Reynolds: Go beyond I-STOP to fight abuse

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(Credit: TMS Illustration by Jon Krause)

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The New York State Legislature typically agrees on very little, but earlier this week, both the Senate and the Assembly unanimously approved I-STOP (Internet System for Tracking Over-Prescribing Act). The centerpiece of the new law is the creation of a real-time database that doctors and pharmacists will check before prescribing or dispensing controlled substances. The goal is to thwart doctor shoppers and finally limit the free-flowing supply of opiate painkillers into our community.

This is a huge victory, and Long Island's elected officials -- no doubt thinking about Tuesday's anniversary of the Medford pharmacy shootings -- played a key role. But there's a lot more work to be done. Limiting the supply of addictive painkillers without simultaneously reducing the demand is a potential prescription for disaster.

As addicts are booted out of doctor's offices and pharmacies empty-handed, the street value of diverted meds like Vicodin, Percocet and Opana will likely skyrocket. Desperate people trapped in addiction who depend on these pills just to feel normal and are scared to death of gut-wrenching withdrawal symptoms do desperate things. Crime could increase, and some will turn to heroin or other drugs as lower-priced and more accessible alternatives.


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For some people, though, this will likely be the first time a doctor or pharmacist has told them "no" -- and the first time that quitting might actually be easier than getting the next fix. Therein lies an opportunity.

At the heart of our prescription-drug crisis is a progressive, chronic brain disease that tears apart individuals, families and communities: addiction. The tragic shootings in Medford last Father's Day highlighted the far-reaching impact of addiction and spurred a fresh look at an age-old disease that affects 2.5 million New Yorkers -- one in seven -- and their families.

The good news is that addiction is treatable, and tens of thousands of New Yorkers who once struggled are leading productive, healthy, loving and fulfilling lives in recovery. Those stories don't make the front page, but each private triumph over addiction enhances public health and makes our community just a little bit safer.

Yet despite all the public attention to painkillers and heroin, drug treatment slots have not increased in recent years. In fact, treatment access is shrinking thanks to government budget cuts, unscrupulous insurance practices and an unprecedented demand for assistance. Some nonprofit treatment providers have closed, while surviving agencies report long waiting lists and an overwhelming demand for help.

Suffolk County just announced another round of cuts to contract agencies, Nassau is threatening to gut health and human services with a $40-million cut, and every level of government is implementing workforce reductions. Insurance companies -- with their own set of economic pressures and seismic shifts in how behavioral health will be financed on the horizon with the upcoming health care reforms -- are routinely denying coverage for detox and limiting drug treatment stays, yet seem to have few qualms about paying for huge quantities of opiate painkillers.

Just as addiction is treatable, substance abuse -- which can lead to physical and psychological dependence -- is preventable. But each time lawmakers slash "discretionary" youth programs, health education initiatives and school-based interventions, they are putting our communities at increased risk and giving addiction a running head start on our kids.

Judging from the increase in overdose fatalities and the steady increase in folks coming through our doors at Long Island Council on Alcoholism and Drug Dependence, Long Island's addiction crisis has gotten progressively worse in the last 12 months. Reversing course will require sustained efforts on multiple fronts. There's no single solution and lawmakers shouldn't think their work is done. We need to make treatment available and affordable for all who need it, and prevention a priority -- and we need to create a community that's supportive of recovery.

We need lawmakers to push those points with the same force and unanimity that gave us a victory on I-STOP.Jeffrey Reynolds is the executive director of the Long Island Council on Alcoholism and Drug Dependence, based in Mineola.

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