SI Advance: Painkiller Overdoses Deadlier than Car Crashes or Murder

From the Staten Island Advance:

On Staten Island, painkiller overdoses deadlier than car crashes, murder

STATEN ISLAND, N.Y.  — Pain medication overdoses killed more Staten Islanders than car crashes or murder in 2010, with the Island once again topping the rest of the city in per-capita prescription painkiller deaths.

Thirty-one Staten Islanders died of “unintentional opioid analgesic poisoning” in 2010, up from 28 deaths in 2009, according to recently-released statistics from the city Department of Health.

That amounts to an overdose death roughly every 12 days.

In contrast, 26 people died in car crashes on Staten Island in 2010, and 17 were the victims of homicide.

The new data is the latest to reinforce what drug treatment experts have long known — that Staten Island is a nexus point in a prescription drug abuse epidemic.

Last year, roughly one prescription for the painkiller oxycodone was filled for every four residents here, and a national prescription pill take-back held last month resulted in a record 402 pounds of unwanted medication turned in here.

“We always think about car crashes, and we always think about murders being this violent way to die,” said Diane Arneth, executive director of Community Health Action of Staten Island and a member of the new Tackling Youth Substance Abuse (TYSA) group. “There were more people who died of opioid overdose, that’s kind of startling.

“It’s clearly something that we have to raise the level of alarm about this, and that’s something that we’re trying to do,” she added.

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For Staten Islanders, the numbers translate to 8.4 deaths per 100,000 residents. The other boroughs show markedly lower rates, with Brooklyn coming in at 2.4 per 100,000 on the high end, and Manhattan with 1.2 per 100,000 on the low end.

The Staten Island rate has skyrocketed by 180 percent since 2005, health department statistics show.

“We’ve got to pay attention and take all the necessary steps to put a halt to it, or at least interrupt the dramatic increase,” said Luke Nasta, the executive director of Camelot Counseling Services. “Unless it’s taken on, on that broad scale with adequate resources, these numbers are just going to continue to increase.”

Citywide, medium- and high-income neighborhood residents made up seven of every 10 deaths, and residents of medium-income neighborhoods were hit particularly hard — with 64 deaths in 2010 compared to just 28 in 2005.

The data also shows that citywide, the unintentional opioid analgesic overdose rate increased by 30 percent from 2005 to 2010, while the heroin overdose death rate dropped by 47 percent.

Although the prescription drug epidemic is often viewed as a problem plaguing the borough’s South Shore, Staten Island saw far more deaths per capita of North Shore residents in 2010 than South Shore residents.

The Department of Health splits the Island into four areas — “Port Richmond,” which actually covers three ZIP codes along the western part of the North Shore; “Stapleton-St. George,” which stretches down the East Shore as far south as Dongan Hills; “Willowbrook,” which covers the entire 10314 ZIP code; and “South Beach-Tottenville,” which covers the southern half of the Island.

In 2010, residents of the Stapleton-St. George area saw the highest per capita death rate in the city, 12.2 per 100,000, followed by Port Richmond at 11.3 and South Beach-Tottenville at 6.6 percent.

Residents of Brooklyn’s Bensonhurst-Bay Ridge neighborhood followed, with 6.2 deaths per 100,000, then Willowbrook, with 5.8 percent.

TU Capital Profile: ASAP Executive Director John Coppola

Featured in today’s Times Union Capital Profile is ASAP’s own Executive Director John Coppola, speaking about how he got involved in work on substance use issues and what are the threats and opportunities for the service provider field today:

John Coppola

Executive director, New York Association of Alcoholism & Substance Abuse Providers

What he does: For the last 16 years, Coppola has been the face of drug counselors and treatment centers in the halls of the Capitol. His association, known by its acronym ASAP, includes more than 250 members and some 20 coalitions — everyone from methadone clinics to Alcoholics Anonymous.

How he got here: Coppola was born in Brooklyn, moved a lot as a child but settled in a Hudson Valley boarding school with an eye toward becoming a Roman Catholic priest. He demurred, but after studying at Orange County Community College and Dominican College ended up in 1979 at the University at Albany pursuing a master’s degree in social work. He got an internship with Catholic Charities in Montgomery County, and was hired after graduation in 1981.

Personal: If you put your toes on the ground in Coppola’s back yard, off Washington Avenue Extension in the Pine Bush, it feels just like the beach. When he can get away from Albany for vacation, the 56-year-old says you’ll never find him far from the water — either the ocean or a beach — and usually with a paperback mystery novel to complete the mindless escape. A divorced father of three and grandfather of five, Coppola says he spends most of his free time catching up with old friends. He does make a mean meatball, though.

There aren’t many people who grow up dreaming of a career in substance abuse counseling. How did you end up in this line of work?

I think I was always able to see the potential in people. When you work in this field, you have daily experience with people who have completely turned their lives around. A lot of us would look at someone who’s homeless, in the street, and see them as lost, and a lost cause. But every once in a while I’ll meet someone who was one of those people at one time, and now they’re walking around, going to a job.

How have the attitudes and approach to dealing with these issues changed over time?

Science has told us so much. We now know that addiction is a disease rooted in brain chemistry, and people who are addicted have a physiology that is different than people who aren’t. When I first started counseling people we had some ideas about abstaining from use, and we didn’t really understand back in those days about which unhealthy behaviors could lead to others.

What about the government’s approach?

Historically, it’s been horrible. Because there’s so much stigma associated with it, frequently it’s the first thing that gets cut. One of the things I believe passionately is that Gov. Cuomo, in his first State of the State, said we have to get better results and make better use of our resources, collaborating across different systems. When I think about addiction treatment, prevention and recovery, in my opinion, that is an amazing driving force that can accomplish all three. If we want to try and reduce child abuse and neglect, we know that 80 percent of mothers and fathers who do that to their children have an addiction problem. But the system is not designed to deal with parents; it’s designed to protect kids. So as soon as you introduce treatments, abuse and neglect practically disappears — the kids are safer, and you don’t need to put them in out-of-home placement. It seems to me that right now, in New York state, the ground is more fertile than it’s ever been to try and reduce the investment.

What kinds of cases are providers seeing the most of?

The number of deaths that are attributable to prescription medications dwarfs the heroin crisis of the mid-’60s. That’s the biggest trend now — it’s alarming and it’s completely out of control. It’s just that we’ve got better medications, that really work, but they’re highly addictive and people are not being properly educated. And they’re being overprescribed.

— Jimmy Vielkind

Read more: http://www.timesunion.com/local/article/Capital-Profile-John-Coppola-3555682.php#ixzz1uqmQ7kRF

Study says prison-based drug treatment could save ‘billions’

Study says prison-based drug treatment could save ‘billions’.

ASAP Quoted in Governor’s PR Announcing Statewide Coalition Supporting Governor’s Initiative to Protect Vulnerable New Yorkers

See the following press release from Governor Cuomo’s office, which includes a quote from ASAP’s Executive Director John Coppola.  ASAP is pleased to join over 100 other advocacy organizations in support of the Governor’s initiative to protect vulnerable New Yorkers.

Governor Cuomo Announces Statewide Coalition to Support Legislation Protecting People With Special Needs and Disabilities Grows to Over 100 Members

Albany, NY (May 10, 2012)

Governor Andrew M. Cuomo today announced that the grassroots coalition formed to support the Governor’s proposed legislation to reform how New York State protects people with special needs and disabilities has grown with more than 100 advocacy groups from across the state now signed on.

 

The Coalition for the Protection of People with Special Needs will participate in a grassroots effort to raise awareness about Governor Cuomo’s reforms through community outreach, sharing with family and friends, and discussing the legislation online, via Twitter and Facebook.

 

In addition, these advocates and providers will continue to educate New Yorkers about the state’s vulnerable population and the ways in which Governor Cuomo’s proposed legislation will help protect those who need our help the most. The Coalition will mobilize New Yorkers with special needs, their family, friends and loved ones to share their experiences and help generate support for Governor Cuomo’s sweeping legislation.

 

This week, nearly 700 advocates who were briefed on Governor Cuomo’s legislation to create a new Justice Center for the Protection of People with Special Needs committed to take action to make sure Albany acts on the proposal this session.

 

The Governor’s office launched www.justice4specialneeds.com, a website where groups and New Yorkers can learn more about the Governor’s proposal. The site has an action center where visitors can e-mail family and friends about the initiative, submit a video testimonial about the issue, share with fellow New Yorkers on Twitter and Facebook, and stay in touch with the Governor’s office about the issue.

 

“Change in Albany only happens when the people make it happen,” said Governor Cuomo. “This legislation will make sure that New York leads the nation when it comes to the treatment and protection of people with special needs and disabilities. Now we need New Yorkers to make their voices heard so that Albany will pass our legislative proposal to create a new Justice Center for the Protection of People with Special Needs.”

 

Paige Pierce, Executive Director of Families Together in NYS, said, “Governor Cuomo’s proposed legislation includes real reforms that will help protect vulnerable New Yorkers and prevent further abuses from occurring. In addition, this bill will provide peace of mind for the family, friends and loved ones of those in the state’s care. The Justice Center will transform monitoring practices and will protect the civil rights of vulnerable people. This is exactly the type of agency that individuals and their families deserve. I am proud to support Governor Cuomo’s bill and hope that both the Senate and Assembly will do the same.”

 

Harvey Rosenthal, Executive Director of the New York Association of Psychiatric Rehabilitation Services, Inc. (NYAPRS), said, “This is a tremendous advance in weeding out, prosecuting and preventing any future NYS based human services work for those who abuse New Yorkers with disabilities. The Governor deserves tremendous credit for the care, conviction, innovation and amount of resources that were committed today towards these ends. These initiatives will no doubt save lives and end suffering previously/currently experienced by thousands of New Yorkers with disabilities.”

 

Peter Pierri, Executive Director of the Interagency Council of Developmental Disabilities Agencies, said, “We applaud Governor Cuomo for this broad initiative to insure the safety and protection of vulnerable people in New York State. Safety and protection are the number one priority for the entire community. We also appreciate his acknowledgment and support for the thousands of direct care workers who are doing great work in their community every day to help people recover and move forward with their lives.”

 

John Coppola, Executive Director of the New York Association of Alcoholism and Substance Abuse Providers, Inc., said, “The New York Association of Alcoholism and Substance Abuse Providers are committed to working with the Governor and Legislature on this initiative. We are pleased that the Governor has actively engaged consumers and providers in the development of this important work which will not only ensure the safety of persons receiving services, but will also contribute to increased trust and better service outcomes for New Yorkers.”

 

Governor Cuomo’s proposed Justice Center for the Protection of People with Special Needs will have primary responsibility for tracking, investigating and pursuing serious abuse and neglect complaints for facilities and provider agencies that are operated, certified, or licensed by six state agencies that provide human services.

 

The following groups have agreed to participate in The Coalition for the Protection of People with Special Needs (click here for the full press release and list of supporting organizations which includes the NY Association of Alcoholism and Substance Abuse Providers- ASAP)

HP: James Knickman w/ NYS Health Fdn on What the Feds Can Learn from NY

Huffington Post blog entry from James Knickman, President and CEO of the NYS Health Foundation:

Emerging From the Mess We’re in: What the Feds Can Learn From New York

Ronald Reagan said that “status quo” is Latin for “the mess we’re in.” It feels like our country is stuck in a big mess right now, with Washington so polarized and so few people willing to reach across the aisle, to compromise, to give any ground at all. Politics is winning out over pragmatism and progress.

Admittedly, New York State has not always been a beacon for functional politics, but when I look at what we have accomplished related to our health care spending, it is clear that New York has been a real leader. The Federal government could learn a lot from our experience and about how essential it is to bring people together in order to make progress.

Take the Medicaid Redesign Team (MRT), the diverse group of stakeholders — including health care providers, advocates, insurers, educators, and consumers — tasked last year with developing recommendations to improve quality and efficiency and reduce costs within Medicaid. The MRT also included State senators and assembly members from both sides of the aisle (Republican Senator Kemp Hannon, Democratic Senator Tom Duane, Democratic Assemblyman Richard Gottfried, and Republican Assemblyman Joe Giglio) working together to effect change.

The MRT looked at a wide range of possible options, from eliminating reimbursement for procedures not backed by good evidence to simplifying Medicaid enrollment processes. No one got everything they wanted; everyone had to make tough choices and make some sacrifices and compromises. But everyone got something, and that’s much better than the status quo or what could have happened with no compromises.

It is too early to tell what the long-term impact of the Medicaid Redesign Team will be on New York’s health care spending, and it will still take time to understand how improvements in the economy and the full implementation of the Affordable Care Act will play into the equation. But there are some promising early signs that the MRT process worked: Our spending has already gone down, and we are on a path to stay within the established four percent annual cap on spending growth and to keep administrative costs at 2012 levels. Perhaps most impressive is that Medicaid expenditure growth has slowed to just over three percent in the last fiscal year.

Granted, some of the reductions in spending are the result of decreased use of health care services at a time of economic crisis: People who are uninsured may be forgoing needed care, and people may be deferring elective procedures like laser eye surgery until they feel more secure financially.

Both the process used by the Medicaid Redesign Team and the substantial flow of system reform funds from the Affordable Care Act have energized health care system leaders to look for ways to fundamentally change the way care is delivered throughout the State.

Much of the slowing in expenditure growth is coming from pressure to address the recent explosion in home health costs. But, hospitals and other providers have worked collaboratively and on their own to develop interventions that use resources more wisely. They have appreciated the opportunity to find efficiencies that maintain the viability of their institutions rather than having to endure across-the-board rate cuts.

The Medicaid Redesign Team also recognized something that the Federal government often sets aside: it is essential to consider the long view when it comes to cost containment. When we look only at what can save money now, today, we end up with rash cuts that are too often penny-wise and pound-foolish. Long-term savings require upfront investments, like New York State’s expected investment of more than a billion dollars to implement new models of payment reform and primary care.

It takes this kind of long-range thinking, and some level of willingness to budge, to make progress and find compromises that will improve our overly complicated health system and move us beyond the mess of the status quo. Washington would do well to follow suit.

Expanded Insurance Coverage in Massachusetts Did Not Increase Addiction Treatment | The Partnership

Expanded Insurance Coverage in Massachusetts Did Not Increase Addiction Treatment | The Partnership.

Register for Free Shared Decision-Making and Recovery Support Webinar

From SAMHSA:

Register for Free Shared Decision-Making and Recovery Support Webinar.