On March 31, 2017, I was fortunate to be able to deliver a TEDx talk at Adelphi University. Entitled, “Smacked By the Storm: How Long Island Can Recover From Its Heroin Crisis,” my speech mapped out a game plan for addressing the current heroin crisis, not only in Nassau and Suffolk counties, but across the nation. I welcome your thoughts and hope you will help share the message.
Gangs and drugs.
With an upswing in gang-related murders, drug overdose deaths and all that comes with unchecked violence and untreated addiction, Long Island is struggling under the weight of two problems that have cracked our suburban veneer.
There’s a common thread between the challenges, but it’s not what you think. Sure, gangs sell drugs and the heroin trade has surely bolstered organized crime in our area as thousands of addicted young people travel from north shore communities into Hempstead, Central Islip and Brentwood to get their fix.
But the common thread here is hopelessness, sadness and despair.
Gangs create alternative realities – a new family, a sense of belonging, a sense of certainty and a sense of power. Opioids, heroin and Xanax numb the pain, calm the nerves and allow a temporary escape. Without intervention, addiction is progressive and so is gang membership and violence.
There’s another common thread in how we approach both problems.
We declare war. A war on gangs and a war on drugs.
We ratchet up the rhetoric, we give police departments new guns, helicopters, and personnel.
We tamp down the problem just enough to quell the public outrage and fear, but it seems we never get to the root causes.
Kids join gangs because it’s easier to get a gun than it is to get a job. They use drugs because it’s easier to get heroin than it is to get treatment. Arrest one gang member or a drug dealer and two more will take their place. Despite outward appearances, they’ll do it somewhat reluctantly and after traveling a road that brings them to that place. That’s where and when we should be intervening.
Instead, we wait. Then we try to wrestle that gun or needle from their hands as they hold on for dear life.
War is ugly, dangerous, scary and threatening. It’s a primitive response that’s not working.
As we deploy more cops, how about we also deploy more social workers? Let’s replace crime scenes with community centers and targeted investigations with targeted job opportunities. Let’s counter gang recruitment tactics with multigenerational exit strategies. Let’s rebuild our community parks, make sure there are things for kids to do and help indigenous community leaders change the culture from inside. Let’s make sure that those who need counseling or treatment can get it upon request 24/7 in as many settings as possible.
And here’s a novel idea: Let’s ask some individuals, families, and communities what they think will work.
Newsday’s Mark Morales is reporting this morning that Long Island has once again set a new record for annual overdoses. Medical Examiners in both Nassau and Suffolk have released the numbers for 2016 and they are stunning, but not surprising. Reported overdose deaths jumped to 493 in 2016 from 294 in 2015. Opioid overdoses between both counties in 2010 totaled 223. Almost half of the 493 fatalities in 2016 (233) were linked to Fentanyl, which has surpassed heroin-linked deaths.
Suffolk continued to outpace Nassau as it has since the start of the epidemic, accounting for 303 of opioid fatalities, while Nassau tallied 190. Fentanyl played a role in almost three times as many overdoses in Suffolk as in Nassau.
The numbers would be infinitely worse without the widespread distribution of naloxone, but we also know that the reported numbers are the tip of the iceberg – a snapshot – of the public health crisis ever to hit Long Island.
Suffolk County’s Medical Examiner is still reviewing 16 cases from 2014, 22 cases from 2015 and 85 cases from 2016 that might be related to opioids. The reasons for the backlog are unclear, but coroners nationwide have been unable to keep-up with the soaring number of autopsies and toxicology tests related to the opioid crisis. The Connecticut medical examiner’s office, for example, has talked about renting a refrigerated truck to store extra bodies and in Milwaukee County, Wisconsin, the medical examiner’s office sometimes has to put bodies on Army-style cots in its refrigerated storage area because it runs out of gurneys.
As bad as the numbers are, they don’t include those addicted Long Islanders who died while in treatment or at a sober house in Florida or some other jurisdiction. They don’t include those who died in car crashes, those who committed suicide or those who were victims of incidental violence. They also don’t include the huge number of lives that have been suspended or theoretically lost to active addiction and incarceration.
Each of those 493 deaths was preventable and the soaring death toll means that we aren’t doing enough or are doing the wrong things. The numbers are jarring, but they still don’t adequately capture the pain, suffering, loss and devastation that’s happening in our homes, schools, and communities.
We are better than this Long Island…
The Nassau County Police Department issued an alert on Friday night warning local residents about a batch of heroin connected with several overdoses in Atlantic City, New Jersey. Six people died and 4 others were revived with Naloxone after using heroin bearing a “King of Death Stamp.”
These kinds of alerts are becoming increasingly common and tracking overdoses in order to prevent subsequent fatalities is an important part of an appropriate public health response. But should we be worried that every time we issue warnings about a ‘bad’ batch of heroin, we are reinforcing the notion that there’s such a thing as a ‘good’ batch or ‘safe’ heroin? That labels and stamps don’t change? Heroin is an illicit drug that has passed through thousands of hands before it gets to the end user and whether or not that batch of heroin has been contaminated with fentanyl or something else, it can kill you.
And while we’re at it, every alert and every news clip about these “bad” batches of heroin should include information about the signs and symptoms of overdose and contain links and numbers where folks who are struggling with a substance use disorder can get help for the disease that puts them at risk for overdose in the first place.
Here’s a quick book recommendation detailing America’s opioid and heroin crisis and how we got here:
Dreamland: The True Tale of America’s Opiate Epidemic