The fentanyl crisis, producing a dramatic surge in overdose deaths, has spurred creative thinking in police and government circles in Ulster, Green and Columbia counties. On Friday at a joint press conference, Congressman Antonio Delgado (D-19) joined State Senator Jen Metzger (D-42), Ulster County Executive Pat Ryan, Ulster County Sheriff Juan Figueroa, and Steve Kelley, CEO of Ellenville Regional Hospital, which has taken a leading role in fighting the opioid and fentanyl menace.
In his remarks Congressman Delgado said, “Some of the most heartbreaking encounters that I have are with parents who've lost a child, or a brother or sister who is reflecting upon having lost a brother or vice versa. Tears typically accompany these conversations. I think about those families every day when we’re talking about these issues.”
He noted that Sullivan County now has the highest overdose rate per 100,000 people in New York State. Meanwhile, Ulster County has seen opioid-related deaths increase by 345 percent since 2010.
Kelley said that the crisis on this front has intensified again. “We know that… we're having another wave. And so it is very likely that we will eclipse our worst year [2017] this year, during the COVID epidemic.”
Sheriff Juan Figueroa discussed the ORACLE team, one of the partners in a new approach to the long-running crisis of opioids and heroin, and now fentanyl.
“These are detectives who are going out and instead of trying to capture criminals, they're going out trying to save lives. It is a completely different approach to what law enforcement usually does,” said Figueroa.
And that is the direction that law enforcement and government are moving toward, with the realization sinking in that the new wave of opioid and heroin addiction is not going away anytime soon and new approaches are needed to cope with this.
Ryan said, “We're going to fundamentally take a different approach that mobilizes the whole of the community to address a community-wide program, we're going to use technology and data to really understand things. We’ve talked about people slipping through the cracks and now we want to prevent that.”
The new plan will bring Ellenville Regional Hospital, area county governments, and various law enforcement groups together. The program consists of two sides: The Network Engagement Tracker, which will track the actions of heroin and opioid addicts and the High-Risk Mitigation Team.
Kelley commented, “No one wants to be tracked, but they certainly want to be saved.” Addicts will be asked to enroll in a database using software that has been developed by Marisa Barbieri of Competitive Solutions, a healthcare information technology firm based in Westchester.
Barbieri’s software product PeerRX was in the news last year. Developed in response to the overdose death of a friend, PeerRX connects addicts to recovered addicts, and allows an unfiltered conversation between those who know these issues personally. Addicts can get valuable information about recovery options and resources, and with that, hope for a better life.
The software looks for indicators known to signal a potential overdose. When that happens, an addict’s caseworker is notified.
“So,” Kelley observed, “instead of case managers coming into work, and going through their list of cases, and maybe doing them from A to Z, they will be using this tool to identify who is most at risk and needs care.”
He contrasted that with the old methods. “In the past we've waited for someone to have an overdose, and then we rush in, and we try to get services for them. And we're still going to do that, of course. But imagine if we could be predicting when they were at a higher risk and engaging them and preventing that overdose.”
The second part of this is development of High-Risk Mitigation Teams. Kelley broke this down into three components, starting with the Fatality Review Team. “These are folks that review cases where someone has passed, and they go through in great detail and try to determine what indicators or circumstances happened that might have triggered this person to overdose.”
The second component is the Overdose Prevention Response Team. These are case managers who know the individuals who are being tracked and protected by the safety net.
Third, the ORACLE teams, pioneered by Sheriff Figueroa. Detectives who respond to overdose calls gather data for the Network Engagement Tracker and find people that have been identified as “high risk” and try to persuade them to come in and get help before it’s too late.
Metzger voiced cautious optimism. “What we’re here today to talk about gives me great hope, I have to say, because this is a proactive approach: taking advantage of technology to create a collaborative network to stay in contact with those suffering from substance use disorder and assist them when they need it.”
Delgado addressed another aspect of opioid and heroin addiction. “I've talked to many families who have expressed fear and the unnecessary shame that accompanies addiction. [When] a loved one is addicted, we have to be better about understanding the disease. Now, the answer isn't incarceration, the answer is help. And I think that's where we are shifting.”
Pat Ryan noted the energy in the room. “I just hope that those that are out there, struggling right now, and their family members know, if they could feel the love and the passion in this room, that would also help them not feel without support and without hope.” However, there remains a lot more to be done as we change gears to deal with the “other plague” that threatens us today. Ryan concluded, “Let's roll up our sleeves now. And let's do the hard work.”