LICADD Executive Director Dr. Jeffrey Reynolds offered the following testimony before the NYS Senate Committee on Alcoholism and Substance Abuse. You may ready the transcript below or view a video of the entire public hearing here.
NYS Senate Standing Committee on Alcoholism and Drug Abuse
Chaired by Senator Phil Boyle
Public Hearing – November 13, 2013 11:00AM-2:00PM
Testimony Presented by Jeffrey L. Reynolds, Ph.D, CEAP, SAP
Executive Director, Long Island Council on Alcoholism and Drug Dependence (LICADD)
Good morning. My name is Dr. Jeffrey Reynolds and I am the Executive Director of the Long Island Council on Alcoholism and Drug Dependence (LICADD). Incorporated in 1956, LICADD provides prevention programs to more than 20,000 young people per year and provides a variety of addiction services, including Screening, Brief Intervention and Referrals to Treatment (SBIRT) to more than 7,500 families annually. Last month, we served 763 families at our offices in Ronkonkoma, Riverhead and Mineola – a record number in our 57-year-history and seven (7) times the number we were serving this time four years ago.
I want to thank you Senator Boyle for convening this hearing and taking the time to gather input from experts in substance abuse prevention, addiction treatment, law enforcement and education. You have consistently been a powerful voice for Long Island and I’m thrilled that you have been named Chair of the Senate Standing Committee on Alcoholism and Drug Abuse.
It’s no secret that Long Island – and in fact, New York and our entire nation – is struggling with an unprecedented opiate crisis that is tearing apart families, destroying communities and claiming the lives of too many young people. You’ve seen the data about arrests, treatment admissions and overdoses and I know that you’ve heard first-hand from parents who have lost children to addiction, from treatment providers and people in recovery themselves. In convening this hearing, you’ve asked for some concrete action items that if implemented, would begin to turn the tide of addiction that continues to sweep across our communities and I’m pleased to share with you, a few ideas.
You’ve wisely included the phrase “connecting the dots” in the public hearing announcement and that’s a great theme because adequately addressing addiction is all about connecting the dots and creating a continuum of prevention, access to treatment and recovery support. Despite all the press and awareness about the opiate crisis, there are still huge gaps in the continuum and in some areas, those gaps are growing wider almost by the day.
Prevention is one such example. The advent of the much maligned “Common Core” curriculum has thrown school administrators and teachers, not to mention parents and students into a spin. Though LICADD’s educators have conducted prevention programs in 58 Long Island schools so far this year, we are already beginning to hear that many schools – with little time and too few resources – are limiting so-called “discretionary” activities like substance abuse prevention programs in favor of activities that relate directly to reading, writing and arithmetic. But here’s the thing: kids who are drunk, high or dead of an overdose don’t do well on standardized tests. We need to make sure that the New York State Department of Education gets that and if need be requires districts to maintain or adopt evidence-based K-12 substance abuse prevention programs as part on an overall approach to help our kids become more successful.
When we talk about connecting the dots, it’s important to understand the connection between alcohol, marijuana and the opiates that are getting all the attention these days. Young opiate users will tell you that they didn’t simply wake up one day and decide to snort a chopped Vicodin or put a heroin-filled needle into their arm. Many began with alcohol at an increasingly young age, experimented with marijuana and a certain percentage moved on to other drugs. As New York State has spirited policy debates about medical marijuana and even legalization given what’s happened in some states, young people are being led to believe that pot is harmless and as their perception of risk decreases, use of the drug is on the rise. We must continue to educate young people about the impact of cannabis on the developing brain and increase access to psycho-educational services for chronic marijuana users who may be treatment resistant or whose level of use doesn’t yet require formal treatment. New York State should be funding such initiatives.
I’d be lax if I didn’t simultaneously mention New York State’s stated commitment to reducing criminal justice costs by lowering incarceration rates. We, of course, applaud this move and ask that you help insure that dollars saved don’t simply land in the state’s general fund, but are re-invested in alternatives to incarceration, addiction treatment and re-entry programs. As you review the Governor’s proposed budget for 2014, I hope you will advocate for this kind of reinvestment.
New York’s passage and subsequent implementation of the historic ISTOP legislation is having the desired effect. We have finally closed the spigot and limited the supply of prescription painkillers into our communities, making it harder for those who use the drugs non-medically to get their hands on OxyContin, Vicodin, Percocet and other opioids. But we haven’t yet taken steps to reduce the demand for such drugs by making treatment more affordable and accessible. If folks turned away by doctors and pharmacists aren’t entering treatment, they are likely turning to heroin dealers, robbing pharmacies and engaging in other crimes to pay the rising street prices for enough pills to simply stave off withdrawal symptoms.
The lack of detox beds has been a problem on Long Island for more than a decade. The loss of beds at Long Beach Medical Center post-Sandy and the institution of a phone screening system at Nassau University Medical Center has compounded the problem precisely at a time when the needs have never been greater. NYS OASAS should investigate options for ambulatory detoxification services on Long Island and immediately fund new demonstration projects in both medical and non-medical settings across both counties.
Wait times at some outpatient treatment agencies can be three to four weeks, because there too, demand has skyrocketed, while County funding has been cut. On the inpatient treatment front, I am aware of several prospective providers who wanting to respond to the incredible needs on Long Island have contemplated projects, yet walk away when they find out that the approval process from OASAS can take a minimum of 2-3 years. In the midst of a crisis, that’s inexcusable. The Affordable Care Act (ACA) promises to make treatment more accessible to tens of thousands of New Yorkers, yet on Long Island, the victory may be a hollow one as we lack the bed capacity necessary to meet the needs of local residents. The recommendation here is simple: Properly fund the full range of addiction services – including licensed treatment, family support services, interventions, advocacy and peer counseling – through the existing network of qualified providers and fast-track approval of new applications.
As we think about barriers to care, it is absolutely critical that we take treatment decisions out of the hands of insurance companies and put them in the hands of qualified addiction professionals. Too often, insurers refuse to pay for inpatient care until a patient fails at outpatient treatment, despite a duration and level of substance use and/or co-morbidities that call for a more intense level of care. When an insurer does agree to pay for inpatient care, they do so for a few days at a time, when every shred of research we have ties outcomes to duration of care. The end result is a cost-shift to Medicaid, expensive jail cells and emergency room visits, all paid for not by the private insurers who collected premiums month after month for years, but to the taxpayers. The end result is an epidemic out of control punctuated by overdose deaths. 2014 must be the year that New York enacts legislation, similar to the way Pennsylvania did several years ago, to make sure that addiction treatment on demand becomes a reality and we put an end to discriminatory and dangerous insurance company practices.
As we connect the dots between treatment and recovery, I truly hope the NYS Legislature will approve Senator Zeldin’s Healthy Sober Home Act. Too many of these so-called sober homes are anything but, run by absentee landlords who threaten public health by jamming as many people as they can into run down homes in communities that already face a number of challenges. These landlords are preying on families and individuals whose dream of a new life is quickly robbed from them by unsafe living conditions, insufficient food, drug-dealing, violence and little or no access to continuing care. Beyond passing this bill, we at LICADD continue to believe that recovery housing is an important part of the treatment continuum and as such, should be fully regulated by NYS OASAS.
And while we are on the topic of recovery, how come Long Island still doesn’t have a Recovery Center for young people? OASAS has funded such centers in other areas of the state, but hasn’t funded one here in this region – a place that given the numbers, needs the help as much as any other region. Our recovering kids need a safe place to go to access services, attend 12-step meetings and connect with each sober kids in a safe, supportive environment. OASAS should help us create that place on Long Island.
Access to good treatment, safe and sober housing and recovery support all depends on our ability to keep people alive long enough to ever make it through the doors of LICADD, or a treatment center or a recovery home. We’re doing a lousy job at that and we are losing too many young people to fatal overdoses. An overdose prevention program funded by the NYS Department of Health AIDS Institute has put Naloxone in the hands of civilians sand resulted in more than 1,000 overdose reversals to date. Given that most overdoses happen after a period of forced or voluntary abstinence, NYS OASAS should support treatment providers in the provision of Narcan to patients and their families as they leave care. Local jails and state prisons should be distributing the drug to releasees. The New York State Department of Education should be encouraging, rather than discouraging schools from stocking Narcan. And to those who worry about sending the wrong message, Narcan doesn’t promote drug use any more than seat belts promote unsafe driving, though overdoses have outpaced car crashes as a leading cause of death in many areas of New York.
I know I’m running out of time, but wanted to give you just a quick list of five other things NYS State can do to address the epidemic:
- Require physicians and others who prescribe a certain level of opioids annually to receive mandatory training in addiction – even if the training is done online to minimize cost and inconvenience.
- Encourage the NYS Health Commissioner to speak out about prescription drug abuse and use his office to educate both patients and physicians.
- The Department of Environmental Conservation (DEC) and Department of Health (DOH) should be doing more together to educate the public about proper drug disposal.
- Appeal to the federal Drug Enforcement Administration (DEA) to modify the drug collection requirements to make it easier to hold drug take-back events.
- Train and support pharmacists who are very often the last person standing between a desperate addict and a bottle of pills.
As much as we often refer to the opiate crisis as a new thing, it’s not. It’s been steadily growing for more than a decade and our collective failure to respond faster and in a more comprehensive way has given heroin a 10-year running head start on our kids. Recovering the advantage requires action from all levels of government, including New York State and the changes we make now will help us with the next drug crisis that appears on the horizon. I very much appreciate the opportunity to share our thoughts with you today. I welcome your comments or questions.
On Sunday, November 11, 2013, Long Island’s educators, treatment professionals, and community members gathered in recognition of substance abuse recovery at the Long Island Council on Alcoholism and Drug Dependence’s 24th Annual Peter Sweisgood Breakfast. This family-focused community event was held at the IBEW Local 25 Hall in Hauppauge, NY and featured powerful stories of personal struggles with addiction, as well as highlighting the efforts of addiction service providers and advocates for changes to policies affecting those suffering from substance abuse disorders.
The Long Island Council on Alcoholism and Drug Dependence (LICADD) honored three individuals whose outstanding accomplishments have shaped public policy, expanded public awareness, enhanced treatment options, and enabled Long Island to address its growing drug and alcohol problems. The honorees include Community Champion and Keynote Speaker NYS Attorney General Eric T. Schniederman; Treatment Champion Dr. Thomas F. Jan, DO, FAOCPMR, DAAPM, DABAM, C-MROCC, FKIA, of Massapequa Pain Management; and Media Champion Jennifer McLogan of WCBS-TV.
LICADD Executive Director Dr. Jeffrey Reynolds summed up the event, “Each year, this gathering is an important opportunity for the Long Island recovery community to reflect on our victories and challenges of the past year, as well as to rally around the crucial issues for the coming year. We have made great strides in 2013 on behalf of Long Islanders struggling with addiction, but there is much left to accomplish in 2014.”
Families are dealing with the devastating effects of untreated addiction across Long Island and every day the region loses at least one person to fatal overdose. However, it remains uncommon for health plans to cover comprehensive addiction treatment, while unnecessary bureaucratic barriers often stand between someone receiving the help they need and remaining trapped in an overwhelming – and completely treatable – disease cycle.
Community Champion New York State Attorney General Eric T. Schneiderman discussed his groundbreaking efforts to secure passage of the state’s historic ISTOP (Internet System for Tracking Over-Prescribing) Act, which he hopes can be used as a model for national legislation. After two months of statewide implementation, the ISTOP system has been used by pharmacists and physicians to conduct millions of searches – and has likely already saved lives. Mr. Schneiderman provided a thorough review of the legislation’s efficacy thus far in limiting doctor-shopping and over-prescribing by practitioners, while following up with a call for additional policies requiring insurance carriers to provide a minimum level of coverage for addiction treatment, so that those people ISTOP pushes towards treatment will have a realistic avenue back to health.
Treatment Champion Dr. Thomas Jan gave an overview of his career as a pain management physician, addiction expert, and recovery advocate; he is a longtime friend and supporter of LICADD’s efforts to save lives on Long Island. Media Champion Jennifer McLogan of WCBS-TV delivered a moving account of her investigation into Long Island’s opiate crisis and her determination to raise public awareness, inspired by several personal acquaintances’ recent struggles with addiction.
In addition, the event’s Recovery Speaker, Taylor S. of East Northport, NY, discussed his own inspiring journey into and back out of the depths of addiction from ages 14-21. His story underlined the extremely treatable nature of addiction as a disease and offered hope to those who battle this illness or have a family member struggling with it.
This community event was made possible by the generous support of Presenting Sponsor – the Christopher D. Smithers Foundation, Serenity Sponsor – Seafield Center, and Breakfast Angels – Kenneth Peters Center for Recovery, Long Island Center for Recovery, The Gift at the Rose Center, and Rebound Brooklyn. Friend sponsors, table sponsors, IBEW Local 25, and On Target Impressions were important contributors as well.More