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Two Congressmen Talk Addiction

In an exclusive interview, we grill the co-chairs of the Congressional Addiction, Treatment and Recovery Caucus about what the US is getting right and wrong.

THE FIX

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Congressional Addiction, Treatment and Recovery Caucus co-chairs Ryan (left)
and Fleming. Photo via and via

By Hunter R. Slaton

05/03/13

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It’s been said that addiction and recovery don’t get enough attention in Washington, DC—a result of the stigma attached to the disease, as well as the reluctance of some sober people to speak out about what they and their families have been through. And the latter is precisely what is needed to push forward a positive legislative agenda on addiction and recovery, according to Rep. Tim Ryan, Democrat of Ohio, who co-chairs the 62-member Congressional Addiction, Treatment and Recovery Caucus alongside Rep. John Fleming, Republican of Louisiana, who is a physician.

“Stories drive politics,” Ryan tells The Fix. “When you think about somebody who has really been to the depths of hell in some instances, and you make it out of that—that is a story of redemption, a story that needs to be told and can help move the needle when you’re talking about raising awareness and fixing the gaping holes in addiction treatment.”

Our exclusive interview with the two congressmen covers the caucus itself, attitudes to addicts and ex-addicts on the Hill, and the effects of US drug policy.

What led each of you to become involved in the Congressional Addiction Treatment and Recovery Caucus?

Ryan: Knowing what was going on with a lot of our troops was one of my original interests in seeing how addiction treatment and recovery were a cycle that a lot of our troops were going through. They didn’t have enough access to care with the trauma they were dealing with, and they were covering it up with drugs and alcohol. And I have an interest in the practice of mindfulness within the addiction community, and had met some people who were using this particular technique and having success with recovery.

Fleming: My pathway is longer and more sinuous. I grew up in a family that had—in my extended family—alcoholism. My grandfather was a terrible alcoholic, he was violent and abusive and eventually died of his alcoholism. [I had] uncles and aunts who were alcoholic and cousins who eventually transitioned to a poly-pharmacy addiction syndrome involving drugs.

I was certainly impressed with all of the carnage that I saw from that. When I was in the Navy doing my training as a resident in family practice, we were all required to go to an [addiction] treatment facility [for] two weeks. Then I ended up on two occasions being an alcohol and drug rehab physician part-time at two different facilities. From there I became interested as a parent in some of the causes and eventually wrote a book on that very subject.

Fleming: “What does concern me is that there’s many in this country that somewhat want to destigmatize the dangers of drug use—particularly, right now, marijuana.”

Do you feel there’s a bipartisan consensus on what needs to be done with addiction treatment in America?

Ryan: I think this could really be one of the areas where we can start to get a little momentum with other pieces of legislation, if we recognize that this issue of [treating addiction] can be a very positive thing—and part of it’s because small investments that we make in this area yield dividends down the line. You’re talking about prevention, you’re talking about saving money down the line of someone with a major addiction, what happens to their healthcare costs, what happens with their car accidents, longer-term jail and prison terms that cost the taxpayer a lot more money.

I’ve heard talk of the possibility of an Americans in Recovery Act bill. If such a piece of legislation were written, what sort of provisions do you think it should contain?

Fleming: Well, I don’t know anything about that bill. I can tell you that from my perspective—in dealing with many different diseases as a physician over the years—the growing aspect of each disease is prevention and early diagnosis. That’s the one thing we don’t see in the area of addiction, yet there’s plenty of data that shows there’s plenty of low-hanging fruit there. We know that early intervention—let’s say teenagers who’ve begun experimenting with drugs—can yield tremendous dividends.

Do you feel individuals in recovery should be more open in order to break the stigma associated with their disease?

Ryan: Absolutely. And we want to utilize the caucus to raise awareness. When you think about somebody who has really been to the depths of hell in some instances, and their family has suffered significantly because of an addiction and you make it out of that—that is a story of redemption and resiliency, and needs to be told. I think it can help move the needle when you’re talking about raising awareness and fixing the gaping holes [in addiction treatment].

Do you think there’s any stigma on Capitol Hill about being associated with addicts or people in recovery?

Fleming: From my perspective, again it’s defined as a disease or disorder, and as a physician it should be treated and considered as such. But unfortunately, like many diseases we treat, it is not curable. We know that addiction leads to permanent changes in the brain. So we have to think of it in terms of a management of a disease such as you would manage diabetes—and I think there’s no reason to have any stigma apart from that.

However what does concern me is that there’s many in this country that somewhat want to de-stigmatize the dangers of drug use. We just had pot day or marijuana day in Colorado, where people were openly using it because it was the first day, I think, it could be used legally.

What worries me about that is addiction virtually always begins in youth, even pre-teens. And the more available, the more acceptable that drug experimentation is, the higher rate of addiction will occur downstream. Those who promote marijuana say that it’s perfectly harmless—and yet those who are in the industry of drug treatment tell me that the most common diagnosis for people entering into treatment is primarily for marijuana addiction.

Despite what either of you may feel about the Affordable Care Act as a whole, do you in general support requiring insurance companies to cover treatment for substance use disorders?

 

Ryan: I do. [With] caucuses like this, we try to stay focused on the things that we can move on together and provide a little bit of an example.

Fleming: My belief in terms of what insurance companies [should] cover or not cover is that insurance companies, like any insurer, should be in the free marketplace and that you pick and choose what kind of coverage you want.

What do you hear from your constituents about friends or loved ones who struggle with addiction?

Ryan: You see a lot of suffering there; you see a lot of pain with the families that have had to deal with this. And it’s not always a story that ripples throughout the community. Unless you’re directly connected, you may not know the extent of the trials that the family has been through, because a lot of people don’t share that—there’s a stigma there.

We continue to hear these stories related to the veterans, where clinicians are identifying 20% of active and 42% of reserve component soldiers as requiring some kind of mental health treatment. Drugs and alcohol frequently accompany these problems and were involved in 30% of the Army suicide deaths in 2003 to 2009.

So it’s civilians, it’s military and ultimately for us I think it’s, “How do we get these folks back into society? How do we get them back to work as small business people or as entrepreneurs or as people in the work force?” That’s ultimately a wasted human resource if we allow them to go without treatment and early intervention.

Ryan: “I think drug courts have been extremely effective in carving out an alternative path for addicts and not to just lock them up but to make sure they get the kind of treatment that they need.”

Does current US drug policy—including incarceration for possession, aggressively going after drug traffickers and spending lots of money to do that—contribute positively or negatively to addiction rates and the availability and efficacy of treatment?

Fleming: If you go back to the numbers, the age at which children actually experiment first with alcohol or similar substances is age 11. They get it in their own homes or their neighbors’, and the risk of addiction in a person’s life is five-fold increased if they experiment before age 15. So obviously early exposure is a critical piece of this.

What that says to me is that we should do everything we possibly can do to keep drugs, even alcohol, out of the hands of minors. That includes everything from educating parents to be sure they know the dangers of early experimentation with alcohol and other drugs [to] watching both their drug cabinets and alcohol cabinets, [as well as] what [their kids] do when they leave the home and who they’re with.

These are all things we monitored with our four kids and it ended up paying off very well for us. But I worry that again, the more relaxed drug enforcement policies become—such as what you see happen in Colorado—that just means drugs are more available, they’re in more homes, they’re more flaunted, and I think all we’re going to see is even higher addiction rates.

Congressman Ryan, do you feel the same or do you have a slightly different view?

Ryan: I probably have a slightly different view. I certainly agree there needs to be a tremendous amount of emphasis on parents and the role of good parenting to make sure that they’re keeping an eye on their kids. Another issue I think that needs to be promoted is drug courts. I think drug courts have been extremely effective in the way that they deal with this, and carving out an alternative path for addicts and not to just lock them up but to make sure they get the kind of treatment that they need. So I think there needs to be consequences, there needs to be discipline, but shifting that through a drug court over to treatment instead of locking people up and throwing away the key [is preferable].

I think in our schools there are programs that begin to address and teach the social and emotional learning that’s needed to deal with peer pressure, whether it’s drugs and alcohol, whether its teenage sex, whether its bullying. There are skill sets that need to be developed because many times these kids get a tremendous amount of peer pressure, especially today when they see [drinking and drug use] on their computer screens, on their iPhones, on TV, on the radio, in the lyrics of songs.

Fleming: One of the big things you hear about in schools is the DARE program—and unfortunately the results have been actually, if anything, to the negative. The reason I think that that’s happening is that they’re not really teaching it to the right people. The right people are the parents. Parents have some really interesting beliefs. For instance, you hear about how parents [say], “Well look, you should teach children how to drink properly and they will grow up to be responsible drinkers.”

I think we should focus on the parents just like we taught parents that children should have seat belts. We taught parents that tobacco is a very bad idea for kids. I think we should do that with drugs and alcohol, but we just haven’t gotten to that yet.

Hunter R. Slaton is The Fix’s Rehab Review Editor.

NYC Members FYI: NEW EMERGENCY ROOM GUIDELINES TO PREVENT OPIOID PRESCRIPTION PAINKILLER ABUSE

BlueRoom

MAYOR BLOOMBERG, DEPUTY MAYOR GIBBS AND CHIEF POLICY ADVISOR FEINBLATT ANNOUNCE NEW EMERGENCY ROOM GUIDELINES TO PREVENT OPIOID PRESCRIPTION PAINKILLER ABUSE

 

New Report from Mayor’s Task Force on Prescription Painkiller Abuse Issues Guidelines and Creates RxStat to Combat Opioid Abuse and Overdose

 

Mayor Michael R. Bloomberg, Deputy Mayor for Health and Human Services Linda I. Gibbs and Chief Policy Advisor John Feinblatt today released the initial report of the Mayor’s Task Force on Prescription Painkiller Abuse, which includes new voluntary emergency room guidelines for the prescription of opioid painkillers to prevent abuse. The guidelines, which will be used in all of the City’s public hospitals, state that the emergency departments will not prescribe long-acting opioid painkillers; can only prescribe up to a three-day supply of opioids; and will not refill lost, stolen or destroyed prescriptions. Between 2004 and 2010, the rate of opioid painkiller-related emergency department visits nearly tripled in New York City, rising from 55 visits for every 100,000 people to 143 and the guidelines are designed to reduce prescription abuse and overdose by encouraging judicious prescribing, patient education, referral to primary care and treatment for substance abuse when needed. The guidelines are also designed to prevent an excess supply of opioid painkillers. We know that three out of four people abusing painkillers obtain them from leftover medications. In addition to the prescribing guidelines, the Task Force report led to the creation of NYC RxStat, which will for the first time combine and use relevant public health and public safety data to combat the problem of prescription painkiller abuse. The Task Force has worked to raise awareness of painkiller abuse through public education campaigns and has worked with the State to create an improved Prescription Drug Monitoring Program. The Mayor made the announcement at Elmhurst Hospital in Queens, where he was joined by Staten Island District Attorney Daniel Donovan, Special Narcotics Prosecutor Bridget Brennan, Health and Hospitals Corporation Chief Medical Officer Ross Wilson, Senior Health Advisor Andrea Cohen, Dr. Lewis Nelson, Professor of Emergency Medicine at the New York University School of Medicine, and Dr. Stu Kessler, head of Elmhurst Hospital Emergency Department.

 

“Prescription painkillers can provide life-changing relief for people in dire health situations, but they can be extremely dangerous if used or prescribed improperly,” said Mayor Bloomberg. “Working with health care providers and public health criminal justice experts our task force is providing the tools to fight a burgeoning epidemic while protecting legitimate health care needs. Together we are committed to addressing the violent impact that drug abuse is having on individuals and communities.”

 

“Changing practice by front line providers is key to changing the course of this epidemic,” said Deputy Mayor Gibbs. “While prosecutors and the law enforcement community rightly focus on those who illegally prescribe, dispense or procure painkillers, health leaders need to focus on encouraging well-meaning doctors and pharmacists to prescribe and dispense these medications safely and judiciously. Our work will proceed on all fronts to curtail the harms that come from painkiller misuse.”

 

“Misuse of prescription drugs is a grave threat to the health and safety of New Yorkers,” said Chief Policy Advisor Feinblatt. “Those suffering from addiction are not the only ones who are harmed by this epidemic. Drug abuse can lead to a wide range of criminal conduct, ranging from pharmacy robberies to Medicaid fraud.”

 

“Prescription opioid painkillers can be just as dangerous as illegal drugs,” said Health Commissioner Thomas Farley. “These new guidelines will help reduce prescription drug misuse while also making sure that patients coming to emergency departments have access to safe and appropriate pain relief options.”

 

“These new guidelines effectively balance our mission to relieve patients’ pain against concerns about drug abuse, dependency and the illicit diversion of opioid medications,” said Dr. Ross Wilson, Senior Vice President and Chief Medical Officer for the New York City Health and Hospitals Corporation. “Under these guidelines, we can still treat acute pain of individual patients responsibly while limiting the risks that arise from significant quantities of unused narcotics sitting in someone’s medicine cabinet.”

 

“Given the important role that emergency departments have in the management of patients with pain, it is important that we maintain our ability to provide pain relief while keeping perspective on protecting the public health,” said Dr. Lewis Nelson, Professor of Emergency Medicine at the New York University School of Medicine. “The recognition that this problem can be addressed with a broad effort across emergency departments provided the initial step in addressing this important issue.”

 

“These guidelines will help emergency department physicians strike a balance between easing a patient’s pain and discomfort while helping to ensure that medications that can be abused are not over prescribed,” said Dr. Stuart Kessler, Board of Directors, New York State Chapter of the American College of Emergency Physicians.

 

Opioid painkillers include: oxycodone (e.g. OxyContin, Roxicodone), hydrocodone (e.g. Vicodin), morphine, fentanyl patches and methadone. In recent years, there has been an increase in the number of New Yorkers reporting misuse of these drugs and in overdose deaths involving opioid medication: Between 2002-2003 and 2008-2009 (the latest data available), self-reported, non-prescription opioid use increased by 40 percent, with 263,000 New Yorkers (four percent of the population) aged 12 and older reporting misuse in 2008-2009. In 2010, prescription painkillers were involved in 173 unintentional overdose deaths in New York City, a 30 percent increase from 2005.

 

The new opioid emergency department prescription guidelines, which hospitals can choose to display in emergency departments, clarify that:

 

  • Emergency departments will not prescribe long-acting opioid painkillers such as extended-release oxycodone, fentanyl patches or methadone.
  • In most cases, emergency departments will prescribe no more than a 3-day supply of opioid painkillers.
  • Emergency departments will not refill lost, stolen or destroyed prescriptions.
  • The posters also include tips to reduce unintended harms of opioid painkillers. The poster is available in English, Spanish, Chinese and Russian. The 11 emergency departments of the New York City Health and Hospitals Corporation, which operates all of the City’s public hospitals, have agreed to adopt these guidelines. The Health Department is encouraging private hospitals to adopt these guidelines as well.

 

Created by the New York City Health Department, the new voluntary prescription guidelines are endorsed by the Health and Hospitals Corporation and the New York State Chapter of the American College of Emergency Physicians, and were influenced by the City Health Information Bulletin on opioid prescribing, “Preventing Misuse of Prescription Opioid Drugs” and opioid prescribing guidelines practiced in other jurisdictions.

 

The large increase in people who misuse prescription painkillers has not only led to a significant increase in the number of opioid analgesic-associated emergency room visits, but also a higher number of painkiller-related fatalities. Unlike previous substance abuse epidemics, this epidemic involves substances – opioids – that are legally produced and sold. This makes the drugs easier to obtain, but also makes it easier for law enforcement and public health officials to track the source and usage of painkillers.

 

With this large amount of data available for analysis, the Task Force, in partnership with NY/NJ HIDTA, created NYC RxStat, which will track relevant public health and public safety data. Participants in RxStat, including representatives from an array of City, State, and Federal agencies (including the Drug Enforcement Administration), will meet regularly to share data and conclusions so that the appropriate City response can be targeted where it will be most effective in addressing the crisis. RxStat members will regularly report on critical indicators that measure the impact of prescription painkiller abuse on the City. In addition to this reporting, RxStat will convene briefings among public health and public safety stakeholders to share strategies and describe trends. This process will provide stakeholders with an up-to-date view of the problem so that they can coordinate efforts and use resources most efficiently and effectively.

 

“It has been my pleasure to serve with Chief Policy Advisor Feinblatt and Deputy Mayor Gibbs, distinguished healthcare professionals, and other law enforcement officials to help develop RXstat and the Emergency Department Guidelines for Opioid Prescriptions,” said Staten Island District Attorney Daniel Donovan. “RXstat marks a milestone in information sharing among those charged with protecting the public’s health and safety. I am confident that the measures announced today will lead to enhanced enforcement of the criminal law, the adoption of best practices in emergency care and after-care, and more effective ways to combat the scourge of prescription drug abuse in our communities.”

 

“RxStat provides us with a truly unique opportunity to design the most effective strategies to reduce prescription drug abuse and its consequences,” said NY/NJ HIDTA Director Chauncey Parker. “By combining the knowledge resources of the key public health and public safety partners, RxStat creates a platform where we can use timely and accurate data to quickly identify emerging drug trends and then coordinate our response.”

 

“Our recent prosecutions have highlighted the tragic connection between opioid addiction and criminal activity. Painkillers generate huge profits for drug dealers, from street sellers to unscrupulous medical professionals. NYC RxStat is an excellent tool that will enhance our investigations,” said Special Narcotics Prosecutor Bridget G. Brennan. “Prevention is key to reining in this epidemic, and the new hospital guidelines will reduce the surplus of addictive pills, which are often sold illegally. Hopefully, these guidelines will serve as a model of responsible prescribing for the entire medical community.”

 

The combined data of various City, State and Federal agencies will ensure that city agencies responding to this crisis will be able to understand the total picture and will be able to adjust their response based on the ever changing circumstances on the ground. By analyzing the data and deploying resources more effectively, the City will be able to keep up with the ever changing patterns of drug abuse.

 

The full report is the result of a collaborative effort from the thirteen members of the Task Force, highlights the work done during the past year, makes recommendations for changes in policy and practice and describes the Task Force’s next steps. It is available at www.nyc.gov

 

If you or someone you know has a problem with painkillers, call 1-800-LIFENET. For information on the emergency department opioid prescription guidelines, visit nyc.gov

 

About the Mayor’s Task Force on Prescription Painkiller Abuse

 

A multi-agency Task Force created by Mayor Bloomberg in December 2011 and co-chaired by Deputy Mayor for Health and Human Services Linda Gibbs and Chief Policy Advisor John Feinblatt, the Task Force’s mission is to develop and implement coordinated strategies for responding to the growth of opioid painkiller misuse and diversion in New York City. Members include Staten Island District Attorney Daniel Donovan; Special Narcotics Prosecutor Bridget Brennan; Health Commissioner Thomas Farley; Executive Deputy Commissioner for Mental Hygiene Adam Karpati; Human Resources Administration Commissioner Robert Doar; Health and Hospitals Corporation President Alan Aviles; NY/NJ HIDTA Director Chauncey Parker; Police Department Deputy Inspector Raymond Martinez; and Department of Education Deputy Chancellor Kathleen Grimm.

Hurricane Sandy Relief Resources

In our efforts to assist local communities affected by Hurricane Sandy, we have compiled a listing of available resources throughout the five boroughs.If your organization is providing resources or services that we can post, please send us an email.  (Example: clothing, food, counseling, shelter, childcare, showers, internet access, medical supplies, etc.)

 

Citywide

Daytime Warming Centers – UPDATED
Click here for a full list of centers:

Overnight Warm Shelters – UPDATED

Bus pickups are available 4:00 PM to 9:00 PM on Monday. Please check back for additional updates.

MANHATTAN WARM SHELTER
George Washington High School, 549 Audubon Avenue between Fort George Avenue and West 193rd Street

BUS PICKUP
Seward Park High School, 350 Grand Street between Ludlow and Essex Streets

QUEENS WARM SHELTER
Hillcrest High School, 160-05 Highland Avenue between 160th and 161st Streets

BUS PICKUP
Waldbaum’s, 112-15 Beach Channel Drive near Wainwright Court and Beach 116th Street
Fort Tilden Park at Beach Channel Boulevard

BROOKLYN WARM SHELTER
John Jay High School, 237 Seventh Avenue between 4th and 5th Streets

BUS PICKUP
MCU Park Parking Lot, 1904 Surf Avenue at West 17th Street

STATEN ISLAND WARM SHELTER
Tottenville High School, 100 Luten Avenue between Deisius and Billiou Streets

BUS PICK UP
Miller Field, 600 New Dorp Lane at Weed Avenue
Mount Loretto, 6581 Hylan Boulevard at Sharrotts Road
Free Showers/Cell Phone Charging
New York Sports Clubs: (Located throughout the tri-state area).
Phone: Click here for locations and contact numbers

Information: NYSC asks that non-members bring a towel. Also, some location may be closed due to the Hurricane. Please call (if possible) to ensure availability.

 

Brooklyn

Emergency Shelters

 

Brooklyn Tech High School
29 Fort Greene Place, Brooklyn
Special Medical Needs Only

Franklin Delano Roosevelt High School
5800 20th Avenue, Brooklyn
All populations

John Jay High School
237 7th Avenue, Brooklyn
All populations

Park Slope Armory
361 15th Street, Brooklyn
Special Medical Needs Only

FEMA Disaster Recovery Center
MCU Park, 1904 Surf Avenue
Time: 8am – 5pm
Phone:  Call FEMA directly — 1-800-621-FEMA (3362) or log on to or disasterassistance.gov.

Additional Information: The centers are there solely to provide an opportunity for face-to-face interaction with FEMA officials who can help devastated homeowners, renters and business owners get the process started to obtain low-interest federal loans.

 

Food, Blanket, and Water Distribution Sites – UPDATED

Location(s): Coney Island: Surf Island Playground – West 25th Street & Surf Avenue; Red Hook: Coffey Park – 85 Richards Street between King & Verona Streets; Corner of Brighton Beach Avenue and Coney Island Avenue

Additional Information: Additional Information:  They will be open on Monday, November 5th from 12pm-4pm

 

Food Drives – UPDATED
Food Drive for Hurricane Sandy Survivors – CROWN HEIGHTS
Sponsors:  State Senator Eric Adams and Assembly Member Alec Brook-Krasny
***Non-Perishable Food Products may be dropped off as follows:
Monday – Thursday, 11am – 6pm
Friday, 11am – 5pm
Saturday, 12noon – 3pm
1669 Bedford Ave. at Montgomery St.
Contact:(718)284.4700

Concord Baptist Church – BEDFORD-STUYVESANT
***Coats, Blankets, Jackets, Gloves, Hats, Scarves and Socks may be dropped off as follows:
Sunday and Monday,  9am – 6pm
Tuesday – Thursday, 9am – 9pm
833 Gardner C. Taylor Blvd. (Marcy Ave. at Putnam Ave. and Madison St.)
Contact: (718)622-1818/19

Annual Community Food Drive – CLINTON HILL
Sponsors:  Ms. Olanike Alabi, 57th A.D. Democratic Organization, Clinton Hill AARP – Chapter 2197
DC37, UFT, 1199SEIU (List In Formation)
***Non-Perishable and canned goods will be collected in support of the Food Pantry sponsored by the
Hanson Place Seventh Day Adventist Church in Fort Greene
Thursday, November 15, 2012
Teen Challenge Center
444 Clinton Ave.
Contact: 718.398-0750

Bronx

Emergency Shelters
Lehman College
250 Bedford Park Boulevard West, Bronx
All populations

FEMA Disaster Recovery CenterUPDATED

Edgewater Firehouse Parking Lot, 1 Adee Place between 9th Avenue and Edge Street

Open 10am-5pm

Phone:  Call FEMA directly — 1-800-621-FEMA (3362) or log on to or disasterassistance.gov.
Additional Information: The centers are there solely to provide an opportunity for face-to-face interaction with FEMA officials who can help devastated homeowners, renters and business owners get the process started to obtain low-interest federal loans.

Manhattan

Cell Phone Recharging Centers/Stations
Time Warner Mobile Station

Location(s): 7th Ave/Greenwich Ave; 23rd/Broadway & Bayard/Mott Sts

Additional Information:  These are mobile charging stations.

 

Emergency Shelters
George Washington HS
549 Audubon Avenue, New York
All populations

High School of Graphic Arts
439 West 49th Street, New York
All populations

Hunter College
Hunter College
695 Park Avenue, New York
All populations

John Jay College
445 West 59th Street, New York
Special Medical Needs Only

Seward Park High School
350 Grand Street, New York
Evacuation Center Only
Food, Blanket and Water Distribution SitesUPDATED

 

Location(s): 419 West 17th Street between 9th and 10th Avenues Manhattan; Pitt Street and East Houston Street
Additional Information:  They will be open on Monday, November 5th from 12pm-4pm

 

Free Showers/Cell Phone Charging
Halevy Life: 802 Lexington Avenue New York, NY 10065 (between 61st & 62nd Sts);

Phone: (212) 233-0633

Information:  Please call (if possible) to ensure availability

 

Queens

Cell Phone Recharging Centers/Stations
Time Warner Cable Store, Queens Center Mall, 9015 Queens Boulevard, New York, NY 11373

Phone: (718) 888-9687

Additional Information:  Stores have charging and internet stations
Emergency Shelters

 

Hillcrest High School

160-05 Highland Avenue, Queens
All populations
Queens College

65-30 Kissena Boulevard, Flushing
All populations

York College
94-20 Guy R. Brewer Boulevard
All populations

FEMA Disaster Recovery CenterUPDATED

 

Fort Tilden Park at Beach Channel Boulevard – Western-most Parking Lot;

Waldbaum’s 112-15 Beach Channel Drive between Beach 65th and Beach 66th Streets

Open 10 AM – 5 PM

Phone:  Call FEMA directly — 1-800-621-FEMA (3362) or log on to or disasterassistance.gov.
Additional Information: The centers are there solely to provide an opportunity for face-to-face interaction with FEMA officials who can help devastated homeowners, renters and business owners get the process started to obtain low-interest federal loans.
Food, Blanket, and Water Distribution Sites – UPDATED
Location(s): Rockaways: Conch Playground – Beach Channel Drive and Beach 49th Street; Hammel Playground – 84th Street & Rockaway Beach Boulevard; Red Fern House Playground – Redfern Avenue & Beach 12th Street;  Beach 41st Street Houses at Beach Channel Drive and Beach 40th Street; St. Francis De Sales Parish (129-16 Rockaway Beach Boulevard at Beach 129th Street)
Additional Information: They will be open on Monday, November 5th from 12pm-4pm

 

Staten Island

Cell Phone Recharging Centers/Stations
Time Warner Cable Store, 2845 Richmond Ave, Staten Island, NY 10314
Phone: (718) 816-8686
Additional Information:  Stores have charging and internet stations

 

Emergency Shelters
Susan Wagner High School
1200 Manor Road
All populations

Tottenville High School
100 Luten Avenue
All populations
FEMA Disaster Recovery Center
Miller Field:  Staten Island, NY (at New Dorp Lane and Mill Road); Mount Loretto at 6581 Hylan Blvd. at Sharrotts Road
Phone: Call FEMA directly — 1-800-621-FEMA (3362) or log on to or disasterassistance.gov
Additional Information: The centers are there solely to provide an opportunity for face-to-face interaction with FEMA officials who can help devastated homeowners, renters and business owners get the process started to obtain low-interest federal loans.

 

Food, Blanket, and Water Distribution Site
Location(s): Parking Lot – corner of Mill Road & New Dorp Lane; Father Capodanno Boulevard and Hunter Avenue
Additional Information: They will be open on Monday, November 5th from 12pm-4pm
Free Showers
Broadway YMCA: 651 Broadway, Staten Island, NY 10310

Phone: (718) 981-4933
Additional Information: In order to help ensure safety and help manage the need, local residents are being asked to call ahead (if possible) before going; and to have proper ID to gain access.  Please call to verify hours of operation.  This service is available to local Staten Island residents only.
Supply Drop-Off
Rab’s Country Lanes: 1600 Hylan Boulevard, Staten Island, NY 10305

Phone: (718) 979-1600
Additional Information:  If your organization would like to help distribute collected supplies to affected families, please contact Rab’s for more information.
Substance Abuse Counseling Services/Outpatient Treatment
YMCA Counseling Service, 285 Vanderbilt Avenue, Staten Island, NY 10304

Phone: (718) 981-4382
Additional Information:  Groups will be held at 2:30pm daily and individual sessions as needed.

Addicted to Painkillers, Unready for Help

via the NYTimes / by PAUL CHRISTOPHER, M.D.

“I’m addicted to painkillers,” J., a thickset construction worker, told me on a recent afternoon in the emergency room, his wife at his side.

Two years before, after months of pain, stiffness and swelling in his hands and neck, his primary physician had diagnosed rheumatoid arthritis and had prescribed three medications: two to slow the disease and one, oxycodone, for pain.

Bolstered by the painkiller, J. had felt more limber and energetic than he had in years. “I could finally keep up with the other guys,” he told me. He worked harder, and his pain worsened. His primary physician increased the oxycodone dose.

Soon, J. was looking forward more to the buzz than to the relief the pills brought. He went to see two other physicians who, unaware that he was double-dipping, prescribed similar medications. When a co-worker offered to sell him painkillers directly, J.’s use spiraled out of control.

By the time I saw him, he was taking dozens of pills a day, often crushing and snorting them to speed the onset of his high. With remarkable candor, he described how the drugs had marred every facet of his life — from days of missed work to increasing debt, deteriorating health and marital strain.

But when I listed the treatment options that might help, J. shook his head, looked from me to his wife, and got up. “I’m all set,” he said, holding up his hands.

Then he walked out of the room.

Despair fell on his wife’s face. “Please,” she said, grabbing my arm, “you can’t let him leave.”

She’d found him twice in the past week slumped on the bathroom floor, impossible to arouse. Though she’d called 911, both times the hospital released J. within hours after he came to and insisted the overdose was accidental. “I just know I’m going to come home one day to find him dead,” she said.

She had good reason to worry. Prescription drug abuse is America’s fastest-growing drug problem. Every 19 minutes, someone dies from a prescription drug overdose in the United States, triple the rate in 1990. And according to the Centers for Disease Control and Prevention, prescription painkillers (like oxycodone) are largely to blame. More people die from ingesting these drugs than from cocaine and heroin combined. Yet while I shared her concern, there was little I could do to force J. into treatment.

My hospital happens to be in Rhode Island, one of about a dozen states where compulsory treatment for someone like J. (that is, someone not under the purview of the criminal justice system) does not exist. Had J. been a resident of nearby Massachusetts — or from one of more than 20 other states that permit involuntary addiction treatment — I would have suggested his wife petition a judge to force him into care. Had we met in any of a dozen states, I could have hospitalized J. myself — against his will and for up to several days.

The requirements for involuntary substance treatment vary widely across the nation, from posing a serious danger to oneself, others or property, to impaired decision-making or even something as vague as losing control of oneself. States approach compulsory treatment for mental illness with far greater uniformity. All allow it, and almost all restrict it to instances in which a patient poses an immediate danger to himself or another.

This common standard stems from a series of federal court cases that set procedural and substantive requirements for mental health commitments. But involuntary commitment for addiction treatment, while certainly not new, has received considerably less judicial attention.

In a 1962 case, Robinson v. California, the Supreme Court held that while conviction solely for drug addiction was unconstitutional, “a state might establish a program of compulsory treatment for those addicted to narcotics.” Many did, others didn’t. The high court has yet to revisit the issue.

Another complicating factor is society’s disagreement about what addiction really is: a disease, a moral failing or something in between. Many (often patients themselves) see drug abuse as purely a choice. Under this view, justifying the lost autonomy and expense to taxpayers that accompany mandated treatment becomes a hard sell.

Yet a large and ever-growing body of research paints a far more complicated picture of addiction.

The cognitive concepts that we typically associate with “willpower” — motivation, resolve and an ability to delay gratification, resist impulses and consider and choose among alternatives — arise from distinct neural pathways in the brain. The characteristic elements of drug abuse — craving, intoxication, dependency and withdrawal — correspond with disruptions in these circuits. A host of genetic or environmental factors serve to reinforce or mitigate these effects. These data underscore the powerful ways in which addiction constrains one’s ability to resist.

The spotty existence of commitment laws for addiction has created something odd in medicine: a landscape where the standard of care differs dramatically from one place to the next. But change seems to be afoot. In March, Ohio passed a law authorizing substance-related commitments. Pennsylvania is considering a similar bill.

In July, Massachusetts extended its maximum period of addiction commitment from 30 days to 90 days, a move driven by the state’s growing opioid abuse epidemic. In the same month, however, California terminated its commitment program for drug abuse.

These shifts come at a time when private insurers increasingly refuse to cover even brief inpatient stays for treatment of opioid abuse and as states grapple with dwindling resources. Still, while short periods of involuntary custody make intuitive sense — to provide protection until the effects of intoxication or withdrawal subside — surprisingly little evidence exists to suggest that a longer period of commitment will lead to abstinence or prevent the behavior that justified commitment in the first place. Science must guide the crafting of these laws, but for now the empirical jury is decidedly out.

As I watched the color drain from J.’s wife’s face, I decided to speak with him again. Short of forcing him to stay, I knew what she wanted was for me to change J.’s mind.

He stood near the exit, arms folded, coat zipped. I waited next to him and for several moments said nothing. Then I wondered aloud whether he feared the physical pain that existed apart from his addiction. Without looking at me, he nodded.

“What if we can find a way to treat your pain and also bring an end to the hurt this is causing you and your family?” I asked. “Perhaps together we can help you get your life back.”

J. paused to consider my offer. For an instant, his face softened.

Then, just as quickly, he jerked his head and was gone. His wife followed him out, in tears.

Budget Call Letter Asks for Zero Growth from State Agencies

Dear Agency Commissioners:

STATE OF NEW YORK

EXECUTIVE DEPARTMENT

DIVISION OF THE BUDGET STATE CAPITOL ALBANY, NEW YORK 12224

September 17, 2012

Robert L. Megna

Director of the Budget

Over the past 21 months and with your help, Governor Cuomo eliminated a cumulative budget gap of $77 billion without raising taxes. He accomplished this by taking a series of difficult but necessary actions that have kept spending growth under strict control while delivering the quality core services that New York’s citizens demand. The Governor is committed to keeping spending growth to two percent or less over the course of his Administration as we continue the difficult task of eliminating our remaining structural deficit and providing the strong fiscal framework that will return New York to economic preeminence.

Continuing efficiencies in government operations will be achieved through ongoing measures, originally recommended by the SAGE Commission, to streamline and consolidate government operations through a range of Enterprise Shared Services initiatives including the Business Services Center, strategic sourcing procurement reform, consolidation of information technology services, and the restacking of our real estate assets. Significant programmatic improvement will be accomplished through initiatives like the Justice Center, enacted this year, to implement uniform safeguards for people with special needs and to prosecute cases of abuse and neglect.

As we begin the important work of developing the 2013-14 Executive Budget, Governor Cuomo remains committed to holding the line on State spending while maintaining his pledge to increase support for schools and health care in a sustainable manner. Accordingly, your 2013-14 budget request for State Operations and Aid to Localities (excluding School Aid and Medicaid, which are subject to different growth caps) must assume zero growth from your 2012-13 cash ceiling for the 2013-14 and 2014-15 fiscal years for both General Fund and State Operating funds spending. In other words, 2013-14 budget requests cannot achieve zero growth through fiscal gimmicks or one-time actions. Funding requests for new initiatives must be offset by corresponding reductions elsewhere in your budget. Maximization of your agency’s use of Enterprise Shared Services will assist in achieving this objective.

We must approach next year’s Budget as we have the past two years: as a means of achieving the Governor’s vision of making government work better for the people of this State. Agencies must work together across functional areas and adopt smarter, more efficient practices to achieve their core missions. Your budget request must reflect actions taken this year and continuing through next year to make government:

Work Better: Include metrics developed over the past two years on overall performance of significant core functions and make recommendations to improve performance. Identify additional metrics as appropriate.

Work Smarter: Take advantage of opportunities to share resources and reflect savings to be achieved through greater use of Enterprise Shared Services and other means of reducing or eliminating non-core functions. After conferring with Governor’s Counsel’s Office to identify any statutory barriers or issues, include recommendations to eliminate or merge functions that are not part of your agency’s core mission.

Operate More Efficiently: Include efforts to improve business processes, eliminate duplication, and reduce the risk of fraudulent behavior and abuse of State resources.

Serve Our Customers Better: Examine all operations to ensure that the services you provide and your hours of operation are geared to customer need and not agency convenience. This must include a serious review of regional operations where we interact with the public on an ongoing basis.

In addition to the agency capital components required by the Budget Request Manual, the New York Works Task Force will also be asking all State agencies and public authorities to submit capital program information to the Task Force in the form of a comprehensive capital program template. Capital entities will be asked to complete the template to display long-term capital plans and to categorize proposed capital investments in a uniform manner. Separate instructions for the capital template will be issued shortly by the Task Force and the Office of State Operations.

We ask that you submit your agency’s budget request no later than October 16, 2012. Your staff can contact an examiner from the Division of the Budget with any questions or concerns. You should also involve your respective Deputy Secretary within the Executive Chamber as soon as possible to ensure all requests are consistent with broader programmatic and policy objectives.

Thank you for your continued partnership as Governor Cuomo works to build a new New York.

Sincerely, Robert L. Megna

Urge Your U.S. House Member and Senators to Support The Behavioral Health Information Technology Act (H.R. 6043/S. 539)

What You Need To Do

Please call your U.S. Representative and Senators today and ask them to cosponsor the Behavioral Health Information Technology Act (H.R. 6043 in the House and S. 539 in the Senate). You can find your U.S. Representative by visiting http://www.house.gov/representatives/and your U.S. Senators at http://www.senate.gov/general/contact_information/senators_cfm.cfm.You can also call the U.S. Capitol Switchboard at (202) 224-3121.

 

If your Representative is on either the House Ways and Means or Energy and Commerce Committees, or if your Senator sits on the Senate Finance Committee, it is especially important that they hear from you. A list of committee memberships is copied below.

What You Need to Know

  •  The Behavioral Health Information Technology Act would amend current law to make certain providers of addiction and mental health services eligible for health information technology (HIT) funds. These funds would include HIT resources provided through the American Recovery and Reinvestment Act of 2009 (ARRA) which allocated funds to many health service providers but excluded most providers of addiction and mental health services from eligibility.
  • H.R. 6043 is awaiting review in the House Energy and Commerce Committee and the House Ways and Means Committee. S. 539 is awaiting review in the Senate Finance Committee. Full text and status of H.R. 6043and S. 539 can be found at: http://thomas.loc.gov.
  • Current co-sponsors of H.R. 6043 include: Representatives Marsha Blackburn (R-TN), Mary Bono Mack (R-CA), Larry Bucshon (R-IN), Michael Burgess (R-TX), Gerry Connolly (D-VA), Charles Dent (R-PA), Jim Gerlach (R-PA), Sam Graves (R-MO), Gene Green (D-TX), Brent Guthrie (R-KY), Larry Kissell (D-NC), David Loebsack (D-IA), Zoe Lofgren (D-CA), Tom Marino (R-PA), Chris Murphy (D-CT),Tim Murphy (R-PA), Sue Myrick (R-NC), Mike Quigley (D-IL), Tim Ryan (D-OH), Chris Smith (R-NJ), John Sullivan (R-OK), Patrick Tiberi (R-OH), and John Tierney (D-MA).
  • Current co-sponsors of S. 539 include: Senators Daniel Akaka (D-HI), Mark Begich (D-AK), Jeff Bingaman (D-NM), Richard Blumenthal (D-CT), Sherrod Brown (D-OH), Ben Cardin (D-MD), Bob Casey (D-PA), Susan Collins (R-ME), Daniel Inouye (D-HI), Tim Johnson (D-SD), John Kerry (D-MA), Frank Lautenberg (D-NJ), Robert Menendez (D-NJ), Jack Reed (D-RI), Bernie Sanders (I-VT), Chuck Schumer (D-NY), Jeanne Shaheen (D-NH), and Sheldon Whitehouse (D-RI).
  • To ensure that the legislation quickly moves toward passage, additional bi-partisan co-sponsors of H.R. 6043and S. 539 are needed today.

If you have any questions, please feel free to call Gabrielle de la Gueronniere or Dan Belnap at Legal Action Center, (202) 544-5478. Thank you for your help!

 

Summary of The Behavioral Health Information Technology Act

 

The Behavioral Health Information Technology Act has been introduced in the House of Representatives, as H.R.6043, as in the Senate, as S. 539. H.R. 6043/S. 539 would amend current law to make certain providers of addiction and mental health services eligible for health information technology (HIT) funds. These funds would include HIT resources provided through the American Recovery and Reinvestment Act of 2009 (ARRA), which allocated HIT funds to many health service providers but excluded most providers of addiction and mental health services from eligibility.In particular,the Behavioral Health Information Technology Act would:

  • Make substance abuse professionals and substance abuse treatment facilities, behavioral and mental health professionals and clinics, and psychiatric hospitals eligible for ARRA incentive funds for the “meaningful use” of electronic health records;
  • Extend eligibility for Medicaid HIT implementation funds to certain mental health and substance abuse treatment facilities (those facilities with at least ten percent of their patient volume receiving Medicaid), private and public psychiatric hospitals, and workforce professionals including certain clinical psychologists and clinical social workers; and
  • Extend eligibility for Medicare HIT payment incentives to certain physicians, clinical psychologists and clinical social workers, and certain psychiatric hospitals.

The Behavioral Health Information Technology Act would also authorize a $15 million grant program through the Department of Health and Human Services’ Office of the National Coordinator for Health Information Technology that would be available to mental health and substance abuse treatment facilities and certain psychiatric hospitals. These grant funds could be used to:

 

  • Facilitate the purchase and enhance the use of HIT;
  • Train personnel in the use of HIT;
  • Improve the secure electronic exchange of health information among mental health and addiction workforce professionals and other health care providers, including primary care providers;
  • Improve HIT for adaptation to “community-based behavioral health settings”;
  • Assist with the implementation of telemedicine, including facilitation of distance clinical consultations in rural and underserved areas; and
  • Collaborate and integrate with HIT regional extension centers.

 

H.R. 6043 was referred to the House Energy and Commerce and Ways and Means Committees where the legislation awaits review, and S. 539 awaits review in the Senate Finance Committee. Full text and status of the Behavioral Health Information Technology Act can be found at: http://thomas.loc.gov.

Few Doctors Know How To Treat Addiction. A New Program Aims To Change That.

By Sandra G. Boodman,  Washington Post,   9/3/2012

They are seen every day in doctors’ offices, outpatient clinics and hospital emergency rooms: men in their 50s with bleeding ulcers; young adults pulled from car crashes; middle-aged women fighting a losing battle against chronic pain.

As dissimilar as they seem, many of these patients are also suffering from another illness — alcohol or drug abuse — that is at the root of the more obvious ailments that keep them cycling through the medical system. Even so, their addiction is rarely addressed by doctors.

A recent comprehensive report by the National Center on Addiction and Substance Abuse (CASA) at Columbia University found that most doctors fail to identify or diagnose substance abuse “or know what to do with patients who present with treatable symptoms.”

Only about 10 percent of the 22 million Americans with a drug or alcohol problem receive treatment, the report found. After including 18 million other people whose only addiction is to nicotine, it estimated that 40 million Americans are addicted to one or more substances. And although effective treatments exist, “the vast majority of people in need of addiction treatment do not receive anything that approximates evidence-based care,” researchers concluded.

Despite its prevalence and impact — addiction is linked to more than 70 diseases or conditions and accounts for a third of inpatient hospital costs, according to CASA — the subject is rarely taught in medical school or residency training. Of the 985,375 practicing physicians in the United States, only about 1,200 are trained in addiction medicine, a scarcity of skills that poses a “formidable barrier” for patients, CASA concluded.

A new training program underway at 10 academic medical centers around the country, including the University of Maryland Medical Center in Baltimore, seeks to address this acute shortage by offering one- and two-year residencies in addiction medicine to physicians who have finished training in another specialty, such as family practice or internal medicine.

The program, launched in July 2011 and sponsored by the American Board of Addiction Medicine, seeks to attract more doctors to the field and to convince organized medicine to approve the medical treatment of addiction as an officially recognized subspecialty, similar to cardiology or sports medicine. Currently that designation belongs only to addiction psychiatry, which is open only to psychiatrists, not primary-care doctors.

“Addiction so much affects the quality of care we deliver,” said internist Jeffrey Samet, ABAM’s president and a professor at the Boston University School of Medicine. “If you don’t address drug or alcohol abuse, you can’t begin to control a patient’s diabetes.”

The training program could not come at a more auspicious time. The federal Substance Abuse and Mental Health Services Administration estimates that up to a third of the 30 million Americans who may gain health insurance under the Affordable Care Act have a substance abuse or mental health problem.

“Given the increase, the potential need for physicians is extraordinary,” said Wilson Compton, director of the division of epidemiology, services and prevention research at the National Institute on Drug Abuse. “In the last 10 to 15 years, we’ve seen a marked increase in medical interventions” to treat addiction, Compton said, referring to several new medicines such asbuprenorphine to ease withdrawal and blunt cravings in people addicted to opiates, a class of drugs that includes heroin, codeine and painkillers such as oxycodone. “You need a workforce who understands and can prescribe these drugs appropriately.”

Three drugs, including naltrexone, have been approved in recent years to treat alcohol abuse.

Psychiatrist Devang Gandhi, who heads the University of Maryland’s addiction residency program, said that the need for treatment has become increasingly apparent to his colleagues outside psychiatry. “I think there’s more recognition in medicine that addiction is present and you can’t just shut your eyes to it,” he said.

While interest in addiction medicine residencies may be growing, funding remains a problem. Although 10 medical centers agreed to train 28 doctors in the first year of the program, money was found for fewer than half of those slots.

One way around that obstacle is to fund residencies, which are traditionally financed by the Centers for Medicare and Medicaid Services and cost about $80,000 per doctor annually, through hospitalsprofessional medical groups or the Department of Veterans Affairs. Psychiatrist Michael Miller, an ABAM board member who helped establish the addiction medicine residency at the University of Wisconsin School of Medicine and Public Health, said the VA has funded a position for a doctor who will work with returning veterans who have substance abuse problems.

Not like ‘Intervention’

Despite the popular view of addiction treatment, shaped by such reality television shows as A&E’s “Intervention,” which ends with an addict’s stay in a distant and expensive inpatient facility, most treatment for drug and alcohol abuse takes place in outpatient settings near a patient’s home. Chief components of treatment are often medications, behavioral therapy and supportive programs.

“The nature of treatment has changed” in the past 10 to 15 years, said Richard Blondell, a professor of family medicine at the State University of New York at Buffalo, who heads ABAM’s committee on training. Studies have bolstered the view of addiction as a complex brain disease, not a failure of willpower or a deep-seated psychological problem.

“We used to think that somebody who was an alcoholic had a behavior problem, and if you just figured out what happened during toilet training you could fix it,” he said. Now, rather than “trying to fix the underlying psychological problem, it may be better to fix the underlying biological problem.”

In Blondell’s view, there is another compelling reason to train more doctors: raising standards. “Sometimes, underqualified physicians gravitate to addiction medicine,” he said.

In many cases, physicians are only minimally involved in treatment. The qualifications of addiction counselors, who provide the bulk of treatment, are often meager. Six states have no minimum educational requirement, CASA found, while 14 require only a high school diploma. The group’s report recommends that addiction courses be added to the required curricula of medical school and training programs.

Feeling powerless

The daughter of a New York social worker, internist Christine Pace said she has always been drawn to working with disadvantaged patients. But as a third-year medical student at Harvard several years ago, Pace said, she “met a lot of patients struggling with addiction and was really frustrated by how poorly served” they were by doctors and by how little doctors knew about treatment.

Pace said she was shocked and upset when doctors rolled their eyes after a patient bounced back into the hospital with endocarditis — a heart infection seen in IV drug users — or severe gastrointestinal bleeding caused by alcoholism.

“We’re not trained to deal with patients who are addicted,” said Pace, who recently completed Boston University’s year-long addiction residency. “We end up feeling powerless and frustrated — and doctors don’t like to feel frustrated and powerless.”

Gandhi, of the University of Maryland, agreed. “The patient population tends to be more complicated and difficult,” he said, adding that addiction is not a glamour specialty like cardiology. Doctors may not “be reimbursed for the services they provide because they’re not doing procedures. And they would much rather do what they are familiar with and what they’re paid for.”

But for some newly minted residents, the lure is the chance to affect patients’ lives in a significant way.

Karsten Lunze, who trained as a pediatric cardiologist in his native Germany before coming to the United States to study preventive medicine at Johns Hopkins and Harvard, decided to become an addiction clinician-researcher. He finished the Boston University program in July and has joined that school’s faculty as an addiction specialist.

“I was looking for a field that would allow me to make a big impact,” said Lunze, adding that he was “struck by the extent of addiction among American patients.

Treating substance abuse patients, he added, can have “a profound impact on their lives. It’s humbling to see what resources our patients can mobilize and how resilient they are.”

SUNY’s Blondell echoed that sentiment. “I see more impressive successes in addiction than I did in family medicine.” Among them is a history teacher in his early 40s who grew up in a family of alcoholics but never drank. After the man suffered a herniated disk and underwent failed back surgery, he became addicted to narcotic painkillers. When his doctor refused to prescribe them, he bought them illegally. His job and marriage imperiled, he sought treatment from Blondell, who put him on buprenorphine, which he took for several years.

Combined with the medicine, which helped him kick his addiction, the man underwent counseling and attended Narcotics Anonymous meetings. Now in recovery, “he’s working, and his marriage is stable,” Blondell said.

Kaiser Health News is a service of the Kaiser Family Foundation, a nonpartisan health-care-policy research organization unaffiliated with Kaiser Permanente.

Governor Cuomo Announces State Makes it Illegal to Sell or Possess Bath Salts or Synthetic Drugs

Governor Andrew M. Cuomo today announced that the New York State Department of Health (DOH) has issued new regulations to crack down on the increasingly widespread use of bath salts and other synthetic drugs.

The new regulations, issued today by DOH and approved by the Public Health and Health Planning Council, will expand the existing list of prohibited drugs and chemicals to include dozens more substances that are now used to make synthetic drugs, better ensuring that distributors can no longer skirt the law by simply modifying the drug’s ingredients. In addition, the regulations will allow for the first time an owner of an establishment and/or an employee selling synthetic drugs to be charged with possession of an illicit substance. Further, to support enforcement, the regulations will increase the criminal penalties for those who violate the rules. Violators will face fines up to $500 and potentially up to 15 days in jail.

“Bath salts and other synthetic drugs pose a direct, serious threat to public health and safety, and we must do everything we can to remove these harmful substances from sale and distribution in New York,” Governor Cuomo said. “The actions we are announcing today attack the problem by helping our law enforcement officers enforce the rules, expanding the list of banned substances used to manufacture bath salts, and imposing tougher penalties so those who sell these drugs are held accountable.”

Over the past year, there has been a dangerous rise in instances of New Yorkers using synthetic drugs. In 2011, there were 39 reported emergency room visits in upstate New York as a result of bath salts. Already in 2012, there have been 191 such visits with 120 occurring this past June and July. According to the New York State Poison Control Center, in 2010 there were only 20 calls concerning synthetic marijuana poisonings. There were 291 in 2011, and there were already 321 through the first six months of 2012.

Bath salts and other synthetic drugs are manufactured with a similar, but slightly modified structure of controlled substances that are listed on Schedule I of the state and/or federal controlled substances laws as a means to avoid existing drug laws. These designer drugs can be – and are – continually chemically modified in the attempt to avoid legal repercussions.

In an effort to mask their true purpose, these products are marketed as “bath salts” or as “legal alternatives to marijuana.” They are currently sold online, in small convenience stores, smoke shops, and other retail outlets. When consumed, these substances produce dangerous effects similar to cocaine and amphetamines, including hallucinations, paranoia, delusions, suicidal thoughts, and violent behavior as well as chest pains, increased blood pressure, and increased heart rates.

Bath Salts are sold under names including, White Lightning, Snow Leopard, Tranquility, Zoom, Ivory Wave, Red Dove, Vanilla Sky, and others. Synthetic marijuana is sold as Spice, K2, Blaze and Red Dawn X among other names.

Although federal law bans the manufacture or sale of many of these substances, as a result of the new regulations put in place today, local law enforcement officials for the first time will be able to pursue perpetrators under state laws and refer violators to local District Attorneys for prosecution.

The State Health Department and the New York State Police will coordinate investigations and arrests with local law enforcement and district attorneys. New criminal penalties will include a fine up to $500 and or up to 15 days in jail. New civil penalties will include a fine of up to $2,000 per violation.

The Governor also announced a new toll-free hotline 1-888-99SALTS (1-888-997-2587). Individuals with information about illegal distribution of bath salts or synthetic drugs are encouraged to call this hotline. For more information visit: http://www.health.ny.gov/professionals/narcotic/index.htm