Report: Rural NY counties hardest hit by opioid addiction crisis

Rural New York counties whose population is largely white have been hardest hit in an opioid addiction crisis that for years was aided by clinicians’ prescribing tendencies, a new analysis has found.

For the first time, policy experts have conducted a wide-ranging analysis examining differences — county by county — in how prescribers wrote orders for opioid medications. The analysis, which relies on data from the Centers for Disease Control and Prevention and sources within New York, reveals a sharp demographic divide.

“We saw higher opioid prescribing in areas that are less populated, more rural and majority white,” said Mark Zezza, director of policy and research at the New York State Health Foundation in Manhattan. The private organization focuses on health improvement for residents statewide.

Zezza said his analysis of prescribing variations covered all of New York’s 62 counties. He found a 400 percent per capita difference between Sullivan County, which prescribed the most opioids, and Kings County (Brooklyn), which prescribed the least. The analysis covers the years 2009 through 2015.

Nassau and Suffolk counties did not rank in the top 10 jurisdictions with the most opioid prescribers, nor in the bottom 10, where the drugs were least likely to be prescribed. They were in the middle, bookended by the two extremes.

Nearly 9 million opioid prescriptions written by health-care providers were dispensed by pharmacists during the years covered in Zezza’s research. The epidemic encompassed a population of at least 145,000 opioid drug abusers during much of the research period, the data show.

In 2015, he found, 2,771 people statewide died of drug-related causes, with two-thirds of those deaths attributed to opioids.

“It’s always kind of staggering for me to see how such a large proportion of the epidemic is due to prescribed opioids,” Zezza said.

A local addiction and drug rehabilitation expert said the crisis remained just as deadly on Long Island in 2017.

“This year, the number of overdoses has tended to climb in an unabated way. And when 2017 is over, it will probably show that we haven’t turned the corner,” said Dr. Jeffrey Reynolds, president and chief executive of the Family and Children’s Association in Mineola.

“We’re seeing signs of worsening — signs of desperation,” he said.

On the Island, Reynolds said many opioid abusers no longer seek prescription drugs because dealers’ prices are too high. Abusers have turned to cheap heroin instead.

“Years ago, it was pretty much a guarantee that people started with prescription pills, then progressed to heroin. Not any more,” Reynolds said. “Being on 30 bags of heroin a day is not unheard of.”

Zezza’s analysis covers the years when paper prescriptions were still widely in use. In 2016, electronic prescriptions were mandated by law as part of a crackdown effort by the state.

Prescription pads were prized objects among illicit drug dealers, who wrote millions of dollars’ worth of opioid prescriptions, local police and state drug-authority records showed.

One reason for getting rid of them was to take opioids off the street. Reynolds asserted that abusers have turned to robbing banks and gas stations to finance their heroin habits.

Meanwhile, the Pharmaceutical Research and Manufacturers of America, or PhRMA, which represents the country’s biopharmaceutical researchers and biotechnology companies, announced a multiyear strategy earlier this month to help end opioid dependence.

PhRMA plans to work in partnership with the Addiction Policy Forum, a nationwide nonprofit. They will fund state and local programs across the country, as well as support new public policies that help families and individuals challenged by drug addiction.

Also, in a statement, the state Department of Health told Newsday that Gov. Andrew M. Cuomo has taken numerous “aggressive steps to combat the heroin and opioid epidemic.”

State health officials listed expanded access to naloxone, the medication designed to rapidly reverse opioid overdoses, as part of that approach, and an investment this year of more than $200 million for prevention, treatment and recovery programs.