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times union: overdose awareness day, a call for wider access to addiction medicine, opioid antidote

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Overdose Awareness Day, a call for wider access to addiction medicine, opioid antidote

By Bethany Bump | August 31, 2018

ALBANY — “After we take a moment of silence,” Keith Brown told the group huddled at the top of the West Capitol Park staircase, “we’re going to break it by saying their name — the name of the person you love who’s no longer here because of overdose.”

There would be no shortage of names, for the death toll keeps rising: a record 72,000 Americans died of a drug overdose last year, up 10 percent from the year before and, in New York at least, the seventh consecutive year of increasing overdose deaths.

Chris. Mike. Joe. Renee. J-Bone. Angelina. Omar. Amber.

The names continued — some said shyly, others proudly, others hoarsely as a voice croaked and hot tears fell — all reminding the speaker why they stood where they stood on this Friday before a long weekend. There were roughly 50 of them: friends, family members and advocates standing shoulder to shoulder at the state Capitol on International Overdose Awareness Day to demand Gov. Andrew Cuomo and legislative leaders take action to prevent further deaths.

“These are folks who are no longer here, not because they are bad people and not because they made bad decisions,” said Brown, whose nonprofit, the Katal Center for Health, Equity and Justice, advocates for a harm reduction (“any positive change”) approach to illicit drug use.

“We know that bad policy and bad public health and the poor decisions of our federal, state and local government agencies are largely to blame for a lot of those deaths,” he said. “Those people did not have to die.”

While New York has taken steps to fight a drug epidemic fueled part by opioids — by strengthening its prescription monitoring program, expanding the types of health care workers permitted to prescribe addiction medicine and removing restrictions for hospitals to provide detox services — advocates say it’s not nearly enough to put a dent in the fast-rising death toll from drugs.

According to preliminary estimates from the CDC released earlier this month, the fastest-growing drug category to contribute to overdose deaths in 2017 was not heroin, but powerful synthetic opioids such as fentanyl, which are being brought in from China and laced into heroin, methamphetamines, cocaine and marijuana.

Several measures could help curb the public health crisis, advocates say, including widespread availability of the overdose-reversing drug, naloxone, and an expansion of pre-arrest diversion programs — like one currently operating in Albany that gives law enforcement the discretion to connect a drug user who has committed a minor offense to services, rather than jail.

Universal access to medication-assisted treatment could have the single largest impact, many argue, especially if it were made available in jails, prisons and hospitals. Such treatment, though recommended by addiction medicine specialists, is controversial because the medications used to curb opioid withdrawal, including buprenorphine and methadone, are opioids themselves — just weaker and without the high-producing effects.

If they keep someone alive and help them to lead a productive life — as many people in recovery from opioid use disorder say they do — that shouldn’t matter, advocates say.

“I have a lot to be grateful for,” said 56-year-old Christopher Evans, of Schenectady, who enrolled in an Albany-area methadone clinic more than two years ago.

It took him several months, even after the methadone, to stop using heroin, as he waited for his dosage to adjust to the lifetime he had spent using drugs on and off, he said. In his later years, he abused drugs to cope with the pain of losing a daughter to cancer, he said. After he adjusted to the methadone, he said, he was able to give up heroin and regain his self-esteem, and today volunteers at the clinic.

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