Ithaca Plan initiatives are moving ahead
As soon as next year, Ithaca-area residents addicted to heroin or opioids will not have to travel to Syracuse or other cities for detox treatment, because there will be a facility in Ithaca.
Since the Ithaca Plan was announced in March, treatment options for drug users in Tompkins County have been increasing to meet the demand. A large gap in local services was the lack of a local detox center, the plan noted.
Now, a local detox facility is in the works as part of the Alcohol & Drug Council, according to Executive Director Angela Sullivan. The details and location are being fine-tuned, but the facility should become a reality at some point in 2017, she said.
Opioid addiction is a growing problem in Tompkins County and across the country. A report this summer from state Comptroller Thomas DiNapoli shows heroin use in New York has exceeded national averages, and the death rate safari-reader://www.ithacajournal.com/story/news/politics/politics-on-the-hudson/2016/06/09/report-cites-nys-growth-heroin-deaths/85642674/”>has also exceeded national trends. The safari-reader://www.ithacajournal.com/story/news/local/2016/02/24/ithacas-drug-plan-cross-new-territory/80853898/”>wide-ranging Ithaca Plan announced by Mayor Svante Myrick laid out a vision for local drug policy.
Just over half a year later, pieces of the plan are coming together. The plan was created with four main pillars — prevention, treatment, harm reduction and law enforcement.
Currently, the Alcohol & Drug Council of Tompkins County offers outpatient treatment services to patients, including intensive outpatient and medication-assisted treatment. The proposed expansion of services would include the addition of 20 to 24 inpatient beds for detoxification, stabilization and rehabilitation.
“If somebody decides at 2 a.m. on a Saturday night, ‘I don’t want to do this anymore,’ there’s no place other than a hospital for them to go at this point, which is not necessarily the appropriate place to go,” Sullivan said.
In 2015 in Tompkins County, 144 people were referred for “medically supervised withdrawal and stabilization inpatient,” Sullivan said. None was treated in the county.
About 800 people received services from the Alcohol & Drug Council in 2015, and 22 percent of those patients said heroin was their primary drug (including all opiates, that percentage rises to 30 percent). In 2010, only 9 percent of patients said their primary drug was heroin.
“We know there are lots and lots of people out there who are not seeking services who might, if the stigma wasn’t there or the risk. That’s sort of the hope of having this detox/stabilization unit … it’s just another health care option for people so they can access services when they need them, where they need them in a way that’s in their community,” Sullivan said.
More treatment help
More treatment options have been trickling into the area. This summer, Cayuga Addiction Recovery Services was one of two facilities in New York to receive $1 million in funding each year to create a new program for women. The funding given to CARS, which serves 25 counties, will be used to hire approximately 30 new staff members and support the operation of a new 25-bed facility on the Trumansburg premises, focused mainly on treating female addicts.
People who use services at the Southern Tier AIDS Program, or STAP, on West State Street in Ithaca will soon have access to basic treatment on site, as the office was selected to be a Drug User Health Hub.
Lillian Fan, assistant director of prevention services at STAP, said the agency has hired a full-time nurse and a doctor, who will work a few hours each week. The clinical space is expected to be open by the end of November, and the medical professionals will be able to treat wounds and provide basic care.
“People often come in with infections, like abscesses or other health concerns, and they ask our staff, and our staff aren’t medical professionals, so we always tell people, ‘You need to see a doctor,’ but people are really hesitant to see doctors or go to the hospital even in the event of an emergency because of how they perceive they’re going to be treated. So a lot of people tend to treat minor, sometimes even major things on their own, and that’s not always beneficial because some of the smaller problems end up becoming major problems,” Fan said.
“By next year, I’m really hoping that our clients can report back that they’re experiencing a difference in the quality of their life, from the action, the conversations that have been spurred and all these new initiatives that are popping up,” she said.
Fan, who is co-chair of the Municipal Drug Policy Committee, said the implementation committee for the Ithaca Plan will be meeting soon to develop priorities and next steps.
A major step in implementing the Ithaca Plan will be creating an Office of Drug Policy. No funding for the office was put aside in Myrick’s proposed 2017 city budget, but the city has applied for grants to fund the office, he said.
“In my budget … you won’t see specifically the drug policy office funded by city funds, and that’s because we’re hoping to win at least one of these grants that will let us open this office with outside dollars,” Myrick said.
Making help accessible
Since late July, Green Street Pharmacy has been able to dispense naloxone, which reverses the effects of an opioid overdose, without a prescription because it has a standing order with New York state.
Only about 10 people have purchased the naloxone since the standing order, said Nicole Pagano, supervising pharmacist. For people with Medicaid, it costs $1 or $3. Pagano said she purchased naoloxone through her private insurance, and it cost her $50. Without insurance, the nasal spray is about $150, and the injection is about $25 per vial.
One of the recommendations in the Ithaca Plan was to increase the number of buprenorphine, or Suboxone, prescribers. Buprenorphine is considered one of the most effective ways to treat opioid dependence. Unlike methadone treatment, which must be performed in a clinic, buprenorphine can be prescribed by physicians and is most effective when combined with counseling.
At least six doctors prescribe buprenorphine in Tompkins County, up from four last year. New York also has increased the number of patients a doctor can prescribe to, from 100 to 250 if the doctor gets additional training. At least three have done so in Tompkins County, Pagano said.
In the future, Pagano said she would like to see Narcan nasal spray included in New York’s standing order so every pharmacy can offer it without a prescription. Pagano also would like to work more collaboratively with other agencies to reach people with addictions who have not sought help yet.
One of the biggest challenges when it comes to treating heroin and opioid addiction is the stigma still attached, she noted.
“A lot of people are afraid to ask for help, at risk for losing their job or losing their status in the community, being arrested, those sorts of things, or just being judged and treated poorly because of the fact that they suffer from addiction,” Pagano said. “That’s still the hardest part, and that’s one thing I’ve tried to focus on is educating other pharmacists, helping them to be more open-minded, helping them to see addiction as a disease so we can actually treat this disease process rather than judge people for mistakes they’ve made.”
Community resources
http://www.carsny.org/”>Cayuga Addiction Recovery Services, carsny.org, 607-273-5500, 334 W. State St., Ithaca.
http://alcoholdrugcouncil.org/”>Alcohol & Drug Council of Tompkins County, alcoholdrugcouncil.org, 607-274-6288, 201 E. Green St., Suite 500, Ithaca.
http://www.healthyyouth.org/”>Community Coalition for Healthy Youth, healthyyouth.org, 607-274-5310, 320 W. MLK Jr./State St., Ithaca.
http://www.ithacacommunityrecovery.org/”>Ithaca Community Recovery, ithacacommunityrecovery.org, 607-216-8754, 518 W. Seneca St., Ithaca.
http://www.ithacahealth.org/freeclinic.html”>Ithaca Health Alliance, ithacahealth.org/freeclinic, 607-330-1254, 521 W. Seneca St., Ithaca.
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