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Last week, protestors denounced Mayor de Blasio’s weak and wrongheaded response to record overdose in New York City. They pointed to the roughly $70 million allocated to the NYPD through HealingNYC, a program set up to reverse the city’s record overdose deaths. That represented half of the programs funds, all of which they said should go to the Department of Health and Mental Hygiene to support a public health approach to tackling the problem. While demanding the immediate reallocation of funds, they continued to point out that public health approaches have been studied and found to be effective, while law enforcement and criminalization-based approaches have never proven to reduce drug use and at times even worsen the problem. (See below for a response from the de Blasio administration.)
Following on the heels of last week, advocates, social service providers and people with a history of drug use staged a protest on Thursday at the office of Governor Andrew Cuomo to raise the visibility of the epidemic of overdose raging across the state and demand bolder political action.
Protestors called on the Governor to: 1) guarantee universal access to sterile syringes, naloxone, buprenorphine and methadone to every New York State resident struggling with a heroin or opioid addiction; 2) mandate that every Office of Alcohol and Substance Abuse Services (OASAS) funded program at least offer buprenorphine and/or methadone to people using opioids; 3) support the creation of safer consumption spaces, also known as supervised injection facilities.
According to the most up to date data from the New York State Department of Health, 7,213 New Yorkers died of overdose from 2013-2015. The vast majority (4,837) of overdose deaths happened outside of New York City. Out of the 11 regions of New York State, New York City had the lowest rate of overdose (9.3 per 100,000), while Western New York had the highest (17.6 per 100,000), followed by Central New York (16 per 100,000), then the Southern Tier and Long Island (15.4 per 100,000 each). Accurate statewide overdose data for 2016 still does not exist.
While New York State’s FY 2018 budget did include $213 million to combat the overdose epidemic, and Governor Cuomo recently announced a program to expand access to naloxone through easy and affordable distribution at pharmacies, there are major gaps in these strategies and a need for transparency to ensure this funding is quickly and effectively utilized.
The entirety of the $213 million appears to go to the Office of Alcohol and Substance Abuse Services (OASAS), with little or nothing going to the Department of Health, which funds critical harm reduction interventions. While many OASAS-funded programs provide quality services that help people struggling with opioids, many others refuse to provide medicated assistance – like buprenorphine or methadone, despite evidence showing their effectiveness – because they continue to promote an abstinence only approach.
Transparency is needed given that the $213 million, described as a 100% increase in funding from 2011, appears to be a small increase from a June 2016 announcement on the release of $189 million for FY 2016-2017, with the additional resources for FY 2018 seemingly coming from the federal government.
New York State does need to ensure immediate access to drug treatment on demand for all its residents, but to tackle the overdose crisis it must also ensure that the treatment offered adopts evidenced-based approaches that work. Additionally, many New Yorkers, especially those in rural counties, have limited or no access to proven public health interventions like sterile syringe access, naloxone, buprenorphine or methadone, leading them to continued heroin and opioid use.
To achieve the critical goals of universal access to these proven measures, New York State should immediately increase funding for the state Department of Health, for education and training of healthcare providers to increase low-threshold buprenorphine access, and for harm reduction programs stretched extremely thin across the state.
Jeremy Saunders is co-executive director of Voices of Community Activists and Leaders (VOCAL-NY).
A Response to Saunders from the Office of Mayor Bill De Blasio:
New York City is facing an opioid drug crisis driven by a toxic mixture of cheap heroin and fentanyl, which is why we launched HealingNYC earlier this year – a city-wide initiative that combines proven public health, safety and educational efforts to reduce overdose deaths. A “one-size fits all” approach won’t help save the lives of New Yorkers at risk, and as Police Commissioner O’Neill said: “you can’t arrest your way out of this problem.” Our plan is working, evidenced by the fact that our first responders have saved nearly 300 lives in 2017 alone with naloxone and helped put these New Yorkers on the road to recovery.
When we announced the plan, Police Commissioner O’Neill said the following: “The bottom line is this; you can’t arrest your way out of this problem. When we interview those who have been fortunate enough to not die after an overdose we won’t lock them up. This is about teaching everyone from school age kids [inaudible] to adults with major substance abuse problems to make good decisions, to resist peer pressure, and to live their lives in a positive, healthy, and productive way. I’m confident New York City can lead the way in this.”