The New York State Senate’s Joint Task Force on Opioids, Addiction and Overdose Prevention held a hearing in Albany on Wednesday to get input from advocates and health officials across the state on the impact COVID-19 has had on the opioid crisis and where to go from here.
Many who have long been working on this issue took the hearing as an opportunity to urge state legislators and Gov. Kathy Hochul to embrace measures — such as safe injection sites and access to mental health services — that languished under the previous administration.
New York is at a pivotal moment in the crisis. Through legal settlements, the state has garnered a $1.5 billion pot of money dedicated to preventing overdoses. It must start planning how to spend this opioid settlement fund next month. Hochul is now in charge and has appointed a new state health commissioner — Dr. Mary Bassett — to manage the crisis. And a worrying upward trend in overdose deaths, fueled by fentanyl and the pandemic, has brought in a fresh sense of urgency.
According to preliminary data from the Centers for Disease Control and Prevention, New York has seen at least 4,289 opioid deaths statewide in 2020 — a nearly 50% jump from the previous year
“We’re here to exhibit courage and imagination as we think about how we’re going to solve the crisis that runs rampant in our state and really throughout our country,” State Sen. Samra Brouk, chair of the Senate’s Committee on Mental Health, said at the start of the hearing.
Dr. Chinazo Cunningham, executive deputy commissioner of the Division of Mental Hygiene at the New York City health department, spent much of her testimony urging the state to lend its support to overdose prevention centers, also known as safe injection facilities. The centers would provide people with a clean space to use drugs under the supervision of medical professionals, while offering links to treatment and other services.
“Unequivocally, these prevention centers save lives,” said Cunningham, noting that there are more than 100 of them operating around the world and none of them has ever reported an overdose death onsite. “Your support and action is critical.”
Former Gov. Andrew Cuomo said the New York State Department of Health would sign off on a pilot for overdose prevention centers that New York City officials had proposed in mid-2018, but it never did, citing concerns about a potential federal crackdown on such facilities. Cunningham urged legislators to authorize the centers, although she and other speakers at the hearing noted that the governor and state health department also had the power to give the green light.
As the head of the department, Bassett could be the dealmaker—or the deal breaker. She was the city’s health commissioner when Mayor Bill de Blasio first announced the pilot and said earlier this year that she still supported them.
“You want to try and keep people alive, get them into treatment, and not punish them, which pushes people away,” she told the news outlet The City in March.
Other speakers at at the hearing raised the longstanding issue of the lack of integration between mental health services and substance use treatment in New York — something they said can stand in the way of people getting care for both conditions when they are ready to access it.
Ashley Livingston, a peer advocate for drug users at the nonprofit Friends of Recovery New York, said she had advised clients to lie about mental health issues when seeking entry to an addiction treatment center for fear they will be turned away.
“If they are feeling suicidal because they’re in withdrawal, I have to say, ‘You know what, don’t say you’re suicidal because an addiction treatment center won’t take you,’” she told lawmakers.
Others said they had also seen clients turned away, despite research showing that about half of those who have a mental illness will also experience a substance use disorder during their lives, and vice versa.
For some advocates, the solution involves merging the state Office of Mental Health with its Office of Addiction Services and Supports — an issue that has long been debated but gained renewed attention earlier this year. The state Senate passed a bill that would combine the two departments during the last legislative session but the Assembly did not follow suit. New York is one of four states that does not have combined substance use and mental health offices.
“I do feel like there needs to be coordination and collaboration, regardless of whether there’s a merger of those two agencies,” said Paige Pierce, CEO of Families Together in New York State, which represents families of children with behavioral health issues.
Touching on the particular impact of the COVID-19 pandemic, some speakers said there was a need to address the childhood trauma that can contribute to substance use disorders in later life. According to the CDC, there’s evidence that “adverse childhood experiences” contribute not only to increased risk of opioid misuse, overdose and suicide, but also diseases such as cancer, diabetes and stroke.
“I encourage you to join us in our request to Gov. Kathy Hochul to develop a cabinet-level task force that can quickly examine the growing body of research on the effects of COVID on children’s mental health,” said Andrea Smyth, president and CEO of the New York State Coalition for Children’s Behavioral Health.
Smyth said she hoped to set aside 25% of the $1.5 billion opioid settlement fund as well as new federal funding to address the opioid crisis for youth substance use prevention and treatment.
Broadly speaking, those who testified at the hearing focused on public health measures to address the opioid crisis and most of the senators overseeing the hearing were on the same page. But State Sen. Patrick Gallivan, a Republican, repeatedly asked speakers what should be done to punish drug dealers and reduce the supply of fentanyl, a powerful synthetic opioid that can put people at higher risk for overdose.
“Should we be doing anything to prevent people from passing on these illicit drugs to the people being hurt?” Gallivan asked Cunningham of the New York City health department.
“The health department is all about implementing evidence-based strategies,” she countered, offering a response that would be echoed by others Gallivan questioned. “Criminalization is not an evidence-based strategy.”
