Last month, 23 people died over an 11-day period from opioid overdoses in Western New York. Last night, politicians, medical professionals, and concerned citizens came together at a public town hall meeting at a packed North Park Theatre in North Buffalo to discuss the epidemic of heroin and opioid addiction in our community. Acting District Attorney Michael Flaherty, Jr. states, “During the past few years, we have witnessed a disturbing rise in opioid addiction and overdose deaths. Unfortunately, this plight knows no borders.”
The event was hosted by Save the Michaels of the World, Inc., an organization founded by Avi and Julie Israel whose son Michael committed suicide in 2011. Michael had been dealing with Crohn’s Disease and was treated with opiates prescribed by several doctors for pain relief. Unbeknownst to his family Michael became addicted to the opioids he was prescribed and took his own life out of depression and helplessness. Opioids include heroin and prescription pain pills like morphine, codeine, oxycodone, methadone, and Vicodin. The night Michael died his father Avi held him in his arms and thought, “What happened? Why didn’t I know anything about this?” The Israels have since created Save the Michaels of the World, Inc. to create awareness of prescription drug addiction, overdose, and suicide.
In attendance last night were U.S. Attorney William Hochul, Buffalo Mayor Byron Brown, State Senators Tim Kennedy and Marc Panepinto, Assemblywoman Crystal Peoples-Stokes, Assemblyman Sean Ryan, Legislator Peter Savage, and Council Member Joel Feroleto. Speakers included Dr. Gail Burstein, Dr. Richard Blondell, Dr. Ann Marie Reynolds, DEA Resident in Charge John Flickinger, Dennis Galluzo, Jodie Altman, Julie Israel, Christina Pearl, and Keri Lock.
In the words of Avi Israel, “This night is about knowledge, if you have knowledge you have the power to navigate the system. We need to have some knowledge when it comes to this situation.”
Mayor Byron Brown began the evening by saying, “This meeting is about listening and about finding solutions. Too many individuals are dying from drug overdoses. As a matter of fact, just this afternoon another heroine death occurred in the Elmwood Village. This year at least 19 deaths in the the city alone have been the result of opioid overdoses and that number could double after toxicology reports are completed. Substance abuse does not discriminate.” He said that Nalaxone or Narcan, an opiate antidote, has been administered over 900 times in the city of Buffalo this year. Brown continued to say that Buffalo has agreed to be the lead agency to train volunteers to assist people seeking addiction. “We are committed to helping those addicted rather than prosecute them,” said the mayor.
The question was posed “What is a realistic solution?” The general consensus was that there is not one single answer. This epidemic started legally and moved on to illegal drugs and it will take a coalition of people coming together; pubic education is the first line of defense.
U.S. Attorney William Hochul proudly explained that the Buffalo police department was one of the first departments in the country to carry Narcan. He said that the U.S. is responsible for 99.9% of the consumption of oxycodone. In Buffalo last year there were approximately 255 fatalities from opioids, and he adds that if it wasn’t for the use of Narcan by our police department, that number of 255 would be dwarfed by the number of fatalities that would have occurred. Hochul said that during National Prescription Drug Take-Back Days, which provide a safe, convenient, and responsible means of disposing prescription drugs, Western New York routinely has the largest quantity from anywhere in the country. Hochul says we have tools that we can use in this battle. They include:
- Narcan – everyone should have Narcan at their disposal and know how to use it. Training is available throughout Erie County and it is now legal in New York State to purchase Narcan over-the-counter, without a prescription.
- Cell Phones – use for power to report drug dealers, even if they are wearing white coats. If you suspect a doctor or nurse over prescribing opioids, report them.
- Patience – as laws crack down on this epidemic, be patient with your doctors who might question your need or want to get a prescription, and be aware that insurance companies may become less likely to fulfill questionable medication claims.
Dr. Gale Burstein, the Erie County Commissioner of Health, said that in Erie County the number of fatalities from opioid overdoses have escalated dramatically over recent years with 103 deaths in 2012, 101 deaths in 2013, 128 deaths in 2014 and almost 300 in 2015. She added that 2016 is off to a rough start. Dr. Burstein warned that Fentanyl is a very toxic prescription that is sometimes mixed with opioids in the illegal market, making a deadly combination that has been responsible for many deaths.
Having just one legal prescription during high school for perhaps a sports injury or a toothache was a huge risk factor for using opioids after high school.
Most people had no idea they were using it. Dr. Burstein cited some statistics noting that last year 40% of the deaths happened in the suburbs, 40% in the city of Buffalo and 8.5% in rural areas. 72% of deaths from overdose were males and were of all ages with an average age of 38 and ranging from 17-83. She noted that the largest risk factor is age, saying adolescents are particularly vulnerable to opioid addiction, but also family history, high risk environment, and a stressful environment play major roles as well. Having just one legal prescription during high school for perhaps a sports injury or a toothache was a huge risk factor for using opioids after high school.
What to do? According to Dr. Burstein, dispose of any unnecessary medication at kiosks throughout Erie County, locations are listed on the county website. Burstein invites people to take part in Narcan training which is available throughout the county. Dr. Burstein also recommends saying “no” to prescribed pain meds, particularly for adolescents. Everyone has the right to tell their doctor they do not want pain meds. In most situations a high dose of Ibuprofen can get people through pain. If necessary, take pain meds only to get you “over the hump” and throw the remainder of the prescription in a drop-off kiosk. Moving forward, an Erie County opiate epidemic task force has been formed to find solutions to the epidemic.
Dr. Richard Blondell, Vice Chair of Addiction Medicine and a professor in the Department of Family Medicine at SUNY Buffalo, cited the following statistics:
- 259,000,000 prescriptions for opioids were written in the U.S. in 2012. This number is now nearly doubled.
- 46 deaths a day due to overdose occurred in the U.S in 2012. This has doubled over the last 2 years.
- In February of this year, in over an 11-day period, 23 people died in Western New York from opioid overdoses.
- Addiction can affect anybody, all ages, all gender, all ethnic groups.
He says, “This epidemic started with prescriptions from doctors that were promoted by Big Pharma and was fueled by patient requests for pain relief. The epidemic continues as more prescriptions are filled at the corner drug store that are financed by health insurance dollars.” Some of these medications are sold to illicit markets where they end up as “gateway drugs” for heroin. Doctors know how to deal with epidemics. Prevention is the answer. Dr. Blondell believes that we can’t treat our way out of this epidemic of addiction. What is needed are:
- More detox services
- More beds for rehab
- More treatment programs
- Better aftercare
- Better coordination
- Expansion of Narcan use
He also believes that we need doctors who are trained to train other doctors in the treatment of opioid addiction, and says that UB has established a 1-year addiction medicine fellowship with ECMC, but he acknowledges that better treatments are necessary along with more funding.
Dr. Anne Marie Reynolds is an Assistant Professor in Pediatrics at SUNY Buffalo who spoke on the effects of maternal opioid use on the newborn. She says she treats two to three newborns a week for opioid dependency. Reynolds explained that opioids cross the placenta and can enter the fetal brain causing the fetus to be dependent upon a drug the mother takes during pregnancy. The ideal treatment option is to get moms in maintenance programs and provide appropriate pre-natal care, but the optimal time for a woman to stop opioids is before getting pregnant. Reynolds made the very sad statement that every 25 minutes a baby was born in the U.S. suffering from opioid withdrawal in 2012 and adds that this number has increased drastically over the past few years.
Julie Israel took the stage to talk about her son Michael who died six years ago. With tears in her eyes she said that addiction is like falling down the rabbit hole and a person is unable to climb out. She went on to say, “The face of addiction is your neighbor, your colleague, or your child. We are caught up in the worst drug epidemic in US history. What happened to Michael is 100% avoidable through education and awareness.” Israel admits that she and her husband were not aware that their son’s doctors were each prescribing medications without consulting one another, a dangerous scenario. She advises everyone to stay informed of what medications your loved one is prescribed and to be knowledgeable on the side effects of each drug along with any interactions.
The face of addiction is your neighbor, your colleague, or your child.
Talk to your pharmacist. Dennis Galluzzo, Executive Director at Pharmacists’ Association of Western New York said that pharmacies are now able to detect when an individual is receiving multiple prescriptions from multiple physicians and/or are being dispensed at multiple pharmacies, and that it is now a felony to fill a prescription for someone under these circumstances.
All the information and advice put forward in last night’s meeting are steps in the right direction to make a change in our community. But as so many of the speakers said, it is all about knowledge and education. We all need to be knowledgeable in order to recognize what is going on in front of our eyes. We need to remove the stigma associated with addiction. Addiction does not discriminate and unfortunately most people have some personal experience with it, and know how painful it is for the individual and everyone around them. Like an octopus, addiction spreads its tentacles touching everyone nearby. Get educated on this important subject. Don’t let anyone you know slip down the rabbit hole.
Save the Michaels of the World, Inc. has established themselves as a 501(c3) non-for-profit organization to raise funds to help them continue to reach out to schools of all levels of education, professional organizations, and other venues such as last night’s meeting. Go to their website to find out more.