Public Forum: Rockland County Panel Discussion on Heroin Epidemic in Valley Cottage and Surrounding Areas

PANELIST INTRODUCTIONS:PAGE 5 2

Ruth Bowles 3 Executive Director

Rockland Council on Alcoholism & 4 Other Drug Dependence 5 Louis Falco III

Sheriff 6 Rockland County Sheriff's Office 7 Christopher Goldrick

Director, Rockland Drug Task Force 8 District Attorney's Office 9 Investigator Jeanne Horan

Field Intelligence Officer 10 Rockland Drug Task Force 11 Nelson Machado

Human Resources Director and 12 Public Information Officer

Rockland Paramedic Services 13

Dr. Carol Slattery 14 Vice President, Detox for Outpatient

and Clinical Services 15 Daytop 16 William Warren

Judge 17 Rockland Family Treatment Court 18 Lisa Wickens, R.N.

Vice President 19 WHO Government Relations 20 Michael Zall

Attorney in Rockland County 21 A Parent 22

START OF PANELIST PARTICIPATION PAGE 7 23

START OF AUDIENCE PARTICIPATION AND Q&A PAGE 62 24 25 ---oOo--- 1 2 SENATOR CARLUCCI: Thank you for coming today 3 to the Senate Task Force on Heroin and Opiate 4 Addiction. 5 I'm Senator David Carlucci, and we have a 6 great panel here today. 7 We've been having these hearings throughout 8 the state, to really get everybody in the same room 9 to talk about the problems of opiate and heroin 10 addiction, to make sure that we get all areas of the 11 community on board to figuring out how we can solve 12 this problem. 13 I have with me today the Chairman of the 14 Task Force, Senator Boyle, who's from Long Island, 15 has come up today. 16 And I'll have Senator Boyle talk to you all 17 for a minute, and then we're going to have everybody 18 introduce themselves, and then we're going to get 19 into the specifics of what's happening right here in 20 Rockland County. 21 Senator Boyle. 22 SENATOR BOYLE: Thank you, Senator Carlucci, 23 and thank you for hosting this forum. 24 As David said, this is -- we're having 25 17 forums around the state, and they're very 1 informal. 2 As I asked today, we have a very 3 distinguished panel of law-enforcement officials, 4 treatment providers, some prevention experts, so 5 we'd love to -- I'm looking to get information, and 6 David as Vice Chair, as well, on the heroin and 7 opioid problem in Rockland County and the 8 surrounding communities. And also, from parents, 9 community members. 10 What I say at the beginning of this usually 11 is that, however this heroin epidemic has affected 12 your life, whether you're law enforcement, 13 treatment, a parent, an addict themselves, if you 14 said, "If I could change the law, or change a couple 15 laws, to make it better, to help us combat this 16 problem, in my family and my community," that's what 17 we're looking for idea -- today, ideas like that. 18 "This law would be great," or, "Right now the 19 law doesn't work, we need to get rid of that one." 20 So any input we would truly appreciate. 21 And thank you again, Senator Carlucci, for 22 hosting this forum. 23 SENATOR CARLUCCI: Great, thank you, 24 Senator Boyle. 25 And we're going to also hand out some 1 index cards, if anybody would like to ask a 2 question, or would like to come to the podium and 3 speak and share your story, we would love to have 4 you participate. 5 So with that, we're going quickly go through 6 the panel. They're all going speak a little bit 7 more at length later, but we want to make sure 8 everybody knows who's here. 9 So, let's start, we'll start down all the way 10 at the end, if we could introduce ourselves, just 11 briefly, and say where you're from. 12 NELSON MACHADO: My name is Nelson Machado. 13 I'm the human resources director and 14 public-information officer for Rockland Paramedic 15 Services. 16 LISA WICKENS, R.N.: Good morning. 17 My name is Lisa Wickens. I'm a registered 18 nurse, and a parent of a child in recovery. 19 At this point, do you want my go through my 20 notes, or you want to wait? 21 SENATOR CARLUCCI: A little bit later. 22 LISA WICKENS, R.N.: Okay. 23 SENATOR CARLUCCI: Thanks. 24 MICHAEL ZALL, ESQ.: My name is Michael Zall. 25 I'm an attorney in the county. And my son died from 1 an overdose of prescription drugs. 2 CHRISTOPHER GOLDRICK: My name is 3 Christopher Goldrick. I'm the director of the 4 Rockland County Drug Task Force. 5 I've been with the District Attorney's Office 6 for about 35 years now, and, you know, trying to 7 fight this epidemic. 8 SENATOR BOYLE: Thanks, Chris. 9 JEANNE HORAN: My name is Investigator Horan. 10 I'm with the Rockland Drug Force. 11 I've been employed by the Rockland Drug Task 12 Force for approximately 26 years. 13 I started out as an undercover. And I have 14 this new position as field intelligence officer. 15 RUTH BOWLES: Hi, good morning. 16 I'm Ruthie Bowles. I'm the executive 17 director of the Rockland Council on Alcoholism and 18 Other Drug Dependence. 19 DR. CAROL SLATTERY: Hi, I'm 20 Dr. Carol Slattery. I am the vice president of 21 Daytop for outpatient and clinical services. 22 JUDGE WILLIAM WARREN: Good morning. 23 My name is William Warren. I'm the 24 Rockland County Family Court Judge who presides over 25 the Rockland Family Treatment Court, which is the 1 court that takes care of child-neglect cases where 2 there's use of alcohol and drugs, or abuse of 3 alcohol and drugs. 4 And I've been a family court judge for 5 25 years, and I've had a lot of involvement with 6 young adults who were involved with the use of, not 7 only opiates, but other types of substances. 8 SHERIFF LOUIS FALCO III: My name is 9 Louis Falco. I'm the Sheriff of Rockland County. 10 I've been in the Rockland County Sheriff's 11 Office for 37 years, and I've never seen anything 12 like this in my history, as far as prescription 13 drugs and heroin in this county, around the state, 14 or around the nation. 15 SENATOR CARLUCCI: Great. 16 And, now, to get right into it, why don't we 17 start with Sheriff Falco, to give us some of the 18 things that you're seeing in the county, and bring 19 us up to date with some of the trends that you've 20 seen. 21 SHERIFF LOUIS FALCO III: I would like to 22 start off by saying, it's not only our county, but 23 it's the surrounding counties, including New Jersey, 24 and also Connecticut. 25 And, again, that's just because that's where 1 we are, but it's all over the nation. 2 Rockland County, last year, more than 3 12 overdose deaths; 4 Dutchess County, 19; 5 Broome County, 31; 6 Erie County, 31. 7 It is unbelievable. 8 And that doesn't even count for all the times 9 that there were saves. 10 In Broome County, this year, there have been 11 five Narcan saves. 12 Does everybody know what the "Narcan" is? 13 Okay, that's to stop exactly what's going on, 14 and reverse the overdose at that time, which all the 15 police officers in Rockland County now are being 16 trained in, as well as my corrections staff, 17 because, believe it or not, inmates are smuggling 18 stuff in, secreting it, and trying to sell it and/or 19 use it in our facilities. 20 So, you know, you wouldn't normally think 21 that a nurse or one of my correction officers would 22 have to have the wherewithal to do an overdose save 23 in our correction facility. 24 But it's not only here. It's in every one in 25 New York State. 1 It's not just the junkie that you saw in the 2 '70s, with a needle in his arm, in an alleyway. 3 It's the valedictorian of the class. It's the 4 captain of the football team. It's the captain of 5 the lacrosse team. 6 There's a statewide survey -- and in the 7 back, when you leave, I put packets out for anybody 8 that would be interested -- from a company called 9 nova.com. And they do all the research nationwide. 10 Cleveland, Ohio; 195 overdoses, just in 11 Cleveland. 12 In Connecticut, 10,183 people admitted for 13 treatment and heroin and unlicensed programs in 14 2013. 174 deaths. 15 Bergen County, this year, 14 deaths, just 16 till March 31st of this year. 14 deaths in our 17 surrounding -- in our adjoining county, in 18 Bergen County. 19 And in this -- and in this -- and, again, I'd 20 like you to get it in the back of the room -- when 21 you go to New York, here's how it reads: 22 New York: Heroin and prescription-painkiller 23 investigations have doubled in Rockland County, 24 New York, northwest of Manhattan. 25 Now, if that doesn't say it, nothing does. 1 We're so close to New York City. 2 And I have to take my hat off to 3 Chris Goldrick who does a phenomenal job with the 4 task force. 5 He and I went back about -- in 2010, which 6 was one of the first prescription-drug cases that he 7 did. And when we out and did our raids to scoop up 8 the people doing the sales, one of first houses on 9 the team that I went to, and I'm not going to give 10 an exact name, but, it was Sally from New City, and 11 her mother says, "You must be mistaken. She's up at 12 UConn." 13 The second house we went to was Sam in 14 Ramapo, and, "You got to be mistaken. He's out at 15 Ohio State." 16 So these kids, their lives were being 17 shattered at that time. Their parents just paid 18 forty and fifty thousand dollars for a semester of 19 school, who's -- also, their lives are being 20 shattered, because they want the best for their 21 children. 22 It's an epidemic here in Rockland County, and 23 surrounding counties in New York State, and 24 throughout the nation. 25 And I want to take my hat off, also, to 1 Senator Carlucci for starting these with fellow 2 Senators around the state. 3 We have to get to the parents and we have to 4 make them aware. 5 I also brought, for everybody's taking, it's 6 a parent's guide to being aware of what's going on, 7 when you're listening to your children, when you see 8 things on their texts, when you're seeing things on 9 their e-mails, the code words...things that are 10 going on that you should be aware of. 11 Just in Bergen County, just recently, there 12 was a mother that wrote an editorial into the 13 "Bergen Record," where every night her son came home 14 for dinner, her bedroom and his bedroom adjoined 15 each other, she would listen, and everything else. 16 And he died of an overdose of heroin. 17 So, it's here. Don't think it can't happen 18 to you. And it starts with the prescription drugs. 19 And, again, my hat off to Chris Goldrick when 20 we started this, taking back these prescription 21 drugs. 22 We average, in Rockland County, 700 pounds of 23 prescription drugs that are brought into the 24 Sheriff's Office and all the police departments 25 throughout Rockland County on an average of every 1 8 months. And we take them up to Dutchess County 2 and we have them incinerated because we don't want 3 them getting into our water system. 4 But I want you to think about it: 5 An Oxycontin pill in Rockland County, an 6 average of $90 a pill. And we're taking in 7 prescription drugs at 700 pounds every 8 months. 8 If that's not saying something, nothing is. 9 We got to keep taking these temptations. 10 You know, grandparents say, Well, what's the 11 big deal? 12 Well, their grandchildren are coming in and 13 going in their medicine cabinet, also. 14 When they're baby-sitting, they're going in 15 that baby-sitter's medicine cabinet, the people 16 they're baby-sitting for. 17 Their own parents. 18 And I would challenge anybody here, how many 19 people carry -- count their pills after they take 20 them in their prescription bottle? 21 I bet you nobody does. 22 Okay? 23 After you have a knee operation and you got 24 Percocet, Vicodin, oxycodone, right, you wouldn't 25 think your kids are going to -- do you count them 1 after you take each pill? I don't think so. 2 And the senior citizens, most importantly, 3 they pay for it, it's a high amount of money that 4 they're paying for that; and, therefore, they don't 5 want to give it up, they don't want to destroy it. 6 And it's sitting in their medicine cabinet; only, 7 that it's being picked on by their grandchildren and 8 others alike. 9 So I say to everybody: If you don't need 10 your drugs, please turn them in and we will destroy 11 them properly. 12 And don't think that it won't happen to you. 13 It will happen to you. 14 Thank you very much. 15 [Applause.] 16 SENATOR CARLUCCI: Thank you, Sheriff. 17 And just to -- I know that we probably have a 18 lot of questions for the Sheriff, but I also want to 19 start the dialogue. 20 We with us a few parents that are here, that 21 are brave to share their story. 22 And we want to thank you for being with us. 23 We have Lisa Wilkens [sic], and Michael who's 24 here, as well. 25 And if -- maybe if you guys want to talk to 1 us a little bit about your experiences, that would 2 really be helpful to us. 3 Michael, would you start? 4 MICHAEL ZALL, ESQ.: Sure. 5 I have some prepared remarks, because 6 sometimes I get very emotional about this. 7 Whenever I write or talk on the topic of drug 8 addiction, I give my credentials. 9 I wasn't supposed to do this. 10 My son Jeremy died a little over a year ago 11 of a drug overdose from prescription drugs. My 12 family suffered for close to 20 years with his 13 addiction. 14 During these years, I have written about the 15 disease, and thought about it extensively. 16 I've reached several conclusions that 17 I believe are relevant to the panel discussion. 18 Substance abuse causes, yearly, more deaths 19 in the United States than caused by the 9-Year War 20 and Vietnam War. 21 Every year more people die of substance abuse 22 than die in auto accidents. 23 These numbers do not begin to quantify the 24 suffering and damage to the family and friends of 25 addicts. 1 Although heroin has grabbed the headlines in 2 recent months, as said previously, it is only the 3 tip of the iceberg. 4 Feeding the heroin market are the vast number 5 of addicts addicted to prescription drugs, such as 6 Xanax, Clonopin, Valium, Oxycontin, Percocet, 7 Demerol, codeine, Adderall, and Ritalin. 8 Only some of these addicts turn to heroin 9 because it is less expensive and easily obtained. 10 A quote from an article: 11 In 2010, there were 38,329 drug-overdose 12 deaths nationwide, and, medicines, mostly 13 prescription drugs, were involved in nearly 14 60 percent of the overdose deaths. 15 Opioid drugs, such as Oxycontin and Vicodin, 16 were the biggest problem, contributing to 3 out of 4 17 medication overdoses. 18 My son Jeremy did not die from an injection 19 of overdose -- an injection of heroin. He died of a 20 cocktail of prescription drugs legally manufactured 21 and sold by pharmaceutical companies. 22 Like the tobacco industry, it's time for the 23 pharmaceutical industry to start contributing to the 24 prevention and treatment of drug addiction. 25 The pharma industry makes billions of dollars 1 from addictive drugs. 2 Purdue Pharma sells Oxycontin. Sales of this 3 drug are 2.5 to 3 billion dollars a year. They've 4 made over $27 billion since the FDA approved them, 5 I believe, in 1995. 6 This is only one of the numerous addictive 7 drugs sold. 8 Each drug has sales of hundreds of millions 9 or billions of dollars every year. A large portion 10 of these sales are sold to our children to feed 11 their addiction. 12 Several days ago, a lawsuit was filed in 13 Orange County, California, by two California 14 counties against five pharmaceutical companies for 15 hiding the addictive effects of opioid painkillers. 16 Hopefully, this is the beginning of a 17 groundswell to hold the drug companies accountable 18 for the devastation they have brought upon our 19 children. 20 Such actions are needed by New York State. 21 Hopefully, such lawsuits, combined with 22 legislation, obtain commitments from the 23 pharmaceutical industry to finance drug-treatment 24 programs, develop non-addictive versions of their 25 addictive drugs, and to contribute to prevention 1 programs through impactful advertisements and school 2 programs. 3 As demonstrated by the tobacco industry, 4 dramatic and impactful advertisements can go a long 5 way in preventing addiction. 6 With advertisements that show the horrible 7 effects of smoking, we teach our children not to 8 smoke. 9 It seems to be working. 10 We need similar ads and education programs 11 directed to the addiction problem. 12 My final point, is that addiction needs to 13 come out of the closet. 14 I realize there is a tremendous stigma 15 attached to having an addict in your family or as a 16 friend; however, those affected by the disease need 17 to openly discuss addiction. 18 When I read an obituary that says, "She put 19 up a brave and valiant fight against cancer," 20 I think about how many of our sons and daughters 21 also put up a fight against their drug addiction, 22 and have lost that battle. 23 Just do not see this in an obituary. It is 24 kept hidden. 25 The public, and more importantly, those that 1 have the power to change the addiction landscape, 2 need to know that tens of thousands of our children 3 are dying every year from addiction, and millions 4 are plagued by the problems surrounding addiction. 5 Similar to HIV and AIDS, a disease that had a 6 terrible stigma attached to it, we need the 7 addiction runs, the addiction walks, and the 8 addiction marathons, and the celebrity sponsors. 9 We need this public attention, not only to 10 raise money, to focus attention to the disease, so 11 that, like AIDS, treatment and prevention programs 12 can be put in place so that our sons and daughters 13 do not continue to die. 14 We wear, and put on our cars, the pink-ribbon 15 logos and wear pink to show that we care about 16 breast cancer. 17 We now need an addiction logo, a big "A," to 18 wear, and put on our cars, to tell the people: We 19 are affected by addiction. You can talk to me about 20 it, and I care about this issue. 21 Those affected by addiction, whether a family 22 member or the addicted, need to come out of the 23 closet. 24 Thank you. 25 [Applause.] 1 LISA WICKENS, R.N.: My name is Lisa Wickens. 2 I'm a registered nurse, and a mom. And I have spent 3 23 years in public service. 4 I spent 14 years working for Albany County, 5 as a registered nurse, and then 8 years at the 6 Department of Health as the deputy director for the 7 Office of Health Systems Management. 8 My job was helping others. My job was crisis 9 intervention for hospitals, nursing homes. Being 10 there after 9/11, setting up the bioterrorism units 11 across the state. 12 And, so, I worked for the Commissioner of 13 Health. And I could help all of those people, and 14 I could fix problems, but I couldn't help my own 15 child. 16 The reason I wanted to speak to everyone 17 today, and I want to just give you a few highlights 18 of what we've gone through, is really to highlight 19 some of the gaps in the system, so that, maybe, with 20 all of the information that the Senate Task Force is 21 gathering, this can be used as, possibly, some of 22 the solutions. 23 I also want to add another point, which is, 24 you know, we've heard a lot about prescription-drug 25 abuse so far today, this morning. 1 And, fortunately, or unfortunately, this has 2 been one of my battles for a long time. I take it 3 personally now. 4 I'm hoping that a lot of families will hear 5 those of you that have been affected, this will 6 help, you don't feel like you're alone. 7 And, also, that it's not just prescription 8 drugs. 9 I-STOP law passed, and has been in effect. 10 And basically what it does, is that people 11 that are looking for prescription drugs, if they 12 can't find them in the cabinet, they go to different 13 doctors to try to get the drugs they need. 14 What happened after I-STOP, is some of those 15 folks that were doctor shopping went to heroin. 16 The cost of a prescription pill out on the 17 street is, I can't believe, up to $90. 18 And, a bag of heroin's anywhere between 19 6 to 10 dollars on the street, and easy to get, and 20 kids aren't -- are comfortable with snorting it. 21 So, I just wanted to make that point, that 22 it's not just prescription drugs. There's a lot of 23 heroin out there. 24 And I'm hearing a lot of young people that 25 are just starting right with heroin. 1 So, this is just some highlights. 2 Almost ten years ago, my child demonstrated 3 potential signs of alcohol and drug use. 4 My pediatrician said: It's a phase. Give 5 him some room. He's 16. 6 One year later, at 17, my child exhibited 7 worsening symptoms of addiction, and I put him into 8 an outpatient treatment program. 9 There, he learned about opiates, he learned 10 about methadone, and there were pills for sale. 11 He got them. 12 The outpatient counselor, that was only a few 13 years older, said: You'll be back, you're not done 14 with this yet. You'll be back. 15 And my child said: This is how they actually 16 talk to people? Is that allowed? Don't you deal 17 with that in the department? 18 At that point we asked -- I asked for 19 inpatient treatment. 20 The insurance company said: Denied. Needs 21 to fail first. 22 All right. 23 My child graduated with honors from 24 high school. 25 College: Went away to college. Two weeks 1 in, long story short, he came home, he asked for 2 inpatient treatment. 3 Denied. 4 Started the local college. Overdose number 5 one. 6 "Miss Wickens, which hospital would you like 7 your child to go to? He's not breathing." 8 I was actually in Albany, working, dealing 9 with one of the Senators, actually. 10 Asked for inpatient treatment. 11 Denied. 12 We start medication-assisted treatment 13 through a local practitioner in Albany, 14 successfully. 15 Medication-assisted treatment is methadone, 16 VIVITROL, Suboxone. 17 Starts doing well. 18 M.D. says it's too difficult to work in this 19 state. They leave; goes back to Connecticut. 20 There's no more doctors around Albany County 21 that will -- that actually prescribe Suboxone. 22 Overdose number two. 23 Then family suicide. My stepson shot himself 24 in the mouth, at 25, after not being able to get 25 assistance for his addiction, that I didn't know 1 about. 2 And, I didn't share this at my previous 3 testimony, but they asked me to bring a ski cap with 4 me to go identify his body. 5 My child, in April, begs for inpatient. 6 Denied. 7 Finishes classes, finishes finals. 8 Begs for detox. 9 Denied. 10 I paid for two days. That's all they would 11 give him. 12 Finishes out that semester on 13 President's List. 14 Asked for inpatient. 15 Denied. 16 Reason: It's been nine months since his 17 outpatient. 18 Starts back on medication-assisted treatment, 19 counseling, Narcotics Anonymous, 20 Alcoholics Anonymous. We're all going to 21 counseling. 22 Things are -- I can't even explain the amount 23 of stress on my family, and my friends, and my 24 colleagues, and the people that I was going to in 25 the Legislature that were listening. 1 I left the Department of Health, because 2 I couldn't afford, with the best insurance, working 3 for the state government, they would not get my son 4 help. 5 He relapses and gets kicked off of Suboxone, 6 first time. 7 Overdose number three. 8 That's just a glimpse; a glimpse of what it's 9 like. 10 So where are the gaps? 11 Public-service announcements, I agree with 12 Michael completely. 13 I drove my son to Pennsylvania, after getting 14 the money, and quitting government service, where 15 I thought I was doing a really good job, so I had 16 enough money to get my son inpatient treatment. 17 On the way to Pennsylvania, I saw billboards 18 that were saying: Prescription drugs, addicted, 19 just as bad. 20 And that they're really powerful, just 21 billboard signs. 22 I come back and I called my friend 23 Senator Hannon from Long Island, and said: What is 24 going on with us? We've got some really scary 25 tobacco/smoking commercials. 1 You guys have all seen them, where she takes 2 her teeth out and puts her wig down, and all that 3 stuff. 4 Right? 5 We need those for this. 6 That was three, four years ago. 7 Now, we do have money. We put money in 8 budget for PSAs. 9 The problem is, who watches TV now? 10 They're watching Netflix. They're watching 11 stuff on -- they're not watching -- they're not 12 watching television, so we've missed that 13 opportunity. 14 There's no billboards. They're not there. 15 Next gap: Insurance. 16 I had great insurance. I worked for the 17 Commissioner of Health. I oversaw every hospital, 18 nursing home, and home-care agency in the state. 19 They reported up to us. 20 But, yet, I couldn't get help for my kid, 21 because the insurance denied him. 22 So he had -- and the other thing is, you're 23 going to deny him? What's "failure"? Death? 24 Because that's what happens. 25 So how much more money does it have -- if he 1 doesn't actually die, what -- how much more Medicaid 2 or money does it cost if the child doesn't die and 3 ends up on the ventilator for life? 4 You have to pay that. 5 Another gap, huge gap, because a lot of 6 families will tell you: I had to kick my son or 7 daughter out so they could get put on Medicaid, then 8 they'll get into some treatment. 9 Another gap: Doctors, pediatricians. 10 I went to my pediatrician. 11 I tried to find somebody that actually, you 12 know, knew how to help. 13 I worked in the Department of Health. I knew 14 every doctor. 15 I had the Office of Professional Medical 16 Conduct that also reports to me. 17 I actually had the Bureau of Narcotics 18 Enforcement in my division. 19 And I couldn't get help. 20 The pediatricians don't know how to deal with 21 it. They send them to another counselor. 22 They go to counselor, and the counselor 23 treats them like an adult. Or, they put them in 24 outpatient treatment. 25 Well, I'd love if my son could tell you about 1 outpatient treatment. 2 Outpatient treatment meant, I learned about 3 better drugs, better outcomes, easier ways to get 4 it, how to crush, how to snort it, how to inject it, 5 before heroin. 6 And, the counselors who are supposed to be 7 experts -- 8 No offense and no disrespect to anyone that's 9 in this field because I have the utmost respect for 10 you. 11 -- but this counselor, this one individual, 12 my son came back and was, like: What is this about? 13 Like, this is -- this is -- this is okay? 14 Another gap: There's no -- there's no -- 15 there's lots of doctors out there that are certified 16 in medication-assisted treatment, but they don't 17 prescribe, because they don't want the addicts in 18 their patient waiting rooms. 19 Or that's what people -- some parents have 20 told me. 21 I will tell you, that's not completely the 22 truth. 23 The truth of the matter is, they don't get 24 reimbursed enough money to get someone started on 25 medication-assisted treatment, because you're not 1 just dealing with, you know, one disease. You're 2 dealing with a disease that affects all elements of 3 a person's life. 4 Their social skills, their activities of 5 daily living, how they learn, how they grow, how 6 they develop. 7 If they start at age 16, they stop developing 8 at age 16 if they start using then. 9 So then you stick them in a group, with 10 people that are 19, 20, 22, and you want them to all 11 talk about what's going on. 12 How many kids do you know, teenagers, are 13 going to sit there and talk about their feelings in 14 front of a group of people? 15 They're not -- it's not going to happen. 16 That's the solution. 17 Then, when you do actually get some 18 treatment, and you save the money, or you get a 19 home-equity loan, to put your kid in another state, 20 their days are like, this: 21 Get up, make your bed. Go to a group 22 meeting. Have breakfast. Go to a group meeting. 23 Free time for about an hour and half, where you walk 24 the grounds. Then you go back to a group, a town 25 hall meeting. And then you all go out on a bus and 1 you go to an NA or AA meeting. 2 And they get paid for that. 3 So, the gaps, I mean, I can go on; the list, 4 I could go on forever. 5 You know, the schools, the education. 6 You know, getting parents involved, and 7 saying: Well, I live in an upper-class or 8 middle-class suburban school. 9 So did I. 10 I'm a nurse. My kids knew about AIDS before 11 they went to preschool. They knew about how to wash 12 their hands, don't touch blood. They knew -- they 13 know it. 14 My one son's actually in his fifth year of 15 pharmacy school; so, trust me, I get it. 16 What I'm hoping from today is you'll hear 17 some of these gaps, and that we'll get some 18 solutions that will really start to attack this 19 problem. 20 This problem is not new. It's been around 21 for ten years. 22 It started with prescription drugs, it's 23 heroin, and, it's just -- it's gotten worse. 24 So I'm hope something people will actually 25 hear some of these things today, and not feel alone. 1 Some of you will actually know kind of where 2 you can go. 3 And I'm always available to talk. 4 And that we'll get some solutions from the 5 government, that's going to help and make some of 6 the changes happen. 7 Thank you. 8 [Applause.] 9 SENATOR CARLUCCI: Thank you, Lisa. 10 Now let's hear from Judge William Warren. 11 And then, maybe, Carol and Ruth, if you guys 12 want to jump in with the work that you do, if we 13 could, that would be great. 14 JUDGE WILLIAM WARREN: Thank you, Senator. 15 I'll just give you a little background. 16 In Rockland County, I started the 17 Rockland Family Treatment Court in the year 2001, 18 because I had parents in treatment, in the courts, 19 involved with child-neglect cases, who, during the 20 course of their being in treatment, during the 21 course of they're being in the courts, actually died 22 as a result of their disease. 23 At the time it was alcoholism and crack 24 cocaine. That's what was going on. 25 More recently, obviously, it's shifted a lot, 1 and now we see a tremendous amount of abuse of the 2 prescription medications. 3 I've got a couple of key points that 4 I thought I wanted to make today. 5 One is, I think it's so important that the 6 education of this problem start at a young age. 7 That the schools really begin to attack it in a much 8 more proactive way than what I think has been going 9 on up to now. 10 I think the kids need to know at a very early 11 age, what the potential risks are, what the problems 12 are. 13 And I think that's part of what may help in 14 this area. 15 I think, I've seen in the courts so many 16 situations, where doctors are prescribing 17 medications for kids without, I think, the 18 understanding of the potential risks of prescribing 19 those medications. 20 And, I've seen so many kids who become 21 addicted to these medications, partly because 22 they're getting them illegally from their parents or 23 their grandparents, as was mentioned before. But 24 also because, they're prescribed by physicians for 25 them far too easily -- 1 Pardon me. 2 -- in my view, far too easily. 3 AUDIENCE MEMBER: Say it again. 4 JUDGE WILLIAM WARREN: So many -- 5 AUDIENCE MEMBER: Say it again. 6 JUDGE WILLIAM WARREN: So many of the 7 individuals who I see started out innocently enough, 8 because they had a problem, a back problem, this 9 problem, and they start out by getting prescription 10 medications from physicians, who may be 11 well-intentioned, but I don't necessarily think they 12 have enough education in the field of addiction to 13 properly prescribe these medications. 14 [Applause.] 15 JUDGE WILLIAM WARREN: More recently, 16 I attempted to find out, in Rockland County, whether 17 we had doctors who are actually certified as 18 addiction specialists. 19 And, actually, Dr. Slattery, who's sitting 20 alongside of me, and I had some correspondence about 21 that. 22 And I was actually only able to locate 23 two physicians who work in Rockland County who have 24 certification as an addiction specialist. And one 25 is affiliated with Nyack Hospital, and one is 1 affiliated with Blaisdell. 2 But in the general practice of physicians in 3 Rockland County, this certification doesn't exist. 4 So if you want to go to someone for neurology 5 or for surgery, you will often want to see it as 6 board-certified physician in that field. 7 If you have a problem in terms of addiction, 8 it is very, very difficult to find a board-certified 9 physician in the field of addiction. 10 And what I've been told by people who have 11 gone through medical school, is that in your 12 ordinary medical education, you really don't get any 13 significant experience or education with regard to 14 the problems of addiction. 15 Now, addiction was recognized probably 16 50 years ago by the American Medical Association as 17 a disease. 18 Nonetheless, there are very few physicians 19 who actually have the level of education necessary 20 to treat the many, many thousands of people who walk 21 in their doors these days with addiction problems. 22 So that's another area I think that needs to 23 be looked at: More physicians who specialize in the 24 field of addiction. 25 The availability of treatment is a common 1 problem. 2 What the woman at the other end explained 3 here, I see all the time. 4 We try to get people into various types of 5 treatment in my court, and, oftentimes, insurance 6 denies. 7 They have to go back to outpatient again. 8 They have to try again, they have to fail again, 9 before they're eligible to go into a higher level of 10 care. 11 So that's another problem that really needs 12 to be looked at. 13 The pharmaceutical industry, as Mike Zall 14 said before, they profit enormously from these 15 medications. They absolutely must make billions of 16 dollars from these medications. 17 Where's the responsibility for the education; 18 to provide the community education? 19 To put some money into helping prevent the 20 problems that these medications are causing? 21 Someone mentioned the smoking ads, which are, 22 I think, excellent. Hopefully, they do deter 23 people. 24 Something similar should be done with regard 25 to this problem. 1 And, lastly, I guess what I would like to 2 mention is that, there is a stigma with this, this 3 disease. There's a terrible stigma. 4 And it was back, I think it was in the -- 5 probably the late '80s, when there was a terrible, 6 terrible stigma with the HIV and the AIDS problem. 7 And the community involved there came out and 8 said: We're not going keep it quiet anymore. We're 9 not going have it behind closed doors. 10 And they came out, and they marched, and they 11 demanded. And our legislators responded to that and 12 provided lots of assistance to deal with that 13 problem. 14 I think something similar has to happen today 15 with regard to the addiction epidemic. 16 And that's what it is: It's an epidemic that 17 we're experiencing. 18 [Applause.] 19 SENATOR CARLUCCI: Great, thank you, 20 Judge Warren. 21 Dr. Slattery, do you want to go? 22 DR. CAROL SLATTERY: Yes. 23 I want to actually first start off talking 24 about statistics, what outpatient has been looking 25 at since 2008. 1 So, in 2008, we had almost 12 percent of our 2 population coming in for admissions with heroin or 3 opiates. And it was mostly opiates, not heroin. 4 The primary substance was alcohol and marijuana. 5 From 2012 to current, although alcohol and 6 marijuana still is a primary problem, the primary 7 substance coming in, 34 percent was heroin. 8 Opiates, in 2012, was the main admission. 9 So in outpatient, with the regulations, you 10 know, from OASAS, and looking at, you know, 11 clinically, what needs to get done, there was a 12 change that was mandated through SAMHSA, through 13 OASAS, saying that we need to really look at 14 addiction differently, and we need to make sure that 15 outpatient programs are using outcomes, are using 16 evidence-based practice. 17 And just recently, they're really, full 18 force, asking the programs to change, and to really, 19 actually mandate it. 20 So you as a family member or a referent have 21 the right to ask what the outpatient program is 22 doing clinically. 23 What type of groups? 24 Are we looking at mental health and addiction 25 separately, and combining if they need to be 1 combined? 2 And if so, mandate something to be done. 3 So I agree with outpatient, and what you were 4 saying, that it has been a struggle. 5 When I first came to Daytop three-plus years 6 ago, I saw that -- you know, that therapeutic 7 community model was not really going to effectively 8 help your heroin-addicted individuals, or even 9 anyone is a dependent on a substance. 10 And we've been trying. 11 So outpatient is evolving in that end. 12 Another area that needs to be looked at is 13 managed care. 14 A year ago I was in Albany, and we were at a 15 lot of forums there with ASAP. And we had all the 16 treatment providers and prevention. 17 And we were told that, because of managed 18 care, the smaller providers are no longer going to 19 be existing. That because managed care is changing, 20 and APG rates are changing, and deficit funding that 21 helps our programs survive, is with -- by 2016, is 22 going to be a totally different world. 23 So, you have to really be mindful, and look 24 at the programs, and see what's going happen in the 25 next couple of years, because it is very scary to 1 see. 2 Another thing that I'm noticing, when I'm 3 looking at the young adults in the adolescent 4 population, is mandations with families and with 5 courts. 6 We have a school program in Rockland County. 7 We also have an adolescent program. 8 We're taking children at 12 years old with 9 addiction. 10 Although they're not coming in primarily with 11 heroin and opiates, they are, you know, down the 12 road, start experimenting. 13 Our young adult population is really looking 14 at the heroin situation and the epidemic. 15 What's concerning me is, the collaboration 16 with a treatment provider and schools, it's not 17 happening. 18 Our schools really need to come aboard, and 19 say: We have a serious problem. 20 And they're the first point of access, along 21 with the families. 22 Because, we -- we have this huge epidemic 23 that we're talking about, but our admissions has not 24 increased so significantly. 25 We had a 12 percent increase from a year ago. 1 So where are these individuals going for 2 help? 3 So, as long as, you know, courts are tied and 4 they can't help the mandation through the 5 adolescent, and schools aren't mandating, the 6 treatment provider gets tied, their hands. 7 And, with the insurance company, I have seen 8 that they want five denials. 9 And to piggyback on what you were saying is, 10 with that denials, you have to be in a program for 11 some longevity. You can't show up at outpatient, 12 stop a month from now, consider that treatment, and 13 then ask for inpatient. 14 They want you to be in level of care. 15 So they want you in an intensive outpatient 16 program for about six weeks, which you're coming 17 almost every day, you know, a minimum of nine hours 18 a week. Then they want you to drop down to your 19 regular groups, or individual counseling sessions. 20 They want you to relapse, and I -- at least 21 five times. 22 Unless you have mental health, or you're 23 mixing a benzodiazepine with alcohol and it's 24 medically going to be a problem, we have a very hard 25 time getting individuals in. 1 And as an outpatient provider, we are very 2 savvy in how we're trying to speak about this 3 client, and we try to personalize it. 4 The insurance -- the private insurance 5 companies, very rigid. 6 And I have to agree, it's something that 7 needs to be looked at. 8 So as an outpatient provider, what we do is, 9 we try very hard to look at them individually, put 10 them in different programs, try to see what the 11 person needs, and really work with the insurance 12 companies, which is a struggle. 13 With I-STOP, I have seen a big increase in 14 helping with the doctor shopping in the last 15 six months. 16 Since July of least year, we have been able 17 to really cut down on individuals when we're 18 prescribing. 19 And as I -- Judge Warren and I spoke about, 20 I am very passionate that our psychiatrists be 21 specialists in addiction medicine. 22 And what we do is, before we even prescribe a 23 client, we are mandated; we run that I-STOP to see 24 if they bought a prescription somewhere else. 25 And if they do, we do not prescribe. 1 And if we have a release to talk to that 2 doctor, we call the doctor who's prescribing. 3 We are very serious on that, because it is 4 becoming a problem. 5 Pain management: Individuals coming in with 6 pain management is on the rise. 7 It is -- it is egregious to the individuals 8 coming in, on their medication, and when they know 9 that they're in an outpatient program, they still 10 are prescribing. 11 It's really not helpful at all. 12 But I-STOP is helping, so everybody needs to 13 know, in New York. 14 Obviously, if our clients what to go to 15 Connecticut or New Jersey, we're limited on that 16 end. 17 And, toxicologies, you know, making sure that 18 we're toxing on a regular basis to see, if we are 19 prescribing maintenance, that they actually are 20 taking it. 21 So that's really, pretty much, where 22 outpatient is at, clinically, and also medically. 23 SENATOR CARLUCCI: Great. Thank you, 24 Dr. Slattery. 25 [Applause.] 1 RUTH BOWLES: The Rockland Council on 2 Alcoholism and Other Drug Dependence is part of a 3 network. 4 First of all, we belong to the Council on 5 Addictions in New York State. We're 36 councils 6 across the state of New York. 7 And we're also members of the Association of 8 Substance Abuse Providers of New York State. 9 The Rockland Council is also a network of the 10 National Council on Alcoholism and Other Drug 11 Dependence, which are 98 councils across the 12 United States of America. 13 And, though we're talking today about the 14 heroin- and opiate-addiction epidemic, we've seen -- 15 the councils across the United States, and the state 16 of New York, have seen this escalate since the 17 1990s. 18 This is not new. 19 When I was a council -- when I worked for a 20 council in Orange County, beginning in 1999, we saw 21 influx of this happening. 22 I made a lot of points that I wanted to talk 23 about, but most of them have been covered. 24 And I'll talk about our role as prevention 25 agency in Rockland County, across the state, and 1 across the United States. 2 Funding opportunities are greatly needed for 3 school-based prevention programs; however, as of 4 right now, school districts across Rockland, across 5 New York State, are being asked to leave the 6 school-based prevention that we're doing because of 7 Common Core. There's no room in school districts 8 anymore for drug prevention. 9 And I've been in the prevention field for 10 over 20 years now. 11 The other piece that I want to bring up is, 12 that we also do family support, and we see families. 13 And you've heard the compelling testimonies 14 of two family members. 15 They are in intense fear. They are 16 completely frustrated. 17 I can't even begin to imagine what it's like. 18 We hear every day at the council, people who 19 come to us, ask for a referral of treatment, and get 20 denied. 21 These denials are death sentences. 22 And I want to talk about the -- we do 23 recovery services, as well. 24 I am a woman in long-term recovery. I am the 25 end result of many years of abstinence. 1 I have gone through intense stigma, 2 discrimination, because I am a woman in long-term 3 recovery. 4 But this is, addiction recovery is a lot 5 different from active addiction. And people need to 6 see the faces of addiction recovery. 7 That's why I'm very up front with my 8 recovery. 9 It is a long process. 10 I am a White woman. I was wealthy. I was a 11 vice president of a bank, a large bank. I had my 12 home -- my house, my car, my keys, my money, and it 13 was still extremely difficult for me to recover. 14 It's a long process. It is a person-centered 15 process. 16 And when our people are coming out of 17 comprehensive -- what we would hope is comprehensive 18 treatment, there's no safe or healthy environments 19 for them to go. 20 In Rockland County, we have 1 halfway house, 21 that has 12 beds for women, and I think 18 beds for 22 men. 23 We have constant calls, for those people 24 coming out of short-term treatment, for halfway 25 houses. 1 There are very few halfway houses across 2 New York State. 3 And, I also want to talk about the 4 inequality. 5 We've been fighting, and I've been fighting, 6 for treatment parity; the inequality between 7 treating other medical diseases and addiction 8 disease. 9 We've heard that today. 10 But the stigma and discrimination against 11 those who suffer from substance abuse continues to 12 prevent effective people from getting the help they 13 need. 14 I know, and I respect the fact that the 15 New York Senate right now are doing these Task Force 16 across the state of New York. And I have been part 17 of them, I've listened to them. 18 I know we've received countless testimonies, 19 countless statistics, and data, related to sales, to 20 overdoses, and to deaths. 21 But I've heard testimony from all the sectors 22 of the community; the most compelling being those 23 families who have lost their loved ones to this 24 disease. 25 So, I hear these Task Force hearings. 1 I hope that the testimony and the data will 2 be utilized to rebuild and to restore our 3 communities that have been so violently ravaged by 4 heroin and opiate addiction since the late 1990s. 5 As the executive director of the 6 Rockland Council, I have a responsibility to the 7 community to listen to these needs. 8 And we are a very small agency, who have seen 9 the escalation of families; these families who just 10 do not know what to do. 11 And I've heard, you know, compelling 12 testimony across the state. 13 So -- and, again, in order to get back into 14 our school-prevention programs, we're going to need, 15 you know, some -- some funding and opportunities to 16 be able to circumvent Common Core. 17 SENATOR CARLUCCI: Well, Ruth, thank you so 18 much. 19 [Applause.] 20 SENATOR CARLUCCI: We're going to shift over 21 to our law-enforcement side. 22 And to kick that off, we'll hear from 23 Sheriff Lou Falco. 24 And then we're going to have questions from 25 anybody here, and have some people with some 1 statements from the audience that's here. 2 Sheriff Falco. 3 SHERIFF LOUIS FALCO III: Yeah, a couple of 4 things. 5 I just want to touch on, I'll jump off from 6 where she ended. 7 I personally believe D.A.R.E. is a good 8 thing, but I also believe D.A.R.E. is done -- it 9 should be done a second time, in the eighth and 10 ninth grade, because I don't think, when it's in 11 fourth and fifth grade, the kids are impressionable, 12 and they look at the police officer and they like 13 the uniform and they make an attachment to us. 14 But then, they go off, under the peer 15 pressure, and everything else that's happening. 16 And I honestly believe that a different form 17 of D.A.R.E. in an education process, not only for 18 the children, but for the parents, should happen in 19 the eighth and ninth grade. 20 And I'd really like to push something down 21 the road for that, because of the awareness piece 22 that you're speaking of -- 23 RUTH BOWLES: Yeah, Sheriff, I just want to 24 let you know that there's evidence-based programs 25 that provide a continuum of prevention services, 1 from Head Start, all the way up to, you know, 2 senior high school. 3 However, there's been absolutely no funding 4 for prevention programs, and no ability to get in 5 the school districts. 6 [Applause.] 7 SHERIFF LOUIS FALCO III: But that piece has 8 to include the parents, too, because the parents 9 have to have -- 10 RUTH BOWLES: Absolutely. 11 SHERIFF LOUIS FALCO III: You know, when 12 I listen to the nurse down at the far end -- and I'm 13 sorry, I don't remember your name -- with all the 14 passions that she put into her own family, as well 15 as coming from where her profession is, she was 16 willing to pay on her own, but she couldn't get them 17 in. 18 We have to get the parents involved. 19 You know, in our correction facility -- and 20 I do a lot of gauging from that, also, since 21 I became Sheriff -- 52 to 55 percent of our inmates 22 have a drug or alcohol dependency, okay, which 23 creates that recidivism, that they just keep coming 24 back and coming back. 25 And in New York State -- and this is no shot 1 at government -- but in New York State, we've shut 2 down so many mental-health facilities and so many 3 other avenues for people to get help at, that it 4 becomes the correction facilities -- the county 5 correction facilities throughout the state are 6 becoming those facilities. 7 And, either way, the taxpayer is paying. 8 They're either paying in our local jail, or 9 they're paying for an outpatient or inpatient 10 mental-health facility. And it just keeps going 11 over and over again. 12 And some of the questions I have my 13 correction officers ask, when somebody comes in and 14 they were arrested on drugs, we get to, you know, 15 know, "What makes you do it?" 16 And their answer always is: We're always 17 chasing the first high. 18 "We're chasing the first high." 19 But nobody's there to stop anything to happen 20 after that first high. 21 We can only do so much in local government. 22 You can only do so much in state government. You 23 can only do so much. 24 But I think there has to be a coordinated 25 effort between all governments -- state, local, and 1 federal -- for us to beat this problem, because this 2 problem is not going to go away, like, crack evolved 3 into -- crack evolved into prescription drugs, and 4 now our kids are at $5 bag of heroin. 5 And it's just -- it's just not -- I don't see 6 it going away anytime soon. 7 So, I'm passionate about it. 8 I know, and I won't speak for Chris Goldrick, 9 I know he is, the District Attorney is, the police 10 chiefs in Rockland County are. 11 We're one county in a big nation, and in a 12 big state. 13 I also think that the penalties for people 14 selling drugs, that are causing this to happen to 15 our children, should be increased. 16 And I believe that's a legislative issue that 17 we should continue to speak about. 18 The penalties have to be increased, as a 19 deterrent. 20 Because, if not, New Jersey, if you -- if 21 there's a nexus between you selling somebody heroin 22 and them dying, you go to jail. 23 In New York State, that's not the case. 24 And I've given that legislation to Senator -- 25 I mean, Assemblyman Zebrowski, which I'm sure, at 1 some point, he will share with his fellow colleagues 2 in both the Senate and the Assembly. 3 We have a very liberal state. 4 We have to get away from that mindset if 5 we're going the save our children. 6 And our children are the future. I can't 7 stress that enough. 8 So I say, I'm willing to come out and speak 9 at any forum. I'm willing to come out and speak at 10 any PTA meeting, any school district, any town-board 11 meeting. 12 And I'm sure my colleagues in law enforcement 13 will do the same. 14 We have to drive this home: It's got to be a 15 partnership between government, law enforcement, and 16 the parents in every community in order to be 17 successful. 18 SENATOR CARLUCCI: Thank you, Sheriff. 19 [Applause.] 20 SENATOR CARLUCCI: Yes, and we also have 21 Chris Goldrick and Officer Horan from the 22 Rockland County Task Force. 23 CHRISTOPHER GOLDRICK: Thank you, Senator. 24 You know, just going back, I started in -- at 25 the drug task force back in 1979, and I was 1 undercover for 4 years. 2 And, then I went back to the drug task force 3 after serving the District Attorney back then in the 4 main office. I went back to narcotics in 1988, and 5 I've been there ever since. 6 In 1988, you had that huge crack-cocaine 7 epidemic, and our numbers were astronomical back 8 then. And it -- you know, it went on for quite a 9 few years. 10 When I took over the drug task force about 11 four years ago, I enlisted some more federal and 12 state agencies to come on board with us. 13 So now we're working more and more with the 14 Drug Enforcement Administration, their diversionary 15 unit, where all they do is go after and investigate 16 doctors and pain-management doctors and pharmacies. 17 We're working with Homeland Security more and 18 more. 19 We basically do street-level cases, and we're 20 seeing a lot of them. A lot of prescription drugs. 21 I'm seeing more prescription drugs in Rockland than 22 I ever have. 23 We're seeing more prescription drugs, but 24 we're starting to see that surge of heroin coming 25 through with our street-level buys. 1 Prescription buys, street-level buys, are 2 happening in open-air markets; and I mean that by, 3 our strip malls, our malls, in the county. 4 Back when I was -- back when I was an 5 undercover, and even after that, in '88, when we 6 went back and we were locking up a lot of guys for 7 the crack cocaine, you had everybody standing on 8 corners. 9 Nobody stands on corners anymore. We don't 10 see it. Society doesn't see it. 11 Everybody is communicating by phone, they're 12 texting. 13 There's huge networks out there, and that's 14 what we go after; that's what our task force is 15 about: To go after the networks, get these people 16 out. 17 We work a lot with the street-crime units in 18 Clarkstown, Orangetown, and Haverstraw. We work 19 with them almost on a daily basis. 20 There are a lot of users that are just 21 running to street corners, and we're picking up 22 those users, and they're going to drug court, 23 they're getting treatment, because that's where they 24 belong. They don't belong in jail. 25 But, you got some serious drug dealers out 1 there that have elevated themselves, from selling 2 the crack cocaine and the network that they had with 3 crack cocaine, now they have a network that is all 4 prescription drugs. And they're coming into the 5 communities of Orangetown, Clarkstown, Ramapo, 6 Suffern, where they weren't before. 7 Now they're there. They're in the schools. 8 And like I said, it's a network. It's 9 technology. 10 It's another huge piece to our investigative 11 means and how we do things. And we enlist the help 12 of our federal agencies to supply us with 13 technology, which they had, they do have money. 14 And we try to, you know, glean from them: 15 What do they see in other areas? What are they 16 seeing in Nassau, Suffolk county, 17 Westchester County. 18 We're seeing it here in Rockland, more and 19 more than ever. And it's very alarming. 20 I don't want to take -- I can go on and on, 21 but I don't want to take up everybody's time. 22 I know there's -- there may be some questions out 23 there. 24 SENATOR BOYLE: Officer Horan, did you want 25 to add to that? 1 JEANNE HORAN: I, too, was an undercover. 2 For about five years, I was out on the streets 3 years. That was back, primarily, it was 4 crack cocaine. 5 And, back then, it was easy to buy drugs on 6 the street, quite honestly. And then, slowly, it 7 became increasingly more difficult, more dangerous, 8 you know, where people were coming at you, and 9 people on the streets were starting to know you. 10 And then the tide kind of turned. And in, 11 like, 2009 and '10, we did a substantial pill case, 12 where we arrested many individuals, from all walks 13 of life, from all ages. 14 And, it basically came down to, again, pill 15 shopping, doctor shopping, all over the county. 16 You know, we tried to narrow it down. It 17 branched out to all areas in the city, New Jersey, 18 and like I said, we took these people down. 19 But, again, the uptick has been unbelievable, 20 where it's become a common drug -- prescription 21 drugs, heroin, that's what we seem to be buying, 22 across the board. We don't see the crack and the 23 cocaine as much as we used to. 24 And, now, these are our cases. This is what 25 we're battling with. 1 And, unfortunately, as the Director said, you 2 know, our staffing isn't where it should be, and 3 we're seeking out help from federal agencies, just 4 to help us out, so we're able to kind of get these 5 cases off the ground and running, and we're able to 6 combat, and possibly get to the source. 7 You know, there's minor victories throughout, 8 with DEA and us and other agencies; but, again, it's 9 just the small nip in the big problem. And, like 10 I said, we're combating it daily. 11 And, you know, we've been trying to make 12 public awareness another part of our mission, where 13 we go out to public -- the communities. Try to get 14 together with the SROs in the schools, try to keep 15 them on track with what we're learning, what we're 16 seeing. And, hopefully, we get that feedback, as 17 well. 18 So, again, it's an ongoing problem, and we 19 hope to, you know, hopefully, make some substantial 20 cases where we're able to combat the problem and, 21 hopefully, do away with some of the sources. 22 So, thank you. 23 SENATOR CARLUCCI: Thank you. 24 [Applause.] 25 LISA WICKENS, R.N.: I just have a comment, 1 I guess -- two comments I wanted to make. 2 One comment is about, you know, learning. 3 I've actually had to make myself learn a lot 4 about this, because I'm one of those people that was 5 a complete nerd growing up and I was afraid to get 6 in trouble. 7 So, I really spent a lot of time with young 8 people, trying to figure out "why?" And why are 9 they doing this? 10 And then when you -- when they tell you, 11 "I want to get well. I don't want to do this," the 12 drug is making them very, very sick. Without it, 13 though, they're sicker. 14 So, they stop really going after the high. 15 They're just -- they're just now trying to find, to 16 maintain. 17 Without it, they can't get out of bed. 18 They're throwing up. Their family is looking at 19 them, they're not making it to school. 20 And these are, generally, you know, a lot of 21 people I've talked to are high-achievers. And they 22 just -- they -- you know, that's not something -- 23 that's one point. 24 The other point is that, you know -- actually 25 there's two. 1 The other point is, you know, I, luckily, or 2 thankfully, grew up with one of -- Albany County 3 Sheriff. And every -- a lot of my friends in Albany 4 know that. 5 And one of the things that he mentioned, 6 there were three or four different people from 7 different sheriffs' office, and we were at 8 Hudson Valley, and what Craig said was is very real, 9 and I think it's just down-on-the-ground real; is 10 that, they can arrest a dealer. 11 Right? 12 They can arrest that dealer, but there is 13 someone right there that's going to step in, because 14 they can actually deal and not be so sick, and make 15 the money to do it. 16 So we can keep trying to arrest people and 17 fill up the jails, but that's not the solution. 18 So, one of the points I think that I've tried 19 to make when I'm talking to parents, there's no 20 quick fix. 21 Okay? 22 But, is that -- as we attack this, as a 23 society, as parents, as legislators, is it's got to 24 be comprehensive. 25 One of the things that I used to always fight 1 with, with hospitals and nursing homes when there 2 was a problem, is don't just stick a Band-Aid on it. 3 Because, you fix it here -- it's like a leaky 4 roof. You fix this here, and it leaks over there. 5 Right? 6 If we don't really have a full package of 7 legislation that starts with all the good points 8 that we've heard. 9 You know, starting young, starting with 10 schools; 11 Getting involved, educating the parents; 12 Putting up those scary ads where the kids 13 will see them; 14 You know, having the treatment, having 15 education; 16 Doctors making sure that they understand, 17 when they're prescribing, what are the 18 ramifications, and what are the risk factors, and 19 next steps? 20 Having better outcomes, and holding people 21 accountable. 22 In hospitals and nursing homes, if you don't 23 have a good outcome, you don't get paid. 24 Why is it different for addiction? It isn't. 25 They just keep -- it's a volume. They just 1 keep getting people in and out. 2 So, it's got to be a comprehensive package. 3 And so I think it's really important. 4 Everything we've heard is so important, it's 5 critical, but, you know, we're not going to fix the 6 problem if we keep waiting, and it's not -- and if 7 it's not comprehensive. 8 My son, there's hope. 9 I had dinner last night with my son and his 10 wife. 11 There's -- there is hope. It's just one day 12 at a time. 13 SENATOR CARLUCCI: Great. 14 Thank you, Lisa. 15 [Applause.] 16 SENATOR CARLUCCI: We also have with us 17 Nelson Macrado [sic] who's from the Rockland EMS. 18 And maybe you want to talk to us about what 19 you're seeing? And, the use of Narcan, how that's 20 been successful, or the challenges? 21 NELSON MACHADO: I can tell you that I'm, 22 actually, also still a field provider. I still work 23 on the streets, and I've seen the volume of heroin 24 overdoses increase over time. 25 From the very start of my career, to current 1 day, it's staggering. 2 And, as many people here have already 3 testified, you're not looking at the stereotypical 4 street junkie anymore. 5 You're showing up at the homes of parents who 6 have found their child unresponsive, and don't seem 7 to know what's going on. They don't understand 8 what's going on, and it's very scary for them. 9 In some cases, I was actually telling 10 Mr. Zall a story about a call that I went on, that 11 involved a father in a suburban home, a well-kept 12 home, who couldn't stay awake, and he didn't 13 understand why. 14 And after doing a little bit of a patient 15 assessment and some history checking, we discovered 16 that we was on opiate medication for a very long 17 period of time. 18 And in order to resolve the dependency 19 issues, the doctor just kept scaling it up for him 20 to deal with his back pain. 21 We resolved that case, you know, with some 22 treatment, and taking him to the hospital. 23 I'm not sure what type of treatment he 24 received afterwards. 25 At the end of the day, I don't know that 1 I know the simple answer. 2 We're all here fighting for our society and 3 for our children. 4 And I think this forum is a step in the right 5 direction. 6 I can tell you, for Rockland Paramedics' 7 part, we are a registered opioid-prevention program. 8 We've trained the Clarkstown Police 9 Department, and they've since deployed Narcan. And 10 I believe they've successfully used it one time so 11 far. 12 And we're here to support the system because, 13 at the end of the day, these tragic stories aren't 14 stories that we want repeated. 15 And I want to thank the two Senators for 16 holding this forum, and for at least looking at 17 every possible avenue to help improve the state of 18 our public-health system. 19 Hopefully, we'll get to the end result and 20 resolve this problem. 21 SENATOR CARLUCCI: Thank you, Nelson. 22 [Applause.] 23 SENATOR CARLUCCI: Now we'd like to hear from 24 the audience that's here, and we'll have ask people 25 just come to the podium. 1 We'll keep it brief. 2 And anybody on the panel that wants to jump 3 in, very informal. 4 And just to highlight again, what we've 5 talked about here today, and what we've heard, are 6 so many different issues, from different areas of 7 the state, different responsible parties. 8 I chair the Mental Health Committee in the 9 New York State Senate. 10 Senator Boyle chairs Alcohol and Substance 11 Abuse. 12 And what we've talked about before is, we've 13 got to break down these silos, that, if you're 14 suffering with addiction, that it transcends into 15 mental health, it transcends into corrections, into 16 our health department. 17 And that's the idea to hear: To break down 18 those silos, get everybody working together, a 19 comprehensive package, to make sure we're addressing 20 these issues. 21 So, please, just state your name, and let's 22 try to keep it brief so we can get to some more 23 people. 24 JUDY ROSENTHAL: Sure, sure. 25 Thank you, Senator Carlucci. 1 Judy Rosenthal from the District Attorney's 2 Office. I'm one of those people who lives in 3 multiple silos. 4 So, District Attorney Zugibe is very clear on 5 breaking down those silos. 6 I work in both the criminal justice world and 7 the treatment world, behavioral health; whether it 8 is addictions or mental health. 9 One of the comments that I'd like to make is 10 about the fact that, and Dr. Goldrick did mention 11 before, drug court. 12 We have a number of Alternative To 13 Incarceration programs. 14 When these folks are getting arrested, what 15 do we do with them? 16 We've now taken them off the street, what do 17 we do? 18 We want to be able to put them in treatment. 19 We have Alternative To Incarceration 20 programs, but the State has cut back. 21 They -- a few years ago, they ended the 22 Road to Recovery, the Steps Road to Recovery, 23 funding. 24 They have reduced funding, at least in the 25 Ninth Judicial District, funding for drug courts, 1 for staffing, as well as for supplies, like 2 drug-testing supplies, which are needed. 3 We're going to be ending a federal grant for 4 a mental-health Alternative To Incarceration 5 program, where, about 85 percent of the participants 6 are also substance users. 7 So, we are looking at the funding for these 8 folks. 9 And, again, it also goes to the insurance 10 piece. 11 We talk about parity. 12 Would we take somebody who is a diabetic or a 13 cardiac patient and say, "You have to fail first?" 14 That's not parity. 15 And that is a bigger discussion, as has been 16 said, for a federal discussion. 17 So I wanted to put both those two issues on 18 the table. 19 Thank you. 20 [Applause.] 21 SENATOR CARLUCCI: Thank you, Judy. 22 CAROL LEIMUS [ph.]: Good morning. 23 Thank you, Senator Carlucci. 24 My name is Carol Leimus [ph.]. I am a 25 lifelong resident here in Rockland County. 1 I've also spent the past 30 years working in 2 HIV and drug use. 3 And I'm speaking primarily as a county 4 resident, but also somebody who has been to numerous 5 funerals, has saved somebody with Narcan, ran the 6 largest syringe-exchange program in New York City. 7 And, I sit and listen to today, there are a 8 number of things come up for me. 9 Number one, I work in the county. I see -- 10 I go to the collaboratives all over county. 11 I'm concerned when I don't see those faces 12 here. They're working with youth. 13 There's a complete disconnect. 14 This is seen as a very separate problem. 15 It's seen as a problem, primarily, from a legal 16 point of view or a moral point of view. And it's a 17 public-health problem. 18 If we talk about prevention, we know, with 19 youth, that just information alone is not going to 20 help. 21 We need to fund programs that do -- are 22 focused on youth development, that really look at 23 giving young people the skills that they need to 24 succeed in life, as opposed to the tunnel-vision 25 focus of "we have to prevent substance use." 1 There are so many risks that youth encounter. 2 This is one of them. 3 And by doing youth development, it's been 4 shown through numerous studies that youth are more 5 likely to avoid substance use. 6 In terms of overdose death, and we kind of 7 got away from that, but I think it's a very 8 important issue, it's completely preventible. 9 I'm concerned that only -- we have -- you 10 only mentioned Clarkstown Police. 11 I live in Orangetown. I'd like to see those 12 police trained. 13 I can't believe that not every police person 14 in this county is carrying Narcan. 15 Every single staff member that worked at our 16 syringe exchange was prescribed Narcan personally, 17 to have it in case we needed it when we saw somebody 18 who was in overdose. 19 It's completely preventible. 20 Suboxone, it's not being promoted enough. 21 It's a very effective alternative to heroin 22 and opioid use. 23 It's very difficult to get, but up -- 24 contrary to methadone, it doesn't create an 25 addiction. It maintains people in a way that blocks 1 the effect of the drug, so they can't get high if 2 they're trying to. 3 These are all alternatives that are 4 available. 5 And as long as we continue to see substance 6 use from the point of view of legality or morality, 7 we're not going to solve this problem. 8 The other thing that I would say, if this 9 county is seeing such a rise in heroin use, we need 10 in Rockland County a syringe-exchange program. 11 HIV is preventible. Hepatitis can be 12 preventible. 13 And we do not need to get to the point where 14 we have an explosion in this county of hepatitis and 15 HIV. 16 So those are my comments, and thank you very 17 much. 18 [Applause.] 19 SENATOR CARLUCCI: Well, thank you, Carol. 20 DR. CAROL SLATTERY: Senator? 21 SENATOR CARLUCCI: Oh, yeah. And just -- did 22 you want to address the -- 23 DR. CAROL SLATTERY: I just wanted to address 24 a couple of things. 25 OASAS has asked treatment providers to 1 actually get certified in the Narcan, which we 2 currently are doing. So that is going to be 3 happening. 4 And your outpatient programs within 5 Rockland County do have Suboxone as part of a 6 maintenance, with -- as long as they're in 7 treatment. You can't just be going there for the 8 Suboxone. 9 So we -- there is -- as treatment providers, 10 there is answers for you on that end. 11 SENATOR CARLUCCI: And, Nelson, did you want 12 to speak about the training of local law 13 enforcement? 14 NELSON MACHADO: I did. 15 Excuse me for a moment. 16 When I spoke -- Chief Murphy is our chief of 17 operations. He's currently spearheading the 18 Narcan-prevention initiative of law enforcement in 19 our county. 20 Clarkstown was the first department trained 21 by our organization. 22 Other departments are on the list, as well. 23 He did tell me that this morning. 24 SENATOR CARLUCCI: Right, and we're working 25 with Sheriff Falco, as well, to make sure all 1 law enforcement is going through the training. 2 There has been funding aside by the State to 3 make sure that that happens. 4 LISA WICKENS, R.N.: I just -- for parents 5 and friends, and to citizens, I'm actually 6 certified. 7 I work out of the largest law firms in 8 Albany, and I got 18 of the attorneys and people 9 there certified. 10 You can do it. 11 If you -- if you're interested, if you have 12 someone, a loved one in your family or close 13 network, that -- you know, that -- that -- that is 14 using and is active, I suggest doing it. 15 It takes half an hour to get certified. 16 There's a nasal spray for people that are 17 afraid of the needles. 18 And -- you know, and works. It gives you 19 time to get them -- you know, to get 911 there. 20 SENATOR CARLUCCI: And if I could just add to 21 that, we're planning on doing a training here in the 22 county for everybody; for residents that are 23 interested in it. 24 And right now, currently, the work is 25 underway to make sure that law enforcement go 1 through the training. 2 And I know Sheriff Falco is heavily involved 3 in that. 4 But we're also looking to put together a 5 program, that anybody that's interested, like Lisa 6 said, would have that opportunity. 7 So as soon as we get that planned and off the 8 ground, we'll make sure that everybody that's in 9 this room knows about it. 10 And we'll also try to get message out, as 11 well, so everybody has an opportunity to do that. 12 JUDGE WILLIAM WARREN: Senator, can I just 13 make one other comment? 14 There was, in the beginning of your 15 presentation, you talked about the need for 16 collaboration amongst various organizations in the 17 county. And you didn't see a lot of folks here who 18 you saw at other places. 19 About two months ago, I went to a program 20 that was presented by a group known as the 21 "Hills Valley Coalition" in Bergen County. It 22 consisted of about five school districts. 23 And they, through the leadership of the 24 counselors at the schools, put together this 25 coalition. 1 And I had a presentation the evening that 2 I was, there which included law enforcement, it 3 include treatment providers, it included parents. 4 It was attended by four or five hundred 5 people in the community. 6 And it was -- it showed to me an excellent 7 collaboration amongst the people in that area. 8 Now, I'm not familiar whether the schools in 9 Rockland -- there are eight school districts in 10 Rockland County -- do anything like that. 11 And I think it would be a great idea if, 12 somehow, they could come together with law 13 enforcement, perhaps under the leadership of the 14 Senator who could get this thing going, to form a 15 larger coalitions. Get the schools more involved. 16 Get them working with people like Sheriff Falco, who 17 I'm sure would be anxious to be there in the schools 18 and help more of a collaboration, which I think will 19 be helpful. 20 SENATOR CARLUCCI: Great, thank you. 21 RUTH BOWLES: Could I just bring up that, in 22 Rockland County, we do have a Drug-Free Schools 23 Coalition that meets once a month. And it does have 24 all sectors in the community involved in that 25 coalition; however, the numbers are low. 1 So... 2 SENATOR CARLUCCI: Thanks, Ruth. 3 JOE RIVERA: My name is Joe Rivera. I'm from 4 Parents Helping Parents. It's a self-help parents 5 support group. 6 We used to be Tough-Love International. That 7 went out of business. 8 And since 2005, my wife and I founded this 9 group. 10 What we need, really, is a coordinator or an 11 advocate that parents can get in touch with, to cut 12 all this red tape to get our kids treatment. 13 Our kids are being turned away from ERs, 14 from rehabs. 15 I don't see anybody from the insurance 16 company showing up here. 17 That's one of our biggest problems. 18 [Applause.] 19 JOE RIVERA: Addiction, especially to opiates 20 and heroin, it's a long-term treatment. 21 We had -- years ago, we had a young lady who 22 went through Daytop and drug court. 23 It took her five months to get the picture. 24 And now she has two children, she's thriving. 25 We have to deal with these things right now. 1 If a person was on a bridge, ready to jump, 2 you're not going to give them a card and say, I'll 3 see you next week. 4 You're going to do it right then and there. 5 We have to really get these kids and young 6 men and women into treatment, and find a way of 7 keeping them into the treatment, because it's not 8 going to go away. 9 Some people it works with the outpatient. 10 My concern is that, the first-time addicts, 11 when they go to any kind of treatment, it's only an 12 8 percent recovery. That's all that can get 13 something out of it. 14 So we have to find a way of giving the 15 parents some tools, and to make it long-term. 16 Thank you very much. 17 [Applause.] 18 UNKNOWN SPEAKER: Thanks, Joe. 19 SENATOR BOYLE: Mr. Rivera, I would just 20 point out that, in the 15 forums that we've had so 21 far, we have not had insurance-company executives 22 and officials on this side; however, they're always 23 in the audience, and they're always watching. 24 And I can tell you that they know. They're 25 very concerned. 1 And one of the things we do in the 2 Legislature is mandate insurance coverage on a lot 3 of different areas. 4 And, we're going to increase coverage and 5 availability and access. 6 And the insurance companies have contacted us 7 to say: We're willing to talk about this. 8 They understand the situation. 9 There's some bad insurance people out there, 10 but there's some very good insurance people out 11 there. 12 And I think that our legislative package, 13 we're going to be have -- have is going to increase 14 availability and access. 15 But thank you very much. 16 [Applause.] 17 JUDGE CHARLES APOTHEKER: Good morning, 18 Senators. Thank you for allowing me to speak. 19 My name is Charles Apotheker. I preside over 20 the Rockland County Drug Court, and have for, 21 I guess, 9 out of the past 14 years. 22 I'm here to speak about a life-and-death 23 problem, because, everyone, everyone here in this 24 room, knows a family that's lost a child to drug 25 overdose. 1 I know of, personally, three families. 2 One, a son of a very high official in the 3 court system; 4 One, a brother of a prosecutor in an 5 adjoining state; 6 And, Mike and Lynn's son, as well. 7 And, so -- besides the rare occasion when 8 we've lost people in drug court to overdose. This 9 hasn't happened too often, but it has happened. 10 I have had a lot of contact with opiate 11 users, especially lately. They generally start, as 12 everybody has said, with the pills that they find in 13 their parents, grandparents, babysitting. And when 14 they run out, because they get to be very expensive 15 on the street, they switch to something very cheap, 16 and that's heroin. 17 And although this is anecdotal, I believe 18 that the recent rise in heroin addiction might be as 19 a result, the unintended consequence, of tightening 20 up of prescriptions for opiate use. 21 The pharmacists now, the doctors now, there's 22 a -- it's being scrutinized, and very heavily 23 scrutinized. And it is a great thing to do. It has 24 definitely changed the way doctors are writing 25 prescriptions. 1 But I have a feeling that that might have led 2 to this movement to heroin because it's a lot easier 3 to get. 4 So what should families do? 5 The families come in here and they look for 6 answers. 7 And I wish I had something more to tell them, 8 other than, if they can get their child into 9 treatment, great. 10 But, a lot of the people that are in active 11 use are resistant to treatment. They don't want 12 to -- they know what it is to withdraw from drugs. 13 They don't want to do it again. They avoid that. 14 And, so, if all else fails, and I know this 15 isn't easy for any parent to do, if you find drugs 16 in their room, call the police. 17 We have, and have had, police officers at our 18 drug-court graduations. I have invited them to 19 come, occasionally they do come, because that is the 20 person that is responsible for saving that person's 21 life. That arrest makes all the difference in the 22 world. 23 And, again, this is not easy for parents to 24 do, but we are talking about life and death. 25 And, you'd much rather put him in the system 1 or her in the system where they have a chance of 2 recovery, than make arrangements for their funerals. 3 We've had great success with our outcomes in 4 drug court. 5 And drug courts all over this country, in the 6 past 25 years, have had great success, more than any 7 other thing that's been tried. 8 Most of our participants get clean, and they 9 stay clean. 10 Yes, they see jail, and they see jail quite a 11 lot, for their lying, and trying to get over. But 12 after a while, you see the lightbulb go off, and 13 they start to get it, and they start to get healthy 14 again. 15 It's amazing what you see right -- happening 16 right in front of your eyes. 17 But for those who don't get it, state prison 18 is in their future. 19 They plead guilty to a felony, they subject 20 themselves to state prison. 21 And when I promise that they get state prison 22 for failing out of drug court, they get state 23 prison. 24 And I tell parents, I've said this many times 25 to parents: I would rather see you visit your child 1 in state prison than make arrangements for their 2 funeral. This is life and death. 3 And as long as we can understand that, maybe 4 we can move to some sense of making this, quote, war 5 on drugs effective. 6 It is not effective only to fight the supply. 7 We have to increase -- or, decrease the 8 demand. That's really the only way this is going to 9 have any effect. 10 Decrease -- we could have all the supply you 11 would want, but if nobody is using it, it doesn't 12 matter. 13 And when we increase -- or, we fight the 14 supply and we make it scarcer for people to buy 15 drugs, what happens? The price goes up. Just like 16 it does with any other commodity. 17 We need to do that. 18 We need to attack this on all levels: supply 19 and demand. 20 But, really, we won't make a difference until 21 we attack the demand. 22 And what can legislation do? 23 We've talked about this, everybody has 24 mentioned this, and I'll mention it: 25 You know how difficult it is for us to place 1 people in treatment, dealing with the insurance 2 companies. 3 Where do they get off being the experts in 4 addiction? I don't understand that. 5 [Applause.] 6 JUDGE CHARLES APOTHEKER: If anything, there 7 should be legislation requiring some kind of 8 independent panel, made up of people who know about 9 addiction, to review these declinations of treatment 10 to people that don't fit into the insurance 11 companies' issues. 12 And at least have some way of appealing these 13 decisions, so that people who are in need of 14 treatment can get it. 15 And that's all have I to say. 16 Thank you. 17 SENATOR CARLUCCI: Great. Thank you. 18 [Applause.] 19 ANDREW BARRETT: Hi, good afternoon, 20 everybody. 21 My name is Andrew Barrett. I'm from 22 Clarkstown Pharmacy in West Nyack and in New City. 23 And, I've been asked today to speak by 24 Senator Carlucci. 25 And the first thing I'd like to say, there's 1 a lot of moving parts in all of this, and there's no 2 simple or easy solutions to any of it. 3 But one of the things I'm grateful for is 4 that you asked me to come today, but I've been the 5 owner of Clarkstown Pharmacy since 1991. And never 6 has anybody in government come to me, to ask me 7 about any opinion with prescription drugs, 8 controlled substances, laws, insurance company. 9 Nobody has ever come to me. 10 And that seems to be a problem here. 11 We have task forces out there. 12 We have insurance companies. 13 We have judges. 14 We have a sheriff. 15 But I'm in this community, and there's a big 16 problem, and I've never been asked my opinion on how 17 we could combat this. 18 And I hope in the future I will be included, 19 and other pharmacists will be included. 20 I'm a pharmacist. 21 I've been a pharmacist since 1981, and I've 22 seen crack cocaine. I've seen the rise in 23 oxycodone, Oxycontin. 24 I'm not that familiar with the heroin 25 situation now, but what I can tell you, back in the 1 late '70s and early '80s, some of you can 2 remember that there was a huge problem with Valium. 3 Valium was "the" drug, and people were 4 abusing Valium. 5 And what did the State do? 6 They limited how many Valium tablets you can 7 get in a prescription. It was 100 tablets or a 8 30-day supply, whichever is less. 9 There is no law like that anymore. That was 10 taken away. 11 I'm getting prescriptions for Oxycodone, 12 360 at a time; 2 every 4 hours. 13 Okay? 14 Has anybody ever thought, maybe, if the 15 person really needs it, they don't need 360 at one 16 time? 17 I mean, common sense has to be looked at 18 here. 19 But these things are not being looked at. 20 Senator Boyle, I have to disagree with you 21 100 percent. If the insurance companies, if there 22 were some good insurance companies, they would have 23 acted already on this, rather than sit and wait for 24 a task force. 25 Why are they waiting? Because they're still 1 making a ton of money. 2 They're denying coverage. 3 They're denying Suboxone. 4 Okay? 5 There are insurance companies out there, I go 6 to fill their Suboxone for a patient, it's not 7 covered. They have to spend $200. 8 Okay? 9 These people don't have $200 to spend, unless 10 they're selling the oxycodone to pay for the 11 Suboxone. 12 [Laughter.] 13 [Applause.] 14 ANDREW BARRETT: But these are the things 15 I see as a pharmacist, that nobody asks. 16 Okay? 17 I sent Senator Carlucci an e-mail, with an 18 article from "Drug Topics," regarding CVS-Caremark. 19 CVS owns Caremark. 20 I'm sure all of you know who Caremark is. 21 Caremark is the insurance company who denies 22 all the prescriptions that you really feel you need 23 to take. 24 Okay? 25 And now CVS owns Caremark. 1 Well, CVS has been filling narcotic 2 prescriptions, as that article pointed out, without 3 DEA numbers from doctors. And it's being paid 4 through Caremark. 5 When I go to fill a prescription and I don't 6 put a DEA number in, that prescription is denied. 7 But CVS was being paid for it. 8 The DEA is currently looking into this. 9 If that was me, I would have been shut down 10 last week. 11 CVS is still going strong. 12 CVS, they'll end up paying a billion-dollar 13 fine after they made $20 billion. 14 There's something really wrong, when you're 15 having these task forces and you don't include 16 someone like me. You don't include a physician, 17 okay, who can prescribe Suboxone, here. 18 Another thing, pain-management doctors, 19 they're all over the place. They're all writing for 20 these prescriptions. 21 What is the requirement to have a 22 pain-management clinic? 23 Does anybody know? 24 Okay? 25 It gives them a license to fill 1 prescriptions -- to write prescriptions for 2 oxycodone, Oxycontin, Vicodin, and have these people 3 come in and pay cash to the doctor, so this way, 4 they get paid a good sum of money to write these 5 prescriptions. 6 Maybe the State needs to say: If you're 7 going to be a pain-management doctor and you're 8 going to write these prescriptions, well, then, you 9 should also figure out a way to get these people off 10 the prescriptions. 11 And maybe have them be Suboxone doctors, 12 because there are so few. 13 But these are all the things that are going 14 on, from my perspective, where I think things can be 15 done. 16 You know, the parents, and God help all the 17 parents who have this problem. 18 I have three children, and, I think, because 19 you can never be sure, that none of them use drugs. 20 But I do know people who, you know, their son 21 has died or daughter has died. And, it's a horrific 22 thing. 23 It's a horrific thing. 24 Another thing, Dr. Slattery mentioned, all of 25 these managed care, that they're going to eliminate 1 the small people: the small doctor, the small 2 pharmacist. 3 I have patients come in, say to me: If my 4 daughter comes in with a prescription for a 5 narcotic, please call me. Don't fill it. Okay? 6 They're under treatment. 7 Do you think if they go to a CVS or 8 Walgreen's they're going to be able to do that? 9 Okay? 10 I-STOP is a great thing, okay, but there is a 11 certain personal issue that needs to be addressed, 12 everywhere. 13 Okay? 14 And we're losing that. 15 Governor Cuomo did a great thing to save 16 money for the state. He moved all of Medicaid into 17 managed care a couple years ago. 18 But what he did was, he moved it into managed 19 care, and now CVS-Caremark runs the managed care. 20 They run 80 percent of all the managed care for 21 prescriptions in the state. 22 Okay? 23 Where is the conflict of interest here? 24 There's a big conflict of interest. 25 These are the things I think you, as 1 Senators, you need to address, and say -- you know, 2 take a step back and say: How can we help people? 3 Okay? 4 How can we force these insurance companies to 5 give our patients what they need? 6 Okay? 7 Because it's costing a lot more money to have 8 them go through the hospital stay than to give them 9 a prescription for Suboxone. I can guarantee you 10 that. 11 There's a lot of great drugs out there today 12 that can help today, but the insurance company 13 doesn't want to pay for it, because they get paid a 14 percentage. 15 And if they have to pay for the drug, it cuts 16 into the percentage they make. 17 And these are some of the things. 18 I would hope, when you go around the state, 19 and I don't know how many more of these you have, 20 you might include some pharmacists, like myself, 21 some doctors who do prescribe Suboxone, where they 22 can give you some of the experiences, rather than -- 23 and require insurance companies to show up. 24 Instead of ask them, why not require it? 25 You're giving them billions of dollars. You 1 can't have them on the panel? 2 I don't understand. 3 I don't understand where they are; why they 4 do what they do; and how they're allowed to get away 5 with what they do. 6 [Applause.] 7 AUDIENCE MEMBER: Good afternoon. 8 Thank you so much for being here and 9 listening to the citizens. It's amazing that -- you 10 know. 11 I'm sorry that we have this problem, I really 12 am, because it couldn't be sadder, to see people 13 lose their children. 14 And a very wise man once said, "An ounce of 15 prevention is worth a pound of cure." 16 And that's where we're at right now. 17 We can't cure something that's so heavy like 18 this with 800 moving parts. 19 It really comes down to the law, and who's 20 affected by the law, and who's, you know -- because 21 I think it's more on the user. 22 If the user had stricter laws, they wouldn't 23 be doing it. 24 And if the dealers had stricter laws, which 25 I'm not even going to get into, but that would be 1 great. If someone could catch whoever is putting 2 this into our community, that would be awesome. 3 Thank you. 4 [Applause.] 5 WENDY BLANCARD [ph.]: Good afternoon, and 6 thank you, Senator, and for the panel, for all of 7 this invaluable information. 8 My name is Wendy Blanchard, and I am in 9 addiction recovery and mental-illness recovery. 10 I have been in recovery for almost 14 months. 11 I was abusing prescription drugs: opiates and 12 Xanax. Mostly codeine, down that road. 13 I don't know much about the heroin epidemic; 14 only what I hear. 15 But, the doctor that I was seeing was an 16 addiction psychiatrist. And I went to him, 17 I believe it was in '99 or 2000, for help to get off 18 of the codeine, which I had tried to wean off of 19 myself. 20 And rather than getting the help that 21 I needed for the mental illness that I suffered 22 from, which was depression since I was a child, and 23 PTSD. I had suffered trauma as a child, and all 24 throughout my life. 25 And, addiction, I became more addicted. 1 Prescriptions were being written for me, just 2 for the codeine, between five and eight hundred 3 pills at a time. As the pharmacist was just talking 4 about, it was a ridiculous amount. 5 And 10 days later, I would go to -- among 6 other controlled substances. He was giving me 7 anything that I needed or wanted for a lot of pain 8 that I had. I have medical issues that he was 9 treating me for. 10 These -- this became such -- my own epidemic, 11 throughout my family -- let me back up. 12 The codeine was being prescribed. Percocet, 13 all of the other opiates. 14 And I started to -- I had a complete break 15 with reality. I guess it started about three years 16 ago. 17 And that addiction and mental illness that 18 was never treated by this addiction psychiatrist, 19 this professional, really ruined my life. And I'm 20 just now beginning to start over. 21 I'm still in recovery, I'm still struggling. 22 And I'm trying desperately, to not only recover 23 myself, but I have a family who's in crisis as well. 24 I have three children. Two of my three 25 children suffer from addiction and alcoholism. 1 My parents: My mother wasn't an addict, but 2 she used pills to make her feel better. My father 3 was an alcoholic. 4 I was married to two people that also have 5 problems. 6 I can't get away from it. 7 I want to help everyone. 8 I want to change public perception out there. 9 There is a stigma attached to people like me. 10 You guys were talking about it before, we 11 have a vision in our minds about what an addict 12 looks like. 13 I'm sure you don't picture me and my story 14 when you think of an addict. 15 But, I'm an intelligent woman, I'm educated, 16 I'm a good person. I just got very lost and 17 disconnected from reality, because of these drugs, 18 and a mental illness that wasn't treated. 19 And I think, in my opinion, doctors need to 20 be educated. 21 I don't think this doctor set out to kill me. 22 I don't think that. 23 I just don't think he realized the 24 ramifications of what was about to happen, and the 25 amounts he was prescribing, and never saying no to 1 me. 2 I ask that you allow me, somehow, to be a 3 part of a panel, a part of this solution that you're 4 all talking about. 5 I'm very passionate about this. It's very 6 close to my heart, not only for myself, but for my 7 family. 8 I have a daughter who's very sick. 9 Talking about the health insurance: 10 I had an intervention for her in January. 11 And after the intervention, she agreed to go to 12 inpatient help. 13 And the insurance company said no. She has 14 to have an outpatient failure first. 15 In February -- and I have a granddaughter. 16 In February she relapsed, but she was somehow 17 able to get over on the outpatient program that she 18 goes to. 19 I didn't have any choice, and I had to, 20 because of my granddaughter who's only -- she'll be 21 6 on June 3rd, she was in danger. And I had to do 22 what I had to do for my granddaughter, and call CPS. 23 My daughter was able to pull one over on 24 them, as well, because nothing's been done. 25 My granddaughter is still with my daughter. 1 My daughter is very sick. She has mental 2 illness, as well. 3 And my hands are tied. 4 She should have been able to go to inpatient 5 treatment, and this would not have happened. 6 So I ask that you allow me to be part of 7 whatever it is that I can do as a piece of this 8 solution for this epidemic that's affecting so many 9 people. 10 Thanks. 11 [Applause.] 12 JOHN SAVIANI [ph.]: Hello, folks. My name 13 is John Saviani from [unintelligible]. I'm a 14 resident of Rockland, 1981. 15 I'm semi-retired. I'm an adjunct professor 16 at Long Island University, in counselor education. 17 I thank you guys for -- and ladies, for being 18 here. 19 I don't think could I top the previous 20 speaker. 21 God bless you. 22 I just -- I wanted to say what she had to 23 say. 24 She already said it. 25 As some people know, I do some advocacy. 1 I'm semi-retired. I'm a volunteer. 2 I'm here, so let me know. And Ruth can 3 contact me. 4 But, I think it's hard to -- you know, 5 I think we're used to judging people. 6 Okay? 7 And I think we have the finest police force 8 here. I'm not -- I'm a town of Ramapo person. 9 I think we have great services all around. 10 However, there are people that are addicted 11 to alcohol, drugs, you name it, whatever they get, 12 they get. They go from pills, then something 13 cheaper comes along, heroin comes along. 14 These -- you know, where people are involved, 15 labels don't fit. 16 Okay? 17 And this lady just said that. 18 I'm kind of losing my track of thought here a 19 little bit. 20 But, I appreciate your help, but this is 21 something, all right, I'm not a young person. 22 I lived through this in the '70s. 23 Okay? 24 You had kids in the '70s. I was a kid in 25 the '70s. 1 You have them now. Let's not lose another 2 generation. 3 Okay? 4 It's all well -- primary prevention is the 5 thing, we know that. 6 As an educator, we know that. 7 However, the bottom line is, that the people 8 who need it can't get it. 9 Not everybody refuses help. They want help, 10 they can't get a bed. 11 "Come back tomorrow, maybe we'll have 12 something for you. Maybe." 13 This is people. Come on! 14 "Come back tomorrow"? "Maybe next week"? 15 I had a chance to go to St. John's Riverside 16 Hospital, try to get somebody in. 17 Forget it. 18 They're waiting outside. They're waiting all 19 day. 20 "Come here at 6:00, maybe we'll have a bed 21 for you." 22 "No." 23 "No." 24 Is this treatment by insurance or treatment 25 on demand? 1 You want your kid treated? 2 Well, if you have good insurance, great. 3 If you got nothing -- sorry, I'm getting a 4 little adamant. 5 UNKNOWN SPEAKER: No, there are no beds for 6 anybody. 7 JOHN SAVIANI [ph.]: There are none. 8 UNKNOWN SPEAKER: None. 9 JOHN SAVIANI [ph.]: There's no beds for 10 anybody. 11 UNKNOWN SPEAKER: Not in Rockland County. 12 Zero. 13 JOHN SAVIANI [ph.]: Where can you go? 14 You wait at Nyack. These people go, they 15 wait, they're turned away. 16 What do you -- come on! 17 These -- not everybody doesn't want help. 18 Not everybody wants to stay high. 19 No, people want help. 20 I've worked with kids for 35 years. 21 Kids know what they're doing. They know they 22 can put it over on mom and dad and me and you, but 23 they want help. They don't want it -- you know. 24 They don't want it. 25 I'm sorry if I get upset. I'm adamant about 1 this. 2 I got time. Any way I can help, Ruth knows 3 me. 4 So, God bless you for trying. 5 Thank you. 6 [Applause.] 7 SENATOR CARLUCCI: One more speaker, and then 8 we'll wrap it up. 9 AUDIENCE MEMBER: Thank you very much for 10 coming, and putting this on. 11 Rockland County is a great place to live. 12 I want to thank you for coming. 13 Listen, prescription drugs; prescription, and 14 drugs, we've got to do something. It's way too easy 15 to get them out. 16 When I listen to my family and my neighbors 17 and my friends, all of these kids that are getting 18 on these drugs, when did we all become mentally ill? 19 I don't -- this is really -- it's a problem. 20 Lisa, by the way, your story was very moving, 21 and I want to thank you for bringing it to the 22 community. 23 My suggestion, perhaps something towards a 24 holistic movement based on health, instead of 25 poison. 1 It's a problem. 2 And thank you for coming, again. 3 [Applause.] 4 SENATOR CARLUCCI: Great. 5 So, really, we just want to thank everybody 6 for participating today. This has been so powerful 7 and so helpful, to make sure that all of these 8 issues are addressed. 9 And we've heard a wide array of different 10 issues that need to get tackled. 11 And I think we can sum it up, in saying, that 12 it's not going to be a silver bullet that helps to 13 alleviate this problem, but it's going to be a 14 comprehensive package of legislation, and working 15 with all members of the community, to make sure 16 we're addressing this issue. 17 So, I really just want to thank everybody for 18 sharing your stories. 19 I know, in many cases, it's not easy, but 20 that's what it takes. 21 And I think what we need to do here in 22 Rockland is to continue to stay focused; focus like 23 a laser, in ways that we can help make sure that 24 these gaps are eliminated. That people aren't 25 waiting for treatment. They're not being denied 1 medications they need or treatment that they need. 2 And we have invited the insurance industries 3 to participate with us; and, unfortunately, they 4 haven't. 5 But we're going to really make sure that they 6 hear us loud and clear, that we are -- we're done 7 with people getting denied treatment that they need. 8 So, I want to thank all the members of the 9 panel. 10 [Applause.] 11 SENATOR CARLUCCI: And, particularly, I want 12 to thank Senator Boyle, who is the Chairman of 13 Alcohol and Substance Abuse in the State Senate, has 14 led up this task force. Has been to hearings around 15 the state, and has heard a little -- you know, some 16 of the same issues at many of the hearings, but with 17 different tints in different ways. 18 And that's what's been so valuable: your 19 input. 20 And we're going to be putting together a 21 report, and I just encourage everybody to read 22 through that. 23 It's going to be a collection of the input 24 that was gathered here today, and other hearings 25 around the state. 1 But any ideas that you have further, this 2 conversation doesn't end today. You can always 3 e-mail us. Send us your stories, send us your 4 suggestions, and that will be part of the solution. 5 So with that, to close, we'll have, 6 Senator Boyle, do you want to wrap it up? 7 SENATOR BOYLE: Thank you so much, 8 Senator Carlucci. 9 And thank you for hosting this. 10 I'd like to thank the panelists, who's -- 11 wonderful information; all the audience members for 12 coming. 13 And as David said, this is going to be a 14 comprehensive package of legislation. 15 It's not the end of the fight, but it's the 16 beginning of the end of the fight, against this 17 heroin epidemic. 18 We had such tremendous testimony and ideas 19 today. 20 And can I tell you, as I said recently, this 21 is not one of those things where we're going to do a 22 report, it's going to come out in six months, and 23 then, maybe, next year. 24 With the technology we have, we've, 25 literally, been texting information to Albany, and 1 they're drafting legislation as we got information 2 today. 3 So -- and we're going to be passing these 4 pieces of legislation, I believe, in the next couple 5 of weeks. We have about three or four weeks left of 6 session, and we're going to win the fight. 7 Thank you so much. 8 [Applause.] 9 10 (Whereupon, at approximately 12:41 p.m., 11 the forum held before the New York State Joint 12 Task Force on Heroin and Opioid Addiction 13 concluded, and adjourned.) 14 ---oOo--- 15 16 17 18 19 20 21 22 23 24 25