ITHACA, N.Y. — On International Overdose Awareness Day, 32 red or black heart were pinned to a purple ribbon commemorating people who have died from an overdose.
One woman remembered her husband the father of her their children. Another person remembered a woman he called “the love of my life.” Another man remembered his Ithaca friends Antwan Brooks and Stephanie Dvorak, both of whom died of overdoses in the past year or so.
At The Space @GreenStar Thursday evening, three panels consisting of health care providers, law enforcement, and community organizers discussed the future of the opioid epidemic locally and recognized to the War on Drugs’ failed past.
“I have been someone who’s walked though the hallways leaving my housing, going to school, and seeing someone in the hallway OD-ing with a needle in they arm, right. But at that time it was a different community and this (panels to discuss addition as a disease and drug reform) was not happening for it. So now it’s in your backyard,” Ithaca activist Phoebe Brown, who grew up in Brooklyn, said.
Instead, those with addiction were treated as criminals and, in many cases, sentenced to decades or life in prison for selling drugs under the Rockefeller drug laws. Harsh sentencing was also doled out to petty criminals and disproportionately to people of color.
Tompkins County Judge John Rowley said that for at least 15 of his 22 years as judge, there have been efforts to undo the damage caused by the Rockefeller drug laws and the selective enforcement of them.
“I do want to note thought that we have made mistakes in the past when we’ve searched for solutions around drug problems,” Rowley said. “One lesson I would hope we’ve learned is that harsher penalties, including the death penalty, are not a viable government policy. In my opinion, they’re an excuse for a policy.”
Rowley, who hosted one of the panels, said the discussions Thursday were not the only way forward for drug policy, but a way to think about how to lessen the stigma of addiction help keep people alive.
“The stigma of addiction, it kills people. It forces people to suffer in secret,” he said. “It’s time to start treating addiction as a disease.”
One issue discussed was the availability Narcan, an over-the-counter drug that instantly blocks the effects of opioids and reverses an overdose.
Will Fox, a firefighter for the Cortland Fire Department and paramedic at Bangs Ambulance, said that when he first became a paramedic in 2010, any unconscious person was given Narcan, which is harmless to people even if they are not overdosing.
He said first responders even gave the drug to people who were suspected to be drunk.
“Since then, as the stats have show so clearly, its just gotten worse and worse and worse and now were little bit more discriminating who gets the Narcan,” he said. “Now I’m administering Narcan to save lives.”
Administering the drug can be done with a nasal spray or with a needle inserted into muscle. Fox said it’s a simple drug to administer.
Ithaca Police Lieutenant Jake Young said all officers are trained to use Narcan.
He said he saw the heroin epidemic really begin to take hold of the community by 2011 or 2012 after it was virtually unheard of in local policing.
And while local ambulance services and the fire department are quick to respond to reports of overdoses, police officers are sometimes the first at the scene.
“For a minute or two when you’re there and the person needs help, it’s nice to be able to at least to get that process started. I think it’s comforting for the officers to have that ability as well as the people we’re helping through it,” Young said.
After the panels, two people from the Southern Tier AIDS Program certified about two dozen people to use the prescription drug and gave out free Narcan kits.
Law Enforcement Diversion Program
Young said one of the biggest new tasks the IPD has been working on to help combat overdoses and drug use is the Law Enforcement Assisted Diversion Program.
In general, the LEAD program gives police officers more discretion than they’ve ever had before when dealing with repeat offenders for low-level crimes, such as stealing or possessing a small quantity of drugs. Instead of arresting the person for those crimes, an officer could offer them participation in the LEAD program.
“They’re able to divert that person into a hub of services instead of putting them through the criminal court system, which opens up a lot of avenues,” Young said.
The program isn’t available for severe crimes, such as violent acts or felonies.
Sgt. Kevin Slattery, who volunteered to head the program, said, “This is really one of the first times that law enforcement collaborates with the public health aspect in our community.”
The LEAD program has been in the works for less than two years, and is contingent on collaborating with other local resources in Ithaca. Both officers said they look forward to starting the program soon.
Supervised Injection Facilities, harm reduction
The most controversial aspect of The Ithaca Plan thus far has been the prospect of supervised injection facilities, which would be safe spaces where people could inject heroin with sanitary supplies under the supervision of nurses. Upon request, people working at the facility would also be prepared to help people get in touch with other agencies to address issues such as housing, medical needs, legal services, etc.
At the panel, three medical doctors endorsed the use of the facilities: Dr. William Klepak,
“We need to move from a law enforcement model to a medical model — that includes harm reduction — to serve all people, all people, of all walks of life,” Klepak said.
He said that just as different methods of treatment are available to people suffering from diabetes and people who smoke cigarettes, different methods of treatment should be available to people with opioid addictions.
“We do need detox in Tompkins County. We need expanded rehab and counseling resources. We need all points of care, no matter where they occur, to expedite getting people into treatment. We need supervised injection facilities, which will especially help those people who are amongst the most disadvantaged of our population,” Klepak said.
He said global data from 97 facilities in 66 cities in 11 countries shows a reduction in overdose deaths, the spread of communicable disease (such as HIV and Hepatitis), and other complications from drug use. He said the data also showed increases in the number of referrals for people to detox, counseling and rehab.
Waldman, an emergency medical physician at Cayuga Medical Center, said the idea some people have that a SIF or a similar treatment option could be enabling drug use is unfounded.
“We don’t want to show any kindness because kindness might be enabling people And it’s sort of a hurtful topic but it does come up in medicine quite a bit,” she said about the mentality.
Waldman said harm reduction is sorely needed in Ithaca in many ways, such as methadone clinic or suboxone, both of which help treat addiction.
“Abstinence based treatment fits in that model but some people aren’t going to be able to do that,” she said. “I’d love to see methadone here in Ithaca. I’d love to see a supervised injection site.”