN BABCOCK: Well, actually, Senator, 19 first, thank you for having me today. 20 But, although I'm a parent and family support 21 coordinator for Horizon Health Services, I'm here 22 today as a parent. 23 And, if it is okay, I have a statement that 24 I put together, that I'd like to read. 25 SENATOR RANZENHOFER: Absolutely. 1 COLLEEN BABCOCK: Uhm, I am a parent and 2 family support coordinator for Horizon Health 3 Services, but before anything else, I'm a parent, 4 and that's why I'm here today. 5 I have a wonderful and amazing 23-year-old 6 son who suffers from addiction disease. 7 When my journey started with my son 8 seven years ago, I, like many other parents, had no 9 idea what I was dealing with. 10 The thought of addiction was the furthest 11 thing from my mind, and heroin was even further. 12 Christopher suffers from a genetic defect 13 called "neurofibromatosis," and he has 14 two inoperable tumors in his brain. 15 Between the ages of 7 and 14, he underwent 16 several brain surgeries. 17 As a parent, I couldn't have imagined that 18 anything could get worse, but there was worse, far 19 worse. 20 When he was a junior in high school, things 21 started to change. Chris started to experiment with 22 substances with other kids in school. 23 As Chris would put it, "From that point on, 24 there was no turning back." 25 Doctors believed Chris, having addiction on 1 both sides of the family, and introduced to 2 narcotics at a very young age, was predisposed to 3 addictions. 4 Could things have been different if doctors 5 would have talked to me about that during his 6 surgeries? 7 Over the next several years, his addiction 8 grew, and doctors who prescribed him an array of 9 controlled substances for disorders he did not have 10 only fueled that addiction. 11 By the time Christopher was 19, he had 12 overdosed twice, and attempted suicide once. 13 I did not recognize my once happy child. 14 Trying to access treatment was a nightmare. 15 Doctors never recommended treatment, nor did 16 they ever talk to me about addiction. 17 If you don't know the names of treatment 18 facilities, how can you possibly find them? 19 There's no listing in the phone book, and 20 there was no -- virtually, no help out there. There 21 was no communication between doctors and 22 substance-abuse providers. 23 By the grace of God, in 2011, Christopher was 24 in the right place at the right time, and became 25 eligible for a pilot program being introduced by 1 BlueCross and BlueShield for IV-opiate addiction at 2 Horizon Village Sanborn long-term inpatient 3 treatment facility, and insurance covered his care 4 there. 5 That's when our lives began to change. 6 As our journey began, I became a sponge for 7 information, wanting to understand the disease and 8 learn as much as I could about addiction and 9 recovery. And we were in the right place. 10 Christopher spent six months at 11 Horizon Village on two separate occasions. 12 The program at Horizon Village not only saved 13 Christopher's life, but mine as well. It helped me 14 as a parent to understand that this is a disease and 15 just stopping is not an option. We needed to work 16 together. 17 Christopher has spent three years in recovery 18 and is still linked with treatment. He has started 19 college, and today life is good, but I don't think 20 that that's a guarantee. The disease can change 21 everything tomorrow, and Chris has to work at his 22 recovery every day, forever. 23 My son's life was saved because he had access 24 to treatment. This is not the case for many others. 25 I attribute his success to the long-term 1 treatment and education he received, education we 2 both received, at Horizon Village. 3 His brain was given time to heal, and the 4 tools and time he needed to learn how to manage this 5 disease. 6 Yes, I was the driving force in the 7 beginning, but now he works at his recovery for 8 himself. 9 Unfortunately, not everybody is able to 10 access these same treatment options. 11 Insurance companies demand failures first 12 before they will allow the much needed long-term 13 treatment programs. Then when failures are too 14 many, they deny them treatment because they don't 15 follow recommendations. 16 Are we forgetting that we're dealing with 17 people who are sick? 18 We do not deny diabetics treatments because 19 their sugar levels are high again. 20 Recovery takes time, especially with our 21 youth whose underdeveloped brains have not matured 22 yet. They are taking some of the most strongest 23 narcotics on the planet known to man, at 20, 30, 40, 24 even 50 times the recommended dosage and putting 25 them in their brains. 1 How could we even imagine that this can be 2 fixed in 30, 60, or even 90 days? 3 Outpatient programs are not working on the 4 young-adult brain. 28 days is not long enough in 5 inpatient. It takes 90 days or more for opiates to 6 start to leave the system, when education can begin. 7 We put our young adults into short-term 8 programs or incarcerate them just long enough to 9 lower their tolerances without the crucial education 10 and tools they need to be successful in recovery. 11 They are going back out onto the streets and 12 using, in most cases, within hours or days, and many 13 are dying. 14 Access to effective medications, such as 15 Suboxone and methadone, for medically-managed 16 recovery have waiting lists up to three months. 17 People are detoxing in treatment facilities 18 with the use of Suboxone, and then being discharged 19 to an outpatient with no access to Suboxone, and 20 just put on another waiting list. 21 What do you think is happening in that 22 three-week waiting period? 23 Today I work as a parent and family support 24 coordinator, to help families better understand the 25 seriousness of opioid addiction and the role in 1 their recovery, to help them navigate the limited 2 resources that are available to them, and help 3 prepare families for the letdowns along the way. 4 The family needs support as much as the 5 person suffering from addiction disease. 6 Recovery is more than just the abstinence of 7 the drugs. It's learning to change the behaviors 8 and use the tools that are given in a long-term 9 setting, and that takes a long time. 10 Quite frankly, that's harder; the hardest 11 part of recovery. 12 I'm here today as a parent, to help spread 13 the message that recovery is possible, but we need 14 to make the resources available and a possibility. 15 We need everyone to come together to change 16 the things and make the resources available for 17 everyone. 18 Every child should have access to the same 19 resources. 20 Today there's a waiting list at every 21 treatment facility in Western New York. 22 Horizon Village, a long-term residential 23 treatment program, has a waiting list of 90 to 24 120 young adults at any given time; the majority of 25 our IV-heroin users, 18 to 27 years old. 1 Our youth are dying while they're waiting to 2 get the help they so desperately need. 3 This is unacceptable, and things have to 4 change. 5 Thank you. 6 SENATOR RANZENHOFER: Thank you, Colleen, 7 for, not only your personal story, but your 8 perspective as -- you know, in your position at 9 Horizon. 10 Lisa, your perspective is a little different; 11 you have a different title. 12 What do you see over there? 13 LISA GLOW: So I am the program director for 14 our Batavia Horizon Health Services outpatient 15 clinic. 16 At this point, over half of our population in 17 treatment are opiate users. We've seen a drastic 18 increase in the number of clients coming in for 19 treatment using heroin and other opiates. The 20 growing demographic being that teens-to-20s age 21 bracket. 22 As a result of the drastic increase and the 23 changing face of addiction, we've had to get 24 creative with how to treat these clients because, as 25 Colleen mentioned, so often, we'll make an inpatient 1 recommendation for a client, and hear back from the 2 insurance company that, unfortunately, it's not 3 medically necessary for them to go inpatient at that 4 time, or, that they need to fail at the outpatient 5 level. 6 SENATOR RANZENHOFER: Who makes that 7 determination whether it's medically necessary? 8 LISA GLOW: The insurance company. 9 SENATOR RANZENHOFER: Okay. 10 LISA GLOW: We'll make the referral, and the 11 insurance company comes back and says "not medically 12 necessary," or, that they need to fail at outpatient 13 first. 14 Unfortunately, what "failing at outpatient" 15 means, is that client continues to use heroin and 16 other opiates. And as we know, overdose is 17 happening and clients are dying. 18 We have found some progress. 19 As a few have mentioned, the I-STOP 20 legislation has helped. At least the scrips that 21 are being written are being written to those that 22 are using them responsibly. 23 We've been training clients, family members, 24 community members; anyone who's interested in being 25 trained on Narcan. 1 If you haven't heard, we -- this coming 2 Wednesday, May 28th, we're doing a large 3 community-wide training, numerous times of the day, 4 open to the public, so that they're able to be 5 trained on how to recognize an opiate overdose, and 6 how to effectively respond using the Narcan kit. 7 Involving family members throughout the 8 treatment process is imperative. If we're only 9 treating the clients, we're only really treating 10 half of what we could be. 11 And we've had to develop an opiate-specific 12 track of treatment in order to really work with this 13 unique demographic of individuals. 14 So I'm hopeful that, as a result of forums 15 like this one, that we'll start to see some changes 16 in terms of access to care and eliminating barriers 17 to the clients that really, really need help. 18 Thank you. 19 SENATOR RANZENHOFER: Thanks, Lisa. 20 Let me just turn to this side. 21 You know, we've heard a lot about the 22 law enforcement and the Horizon perspective. 23 I guess I'll start off with GCASA, because 24 I'm very familiar with your organization. 25 Dr. Fisher and John Bennett, why don't you 1 share your perspective in terms of what you're 2 seeing on this particular problem. 3 JOHN BENNETT: Thank you. 4 Thank you for having us here today. 5 And I certainly want to appreciate the Senate 6 for convening a lot of these regional forums. 7 I think, you know, this does a lot to reduce, 8 or at least take a look at, some of the stigmas 9 associated with the work that we do. 10 So what I do is, I took a look at -- 11 Sister's Hospital, back in 2001 and 2002, approached 12 Genesee County, and I know, uhm -- they were looking 13 to start a methadone program up here. 14 So I remember having to look up how many 15 opiate-treatment patients we had in treatment. And 16 that year, I think it was 2001-2002, we had 17 three opiate-primary patients in treatment. 18 So, you know, we gave that information back 19 to the County, the Community Services Board. And, 20 eventually, there didn't seem to be a need for 21 opiate-treatment service -- or, for methadone in 22 this county. 23 So we roll the clock, you know, forward to 24 2014, we had -- we've had 483 admissions that are 25 opiate-primary since 2008. 1 We started our program back in 2006-2007, 2 when we started prescribing medication-assisted 3 treatment, buprenorphine, for opiate-treatment 4 patients. 5 So, right now, I think, Dr. Baker, we 6 currently have about 175 active admitted patients 7 who are opiate-primary. 8 I echo Lisa's statement, that more than half 9 of our caseload right now is opiate-primary. 10 And, again, we've all had to get creative. 11 I think one of the big -- one of the big 12 problems for us -- well, I think one of the things 13 to understand, I mean, the 12-to-25-year-old bracket 14 is the biggest -- 15 SENATOR RANZENHOFER: "12" did you say? 16 JOHN BENNETT: -- 12- to 25-year old is the 17 largest-growing number of opiate prescription pain 18 medicine. Non-medically used prescription pain 19 medicine. 20 And if you look at -- you know, if you've got 21 a young person, that 12-to-17-year-old group, you 22 know, they're taking medicine out of their 23 grandma's, you know, medicine cabinet, and they're 24 getting together on a Friday night and they're just 25 having -- they think they're just having fun. You 1 know, they're, like, Let's just take a few pills. 2 And -- but what we know about opiate is that, 3 you know, doing that for two or three weeks, and for 4 some of these kids, you know, they're popping them 5 every day, thinking this is no big deal. This is a 6 prescription medication. My grandma uses it, my 7 mother uses it...whatever. 8 And over a period of time now, they try to 9 stop using, and now they start to get sick. 10 So, they're no longer necessarily looking for 11 that high. Now they're just, you know, taking a 12 pill to go -- before they go to school so that they 13 don't get sick. 14 And that's how, sometimes, young people 15 become addicted to these -- you know, these 16 substances, by just kind of experimenting, playing 17 around, and then, eventually, they start to -- they 18 want to get off of them. They go through 19 withdrawal, and they continue to use. 20 I think the I-STOP has been great. I mean, 21 it's been a -- so I appreciate, you know, some of 22 the legislation around that. 23 I think that the medication take-back has 24 been wonderful in getting some of the drugs off the 25 street. As the Sheriff indicated, though, it's 1 caused an increase in price in the prescription 2 pills on the street, and a decrease in heroin. And 3 heroin's become much more prevalent. 4 I'm disappointed to say that, you know, we 5 have patients trying to sell heroin sometimes in our 6 waiting room. 7 And -- you know, so that's a change for us, 8 you know, trafficking drugs in our waiting room. We 9 didn't have to deal with that, you know, five or 10 six years ago. We didn't have to deal with people 11 saying, you know, If you don't help me today, I'm 12 going to vomit in your waiting room. 13 And, so, those are the types of changes in 14 our treatment system. 15 Our counselors have to -- you know, they had 16 to educate themselves. 17 We've had to do a lot of training on opioid 18 addiction, because I think, as a field, you know, we 19 were kind of behind the gun seven, eight years ago. 20 I think that one of the concerns for me in 21 this community is that we have very few private 22 practitioners who prescribe, and so it creates a 23 backlog in our system. 24 We have two doctors who work for us. Each 25 can prescribe up to 100. 1 Right now, we are -- you know, we are really 2 at a max. They're both part-time physicians. 3 We need physicians in our community to take 4 our patients who are doing well, who have been, you 5 know, clean for eight months or a year, who are 6 medication-compliant, who are on low doses of 7 Suboxone, who will take our patients and not worry 8 about. 9 I know some of the fears -- well, 10 anecdotally, what they've told me was: I don't want 11 to get those phone calls at two or three in the 12 morning. I don't want to deal with patients in my 13 waiting room, you know, arguing, frustrated, 14 vomiting; whatever that is. 15 And we try to reassure them that the patients 16 that we're dealing with, that we would refer to you, 17 are doing well. 18 But I think, you know, physicians are afraid 19 to take on this population. 20 So I think, you know, educating our local 21 practices is a good thing. 22 And then I also think that there's a place 23 for prevention in this. 24 We -- I don't know of any, and there might 25 be, but, I talked with my prevention assistant 1 director yesterday, and I asked: Is there any 2 evidence-based stuff out there right now for 3 preventing opiate use? 4 And, so, she was looking into that. She 5 didn't think there was. 6 So I think that, you know, we need some 7 better prevention tools out there, because 8 I think -- you know, I think that's where it's at 9 with the young people, is to try to prevent this 10 from happening. 11 And -- and -- and, so, thank you. 12 SENATOR RANZENHOFER: Thanks, John. 13 Dr. Baker, your perspective on the medical 14 side? 15 DR. BRUCE BAKER: I'd like to go over one 16 thing that you said, in educating medical students, 17 educating doctors. 18 Before you do that, they have to -- you 19 raised, Rochester. They created something called a 20 "biopsychosocial concept of medical care." 21 Well, the "social" part is the part that's a 22 big problem here. 23 And as a student or as a practitioner, they 24 have to get inside their patients' heads and 25 families and realize what the social situation is. 1 I was medical director at Hope Haven for 2 25 years. And I see, over the last five, six years, 3 over half -- a third of my patients had no idea of 4 what normal social behavior is. 5 So -- and at GCASA and at the hospital and 6 Horizons, we put up with an awful lot. But, 7 frequently, it just doesn't work because people 8 can't accept it. 9 I'd just like to share what some of my 10 patients have told me over the years. 11 The relief of pain or good feeling they get 12 from using opiates is nothing compared to what they 13 go through with withdrawal. 14 And, unfortunately, the opiates, once they 15 get into them -- or, how do they get into them? 16 There's two main ways. 17 One is the diversion from legally prescribed 18 drugs. Even some older people sell them. Get more, 19 they want to sell them, or their kids sell them. 20 The other, although marijuana is not 21 universally accepted as a gateway drug, my patients 22 tell me that, as young people, even teenagers, they 23 began using marijuana. 24 Well -- so marijuana is not necessarily 25 directly responsible for opiates, but, when you 1 think about it, they're using marijuana in 2 association with people who do use the hard drugs. 3 And, sure, "Well, try this, see how it 4 works." 5 Well, once it begins working, they have to 6 take more and more and more. 7 And just quickly to say how this 8 buprenorphine, Suboxone, works, it -- buprenorphine 9 is an opiate. And, uhm -- it -- it's accepted as an 10 opiate by the receptors in the brain which are now 11 chronically diseased. They don't work at all well. 12 But I'm not a scientist. For some reason, 13 I don't -- I cannot explain, the buprenorphine 14 opiate does not require escalation. We normally 15 start with a dose of 8 milligrams a day, along with 16 2 milligrams of the Narcan you mentioned. And the 17 reason this is put together is so that they can't 18 get a buzz by snorting it or injecting it. 19 We do use something called "Subutex," which 20 is just buprenorphine, for pregnant ladies, because 21 we don't want the baby exposed to the naloxone. We 22 don't want the baby exposed to the opiate either, 23 but at least it's a small controlled drug. And when 24 the baby is in the hospital, the nurses, the 25 doctors, the hospitals, they know there's a problem 1 and they're prepared to treat any withdrawal, which 2 is -- in my experience, has been very, very rare. 3 One time I saw -- I knew that mother was 4 using lots more drugs. 5 So as a -- as -- what the Suboxone will do, 6 it will replace the other opiates. It will maintain 7 withdrawal without need for increasing the dose. 8 All right, now, they've got to get off this. 9 It's still an opiate. 10 Well, we're looking forward, probably a year 11 or two, before they get off. We gradually decrease 12 the dosage. 13 The way we do it, is we'll go from 14 8 milligrams every other day, to 6 milligrams every 15 other day, and do that for a period of time. 16 The receptors in the brain don't realize that 17 they're getting less because they're gradually being 18 reset. 19 The brain never forgets, because you're still 20 an addictive person. And so the time they're off 21 it, hopefully. 22 Now, unfortunately, some people relapse in 23 spite of all the help they've gotten. And many 24 people have to go through two, three, four times. 25 But I don't know of any other way we can do 1 this. 2 And I think, in my experience, going back 3 many years, but just recently with GCASA, I think 4 it -- I think it's worthwhile trying. 5 And as far as cost-effectiveness is a 6 concern, it's a bargain. 7 SENATOR RANZENHOFER: Thank you. And, 8 Doctor, I appreciate that, the medical perspective. 9 And you had alluded to, you know, the 10 hospital setting, and what you're seeing there. 11 And I'm just going to turn to 12 Mary Beth Bowen. 13 What are you seeing in United Memorial 14 Medical Center with this problem? 15 What's happening in your emergency room? 16 What's happening, you know, in the hospital? 17 MARY BETH BOWEN: Thank you. 18 And thank you both for being here today. 19 It's certainly an important topic for the 20 community, and a huge consumption of resources. 21 And, sadly, we don't do a good job medically 22 treating people and getting them recovered. And 23 that's a challenge in the acute-care setting and the 24 hospital. 25 We see patients primarily in four venues: 1 In the emergency room, and this can be a 2 variety of people coming in for acute treatment, 3 overdoses, or alcohol-related. 4 We started looking and tracking our 5 statistics after the bath-salts epidemic that we had 6 in this community a few years ago. And the work of 7 this group and other members of the community really 8 were able to nip that in the butt, but it taught us 9 some lessons. 10 And in our ER, from 2013, we saw a total of 11 62 overdose patients. 12 Year-to-date this year, we've seen a total of 13 130. 14 And, so, there's a significant increase. 15 That is not just opioids. That is also 16 including alcohol. It could include other 17 ingestion. So it's not truly that, but the change 18 is remarkable. 19 So the impact is throughput of the ER. 20 I spoke with the ER physicians, and their 21 frustrations center around appropriate and easily 22 accessible treatment options, particularly for the 23 mentally ill who have a chemical dependency. That 24 is a challenge to get people into programs timely. 25 Other -- on the inpatient side we have 1 drug-seekers; people are who addicted who will come 2 in for treatment. And we spend a tremendous 3 resource doing workups to determine whether or not 4 they have health issues that need to be treated, or 5 whether they're just -- it's a mechanism and an 6 access to the substances they require. 7 Our OB population, we do have a number of 8 mothers who do come in addicted. We test every 9 delivery that comes in for substance. We probably 10 have a 25 percent positive rate. 11 Fortunate for us, we have very good working 12 relationships with both Children's Hospital in 13 Buffalo and Strong in Rochester, so we're able, not 14 only to care for the moms, but also to treat -- 15 transfer the babies to get them treated immediately. 16 And then our third -- 17 SENATOR BOYLE: [Unintelligible.] 18 MARY BETH BOWEN: 25 percent. 19 SENATOR BOYLE: Of pregnant or delivering? 20 MARY BETH BOWEN: Delivering. 21 SENATOR BOYLE: Wow. 22 MARY BETH BOWEN: And then the fourth 23 mechanism where we access, we have the -- a 28-day 24 program, and it's a challenge. 25 Access to care, funding for care, delays in 1 the admissions, create variables. And, also, 2 there's just a failure rate. 3 We don't have good medical management, and 4 there's not standing -- I think that John and Lisa 5 alluded to this, there are not necessarily best 6 practices out there. There's not one recipe for 7 success in doing this. And it's a challenge, 8 because the families are tremendously frustrated. 9 The resources aren't available. 10 And for the providers, they don't -- they 11 don't feel successful. I mean, medical people want 12 to help and cure people, and this is truly a 13 challenge. 14 One other comment that our ER physicians 15 asked that I make separate, is, uhm -- I said, 16 "Do you have any other concerns that you'd like me 17 to bring forward?" 18 And they said they have concerns around 19 e-cigarettes. They see them as another mechanism 20 for drug delivery in a creative population. 21 So they wanted to just bring that to the 22 forefront. 23 SENATOR RANZENHOFER: Okay, now you had 24 touched upon on the mental-health aspect, also, in 25 combination with the drug aspect. 1 So I'm going to ask Augusta Welsh, how are 2 these -- how are the two related? 3 I mean, obviously, you're mental-health 4 services, but, I imagine a large component of that 5 is also, you know, folks that are at some stage in 6 their addiction to heroin or prescription medication 7 or other illegal substances? 8 AUGUSTA WELSH: Thank you both, Senators, for 9 inviting us today. 10 When we reviewed our system over the past 11 decade or two, what we found were a couple patterns, 12 and I think, mainly, there's some other providers 13 here from the community that I'm sure have seen the 14 same thing, is that, when mental illness starts in 15 somebody, usually they aren't aware of it and they 16 don't know what to do with the symptoms. 17 So the majority of people who really have not 18 had the diagnosis of mental illness at that -- at 19 this time really are trying to work with their own 20 symptoms in any which way they can. 21 Well, one of the easiest ways is to 22 self-medicate with alcohol and with other 23 substances. The more readily available they are, 24 the more you can get them. 25 We see that, especially now with our younger 1 population. 2 As everyone has attested to, you know, if 3 you've been around long enough in the field, years 4 ago, 25 years ago, a heroin user looked very 5 different than a heroin user looks today. 6 They were few and far between, but, they were 7 individuals who had been addicted for years and 8 years and years, and really had gone through the 9 whole spectrum of substances and kind of ended at 10 heroin. 11 Now we have a couple of programs that 12 I believe have identified people sooner. And, a 13 couple who have jammed people up, like the I-STOP, 14 for example. 15 You know, that we -- I can give you cases, 16 where our psychiatrists have been able to look and 17 see that somebody has already received a number of 18 prescriptions for painkillers and opiates from other 19 docs, so that they won't go in that direction, or, 20 they will actually adjust some of their medications 21 so that it doesn't exacerbate the problem. 22 We also, you know, are fans of the Take-Back 23 program. 24 I grew up with a generation of parents who 25 kept everything. You know, the cotton balls in the 1 bottle, to the tin foils, to everything else. 2 Well, they also kept drugs. 3 And when my father passed away, and my mother 4 was placed in a nursing home, we, literally, were 5 able to take bushels to be destroyed; to be taken 6 back. And many of them were painkillers. 7 Just as was mentioned before, kids are taking 8 anything out of cabinets now that are just 9 prescription, just to see what they will do. 10 It's, you know, called "fishing," and you can 11 put it in a nice bowl, and whatever looks like a 12 pretty color, that's what you're going to ingest. 13 And if you ingest it with alcohol, as a 14 solvent, you're going to get the reactions much 15 stronger, much faster, and it puts these kids at 16 high risk. 17 What we find very difficult is, yes, we have 18 seen our numbers go up. Our co-morbidity for 19 substance abuse, and mental illness, in general, has 20 increased, probably, from 40 to 50 percent over the 21 last few years. 22 But what we see, and specific to heroin, is 23 that heroin and these type of drugs has been the 24 first time that our psychiatrists have been talking 25 about, that that exposure, as has been mentioned by 1 Dr. Baker and other people, to the young brain 2 really can lead to mental illness. 3 We always saw it as the symptoms of mental 4 illness. Like I said, were being self-medicated. 5 What they're saying now is, truly, you have 6 substances that you're using that can lead to a 7 mental illness and problems later in life, in 8 addition to the addiction. 9 And those have been some of our biggest 10 concerns. 11 We'll say to one another at work, Do you know 12 why you're here? 13 And it's not that -- or, to another provider, 14 Why are you here? Do you realize what you're here 15 for? 16 Not that they're questioning anybody going 17 into early dementia. 18 What we're saying is, there's a reason that 19 we're here right now, together; not only in this 20 panel, but working in coalitions and looking at this 21 problem. 22 Because I think this is a really important 23 time, that we really need to intervene somehow and 24 stop this, because if we've now made it, as 25 Sheriff Maha said, so incredibly cheap to put these 1 substances on the street, you've opened a gateway to 2 anybody trying it. 3 And I believe that, anecdotally, like Narcan, 4 we have to teach our emergency workers because it's 5 going to be more prevalent. We have to teach the 6 community. 7 But I'm also wondering: 8 If you have an adolescent who is 9 experimenting, what's going to be the impact? 10 Is that adolescent going to take into 11 consideration that they may have an out because so 12 many people have an antidote? 13 You know, are they going to be more willing 14 to try it or to experiment if they know about that, 15 too? 16 So it's a real tough balance right now for 17 what's going on in the community. 18 And when I ask myself, "Why are we here?" 19 I think Mrs. Babcock put it right on the table, that 20 we definitely need to come together right at this 21 moment, because I think it's crucial in what's 22 happening out there. 23 SENATOR RANZENHOFER: Well, thank you. 24 And I was really kind of astonished to hear 25 the different paradigm, in terms of the mental 1 illness leading to the drug abuse, the drugs 2 actually cause causing mental illness. 3 And, you know, on your second point there, 4 I mean, that's why we're having these hearings, is 5 we hope, you know, very soon -- I mean, we're -- you 6 know, we've had some hearings already, and we're 7 working on legislation, but, very soon, to hope to 8 announce some solutions, you know, to the problems, 9 based on what we hear, here, and across the state. 10 And before we, you know, open it up to 11 questions and comments from the audience, I'd just 12 like to turn to Donna Sherman, and just hear your 13 perspective in terms of what's happening with this 14 issue, you know, from the VA perspective? 15 DONNA SHERMAN: Thanks again for inviting us 16 here today. It's a real privilege to be able to get 17 to speak for our veterans. 18 I guess we're not -- we are seeing an 19 increase amongst veterans in opioid abuse and 20 dependency, but not at quite the same rate as the 21 community. 22 In our treatment programs, we're seeing about 23 a third of our patients with opioid dependence. 24 When we speak about veterans, I think, in 25 some ways, veterans can often roll up all kinds of 1 concerns into one package. 2 We hear from some veterans that, when they 3 were soldiers, that they were injured in combat, 4 prescribed opioids for the pain so that they could 5 continue with their deployment. 6 And sort of unbeknownst to them, becoming 7 more and more tolerant and dependent on prescription 8 opioids, returning to the states and finding, you 9 know, that they really had a habit that was getting 10 expensive, and resorting to purchasing street heroin 11 instead. 12 So I think, with veterans, they present, or 13 they can, when they're in addiction or 14 behavioral-health treatment, can present with 15 certain co-morbidities that can make treatment a 16 little bit more of a challenge, and needing for it 17 to be a little bit more tailored. 18 So an example of some of the complexities can 19 be: 20 The diagnosis of PTSD, which is an anxiety 21 disorder. And, certainly, opioids can help with 22 calming some of those symptoms. 23 Obviously, coming back with pain; so somebody 24 who's going to be having chronic pain, but, yet, is 25 also struggling with an addiction, how do we decide 1 how we're going to treat that? 2 Finally, traumatic brain injury can also be a 3 factor. And many of our newer veterans coming back 4 are on the younger side, being in their earlier to 5 late 20s, and are feeling pretty powerful and not 6 at risk. So, maybe being willing to take a little 7 bit more risk than other groups. 8 So, we have a comprehensive treatment 9 programs at VA. Right now, I have four different 10 components of our substance-abuse services: 11 We have a 28-day residential treatment 12 program; 13 A standard outpatient treatment program that 14 branches to all of our CBOC locations. 15 "CBOC" stands for community-based outpatient 16 clinic, so we deliver services for SUD through 17 telehealth there; 18 We have tobacco-disorder services; 19 And, finally, a Suboxone program. We have 20 two waivered providers. 21 Right now, we have about 100 cases in our 22 Suboxone program, and offer a standard outpatient 23 approach. 24 I think we also -- there's a number of very, 25 I think, innovative initiatives that VA, as a whole, 1 has undertaken to address this problem. 2 One of them is the CPRS record, computerized 3 record. 4 So, basically, we have records for veterans 5 over the whole country. We can see what veterans 6 are doing in any location; and, so, we're able to 7 coordinate care, and keep track of what they're 8 being prescribed, and whether those prescriptions 9 are appropriate for what their disorders are. 10 Congress actually tracks our pharmacy 11 numbers: How many opioid prescriptions are being 12 written? What are the levels of those 13 prescriptions? 14 And there are metrics that we're assigned 15 that we have to make improvements on. 16 So, in other words, if there are too many 17 opioid prescriptions being written at too high of 18 dosage, then there's got to be a process by which we 19 reduce that. 20 So, locally, we've got a couple of things 21 that we're doing. One of them is the opiate review 22 board. 23 This is a physician-provider board, where the 24 numbers are run on the highest users of prescription 25 opiates in the facility, and those cases are 1 clinically reviewed by a panel of physicians to 2 determine whether the dosage is appropriate. 3 All our physicians also participate in 4 I-STOP. 5 So, ideally, veterans are being very closely 6 monitored for their prescriptions, both, within the 7 VA system, and, are monitored for possible doctor 8 shopping and pharmacy utilization in the community. 9 So I think that this is real innovative, and 10 it's probably not without its flaws, so far. But -- 11 and I won't say we're perfect, but, we're really 12 committed to going all out to support our veterans 13 in their recovery efforts. 14 Another program that I can talk about a 15 little bit is our chronic-pain clinic, which is a 16 place where, okay, so we know that veterans are 17 going to have pain, and, you know, so what are we 18 going to do about this? 19 I mean, legitimate pain is a separate issue 20 from opioid addiction. 21 And, so, what we offer in the chronic-pain 22 program, which is run by a pain-specialist provider 23 and a licensed pain psychologist with a pain 24 specialty, really, the pain is assessed there. 25 Medical -- it has to be medically substantiated, and 1 then non-opioid strategies for the management of 2 pain are taught through that clinic. 3 So on the prescription side, we really are 4 doing a lot to assist veterans. 5 On the treatment side, we've got any number 6 of services. 7 We have -- now, many of our veterans who are 8 involved in opiates are going to have brushes with 9 the law; and, so, we have a veterans justice 10 outreach worker, who I think is here today. His 11 name is John LaHood [ph.], and he's in the audience. 12 And he goes around and touches base with all 13 of our courts, to make sure that we know who our 14 veterans are and what help they need. And he helps 15 link them to our services. 16 We also have two people on my staff who 17 interact with the Buffalo Veterans Court and the 18 Niagara County Veterans Court, to coordinate any 19 care that we're delivering in substance abuse 20 directly with that court. 21 We have a number of services, certainly, 22 through our OEF, OIF, OND, which is sort of a fancy 23 way of saying all the new wartime initiatives. That 24 kind of captures those three: Afghanistan, Iraq, 25 and New Dawn. 1 They provide case-management services, and 2 help veterans get into the care at VA. 3 We have a huge mental-health clinic in 4 Buffalo that also branches out to all of our CBOC 5 locations to deliver mental-health services. 6 And, of course, our addiction services. 7 So, I think we're -- we're doing a lot, and 8 we probably could do more. 9 Veterans are not immune from addiction, 10 certainly; but, yet, substance abuse, and opiate use 11 especially, tends to be highly stigmatized. 12 And, the desperation, described by 13 John Bennett earlier, of some addicts, I think 14 really makes it tough for people to have willingness 15 to help this population at times. 16 One of our biggest challenges, and I'm hoping 17 that other providers are going to agree with me, is 18 the recruitment, retention, of approved providers 19 who are willing to work with this population. 20 It's extremely labor-intensive, and takes a 21 very, sort of, compassionate, yet tough, personality 22 to be effective. 23 Our veterans are strong advocates for 24 themselves, as well; and, so, you know, we have to 25 be willing to reach an equalized compromise in our 1 decisions with them about treatment. 2 So, I guess -- you know, I'm based more in 3 Erie County. That's where my office is. 4 We have a community program in Erie County 5 called "Painkillers Kill More Than Pain." 6 That's been a really great public-awareness 7 campaign. There's been billboards and video. 8 Certainly, WNED had a short shot that was let 9 out for view over months, really discussing the 10 dangers of opioid abuse and dependence. 11 So, thank you. 12 SENATOR RANZENHOFER: Well, thank you, Donna. 13 I appreciate your comments, and the allusion 14 to veterans courts, and, you know, the special, you 15 know, attention that needs to be on that particular 16 issue. 17 I know we have some veterans in the audience. 18 Perhaps we'll hear from them as we, you know, move 19 into our second hour. 20 I know there are a number of people here that 21 would like to speak and share their comments. 22 I know that our office had been in touch with 23 one, Amber Mottser [ph.]. I'm not sure if she is 24 here, or if she feels comfortable speaking. 25 But, certainly would like to hear from some 1 folks that are sitting in the audience, if you want 2 to share your stories and situations with us, in 3 terms of, you know, what needs to be done; what your 4 suggestions are. 5 Whether it be law enforcement, whether it be 6 intervention, whether it be treatment, whether it be 7 education, if you're comfortable, stand up and 8 speak. 9 Thank you, Amber. 10 AMBER MOTTSER [ph.]: Hello. 11 SENATOR RANZENHOFER: Good morning. 12 AMBER MOTTSER [ph.]: Thank you for 13 letting -- or, asking me -- well, having my 14 counselor at GCASA asking me to come and speak and 15 share my story. 16 I'm actually pretty familiar with the format. 17 I've spoken in Western New York, over in Buffalo, as 18 a survivor of human trafficking. 19 Unfortunately, that's where my drug addiction 20 had taken me. 21 I first used heroin at 16 years old. 22 My friends were users of heroin. I had 23 already been experimenting with other substances, 24 and it just came across my path. And at that point, 25 honestly, that was my way out from my family home 1 life. I just had a really -- I suffered a lot at 2 home. Alcoholic family, and things like that. 3 And I remember when I told my grandparents, 4 when I was 20, that I was addicted to heroin, and 5 they were just shocked, because they hadn't seen it 6 since Vietnam, you know, and they just were 7 unfamiliar with it. 8 And I remember having tears in my eyes and 9 saying, "This is an epidemic." 10 Like, the face of heroin addiction has 11 totally changed. You know, it's teenage girls in 12 the suburbs. It's not, you know, junkies in the 13 city -- in the inner city anymore. It's just not 14 like that. 15 And I've been through inpatient four times. 16 One time, it took me all the way down to the 17 Walter Hoving Home, which is a non-for-profit 18 Christian organization in New York City -- right 19 outside of New York City. And I stayed there for a 20 month, and I came back, and I collected 11 months 21 clean. Went through the GCASA program. 22 Unfortunately, back in January, I did have a 23 relapse, because when I -- I think a lot of it had 24 to do with, when I came back up from New York City, 25 I decided I didn't need the Suboxone program. And, 1 eventually, it caught up with me, and I relapsed. 2 But now I'm currently on the Suboxone 3 program. 4 I know a lot of people that are really 5 successful with it. 6 And I know some people that aren't successful 7 with it; and reason being for that is, they don't 8 have long-term care, they don't have long-term 9 treatments. 10 It's been my experience that it needs to be a 11 whole lifestyle change. It's not just surface 12 issues, it's not just underlying emotions. It's the 13 whole five aspects of wellness: spiritual, 14 emotional, physical, all of those things, mental, 15 and caring for those. 16 That's what I've been doing in my recovery 17 program, and it's been working pretty well for me. 18 Currently, I just finished a year at GCC. 19 I'm going to -- I'm pursuing to be an addictions 20 counselor. And, eventually, I'd like to work for a 21 non-for-profit organization. 22 I directly correlate with PATH organization 23 which works out of Buffalo. We're opening a drop-in 24 center for human trafficking. 25 A lot of these young girls -- I don't know if 1 you've connected these two points yet, but a lot of 2 these young girls that are addicted to heroin are 3 resorting to trafficking themselves on the Internet. 4 So, I mean, that's a huge issue that we're 5 looking at over there. 6 But, I think it's really great that you guys 7 have brought a light, and really brought an 8 awareness to the community here, because it has 9 changed. 10 I've only lived in Batavia in two years and 11 I've seen dramatic change, even in the style of the 12 groups that I attend at GCASA. And the kind of 13 people that are coming there are becoming younger 14 and younger. And, it's just not who you would 15 expect. 16 And I know that there's people in my family 17 that have been affected by this disease. 18 People I've gone to high school with have 19 overdosed and died. 20 I mean, it's really sad that our young people 21 are killing themselves. 22 So, I just want to say thank you, again, for 23 letting me come up here and just share my 24 experience. 25 SENATOR RANZENHOFER: Okay, let me ask you a 1 question. 2 For you, the 28-day -- you said you relapsed 3 four times. 4 Were -- your treatments, 28 days, and then 5 you had the outpatient, you said that worked for you 6 to some degree. 7 But you said that, for others, it must be -- 8 it needs to be a much longer treatment program? 9 AMBER MOTTSER [ph.]: Yes, because what I've 10 noticed, I think, for my benefit, is that I just 11 don't get along with my family and that background, 12 so it was easy for me to break away from that 13 situation. 14 Other people, what I've noticed, because I do 15 go and speak at the alumni meeting Wednesday nights 16 over at Hope Haven, and what I've noticed with 17 people, is after the 28 days worth of treatment, if 18 they get that long, because of their -- you know, 19 the insurance company, they go home and they're back 20 in the same circumstances, same exact situation, 21 same exact people. 22 It's just -- it's a matter of time before it 23 happens again, whether Suboxone or not. 24 So, uhm -- I don't know, I think there just 25 needs to be more done. 1 I know for me personally, even when I was 2 living on the streets, I tried to get into rehab 3 multiple times. It took me almost six months to get 4 into a rehab. 5 I went to ECMC, Stutzman. I got denied both 6 places. 7 I called Syracuse Behavioral Health for 8 3 1/2 months. While being homeless, I could find a 9 phone every day and try to call, because I really 10 wanted the help. 11 And I think that that's a major aspect, too, 12 is, are these people really wanting help? 13 And the sad part about it is, that those that 14 do, is the help and the resources available? 15 SENATOR RANZENHOFER: Okay. 16 AMBER MOTTSER [ph.]: And sometimes it's not. 17 SENATOR RANZENHOFER: Okay, well, thank you. 18 Thank you very much. 19 UNKNOWN SPEAKER: [Not on video.] 20 Amber, where do you live now? 21 AMBER MOTTSER [ph.]: I live here in Batavia. 22 UNKNOWN SPEAKER: [Not on video.] 23 Are you in supportive living? 24 AMBER MOTTSER [ph.]: No, I did not go 25 through the supportive-living program. 1 I did spend three months at the 2 Atwater House. 3 My personal opinion is, the co-sex thing that 4 they have going on there, males and females, is not 5 working. 6 UNKNOWN SPEAKER: [Not on video.] 7 But you did spend three months -- 8 AMBER MOTTSER [ph.]: Three months there, 9 yeah. 10 SENATOR RANZENHOFER: Are there some other 11 people that would like to speak? 12 If you would -- this lady is right in front. 13 Just -- if you would, just identify who you 14 are so we know who you are. 15 CHRISTINA AMABALAY [ph.]: My name is 16 Christina Amabalay [ph.], and I'm a 17 nurse practitioner for Horizon Health Services. 18 I do work with the chemically-dependent 19 population. 20 One of my roles is to meet with people who 21 are opiate-dependent and discuss their options. 22 I feel that, as a nurse practitioner, I have 23 full prescription privileges, which means I can 24 prescribe any medication on the market, with the 25 exception of Suboxone. I can prescribe it off-label 1 for pain, but not for the addictions. 2 This is limiting the access to care and to 3 medication-assisted treatment which is desperately 4 needed right now for opiate dependence. 5 So, when I meet with clients to determine 6 whether or not they would like to try 7 medication-assisted treatment, and they're 8 opiate-dependent, and they're still actively using, 9 and I say to them, "These are the options that 10 I think you have. Suboxone is a great option, but, 11 we have a six- to eight-week waiting list," and they 12 look at me and say, "So what am I supposed to do in 13 the meantime"? 14 And in the meantime, they either: 15 Go through that tortuous withdrawal on their 16 own; 17 They go to detox where they get a dose of 18 Suboxone, but then are discharged and don't have a 19 scrip for Suboxone; 20 Or they continue to use while they're on the 21 waiting list for Suboxone. 22 So it's my feeling that some emergency 23 legislation is needed, to allow a very important 24 part of the medical community, which is 25 nurse practitioners, to prescribe Suboxone. And 1 I think we need it very hastily. 2 So I would very much appreciate any authority 3 that you might have to allow this legislation. 4 SENATOR RANZENHOFER: Senator Boyle had a 5 comment. 6 SENATOR BOYLE: Yeah, you make an excellent 7 point, and we've heard that in a number of forums. 8 The problem is, it's a federally regulated 9 drug. And there's a cap on the number of patients 10 that a doctor can have, but it's all federally 11 regulated. 12 I think, as part of this legislative package, 13 what we're going to do is, is either have a 14 resolution or some force from New York State 15 Legislature saying to Congress, Hey, get on the ball 16 and change this. 17 But it's a federal situation with Suboxone, 18 unfortunately. 19 CHRISTINA AMABALAY [ph.]: So what is the 20 next step? 21 I want to be involved in the next step, 22 because I feel that there's urgency about this and 23 it's not being taken care of quickly enough. And as 24 a result, people continue to use and overdose, and 25 die. 1 SENATOR BOYLE: What I would recommend is, 2 and this sounds corny, but write your Congress 3 person or contact their office. 4 We will do, as state legislators, but your 5 federal representatives, they need to know exactly 6 what you're saying. 7 It makes perfect sense, and it should be this 8 way, but we as state legislators do not have 9 jurisdiction over Suboxone in particular. 10 CHRISTINA AMABALAY [ph.]: Okay. Thank you. 11 DR. BRUCE BAKER: Senator -- 12 SENATOR BOYLE: Yeah. 13 DR. BRUCE BAKER: -- as a practicing 14 physician, I'd like to say that I think the 15 nurse practitioner is perhaps better qualified than 16 the average physician, because the nurse 17 practitioners are much better -- more aware of the 18 social problems that people have. 19 SENATOR RANZENHOFER: Good, thank you. 20 DR. BRUCE BAKER: And I would endorse that 21 500 percent. 22 SENATOR RANZENHOFER: Just 500. 23 [Laughter.] 24 SENATOR RANZENHOFER: I know there was 25 another hand in the back. 1 Yes, why don't you tell us who you are, and 2 come to the microphone. 3 LAURIE CURRIER [ph.]: My name is 4 Laurie Currier [ph.], and my daughter is a 5 recovering heroin addict. She has been in recovery 6 for the last two years. 7 And, everything that everyone had said this 8 morning makes so much sense as far as not being able 9 to find the help necessary. 10 So I'm very glad that you're having this talk 11 this morning, because I think that, again, the 12 stigma that goes with heroin addiction, you know, 13 that they are the castoff people. That they're not 14 your child, your sister or brother, your mother or 15 father. 16 And, they truly are. 17 When we sought help for my daughter, we were 18 told that there was a six-month waiting list. 19 We were also told by our insurance company 20 that she needed to fail on the outpatient first. 21 With heroin addiction, I've discovered that 22 without an inpatient piece, outpatient is reluctant 23 to work. 24 We have gone through the gamut, as a family, 25 trying to find help. 1 So I do think family is a huge piece. 2 There has been so many roadblocks along the 3 way. And even when help was available, it was 4 limited to 28 days. 5 There is a link between mental health and 6 addiction. 7 And it took my daughter going out of state to 8 a clinic that dealt with both mental health and drug 9 addiction, together, in order to help get her on the 10 right track. 11 She had -- when I told her I was coming 12 today, she had said that, you know, the Narcan 13 program, that, I don't know how much would, as 14 Augusta had said, be an easy out for addicts. 15 Maybe for people that were experimenting the 16 first time, but for the most part, an addict would 17 rather be left alone and die than take Narcan 18 because of the painful snap back to reality. 19 We are a typical middle-class family that 20 are -- we're very involved in our children, their 21 education. Drugs were not abused in our home. 22 And, yet, I am the parent of an addict. 23 So that I think there needs to be more out 24 there, that when you are seeking help, that you can 25 get the help when you need it. 1 That there shouldn't be someone at an 2 insurance company, sitting behind a desk, saying, 3 you know, Nope, she doesn't need that treatment; 4 when, as a parent, and even her physician had said, 5 and wrote letters, and appeals, saying, yes, she 6 did. 7 It took, actually, a government member 8 telling me, "Drop her off your insurance so that she 9 can get Medicaid." 10 And, it was through Medicaid. 11 And there is a huge connection between 12 law enforcement and the addicted population. 13 My daughter did things that she never would 14 have done otherwise. Under the influence, anything 15 was fair game. 16 I can't thank the Mental-Health Drug Court 17 here in Batavia enough for the help that they 18 provided my daughter. 19 Judge Balbick and Nichole Desmond were 20 wonderful. 21 And, that, I think everyone needs to work 22 together in order to make this a known problem. Not 23 hide. 24 You know, it's very hard to get your children 25 into a program; and, yet, no one talks about it. 1 This is the face of addiction. You know, 2 that we are very typical people. 3 And I sincerely hope that we can give it a 4 voice, give it a name, get more help in our 5 community, because it's here, it's big, and people 6 don't recognize it. 7 Thank you. 8 SENATOR RANZENHOFER: Well, thank you very 9 much. 10 I know that Nichole and Judge Balbick do a 11 very good job. 12 And we're going to get to a couple of people, 13 but I just want to throw something out here, 'cause 14 I hear a lot that you have to fail first before you 15 get into a longer-term program. 16 So my question is: Does the 28-day program 17 work in some cases, and that's why they make you go 18 through it first? 19 I mean, if it fails in 100 percent of the 20 cases, why would anybody ever do it? 21 So I don't know if anybody has any thoughts 22 on that? 23 I guess we'll take a couple of comments here, 24 and then we'll go back to some folks in the 25 audience. 1 Donna, and then Colleen. 2 DONNA SHERMAN: I think it really comes down 3 to making individualized assessment of each case 4 that's coming in. 5 I think the earlier someone is in the 6 addictive process, the better chance that a 28-day 7 program will be adequate. 8 But, oftentimes, more supports are needed. 9 And people can really run the gamut in terms of what 10 their needs are. 11 You could have someone who has a lot of 12 psychosocial support, a job, et cetera, and just has 13 had some chronic pain and became addicted 14 inadvertently. And someone like that could 15 participate in Suboxone for a year, taper off, do a 16 28-day program, and be fine. 17 And others who have more psychosocial 18 deficits, more mental-health or trauma-related 19 issues, are going to need more and more intensive 20 services over a longer period of time. 21 SENATOR RANZENHOFER: Okay, Colleen, do you 22 want to comment on that? 23 COLLEEN BABCOCK: I do agree with what Donna 24 says, but I think that, also, with the young-adult 25 brain, you're dealing with a totally different face 1 of addiction. And the 28-day programs do not work. 2 I will tell you that the majority of your 3 young-adult population, 12 to 27, repeat those 4 programs over and over again, such as Amber. 5 Why not start with the long-term program, 6 give them the solid foundation that they need to get 7 on their feet. And then, if you have to refresh 8 down the road with outpatient or 28-day program, 9 you're at least appropriately targeting that 10 young-adult brain, giving it time to heal, so that 11 they can absorb and take in the tools that they need 12 to be successful. 13 So, I think we really need to look at 14 starting with long-term treatment before the 28-day 15 program. 16 SENATOR RANZENHOFER: Right off the bat. 17 COLLEEN BABCOCK: Right, exactly. 18 SENATOR RANZENHOFER: Okay. Thank you. 19 I know there were two women in the front. 20 MARY BETH BOWEN: Senator, I would echo that. 21 I think that our experience with the 28-day, 22 it's the exception versus the norm. 23 We have people who have gone through the 24 program six, seven, eight, nine times, and seen at 25 that point they have achieved sobriety. 1 The other challenges, it's a very difficult 2 population to follow, because if the patients are 3 not connected with a GCASA program or another 4 program, they're home -- they're classified as 5 "homeless" in our system and we can't access them to 6 see where they are at. 7 AUGUSTA WELSH: Senator, in -- you know, in 8 our historical addiction programs, we have always 9 seen that, after somebody went through the 28-day 10 program, the -- for whatever addiction, they did 11 best when they had the most supports. Whether it 12 was the halfway house, family was involved, they had 13 resources. 14 When you have -- you know, we keep talking 15 about these young adults. 16 When you have these young adults, they may 17 still have the chance for the family being intact. 18 But a lot of times, with the 28-day program, 19 it is, you -- you, literally -- you know, I'm a 20 nurse, first and foremost. You literally have had 21 changes physi- -- changes the physiology of their 22 brain. This is not a quick adjustment. 23 And, you know, when I was talking before and 24 I spoke, and it wasn't about Narcan not being a good 25 thing. 1 What I was speaking about is some anecdotal 2 things that came back through some of our 3 therapists, that, literally, they have said kids 4 have wondered about this, you know, saying, Okay, 5 maybe I'd be more apt to try. 6 We also have a number of youngful [sic] -- 7 young clients that we see, that are beginning to get 8 into more of crimes on a minor basis, because some 9 of their comments have been: 10 "Well, they won't hold me accountable. I'm 11 still a youthful offender." 12 "They won't hold me accountable" if they're 13 17 or 18 "because the jail's full." 14 So they're looking to see how to manipulate 15 their environment. 16 But in regard to the treatment of this, the 17 longer that you have, the more that you can taper 18 the supports, the better chance you're going to have 19 the first time out. 20 And I would definitely defer to Jodie from 21 Renaissance House, next, to explain that. 22 SENATOR RANZENHOFER: We're going to take the 23 woman in the black, who raised her hand. 24 Yes, you. 25 So you want to make a comment? 1 AUDIENCE MEMBER: [Inaudible/no microphone 2 used.] 3 SENATOR RANZENHOFER: Use the microphone. 4 And then the woman in the gray will go after 5 her. 6 And does anybody else -- well, the gentleman 7 in the back will be next. 8 SHERRY PLASIC [ph.]: Well, I just wanted to 9 tell a little bit about my son Daniel. 10 My name is Sheryl Plasic [ph.]. I'm here 11 with my son Dan. We're from Niagara Falls, 12 New York. 13 My son was a veteran. He came home. He was 14 a journeyman plumber. Bought his own home at 23. 15 Was doing extremely well. 16 And, he hurt his back at work, and was 17 prescribed by a large pain-management facility here 18 in Western New York, he was prescribed large amounts 19 of Lortab. 20 We didn't realize he was addicted until he 21 came to us and said he wanted to stop taking them 22 and he couldn't do it on his own. 23 And we started at ECMC. 24 We went to Lakeshore. 25 On to the VA. 1 But I think talking about the facilities and 2 a places for people to go when they are addicted is 3 so important. We need more facilities built in our 4 area. 5 The one at Horizon, which they're trying to 6 get going, I can't believe that they even have to 7 have a problem getting that built. 8 My son, finally, after begging the VA to get 9 him in there, he hung himself the first night he was 10 there. 11 So I guess, along with what everybody else 12 has said about the stigma attached to it, and how 13 the new face of addiction is these days, it is. 14 This is what the new face of addiction is 15 [pointing to picture being held up]. 16 I just hope we can get that facility built in 17 Sanborn because I really think we need more. A lot 18 more. 19 Thank you. 20 SENATOR RANZENHOFER: Thank you, 21 Sheryl [ph.]. 22 I'm very sorry about the loss of your son. 23 And the braveness that you showed in coming 24 here today and sharing that with us, I appreciate 25 that. 1 SHERRY PLASIC [ph.]: [No microphone used.] 2 Thank you. 3 We were a big part of getting the I-STOP, 4 along with Saving Michaels of the World. 5 And our PSA is on through Painkillers Kill 6 More Than Pain. And one of those three are my 7 husband and I, putting up my son's picture, trying 8 to educate people about what addiction is. 9 SENATOR RANZENHOFER: I remember dealing 10 with, you know, families like yours, when we were 11 dealing with the I-STOP program, and, you know, the 12 tragedies that occurred, you know, that led up to 13 the implementation of that program. 14 The woman in the -- well, you know who you 15 are because you're already standing up. 16 [Laughter.] 17 JODIE ALTMAN: I do because I'm antsy. 18 Hi, I'm Jodie Altman. I'm the director of 19 the Renaissance Campus in West Seneca, and we're a 20 62-bed campus for adolescents, ages 12 to 20. 21 70 percent of our kids are addicted to 22 heroin, 90 percent to pills. 23 Our problem is twofold. 24 The ones that are under 18, there's nowhere 25 to send them for detox, because people think they 1 don't need detox, and so we lose them from 2 treatment. 3 Bigger than that, when you talked about 4 Medicaid, and getting your child off of health 5 insurance to get them on Medicaid, right now, our 6 kids are carved out of the managed Medicaid until 7 2015. 8 If they are not kept carved out, treatment as 9 we know it for these 13, 14, 15, 16, and up, kids 10 will no longer exist, because, then, like the 11 insurance companies, Medicaid will say, We'll treat 12 them in 7 days. 13 You don't treat an addict -- an opiate 14 addict, and a 12-year-old opiate addict, in 7 days. 15 So our issue right now, that we need help 16 from -- from everybody, but also, you know, 17 specifically from this Committee, is we need to keep 18 this carve-out. We need to not allow managed care 19 to affect our adolescents, or else our program and 20 programs like us, which there are none in 21 Western New York, will close. 22 So that's our issue. 23 SENATOR RANZENHOFER: Okay. Thank you. 24 I just turned to Senator Boyle. 25 He said that that's an issue that's come up 1 at a number of hearings, this carve-out issue. 2 Because I wasn't sure if it was a state or 3 federal. 4 He said that is an issue that we can deal 5 with. 6 SENATOR BOYLE: We have some input on that. 7 SENATOR RANZENHOFER: Okay, great. 8 There was a gentleman in the back. 9 And then -- why don't you come on up, and 10 walk to the microphone. 11 And then the gentlemen in the black shirt, 12 with the white, you'll follow him. 13 Okay. 14 NICHOLAS BURKE [ph.]: Yes, my name is 15 Nicholas Burke [ph.]. I'm the school security 16 officer for the Batavia City School District. 17 And I work closely, and I, you know, want to 18 thank the City of Batavia Police Department, because 19 I work with them, you know, regularly throughout the 20 year. 21 One of the things that I wanted to mention 22 was, you know, and so far, a lot of people have 23 mentioned about the treatment and the recovery from 24 drug addiction. 25 But I've been in my position at the school 1 since 2001. And I would say, within the last 2 three or four years, probably since 2010, the 3 general drug culture at every school in 4 Genesee County has increased tremendously. And I'm 5 not just speaking for Batavia. 6 I've gone to forums at -- you know, talked to 7 the officer at BOCES, and at every school, there's 8 just a significant increase in drug culture. 9 And I think that we need to try to find a way 10 to educate kids, as early as elementary school, 11 middle school, about the dangers of, not only heroin 12 and opiate addiction, and -- and, you know, the 13 harder drugs, but, also, you know, marijuana, 14 et cetera. 15 Just a brief story: 16 I coach. I coach track and field, and 17 football, for Batavia. 18 And I was at a track meet this winter, and 19 I had a girl on the team that I coach, like, you 20 know, in a public setting, pleading with her mom to 21 buy her a vape. An e-cigarette. 22 And, you know, pleading: Mom, mom, everyone 23 is using these e-cigarettes. You know, all my 24 friends, they got them. We -- they vape all the 25 time. 1 And the problem is, is that there's no -- at 2 this stage, there is very little or no state 3 regulations on e-cigarettes, but what these kids 4 have found is, they can take marijuana oil, hemp 5 oil, which is 90 percent potent, and they can put it 6 in their vaporizer and they can use it. 7 And it doesn't smell like pot. So, like, you 8 know, when I'm at school, I can't sense it or smell 9 it when I -- you know, whatever. 10 You know, and it's very accessible. 11 And so what we have is, we have these kids 12 whom, culturally, you know, because of, that's just 13 the way, you know, it is right now, who think that, 14 you know, vaporizing, vaping, is okay. 15 You know, and I think Dr. Baker mentioned 16 about the correlation between, you know, whether 17 marijuana is a gateway drug or not. 18 But -- but I just see this heightened drug 19 culture in the last few years. And I think that 20 that's partly to, you know, explain some of the 21 increase in the heroin and opiate addictions, and, 22 you know, the troubles in rehab, et cetera. 23 So if I could just recommend some -- you 24 know, one thing, it would be, you know, dealing with 25 the treatment. And the rehab is, obviously, a huge 1 undertaking and trying to solve that. 2 But I think that we also, because that's so 3 difficult, need to focus on the education, and 4 trying to prevent, and to -- to, you know, lessen 5 this drug culture before it starts. 6 You know, this girl that was talking to her 7 mom is a 97-average student at our school, who's had 8 zero referrals for discipline. She's not a bad kid, 9 and she thinks it's okay. 10 You know? 11 The other thing with the vaporizers, as far 12 as the, uhm, you know, state regulations, or 13 starting to do this, you know, come up with some 14 sort of regulations for them. 15 The nicotine oil that you can buy comes in 16 flavors. It smells like cherry, smells like 17 blueberry. 18 And, you know, a 5-year-old kid, and, you 19 know, you can buy them in town. And, you know, 20 I see 16-, 15-year-old kids with them, you know, 21 regularly. 22 It's nicotine. You know, it's the equivalent 23 of putting, I don't know, 100 nicotine patches on 24 your skin. 25 And a mom or dad can leave that nicotine oil 1 sitting on their table, and it smells like cherry. 2 And a 5-year-old kid can go and put pick that bottle 3 up and squirt it in their mouth, and it will kill 4 them. 5 You know? 6 And, so, you know, in regards to, kind of 7 getting off the subject a little bit, the heroin and 8 the opiate addiction, and trying to solve that 9 problem or educate, I think that we need to look at 10 trying to educate kids, and trying to regulate some 11 of the things that are the gateway to leading to the 12 stronger drugs. 13 So -- so, thank you. 14 SENATOR BOYLE: Thank you very much. 15 SENATOR RANZENHOFER: Thank you. 16 Thank you, Nicholas. 17 The gentleman in the black shirt. 18 JASON NORTON: Good morning. 19 Can you hear me? 20 Okay. 21 I'm Jason Norton, and I currently am employed 22 at the YMCA, and my wife and I co-pastor at 23 EFF Church in the YMCA. 24 I didn't think I would come here today and 25 speak, but there was a short story that I wanted to 1 share with you. 2 I also have a history of drug addiction and 3 alcoholism, and it sums back many years, and has 4 crept back into my life later. 5 I'm sober now, obviously. 6 But, I came here today to tell a quick story 7 about my brother. 8 My younger brother is, as of last night at 9 10:00, had six days clean, on heroin. 10 I haven't spoken to him yet today. He works 11 the B shift. 12 He is just now coming to his four days off 13 with the holiday, and got paid, so I'm hoping that 14 he maintains his sobriety. 15 But he himself had trouble trying to get into 16 GCASA. And one of the reasons also was, he's 17 working. That's one thing he didn't lose yet. 18 But the whole Suboxone issue, with the 19 doctors, he couldn't -- you know, you got to see a 20 certain doctor in order to get the Suboxone. 21 He's been trying to quit for two months. 22 You know, unfortunately, we're all busy 23 people, and we can't walk with people, hand in hand. 24 I can't be with him 24 hours a day to make sure that 25 he makes the right choices, or doesn't go hang out 1 with somebody that he's been using it with. 2 And a lot of us know, and we sit around 3 worrying, like, Well, how they are doing? 4 But, he himself also had two overdoses. 5 And another bit of awareness I want to bring 6 is, he was a marijuana smoker. 7 I can't remember if he got in trouble with 8 the law, or how it happened. He probably ended up 9 in a program. But, somebody had prescribed him 10 Suboxone to get off marijuana. 11 Because of that, he ended up on street 12 heroin. You know, he was an intravenous-user. 13 And so he's been struggling, and this has 14 been going on for 20 years. 15 He was sober. 16 And, of course, the same story that we've 17 been hearing here today. 18 He fell off a motorcycle, got back on pain 19 pills, which led back to heroin. For the last 20 nine months, he's been running, of course, to 21 Rochester, or wherever he can get it. 22 So I wanted to just bring an awareness, 23 I think that the education part, as far as the -- 24 medically, you know, what we're prescribing. 25 And I just want to echo what I'm hearing, is 1 our lack of being able to prescribe the medications 2 to help people get off the opiates. 3 But, also, the overprescribing of the opiates 4 and the heroins and the painkiller -- not heroin, 5 but the painkillers that is leading to this problem. 6 And I just wanted to put one more note in 7 there. 8 There are -- I think programs are starting to 9 rise up that maybe some of us are not aware of. 10 Total Freedom is a faith-based program in 11 Darien, that is an eight-month program, minimum. 12 And if the people are willing to work it, 13 they're pretty strict out there. 14 They also help them get back on their feet. 15 They help them get work. Make them -- you know, get 16 them to be a better, you know, success in the 17 community, or whatever, and in society. 18 So that's just something that I wanted to 19 throw out there. 20 But, you know, I think the difficulties and 21 all the red tape of the insurances and trying to get 22 into some of these programs, and then, of course, 23 the prescriptions, and -- I think leads to these 24 street drugs that, then, people just find themselves 25 stuck on. 1 But, again, addiction crosses all cultural 2 lines, whether you're making six-figures or sleeping 3 behind the dumpster at Wendy's. I mean, it's -- 4 it's in our face. 5 So, I wanted to say thank you to everybody 6 that's here, and all of you guys for bringing all 7 this awareness. 8 So, thank you very much. 9 SENATOR RANZENHOFER: Well, thank you, Jason. 10 DONNA SHERMAN: Senator, I wanted to bring to 11 this group's attention that there is a SAMHSA report 12 called the "DAWN Report" (Drug-Abuse Warning 13 Network). 14 And what it -- there's a report called 15 "The Drug-Related Mortality." 16 And what they do is, they track the responses 17 of participating communities, on the incidence, 18 causes, and demographics related to drug overdoses. 19 Not all counties in New York State are 20 participating in this data-collection effort. 21 For Buffalo and Niagara, and the last report 22 was in 2010, and it showed, I think about -- and I'm 23 going to get the numbers a little bit wrong, but 24 they're pretty close ballpark -- around 25 85 drug-related mortality cases. 1 In Buffalo-Niagara, 34 of those overdose 2 deaths occurred in health-care facilities. 3 I'm really moved by a lot of the parent and 4 provider testimony that I'm hearing today, because 5 addiction really causes sorrow in all of us. And we 6 struggle when our family members are caught up. 7 For us at the VA, we -- our heart goes out to 8 our veterans who served their countries, and came 9 back to face addiction-related issues on opioids. 10 We work as hard as we possibly can at VA to 11 help any veteran who comes to us. 12 We have no waiting list, and we have capacity 13 to treat any veteran who has opioid or other drug 14 problems. 15 SENATOR RANZENHOFER: Well, I think the 16 comment, but for the grace of God, it could be 17 anybody. You know, it's not defined by, you know, 18 where you live, who your family is, you know, how 19 much you make, what your job is. 20 I mean, it is just out there everywhere. 21 And, you know, it could be my family. It 22 could be your family. It could be your nextdoor 23 neighbor's family. 24 You just -- you know, you just don't know. 25 No one is immune from this situation. 1 I did see a couple of other people's hands up 2 there. 3 Why don't we take a couple of the comments 4 from here. 5 John. 6 JOHN BENNETT: Yeah, I guess, I -- you know, 7 I've heard a lot of testimony today, and especially 8 around the lack of beds in Western New York. 9 And I want to say that, you know, that 10 Terence O'Leary, who's the director of Bureau of 11 Narcotics, was up here last year. He spoke at the 12 regional consortium. 13 He said that New York and -- Western New York 14 and Long Island were the two trouble spots in 15 New York. 16 I think he said that the rates of 17 prescription medications were seven times that of 18 the rest of the state, or something like that. It 19 was close to that. 20 So we've known for a while, that 21 Western New York. 22 And I do appreciate that we did get 25 new 23 beds in Western New York, but you can see that 24 25 beds really has made just -- you know, it's a 25 drop on the head of a pin. 1 And I know Amanda spoke about -- you know, we 2 run a 17-bed community residence. 3 We've talked for a long time about having a 4 male and a female residence. 5 And so we have a co-ed, because we want to be 6 able to offer services to women. 7 It used to be an all-male facility. 8 And there are struggles with having a co-ed 9 facility, for staff and for patients. 10 And it's very difficult, depending on your 11 background, when you come into a co-ed facility, to 12 maintain your sobriety in there. 13 So, I just want to put a -- you know, put a 14 plug in for beds in this region. 15 I mean, that's -- it's a huge need in this 16 region, and we've known it for a while. 17 So, I mean, the data is out there. 18 So, that's all. I just wanted to -- 19 SENATOR RANZENHOFER: Thanks, John. 20 COLLEEN BABCOCK: If I could just interject 21 on that a moment, we did get approved for the 22 25 beds, but we don't have them yet. We're waiting 23 for the young-adult treatment facility to be built 24 in Sanborn, which is going -- 25 SENATOR RANZENHOFER: That was the comment, 1 yeah. 2 COLLEEN BABCOCK: Yeah. 3 -- which is going to be -- or is designed to 4 meet the needs of the young-adult opiate-addicted 5 brain, 18 to 25. 6 We drastically need that facility to open. 7 And it was supposed to start in the fall of 8 this year. And I know that it's been pushed off a 9 little bit more. 10 But, again, any input that you can have in 11 getting that moved along would really, really help 12 our community. 13 We have, as I said earlier, 90 to 120 young 14 adults, 18 to 27, waiting on that list to get into 15 Horizon Village. 16 SENATOR BOYLE: Was that a funding issue or a 17 zoning issue? 18 Or do you know what the holdup is? 19 COLLEEN BABCOCK: I don't know exactly what 20 the holdup is. 21 AUGUSTA WELSH: I think it's a red-tape issue 22 with people who need to -- 23 SENATOR RANZENHOFER: Sounds familiar. 24 AUGUSTA WELSH: -- with people who need to 25 approve the facility. 1 It's not for lack of wanting to get it going. 2 SENATOR BOYLE: By "the people," you talking 3 about OASAS, on the state level? Or the -- 4 AUGUSTA WELSH: [Nods head.] Uh-huh. 5 SENATOR BOYLE: Really? 6 Okay. 7 SENATOR RANZENHOFER: Okay. 8 Well, that's something that we can easily 9 take a look at. 10 SENATOR BOYLE: Uh-huh. 11 SENATOR RANZENHOFER: A couple of ladies, two 12 or three back there. 13 We can go for about another, maybe 15, 14 20 minutes, maybe even a little longer. 15 But why don't we -- the people that want to 16 speak, why don't you actually all kind of migrate 17 over to the microphone. 18 ROSEMARY CHRISTIAN [ph.]: Thank you very 19 much. 20 I am Rosemary Christian [ph.] 21 I want to thank you. This was very 22 educational to me. 23 I want to say there are men and women that 24 have served our country. Thank you. 25 But this has happened for years and years. 1 Ever since the Vietnam war, my friends have come 2 back addicted. 3 Education, we need it, from second grade, on. 4 We need family structure. No doubt about it. 5 I want and I need an answer, as to why our 6 Governor or this state is possibly going to pass 7 marijuana? 8 Tell me, how can we? 9 SENATOR RANZENHOFER: Well, I appreciate your 10 comments. 11 We're not going to get into a -- you know, a 12 discussion. 13 ROSEMARY CHRISTIAN [ph.]: I'm trying to -- 14 SENATOR RANZENHOFER: I understand what 15 you're say. 16 ROSEMARY CHRISTIAN [ph.]: But the thing of 17 it is, here's our state representatives that are 18 possibly passing it for medical purposes, fine. 19 But it doesn't lead just to medical purposes. 20 Look at Colorado and what's happening there. 21 SENATOR RANZENHOFER: Yeah, and I understand, 22 actually, that's an issue that's being discussed 23 with the Legislature. 24 And we've had meeting rooms like this filled 25 with 300 people, saying that their babies need these 1 medical oils to cut their seizures from 150 a day, 2 down to 2. And they have a very, very compelling 3 story to tell, also, that they suffer every single 4 day, watching their kids go through these seizures, 5 any of which can kill them. 6 So, it's a complicated issue which is being 7 discussed right now. 8 I'm not sure what the resolution of that is 9 going to be. 10 You know, I've listened, and I know 11 Senator Boyle has listened, to both sides of the 12 story. And, you know, it's a very, very tough issue 13 that we are going to be dealing with. Not the 14 recreational use of it, but, medical use, and 15 whether there should be limited medical use for 16 children, you know, to stop their seizures. 17 So it's an issue, I appreciate your bringing 18 that up. And, again, it's something that's on our 19 minds every day as we're dealing with this issue, as 20 well. 21 ROSEMARY CHRISTIAN [ph.]: Like I said, 22 Senator, I can understand the medical issues of it. 23 But the fact that the recreational, no, 24 I can't. And it should have been stopped. 25 It just, apparently, seems like some of our 1 state legislators just don't have the balls to do 2 anything properly. 3 Thank you. 4 SENATOR BOYLE: We're not going to legalize 5 marijuana for recreational purposes, I can tell you 6 that. 7 SENATOR RANZENHOFER: That's not going to 8 happen. 9 Thank you, Rosemary. 10 Yes, ma'am. 11 CINDY B.: My name is Cindy B., and we lost 12 our son a year ago to heroin-fentanyl overdose. 13 I just wanted to speak about three different 14 things: 15 One, the education of physicians. They need 16 to know conditions, such as ADD, predispose people 17 to addiction. 18 The marijuana issue: My son was out of jail 19 and clean. He smoked marijuana with a friend. It 20 lowered his inhibitions. He came home and found 21 some pills he had stashed, and OD'd. We did not 22 have Narcan. We were able to save him that time. 23 We have insurance. It covered any program we 24 could have got him into. Fought tooth and nail to 25 get him in rehab several times. 1 Finally, we did get him into a couple 2 different programs. 3 Once, again, when he came out, there isn't 4 the support afterwards. You come out of rehab and, 5 there you are. 6 So, we also had him end up back in jail 7 again. 8 And after doing, I believe it was, like, 9 six months, and he was sober, and he did want rehab. 10 Unfortunately, he didn't have an active 11 addiction at that time. 12 So rehab, at a point in time when he was 13 clear and level-headed, that may have worked for him 14 because he was going into it willingly with a clear 15 mind. 16 It wasn't an option for him because he didn't 17 have a current addiction. 18 So I would like to see laws where, crimes 19 that are addiction-generated, they have a component, 20 after jail, where they do have to go to rehab, where 21 they can learn the skills to continue their lives 22 drug-free. 23 Thank you. 24 SENATOR RANZENHOFER: Well, thank you, Cindy. 25 MARY PHILLIPY [ph.]: Hello, my name is 1 Mary Phillipy [ph.]. 2 I'm here is a parent. I have five sons, two 3 of which are addicts. 4 My oldest son Anthony told me his first time 5 smoking marijuana was when he turned 11, in the 6 first month of being 11 years old. 7 By the time he was 15, he was addicted to 8 heroin. 9 At the age of 22, he had already had 10 three overdoses. 11 I sent him to a rehab. 12 After five days of calling around and trying 13 to find anyplace that he could get into in 14 Western New York, and I ended up taking him to a 15 place in Louisiana. It cost me $40,000 of our 16 life's savings. 17 He was there for 7 1/2 months. 18 In the first hour of leaving that bubble, he 19 was dropped off at the airport, to come home, and 20 his anxiety hit the roof so much that he went to the 21 bar with the $10 that they gave him. 22 So he relapsed within the first hour. 23 There was no recommendation of any 24 counseling, except for, that there was an open line 25 to them forever, if he needed to call. 1 Unfortunately, I wasn't -- still wasn't 2 educated enough to understand fully. And I feel 3 I should have been, because I lost my mother to 4 addiction. My brother is in the hospital dying 5 right now from liver disease to his heroin addiction 6 and alcoholism. 7 I have an 18-year-old who's addicted to 8 marijuana and alcohol. 9 Uhm, the gateway, marijuana, in my eyes, it 10 is a gateway. It's just that start of leading up to 11 more dangerous drugs. 12 When Anthony relapsed, I did the same thing 13 that I did the first time, only I -- instead of 14 calling around Western New York, I drove between 15 Western New York and Pennsylvania, for 48 hours, 16 trying to find him a place to go, because he asked 17 for help again. 18 Couldn't find a place to go. 19 I took him home, and his withdrawal was so 20 overwhelming for him, that he took off. Stole keys 21 took off, and he stole a dirt bike from our land. 22 I had to put him in jail. 23 I put him in jail. 24 And while he was in jail, I called the 25 insurance company, begging them to let him go 1 somewhere. 2 As a result of that, I took him out on his 3 23rd birthday. I took him to a 28-day rehab 4 which, again, was out of state. Not in state. It 5 was in Pennsylvania. 6 Within a week and a half of him being home, 7 he relapsed again to alcohol. 8 Four days ago he tested positive for heroin 9 and cocaine. 10 In the past month, he's lost 30 pounds, and 11 I'm at my wit's end. I don't know where to go from 12 there, because there is no place for -- I mean, 13 there's places to go, but they don't have the help. 14 28 days doesn't work. 15 And when you talk about the 28 days and 16 failing, you have to fail at outpatient before you 17 even get 28 days. 18 I had to fight for that over and over and 19 over again, and by the grace of God, I got him the 20 28 days; only, now, he's right back in the same 21 situation he was before, because the drugs are not 22 the problem for the addict. Reality is the problem 23 for the addict. It's the anxiety. It's the brain 24 damage that's caused by the heroin, or the other 25 drugs done before they get to the heroin. 1 He already had a mental disorder, the anxiety 2 and depression. And after doing the heroin, now 3 he's got an added brain disorder: brain damage. 4 So we do need a huge change. 5 I brought two readings that he wrote, so that 6 you can hear from the addict's point of view, from 7 someone who's in pain. 8 The first one he wrote in full addiction 9 while he was high. And the second one he wrote just 10 after he entered rehab and he was clean. 11 "Lord, tell me, will I ever be forgiven for 12 this life I'm living? 13 "It's so hard to see the sun from the bottom 14 of the grave. 15 "Will my eyes ever perceive Him? 16 "By demons I have always been driven. I've 17 run these tracks for so long, you know I've lost my 18 way. I've cut the flesh, the bone, the tendons, but 19 will I ever find redemption? 20 "Lost my soul so long ago, how will I carry 21 on? 22 "Although my hand the snake has bitten, I no 23 longer want to be my own victim." 24 This one he wrote after being clean. 25 "I'm feeling horribly sick. I'm sick of all 1 these feelings. They creep up from the floor and 2 crawl across the ceiling. They feed upon my soul 3 and my soul is depleting. 4 "My wrist forever scarred, my heart forever 5 bleeding, oh, so long ago I dug my trenches, and now 6 I don't care much for the body cleanses. 7 "I can walk a million miles, I may dig a 8 thousand feet, but will I ever find the happiness 9 that's right in front of me? 10 "Oh, so many times I've passed my trials, for 11 I'm still walking strong at a million miles, but my 12 feet are blistered raw and they're bloody to the 13 bone, and every step I take takes me further from my 14 home. 15 "Oh, so many times I've drowned my sorrows, 16 but tonight I wonder if I'll see tomorrow. 17 "Will the sun refuse to shine? 18 "Will I open my eyes? 19 "Will I see the light of day and will I still 20 feel all of this pain?" 21 SENATOR RANZENHOFER: Thank you, Mary, for 22 sharing that information. 23 Thank you. 24 How old is your son? 25 MARY PHILLIPY [ph.]: Twenty-three. 1 SENATOR RANZENHOFER: Thank you. 2 MARY PHILLIPY [ph.]: Thank you. 3 JEFFREY GRAY [ph.]: My name is Jeffrey Gray. 4 I'm a counselor at GCASA. 5 And, first, I'd like to thank you, Senators, 6 for being here for the forum today. 7 I guess what I've heard is, I don't know if 8 any new laws are going to help or change. 9 I think maybe regulation, insurance-company 10 regulations. 11 I echo the sentiments of previous speakers 12 that sometimes it just seems impossible to get 13 somebody into treatment. They have to fail at 14 outpatient. And sometimes failing for our people 15 means that they're dead. 16 I think Mr. Bennett mentioned we need more 17 Suboxone providers. 18 I think the regulations with insurance 19 companies need to change, where we can get somebody 20 into a long-term residential program, because it 21 seems to be what works best for opiate people. 22 I was sitting there, thinking, I remember, 23 I've been -- I've been with GCASA for a total of 24 10 years. And I think the first person that 25 I encountered that was an opiate addict, was a young 1 man, 18 years old, from Warsaw, New York. 2 And I don't even think I worked at GCASA. 3 I think I was just doing my internship through 4 Genesee Community College. 5 And I was just flabbergasted that this 6 18-year-old kid from a small little town, Warsaw, 7 New York, was addicted to heroin. 8 And I had many conversations with him, trying 9 to figure out did this -- you know, Where did you 10 start? And, you know, how did you end up being 11 addicted to heroin, from Warsaw? 12 It wasn't Buffalo or Rochester or 13 New York City. It was this tiny little town. 14 Ten years later, I have to tell you, I'm not 15 shocked anymore when I have conversations. 16 And that stinks, that I'm not shocked anymore 17 that there's 18-year-old kids from small little 18 hamlets in the middle of nowhere that are addicted 19 to heroin. 20 Again, sir, I just echo the statements, that 21 I think three things that we need are: 22 Better regulations with insurance companies 23 so that we can get somebody into long-term care; 24 More Suboxone providers; 25 And I think, more beds. We need more 1 long-term residential beds to treat these people. 2 Thank you. 3 SENATOR RANZENHOFER: Thank you, Jeffrey. 4 MIKE: Hi, my name is Mike, and I'm an 5 alcoholic. 6 Oh, I'm sorry. Wrong meeting. 7 [Laughter.] 8 AUDIENCE MEMBER: Hi, Mike. 9 [Laughter.] 10 SENATOR RANZENHOFER: That was pretty funny. 11 MIKE: Just a couple things I want to 12 mention. 13 I got straight in 1972 in Buffalo, New York. 14 And, I had a conversation with a guy who 15 worked in Gary's profession, and he encouraged me to 16 get some help. 17 And I ended up talking to a guy named 18 Dick Gallagher [ph.]. And Dick Gallagher sent me to 19 see David Mahoney, who was an attorney. 20 And David Mahoney put me in front of 21 Judge Doerr. 22 And, Judge Doerr sent me to a Presbyterian 23 minister, who ended up being my therapist. 24 And all of these people did one thing: they 25 talked to each other. 1 I couldn't lie to one and run to the other 2 one and lie to them. 3 In case you don't know it, addicts lie. 4 And I couldn't play anybody off against 5 anybody. Everybody talked. 6 Law enforcement has a real tough job. They 7 have to deal with my relapses. 8 Treatment providers have a hard job because 9 they have to find out what's the truth and what's 10 not the truth. 11 And it's a difficult job dealing with 12 addicts. 13 I just want to emphasize again, I'm a 14 recovering addict. 15 Law enforcement has a hard job; a real hard 16 job. I wouldn't want their job. 17 The other thing I want to mention to you, 18 just briefly, is that I noticed that when we stood 19 up and faced the flag, we said "under God." We all 20 did this morning. 21 Try to find the "G" word in treatment 22 anymore. 23 Try and find it. 24 You won't see it. 25 If you read the early literature of 1 Alcoholics Anonymous and Narcotics Anonymous, the 2 "G" word is through the whole book. 3 If you want to know why relapses are so bad, 4 go back to the original literature. 5 Faith has a great deal to do with recovery. 6 "Faith has a great deal to do with recovery." 7 I would encourage people -- and by the way 8 I'm not a pastor. 9 I would encourage everybody -- law 10 enforcement, Senators, everybody -- to look at the 11 early history of the recovery movement in the 12 United States. It was faith-based. 13 Faith has a lot to do with making people 14 well. 15 And, once again, we started the meeting today 16 with "under God." 17 Thanks a lot, guys. 18 SENATOR RANZENHOFER: Thank you, Mike. 19 A couple of final thoughts from the panel, 20 and then we'll wrap up. 21 I know that Senator Boyle has got to catch a 22 plane. 23 So, anybody want to add some final thoughts? 24 Sheriff. 25 SHERIFF GARY MAHA: Senator, just a comment 1 on the e-cigarettes. 2 I know one gentleman brought it up. I think 3 I heard it from one of the panel people. 4 I talked to Senator Gallivan about this back 5 in January because of the concerns we've had on this 6 same issue with, you know, dealing with 7 e-cigarettes. And this is the fad nowadays of young 8 kids. 9 If you go into these smoke shops on the 10 reservation, they have all kinds of flavors of oil 11 they can vaporize, and they're putting drugs in 12 there. 13 So I think there's something there that we 14 need to address as far as regulation of 15 e-cigarettes. 16 SENATOR RANZENHOFER: Thanks. 17 Any comments, Doc? 18 DR. BRUCE BAKER: I do. 19 It is difficult to get people in treatment. 20 But what is very frustrating, is some people 21 will get right there, but they just -- no matter 22 what you do, no matter what you say, they refuse 23 treatment. 24 And that is one of the most difficult things 25 to deal with. 1 Isn't that right, Mike? 2 COLLEEN BABCOCK: I will kind of interject on 3 that. 4 My son, my 19-year-old son, didn't go into 5 treatment willingly. He did not think he had a 6 problem. He thought life was fine. 7 And I was the driving force behind that for a 8 long time. But, we got to a point in our 9 relationship where we were able to set some clear 10 boundaries. And I have never, ever veered from 11 those boundaries. 12 And my son's clean today, for three years. 13 There's been ups and downs, but, somewhere along 14 that journey something clicked. Something clicked 15 with why he was there; why he was working that 16 recovery; with his faith. His faith changed and 17 grew. 18 You cannot expect -- and I'll say this a 19 thousand times over. I'll go to my grave with 20 it. -- you cannot expect a young adult, especially 21 in active addiction, to make a rational decision. 22 As a parent or a support, you need to make 23 those decisions for them. And you need to be that 24 driving force. And then you need to pray and hope 25 that something does click, because you're always 1 going to have people that are going to choose to 2 stay in addiction. They're going to choose to 3 never, ever change. 4 That's been through the course of history. 5 But you're also going to have those success 6 stories, like my son, who decided that life could be 7 different. 8 SENATOR RANZENHOFER: Thanks, Colleen. 9 JOHN BENNETT: Yeah, Colleen, I just want to 10 say, I mean, I agree with that. 11 I think that, on a huge level, you know, 12 people who are coerced into treatment do very well. 13 In fact, probably do better in long-term care; and, 14 because, something happens while they're in 15 treatment. 16 COLLEEN BABCOCK: Uh-huh. 17 JOHN BENNETT: And that's where the longer 18 stays help, because it's very difficult to -- you 19 know, to get it early on. 20 I mean, we know that denial is part of this 21 illness; and, so, it is just hugely important to 22 have people in longer treatment stays. 23 You know, we're all worried about the whole 24 redesign, the Medicaid redesign, which I know is 25 coming. And I think there's some opportunities for 1 us, hopefully. 2 But we all, we just don't know where that's 3 going to fall for our patients. 4 And so, I mean, I know that's been talked 5 about already today, some of the Medicaid stuff. 6 And so, hopefully, you know, all of these 7 types of facilities and types of treatments will 8 still be available a year or two years or five years 9 from now, I mean, because it's a continuum of care, 10 and we need all of them, so... 11 ASST. U.S. ATTY TIMOTHY LYNCH: Mike, I just 12 want to share one story. 13 You know, at the federal level, we're so 14 often focused on the major suppliers who bring 15 heroin into our area, and the doctors, and the 16 people who divert the drugs. 17 But in one instance, I had one of the 18 prosecutors in my office come to me and say: Hey, 19 I've got this witness, it's a young girl. She can 20 be a vital witness on this case that I have. 21 It's not somebody we would normally charge, 22 but, you know, he said to me, "She's got this 23 serious heroin addiction." 24 And she couldn't get the resources that were 25 needed for her to overcome her addiction. 1 So we eventually agreed, although we wouldn't 2 have charged her originally, we charged her just so 3 we could get her into treatment. 4 And, you know, it's not something we would 5 normally want to do, but we really saw it as the 6 only option. 7 And, you know, I know from -- I know some 8 people -- and I haven't heard it here, but some 9 people look at law enforcement as the problem -- you 10 know, one of the problems sometimes, or, we're 11 trying to arrest people, arrest our way out of the 12 problem. And I don't think that's the case. 13 You know, we -- in our system, you know, we 14 often send a lot of people to treatment programs. 15 We're not looking to incarcerate, you know, 16 the individuals who are addicts, but there really 17 sometimes is that forced or coerced treatment that's 18 necessary. 19 So... 20 COLLEEN BABCOCK: I commend you. 21 SENATOR RANZENHOFER: I think what we'll do 22 is, I'm going to just have Senator Boyle make a few 23 comments, and then I'll make comments. 24 And a number of us will be around for a 25 while, if there's anybody that wants to come up and 1 say anything or talk to us. 2 Although I know Senator Boyle has a plane to 3 catch, but I'll be here, and maybe some of the panel 4 members will, also. 5 So, Senator. 6 SENATOR BOYLE: Thank you, 7 Senator Ranzenhofer. 8 And thank all of you. 9 Just quickly, a comment about what Tim was 10 saying: We've heard that around the state, where 11 parents have actually been put in a position where 12 they had their children arrested, just because -- 13 just so they could get them the treatment that they 14 needed. 15 That is a system that truly needs reform, and 16 that's exactly what we're going to do here. 17 I do want to say that, I thank everyone. 18 The parents who have lost children, and those 19 that are in recovery, I give you my prayers and best 20 wishes. 21 And thank you for sharing your stories, 22 because this is going to make a difference, from the 23 panel today, from the audience. 24 I know we talk about, you come to a thing 25 like this and you think, Well, maybe a year from 1 now, or a couple years from now, it's going to 2 change. 3 I can tell you, with technology, that's not 4 the case, because as we were talking today, I was 5 texting my staff in Albany about ideas. And they 6 ran the ideas by the counsel in the last two hours, 7 and they actually drafted the bill and sent them 8 back to me a couple minutes ago. 9 So we actually have bills that are going to 10 be introduced next week, based on what was said here 11 today. 12 I thank you all. 13 Mike, I cannot thank you enough. This was a 14 wonderful forum. 15 Appreciate it. 16 SENATOR RANZENHOFER: Well, Senator Boyle, 17 I want to thank you for, you know, traveling here 18 from Long Island, and, you know, getting here at 19 two in the morning. 20 And, you know, I know that you've traveled 21 extensively across the state, from -- you know, from 22 Buffalo to Batavia, to Rochester, to Syracuse, to, 23 you know, all over the state. 24 And, you know, your advocacy and your 25 patience in helping to craft solutions to the very 1 serious problems that we kind of know about, but you 2 really don't appreciate until you hear about it, not 3 only from, you know, the members of the panel that 4 are up here, with law enforcement and with treatment 5 and with education. 6 You know, but for the folks that are sitting 7 on the other side of the dais, and, you know, 8 I mean, the courage that you have, and the bravery 9 that you have, to come up at a public forum and talk 10 about your -- you know, your personal tragedies and 11 your personal life stories, I don't know if it's 12 something that could I do. 13 So I want to thank each and every one of you 14 that have come here today and shared that with us. 15 Because, the objective is to try to do -- 16 from a legislative standpoint, to try to provide, 17 you know, some benefit, some solutions, to a very 18 humanistic problem, where, you know, you don't -- 19 you know, is there a law that you can pass that will 20 make a difference? 21 Well, hopefully, there is. 22 But, can a law solve everybody's problems? 23 Probably not. 24 But, you know, to listen to what we have 25 heard here today is going to be helpful. 1 You know, I know that Senator Boyle has been 2 working on the legislation. It's been a work in 3 progress. 4 And, you know, I know we wanted to hear from 5 everybody here, not only on the panel, but in the 6 audience, about how it's affected Batavia and 7 Genesee County, you know, Leroy, Pembroke, you know, 8 but our local community here. 9 So, thank you, Senator, for joining us here 10 today. 11 Thank you panel members for agreeing to take 12 time out of your very busy schedules and lives to be 13 here. 14 And, again, for everybody that has sat in the 15 audience, and either spoken or not spoken, you know, 16 thank you for being here today and sharing your 17 story with your presence, and then with your words 18 if you chose to speak. 19 So, thanks very much. 20 [Applause.] 21 (Whereupon, at approximately 12:01 p.m., 22 the forum held before the New York State Joint 23 Task Force on Heroin and Opioid Addiction 24 concluded, and adjourned.) 25 ---oOo---