CANTON — As the St. Lawrence County Opioid Task Force nears its one-year anniversary in December, St. Lawrence County Public Health Director Dana Olzenak McGuire said recruitment has been strong and the efforts have been fruitful.
“I think there has been a lot of education about how big the epidemic is, what our stigma is around it and just trying to bring the awareness, so I think that is what we did a really great job about,” Ms. McGuire said. “It’s my goal that while we are educating the group, we’re thinking about what action items we do for the communities. It’s one thing to come together as a group, then the next movement is, OK, so what are we going to do.”
One of the first things the group has done is come up with a resource book and has been talking about how best to bring it to the community. The book is in a draft form and will be available through the Public Health Department’s website, as well as providers, pharmacies and schools, when it’s ready.
During Friday’s Opioid Task Force Partners 4 Substance Use Prevention monthly meeting at the Fairfield Inn & Suites, a conference room was filled with stakeholders from around the county who listened to a presentation by Dr. Paul Updike, Buffalo.
Dr. Updike spoke about Western New York’s response to the opioid crisis by focusing on MAT, or Medication Assisted Treatment services, as a way to combat the epidemic.
The issue of mandatory medication assisted treatment services in county jails was raised during the meeting and St. Lawrence County Jail Administrator Peggy Harper told Dr. Updike that the concern was the prescription drug suboxone is a black market drug that is a problem with inmates.
Moreover, during the Nov. 4 St. Lawrence County Legislature meeting, a handful of lawmakers tried to shoot down a resolution that would oppose a state bill creating the mandate on county jails, causing them to shoulder what could be about $76 million.
The resolution opposing the bill passed the county legislature 10 to 5.
“In our jails, the simple majority of patients in jail are patients with an opiate effect and so now they’re in jail and now they’re withdrawing and as I said, there is a high demand then in the jail for the medication,” Dr. Updike said. “And so the fact that there is diversion in this kind of thing and there’s a black market and all of this, is not surprising. I would argue, and the literature would definitely support it, actually, the way to get that out of there is to treat them.”
In addressing the county opposing the state mandate, Dr. Updike said the financial concern is one that is also looming over Erie County.
“I do accept and understand all of that, and it’s not as if I’m up here saying I have a nice and easy solution for that,” Dr. Updike said. “Medically speaking it just makes sense in the world . . . In our holding center, we have had a terrible rumble with these inmates committing suicide going through acute withdrawal.
“So what is the cost benefit analysis there, yes it will cost money, is there some way we can support it. I realize it’s not free and may be a real burden, but not doing it has been a burden to.”
Legislator Rita E. Curran, R-Massena, one of the lawmakers to oppose the state mandate in county jails, is also a nurse practitioner from Louisville.
“I don’t have a problem with us giving it in jails, but the first thing that happens to any inmate when they put them in jail is the state of New York cuts off their Medicaid,” Mrs. Curran said. “So now there’s no source to pay for any of their pharmaceuticals, their insulin, the dialysis, or anything else that they have, and in the budget, we are capped at a 2 percent tax increase each year.”
She said that is timed to things like the state’s Raise the Age legislation, which is 100 percent paid for by the state unless the cap is exceeded, at which point none of it is paid for by the state, which will cost funding for the next programs, she said.
“So it’s almost set up like a bunch of quicksand with a couple of things floating like you might be able to step on it when you go for things budgetarily,” she said. “I wish that money weren’t the issue when it comes to county policy, but the money is so tied to all the other programs that we are mandated to have.
“I agree with you, that we need to do this, but I think that there is an easier way to do this. We should have a grant that would be able to pay for the MAT at the jail, and we should be able to pass some sort of law that says if you’re on suboxone . . . when you come in we’re going to take your sealed stuff and bring it with you and let you use your own meds while you’re in jail.
“I think we would be much better off to treat anybody who wants suboxone, to give it to them and not be so tied up in (other usages of drugs),” she said. “Because if it doesn’t kill you seven days a week, then you’re still here and we can still work with you.”