To Examine the Issues Facing Communities in the Wake of Increased Heroin and Opioid Abuse

1 NEW YORK STATE JOINT SENATE TASK FORCE

ON HEROIN AND OPIOID ADDICTION 2 ---------------------------------------------------- 3

TO EXAMINE THE ISSUES FACING COMMUNITIES 4

IN THE WAKE OF INCREASED HEROIN AND OPIOID ABUSE 5 6 ---------------------------------------------------- 7

Niagara University 8 Dunleavy Hall, Room 127

5795 Lewiston Road 9 Niagara University, New York 14109 10 May 7, 2015

4:30 p.m. to 6:00 p.m. 11 12

PRESIDING:13

Senator Robert Ortt, Co-Chair 14 15 16 17 18 19 20 21 22 23 24 25 1

SPEAKERS:PAGE QUESTIONS 2

Richard C. Kloch 11 3 State Supreme Court Justice

New York State 4

James R. Voutour 23 35 5 Sheriff

Niagara County 6

Michael J. Violante 43 7 District Attorney

Niagara County 8

Unplanned Audience Member Interaction 56 9

E. Bryan DalPorto 62 72 10 Superintendent of Police

City of Niagara Falls 11

Avi Israel 77 12 A parent

Personal Story 13

Christina Schweindler (ph.) 91 14 A parent

Personal story 15

Lisa Catanese (ph.) 98 16 Family member

Personal story 17

Anne Constantino 110 18 President & CEO

Horizon Corporations 19

Paul Wacnik, Ph.D. 119 129 20 Field Medical Director

Pfizer, Inc. 21

Donald Ingalls 151 22 Vice President, State and

Federal Relations 23 BlueCross/BlueShield of

Western New York 24 25 1

SPEAKERS (Continued): PAGE QUESTIONS 2

Monica Romeo 156 3 Director, University Counseling Center

Niagara University 4

Audience Participation 161 5 6 ---oOo--- 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 1 SENATOR ORTT: All right. 2 Good evening -- or, good afternoon, I guess. 3 First of all, I want to thank all of you for 4 being here. This is the third heroin forum -- 5 heroin and opioid addiction forum that we're having 6 across the state. 7 Last night we had one in Rochester. 8 Tonight, obviously, this is the third 9 hearing, at Niagara University. 10 And then there will be one more, in June, in 11 the Albany area. 12 There will probably be several others in the 13 fall, maybe late summer. 14 Obviously, this is -- has come about because 15 of the growing epidemic that we see across our 16 state, and even across the country, when it comes to 17 heroin and opioid addiction. 18 For those who don't know, I am 19 Senator Rob Ortt. I suspect it says that here, 20 but -- and I'm joined by a great panel here tonight 21 who I will introduce as they come up. 22 I want to thank Niagara University for 23 hosting this. 24 Before we get started, just a couple 25 housekeeping items. 1 The bathrooms are in the back, I believe, 2 right at that back corner over there. 3 And, certainly, for the presenters, if 4 there's not enough microphones, we can share 5 microphones, you know, pass them along. 6 Before we get started, though, I want to call 7 attention to kind of a separate item, but I think 8 it's important. 9 I want you -- I ask everyone to join me in 10 remembering John Levulis. 11 John was a graduate of Niagara University's 12 Class of 2012. He was an outstanding member of his 13 ROTC class while here at Niagara University, and was 14 serving as a first lieutenant in the United States 15 Army. 16 On Friday, May 1st, while traveling in a 17 military convoy to Joint Base McGuire-Dix-Lakehurst 18 to conduct mounted-gun retraining, the vehicle 19 First Lieutenant Levulis was traveling in was struck 20 by a civilian vehicle. 21 Today, First Lieutenant Levulis passed away 22 from the injuries he sustained in that accident. 23 Three other soldiers are recovering from 24 their injuries. 25 I just ask you to join me in a moment of 1 silence to remember First Lieutenant Levulis. 2 (A moment of silence is observed.) 3 SENATOR ORTT: Thank you. 4 In the interest of -- I want to go over sort 5 of the program, so those understand. 6 In the interest of time, you know, this is 7 one of those -- I was at the hearing last night at 8 St. John Fisher. 9 And everyone up here, a lot of folks here who 10 have personal stories, and there's folks here who 11 are dealing with this on the front lines. We have 12 service providers, we have law-enforcement 13 officials, we have folks in our criminal justice 14 system. 15 And the goal, obviously, is for all of us to 16 learn, to gather information. Certainly, that's why 17 I'm here. 18 However, we could probably be here till 19 midnight, if we wanted to be, going over this. 20 So what I would ask is, the presenters, just, 21 if you can be mindful of your time, because we have 22 several we want to get through, you know, in a 23 timely manner. 24 So, I want to thank Niagara University, 25 I want to thank Father Marr (ph.), and 1 Father Leveck (ph.), for opening this up to us and 2 allowing us to have this here. 3 Heroin addiction, as most of you know, is a 4 problem in our -- is a growing problem in our 5 communities. It is making its way into our schools, 6 tearing families apart, and destroying lives. 7 What was once a hard, but relatively 8 inaccessible drug, has now transitioned into a cheap 9 and widely available drug that's made it 10 exponentially more deadly. 11 It is time to focus on more effective 12 prevention and treatment programs in order to combat 13 this epidemic, improve the lives of those affected. 14 and take back our streets from the drug dealers. 15 This is happening everywhere: upstate, 16 downstate; rich, poor, middle-class; urban, 17 suburban, rural. 18 There's probably not a parent or a family 19 member who has lost a loved one, or has had a loved 20 one go through this, that probably didn't -- at one 21 time, didn't think, Not my kid. Not my family 22 member. 23 That's what is so insidious about this. It 24 has really changed from a drug that was injected 25 through needles, to a much more accessible form, 1 whether it's through pills or snorting or what have 2 you. 3 The Heroin Task Force will continue to 4 examine the issues facing communities in the wake of 5 increased heroin abuse. 6 The Task Force will hold forums, such as 7 this, meet with experts, and evaluate what State 8 measures may be needed to further reduce drug abuse 9 in New York. 10 I do want to say, too, I wish there was one 11 thing that we could do. I wish could I tell you 12 there's one thing we could do and fix this, or that 13 there were three things that we could do to fix 14 this. 15 But as I know, many of you know, and the 16 panelists certainly up here can tell you, there is 17 not just one thing; there's no silver bullet. 18 It's going to be an ongoing conversation, and 19 probably a series of measures, to try to address 20 this. 21 One of the biggest, though, is certainly 22 education for everyone here, and getting the word 23 out. 24 We will build upon the tremendous work 25 conducted by former-Task Force Chairman 1 Senator Phil Boyle, Vice Chair Senator 2 Mike Nozzolio, and Senator David Carlucci. 3 We need to increase awareness and prevention 4 efforts, and make sure that treatment and recovery 5 options are available to those who need them. 6 And one key budget item, recently, we were 7 able to provide school nurses with Narcan, and train 8 them in administering the heroin antidote. 9 This is a pretty incredible drug that, 10 literally, can take someone who, in all other 11 facets, is gone, and bring them back. 12 And I know for a fact, as I'm sure some of 13 the folks up here will tell you, it absolutely has 14 saved lives. 15 Specifically, we are looking at working with 16 insurance companies to cover drug-rehabilitation 17 treatment up to 90 days; use proceeds from drug 18 seizures to purchase Narcan, fund school resource 19 officers and youth drug-prevention programs; 20 facilitate interagency cooperation among 21 law-enforcement groups; create state funding for 22 local drug units; stiffen penalties for dealers; and 23 boost funding for the State Office of Alcoholism and 24 Substance Abuse Services. 25 Several weeks ago, actually, members of my 1 staff joined other legislative workers to receive 2 training on the utility and administration of 3 Narcan. 4 Just a couple statistics. 5 Recent opiate statistics show a pressing and 6 urgent need to find a solution to the statewide 7 epidemic. 8 Deaths from opiate overdoses are increasing 9 across the state, with 34 suspected opiate deaths in 10 Erie County so far this year, including 13 in just 11 one week. 12 In New York City, the most recent statistics 13 available showed that for the second straight year, 14 heroin deaths surpassed homicide, with 420 people 15 dying from heroin overdoses, compared to 16 335 homicides, in 2013. 17 The High-Intensity Drug Trafficking Areas' 18 2015 threat assessment provides significant 19 findings. 20 Drug-involved overdose deaths increased 21 32 percent in Niagara County, from 105 to 2012 -- 22 105 in 2012, to 139 in 2013. Niagara County has one 23 of the highest rates of hydrocodone and oxycodone 24 prescriptions, and, of course, the district's 25 proximity to the Canadian border certainly makes it 1 a hub for these types of threats. 2 Without further ado, I guess I will start the 3 panel. 4 I do have one change. 5 I know State Supreme Court Justice 6 Richard Kloch has another engagement to go to, and 7 so in the interest of his schedule, we will start 8 with Judge Kloch. 9 Judge. 10 JUDGE RICHARD C. KLOCH: Thank you, Senator. 11 Senator, I want you to know that where I'm 12 going after this presentation, is to a function at 13 Lockport High School, kindergarten to 5, that, 14 initially, you were supposed to be at. 15 So I am the chief fill-in for you, Senator. 16 My daughter -- 17 SENATOR ORTT: They got an upgrade, I think. 18 JUDGE RICHARD C. KLOCH: My daughter will 19 accompany me, and we're going to be talking about 20 role models and heroes. 21 Senator, I would like to thank you for 22 conducting this forum on an issue of such importance 23 to the health and welfare of so many New Yorkers. 24 Heroin and opiate addiction has risen 25 dramatically over the last several years. This 1 growth in abuse has been fueled by the affordability 2 of heroin, particularly when we have seen that the 3 product is being cut or laced with fentanyl of 4 dubious quality. 5 Fentanyl, as we know, is a poison. It is 6 manufactured cheaply, and because of no adherence to 7 standards, can be extremely fatal if used even once. 8 The increase in overdoses we have seen in the 9 state and locally can be attributed recently to, 10 I believe, fentanyl poisoning. 11 Now, my comments will be chiefly directed to 12 the recent increase in heroin abuse. 13 Prescription-opiate issues are another 14 subject of particular pain to those afflicted and to 15 their families. 16 Others I know will be more qualified to speak 17 of the problem today, the problems attendant with 18 prescription-drug uses. 19 But with both heroin abuse and other opioid 20 abuse, I find, many times, that the defendant in 21 front of me, while they're charged with possession 22 or sale of drugs or some other criminal offense, is 23 an addict, a victim, hopelessly lost to an addiction 24 that robs an individual of dignity, health, family, 25 and steals one's very soul. 1 Recently, the New York State Attorney 2 General, with the dedicated work of the State 3 Police, Southern Tier Drug Task Force, and other 4 police agencies, conducted a drug-interdiction 5 effort, designated as "Operation Horseback," in 6 Chautauqua County. 7 49 individuals were indicted. 8 I was asked to preside over that prosecution 9 because of the large number of indictments. 10 I quickly discovered that many of those 11 charged were first-time offenders. 12 It was obvious, even at arraignment, 13 particularly at arraignment, that these individuals 14 were physically ill. 15 The prosecuting officers and the attorneys, 16 by that prosecution, not only decreased the flow of 17 drugs in that community, but, in many cases, saved 18 the lives of the very individuals arrested. 19 It's incumbent to me in those proceedings to 20 be always mindful that I am dealing with people, and 21 to be compassionate. 22 What is the message I will try to convey to 23 you, Senator Ortt, as a representative of the 24 New York State Senate? 25 This New York Legislature has provided to the 1 judiciary an effective tool in this war against 2 drugs by the enactment of Article 216 of the 3 Criminal Procedure Law: the judicial diversion 4 program. 5 When first enacted in 2009, there were many 6 judges in the New York judiciary who scoffed at the 7 law. 8 I remember, as a supervising judge, our 9 initial meetings were, really, the judges ridiculed 10 the law. 11 I believe it is safe to say that many in law 12 enforcement similarly believed that it would be 13 futile, perceived as a reduction, not a straining of 14 their efforts against drug dealers. 15 I'm here to tell you that the judicial 16 diversion program has been a success. 17 First, most drug indictments result in 18 convictions. 19 Convictions in my criminal parts throughout 20 the 8th Judicial District is probably at about 21 100 percent. 22 And, Mr. Violante, you will probably concur 23 that your rate of convictions for drug cases in 24 Niagara County is probably, if not at, 100 percent. 25 Second, many participants in a judicial 1 diversion program actually take advantage of the 2 opportunity offered by the drug courts, which make 3 up the diversion program, to save themselves from 4 addiction. 5 The feeling you get when you see even one 6 person, one person, saved from a life of addiction 7 and/or crime is indescribable. That only happens 8 because, again, the Legislature, in 2009, wisely 9 enacted the diversion program, and because of the 10 hard work that later was followed by drug courts in 11 the state. 12 Third, if an individual is not serious in 13 their efforts to cure their affliction and conform 14 to the law, with a conviction in hand, it's easy to 15 proceed to sentence. 16 Remember, the defendant, first, must plead 17 guilty before being eligible for diversion. 18 But I come here not only to praise the Senate 19 in regard to the passage of the diversion program, 20 but to tell you that more can and must be done. 21 Number one: Drug courts. 22 The success of the diversion program rests 23 squarely on the efforts of the drug courts. 24 In the 8th Judicial District, we have 25 fabulous drug-court judges and staff. 1 In my prepared statements, I've listed them 2 all. They include Judge Violante from 3 Niagara Falls, Judge Russell from Buffalo, and all 4 the other judges that make up the part of the 5 drug-court teams in the 8th Judicial District, 6 including county and family court judges. 7 Senator, it's imperative that the 8 New York State Legislature enhance the funding of 9 drug courts so that we can continue to help people 10 in dealing with addictions in the drug-court 11 setting. 12 Second: Probation funding. 13 By the very nature of the diversion program, 14 a participant is placed on interim probation for up 15 to two years. This allows the defendant to be 16 treated for the drug addiction, but also to show 17 adherence to probation supervision and standards. 18 Probation supervision is the key. 19 In 2007, I served as a member of the 20 Task Force on the Future of Probation in New York 21 State, appointed by Chief Judge Judith S. Kaye. 22 Let me, Senator, for you, since you weren't 23 in office then, read you a part of that task force 24 report. 25 "In New York State, one of the probation's 1 most taunting constraints is a startling lack of 2 resources. National academic and policy experts on 3 probation and community corrections have said for 4 years, that probation is the most underfunded part 5 of the criminal justice system. 6 "New York probation certainly illustrates 7 that point. 8 "Few, if any, New York probation departments 9 are funded adequately, in terms of having reasonable 10 caseload sizes for either adult or juvenile 11 probationers. Many lack the necessary resources to 12 pay for the essential community-based services 13 needed to prevent recidivism, such as drug 14 treatment, job and vocational training and 15 placement, and mental-health services. 16 "Again and again, the task force heard from 17 probation directors and other experts that almost 18 all probation departments constantly struggle to 19 control caseload size and triage necessary services 20 with little to no budget growth. 21 "Average caseloads for probation officers are 22 frequently well over 100-to-1, far above any 23 acceptable national standard. 24 "While this state of affairs is a national 25 phenomenon, it is especially pronounced in 1 New York State where, over the last two decades, the 2 State has systematically disinvested in probation. 3 "In 1986, New York State was reimbursing 4 county probation departments almost 47 percent of 5 their total budgets. 6 "Historically, the State provided almost half 7 of the county probation budgets, since almost half 8 of the adults on probation were convicted felons. 9 "And local probation departments were viewed 10 by the State as saving in the tremendous cost of 11 housing those offenders. 12 "For the state, probation offers the largest 13 alternative sentence to prison. 14 "In the late 1980s, this all started to 15 change. The State gradually and continually reduced 16 support for the local probation departments. 17 "Today, reimbursement to local probation 18 departments hovers around 18 percent, a staggering 19 withdrawal of aid over the last 20 years. 20 "The cumulative loss in State aid over this 21 period is difficult to calculate, but in the last 22 year alone, the State would have provided almost 23 $130 million to counties, as opposed to the 24 $52 million, the amount that now goes directly to 25 local probation departments that it actually 1 provides. 2 "Over the last two decades, the State has 3 provided less funding each year, and continues, and 4 counties have lost some hundreds of millions of 5 dollars in State aid. 6 "It's difficult to identify the reasons 7 behind this ongoing disinvestment. No similar 8 pattern in State funding to prisons, parole, or 9 state police is evident. 10 "In the final analysis, it is most likely the 11 case that the State systematically reduced funding 12 to local probation departments simply because it 13 could; that is, state policy and budget officials 14 assume, that if they withdrew aid from local 15 probation departments, then the local county 16 executives, the mayors, and legislators would have 17 to make up the funding shortfalls with the local 18 tax-levy dollars. 19 "As the State has withdrawn funds from 20 probation, local officials have struggled to make up 21 the budget shortfalls the State created. 22 "Even in tightly constrained local budgets, 23 county officials recognize the importance of having 24 at least minimally functioning probation departments 25 that supervise thousands of probationers in their 1 communities, and of having at least some ability to 2 provide timely reports to state courts. 3 "The probation-funding story then is a 4 classic one, of the State simply forcing costs down 5 to a county level, and of reaping some small budget 6 saving. 7 "The problem with this situation, however, is 8 that most counties have not made up the entire 9 shortfall from the State. 10 "As a result of declining State 11 reimbursement, almost all of the new money counties 12 have put into probation over the last two decades 13 has covered budget deficits in local departments; 14 thus, over time, counties have been unable to 15 adequately fund their departments, as the number of 16 probationers has risen, and the cost of technology 17 and information-system infrastructure has grown." 18 That's the end of what I want to read from 19 that report. It was a 2007 report. 20 What has happened since that report? 21 Senator, you weren't there, because you're 22 just new, but I'll tell you what happened since that 23 report. 24 Nothing. 25 Nothing! 1 This must change. 2 So, Senator Ortt, I would ask you to help us 3 fight this war on drugs by properly funding 4 probation, to be able to help people caught in 5 addiction. 6 The drug problem is a difficult one. The 7 front-line soldiers -- the sheriffs, agents, 8 officers -- are tireless in their attempt to stem 9 the flow of drugs. 10 In a period of time where some find it easy 11 to criticize police enforcement, they should be 12 recognized for the tremendous job that they do, the 13 dedication that they exemplify. 14 As always, being a soldier, you know this, 15 Senator: It is a foot soldier who wins or loses the 16 war. 17 As true professionals, they deserve you to 18 listen to their opinions, which I know that I would 19 join in completely. 20 Thank you, Senator. 21 SENATOR ORTT: Judge, thank you very much. 22 I know the judge has to depart, so, I thank 23 you for taking the time. 24 And tell the school over there I said 25 "Hello." 1 JUDGE RICHARD C. KLOCH: Thank you, Senator. 2 SENATOR ORTT: Before we go to the next 3 speaker, I do want to make a note. 4 One of my colleagues -- I have 5 three co-chairs. One of them -- well, both of them 6 could not be here. 7 One of them just had back surgery. He's from 8 the Albany area, Senator George Amedore. He is also 9 the chair of the Substance Abuse Prevention 10 Committee in the Senate. 11 But his chief of staff, Doug Breakell, is 12 here, somewhere. 13 I don't know if Doug wants to -- is he in the 14 room? 15 Oh, he's way in the back. All right. 16 So Doug's here. I want to thank him. 17 And I do believe we have a representative 18 from Senator Gallivan's office as well, who is here. 19 We also have numerous local elected officials 20 here, far too numerous for me to enumerate all 21 individually. 22 I just want to thank all the elected 23 officials who are here, not only for being here, but 24 for your commitment to helping us curb this growing 25 problem. 1 All right. Our next panelist is someone who 2 certainly is no stranger to this, our Niagara County 3 Sheriff, Sheriff James Voutour. 4 SHERIFF JAMES R. VOUTOUR: Thank you, 5 Senator, and thank you for the opportunity to be 6 here. 7 And I want to thank my colleagues who I work 8 with closely every day here, the chiefs of police of 9 our three major cities in Niagara County. 10 And although I may be the one talking at this 11 point, it's a team effort between the four of us for 12 these issues that we're talking about today. 13 Senator, I was asked to talk about some 14 statistics. 15 And I just want to share some, not entirely 16 accurate, but to the best of my ability, statistics 17 in Niagara County, and these for a time period, from 18 just January of 2015 until, pretty much, today. 19 As far as opiate-overdose deaths, we've had 20 three in the city of North Tonawanda, three in the 21 city of Lockport, five in the city of Niagara Falls, 22 and then in the twelve towns outside of those 23 cities, a total of four. 24 Those are 15 deaths from heroin, fentanyl, or 25 opiates. 1 SENATOR ORTT: That's this year? 2 SHERIFF JAMES R. VOUTOUR: Since January 1st. 3 We, obviously, have an issue. 4 I could spend a lot of time talking about the 5 issue, but I think we all know what it is and how it 6 works. 7 But I want to talk a little bit from a 8 law-enforcement perspective, the part that we deal 9 with on a daily basis. 10 We have a Niagara County Drug Task Force, 11 which encompasses, obviously, Niagara County 12 sheriffs' investigators, but also the city of 13 North Tonawanda detectives and Lockport detectives, 14 as well as Niagara Falls detectives. 15 City of Niagara Falls also has a drug task 16 force. 17 So between the two of us, we pretty much have 18 100 percent, with a couple small exceptions, of the 19 drug activity in Niagara County. 20 I've been on raids, where we knocked down 21 doors. 22 In fact, I was the one knocking down the door 23 for many years before I was sheriff, which 24 I actually miss doing. It was a lot of fun. 25 But, I've been on raids with all three of 1 these guys, as chiefs, where we go out with our guys 2 and boots on the ground, and we ask them what's 3 going on. 4 And I want to share with you the perspective 5 that the typical investigator or detective deals 6 with on a daily basis, which I think is critical. 7 One of the biggest problems that we have is 8 the dealer who gets diversion, and is back out 9 dealing the next day. 10 Now, I respect Judge Kloch. He is one of the 11 finest judges we have, and I'm sorry that he had to 12 leave. 13 And there is a place -- I do believe in 14 diversion. There is a place for addicts in 15 diversion. 16 There is no place, when our men and ladies 17 kick in a door, carrying big guns because we know 18 there's guns inside, and we put our life at stake to 19 protect your kids, and we grab a dealer with 20 100 hits of heroin, and he steps into court, says he 21 has a problem, and he steps out, back on the street, 22 and we're getting a search warrant for him again 23 three weeks later. 24 I have a problem with that, a big problem 25 with that; as do my colleagues. 1 Diversion has its place for users. 2 Diversion does not have a place for sellers. 3 A seller with heroin and fentanyl is no 4 different than someone that walked across this 5 campus firing a gun. Sooner or later, you're going 6 to kill somebody. 7 And how do we treat the guy with the gun? We 8 lock him up. 9 How do we treat the drug dealer? We put him 10 in outpatient services. 11 The services, I've seen their success, but 12 I've seen their failures. 13 I'm not here to say diversion doesn't work. 14 It does work, but it works for the 15 individuals who have problems, not the dealers. 16 The dealers are killing our kids. 17 And we're sick of chasing our tail, with 18 limited funding, to continuously lock them up over 19 and over and over again, so that they can come out 20 and just sell again. 21 Recently, one went into court. 22 And one of my investigators, I stopped in the 23 office and asked him how things were going, and he 24 was all frustrated. 25 And I said, What's wrong? 1 He goes, We had a dealer. We've been working 2 him on a wire. It cost a lot of money. We made a 3 lot of buys. He went into the court, and he told 4 the judge -- not Judge Kloch -- but he told the 5 judge he was in front of, that he was addicted to 6 marijuana. And he was set free. 7 And then our confidential informants were 8 telling him, my investigator, just days later, He's 9 selling again. He's back selling again. 10 He just walked out of court. 11 So, Senator, that's one of our issues. 12 Diversion is an excellent program, but we 13 have to separate the users and the sellers, and lock 14 the sellers up. I have plenty of room in the jail. 15 Of those overdoses in the -- in 16 Niagara County, in North Tonawanda, the use of 17 Narcan, they've had 10 total overdoses since 18 January. 19 And, again, these numbers could be a little 20 bit off, and I'll explain why in a minute. 21 They've had 10 overdoses: 3 deaths, as I said 22 earlier, but they've had 6 saves with Narcan. 23 City of Lockport, over a dozen overdose 24 cases. 12 saves and 3 deaths. 25 I think they saved somebody yesterday, Chief. 1 Correct? 2 I know we saved somebody two days ago. 3 If you don't know how this stuff works, 4 I watched it firsthand a couple of weeks ago. 5 It was a Sunday morning. I was in my office, 6 catching up on some work, because no one bothers me 7 on Sunday mornings. And a call came in very close 8 to the department, of an unresponsive female, not 9 breathing, possible overdose. 10 Since it was close to the department, and it 11 was Sunday morning, I responded very quickly from my 12 office. Got there within a couple minutes. 13 I personally carry Narcan myself. 14 One deputy beat me there. I watched as he 15 sprayed the Narcan up this young lady's nose, and 16 I watched her come to life in about five seconds; 17 from not breathing, unresponsive, to sitting up and 18 talking. 19 Does it give them a second chance at life? 20 Yeah, it does. 21 Does it mean they can possibly use drugs 22 again? It sure does. 23 But that was somebody's daughter. 24 And we'll continue to do those types of 25 things. It's very important that we have this 1 Narcan. 2 But more important, that we address the 3 people that are delivering the product: the sellers 4 of heroin and the sellers of fentanyl. 5 Niagara Falls also has had 5 deaths, as 6 I mentioned earlier, but they've had over 14 saves 7 with Narcan. 8 Out in the county, basically, the area where 9 my guys and gals patrol, the 12 towns, and this 10 includes the town of Lewiston police, the town of 11 Niagara police, we've had, since just January 1st, 12 27 overdose cases. 13 27. 14 We were able to save around eight or nine of 15 them. Four resulted in deaths. 16 These aren't your typical drug dealers 17 standing on the corner, like you all envision, and 18 I think you guys know that. 19 The case I spoke about where I witnessed it 20 working, I stepped in the bedroom and saw award 21 after award for athletics, of a young lady, very 22 pretty young lady, honor student, athlete. 23 These are the people that are being affected. 24 These are the people we have to get after. 25 Senator Ortt, a couple things I'd like to 1 see. 2 I know my second talking point was: What are 3 we going to do? 4 Law enforcement has to step up. We're not 5 doing a good enough job, we're not accurately 6 reporting. 7 We don't know - it took us a week to figure 8 out how many overdoses we had. 9 That's unacceptable, and I take 10 responsibility for that. 11 There's ways that it gets lost. 12 A call might be dropped in our computer as an 13 "unresponsive person," so it could be dropped as a 14 medical call. 15 Later we found out it's a heroin overdose, 16 and it's not changed in the computer. 17 We need a way to report it. 18 And why is reporting so easy? 19 Because to get where we want to go, we've got 20 to know where we've been. We have to know what's 21 going on out there. 22 Niagara County needs a central repository for 23 heroin and opiate overdoses. 24 We need a central place to collect this, 25 whether it be the health department, whether it be 1 Chief DalPorto, whether it be Senator Ortt, because 2 I'm sure he has nothing else to do. 3 But someone needs to collect this 4 information. 5 Secondly: This information needs to be 6 forwarded to our intel centers. 7 We're getting our intel centers, our criminal 8 intel centers, up and running. We're make progress 9 with that. It is the future of police work, 10 gathering intelligence, especially with social-media 11 availability. 12 But we need to be charting, mapping, looking 13 at the sellers, and who's providing these drugs to 14 each and every one of these overdoses. 15 I can tell, when you I started on the road, 16 when somebody overdosed, you went, you took a 17 report, you called the coroner, and you moved on to 18 your next call. 19 That's what we did. 20 These have to be investigated criminally, 21 every one of these. 22 I put a procedure in place about six months 23 ago at my department, where I have, any overdose, 24 I have to send out a criminal investigator and a 25 drug task force investigator, and we do everything 1 under the sun to find out who gave the drugs to this 2 person, so that we can, hopefully, bring criminal 3 charges and take that person off the street. 4 The third thing is funding. 5 We, unfortunately, and I hate to say this, 6 but we have to triage cases. We have to look at 7 drug dealers, and we have to figure out which ones 8 we can afford to go after. And that is sad. 9 There's just not enough money to go after all 10 of them, so we, literally, triage our drug dealers, 11 and figure out which ones we can go up on wires. 12 And a "wire" is when we get a search warrant 13 and listen to telephone conversations, and so forth. 14 They're very expensive, very time-consuming, 15 because you have to monitor those wires 24 hours a 16 day for an extended period of time, and, you have to 17 have boots on the ground doing surveillance, so that 18 when you hear something on the phone, you can go to 19 court and verify that what you hear is actually 20 happening by someone watching the suspect. 21 They're very expensive to do. 22 I know the AG's Office does not provide any 23 funding at the state level for wires, and that would 24 be a great source that we could go to. 25 The third thing I spoke about was the 1 diversion program, separating the users from the 2 dealers. 3 The dealers got to get locked up. They 4 belong in state prison. They have to get locked up. 5 We have to divide that up. 6 A user in diversion is fine. I've seen 7 success. 8 I've seen failure. There's a lot of failure 9 that goes on. 10 Thursday afternoon, I know that I'm going to 11 get, sometimes, 10 to 15 inmates in from the City of 12 Niagara Falls court, people that failed, and got 13 sent to jail. Every Thursday I get that. 14 That's not to pick on Niagara Falls. They 15 just happen to be the largest city and make up the 16 majority of the inmates at the Niagara County Jail. 17 But I know, every Thursday afternoon, the bus 18 gets filled up, and it's everybody that flunked out 19 of drug court gets to come to jail. 20 And, personally, the more the merrier, 21 because I know they're not selling to anybody in the 22 jail. 23 Finally, Senator Ortt, the last thing is, I 24 just want you guys to know that, from a 25 law-enforcement perspective, this bothers us. We've 1 all had, all of us, have had friends. 2 I -- I personally have friends, a well-known 3 businessman and a nurse, mother and father, great 4 people, whose son died a year ago from a heroin 5 overdose. 6 We take this personal. 7 Another recent case is, someone I didn't know 8 personally, but know all their relatives. And they 9 call me and ask me about it. You know, What can we 10 do, sheriff? What can we do to fix this? 11 It hits home. 12 And I just wanted to -- I hope that 13 I portrayed to this audience, the 14 boots-on-the-ground perspective, because not all -- 15 the four of us here are all alike. 16 We hate sitting at a desk. We want to get 17 our hands dirty. 18 We all work the streets together, all four of 19 us. We're active law-enforcement leaders. 20 We ask our people what they need. We go out 21 with them. We watch what they do. We see the need. 22 We see people die in front of our eyes. All of us 23 have seen that. And we've seen the saves. 24 I appreciate the time to talk here, and 25 I would welcome questions when we get to that point. 1 SENATOR ORTT: Thank you, Sheriff. 2 I have two questions for you, Sheriff. 3 As far as the -- we talked about the dealers. 4 Last night in Rochester, the chief of police 5 from Brockport was there, and he was talking about 6 the same kind of thing, drug dealers. 7 In his experience, he was 14 years as a 8 narcotics police officer, a lot of the drug -- 9 sometimes -- and this was brought up, sometimes you 10 do have people who will deal to get money, to then 11 go and buy more drugs for themselves. 12 SHERIFF JAMES R. VOUTOUR: Correct. 13 SENATOR ORTT: But a lot of times, he felt, 14 more often, you had dealers out there who were 15 simply dealing to make money. This was a business 16 to them. They didn't use, or certainly weren't 17 addicted, or whatever. These were people who were 18 business folks. 19 Is that your experience as well in a lot of 20 cases? 21 Or -- or, I guess, what might be the 22 breakdown, at least here in Niagara County, as far 23 as -- 24 SHERIFF JAMES R. VOUTOUR: Exactly the same. 25 He couldn't have said it better. 1 You know, when you go in and do a search 2 warrant, and he has 100 or 200 packets of heroin, or 3 a couple of grams of crack cocaine, that's not 4 personal use. 5 You know, we don't go to McDonald's and buy 6 100 hamburgers. 7 If we buy 100, that means we're probably 8 giving them away or we're selling them to someone 9 else. 10 We buy one or two hamburgers. 11 It's the same thing with drugs. We see it 12 all the time. 13 I know that three of these guys all worked in 14 drugs. I mean, they see it as well. 15 There's a difference between users and 16 sellers, and the chief in Brockport is absolutely 17 correct. Most of those times, those guys are 18 business people, which is why they're cutting it 19 now. 20 In case you don't know, "cutting" it means 21 you're, basically, diluting it. 22 It would be no different, if you're in a 23 restaurant, if you put water in the A-1 Steak Sauce, 24 you're cutting the A-1 Steak Sauce. 25 They're taking heroin and cutting it with 1 fentanyl, because fentanyl's cheaper, and it's more 2 addicting. 3 So it's good business practice, because 4 you're luring your customer in, you're offering a 5 product at a reduced cost to you; therefore, your 6 profits go up. 7 And with the fentanyl, you're building that 8 addiction, so that customer comes back to you more 9 often. 10 If we had these people in the real world, 11 we'd have a great economy. 12 SENATOR ORTT: And last thing: We talked 13 about funding, Sheriff. 14 One of the things brought up to me last 15 night, I was not made aware -- I was not aware of 16 this before, was that, recently, the federal 17 government, and I'm not sure if it was an 18 expiration, if it was made by the DOJ, or if this 19 was a congressional, you know, legislative act, but 20 the federal asset-forfeiture law was recently either 21 expired or repealed, or what have you. 22 Now, the task forces, like a county task 23 force, can still, I believe, get funding, or have 24 access to this. 25 But, like, in the city of Niagara Falls, the 1 police department can no longer get that. 2 And Sheriff -- or, Chief, I think it was, 3 Varrenti, from Brockport, he felt that if the State 4 took action to pass legislation that mirrored the 5 federal asset-forfeiture law, that would go a long 6 way to funding the wiretaps and the very expensive 7 ways to go after these guys. 8 SHERIFF JAMES R. VOUTOUR: Right, it's a very 9 complicated question, Senator, but let me explain it 10 the best I can, quickly. 11 At the federal level, basically, on an asset 12 forfeiture, so, you -- you have -- you do a search 13 warrant, and a drug dealer has a lot of drugs and 14 he's got 10,000 cash. We typically will seize that, 15 because we can prove that it's profits of drug 16 sales. 17 We seize that, and we can use it for 18 law-enforcement purposes. 19 Generally, at the federal level, we'll get 20 about 80 percent of that, the feds take 20 percent 21 for processing, which is done through the 22 U.S. Marshals. It's a very fair breakdown. 23 What happened is -- well, let me back up. 24 We can also seize at the state level, but the 25 state -- the State of New York cuts it four or 1 five different times. And by the time everything is 2 said and done, a $10,000 seizure would probably net 3 less than $1,000 back to the police department, 4 because of numerous ways that they take a piece of 5 the action. 6 What happened at the federal level was done 7 with -- and this just appalls me -- was done with a 8 memo from Eric Holder, our former AG. 9 He wrote a memo that said, local law 10 enforcement can no longer ask the federal government 11 to take their -- to process their seizure, unless 12 the federal government has been involved in the 13 investigation from the beginning. 14 And many times we do joint investigations 15 with the DEA, which is a federal agency. 16 So if we're doing a joint investigation with 17 the DEA, nothing has changed with federal asset 18 forfeiture. 19 But in the past, when we do a local 20 investigation, like a lot of our investigations are, 21 and that same $10,000, where we used to get $8,000 22 of it to use towards law-enforcement equipment, or 23 buy money, or wire money -- 24 Actually, we can't use it for wire money 25 because that would be salaries, and we can't use it 1 for that. 2 -- but, that has been taken away, and it was 3 taken away in a memo. It did not require any 4 congressional oversight. It did not require an 5 Executive. 6 It was taken away by the memo of the former 7 Attorney General, Eric Holder. 8 SENATOR ORTT: Okay. But there are certainly 9 things we can do at the State level on that, to help 10 out local police departments. 11 SHERIFF JAMES R. VOUTOUR: Yes. 12 And the State of New York is trying to get 13 rid of asset forfeitures altogether. 14 They want us to -- they think that -- when 15 I went and testified in New York City on this a 16 couple of months ago, in an Assembly hearing, and 17 I heard everybody testify that, you know, the cops 18 just go down the street, and if they see two cars, 19 one's a Porsche, one's a Chevy Chevette, that the 20 cops will pull over the Porsche and just seize it 21 for no reason. 22 I can assure you, that simply does not 23 happen. We don't take property for no reason. 24 We just don't do it. 25 But the Assembly listened to person after 1 person, because I sat there, say that that's what we 2 do, and they're all advocating for us not taking 3 anything from drug dealers. 4 So if the drug dealer that kills your son or 5 daughter has $100,000 from drug sales, there's a 6 certain amount of legislators in New York State that 7 say we do not have the right to take that money, and 8 it should stay with them. 9 Thank you to the Senate for blocking that, by 10 the way. 11 SENATOR ORTT: I can tell you the sheriff is 12 100 percent right. 13 As somebody who is down in Albany on a 14 regular basis, there is a strong cohort of 15 legislators, mostly from the city of New York, who 16 feel that no one should go to jail, drug dealers 17 should keep their money. 18 They're much more concerned about the drug 19 dealer and about potential criminals than they are, 20 sometimes, or it seems, about their potential 21 victims or their actual victims. 22 So, Sheriff, I want to thank you for your 23 testimony. 24 SHERIFF JAMES R. VOUTOUR: Thank you. 25 SENATOR ORTT: Thank you for being here. 1 What we're going to do, as we go through each 2 panelist, I would just ask that, after we're all 3 done tonight, if the panelists could stick around. 4 Obviously, we have several members of the 5 audience. 6 And if we went through every question, we'll 7 have to get our sleeping bags and our pillows out 8 tonight. 9 So, in the interest of not doing that, what 10 I would ask is, if the panelists could kind of stick 11 around afterward, and the folks in the audience, if 12 you have a specific question for a member of the 13 panelists, I'm sure they would be happy to answer 14 that. 15 I do want to recognize, out of our three 16 police chiefs, Chief DalPorto, from our Niagara 17 Falls Police Department, he's going to be speaking 18 tonight. 19 However, we do have Chief Eggert from the 20 city of Lockport, and Chief Hall from the city of 21 North Tonawanda. 22 All three of these guys are just like the 23 sheriff, on the front lines. 24 And I want to recognize both the chief from 25 Lockport and chief from North Tonawanda, who I know 1 do a great job, and who, again, see this probably 2 all too often. 3 So, I apologize that we couldn't get everyone 4 to speak, but I'm glad you guys are here. 5 And, certainly, if you do have something you 6 would like to add to any of the testimony on this 7 law-enforcement aspect, feel free to chime in. 8 At this time, we will turn it over to 9 Niagara County District Attorney, 10 Mr. Michael Violante. 11 DA. 12 DA MICHAEL J. VIOLANTE: Thank you, Senator. 13 I'm going to go backwards, because something 14 came up that kind of hit home with me. 15 My office policy is, with regard to funds, 16 this is cash only. It doesn't deal with property, 17 including expensive watches and chains, and the 18 like, as well as vehicles. 19 But with regard to cash, that's found on a 20 defendant, where there's law-enforcement 21 interaction; that is, someone is arrested, part of 22 my office's plea policy is, no one gets a plea 23 unless they agree to surrender the right to the 24 cash. 25 So, in our own little way here in 1 Niagara County, we're trying to develop a way that 2 we can get the money away from these guys, hurt them 3 a little bit in the pocket, as well as, hopefully, 4 at some point in the future; that is, after they're 5 arrested and we prosecute them, that they can, 6 potentially, end up in jail. 7 But, generally speaking, the sheriff has it 8 right. Law enforcement, generally, has it right 9 with regard to the difference between dealers and 10 users. 11 I would say in 85 to 90 percent of the cases, 12 you can't tell one from another, unless you're 13 dealing with the drug-enforcement agencies, 14 including the federal and state agencies, where 15 there's a big guy, guy's much bigger than we 16 normally see around here, that's strictly a dealer, 17 and makes hundreds of thousands and millions of 18 dollars. 19 Most people on the street do both. They sell 20 a little bit in order to get enough for themselves. 21 They take a piece for the guy that gave them the 22 drugs, the front. 23 I give you the drugs, you don't pay me 24 anything. 25 That's fronting it. 1 You go out and sell it, and when you make the 2 money that you owe me, you bring it back, and for 3 that, I give you a little piece so you can go out 4 and smoke the crack. 5 That's generally with crack. 6 With regard to heroin, I don't think anybody 7 here is old enough to know this, but the cut, years 8 ago, was not fentanyl for heroin. It was something 9 that was akin to powdered sugar, and people weren't 10 dying. They were getting high from using heroin, 11 illegally, of course. 12 The whole game has changed. 13 The cut now is not something that's easy for 14 the system to accept, as well as the heroin itself. 15 The cut now is fentanyl. 16 Fentanyl kills you. 17 The Narcan, the Narcan is used to save lives. 18 The Narcan is being used more to save the 19 person from the over-abuse of the opiate fentanyl 20 than it is from the heroin itself. 21 By the time you -- that heroin is cut so much 22 before they use -- throw the fentanyl in it, it 23 wouldn't get you high for 10 seconds. 24 Now, realizing all that, we have to deal with 25 the frustration -- and the only judge in the 1 building left -- we have to deal with the 2 frustration of dealing with drug -- people charged 3 with possession or sale of drugs; whether it's weed, 4 it's some other form of opiate, it's pills. 5 And there's a lot of pills out there. 6 Even though Dr. Med is out of business, 7 there's a lot of pills out there. 8 And when someone comes before the court -- 9 Probably most of you that have known me for 10 45 years, know that I was a defense attorney for a 11 long time. 12 -- it would be my responsibility to ask the 13 judge to consider my defendant, the guy standing 14 next to me, that paid me, or, if I was a public 15 defender, my obligation to him is to try to get him 16 the best deal possible. 17 If that's drug court, because I in my heart 18 believe that he belongs in a diversion program in 19 order to cure himself, so to speak, with the help of 20 others, of his addiction, it's my responsibility to 21 ask for such. 22 We're in a small county. Let me tell you how 23 easy this is. 24 The personalities of the local attorneys that 25 the judges trust have a lot to do with whether these 1 guys get drug court. 2 I'm not going to name names, but there's 3 several guys in Niagara County -- Lockport, 4 North Tonawanda, and Niagara Falls -- that have been 5 around so long, that the judges trust their input 6 with regard to what they claim about this particular 7 defendant, that their request to be screened for 8 drug court, judicial diversion, you can call it 9 whatever you will. 10 It's, basically, judicial diversion uses drug 11 court in order to effect or facilitate the person 12 getting into the program. If successfully 13 completing the program, it results in a reduction of 14 the charge, which is of great success for the 15 individual, and the people that help the providers, 16 the sponsors, for these people. 17 In veterans court we have a lot of drug 18 addicts. Several of them are alcohol -- some of 19 their addiction is alcohol-related. Their sponsors 20 are former vets. 21 We had -- vets court in Niagara County 22 started a year ago. It's on Thursday afternoons. 23 We've got about 25 guys in vet court. 24 The mentors in that court are former users or 25 alcoholics, that are vets. They work at the VA, 1 some of them as counselors, and others are just 2 volunteers. And it's fantastic to watch this go on. 3 So there are some good examples how these 4 programs that are State-run and State-funded can 5 help. 6 The basics, however, are: We need to try to 7 convince the court, and we do, as prosecutors, that 8 certain people belong in a diversion setting, and 9 some don't. 10 Let me give you an example. 11 The laws are written in such a way -- this 12 law of 2009, judicial diversion, is written in such 13 a way that only certain types of defendants are 14 allowed to even request a judicial-diversion screen. 15 They are non-violent felons. Generally, without 16 reciting them all, they deal with larcenies, they 17 deal with possession of stolen property, they deal 18 with possession of forged instruments. These are 19 thieves. 20 Thieves are allowed, according to the 21 statute, to request diversion, because they're 22 stealing in order to gain property, to go and sell 23 it on the street corner for $20 so that they can go 24 buy drugs, in the simplest terms. 25 When we feel -- now, this is my call -- when 1 we feel that someone is charged with a violent 2 felony; for example, a house burglary, and it's a 3 young kid, and it's someone that we know through -- 4 through, whether it's defense counsel and others, or 5 just defense counsel, that drug addiction is a 6 significant issue, if he's screened for drug court, 7 and he's otherwise accepted into drug court but for 8 the fact he's being charged with a violent felony, 9 I may choose, it's my decision, to reduce that 10 burglary second to a burglary third, which is 11 non-violent. 12 It's not a house -- house burglaries are 13 violent. 14 Burglaries of a garage, of your shed, 15 et cetera, are non-violent. 16 We do that on occasion. It's rare, it 17 doesn't happen often. 18 And I will tell you this: We become, and the 19 judges become -- Judge Sheldon, Judge Murphy, 20 Judge Kloch, Judge Violante in Niagara Falls, 21 Judge Watson in Lockport -- become very difficult 22 with people that are given a chance to get into 23 these programs, that don't belong in the program in 24 the first place but for my action as the district 25 attorney, and they find out that they end up in 1 state prison real quick. And it happens all the 2 time. 3 The sheriff just mentioned it. 4 Judge -- the reason that Thursday's a big day 5 for the sheriff to get bodies back from 6 Niagara Falls City Court, is that's the afternoon 7 that Violante has drug court. 8 So he's got 50 or 60 people in drug court. 9 They go into -- into -- at some setting, they go, 10 whether it's that day or the day before, to the 11 little makeshift lab that they have in Niagara Falls 12 City Court. They give their urine. They flunk the 13 urine test, and they end up sitting in the box 14 instead of in the audience. And after court's over, 15 they go stay -- they are invited to stay at the 16 Niagara County Jail for a week, to cool their heels, 17 come back into drug court. 18 If their -- if it's a first or second 19 indication of their inability to work with the 20 system, they may give them another chance. 21 When it looks like it's not going to work 22 out, they're resentenced to jail time, and they know 23 that before they get into the program. 24 But it's absolutely a joke what these violent 25 guys and/or -- violent guys, it isn't a joke, 1 because we don't let them into the drug programs. 2 But the people that talk in the jail, and the 3 sheriff hears it all the time, and when he talks to 4 his guys, to his COs, that work the jail, that's 5 all these guys talk about, is getting into diversion 6 so they can skip going to jail. They'll make 7 believe that they want to be involved with the 8 diversion program for a while so they can get back 9 on the street, whether it's to sell dope or it's to 10 commit other crimes. 11 We got a guy that breaks into cars every day. 12 Every day, he's on the street, he breaks into a car. 13 He gets locked -- and he's got a drug problem, but 14 he's also 60 years old. 15 I'm surprised he's lived this long. He 16 should be dead by now with all the dope that he's 17 used in his life. 18 But the point is, he gets back on the street. 19 There's no reason that guy should be on the 20 street. 21 So, we look at this in a different way, 22 prosecutors and law enforcement, in a frustrating 23 way, in an angry way at sometimes, is the fact that 24 the revolving door includes not only judicial 25 diversion, it includes the unwillingness of judges 1 to lock these guys up that belong in jail. 2 Even for minor crimes, petty-larceny-type 3 crimes, these guys that go boosting in the stores 4 and steal, in order to be able to sell whatever they 5 stole to buy dope, because it's a misdemeanor, they 6 get a $500 bail, and, two hours later, they're back 7 on the street. And the next day, they're boosting 8 in the store so that they can get money to go out 9 and buy more dope. 10 A message should be sent to the people that 11 have the responsibility to keep some of these guys 12 and gals off the street. 13 We can only do so much. 14 We make recommendations, where necessary, on 15 violent crimes all the time, to keep people locked 16 up that have committed, or are accused of 17 committing, a violent crime. 18 The ones that slip through the cracks are, 19 generally, in the city courts, where their crimes 20 are minor, but they're persistent. They never stop. 21 While they're on the street, they're 22 committing crimes. They may get caught once today, 23 but they stole five times. They only got caught 24 once. 25 So, the persistence, and what that costs you 1 and I as taxpayers, what that costs the 2 law-enforcement agencies that have to chase these 3 guys around, rather than spending their time keeping 4 other communities safe, is a little frustrating. 5 But, Judge Kloch talked about judicial 6 diversion. 7 I want you to know it's here to stay. 8 My politics are very conservative. 9 Unfortunately, a lot of these laws that deal 10 with the way we treat individuals that are brought 11 to justice in a criminal courtroom are far more 12 liberal than my liking; including the way they 13 changed the drug-law penalties about five years ago. 14 I was never in favor of that. I'm not now. 15 Adding -- adding to -- adding to that problem 16 is, we can only do -- we do the best we can, by 17 making sure the people that we can prove crimes 18 against plead guilty to felony crimes where it's 19 possible. 20 The rest of it is left in the hands of the 21 courts, and we hope for the best. 22 But, the persistent -- the persistent use of 23 drugs in our society creates most of the larcenies 24 that you see, most of the break-ins. 25 Most of the car break-ins and the house 1 break-ins, and, the scrappers, the empty houses in 2 Niagara Falls, which there are hundreds of, the 3 copper thefts, we do what we can to make sure, when 4 we catch these guys, that we do what is possible to 5 lock them up so that that kind of activity stops. 6 And, frankly, for the past several months, 7 we've been doing a pretty good job on that; 8 Niagara Falls PD has. 9 And we have, I don't know, Chief, about four 10 or five guys locked up in state prison that were the 11 big players in that copper theft from the vacant 12 houses. And since they've been away, things slowed 13 down an awful lot. 14 So I assure you, that knowing -- knowing this 15 business as well as I do from both sides, there is 16 no simple -- simple answer to the question as how we 17 stop or prevent people from getting involved with 18 the use of, and then becoming addicted with, 19 narcotics; opiates in particular, opiates with 20 fentanyl involved which become deadly. 21 We're working on it. 22 Those that wish to help themselves, those 23 that wish to work with us at every level: 24 Misdemeanor; misdemeanor level and city 25 court, there's drug courts. 1 Felony level, there's judicial diversion. 2 Felony level, in county court as well, we 3 have veterans court, where we're helping guys that 4 fought -- fought the good fight for us, on behalf of 5 the military duty that they did for our country. 6 It's all related to substance abuse. It's 7 just a fight that we have to continue to fight. 8 Waging the battle is easy, because that's 9 what we do. 10 Winning the war is something else. 11 Money is always an issue. 12 I know Judge Kloch brought up an example. 13 We could always use more money. 14 We could always use more programs that are 15 funded by the State, that will be of assistance to 16 us in going through the work that the law 17 enforcement does, including the prosecutor's office. 18 We work hand in hand with the federal 19 government, with Bill Hockel from the 20 U.S. Attorney's Office, on a regular basis. 21 The sheriff and the local PDs from Lockport 22 and North Tonawanda and Niagara Falls work with the 23 DEA and the ATF regularly. 24 There's interaction in all of those programs, 25 and they're all after the time result, we hope; that 1 to get these bad guys off the street and keep them 2 in jail. 3 We just keep trying as hard as we can, and, 4 hopefully, we're winning some of the battles. 5 Thank you, Senator. 6 OFF-CAMERA AUDIENCE MEMBER: Senator, I don't 7 mean to change the way you're doing things, but I 8 am -- my son was a victim, just recently, March 6th. 9 Okay? 10 SENATOR ORTT: I'm very sorry. 11 OFF-CAMERA AUDIENCE MEMBER: And -- thank 12 you. 13 But I'm not here to listen to you guys pat 14 yourself on your backs, because I that know you guys 15 are doing all that you can. Okay? 16 Where -- where can we help? 17 Where do we come in? 18 Who do we go to, to say, Here, we want to go 19 to the Senate and the Legislature, and everything, 20 saying, We want this money to go here. This is an 21 epidemic. We want our money to go here. 22 I appreciate you all being here. That's 23 great. 24 But what I'm here to see what I can do, you 25 know, and what we all can do; not to hear what you 1 guys have done. 2 Let's see what we can do. 3 DA MICHAEL J. VIOLANTE: Why don't you wait a 4 minute, and I can tell you. I hope to tell you. 5 SENATOR ORTT: Just -- I can't let it turn 6 into -- 7 OFF-CAMERA AUDIENCE MEMBER: But we -- 8 SENATOR ORTT: -- but I can't, because there 9 has to be some order to it. 10 And so -- and, unfortunately, I have to be 11 the one to do that. I apologize. 12 But, first of all, the point is, the Senate, 13 in this case, is looking to try and find new 14 solutions to the issues, because we're not seeing -- 15 obviously, there's more that needs to be done. 16 We're going to hear from families, after the 17 law enforcement -- we have law enforcement, we have 18 service providers, and we have families still to get 19 through. 20 And, certainly, for the family members who 21 are out in the audience, I think when you hear the 22 family testimony, that may help you identify from 23 other families, what you can do. 24 OFF-CAMERA AUDIENCE MEMBER: (Inaudible) 25 ideas too. 1 SENATOR ORTT: Well, absolutely. 2 And, certainly -- look it, I'm a state 3 legislator. I'm always open to receiving ideas from 4 constituents. 5 But part of the reason I'm here, just like 6 you, you know, is to also hear from these folks, 7 because that's going to inform what we do. 8 So you're not just hearing what they're 9 doing. I think you're hearing what their challenges 10 are as well, because, in those challenges, that's 11 where have I to step in or the Senate has to step in 12 to try to find some solutions. 13 And, again, you have to understand, this is 14 the law-enforcement component. 15 There's multiple components. 16 I can't tell you that there's one thing. 17 I said at the beginning, there is not one thing. 18 I know that grief demands some kind of an 19 answer, but I don't have one silver bullet. 20 And that's not what this hearing is going to 21 do tonight. It's not going -- we're not going to 22 walk out of here, feeling like, Whoa, we just solved 23 this thing. 24 That is not going to happen, nor is that the 25 expectation. 1 But I know, from my standpoint, I don't know 2 about heroin epidemic. 3 I mean, I don't know anything about heroin. 4 I'm learning about it. I'm learning more and 5 more about it. 6 Some of the folks in the audience, I'm sure 7 do know a lot about it, but there may be someone out 8 there that doesn't know about it. 9 And part of this, I think, is education, 10 because I think, ultimately, this is going to be -- 11 these guys are getting after it after it's already 12 gone. Your kid's already addicted. Your kid or 13 your loved one is already moving along. 14 So part of this is to identify, as loved 15 ones, how we can stop it in the home, or address it 16 in the home. 17 But, certainly, if there's any family member 18 here who wants to send me something, or you have an 19 idea or you have a personal story that you think 20 I need to hear, by all means. 21 I wish I could hear them each individually 22 tonight, but, by all means, you know, 23 Ortt@NYsenate.gov, and, you know, we'll make sure 24 that that gets out. 25 But, again, Ortt@NYsenate.gov. 1 Call my office, at 434-0680. I'm in 2 Lockport, is my district office. 3 And call all your legislators. There may be 4 someone here I realize who is not from my district. 5 So reach out to Your State Senator or your Assembly 6 person. 7 As you heard the sheriff talk about, 8 sometimes different legislators in different houses 9 have different views on this stuff. 10 So it's important, at the end of the day, 11 we're going to always react to you, if you're 12 getting a lot of e-mails on one issue, or if you 13 hear a powerful story. 14 I heard a powerful story last night from a 15 mother and her son. Her son is now two years 16 without using heroin. I don't want to say he's not 17 addicted, because I'm assuming you're always 18 addicted, you always deal with that. But, he was 19 going to kill himself. And in this case, she was 20 able to save him. 21 I realize that doesn't happen all the time. 22 But, she was able to save him. And, quite 23 frankly, he's only here today because of her, and 24 he's lucky. I mean, to some degree, he's very 25 lucky. They were able to locate him before he ended 1 up -- 2 So my point is, I heard that story, and that 3 resonated with me, and that affected me, and 4 affected how I think about this, and how I go 5 forward. 6 And so that's what I'm here, but I'm also 7 here to hear from the service providers, to hear 8 from the law-enforcement folks, to try to identify 9 ways to -- ultimately, to protect your loved ones, 10 which is why we're all here. 11 So -- and, again, we have -- you know, last 12 night in Rochester, we had about 20 people. 13 Tonight we have significantly more than that. 14 So, unfortunately, just the size of the crowd 15 and the size of the panel somewhat dictates. 16 But, again -- 17 OFF-CAMERA AUDIENCE MEMBER: I didn't mean to 18 -- 19 SENATOR ORTT: No, no, go ahead. It's okay. 20 It's all right. 21 OFF-CAMERA AUDIENCE MEMBER: Maybe I'm just 22 anxious, I'm not sure, I don't know. 23 SENATOR ORTT: Anxious is fine. 24 OFF-CAMERA AUDIENCE MEMBER: I'm grieving, 25 I'm still grieving. 1 SENATOR ORTT: No, I certainly understand. 2 Like I said, for any family member out here, 3 and you're going hear from -- on the personal side 4 tonight, you're going to hear from folks who are -- 5 who will always be grieving. There's always a hole 6 when you lose a loved one. 7 Nothing -- nothing I do, unfortunately, can 8 ever bring that person back, and that's what sucks. 9 Okay? 10 So -- but thank you for your question, and 11 for your sharing your story. 12 Our last -- this is our last panelist on the 13 law enforcement side, is going to be Superintendent, 14 I guess is the actual title, Police Chief, top-cop, 15 in Niagara Falls, Bryan DalPorto. 16 SUPT. E. BRYAN DALPORTO: Thank you, Senator. 17 Good afternoon. 18 It's my great pleasure to be here today. 19 Like the Senator said, my name is 20 Bryan DalPorto. 21 I'm the superintendent of police for the city 22 of Niagara Falls, New York. 23 I will start off with a few things that came 24 up. 25 First of all, ma'am, I'm very sorry for your 1 loss. 2 But, that said -- 3 Obviously, we're very sorry for your loss. 4 -- we in law enforcement don't often get an 5 opportunity like this to get the Senator's ear, so 6 I think, you know, we really owe him, from law 7 enforcement and the public, some thanks, that he is 8 willing to listen to what we think the problems are, 9 and then take to it that next level. 10 So I feel your frustration, but I do think 11 this is the building block to the fix that you're 12 looking for. 13 And I would realize -- you know, I realize 14 everyone's looking for instant gratification. 15 And if I were in your shoes, I would 16 certainly be the same way. 17 But I do think this is part of the solution. 18 I wasn't going to talk about this, Senator, 19 but since it came up, first of all, I'd like to say 20 I completely agree with what the sheriff and the 21 district attorney said, as I believe my counterparts 22 here, Chief Hall and Chief Eggert, would agree with 23 everything they said. 24 I will also tell you, I spent the majority of 25 my career investigating narcotics before I put this 1 white shirt on. And I will tell you, the narcotics 2 units throughout the county rely so heavily on that 3 asset forfeiture. 4 And any cut to that forfeiture would impact 5 the investigations, because we would have to divert 6 money away from other things to fund that, because, 7 obviously, we're still going to continue our fight 8 against illegal drugs. 9 So that asset forfeiture is crucial to the 10 fight against drugs, and I can't stress that enough. 11 It was very disappointing to hear, the memo 12 that the sheriff talked about, when that came out, 13 it was very disappointing, because, like the 14 sheriff, I know that that money, when seized, is 15 seized appropriately within the law. 16 So, anything that you could do to help us 17 out, I'm sure that would be much appreciated 18 throughout law enforcement, and I think it would 19 help everyone's cause. 20 Like many places across the country, 21 Niagara Falls has become a victim to the epidemic of 22 heroin and opiate abuse, addiction, and death. 23 This epidemic, in my opinion, has grown to a 24 scale so large, it can only be combated by local, 25 state, and federal entities working together and 1 forming partnerships between police, the judicial 2 system, prosecutors, politicians, and health-care 3 professionals. 4 I cannot stress enough, in my opinion, law 5 enforcement can only be one spoke in the wheel of 6 fixing this complex issue. 7 I also believe that we have to talk about 8 these issues in forums like this so the issues can 9 be addressed and fixed. 10 The city of Niagara Falls, with a population 11 of 50,000 people, has experienced a spike in opiate 12 usage and heroin usage over the past several years. 13 Since the beginning of this year, January, 14 the Niagara Falls police and the Niagara Falls Fire 15 Department have responded to 17 overdoses related to 16 opiates. Out of that, 5 individuals have died. 17 That's just simply unacceptable. 18 Fortunately, with the use of Narcan, in 2014, 19 the Niagara Falls Fire Department were able to save 20 10 people, and 4 so far in 2015, by administering 21 the counteragent. 22 Rule of thumb, if we can get there in time, 23 usually, we can save their lives with the use of 24 Narcan; however, it's a great tool to first 25 responders, but it doesn't, in my opinion, address 1 the core problem. 2 We talked a lot about users. 3 I'm going to talk a little bit, although 4 I agree with the sheriff and the district attorney, 5 about what I believe and what we've seen in 6 Niagara Falls and some of the other cities about the 7 core problems that really need to be addressed, as 8 well as, obviously, the users. 9 To do that, I think we have to take a look 10 back in history. 11 Recent history: In Niagara Falls, as well as 12 the other cities, and I believe -- and the reason 13 why I bring this up, is I think this -- I believe 14 this script to be played out throughout this county, 15 and throughout this country, to be honest with you, 16 and it's one of the reasons why I say this issue is 17 larger than just law enforcement alone. 18 We in law enforcement, especially in 19 Niagara Falls, have seen a majority of these people 20 start this addiction with some sort of prescription 21 pain medication. They either obtain this medication 22 legally through a doctor's prescription or through 23 some sort of illegal fashion. 24 When the prescriptions are obtained legally, 25 often the addiction begins. 1 Once off the prescription, we have witnessed 2 people resort to buying the medication illegally, 3 often from people with legal prescriptions. 4 When that process becomes too expensive, they 5 turn to some other form of opiate, usually heroin. 6 We've also seen people who receive 7 prescriptions legally, sell their medications 8 illegally. 9 And, of course, we've seen legal 10 prescriptions stolen for the purpose of illegal 11 consumption. 12 Like Narcan, pill take-back programs have 13 helped provide people with an outlet to turn in 14 these prescriptions so they're not victims of crimes 15 and they're not used in illegal fashion; however, 16 again, I don't believe that addresses core issues. 17 For many years, the Niagara Falls police 18 narcotics unit, as well as the county drug task 19 force, has received tips on doctors who are freely 20 prescribing pain pills, creating a culture of 21 addiction, which usually leads to some form of 22 illegal activity. 23 These activities are always investigated, and 24 usually we find that there is not illegal activity; 25 however, on occasion, we find that there is illegal 1 activity. 2 In 2011, the Niagara Falls Police Department 3 and agents from the Federal Drug Enforcement Agency 4 arrested and charged a local doctor who can only be 5 described, in my opinion, as a drug dealer with a 6 medical license. 7 In this case, the doctor, who was the only 8 doctor in a relatively small practice, was the 9 number-two prescriber of controlled substance in all 10 of New York State, to include New York City. 11 At the time of his arrest, there were 12 157 licensed physicians practicing medicine in 13 Niagara Falls. He prescribed more controlled 14 substance than all other physicians in Niagara Falls 15 combined. In most cases, no physical exam took 16 place by the doctor before giving out the 17 prescription. 18 In a lot of these cases, the pills were 19 resold illegally on the streets of all of 20 Western New York. 21 I realize that he is one bad apple in a great 22 majority of medical doctors and professionals that 23 take steps to ensure the integrity of their 24 profession; however, I highlight this example 25 because, again, I think the script plays out over 1 and over again. 2 In 2012, in North Tonawanda, a doctor was 3 arrested by the DEA after it was learned most of the 4 addicted patients from the 2011 case transferred to 5 him because he was freely prescribing pain 6 medication. 7 So what happens when a person becomes 8 addicted and can no longer get prescription 9 medication or afford to buy the pills illegally on 10 the street? They turn to heroin. 11 Heroin has surpassed cocaine as our 12 number-one problem that our narcotics officers face. 13 Recently, our narcotics detectives have 14 focused the majority of their time on heroin, 15 conducting raids on drug dealers and heroin dealers. 16 Law enforcement in New York, in my opinion, 17 have made great strides in this area with the I-STOP 18 program. It's an Internet system of tracking 19 overprescribing. 20 This system severely reduced the flow of 21 prescription opiates, such as Oxycontin; however, 22 what it did indirectly, is it raised the price of 23 the illegal pills, driving more people to the 24 illegal use of heroin. 25 For example, a single bag of heroin on the 1 streets of Niagara Falls today you can get for 7 to 2 10 dollars, compared to 40 to 100 dollars for a pain 3 pill on the streets of Niagara Falls. 4 It's quite a savings if you're a drug 5 dealer -- or, drug user. 6 As the sheriff had told you, this problem 7 knows no boundaries. It happens to urban, rural, 8 suburban parts of the county, state, and country. 9 It happens to the young, the middle-aged, the 10 elderly. It crosses racial, economic, and social 11 boundaries. 12 Again, to reemphasize: On the street, heroin 13 is cheap, it's easy to buy, it's easy to conceal if 14 you're using it, and it's easy to hide from the 15 police on the street and during search warrants. 16 Recent studies estimate the number of heroin 17 users is around 330,000 nationally, and growing. 18 That's about 70 -- that's about a 75 increase from 19 5 years ago, and almost three times, compared to a 20 decade low of 119,000 in 2003. 21 So your question is, I guess, where do we go 22 from here? 23 In my opinion as a law-enforcement 24 administrator, and, again, spending the majority of 25 my time investigating these narcotics crimes, we 1 have to take a hard look at the way the physicians 2 are subscribing (sic) these medications, because 3 I believe that could be a core root of this problem. 4 We have to monitor the amount that are given 5 out. 6 We have to enforce the applicable laws that 7 the district attorney talked about. 8 Why (sic) I do think diversion and treatment 9 for users is crucial, I agree with the sheriff that 10 we have to punish and prosecute those offenders 11 because of this epidemic. 12 Again, I will tell you, I believe firmly that 13 it can only be done with the help of everybody in 14 this room. 15 And I would like to thank the 16 district attorney, Mike Violante, for his vigorous 17 prosecution of drug dealers; the sheriff and the 18 U.S. Attorney's Office, because we all work 19 together, as well as my law enforcement partners. 20 I'd also like to thank you, Senator Ortt, 21 because like I said in the beginning, and I felt it 22 was important to say that in the beginning, 23 oftentimes, whether it's drug use or any other type 24 of crime that's committed, our voice doesn't often 25 resonate up the channel. 1 So we appreciate you listening to the foot 2 soldiers, like you talked about, which, basically, 3 is all of us, because none of us -- you know, none 4 of us run departments that are so large where we're 5 not out there on police calls also. 6 So, that's my opinion, and I'm happy to 7 answer any questions to the best of my ability, sir. 8 Thank you for having me. 9 SENATOR ORTT: Well, thank you very much. 10 [Applause.] 11 SHERIFF JAMES R. VOUTOUR: Senator, could 12 I add one thing to that? 13 SENATOR ORTT: Yes. 14 SHERIFF JAMES R. VOUTOUR: A couple important 15 dates, Chief, when you're talking about that. 16 1999 is really when, for whatever reason, 17 pain medication became prevalent. It was something 18 with the USDA, or somewhere, where they wanted to 19 manage pain better. 20 And, in 1999, when we started prescribing 21 these opiums, the pain pills, if you look at the 22 charts, the overdoses for opiums followed the number 23 of prescriptions, just like this, a parallel line. 24 As the number of prescriptions went up, the 25 number of overdose deaths went up. Parallel lines. 1 DA MICHAEL J. VIOLANTE: It's the number of 2 sales. 3 SHERIFF JAMES R. VOUTOUR: Correct. 4 Fast-forward to -- 5 DA MICHAEL J. VIOLANTE: Sales went up. 6 SHERIFF JAMES R. VOUTOUR: Sales went through 7 the roof. 8 Fast-forward to 2013: August 13, 2013, the 9 passage of I-STOP, which in law enforcement we all 10 thought was a great idea, and it is a great idea, 11 but what did it do? 12 I-STOP prevented the users from shopping for 13 these pills, because now there was a database where 14 a pharmacist could look and say, Okay, Johnny Smith 15 just got pills next door. He can't get pills from 16 me today. 17 It prevented, and greatly reduced, the 18 ability to shop doctors and to get those pills, so 19 they went to alternatives, as Chief DalPorto spoke 20 about. 21 And we look at heroin overdoses, post 22 August 13, 2013, right up, straight up in the air, 23 almost, of the overdoses, because they switched from 24 the pills to the heroin, mixed with fentanyl, and 25 there's your issue. 1 But I couldn't agree more that the doctors -- 2 OFF-CAMERA AUDIENCE MEMBER: Number-one 3 reason. 4 SHERIFF JAMES R. VOUTOUR: -- yeah. 5 SENATOR ORTT: Well, I think there's -- we're 6 going to hear later on from Avi, who most of you 7 probably know, as well as some others. 8 But, there is, and, Superintendent -- 9 I'm not used to saying that when I look at a 10 police guy. It's usually a public-works guy. 11 -- but, there is potential legislation out 12 there, and there are -- there is an effort to change 13 the way doctors are trained. And when they go from 14 medical school, on up, even to change or add 15 curriculum to their -- you know, they have to go 16 through continuing learning, just like a lawyer, or 17 whatever it was, to even add something to that, that 18 would really change -- because I believe, in some 19 cases, that there are certainly bad doctors. 20 Now, those guys, that's why we have you guys, 21 ultimately, is to try and identify that, and give 22 you the resources, whether it's I-STOP, or whatever, 23 to find those guys. 24 But there are also doctors, just like there 25 are judges, and -- who sometimes get duped, or don't 1 realize what is going on. They don't realize that 2 this kid, or this individual, before them was 3 somewhere else before, or -- or whatever it might 4 be. And, they're well-meaning, but they're not 5 trained or educated on prescription, when it comes 6 to these pain medications, and, inadvertently, they 7 are hooking people on them, at least that's what -- 8 I've heard that enough times, and I just wanted to 9 address it here. 10 Some of these things I am hearing now, you 11 know, over and over again, going back to when 12 I started in the Senate in January. 13 And I know we're going to hear more about 14 that, so I don't want to steal anyone's thunder. 15 But I think, you know, again, right there is 16 the perfect example, because this is -- these are 17 things that we can address; you know, not just at 18 your level. These are certainly things that I can 19 bring back, and my co-chairs can bring back, and we 20 can try and get legislation passed that would 21 address that. 22 I think what we're trying to do, there's a 23 lot of things, but we are certainly trying to get to 24 the core of this issue, because, unfortunately, once 25 someone is addicted and they're to a certain point, 1 unfortunately, a lot of times what you see is just a 2 cycle in a life that is now -- and I know we'll talk 3 about that as well when we get to our -- some of our 4 service providers. 5 OFF-CAMERA AUDIENCE MEMBER: (Inaudible.) 6 SENATOR ORTT: Yeah, and we'll get to that. 7 We -- we will touch on that. 8 I think we got -- again, the law enforcement 9 is one aspect. We have a variety to get through, 10 and I think we got to get through it all. And I'm 11 confident that many of your thoughts or concerns 12 will be addressed. 13 I want to thank all the folks in law 14 enforcement who are here tonight. I feel -- well, 15 first of all, I feel very safe in this room. 16 [Laughter.] 17 SENATOR ORTT: But I want to thank all of you 18 for being here tonight, because I know you could be 19 with your families, you could be home, you could be 20 cutting the grass, and, you're here, because you 21 care, because you give a crap, and you don't want to 22 see more people in the position where you get there 23 and it's too late, or back in the system. You don't 24 want to have all of that busload of people coming on 25 Thursdays. 1 So, I thank you for your support. 2 Mr. DA, thank you for being here. 3 I certainly encourage you guys to stay, but 4 I understand if someone does have somewhere to be, 5 that that's understandable too. 6 We're going to turn to the personal-stories 7 aspect now. We have three panelists in this 8 section. 9 Avi Israel, who is the parent of a deceased 10 user; 11 Christina Schweindler (ph.), who is the 12 parent of a recovering user; 13 As well as Lisa Catanese, who is also the 14 parent of a recovering user. 15 Avi, why don't we start with you. 16 AVI ISRAEL: Thank you. 17 Thank you, Senator, for holding this forum, 18 and, thank you, everybody, for participating. 19 I -- almost four years ago, I experienced the 20 worst thing that any parent can, and I do understand 21 what you're saying. 22 My 20-year-old son walked into the back 23 bedroom, put a shotgun to his neck and pulled the 24 trigger. 25 And I walked into the room, and parts of 1 Michael were all over the wall, and he was 2 struggling to breathe. And in a couple of seconds, 3 he took his last breath. 4 So I was, basically, the first one to hold my 5 son, and the last one to hold him. 6 But how did my son get there? 7 My son suffered from Crohn's Disease, and 8 Michael was prescribed into addiction by three 9 doctors that took care of his needs. 10 He was prescribed painkillers from one 11 doctor, Xanax from our family doctor, Cymbalta from 12 another doctor, and a slew of drugs for his 13 Crohn's Disease. 14 At the time when Michael was going through 15 his addiction, he told us, he says, Dad, I'm 16 addicted. 17 And my response was, What are you addicted 18 to, Mike? 19 And he says, I'm addicted to my pain pills. 20 I don't know how to get off. 21 So we went to his doctor and we asked him. 22 And I got a tap on the shoulder, and the doctor told 23 me, "I know what I'm doing." 24 Michael went through surgery, and that was 25 March of 2011. He spent 40 days in the hospital. 1 During that time, I asked the doctor again 2 about Michael's addiction, and he told me that, 3 We're going to wean him off, we're going to detox 4 him, while he's in the hospital. 5 Well, guess what? Michael walked out with 6 three prescriptions for hydrocodone and a 7 prescription for Xanax. 8 We found out that there's really no system in 9 New York State, how to control prescribing. There 10 is no system of doctors talking to each other. 11 There is no system for pharmacies. 12 Michael went into detox, and was there for 13 three days, and we were told that our insurance 14 company was not going to pay for it. 15 So Michael came home. 16 On May 17 of 2011, Michael tried to commit 17 suicide. He locked himself in the garage, with the 18 car running, and sent me a text that said, "Dad, you 19 don't deserve a son like me. I love you." 20 So I ran home; and I left my job and went 21 home, and called 911. And there was Michael in the 22 garage. And we were told we had to go to ECMC. 23 At ECMC, Michael was put into the CPAP unit. 24 And if you never saw that unit, that's okay, 25 because you never want to see it. 1 There was a woman that was relieving herself 2 on the floor. There was a guy banging his head 3 against the wall. There was a guy that was talking 4 on the phone, when there was nobody there. 5 And my son said, Dad, please don't leave me 6 here. 7 I said, Okay, Mike, we'll see what we can do. 8 And another psychiatrist came back and said, 9 Your son has a tendency to lie. 10 Well, no shit, the kid is addicted. What do 11 you think he's going say? Look at this place. What 12 do you think? Do you think anybody would want to 13 stay here? 14 So Michael came home with me at 2:00 in the 15 morning. 16 On June 4th, Michael was trying to get help. 17 He was -- there was no drugs in his system. And he 18 called his counselor, and she said there was no 19 beds. 20 And he just said, to hell with it; went in 21 the room and shot himself. 22 So here's what we found out since then, and 23 I've been doing this for close to four years now: 24 Our system is broken. 25 We have doctors who swallowed whatever 1 pharmaceutical company gave them, and they told them 2 there's a magic pill here, it's opiate, and it's 3 going to cure all the pain. 4 And the medical community, all these 5 prescribers, have bought into the bullshit that 6 pharmaceutical companies have. 7 It's 100 million people are taking pain pills 8 in this country. That's a lot of money, and doctors 9 were getting some kickbacks. 10 So instead of taking care and finding out 11 what exactly is wrong with you, they were treating 12 symptoms, not the cause. They're treating symptoms. 13 And what a great way to get somebody 14 addicted, and you know you've got a patient for 15 life. 16 So here's my son, this 18-year-old, was being 17 prescribed all these deadly medication. Not one 18 doctor talked to the other, and not one pharmacy was 19 connected with the other. 20 So we decided to start working on that, and 21 we got I-STOP going. And with the help that 22 Eric Schneiderman did, we got it through. 23 I-STOP is doing what it's supposed to be 24 doing: it stopped the flow of opiates. 25 What the State has failed to do is to make 1 sure that there's education. That was never -- that 2 was never done, because two components of I-STOP has 3 never been implemented. 4 One is, doctor education. 5 Even today, you can go see a doctor and you 6 can tell them that I got a back pain, and he'll give 7 you pills for 30 days, because that's all he can do. 8 But if you call back in a week and say, Guess 9 what, Doc? These pills are not working, I need 10 something stronger, he can give you another set of 11 pills, and he can give you 240 pills. 12 That's a loophole in I-STOP, and a lot of 13 doctors are taking advantages of it, and a lot of 14 people are using it. They can grab 240 pills, keep 15 100 for themselves, and sell the rest on the street. 16 There's no one way to fight this. You cannot 17 arrest everybody. You can't arrested every kid. 18 Because my son went to St. Joe's High School. 19 Went to University of Buffalo, was studying 20 architecture. 21 These kids are good kids. They're not bad 22 kids. 23 The temptation out there is a lot greater 24 what we had as parents. We had as parents, was a 25 bottle of beer, and we had a joint, maybe some coke. 1 Think about what a kid facing today. 2 You can go to a 7-Eleven and get these 3 synthetic drugs and get hooked on those. 4 You can get a knee injury, and go to a drug 5 dealer with a white coat and he'll keep feeding you 6 pills. 7 You can go to a dentist and have a wisdom 8 tooth pulled out, and get 30 pills. 9 This is a manmade plague. 10 This was started by pharmaceutical companies, 11 carried on by doctors, subsidized by insurance 12 companies, and here we are: we have a whole 13 generation of people who are addicted. 14 So what can we do to change? 15 We got to lobby people like Senator Ortt. 16 We got to lobby every Assemblyman or 17 Assemblywoman in our area. 18 We got to change laws, and we can do it. 19 We got to enforce education. And when I say 20 that, I mean educations for doctors -- or I should 21 say, for all prescribers. 22 Education for kids in school, not just in one 23 week, Red-Ribbon Week. 24 OFF-CAMERA AUDIENCE MEMBER: Thank you. 25 AVI ISRAEL: All week, all yearlong. 1 We have to educate the parents. 2 You should educate yourself of what the 3 doctor gives you. Is it really necessary? 4 You know, this country -- the last numbers 5 that we have is 2007. This country spent 6 $55.7 billion on opiate addiction. Okay? 7 We have laws in New York State that says 8 you cannot prescribe opiate to somebody on 9 workmens' (sic) comp longer than seven days. 10 Not a goddamn single doctor listened to that. 11 They don't send you to treatment like a 12 chiropractor. They don't send you to PT. 13 They gave you pills and send you to work, 14 because that's what the insurance company wants. 15 They want that person back at work. 16 So the person goes back to work. 17 And some of the statistics that don't go into 18 the big pictures, that you guys didn't talk about, 19 how many drugged-driving are there are? 20 My son is not part of the statistic because 21 he committed suicide. 22 So did Daniel Placek, who served his country, 23 got hurt at work. Dr. Gosi (ph.) filled him with 24 enough pills to keep him going for two years. 25 This kid, at 28 years old, hung himself at the 1 VA hospital, right in the hospital. 2 What I'm telling you is, we all need to get 3 off our asses, get involved in our community. This 4 is our problem. 5 You can't rely on pharmaceutical companies or 6 the government to save us because, guess what? We 7 built 11 goddamn hospitals in West Africa for 8 35 people to use them, but we can't spend any money 9 here. 10 You know, our government does not want to 11 spend any money here, and admit that this is a 12 manmade, this is an American-made, plague, because 13 you know what? These guys in Washington are not 14 going to get this money from the lobbyists. 15 Pharmaceutical companies are going to start making 16 less money. And who gives a crap if an 18- or 17 20-year-old kid died? 18 They don't care. That's another casualty. 19 This didn't start by anybody but the medical 20 community, which include pharmaceutical, which 21 include the doctors, which includes insurance 22 companies, which includes everybody. 23 We got one place here to treat young adults, 24 Kids Escaping Drugs. 25 You know that? All the way from Syracuse to 1 the Pennsylvania border, 62 beds. That's all we 2 have. 3 Anne Constantino will tell you about 4 Horizon Services, and how many people are on the 5 waiting list. They'll tell you about their loved 6 ones that can't get any treatment. 7 You know, we spend over $1 1/2 billion in 8 New York State on treating addiction. 9 You know what? If we spent that kind of 10 money on education, we could knock this crap right 11 out of here. 12 You know, we got a cliff, and we got people 13 falling off the cliff, and everybody at the bottom 14 of the cliff are saying, We got to build a hospital 15 for the injured. 16 But if you put a rail at the top of cliff, 17 nobody will fall down. 18 That rail is education. 19 Education will solve this problem. 20 Educate the goddamn doctor. 21 There is a bill right now in the State 22 Assembly, A.355. 23 Write it down: A.355. 24 I urge you all to call your Assembly person 25 and have them sign on to this bill. 1 It's three hours, every two years, to educate 2 the doctors in how to prescribe. 3 Senator Ortt will tell you that there's a 4 bill that passed last year, 59-to-0 in the Senate, 5 to educate the doctor. 6 The bill in the Assembly was held up by one 7 woman, Deborah Glick from Manhattan. 8 Why don't you give her a call. She cares 9 more about animals than human beings. 10 So I'm telling you, you can get -- you can 11 change things. Get involved. 12 Get involved like I did. 13 Don't sit around and cry about your son. 14 Take that goddamn anger and turn it into 15 something really positive. 16 Turn it into something positive. Lobby 17 everybody, you know? Get involved in your 18 community. Go to the schools and talk to them about 19 what's going on. 20 We do that with Horizon. We do that with 21 Kids Escaping Drugs. 22 Join our group. It's called "Save the 23 Michaels of the World." 24 Help us, you know? We need to change. We 25 need to get that stigma out of the way that addicts 1 are nothing but scumbags. 2 I don't call them "addicts." 3 I call them "patients." 4 They're patients. It's a chronic disease. 5 You know, if somebody smokes all their life 6 and gets cancer and goes into the hospital, they're 7 not gonna turn them away. They don't turn them 8 away, even though he did, he was an addict; he 9 smoked all his life. 10 But, yet, somebody that does take a pill at a 11 party, a kid that takes a pill at a party, or 12 somebody that was prescribed into addiction because 13 of a knee injury or a back injury, we shy them, we 14 call them "junkies." 15 That's not right. That's not the way it's 16 supposed to do. 17 So I urge you all: Get involved. Don't 18 swallow the crap that people give you. 19 Your kids mean something. 20 Your loved ones mean something. 21 I have a hole in my heart, and you know what 22 it is, that will never be filled. 23 Every holiday I sit and I look to see where 24 my son is. 25 But you know what? I got involved with 1 BlueCross/BlueShield, and Anne Constantino from 2 Horizon, and we had an awareness campaign, and we 3 need to keep it going. It was called "Painkillers 4 Kill More Than Pain." 5 We did something. 6 Education will solve this. 7 Education is the way to go. 8 We need control of prescribing. We need 9 doctors to stop handing out these pills like 10 Halloween candy. 11 If you get a root canal, one pill is enough. 12 You don't need 30. 13 We need education to everybody, and we need 14 easy access to treatment. 15 That's going to solve the problem. You know, 16 this is made man -- all manmade. 17 We need easy access. 18 When somebody tells you, "I need some help," 19 don't say, Come back in two weeks; don't say, Come 20 back in a month. Take them in. 21 When somebody overdosed -- and, officers, you 22 guys tell me -- when somebody overdosed, and you 23 revive them with Naloxone, what's the procedure? 24 None. 25 There is none. 1 Most places will hand you a referral sheet 2 and say, Call. 3 The Governor has a bill that he has not 4 introduced, that will mandate a hold for three days; 5 72 hours. 6 Senator Ortt, I wish you'd take that over, 7 because we need that hold, because there's 8 statistics that say that if you get treated right 9 away with Suboxone, you will last. But if you're 10 just left alone, you're gonna go right back to 11 using. 12 So I urge you all: Get involved. 13 Get involved with your legislators. Get 14 involved in your community. 15 It takes a village to raise a kid. 16 And we've lost enough kids. We've lost a 17 generation. 18 Addiction is a disease. It's a chronic 19 disease. It doesn't go away. 20 Remember that. 21 Thank you. 22 [Applause.] 23 SENATOR ORTT: Thank you, Avi. 24 I know that's -- I know you've given that 25 talk numerous times, and I know you'll continue to 1 give it until it gets addressed. 2 So I appreciate you coming here. 3 For the news cameras, you may have to edit 4 some of Avi's language, however. 5 [Laughter.] 6 SENATOR ORTT: That's okay. 7 This is live TV, Avi. That's okay. 8 AVI ISRAEL: I'm sorry. 9 SENATOR ORTT: That's okay. You don't have 10 to apologize to me. 11 OFF-CAMERA SPEAKER: It's called "passion." 12 SENATOR ORTT: That's right. 13 Thank you. 14 Our next speaker, panelist, is going to be 15 Christina Schweindler, the parent of a recovering 16 user. 17 Christina, thank you for being here. 18 CHRISTINA SCHWEINDLER: Thank you for having 19 me. 20 I sat there, after I had asked if I could 21 join this panel, and I thought, how do I summarize 22 the hell that my family has been through in the last 23 3 1/2 years in a -- 5-minutes' time? 24 You can't. 25 Addiction has destroyed my family. It has 1 ripped my son apart. 2 And, thankfully, he is still here today, but 3 we've gone through four rounds of inpatient 4 treatment. 5 This last time, and he's still in a program 6 right now, was the longest that we could get an 7 insurance company to cover him, to be in for 8 28 days. And it was a battle to get him to that. 9 And the only reason, is because it was 10 Court-mandated, because, unfortunately, my son, who 11 is a good kid, made poor choices because of 12 addiction, and got in trouble with the law, which is 13 a horrible thing in itself when you're facing 14 charges of possession, you know, having different 15 controlled substances on you, driving under the 16 influence of drugs. 17 But the person that actually called the 18 police that night, that was behind my son, if 19 I could see him today, I would hug him, because he 20 truly is the man that stopped the destruction that 21 my son was on, that I couldn't stop, that his 22 brothers couldn't stop, his father couldn't stop. 23 And you don't wake up one day and decide, I'm 24 going to use heroin today. 25 It's a gate -- there's a gateway that leads 1 into that, and like law enforcement was saying. 2 You know, my son, we live in Clarence. I've 3 raised three children. You know, suburbia, the 4 grass manicured, you know, you don't think that you 5 are going to run into this. 6 You know, stupid me. You know, I never 7 thought I would ever have to go through this, but 8 I did. I'm living it now. 9 It started from a shoulder injury from 10 sledding with his brothers, and a prescription for 11 Lortabs, and, it just triggered from there. 12 And the Lortabs got too expensive, and he 13 went to heroin. 14 It's still hard to sit here today and think 15 about the day that he actually came to me and said, 16 "Mom, I've used heroin," because my world completely 17 pulled out from underneath me. 18 The hole that Avi has is something that 19 I hope to God I never have to experience in my life. 20 And it happens. 21 And parents just need to be aware. You need 22 look for the signs that are out there. 23 You know, this was a kid that worked 24 constantly, always had money in his pocket, bought 25 his own cars, buy things for his brothers. 1 And then, all of a sudden, Mom, can I borrow 2 20 bucks for gas? 3 Mom, do you have, you know, oh, I'm a little 4 short. Can you give me a couple bucks to get me to 5 payday? 6 What did do you with your money, Carl? 7 Oh, I bought some stuff for my car. 8 You know, and the excuses started coming. 9 Be aware. 10 Don't be afraid to ask questions. 11 Look for, you know, little things. 12 Prescription. We had prescriptions sitting 13 in our house, that I never even gave it a thought. 14 You know, you're prescribed something from the 15 doctor, and, you know, we have a medicine cabinet. 16 You put it up in the medicine cabinet. 17 I went in there the one day, and everything 18 was gone. Like, I didn't even look in there, and 19 say, Christina, why would you not look in there and 20 suspect something? 21 Because I didn't think that there was a 22 problem. 23 I guess my -- my biggest thing, to be aware, 24 is -- first of all, you're all here, so that's a 25 step in the right direction, because you want to 1 have awareness. 2 But, helping someone who has a problem is a 3 challenge when they're an adult, because the parent 4 loses their voice. 5 If they need help, and they want help, or my 6 son has come to me and said, Mom, please, take -- 7 I need to go. I want -- you know, I want -- please, 8 let's -- you know, find me a spot, I would call. 9 How old is your son? 10 He's 22. 11 He has to call himself. You can't make the 12 appointment for him. He's an adult. I can't take 13 any information from you. 14 So when you have someone who is struggling 15 with addiction, and in the moment they want that 16 help, because they're either sick because they're 17 coming off of something, or, maybe they truly want 18 help, but now they're afraid because they know 19 they're going to be sick when they go into 20 treatment, now you got to pin that person down, and 21 sit them down and say, Let's call. 22 We went through that many times. 23 And the last time that he -- that Carl went 24 in, it was no thanks to my son Kevin. 25 My 17-year-old son had to sit down and say to 1 him, You've put our family through hell, Carl. 2 You're not doing this to mom anymore. If you don't 3 want to stay here, then you can't come back to our 4 house. 5 A 17-year-old brother having to say that. 6 The longest they kept him was two weeks. 7 Two weeks, and they sent him to outpatient. 8 There needs to be something implemented with 9 the insurance companies for longer care. 10 You know, if he wasn't covered under my 11 health insurance, that would be a totally different 12 story, because the government, you know, you'd -- 13 he'd have Medicaid, and they would pick that up and 14 they would pay for it. 15 But because he's covered under me, 16 everything's a battle. 17 That's where I think government just needs to 18 step in and let the parents have a voice. You have 19 someone who can't make a conscience decision, from 20 minute to minute, when they're using. 21 But you need someone -- you need these 22 insurance companies to start paying. 23 And we need more facilities. 24 There's waiting lists for Suboxone doctors. 25 There's waiting lists for inpatient 1 facilities, where, you know, we have empty hospitals 2 that could be used as facilities. 3 There's many people in Western New York that 4 need help. Many. 5 That's my thoughts for today. 6 And, you know, if I -- just think about 7 awareness, and what's in your -- you know, your 8 surroundings, with your loved one at home, because, 9 look for the little signs. 10 I was oblivious to them for a long time. 11 But, luckily, at this point, we're on a path 12 of recovery. And all I can do is hope that tomorrow 13 is another good day. 14 SENATOR ORTT: Thank you, Christina. 15 [Applause.] 16 SENATOR ORTT: I have to -- just make it 17 quick Avi, because we have other -- 18 AVI ISRAEL: I just want to make a point 19 about Suboxone, which she brought up. 20 We are running out of the Suboxone -- doctors 21 who can prescribe Suboxone in this area are just 22 about full. They are only allowed 100 patients. 23 What I don't understand is, and you guys can 24 probably jump in, and, Senator, you and I talked 25 about it, we require doctors, to prescribe Suboxone, 1 to take a test through Health and Human Services, 2 and get an Z license -- an X license from the DEA; 3 but, yet, at the same time, any Joe, Jane, or 4 whatever, that has a medical license can just get 5 from the DEA a license to prescribe narcotic. 6 So it's amazing to me that, to prescribe the 7 poison, you don't need to take a test. But to 8 prescribe the antidote, you have to take an 9 eight-hour test and pay money. 10 Something is not right. 11 SENATOR ORTT: Okay. That's a good point, 12 Avi. 13 Christina, thank, you again. 14 Our next panelist, Lisa Catanese. 15 Lisa, thank you for being here. 16 LISA CATANESE: Thank you. 17 I'm probably going to get a little bit more 18 choked up. 19 Avi is passionate. 20 I might get a little bit more teary-eyed, and 21 so I apologize if it takes me a little bit just to 22 get through my two pages here that I wrote down. 23 Today I'm here to talk to you about, and tell 24 you about, my brother who passed away 490 days ago, 25 at the age of 29. 1 When I spoke to Anne Constantino, and she 2 asked if I'd be willing to come here and speak, 3 I was very excited. 4 I read through the e-mail that was sent to 5 me, and saw that I was being asked to come here and 6 speak as a victim. And that was probably one of the 7 most devastating reality checks that I've had since 8 the phone call I got from my father when my brother 9 passed away. 10 My brother was star quarterback at 11 North Tonawanda High School, graduated 2002, with 12 every opportunity in front of him. He had his plan 13 set: he was going to go to school, he was going to 14 be a nurse. 15 He had a great life. He really -- he enjoyed 16 himself to the fullest every single day of his life. 17 He socially drank, socially smoked marijuana. 18 Got injured in 2004. 19 When he was injured in the 2004, he was taken 20 to the hospital, he had to have emergency surgery, 21 and had a plate put in his jaw. 22 When he was there, he was able to 23 self-administer his pain medication from a little 24 button that was hooked up to the side of his bed. 25 Down the road, he told me that, that moment, 1 when he pressed that button and gave himself the 2 painkiller, that nothing had ever felt that good 3 going through his entire body before. 4 That was it for him; he was hooked from that 5 moment on. 6 Because he was in nursing school, he was able 7 to inject himself with the heroin. 8 In looking back, there was things that 9 I missed. 10 He started using pain pills. 11 When he wasn't able to afford the pain pills 12 anymore, he moved to heroin. 13 He was a functioning user. He worked 14 40 hours a week. He had a girlfriend. He needed to 15 get high on a daily basis to feel normal, in order 16 to go to work. 17 He caused friction in our family. 18 He often said that my parents were his 19 enablers, and I was his disabler. 20 I would call everybody and say, Hey, mom gave 21 Phil 100 bucks to pay his electric bill. Don't give 22 him 100 bucks to pay his electric bill, to my 23 grandmother, to my father. 24 My relationship with him was strained for 25 many years, because I could not bring myself to be 1 around him. 2 I decided one night -- I watched my mom cry 3 in my kitchen, and I decided that was the night that 4 I was done sitting and watching him. 5 I drove to his apartment in North Tonawanda, 6 and I let myself in his door, and it was like a 7 scene from "Intervention." There were needles all 8 over the place, there was spoons that were burnt all 9 over the place, and he was knocked out on the couch. 10 I stayed there, and waited for him to wake 11 up. I was hollering, I was screaming at him, I'm 12 taking you to ECMC. We're going to ECMC. 13 He was flat-out refusing. "I'm going to call 14 the police on you." 15 I said, Okay, good, call the cops, because 16 maybe they'll be able to help me get you to the 17 hospital. 18 I got him in the car, and we drove to 19 291 Elm, which was a quick, get him in the door, 20 "I need him to stay here." 21 When we got there, he had used a large amount 22 of Xanax that day, but there wasn't enough in his 23 system for them to take him. 24 They told us that, in order for him to be 25 taken there, he would actually have to use more, and 1 get a physical. Once he did those two things, we 2 could go back, and, fingers crossed, that there 3 would be a bed available for him. 4 We did that, we got him back in there. 5 Two days later, he was smoking a cigarette, 6 and they kicked him out. 7 He was back in his apartment, doing his 8 thing. 9 From there, I did the same thing again, and 10 I went to the apartment, and I was kicking and 11 screaming, and I got him to go to Stutzman, 28-day 12 program. 13 I sat through every family group with him. 14 He got out, and he used again. He did this 15 for about four years, on and off. 16 And, he was finally arrested, and charged 17 with six felonies, and my family was excited. We 18 felt like, okay, finally, somebody else is going to 19 get involved. Finally, someone's going to take the 20 control out of his hands. 21 My brother was one of the first successful 22 people to complete the diversion program in 23 Lockport. 24 He -- once the diversion program told him 25 where he needed to go, he needed to go to 1 Horizon Village. He went kicking and screaming. 2 Fortunately, once you're in Horizon Village, 3 you're not allowed to talk to your family for a 4 couple of days, which was a blessing. And he -- he 5 stayed his four months there. He was a rock star 6 there. He was on -- in different programs there, 7 where he was able to go into the meetings in the 8 community. He was able to mentor other people that 9 were coming in the door. He helped plan all of the 10 family parties there; a summer party, a Halloween 11 party, for families to go there and get involved, 12 and learn, and become educated. 13 I went to every family meeting. I took every 14 phone call he ever made to me, and I never gave up. 15 I was there with him that entire time he went there. 16 When we got the phone call from Horizons that 17 said, We're going to start planning the next step 18 for Phil, where he's going to go from here, my 19 parents and I were almost kicking and screaming as 20 much as he was to go in, because we didn't want him 21 to come out. 22 He was -- the next step of his program, along 23 with the diversion program, was for him to go to a 24 place called an "Oxford House." 25 An Oxford House is a self-run, clean place 1 for gentlemen who are all going -- who are all in 2 the same steps -- same stages of recovery. 3 He was there for about two years, and, he was 4 the president at the Oxford House, which meant he 5 was a huge piece of the puzzle when somebody wanted 6 to interview to come live there; it was a group 7 decision. He was responsible for paying the bills, 8 collecting the dues from the other gentlemen. 9 They were all responsible for telling each 10 other, You need to do a drug test. You need to do a 11 drug test. 12 He said that that was probably the best time, 13 the best point in his life. He needed the 14 camaraderie that he got there. 15 And once he was at that point, he worked 16 really closely with Horizons to get out there and 17 advocate and talk to people. 18 And this is something he wrote, that was, and 19 still is, published in some literature from 20 Horizons. 21 "I am an alumni of Horizon Village. I was 22 admitted in the summer of 2010. I truly had no 23 other options. Due to my substance abuse, I had 24 destroyed all aspects of my life. I lost the career 25 I had in my profession. I had driven my family, 1 friends, and girlfriend away. I have legal issues 2 with serious consequences. I was financially, 3 emotionally, and spiritually bankrupt. 4 "Having nowhere to go, no way to get there, 5 and nothing to do when I got there, I found myself 6 in the lobby of Horizon Village, not knowing what to 7 expect for the rest of my so-called life. 8 "My first weeks were rocky. I was angry. 9 This is where I had ended up at this point in my 10 life. I never had more than one week clean from all 11 substances. 12 "Just the time away from the drug was a huge 13 part in my path to finding myself. 14 "Horizon Village allows to you become 15 proactive in your treatment. I started to grow in 16 my recovery because of this. I found qualities in 17 myself I either overlooked or didn't know that 18 I had. 19 "By completion, I had a grasp on who I was 20 and how I got to be the person I wanted to be. 21 "Recently, I was offered a job in my chosen 22 profession, offering better opportunities than the 23 job I had lost before my stay at Horizon Village. 24 "I wish I could say it came to me with ease, 25 but that is simply not true. I lost good people in 1 my life for different reasons. 2 "One thing I learned, is that no matter what 3 it is, Horizon Village, recovery or life, it's not 4 easy, but it's fair. 5 "Everyone is given 24 hours in a day. What 6 you choose to do with today greatly affects what you 7 could do with tomorrow. 8 "I adopted this motto while at 9 Horizon Village. 10 "I don't know where I would have ended up, 11 but if I never went to treatment, I can definitely 12 say my time at Horizon Village saved my life." 13 In 2013, my brother relapsed, and he relapsed 14 hard. He went back to using what he had used, the 15 amount of what he had used, years before. 16 We found ourselves in the same predicament 17 again, so, we did what we needed to do to have him 18 arrested, to put him in the holding center, to keep 19 him off the street. 20 Visiting my brother in jail twice a week was 21 the most devastating environment that I wanted to 22 see him in, but I saw him, and I went the two times 23 a week, and I took every phone call that he made 24 from the holding center, because he knew I was 25 always going to be there for him. 1 On December 30th of 2013, he was at court, 2 and he was scheduled to do a door-to-door transfer 3 the next day. 4 On December 31st, he was going to wake up, he 5 was going to get in a van and go to Horizon Village. 6 And the night before, I was talking to him, 7 and he said, Lise, something just doesn't feel 8 right. I feel like I'm broken. 9 And I just said, Stop it. I'll see you at 10 the Village tomorrow. I've got your bags packed. 11 You're going to be fine. I love you. I'll see you 12 tomorrow. 13 At 10 a.m. the next day, the van from 14 Horizon Village went to pick him up. 15 When the door was opened from the holding 16 center, he ran. 17 And my dad called me and said, Your brother 18 ran. 19 I said, You're frickin' lying. He did not 20 run. Don't say he ran. 21 He ran. 22 We thought, it's only going to be a couple of 23 days, he's not going to last long on the street. 24 He's going to need one of us, he's going to call. 25 Pins and needles, waiting for that phone 1 call. 2 On January 2nd of 2014, I was at work. It 3 was snowing that day. We were allowed to leave work 4 early, and I was pretty excited. It was my son's 5 birthday. We were having a birthday party at 6 Chuck E. Cheese for him that night, and I was on my 7 way to Wegman's to get his birthday cake. 8 My phone rang, it was my dad. He said, What 9 are you doing? 10 I said, I'm driving. 11 He said, You need to pull over. 12 I said, I can't. I got -- what's going on? 13 And he said, Your brother's no longer with 14 us. 15 And I said, That's not true. 16 And he was sobbing at his desk at work, and 17 he said, Your brother's longer with us. 18 And I said, Well, you're his father, so fix 19 it, because that's not acceptable. Don't tell me my 20 only sibling is gone. 21 I don't remember what transpired over the 22 next couple of days. 23 I know that, at this point, I can't get an 24 image out of my head every day of my brother passing 25 away by himself in a hotel room. 1 I can't drive past a Red Roof Inn without 2 getting pain in my heart. 3 Here we are, 490 days later, and it feels 4 like it was yesterday. 5 He left behind a fiancee and a one-year-old 6 baby girl. 7 And, my heart hurts every day. 8 I don't know how my parents function, because 9 I look at my kids every night, and put them to bed, 10 and I don't know how my mom feels to know that her 11 baby is gone. 12 This is never going to change. It's going to 13 continue this path that it's on. 14 And one thing I learned and he taught me, was 15 that it's a disease. 16 It's a disease. It's nothing to be ashamed 17 of. 18 People that have cancer aren't ashamed. 19 People that have diabetes aren't ashamed. 20 It's a disease, and it needs the attention 21 that every other disease that's out there gets on a 22 regular basis. 23 That's my story. 24 And this is a picture of my baby brother, and 25 I appreciate you giving me the opportunity to come 1 and tell his story, because I think that, something, 2 if I can help one person by telling his story, 3 that's an amazing thing. 4 And he was an awesome person, and I'm not 5 going to let his addiction justify his life. 6 [Applause.] 7 OFF-CAMERA SPEAKER: A sad chapter doesn't 8 make a book. 9 SENATOR ORTT: Lisa, thank you very much 10 for that. I know it was not easy for you, but 11 I certainly appreciate you doing it. 12 We now move to the last segment of our 13 panelists, certainly not least. 14 Anne Constantino is the president & CEO of 15 Horizon Health Services, where, once upon a time, my 16 mother-in-law worked, and we've heard tonight about 17 their value. They're certainly a leader in 18 Western New York, and in other areas, in addiction 19 treatment. 20 So without further ado, Anne, I'll turn it 21 over to you. 22 ANNE CONSTANTINO: Thank you. 23 I was actually hoping it wasn't going to be 24 me so I'd have a little more time to collect myself, 25 because I have to say, every single story, family, 1 person, matters, not only to me, but to everybody in 2 my organization that is on the front lines and the 3 foot soldiers on the treatment side. 4 So, let me read my remarks. 5 Thank you, Senator Ortt, and the Committee, 6 for the opportunity to share my perspective on the 7 heroin crisis in our community. 8 My name is Anne Constantino. I'm the 9 president & CEO of the Horizon Corporations, which 10 include Horizon Village, and Horizon Health 11 Services. 12 And, recently, in 2014, we took over 291. 13 And I do want to say that it wasn't us that 14 kicked him out for smoking. 15 I am not a doctor. My training and 16 background are actually in addiction treatment, and 17 I've worked in the field of treatment recovery for 18 over 30 years. 19 The mission of my company is recovery; saving 20 lives and changing lives. 21 I'm an optimist by nature, but I want to say 22 that we are losing the war. 23 The past 10 years of my 30 years have been 24 unlike anything I ever would have imagined when 25 I started in this field. 1 And every day, when I think that we've seen 2 the worst of it, we haven't, and it is 3 heartbreaking, the tragedy that continues. 4 So, a few statistics. 5 In 2014, in Erie County alone, 2014, the 6 stats I have is that we lost 116 people to fatal 7 opioid overdose. That's more than two a week. 8 The numbers for 2015 I know are worse. 9 And we can easily estimate that the number of 10 non-fatal overdose, and the costs of those non-fatal 11 overdose, are astronomical. I can't even imagine. 12 And we don't know, and so many go unreported. 13 Most weeks, we, my agency, we know, either 14 we've served people in the past or they're current, 15 of several individuals that have died or overdosed. 16 I said "several." 17 Several. 18 This is, like, unheard of. And, we're just 19 one -- we're just one place. 20 Anybody who is in the treatment field, we're 21 in completely unprecedented territory; and, frankly, 22 we're unprepared. 23 Our hearts are broken with the families that 24 we work with. It's so sad. 25 I was saying on the way here, we have grief 1 counselors in our organization going and treating 2 our counselors. 3 And we cannot comprehend, and don't want to 4 comprehend, how devastating the losses are to the 5 families. 6 So as the sheriff said, yes, this is 7 personal. It's personal for us. 8 And I don't understand how it can be that we 9 are losing this many people, and we've not had a 10 huge call to arms. 11 And, you know, thank you for this, but, this 12 is -- think about what we did for Ebola. 13 I can't imagine that anything else could 14 happen and this many people would die, and this many 15 families would be affected, and, it's just not 16 enough. It's not enough. 17 So, we know how we got here. I don't have to 18 go into that. 19 You know heroin is a highly addictive drug. 20 Opiates are highly addictive. 21 We're -- as human beings, our biology, we're 22 powerless over the attraction of that kind of drug. 23 The addiction happens fast, with a rapid and 24 frightening decline. Individuals and their families 25 don't see it coming, and they don't know what to do. 1 Families alternate, really, between denial 2 and fear, rationalization and anger. They are so 3 not prepared for what is happening. 4 Imagine how any of you would feel if your 5 children were suddenly different, sick, unreachable, 6 and lost to you, for a deadly drug. 7 Horizon Health Services and Horizon Village 8 are on the front line of the battle. We serve 9 individuals and families experiencing problems with 10 behavioral health. 11 We know, we know from research and 12 statistics, and I'll spare you the details, that for 13 this kind of addiction, Horizon Village, or 14 something like Horizon Village, is the best chance 15 somebody has. Enough time and distance, not a few 16 weeks; enough time so that they come back, and they 17 become the people that they were. 18 It's the preferred level of care. 19 And the waiting list to get into 20 Horizon Village ranges between 65 and 100 people at 21 any given time. Those are not applications. Those 22 are people whose applications are completed, that 23 are waiting. 24 They're waiting. 25 If someone can't get into long-term 1 residential treatment, what are the alternatives? 2 You guys triage drug dealers? 3 We triage patients. 4 Horrible. 5 For some, they will go to short-term 6 inpatient which will provide some basic crisis 7 stabilization. 8 Others are linked directly to outpatient 9 treatment, which is generally ineffective in 10 providing enough structure for early recovery. 11 It helps if they're on medication-assisted 12 treatment. And we've already talked about the 13 waiting list for Suboxone. 14 Also, let me say, that nurse practitioners, 15 which are licensed and credentialed in 16 New York State to prescribe medication, cannot, even 17 with an eight-hour course, cannot prescribe 18 Suboxone; nurse practitioners, which are the, you 19 know, backbone of our health-care industry. 20 For individuals with serious addiction, and 21 their families, they're experiencing a living hell. 22 No one wants to be an addict. Unfortunately, 23 the power of opiate addiction is overwhelming. That 24 powerful addiction often leads to tragic results. 25 So what do we need to do now, and not wait? 1 We need to take action at every level of the 2 community. This is a public-health and community 3 crisis, and it should not wait any longer for us to 4 get more resources. 5 All sectors of the health-care and 6 human-service delivery system must be on alert and 7 participate in the prevention identification, 8 intervention treatment, and follow-up for serious 9 addiction. 10 Everybody in the health-care system, for them 11 to do that, they need education, and they need 12 support. 13 First, and foremost, broad-based community 14 prevention through information and education is 15 essential. It's important to know this is not a 16 disease of choice, willpower, or character. 17 And, educating children in fifth grade is not 18 the solution. We need a broad-based community 19 campaign of ongoing education. 20 We need harm reduction. 21 The power of the addiction leads to impulsive 22 and dangerous behaviors, often resulting in 23 overdose. 24 We can, and we do, save lives, by being aware 25 of the signs of overdose, and by equipping 1 everybody, honestly, everybody, in the community 2 with Narcan, which is the antidote to opiate 3 overdose. 4 We give Narcan to families, and every family 5 member needs Narcan. 6 If you are sitting there and you have a 7 family member who is addicted to opiates, and you're 8 not trained on Narcan, you need to call us, and 9 we'll get you trained and get you a kit. 10 There is a shortage of the kits, though, so, 11 that is a problem. 12 Yep. 13 Harm reduction can include engagement 14 interventions and community-based supports, 15 including support for families whose loved one is 16 either in early recovery or has relapsed or 17 continues a drug-abusing lifestyle. 18 When someone is struggling with a serious 19 addiction, we need to open as many doors of support 20 as possible for them and their families. 21 They're seriously ill. 22 Treatment is effective. Make treatment 23 available on demand. 24 We need to do the -- in order to do this, we 25 need to expand treatment and long-term recovery 1 resources in our community, including supportive 2 housing, recovery coaches, case managers, people out 3 in the community working with people. 4 Treatment can include medication and 5 counseling. The sooner someone can start, the 6 better. 7 We know that long-term recovery is possible, 8 and that affected individuals can live long, 9 healthy, and happy lives. 10 We're grateful to the Governor and to OASAS 11 for approving Horizon Village for an expansion grant 12 in 2013. 13 And I actually want to credit Avi and his 14 group for -- although, we've been screaming about it 15 for years, families make a difference, because they 16 think we're self-serving; like we wanted to serve 17 more people. 18 Honestly, we don't. 19 I'd be happy to sell shoes. 20 Those 25 beds are under construction and 21 development, and they'll be open next year. 22 Thank God it will help, but not solve our 23 problem. 24 Lastly, I want -- I want to -- I know that 25 people recover at their own individual pace. They 1 want to get better. 2 They want to get better. 3 It's hard. 4 We know that people can get better. 5 So, lastly, we need to do better. This is 6 urgent. 7 I'm hoping that, if you don't remember 8 anything else I said, it's about the urgency of the 9 problem. 10 We can have a lasting impact on this 11 epidemic, but it needs to be an urgent priority at 12 all levels. 13 Thank you. 14 [Applause.] 15 SENATOR ORTT: Anne, thank you very much. 16 I just want to mention that Anne has spent 17 her life doing this; her adult life. 18 So, she's only 35, but she's spent all those 19 years doing it. 20 [Laughter.] 21 ANNE CONSTANTINO: Thank you. 22 SENATOR ORTT: But, Anne, thank you very 23 much. 24 Okay. Our next panelist is Paul Wacnik, 25 who's a Ph.D., field medical director for Pfizer. 1 Paul, thank you for being here. 2 PAUL WACNIK, Ph.D.: Thank you. 3 I'm definitely going to change gears a little 4 bit and talk about pain medications. 5 And, of course, you know, I'm with Pfizer, so 6 we are developing pain medications, but these new 7 medications actually incorporate technology designed 8 to make misuse and abuse a lot more difficult. 9 And I really appreciate the Senator's efforts 10 to understand the entire spectrum of opioid use, 11 and, of course, abuse. 12 And my specialty is pain, pain management. 13 This afternoon -- and, again, I appreciate 14 your time. 15 So I'm a scientist at Pfizer, I'm an employee 16 at Pfizer. However, certain views that I'm going 17 talk about today are really my own opinions, and not 18 necessarily those of Pfizer. 19 And I didn't receive any honorarium or any 20 money to be here as well. 21 So part of my job, actually, is education. 22 In fact, that's one thing I do, is talk about 23 these new technologies, to make sure that everyone 24 is aware of them. But I also talk to physicians 25 about the different types of pain, the pains that -- 1 where opiates are really not appropriate, and some 2 pains that opioid may be appropriate. 3 So let's first look at why doctors even 4 prescribe opioids. 5 As Avi mentioned, there's 100 million 6 Americans on chronic -- with chronic pain. 7 And if you combine all the cancer patients, 8 diabetic patients, heart-disease patients, it's 9 actually larger than that. 10 So, certainly, chronic pain is an epidemic of 11 its own, in its own right, and it's very costly. 12 The Institute of Medicine estimates 13 $6 billion a year it costs to manage in lost work 14 productivity for chronic pain. 15 And, certainly, the biopharmaceutical 16 companies, biotech companies, you know, have other 17 drugs other than opioids. And we're working on new 18 drugs as well, that are not opioids. 19 But, today, there's still a place for 20 opioids, for the right patient. 21 And that's what we're getting at: it's got to 22 be the right patient. 23 And if you look at what these drugs say, and 24 this is what the FDA approves, it's only for the 25 patient that's failed other modalities, and these 1 are the extended-release opioids. 2 Now, the extended-release opioids are the 3 ones that have the highest opioid content. They're 4 made to be slowly released in the body for chronic 5 pain. 6 But once they're abused and tampered with, 7 then you get -- they get the big high, and that's 8 why they're abused. 9 So the technologies I want to talk about 10 today, are really to kind of, you know, hamper that 11 tampering ability. 12 And as we've been talking about, I mean, 13 there's a lot of costs, you know, and I don't need 14 to go over that, of treating abuse; you know, 15 medical costs, law-enforcement costs. 16 So, we certainly should be able to find money 17 to, you know, use these new technologies. 18 So what can a drug company do? 19 So we work with the FDA to actually develop 20 these. We're developing the technologies. The FDA 21 is giving us guidance; like, what you need to do to 22 show that these are -- potentially, can prevent 23 abuse, but still deliver pain relief. 24 So when we have a drug like this, we 25 certainly have to show they're effective for pain 1 relief, but also that they -- when tampered with, 2 they're not -- as -- you know, patients don't get 3 the high. 4 So the science is still evolving, but the FDA 5 has definitely recognized that this is -- this work 6 is important. 7 In fact, the deputy director for regulatory 8 programs, Dr. Throckmorton, stated, "The development 9 of these abuse-deterrent opioids is a public-health 10 priority for the FDA." 11 Similarly, the White House expedited the 12 development of these abuse-deterrent formulations in 13 one of their steps to address the prescription-drug 14 epidemic. 15 So I think a lot of people are on board. 16 Certainly, some pharmaceutical companies are 17 on board, including my own. 18 So the FDA came up with these guidance, and 19 what are the technologies? 20 There's several categories of technologies, 21 and the first technology that's been out there, is 22 to make the drug hard to crush. So you can't -- you 23 hammer it, you try to put it in a coffee grinder, 24 and it doesn't turn to a powder, so you can't snort 25 it. 1 OFF-CAMERA AUDIENCE MEMBER: You can't snort 2 it, but you can melt it. 3 PAUL WACNIK, Ph.D.: You can melt it? 4 But it's also -- that's one -- as I say, 5 that's one of the technologies. 6 So this is a brand-new area for developing 7 drugs, so that's one of the technologies. 8 If you try to dissolve it, it turns into a 9 gel so you can't inject it. 10 Other drugs, opioids, will have the 11 painkilling part and an antagonist, or something 12 that works against it. 13 So if you take the drug, you'll get -- and it 14 goes in your gut, you'll get pain relief, and it 15 will pass through -- the other drug will pass 16 through your body. 17 But this antagonist, if you crush it, and if 18 you dissolve it, it will come out in that solution. 19 So when you try to get high off of it, that other 20 drug blocks part of the high. So, only when it's 21 tampered with. 22 So those are two technologies that are out 23 there today. 24 The drugs are out there, they're available 25 to -- for prescribers to prescribe. 1 Future drugs will look like aversions. 2 So if you take an opioid the wrong way, you 3 try to abuse it, you'll get another drug that will 4 activate a fever or flushing or something that's 5 going to make it really unattractive to get high off 6 of that drug. 7 Another thing might be a delivery system, 8 where you actually put a depot in the arm, and it 9 slowly releases the pain drugs, and you can't, 10 again, get that high, where you get a lot of drug 11 into your system. 12 And other things, like prodrugs, that's a 13 technology that's -- the drug, the painkiller, 14 doesn't actually become active until it's in your 15 gut. So it's something that reacts in your body, 16 then you get pain relief. You can't manipulate it 17 outside of the body. 18 Again, this is our future, and I think this 19 is where pain opioids are going. 20 And as I mentioned, we're working at other 21 targets, other than opioids, but opioids still -- 22 still play a role. 23 So the FDA does actually work with us, to 24 make us show that these are going to, potentially, 25 prevent abuse. 1 So, we have to do things on the laboratory 2 bench, such as the crushing, the grinding. You 3 know, we look at a serum of volunteers, to see if 4 there's more or less of the opioid in there. 5 But the ultimate test we have so far, is 6 actually to look at, actually, drug addicts. 7 So we give them, we blind them, so, here's 8 the non-abuse drug; here's the abuse-deterrent 9 formulation. And they don't know which it is. They 10 either snort it, inject it, or take it orally, 11 overdose -- not overdose -- I mean, just high 12 concentration. 13 And you ask: How high? How much do you like 14 it? Would you take it again? 15 And these abuse-deterrent formulations have 16 to show that there's a big reduction in that liking 17 of the drug. 18 And that's what the FDA has -- the guidance 19 they've given us, these are the kinds of studies we 20 have to do, and then we can get this labeling. 21 But, again, that's a very -- that's one -- 22 you know, it's one study, with about 30 patients -- 23 or, subjects, volunteers, but what does it mean when 24 it gets into the field? 25 Is it going to affect emergency room visits? 1 deaths? 2 I mean, those are the kinds of things we're 3 still learning. 4 One of these drugs, Oxycontin, has been out 5 now since 2010. 6 So we have -- you know, people have looked at 7 the data, and they've looked at, how does that 8 affect use of that drug? 9 And it turns out that it really has affected 10 the abuse of Oxycontin. 11 In fact, there was -- the study shows there 12 was a 41 percent decrease in abuse of Oxycontin. 13 So that's one drug that's abuse-deterrent. 14 It's not as valuable for the street value, and it's 15 abused a lot less. 16 We see that -- we that every time there's -- 17 well, there's only one that's been out there for a 18 while, and it actually seems to really drop, in the 19 real world, some of this abuse behavior. 20 There's also some cost estimates connected 21 with abuse-deterrent formulations. 22 And we talked about all the costs and the 23 issues with treating abuse and addiction. 24 In fact, one researcher showed that, overall, 25 there could be -- that Oxycontin, in its 1 abuse-deterrent formulation, actually saved 2 $430 million annually in health-care costs. 3 Another researcher estimated that, if all 4 drugs were abuse-deterrent, we could save between 5 1,700 and 4,000 dollars per patient. 6 So there is definitely cost-savings with 7 these deterrents, I think. 8 So, I just want to summarize: 9 So abuse-deterrent opioids incorporate 10 technology designed to make the opioids more 11 difficult to manipulate, misuse, or abuse, while 12 still providing pain relief for the chronic-pain 13 patients. 14 And it should also be noted that, all 15 opioids, even these new technologies, can still have 16 some -- they still have the potential to be misused 17 and abused and diverted. And predicting exactly 18 who's going do that is a task that's very difficult. 19 So the opioid crisis is extremely difficult. 20 There's no magic bullet, as the Senator pointed out. 21 And, abuse-deterrent opioids will not be the 22 sole solution, but they can play an important role 23 as part of a comprehensive approach to adjust 24 misuse, abuse, and diversion. 25 So I ask the Senators to do what they can, by 1 oversight or by laws, to make sure that there is no 2 untoward barriers for doctors and patients to get 3 these abuse-deterrent opioids. 4 And I thank you for your time, and I'll 5 answer any questions. 6 SENATOR ORTT: Thank you, Doctor. 7 I know, Superintendent DalPorto, you have a 8 question. 9 SUPT. E. BRYAN DALPORTO: I just, more so of 10 a statement, really to the panel, and you, Senator. 11 And, with all due respect, sir, we certainly 12 appreciate the science behind it, because, 13 obviously, we need medications to cure illness. 14 So I say this with all respect, and I can 15 just tell you what I know as a policeman. I'm 16 certainly not smart enough to be a scientist. 17 But, when -- and I say this as an advisory to 18 the board, to yourself, when passing legislation, 19 and to your company, what we've seen in law 20 enforcement, often, specifically in a lot of our 21 cases in Niagara Falls, we've seen where doctors are 22 prescribing those pain medications, Oxycontin. 23 And then, you're right, the company has come 24 out with fixes, such as time-release mechanisms, 25 things like that, to make it less attractive to the 1 user, and to the doctor to prescribe. 2 That said, we've also seen the doctors then 3 turn around and prescribe a different type of 4 medication without those safeguards. 5 So my suggestion to you, sir, and your 6 company, and, again, with all due respect, when you 7 reengineer a drug or a narcotic to fix an issue, 8 let's take the old one off the market so that can't 9 happen; and, specifically, it happened with Oxy and 10 Opana. 11 [Applause.] 12 SUPT. E. BRYAN DALPORTO: And I say that with 13 all due respect. 14 I know, you know, your job on this panel, 15 specifically tonight, is very difficult, and I say 16 that with all appreciation. 17 But I do think the only way to fix this 18 problem is to be true and open. 19 And I think, you know, that's something that 20 really happened. You know, they switched from 21 Oxycontin, because of your good efforts, and moved 22 to Opana, which did not have the time-release 23 mechanism. 24 So if we're going to fix it, let's take the 25 old one off the market. 1 OFF-CAMERA SPEAKER: Yeah, I agree. 2 OFF-CAMERA AUDIENCE MEMBER: Isn't there a 3 drug, there is a shot, because my son wanted to get 4 it. There's a shot -- 5 OFF-CAMERA SPEAKER: Vivitrol. 6 OFF-CAMERA AUDIENCE MEMBER: Yeah, yeah, if 7 you can't -- right. Because he was in rehab, he was 8 doing so good, I can't tell you. And he wanted that 9 shot before he got out, but his insurance wouldn't 10 give to it him. 11 SENATOR ORTT: Wouldn't cover it. 12 OFF-CAMERA AUDIENCE MEMBER: So he got 13 Court-ordered by, Judge Violante, court-ordered it. 14 But, then, my son wanted so bad to have it 15 before he got out, because most kids that are on 16 this, they don't want to be on it. You know, let's 17 be honest. 18 So, he -- Horizon, he's already been through 19 Horizon, boo-beep, boo-boop, he did everything, 20 right. 21 So now he's in trouble, goes through all the 22 other crap. 23 So, now, he has to go to Horizon to get the 24 shot. Horizon makes him go through like these three 25 different parts all over again, he's already been 1 through, and then he killed himself. He did it 2 right before he was going to get the shot, he did it 3 probably as much as he used to do, and he, OD'd, 4 because Horizon wouldn't give -- I'm not blaming 5 Horizon, but, you know, I just to -- 6 SENATOR ORTT: I know. 7 OFF-CAMERA AUDIENCE MEMBER: -- try to -- 8 SENATOR ORTT: And I -- I -- well, and -- and 9 I don't want someone up here to be blamed, because 10 there's no one -- 11 OFF-CAMERA AUDIENCE MEMBER: No, but 12 I just -- 13 SENATOR ORTT: No one -- 14 ANNE CONSTANTINO: That's -- it's okay. 15 SENATOR ORTT: -- and -- 16 OFF-CAMERA AUDIENCE MEMBER: (Inaudible.) 17 ANNE CONSTANTINO: Yeah, I do. 18 OFF-CAMERA AUDIENCE MEMBER: It's too bad the 19 insurance companies have to be like that. And I'm 20 sure that's why Horizon did that, because of certain 21 insurance regulations. 22 OFF-CAMERA SPEAKER: Regulations. 23 OFF-CAMERA AUDIENCE MEMBER: It shouldn't be. 24 SENATOR ORTT: And that's why we're here, 25 though, tonight, is to identify these things. 1 And I do want to make a statement about 2 Mr. -- Dr. Wacnik. 3 One of the things that I do think, you know, 4 Pfizer is not changing and spending millions of 5 dollars to come up with new drugs because they just 6 want to. 7 They're doing it because there's pressure to 8 do it. 9 And that's -- so I say that only to say that, 10 coming here, and calling your legislators, and going 11 to the news stations, and getting involved like Avi 12 talked about, it does work. 13 It is slow, and it's never as fast as we want 14 it to be, and it never brings back these people up 15 here. 16 But, each day, just like the recovery, each 17 day, Avi has to get up, and we have to push forward. 18 Each day, we have to make the calls. 19 And, slowly, you start to see new drugs come 20 out, with different safeguards, and that's a 21 component, because you're never going to get rid of 22 all pain medication. I think we all know that. 23 There is legitimate pain medication, and there are 24 going to be companies that produce it, and it's a 25 multi, sort of, process. There's the doctors, 1 there's the company, there's the insurance, which 2 that woman talked about, which I hear all the time, 3 insurance companies that really are -- there's an 4 issue there. 5 And I'm not picking on insurance companies, 6 because I'm going to get to them next. And I don't 7 want -- we saved them last. 8 No, I don't want to -- again, everyone here 9 plays a part in the ultimate solution. It's not one 10 person. It isn't the cop who locks the person up. 11 It isn't just the drug company. And it's not just 12 the State representative, or the person at Horizon, 13 or -- it's got to be all of this. 14 And part of it is learning this. 15 For me, certainly, I'm learning a lot. 16 I learned a lot last night. I learned a lot today. 17 But, again, I think this is an important part 18 to understand, that there are efforts, and there is 19 science afoot, to try and come up with very creative 20 ways to prevent people, you know, from abusing it. 21 Avi. 22 AVI ISRAEL: Senator, I just want to, Paul, 23 first of all, I commend you for being here, because 24 you were going to get beat up no matter what. 25 [Laughter.] 1 PAUL WACNIK, Ph.D.: True. 2 SUPT. E. BRYAN DALPORTO: But, I mean, 3 I really would like to ask you, in your own personal 4 opinion: Do you really think that opiates should be 5 prescribed for moderate pain? 6 And let's be honest. 7 Because, the FDA has approved opiates to be 8 prescribed for moderate to severe pain. 9 There is a place for opiates. 10 My God, if I was dying of cancer, give me all 11 the opiates in the world. 12 But if I have a back pain, you know and I 13 know that, that, you know, the use of opiates for 14 back pain, and stuff like that, really doesn't work. 15 Long-term use of opiates to eliminate pain 16 does not work. It just, basically, masks the 17 symptoms. 18 Do you really think that doctors should be 19 educated, when to prescribe it? 20 And do you think that the public should be 21 educated on when to take it? 22 And do you think that, let's save it for just 23 the severe pain? 24 I'd like to hear what you have to say. 25 PAUL WACNIK, Ph.D.: Yeah, so I don't 1 prescribe to anyone, because I'm a scientist. 2 AVI ISRAEL: No, no, I understand that. 3 PAUL WACNIK, Ph.D.: But I've studied pain, 4 you know, mechanisms, and know how opiates work, and 5 when they're... 6 And the simple answer is, yes, there should 7 be better alternatives to opioids. 8 The problem, the thing is, that opioids 9 still, because there aren't good enough alternatives 10 for opioids, we still are stuck with them for a 11 while. 12 I think we're working on better alternatives. 13 They haven't come along. 14 Pharma's tried a long time to have 15 alternatives, and it's not really been that 16 successful. 17 But, you're right; I mean, the science is 18 kind of -- is not that strong for long-term opioid 19 use. 20 In fact, it's more -- it maybe do more harm 21 for the patient than good. 22 But that said, for short-term use, possibly, 23 but then it's low doses. 24 So, I think education, and getting the 25 right -- again, the right patient, the right dose, 1 is where we gotta go. 2 So -- and the training, you know, for the 3 physicians is maybe not good enough. 4 SENATOR ORTT: And, Doctor -- 5 And thank you for that question, Avi. 6 Doctor -- 7 Yes. 8 OFF-CAMERA AUDIENCE MEMBER: I just want to 9 take a minute. 10 I wanted to say that I appreciate all you 11 people coming, and all that stuff. And I agree with 12 a lot of what -- 13 SENATOR ORTT: We don't have a mic. 14 Ma'am, if you could just use the microphone. 15 OFF-CAMERA AUDIENCE MEMBER: -- and I 16 appreciate it, you know. 17 And I must say, I really feel bad for the 18 officers, and the reason I do, is because I don't 19 think you have enough men to get these guys who are 20 pushing it, because that's the origin of the drug 21 traffic. They're the ones that are pushing it. 22 They go to Target and Wal-Mart and buy these 23 phones that they throw out. And I thought, they 24 don't want to get involved because, see, that's 25 business. 1 Our lives don't mean anything, but, see, 2 that's business. 3 And if they had cameras to see who's buying 4 these phones, even though they send other people in 5 to buy them, they toss them. They buy five, six, at 6 a time, so they can't be traced. 7 Isn't that true? 8 SUPT. E. BRYAN DALPORTO: Yes, that's 9 absolutely true. 10 OFF-CAMERA AUDIENCE MEMBER: I understood 11 that. 12 And the other thing I heard, which I thought 13 was very valuable, is that there was a country, 14 I think, in South America, and I think it was 15 Bolivia, and I heard this not too long ago, and they 16 cut off the smugglers and the drug trafficking by 17 making tough laws. 18 If you sell it, you get killed if they catch 19 you. 20 So your walk to get these guys won't be at a 21 loss. 22 They will go to trial, whatever, and they'll 23 get killed; they'll take the electric chair, or get 24 shot. 25 And the ones that probably -- especially for 1 the kids who die because of these things, they're 2 being pushed, they call these kids, they call them 3 up, to see if you need anymore. 4 And the other thing is, these kids are afraid 5 to do anything, because they have the drive-bys, 6 where they threaten your family. 7 Isn't that true? 8 OFF-CAMERA SPEAKER: Yes. 9 SENATOR ORTT: Ma'am, do you have -- 10 OFF-CAMERA AUDIENCE MEMBER: Well that's got 11 to be stopped. 12 And what do we need? 13 We need stronger laws, to get the source of 14 these things that are happening. 15 The source is more important; not more 16 important than the kids, of course not. But I mean, 17 it's where it's at. 18 And then the pills can, we won't need as many 19 from you, hopefully. 20 [Laughter.] 21 OFF-CAMERA AUDIENCE MEMBER: You know what 22 I mean? 23 So I just think -- and where I heard this 24 from was on Fox news, Bill O'Reilly, was a reporter 25 there, and he said, I think it was Bolivia, I'm not 1 sure. 2 But, we need that kind of laws. 3 We're letting these criminals come across the 4 border like it's Walt Disney, you know? 5 SENATOR ORTT: Right. And I certainly think 6 we can strengthen laws. 7 I don't think we're going to have Bolivia 8 laws. 9 [Laughter.] 10 SENATOR ORTT: Just, probably, you know, not 11 going to get to that point. 12 I don't think we're going have Bolivia laws, 13 but I know what you are trying to get at, 14 stronger -- 15 OFF-CAMERA AUDIENCE MEMBER: But we do have 16 electric chairs. 17 SENATOR ORTT: -- stronger penalties. 18 OFF-CAMERA AUDIENCE MEMBER: And we do do -- 19 still do do some hangings. 20 SENATOR ORTT: I think the death penalty was 21 outlawed in New York State, though. So -- 22 OFF-CAMERA AUDIENCE MEMBER: I think America 23 has become wimpish, and sort of the politicians. 24 SENATOR ORTT: Sure. 25 OFF-CAMERA AUDIENCE MEMBER: And they have 1 to, have to, do something about the laws, to make 2 them stricter, because they're coming across like 3 little ants. 4 SENATOR ORTT: I think these guys would all 5 agree with you on that. 6 But thank you for your comments on that. 7 OFF-CAMERA AUDIENCE MEMBER: No problem. 8 Thank you. 9 [Applause.] 10 SENATOR ORTT: Thank you. 11 I've been called worse than "a wimp," that's 12 for sure. 13 [Laughter.] 14 SENATOR ORTT: I just wanted to say, again, 15 the fact that a company like Pfizer, these 16 companies, obviously, like any other company, make 17 money. That's why they exist. 18 I mean, let's be honest. 19 So they don't spend extra money if they don't 20 have to. 21 And so I think my point is, to me, that's an 22 example of the pressure from people talking about 23 this, and pushing it, whether it's an Anne, whether 24 it's an Avi, whether it's law enforcement, people 25 like me. 1 And you get to people like me, and then I 2 start talking about it. 3 And then people like Pfizer, and his bosses, 4 start to react. 5 And don't forget, too, they, ultimately, when 6 these drugs -- for these drugs to be approved, are 7 approved at the federal level. 8 So, this isn't just a community or state 9 issue. I'm sure the doctor will probably agree. 10 This is also something to talk to your federal 11 officials, whether it's Congressman Collins, 12 Congressman Higgins, Senator Schumer or Gillibrand, 13 because they do play -- can play a part in drugs 14 coming to market or being approved, these new drugs, 15 because they will get pressure, sometimes, as you 16 can imagine, from companies who say, We don't want 17 this to come because it might change our business 18 model, or whatever. 19 So just keep that in mind as well. 20 This is, again, a broad range. 21 But, Doctor, I know you came from, is it 22 Boston? 23 So, thank you for coming in. 24 And, certainly, I'd appreciate if you would 25 stick around. Maybe somebody wants to grab you 1 afterwards. 2 SUPT. E. BRYAN DALPORTO: Senator, can I ask 3 one quick question of the doctor? 4 SENATOR ORTT: Sure. 5 SUPT. E. BRYAN DALPORTO: Doctor, how long 6 have you been in the business with Pfizer? 7 PAUL WACNIK, Ph.D.: Pfizer, for one year. 8 SUPT. E. BRYAN DALPORTO: Well, the business, 9 I guess, itself, not really Pfizer. 10 PAUL WACNIK, Ph.D.: Been in pain research 11 for 12 years. 12 SUPT. E. BRYAN DALPORTO: I guess the reason 13 I ask is, I'm cur -- I'm going to take off my 14 sheriff uniform for a minute and put on my dad hat. 15 I took my 16-year-old for her consultation to 16 get her wisdom teeth out last week. 17 At the end of the consultation, the lady, who 18 was very nice, at the desk said, going through the 19 whole procedure, "When she's all done, we'll give 20 her a prescription for pain medication." 21 And I said to her, "No, thank you." 22 And she goes, "Well, we'll just give it to 23 you. You can take it if you need it." 24 And I said, "No, thank you. I don't want it. 25 She's not taking anything that's opium-based." 1 And I just got this blank stare from her, and 2 I said, "Don't waste the paper." 3 Now, in August of '84, I got my wisdom teeth 4 out, and Dr. Minenti (ph.) told me, "Put some ice on 5 it. If it really hurts, take an aspirin." 6 OFF-CAMERA SPEAKER: Yeah. 7 SUPT. E. BRYAN DALPORTO: The question is, 8 what's changed? 9 PAUL WACNIK, Ph.D.: Well, that's a really 10 good question. 11 Certainly, there are more options for pain 12 relief. I mean, heard about some of them today, you 13 know, where there's a pump, if you're getting a 14 surgery in the hospital, different classes of pain 15 analgesics. 16 So, when we're talking about opioids, that's 17 just one. There's others that work on different 18 receptors in the brain, and so that has changed. 19 There are more options, actually, than 20 opioids, but opioids are always effective. I mean, 21 it works across the board. 22 Other drugs maybe works for one person, not 23 for another person. 24 Opioids, as was mention, because of our own 25 biology, we have the receptors, we're going to 1 respond to these. So, it's a very simple solution 2 that works for everybody. 3 But you can use small doses and in short time 4 courses. I mean, this needs to be managed properly. 5 So I don't think there is any one thing that 6 has happened, to answer your question. 7 I mean, hopefully, we're getting -- we are 8 getting to have more options, but, it's still -- 9 because it is so effective and so potent for a pain 10 reliever, we still have it; we still have opioids, 11 and a lot of them. 12 And there's a lot of different companies that 13 make them. You know, some of them are really cheap, 14 they're generic. 15 You know, they're -- it's -- so to regulate 16 the use and practice, and making everyone use 17 abuse-deterrent formulations, will take -- we 18 can't -- I doubt we're going to regulate ourselves 19 as an industry. 20 We can develop these new drugs with the 21 technology, but it will take, probably, laws, or -- 22 to make everyone -- you know, all abuse-deterrent. 23 So -- because if there's money to be made 24 with the non-abuse, deterrent formulation, they're 25 going to make it. 1 Insurance companies have to pay for it as 2 well. That's the thing too. 3 AVI ISRAEL: I think we need to retrain our 4 prescribers as to not prescribe that stuff. 5 I've ran into so many parents with the same 6 thing: Just take them. Just take them. Don't call 7 me over the weekend because I'll be playing golf. 8 You know, all that stuff. 9 We need to really retrain our prescribers -- 10 when I say "prescribers," because it goes across the 11 board, from doctors, to nurse practitioners, to 12 physician assistant -- to start using other things, 13 and not -- the first option should not be opiate. 14 Opiate should be the last option to be -- to 15 treat pain, especially for moderate pain, like a 16 wisdom tooth pulled. 17 We all survived wisdom tooth, and, you know 18 what? 19 SENATOR ORTT: You have to use the 20 microphone, to -- yes, you do. Unfortunately, this 21 is all being taped. 22 UNIDENTIFIED AUDIENCE MEMBER: Oh, then maybe 23 I don't want, so -- 24 SENATOR ORTT: Well, then, maybe not. 25 UNIDENTIFIED AUDIENCE MEMBER: This is for 1 sheriff. 2 You are the third person that I've spoken 3 with, who talked to me, who talked of their child, 4 for their wisdom teeth, getting Lortabs. 5 Kathy Hockel (ph.), I spoke to her last 6 October. Her daughter was prescribed Lortabs for 7 wisdom teeth. 8 Chief Wickett, of the town of Hamburg police, 9 just told me a couple weeks ago, he refused, just 10 like you did, to have Lortab prescribed for his son 11 to have his wisdom-- his daughter, I'm sorry. 12 What is going on with the ice pack and 13 Tylenols that we used to get when we had our wisdom 14 teeth? 15 I don't understand where the mindset is in 16 these -- with these dental procedures that are 17 minor. 18 We just lived with the pain like for a day 19 and a half, two days. 20 I don't understand -- I don't understand. 21 I got Lortabs for a broken leg. I took two. 22 I didn't take anymore because they made me so -- 23 I was, like, this is ridiculous. This is absolutely 24 ridiculous. 25 And as far as the Oxycontins are concerned, 1 the State of Kentucky is now in the midst of suing 2 the company that started -- that started -- it's a 3 small Connecticut, family-based company, that 4 actually are the people, the pharmaceutical company, 5 that actually came out with Oxycontins. 6 I don't have any faith in the FDA, because 7 they approved the company that made them, small 8 company, said, They're not addictive, they're not 9 addictive, they're not addictive. 10 SUPT. E. BRYAN DALPORTO: Purdue Pharma. 11 You can say it, Purdue Pharma. 12 UNIDENTIFIED AUDIENCE MEMBER: Thank you. 13 I forgot the name. 14 And the FDA took their word for it, looked at 15 their research, which was false, and said, Okay. 16 SUPT. E. BRYAN DALPORTO: They got fined 17 $650 million. 18 UNIDENTIFIED AUDIENCE MEMBER: Did it -- 19 SUPT. E. BRYAN DALPORTO: That's a slap in 20 the hand when you are making. 21 UNIDENTIFIED AUDIENCE MEMBER: Billions. 22 SUPT. E. BRYAN DALPORTO: -- $3 billion a 23 year. 24 UNIDENTIFIED AUDIENCE MEMBER: Billions. 25 And so my faith in the FDA is a little -- 1 SENATOR ORTT: But that's why you have to 2 reach out to your elected, because, you know, 3 they -- if you tell them, say, Look it, I don't 4 believe the FDA, so have you to hold the FDA's feet 5 to the fire on some of this stuff, certainly. 6 But I appreciate that. That's a very good 7 comment. 8 UNIDENTIFIED AUDIENCE MEMBER: And then, as I 9 said, Lortabs for wisdom teeth, it just boggles my 10 mind. 11 AVI ISRAEL: I testified in front of the FDA 12 about two years ago, against Zohydro. 13 Zohydro is a pill that came out, with up to 14 50 milligrams of heroin in there, crushable. 15 And, the advisory committee voted 11-to-2 not 16 to approve that pill. 17 Not to approve it. 18 And a day after hydrocodone was up-scheduled 19 to Schedule II, which you can only get a 30-day 20 supply, the FDA has approved Zohydro. 21 Can you imagine your kid taking up to 22 50 milligrams of heroin, basically, made in a lab, 23 crushing it and snorting it? 24 There were people that came to testify that 25 couldn't find a podium, that's how high. 1 Five people died during the trial of that 2 pill; and, yet, the FDA has approved it. 3 And what I heard from Doug Throckmorton, and 4 which do I talk to him on a regular basis, his 5 explanation was, there's a need for the pill. 6 There's a need for it. 7 We have 760 different combinations of opiates 8 on the market today. 9 There's a need for another pill. 10 SENATOR ORTT: Thank you, Avi. 11 We've got to move on to the next panel, 12 because we have two more that we have to get through 13 in about a half hour. 14 So I'm going to ask both panelists to limit 15 your remarks to 15 minutes, if you can. 16 DONALD INGALLS: Oh, I'll be quicker than 17 that, Senator Ortt. 18 SENATOR ORTT: I just wanted to let everyone 19 know, because this is an actual hearing, anyone who 20 spoke needs to give their name, because it needs go 21 in the official transcript. 22 So, nothing is going to happen to you if you 23 give your name. No one is going to come visit you. 24 It's just for the record, because this is a legal 25 hearing conducted by the New York State Senate. 1 So, I'm sorry I didn't say that before. 2 Perhaps it would have dissuaded somebody; I hope 3 not. 4 I didn't know that myself, so, next time 5 we'll all know. 6 So, I'll now turn it over to Don Ingalls from 7 BlueCross. 8 DONALD INGALLS: Thank you so much, 9 Senator Ortt. Glad to be here. 10 I'm Don Ingalls, vice president of state and 11 federal relations for BlueCross and BlueShield of 12 Western New York, and very pleased to be here to 13 testify. 14 There's been a lot of conversation by a lot 15 of panelists today about the need for education and 16 prevention, and I think that's probably been a 17 universal comment from everyone. 18 So I'm here just to describe a 19 public-awareness campaign that we undertook 20 regarding the epidemic of prescription painkillers. 21 Avi and his wife came to us back in 2013 and 22 talked to us about the issue, and we listened; we 23 learned the statistics that we've talked about 24 tonight, and other statistics, and how the epidemic 25 has spread and has been -- has grown, and we took 1 action. 2 We responded by leading a community-wide 3 initiative to raise awareness of the danger of 4 painkiller addiction, and we were able to pull 5 together over 50 community organizations and 6 businesses, to educate our communities and provide 7 access to help. 8 And, collectively, the community partners 9 that were involved in the effort committed more than 10 $1.6 million to the campaign. 11 It was officially called "Project Hope," but 12 it was dubbed "Painkillers Kill" in advertising and 13 social media. 14 And, together, the campaign eventually 15 generated about $3 million in earned media. So, it 16 was quite extensive. 17 It had several components, aimed at 18 increasing awareness and education. 19 First was a 30-minute documentary produced by 20 public-television station WNAD, which aired several 21 times, and included a call-in opportunity for people 22 that needed, wanted, more information and help. 23 And I think, as people who were there know, 24 that the phones started ringing before the show 25 aired, and kept ringing afterwards, and a great need 1 for information, and people were calling. 2 It was -- also had a hard-hitting TV, radio, 3 print, billboard, and online advertising campaign 4 dealing with the death from painkiller addiction and 5 the severity of the problem. 6 A unique website was managed by our friends 7 at Horizon Health Services, to serve as a central 8 resource for people looking for help and looking for 9 information, including a 24/7 toll-free hotline. 10 We had education in middle schools, including 11 resources and curriculum plans. 12 Information cards; cards were distributed to 13 local pharmacies and doctors offices and schools 14 about the painkiller issue and about how to get 15 help. 16 Promotion of Western New York prescription 17 drug drop-off events. 18 And, a continuing medical education event, 19 course, attended by over 250 health-care 20 professionals and prescribers. 21 The results were pretty impactful. 22 We did a study after five months of the 23 campaign, and we found: 24 That two of three consumers that were 25 surveyed recalled seeing the campaign; 1 72 percent of consumers indicated that the 2 campaign had increased their awareness of the 3 effects of painkillers, and the problems that can 4 happen; 5 95 percent of people responding recognized 6 that prescription painkillers are highly addictive; 7 And one-third, at the time, stated that -- 8 realized that painkillers were a synthetic form of 9 heroin. 10 More importantly, more than one in three 11 consumers took action based on the campaign; most 12 often, by discussing the topic with friends or 13 family, or discarding the expired medications in 14 their medicine cabinets, as Miss Catanese had talked 15 about. 16 In survey of the 184 medical providers that 17 attended the campaign's events, more than 80 percent 18 agreed that the program enabled them to properly 19 discuss medication level -- addiction levels of 20 prescription painkillers, and described the 21 resources are available for treatment and recovery. 22 I just reiterate this and share this 23 information about the campaign as one example of 24 what's possible to do in terms of educating the 25 community and medical professionals and parents and 1 young adults in -- into the problem, and urge that 2 building on the success of this, that other efforts 3 continue at the statewide level. 4 The "Combat Heroin" website is an important 5 element, an important effort. 6 And I know the Senate has put in, I think, 7 $12 million in the budget, in terms of some of the 8 programs, going forward. 9 But I think this program, this campaign, 10 really showed the need for education and prevention, 11 going forward. 12 We can't treat our ways out of the epidemic 13 alone. We have to prevent it. And education, as 14 Avi and others have said, is the key to doing that. 15 So I'm here to advocate for that, and glad to 16 be a very part of this. 17 SENATOR ORTT: Don, thank you for your 18 testimony, and I think your point is well taken 19 that, just, you know, you can't treat your way out 20 of it, you can't arrest everybody; you know, you're 21 never going to get rid of every pain medication. 22 The key is, I think, on the prescription and 23 education side. 24 SUPT. E. BRYAN DALPORTO: I wish that 25 other insurance companies jumped in like 1 BlueCross/BlueShield did. They did a terrific job. 2 SENATOR ORTT: Well, that's great. 3 You guys can be a -- perhaps a leader for the 4 other insurance companies, as you've been in other 5 areas. 6 DONALD INGALLS: Thank you. 7 SENATOR ORTT: Thanks, Don. 8 Our last panelist tonight is Monica Romeo. 9 Fittingly, she is from Niagara University, 10 and so I guess it's a fitting way to wrap up the 11 hearings. 12 So, Monica, thank you for being here, and 13 thank you for your testimony. 14 MONICA ROMEO: I'm so happy to be here to 15 talk about this really important topic. 16 I'm the director of the university counseling 17 center here at Niagara University. 18 And, often, people believe college to be kind 19 of a protective factor in a student's life; you 20 know, it's this kind of little bubble of a happy and 21 great time in a student's life. 22 What we find, when it comes to addiction, is 23 that, often, that is where college is not a 24 protective factor. 25 So we work really hard, educationally, to 1 inform our students of the services that we offer. 2 And we also collaborate extensively with 3 providers off campus. Horizon is one of our 4 number-one referral sources off campus. 5 I would say, Senator, that probably the most 6 important thing I would love to convey, in terms of 7 how do we address this issue, is education. 8 The destigmatization of mental health and 9 addiction is huge. 10 What we see on campus is that students are 11 afraid; they're afraid to admit that they use, and 12 they're afraid to tell other people that they use. 13 So when we're working with a student who has 14 an addiction, and we see very few students with a 15 heroin addiction or an opioid addiction who are 16 willing to come forward, but when they do come 17 forward, the challenge is getting them to open up to 18 their family and have that conversation with them, 19 because mental-health laws do dictate, you know, 20 once a student is 18, I can't just call mom and dad 21 and say, "I'm really worried about your son or 22 daughter. Here's what's going on." I have to get 23 permission from that student to have that 24 conversation. 25 So education to destigmatize how we view, as 1 a society, mental health; and, particularly, 2 addiction, that heroin and opioid addiction, you 3 know, does not discriminate. It affects people from 4 all walks of life, genders, races, geography. 5 So that's really important. 6 I think the other piece that's really 7 important, and I would love to see our insurance 8 companies take a lead in this, is educating our 9 seniors in high school and their families on how 10 they use their insurance once they go to college. 11 So, we'll see students from across the state, 12 as well as across the nation, who come here, and 13 then when they have an addiction, where we do send 14 them for treatment? 15 So, I may be able to call Horizon, but if a 16 student is from Connecticut, their insurance doesn't 17 work here; or the student is from Syracuse, so 18 they're out of network in Niagara County. 19 So what happens then, is that the student has 20 to withdraw. So now we have a student who, parents 21 have paid for half of a semester, and now parents 22 are out, you know, that money. 23 Financial aid, you know, implications kick in 24 for financial aid. After six months, you have to 25 start paying back loans. 1 You know, there's so many things that come up 2 because we're just not sure how to utilize the 3 supports that we have. 4 The other issue is, where do we send 5 everybody? 6 You know, unfortunately, we're clogging up 7 Horizons, and a lot of students are on their waiting 8 lists, because we just don't have enough providers. 9 And we certainly don't have enough providers on 10 campus. We just can't fund everything as much as we 11 would like to; just as Horizons probably would love 12 to hire 100 more counselors, funding, and, you know, 13 salaries, prohibit them from doing that. 14 So, I think the education and funding pieces 15 of this puzzle are probably the most important for 16 us in being successful in addressing this issue. 17 And if ever the phrase, "It takes a village," 18 right, to support a child or a family member or a 19 loved one, this is probably one of the cases where 20 it is the most salient. 21 So, thank you. 22 SENATOR ORTT: Well, thank you very much, 23 Monica. 24 Certainly, I'm also -- in addition to this, 25 I am the Chairperson of the Senate Committee on 1 Mental Health and Developmental Disabilities, which 2 I'm sure you know. 3 MONICA ROMEO: Of course I do. 4 SENATOR ORTT: Because you're up on your 5 profession. 6 But, I certainly know the connection between 7 mental health. And it's not -- it doesn't mean 8 you're -- you know, you're someone who needs to be 9 in a padded room. 10 Mental health is a stigma that goes along 11 with that as well. 12 You could have a very minor -- someone you 13 know, that appears to be functioning, may suffer 14 from depression, or whatever it may be. 15 A lot of times, that will lead to addictions 16 or substance abuse of some sort, where they're 17 self-medicating to deal with whatever mental-health 18 issue, or, that leads to, maybe, some poor judgment, 19 in a lot of cases. 20 And then when you combine the mental health 21 with the addiction, needless to say, that's a very 22 bad combination. 23 And I'm sure you see that on a regular basis. 24 So that's, certainly, something near and dear 25 to my heart. 1 I guess, just as a conclusion, I really can't 2 thank the panel -- 3 I'm sorry? 4 OFF-CAMERA SPEAKER: Transportation. 5 SENATOR ORTT: Transportation is also an 6 issue. 7 Again, I -- if you're going to make a 8 comment, you need to come forward with your name and 9 a microphone. 10 ATHENA TUCKER: My name is Athena Tucker. 11 I work as a registered nurse and care 12 coordinator for St. Mary's Neighborhood Health 13 Center. 14 I'm also a resident of North Tonawanda, so 15 I had the privilege of Senator Ortt being my mayor. 16 SENATOR ORTT: Well, thank you, Athena. 17 ATHENA TUCKER: So, anyways, transportation 18 is a huge issue, especially with my patients that 19 are on Medicaid. Okay? 20 Transportation was cut in the beginning of 21 the year, so now my Medicaid patients have to get 22 bus tokens. 23 What does that mean? 24 It means that they have to call the 25 social-services office, the 800 number for Medicaid, 1 or whatever, for transportation, seven days in 2 advance to get bus tokens. 3 Seven days in advance. 4 Now, this puts a strain, especially on my 5 patients that happen to be from North Tonawanda. 6 Because North Tonawanda doesn't have a lot of 7 primary-care providers, so I do get patients from 8 North Tonawanda into Niagara Falls. 9 How are my patients supposed to go pick up 10 the bus tokens? 11 Okay. How are they supposed to make it to 12 their programs, because there are no programs in 13 North Tonawanda? 14 This is my plea: 15 We need more programs. 16 We need transportation, public 17 transportation. 18 To get to North Tonawanda, I think there's 19 one metro bus later in the evening. I mean, I've 20 tried to get the schedules, and, no match, no match, 21 no match. 22 To get to Niagara Falls from North Tonawanda, 23 you have to walk to Tonawanda and take a bus from 24 Tonawanda into Niagara Falls. 25 One of our primary mental-health people was 1 the Dale Association, which was located in, you 2 know, more of the downtown region there. And, it's 3 moved now to River Road, not within walking distance 4 of some of our families. 5 I'm actually being proactive, not even just 6 with my position over at Mount St. Mary's, but in my 7 own community. I just got an approval from our 8 current mayor to do a city health assessment and a 9 survey, to really, really get in the -- you know, in 10 the depths; in the highways and the byways, and, you 11 know, really listen to their need in there. 12 So I just wanted to put that out there. 13 SENATOR ORTT: Sure. 14 ATHENA TUCKER: And, Sheriff Voutour, and 15 even -- I'm sorry -- 16 SUPT. E. BRYAN DALPORTO: Chief DalPorto. 17 ATHENA TUCKER: Yes, sorry. 18 -- I'm sure you're familiar with 19 Kelly Linfel (ph.). She was crime analyst with NFPD 20 for a while. 21 Your crime maps that you're looking for, for 22 drug-related crimes, and whatnot, to know what's 23 really in there, that data, that statistics, she 24 already has that data and those statistics. She 25 actually finished it in one of her master's programs 1 here for criminal justice. 2 And when she had told me that she was working 3 on these crime maps, I asked her, I said, Well, can 4 you do some on drugs, so when I'm out there 5 educating and providing my brief intervention with 6 these one-on-one people, and trying to connect them 7 with these linkages and these -- and these resources 8 that we do have in the community to help them? she 9 did those. 10 And for Niagara Falls, I actually forwarded 11 it to a friend of mine, Claudia Kurtzworth (ph.), 12 who was writing the county health assessment at the 13 time, back in 2013. And her data was actually used 14 for that, for Niagara Falls. 15 As far as I know, the North Tonawanda crime 16 maps, I don't think that they left the roll-call 17 office at NTPD. 18 So, I'm sorry the that chief left. 19 SENATOR ORTT: Well, certainly, 20 transportation, I thank you for coming forward and 21 speaking. 22 Certainly, transportation is a major issue 23 when it comes to a lot of folks in Western New York, 24 and, certainly, Niagara County. 25 And I know, recently, we did secure some 1 additional funding for the NFTA, but, that's a 2 bigger issue. We could have a hearing just on that. 3 But, I really want to thank the panelists for 4 being here. 5 I know a lot of you shared very personal 6 stories. 7 Many of you are engaged in this as your life 8 work. This is not just a hearing for you. This is 9 a mission; this is something you're engaged in for 10 the rest of your life. And, I thank you for that. 11 To the folks in law enforcement, thank you. 12 To both of you, I have no words to 13 (a) express. You have a lot of courage being here. 14 I wouldn't even begin to say that I know how you 15 feel; but, certainly, I'm empathetic. 16 And I appreciate you being here, because it 17 certainly impacts all of us, and helps us get to 18 where we want to be. 19 And to all of you who continue to try and 20 effect positive change, I thank you very much for 21 what you're doing. 22 And to all of you, who -- and especially to 23 all of you, because you stayed all the way through. 24 I wish could I say there was an award or 25 something, but there's not, but, I know it was very 1 interesting. 2 And, certainly, hope -- I'm hoping you will 3 take something out of this as you go back into your 4 communities, to your homes; even just from being 5 here tonight, that you heard some good things, some 6 areas where we need to improve, obviously, and maybe 7 some action items for all of you as well. 8 So, there will be -- again, there will be 9 more hearings. 10 I don't know -- there was one in Rochester, 11 one here tonight. I don't know if there will be 12 another one up in this area, but, certainly, keep 13 watching the news. 14 You can reach out to my office. 15 Especially, as we get into June, we are going 16 to attempt to pass legislation, and using these 17 hearings as a guide. So, certainly, look for that. 18 And, again, thank you for being here. 19 [Applause.] 20 (Whereupon, at approximately 7:30 p.m., 21 the public hearing held before the New York State 22 Joint Senate Task Force on Heroin and Opioid 23 Addiction concluded.) 24 ---oOo--- 25