Long Island is at the epicenter of the growing abuse of prescription painkillers.
State figures show a sharp increase in prescriptions for painkillers such as OxyContin in both Nassau and Suffolk counties in the past three years, while more Long Islanders are seeking help for addiction to prescription pain pills. Experts say those seeking treatment likely represent only a portion of the abusers.
The rise in prescription rates and the numbers of people seeking treatment are the backdrop to the Father's Day murders of four at a Medford pharmacy. A Suffolk grand jury indicted David Laffer, 33, who police say abused prescription drugs, on five counts of first degree murder.
He is also accused of stealing thousands of painkillers from the pharmacy after the shootings. Laffer's wife, Melinda Brady, 29, who police said is an addict, has been charged with driving the getaway car.
Treatment providers said many addicts fall prey to prescription addiction after exploring the medicine cabinet.
"The next thing you know he is stealing from his parents, he's stealing from his neighbors, and in and out of jail," Traci Donnelly, vice president and director for the New York region for Phoenix House, a drug treatment provider, said about the problems brought on by addiction.
There have been 16 holdups of pharmacies on Long Island since October 2008. Four of these, including the Medford robbery, were this year, and 12 of the 16 were in Suffolk. Thieves overwhelmingly stole oxycodone-based painkillers or those containing hydrocodone, according to the federal Drug Enforcement Administration.
Drug Enforcement Administration figures show that statewide the number of armed robberies of pharmacies rose from two in 2006 to 28 in 2010. During that period the number of pills taken increased from 1,176 to more than 20,000, which the agency attributes to a mounting demand by addicts and dealers for prescription drugs.
Nationally, armed robberies of pharmacies leaped 81 percent over the same four year period -- from 380 in 2006 to 686 in 2010, according to the DEA.
Experts do not dispute that prescriptions for painkillers have skyrocketed and that abuse of these pills is sharply on the rise. They say the pills, when prescribed properly, serve a vital purpose for people in pain.
"Unfortunately our population is getting older," Blum said. "There are lots of older people taking medications so they can function at home and not be institutionalized."
Blum cautioned against drawing a connection between any increase in prescriptions and the illegal market for drugs, which he blames largely on out-of-state pill mills.
Marc Yland, president of the Suffolk County Medical Society, blamed much of the illicit flow of such pills on diversions from pharmacies and manufacturers, but he said more and more doctors are writing prescriptions for highly addictive narcotics. The increase is, in part, a recognition of the drugs' usefulness in fighting pain. But he said money is also a reason for the increase.
"It's a reflection of medicine in general," he said.
One window into prescription drug abuse on Long Island can be seen in the number of area residents admitted to state certified treatment programs, which grew from 1,612 in 2005 to 3,626 last year, a jump of 125 percent. The largest bump was from 2009 to 2010, when 752 more admissions were recorded than the year prior, a 26 percent climb.
As the number of people seeking treatment for dependence on pain pillssuch as OxyContin has sharply increased, so has the number of prescriptions written for these pills, records show.
There were 650,000 prescriptions for oxycodone filled in Nassau and Suffolk counties in 2010, a 46 percent increase from 2008, according to the New York State Department of Health. Prescriptions for hydrocodone dipped 7 percent in 2010 compared to 2008. The department could only provide these figures for the last three years.
Suffolk has the third highest prescription rate for the drug out of 62 New York counties with nearly 26 prescriptions of oxycodone per 100 residents in 2010, the state figures say. Nassau County had nearly 20 prescriptions per 100 residents.
According to the state Office of Alcoholism and Substance Abuse Services, which compiled the treatment figures for Newsday, most of the residents they tracked sought help at treatment programs on Long Island. Experts say thousands of other addicts have not sought treatment.
During the 2005-10 period, admissions to certified treatment centers rose most sharply among addicts aged 18 to 24. They represented 36 percent of treatment admissions in 2010 compared to 23 percent in 2005. In June, New York Attorney General Eric T. Schneiderman said between 2007 and 2010, Long Islanders -- who represent 15 percent of the state's population -- accounted for more than 20 percent of the state's admissions for treatment of drugs such as Vicodin.
While treatment providers on Long Island say the needs of the most critical cases are being met promptly, many addicts are waiting anywhere from a few days to a few weeks to get an initial assessment or a treatment bed.
Addicts who can't get help quickly often lose their zeal to get off drugs, providers said.
"Each of those admissions to me is a victory," said Jeffrey Reynolds, executive director of the Long Island Council on Alcoholism and Drug Dependence. "But the much larger issue is the multitudes of users who are not making it through those doors."
The number of people admitted to rehab for prescription drug abuse ballooned nationwide from 1999 to 2009, according to figures from the federal Substance Abuse and Mental Health Services Administration. In 1999, 1 percent of substance abuse treatment admissions were for opiates other than heroin -- mostly painkillers like oxycodone or hydrocodone -- while the share increased to 7 percent in 2009.
Mark Epley, executive director of Seafield Center, which runs treatment programs in Nassau and Suffolk counties, said withdrawal from an opiate like hydrocodone is comparable to that from heroin. Addiction to prescription narcotics presents its own set of hurdles to users who want to get clean and those trying to help them, he said.
Addicts may have legitimate pain issues that have to be addressed even as they are weaned from the pills, Epley said.
"When you deal with anybody who is addicted to a prescription medication it's always a challenge," Epley said. "It's just very complicated."
For many users the pills lack the stigma associated with street drugs, said Mary Silberstein, director of addiction recovery services at The Pederson Krag Center, which offers treatment and prevention programs in Suffolk. Users get prescriptions from people they trust -- doctors -- in settings ranging from hospitals to dental offices, she said.
"They are seeing them from the beginning as something that is not harmful," Silberstein said of the pills. "Prescriptions are being written much too freely for pain management."
Despite increased attention to the problem of prescription drug abuse, treatment specialists say getting all addicts who want help access to immediate care remains a struggle. And Government spending cuts to some treatment providers on Long Island, they said, are coming at the worst moment.
"At a time when we all agree as a community that the need is greater than ever before the available treatment slots are less and less," Reynolds said.
With Andrew Strickler