D.A. Vance: We can turn the tide on opioid ODs

Cy Vance, the Manhattan district attorney, led a discussion on the Lower East Side about how the opioid crisis is being combatted. Photos by Sydney Pereira

BY SYDNEY PEREIRA | Between 2010 and 2016, drug overdoses in New York City more than doubled. The culprit behind the surge was opioids — the drugs that have sparked an addiction crisis plaguing nearly every corner of the country, killing tens of thousands nationwide.

But the city’s recent statistics were the silver lining at a discussion led by Manhattan District Attorney Cy Vance on Oct. 25 on the Lower East Side at the Grand St. Settlement at the Essex Crossing Community Center.

Last year, overdoses in the city remained relatively flat, increasing by only around 2 percent, rather than the 51 percent spike between 2015 and 2016.

“It’s a prairie fire that’s taken off,” Vance told this paper. “First of all, you gotta get it controlled so that it stops expanding.”

Only then can you “turn the tide,” he said. The latest apparent plateau in citywide overdoses appears to indicate that so-called “prairie fire” is under control, so that the city should now ultimately be able to lower the overdose death rates, Vance said.

“We’ve done it with other crime trends,” he said, pointing to gun violence in the 1990s. “I think we can do it with opioid addiction. But addiction is a very subjective, individual thing. Drugs are easily accessible.”

Experts with extensive knowledge of the opioid crisis in the city shared insights into curbing the deadly scourge, such as distributing overdose-reversal naloxone kits and eliminating the negative stigma surrounding methadone treatment. They also highlighted the increase of deaths from fentanyl, an opioid 50 to 100 times stronger than morphine.

Of nearly 1,500 overdoses in the city last year, 57 percent involved fentanyl, according to the Department of Health and Mental Hygiene. Over all, eight in 10 overdose deaths involved an opioid.

“This is a beast of a different kind,” said Lorenzo Register, of the Lower East Side Service Center.

Cocaine and fake pills are increasingly laced with fentanyl, which can catch users unaware if they are accustomed to using cocaine or pills without the dangerous additive. Last year in the city, 146 deaths involved cocaine and fentanyl without any heroin — up from 122 in 2016, according to the Health Department.

Another panelist, Reilly Glasgow, a harm-reduction specialist at the Lower East Side Harm Reduction Center, said naloxone and safe-injection sites are critical for saving lives. He said he has saved some 50 lives with naloxone.

“I have the privilege of hearing someone breathe for the first time again,” Glasgow said.

At the Lower East Side Harm Reduction Center, his goal is to educate people on how to use these potential lethal substances safely.

“We understand that people are going to do drugs,” Glasgow said.

Teaching people how not to collapse their veins or how to use clean needles can help intravenous drug users be as safe as possible, “so when they are ready to stop, they are healthy enough to stop,” he said.

Though illegal at the federal level, in May, Mayor Bill de Blasio greenlighted a plan to open four safe-injection sites — dubbed “overdose prevention centers” — after advocates urged him to release a city Health Department report commissioned to study the matter. The sites would provide hygienic spaces for people to use drugs under medical supervision. Drugs would be obtained off site — the centers would not provide them. But the sites would help people inject drugs safely while simultaneously offering other health and social services that would be co-located with them.

The city has slated the safe-injection sites for Washington Heights and Midtown West in Manhattan, Park Slope in Brooklyn, and Longwood in the Bronx — although the mayor will need approval from Governor Andrew Cuomo’s state Health Department, Gothamist reported in May.

At the opioid form, panelist Angela Frazier spoke about the need for substance users to build networks of sober friends.

D.A. Vance, whose approval the mayor also needs for the plan, has signaled support for the initiative. He said in May that those “suffering and dying from opioids need bold public health interventions — not the heavy hand of the criminal justice system.

“I understand there is political disagreement and principle disagreement around whether or not safe-injection sites should exist, but you have to make a decision,” Vance told this paper. “We know they are going to shoot up in the McDonald’s restroom or under a subway track on an elevated train and die. So, to me, the choice is to save lives and to save lives through safe-injection site facilities.”

Unofficial safe-injection sites are already a reality around Manhattan, regardless of the mayor’s plan, Glasgow said at the October panel.

The Health Department’s report that sparked the mayor’s action estimated four supervised injection facilities could prevent 130 overdose deaths and save $7 million in public healthcare costs, if located in the most severely affected neighborhoods.

The city ultimately did not choose to site all the locations in the most severely impacted neighborhoods — including no site in Staten Island, the borough with the second-highest rate of overdose deaths in 2017.

The Bronx currently has the highest rate of overdose deaths in the city. In Manhattan, East Harlem has the third-highest opioid overdose rate, exceeding the city’s 2017 average. Central Harlem and Washington Heights also have opioid overdose death rates above the city’s average.

For the first time in the last 11 years, black New Yorkers had the highest rate of overdose deaths in comparison to white and Latino New Yorkers last year.

For people fighting the opioid crisis on the ground, it is critical to build a support system, the panelists stressed.

“A lot of people are spiritually broken in active use,” said Angela Frazier, a peer navigator at the Educational Alliance’s Center for Recovery and Wellness. “You have to find something to fill that void.”

Frazier works with recovering addicts to build a network of sober friends through “recovery clubs” — basically, weekend hangouts for people staying sober. She said “recovery clubs” are a space for everyone, addicts or not.

“You have to redefine what fun means,” she said. “That’s how you start your sober network.”

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