Report Finds Gaps in Access to Opioid Addiction Help on Staten Island
The report — which was distributed last week — was a model for multidisciplinary needs-assessment projects on opioid addiction and recovery, said Dr. Silvia Martins, an associate professor of epidemiology at Columbia’s Mailman School of Public Health. Dr. Martins was a faculty adviser on the project, along with Dr. Lisette Nieves, a professor at New York University.
“Even within the same institution, we don’t always talk to each other. We are too busy with our own research projects,” Dr. Martins said. “I think that projects like this that bring together people with different expertise should be done more often. For sure. Not only at the city level but at the state level.”
Though the effort fell outside her mandate to prosecute drug crimes, Ms. Brennan said treatment, law enforcement and medical research all have a hand in curbing the epidemic.
“What you’ll find working in this area is that people have a lot of biases. We come with our baggage through the years, we develop a certain perspective, and there it is,” she said. “This epidemic is just different from everything else we’ve dealt with, so the approaches have to be different.”
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Alex Wroblewski/The New York Times
“And it’s a different time. If we’ve learned one thing,” it is that “problems of addiction are not going to solved with making lots of arrests.”
The district attorney, Michael McMahon — who describes himself as a lifelong Staten Island resident and whose office investigates drug overdoses as criminal cases — shared overdose data with the researchers. Dr. Nieves called that precisely the sort of collaboration “across diverse stakeholders” that she said can yield solutions.
“I lived through the crack epidemic and I never saw this kind of coordination. And this is something that we can learn from,” Dr. Nieves said. ”You can either act like it’s not happening or you can make the information public. And they want to be leaders in this and I was very inspired by it.”
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The benefits to collaborating, Mr. McMahon said, are simple: substance abuse problems bleed into other issues, including domestic violence, larceny and violent drug-related crimes. Mr. McMahon echoed Brennan’s comment that the solution does not simply rest on making arrests.
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“Where I still see the big gap is the disjointed and ineffective prevention education program,” he said. “That’s where I don’t see a collaboration yet. We’re meeting with principals and superintendents, we are working on it, but I won’t be happy with that part until it’s discussed just like tobacco.”
In the report, the researchers said that expanding treatment options, rather than law enforcement approaches, was crucial to stemming the increase in opioid deaths. Mr. McMahon and Ms. Brennan agreed.
The report recommended expanding medication-assisted treatment options and training physicians about treatments like buprenorphine, an opioid substitute that helps addicts with withdrawal symptoms while they try to quit using. In particular, the report said those services should be more centrally located on the island. The broader recommendations included media campaigns to raise awareness about opioid addiction and reduce stigma, and using the voices of recovering addicts.
Moving forward on those recommendations, however, will not be easy. Community members may feel apprehensive about bringing more treatment centers into their neighborhoods, Dr. Martins said, because of the stigma associated with drug addiction.
She added that some addicts want to leave the borough for treatment.
“There’s another complex finding related to this question is that there’s also stigma among people that have an opioid abuse disorder to seek treatment; only a fourth of them will end up seeking treatment,” Dr. Martins said. “There’s stigma among users and their family members and they don’t want to be seen by their neighbors seeking treatment.”
The analysis of overdoses by ZIP code revealed that while addiction is a problem across the island, more overdoses occurred on the central part of the island.
“When we went into this, it was presented as a white middle-class problem that hit Staten Island,” Patricia Wendt, one of the researchers, said. “But it didn’t take us long to learn that it’s affecting people across all demographics in the island. I think the important thing is that addiction doesn’t discriminate.”
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