“It comes in waves.”James Miotto, Island Park’s fire chief and an emergency medical worker, said the Fire Department gets called to the scene of a heroin overdose as frequently as four times a week, although, he added “When it slows down, we get [one] every two weeks.”
Many local medical facilities are hosting training sessions that teach people how to use a potentially life-saving overdose remedy called, naloxone, or Narcan. Kugler said that this medicine, in the form of a nasal spray, temporarily stops the progression of an overdose, noting that it has been an invaluable tool in the fight against opioid overdoses.
“Before, we used to get a lot of patients who were overdosed to the point of [being] brain dead by the time we could get them resuscitated,” Kugler said. Now, he noted, “We’re able to do more for individuals” treated with Narcan before medical assistance arrives.
But overdoses are only one part of this epidemic. In fact, Dolan describes the condition of many addicts as “between overdoses.” He said that one way to break the cycle is to change a part of New York state’s mental hygiene law, called Kendra’s Law.
Under the statue, those with severe mental illnesses who pose a threat to themselves or the community can be compelled by a judge to take medication, or be forcibly institutionalized.
Dolan said that opioid addiction is a severe mental illness, but isn’t treated that way under the law. After an overdose, he explained, addicts are released to the care of their parents or other relatives, who don’t have the understanding or skills necessary to deal with an addict. “Kendra’s Law should be expanded to include addicts,” Dolan said, adding, “It’s well understood that coercive methods are useful for getting people into treatment.”
According to Dr. Genevieve Weber, associate professor of counseling and mental health professions at Hofstra University, the disease doesn’t stop with the addict. “It’s a family disease,” she said.
Often, the family wants to keep the situation quiet. “We don’t want to admit it,” Weber said. “We don’t want to bring outsiders into the circle.”
Hospitals and police stations can serve as opportunities to get addicts into treatment, she said, adding, “When they’re under the influence, there’s no talking to them.” But a brief detox could provide a window.
Weber agreed that coercive methods could help families get their loved ones the help they need. “Prison is one of the biggest mental health providers in the country,” she said. “If there was some law in place, where someone was in a place of desperation, to get them, in an involuntary way, into detox. Once they’re in a treatment program,” that window of opportunity widens.
Most important, she said, the treatment window must be kept open. “I’m a fan of any harm-reduction approach,” Weber said of needle exchanges or "shooting galleries," where professionals can monitor addicts, and offer them information on treatment, in addition to medical attention, should they need it.
Such harm-reduction approaches have been widely criticized as “enabling” the problem, but Weber doesn’t see it that way. “As long as you can keep these people alive,” she said. “You’re increasing the chance that you’ll be able to reach them.”