ALBANY — Lawmakers railed against the state Department of Health on Tuesday for not publishing updated opioid-related death counts required by state law and declining to participate in a hearing on substance abuse issues as overdose deaths spiked during the COVID-19 pandemic.
Assemblymembers held a virtual hearing Tuesday exploring the impact of the coronavirus and people suffering from substance abuse disorders and the availability of supportive services.
Melissa Moore, New York’s deputy state director with Drug Policy Alliance, recounted harrowing anecdotes of ways New Yorkers struggling to recover from substance abuse have worked to prevent a relapse during the pandemic.
“People are trying to use syringes for more than a week, sharpen them on rusty surfaces or clean them with bleach — things that are detrimental to people’s health,” Moore said. “More people are using alone with no one to help if things go wrong.”
The state DOH has stopped paying existing contracts for the state’s syringe exchange program, which has expanded access to sterile hypodermic needles and syringes since 2001, Moore said. The state has withheld funds from increasing programs or departments as it faces a nearly $30 billion budget shortfall over two years and anticipate broad 20% cuts to education, healthcare and localities.
Overdoses increased an estimated 20% this year, Moore said.
Dr. Kimberly Sue, medical director for the National Harm Reduction Coalition, agreed Tuesday that patients are “sharing and using needles down until they’re dull,” and partly attributed the uptick in overdose deaths to fentanyl.
“This is a poisoning crisis,” Sue said. “People are playing Russian roulette. We are forcing them to play Russian roulette. I am a treatment provider. What we are doing is not enough.”
Moore advocated for the state to update its “draconian” laws and implement evidence-based drug policy, including decriminalizing the possession of syringes or hypodermic instruments and adopting overdose prevention centers statewide.
Lawmakers sharply criticized the state DOH during the hearing for failing to do its job, as department representatives did not participate.
Legislators invited any department deputy to testify Tuesday, but officials declined, said Assemblymember Linda Rosenthal, D-Manhattan.
“Face the music. ...Understand where service need to be given and perhaps the localities know and service providers might know... but that’s not helpful if the state Health Department is not doing its job,” said Rosenthal, who chairs the Assembly’s Alcoholism and Drug Abuse Committee.
Scheduling conflicts did not permit the state DOH to participate in Tuesday’s hearing, according to a statement from Erin Silk, a spokesperson with the department.
The state DOH has not published overdose data since January, or before the pandemic hit the U.S. The department is required to publish quarterly reports detailing opioid overdose information, including deaths, emergency department visits and hospitalizations in each of the state’s 62 counties. The reports are required by state law and recommendations by New York State Heroin and Opioid Task Force, according to health.ny.gov.
“The April and July quarterly reports are currently being finalized for release, while the Department of Health continues its unprecedented statewide response to the COVID-19 global pandemic,” Silk said Tuesday.
A statement is posted at the top of the Opioid-Related Data webpage on the state DOH’s website about its commitment to timely opioid-related data to support statewide prevention efforts.
“This information is a valuable tool for planning and can help identify where communities are struggling, help tailor interventions and show improvements,” according to health.ny.gov/statistics/opioid
Health Committee Chair Assemblymember Rich Gottfried, D-Manhattan, railed against the department for its lack of response. He also implored officials to take responsibility for their role in state substance abuse issues as the department regulates naloxone, or the medication designed to rapidly reverse an overdose, and other preventive substances.
The department is responsible for registering accurate overdose death counts in New York, and should have sent another official to testify if Commissioner Dr. Howard Zucker was unavailable, Gottfried said in his opening remarks.
“Maybe if we had highlighted issues they were interested in, maybe they would have been able to send us a deputy or assistant commissioner,” he said. “We had none of that kind of response from the Health Department, and I don’t think that’s acceptable.”
On average, about 100 Americans overdose each day, said Rosenthal, and suspected nationwide overdoses have risen nearly 18% since mid-March as people struggle with unemployment, financial stress, mental health and other issues during the pandemic.
Rosenthal cited local statistics during his remarks. In the north country, Jefferson County’s health department issued an overdose warning on Monday in response to four known, non-fatal overdoses, which occurred in a 24-hour period.
“Despite this national data, we have no idea how many overdose deaths there have been in New York state since 2019,” Rosenthal said.
Overdose deaths greatly increased this year due to COVID-19, but overdose spikes, especially related to opioid abuse, have ravaged the nation for more than a decade. The state reported a 38% increase in overdose deaths between 2015 and 2016, or an increase of 900 New Yorkers. Rosenthal said it was the state’s largest increase in six years.
Detox facilities did not accept patients at the height of the coronavirus outbreak this spring and have been slow to reopen — especially downstate and in New York City.
People struggling with substance abuse have higher risk of compromised immune systems and contracting COVID-19.
“For people who need treatment, staying home may not have been an option,” Rosenthal said.
Many patients, especially in low-income and minority communities, lack reliable internet access, laptop or mobile device and did not receive necessary treatment as non-emergency medical appointments largely moved to telehealth to reduce the spread of the virus. Most recovery meetings moved online.
People in recovery suffered increased risk or instance of relapse as it became difficult to access treatment and necessary medication.
“It took months to initiate a methadone delivery program,” Rosenthal said of the pain reliever that can be used to treat narcotic drug addiction.
Some programs existed in New York City to mail naloxone kits to homes.
Office of Alcoholism and Substance Abuse Services Commissioner Arlene González-Sánchez said the office worked closely with opioid treatment providers to ensure New Yorkers did not have interruptions in medication-assisted treatment. The state was one of the first to request and receive a federal emergency waiver for patients in recovery to take medications home or for secure deliveries when medically appropriate. Patients must be assessed to qualify for home delivery under federal law. Patients approved for take-home medication did not require a second evaluation to have opioid prescriptions delivered to their homes.
Similar delivery programs did not widely exist outside of New York City and downstate metro counties.
Rosenthal asked what number of residents received the medications they requested and pressed González-Sánchez for updated overdose data, but the commissioner referred the legislator to the state DOH.
“Under normal circumstances, this data is always lagged because it’s not just one source that submits the data. ... I’m hopeful that soon, we will be able to see the report,” González-Sánchez said, “at that point, we can speak a little bit more clearly and that will help us move forward.”