The numbers could have been in neon. They were that glaring.
Every day, 131 people in the United States die from an overdose.
“It knows no bounds,” Robert Kent, general counsel for the state Office of Alcoholism and Substance Abuse Services, told a packed room of NYSUT members who gathered for the biennial Health and Safety Conference this past weekend. Pay no attention to geography, economics, social status, or other would-be markers for preconceived notions about opioid use. Its poisoned arrow hits everywhere.
The U.S. consumes 85 percent of prescription opioids for the world, Kent noted. Their use often leads to the use of heroin, which can be snorted, smoked or injected with a needle, and that drug is increasingly supplemented or even replaced with fentanyl. A synthetic opioid, fentanyl is primarily concocted in China, and it is lethal in even the smallest amounts—about a tenth the size of a penny. It is 100 times stronger than morphine.
“The drug of choice is lethal,” Kent said.
On the very day of Kent’s presentation, the federal Drug Enforcement Agency raided a home fentanyl mill in a wealthy Westchester County town, seizing 11 pounds of fentanyl and 13 pounds of heroin. It was enough drugs to kill nearly two million people.
Last year, 70,200 people died from a drug overdose, and 68 percent of those deaths involved opioids, according to the Center for Disease Control. That is more names than are etched on the Vietnam Wall commemorating the 58, 220 Americans who died in that long war.
Kent said the “perfect storm” was created by an explosion in the use of opioids, easy access to cheap heroin and fentanyl, and insurers blocking access to substance abuse treatment, often insisting on failure first at other treatment options. These are capped off by “the stigma of addiction,” he said.
Some changes are being made to address these problems. Half of the insurance policies written in New York are not subject to New York laws, he said, but for those that are, there is now immediate access to treatment: no more waiting.
OASAS has just been awarded $5.1 million in funding to create 14 new recovery community centers.
About 45,000 people a year are served in opioid treatment programs in New York, Kent said, and OASAS also uses certified peers in emergency rooms, jails and on the street to connect with users. At www.combataddiction.ny.gov, treatment facilities now update their sites every morning to indicate where beds are available for treatment.
Approaching the opioid epidemic from many angles will help tip the scales. OASAS, the New York State Education Department and the Department of Health sent 24,000 educational and informational flash drives to schools throughout the state, accompanied by a letter.
Schools are vital prevention partners, particularly since the majority of addictions begin in teenage years.
Coaches, for example, can play an important role by not urging students to take shots or pain pills in order to play through injuries.
Laura Ficarra, prevention planning and education coordinator at OASAS, said there is a link between mental health issues and addiction, especially with young people trying to self medicate. As of July 1, 2018, all K-12 health teachers must include instruction on multiple dimensions of mental health. The focus is on wellness, prevention and how students can access assistance, Ficarra said.
Programs that focus on school-wide positive actions help students to feel good about themselves and involve the entire school community. Positive action outcomes include a decrease in substance abuse and an increase in self-care, she said.
Ethan Doak, a fourth-year teacher and member of Hudson Falls Teachers Association, uses 15-minute lessons twice a week in positive action, which focuses on social skills, the concept of self and how to deal with tough times.
“I see the carryover into the curriculum,” he said. “It allows students to think collaboratively and to think through things and feel emotions.”
Other schools use PAX, a team-based classroom game that teaches students skills necessary for self-regulation. It is known to reduce aggressive and violence, disruptions and inattention. These are all skills that can help students build self-confidence, regulate their emotions, and resist drugs. OASES covers cost of training and materials for PAX.
Teacher Ruth Grisham of the Schenectady Federation of Teachers remembers when a young, bright, hard-working student of hers began missing school. She was told he was being used as a mule for a family drug business.
“I don’t know when I’m going to be able to process that,” she said, choking up.
Another former student of hers was written up in the newspaper for selling drugs.
Her school now uses full implementation of PAX in grades K-5.
“This is evidence-based and focused on preventing alcohol and drug abuse,” she said. On the surface, it is a lively game.
“Part of how we get where we need to is to work with students while they’re young,” Kent said. “We’re teaching them how to be focused, less isolated…to help them deal with isolation, pain or trauma.”
With new federal funding from Substance Abuse and Mental Health Services Administration, 11 new districts will be funded for PAX programs, he said, and programs are already going into Hempstead and Staten Island.