ALBANY – When advocates get their way on an issue at the state Capitol, they usually disappear, quietly and happily.
Not so with a group of Buffalo parents who helped lead the political push in Albany last year to get a law enacted that cracks down on liberal dispensing of prescription painkillers that can be highly addictive.
Now, this same group of parents is back at the Capitol, saying the Cuomo administration is failing follow through on the second phase of their effort to combat prescription drug abuse: expanded drug treatment.
“While this was a wonderful law, they’re dropping the ball and leaving thousands fighting for their lives,” said Patricia McDonald, a Buffalo resident whose daughter, Adrianne, died two years ago from a heroin overdose following what she believes was an addiction to potent prescription painkillers.
With much fanfare, Cuomo and lawmakers last year approved the Internet System for Tracking Over-Prescribing Act, or I-STOP. Key provisions kick in later this year, including “real time” tracking of painkiller prescriptions to prevent overdispensing.
At Cuomo’s side were several parents, most from the Buffalo area and Long Island, whose tragic stories involving their dead or addicted children became the plot lines to help get the law approved.
Though happy then that the new law was approved, many of those same parents today are seething.
“When I-STOP passed, it seems like the support from the governor’s office stopped,” said Avi Israel, who was one of the central lobbying forces to get the law approved. His son, Michael, 20, killed himself in the family’s North Buffalo home in the midst of an addiction to painkillers.
The administration disputes these claims and says it is taking a proactive approach to deal with drug addiction. Moreover, it believes there are enough treatment slots to meet the demand.
Some providers and these parents dispute that claim.
Treatment officials talk of long waiting lists to get into residential facilities, which some say is often needed to break an opiate addiction. One facility in Buffalo has up to 70 people at a time on a wait list.
Several parents contacted The Buffalo News after a recent article about the effects I-STOP has had on curbing prescription drug abuse to say they had to travel as far away as Florida to find available beds for their addicted relatives and friends.
Some area parents who helped lobby for I-STOP were at the Capitol a week ago to drum up support for additional treatment options. They talked of a meeting they attended last August at the Capitol – after I-STOP’s passage – to begin a push for more treatment beds.
Gov. Andrew Cuomo’s chief health adviser, James Introne, showed little support, they complained.
“He said we were wasting his time,” said Cheryl Placek, a Niagara Falls woman whose son, Daniel, a 28-year-old Navy veteran, committed suicide while addicted to prescription painkillers. Her comments were backed up by Israel and McDonald, who both attended the meeting.
The Cuomo administration strongly disputes that Introne, a veteran health care expert whose first top state job in the field was during the administration of Gov. Hugh Carey, was disrespectful to the group of parents.
Asked why they were speaking out now about a meeting that happened six months ago, Placek, McDonald and Israel said it was because they had hoped the Cuomo administration would address their concerns.
“What made us stay silent was the hope the state was going to do something,” Israel said.
The parents, who have no direct stake in the effort because their addicted children have died, are grateful the administration is adding 25 treatment beds apiece for the Buffalo area and Long Island. And 100 new beds are coming next year for veterans, 25 in Niagara County. But advocates in Western New York say it is not enough.
Addiction experts have differences over treatment. Many physicians believe opiate replacement therapy – with such drugs as buprenorphine – offer far better results than residential treatment and other counseling therapies that they say have high relapse rates.
Federal data shows New York had the second highest number of people – 123,000 – behind California in addiction treatment facilities in 2011, the state officials point out. And New York had the highest percentage of opioid treatment programs, methadone clients and people using buprenorphine, they added.
A Cuomo administration group working on the issue has identified several barriers to more treatment beds, including lack of providers and costs. That group believes that goals will include access to methadone and buprenorphine and expanded treatment in office-based settings, which will be a better option to people in rural areas.
The state is now requiring medical directors in its addiction treatment system be authorized to prescribe buprenorphine and that new medical directors coming into the system be board-certified in addiction medicine.
But at a state budget hearing last week, lawmakers raised concerns about rising opiate addictions and treatment options.
“What I’m suggesting is not enough money is in the budget to handle the explosion of opiate addiction in New York State. Why is that?” Assembly Alcoholism and Drug Abuse Committee Chairman Steven Cymbrowitz, a Brooklyn Democrat, asked one of Cuomo’s point persons on drug treatment.
“Assemblyman,” responded Sean Byrne, executive deputy commissioner at the Office of Alcoholism and Substance Abuse Services, “we currently believe we have sufficient funds to respond to the demands we are seeing.”
“So you will be able to eliminate the explosion of opiate abuse?” the lawmaker asked.
“Stopping the proliferation of the circulation of illegal drugs is not something that’s directly in control of OASAS. That’s something that’s more appropriately the function of policing agencies,” Byrne said.
“So,” the lawmaker asked, “there is enough money for treatment services to all those with opiate addictions?”
“Yes, sir. Yes, sir,” Byrne responded.
In later questioning, Sen. Tim Kennedy, a Buffalo Democrat, told Byrne that his own agency’s statistics show that only 16 percent of the residential treatment needs in Western New York are being met, while in New York City, 111 percent of the need is met because of an overabundance of beds.
Byrne disputed that there is a shortage in Western New York, or anywhere in the state.
As of last week, he said, the treatment system had available beds for any addicts in need. Officials Friday said the statewide drug treatment system has an 82 percent utilization bed rate on most days, meaning as many as 1,000 “intensive resident beds” are available.
But providers in Western New York say there is a shortage, and that state officials have told them to send people in need to unused facilities in New York City – a route they say is therapeutically unworkable if families are to be involved over the months of treatment.
“You’ll always hear providers say we can do more with more,” Byrne told Kennedy during the hearing.
Kennedy called the official’s answer “a play on numbers.”
Prescriptions for hydrocodone, a painkiller, in Erie County were more than triple that of any other controlled drug between 2008 and 2010, according to the state Office on Alcohol and Substance Abuse Services.
In the four years ending in 2011, noncrisis admissions to drug treatment providers for prescription opioids rose 74 percent to 1,462 cases. Three-quarters were for people age 35 and under.
“This is a problem that’s not going away. This is a problem that’s going to be magnified as I-STOP is implemented and there is more of a need for this addiction services,” Kennedy told the Cuomo official last week.