Laws aim to prevent heroin addiction

New York governor Andrew Cuomo has signed into law a series of bills aimed at combating rising rates of opioid and heroin use in the state — a package of measures that marks a shift toward treating drug abuse as a health issue, rather than a crime. 

The laws are designed to increase access to opioid antagonists, such as Nolaxone, increase access to addiction treatment, and expand budget allocations for community prevention programs.

New York State legislators earmarked an additional $166 million in the state budget for community programs, such as increasing the number of opioid disposal centers, where people who have been prescribed opioid medications can safely dispose of the drugs.

The package of laws also changes prescription regulations for opioids such as oxycodone, diapmorphine and fentanyl, lowering prescription limits from 30 days to seven days worth of medication.

Dr. Melissa Stein, the medical director of the substance abuse division at Montefiore Health System, said doctors’ routine and excessive prescription of opioid medications is one of the major causes of the national heroin epidemic.

“Starting about 10 to 15 years ago there was a movement to be more aggressive in treating pain,” she said. “Physicians underestimated the addictive potential of opioids.”

Historically, heroin abuse has largely affected inner city communities because it is a cheap, accessible drug, Dr. Stein said.  But as opioid prescriptions became more common, heroin use has turned into a growing problem in middle- and upper-class neighborhoods.

“Anyone can become addicted to heroin or any other opioid medication,” Dr. Stein said. “Our bodies will become dependent if we are exposed to them for a long period of time. We think of addiction as when people continue to take the medication or drug even after there are negative outcomes.”

In a September, 2015 investigation, The Press found that heroin abuse in Riverdale, particularly amongst young people, was becoming an increasingly pervasive issue. 

In May, 2015, the Drug Enforcement Administration confiscated 70 kilograms (about 155 pounds) of heroin from a W. 251st Street home that had been used to distribute the drug throughout the northeast.

“Historically, people have become addicted to heroin from more recreational use,” Dr. Stein said. “What we are seeing more now in the past five years, people’s first experience with opioids is with prescribed medicine.”

The new package of laws is a sign that the statewide perception of drug addiction and drug addicts is changing. In a statement emailed to The Press, state Sen. Gustavo Rivera called opioid abuse a public health issue, signaling a move away from treating it as a crime.

“By treating substance abuse and addiction as matters of public health and not as criminal offenses, our state has taken a meaningful step in addressing the heroin and opioid crisis that continues to deeply impact several communities throughout New York State,” he said. 

The bills also seek to increase access to treatment of opioid addiction.

“There is finally a consensus the ‘war on drugs’ is an abject failure,” Bronx Councilman Andrew Cohen said. “The thinking around heroin addiction is evolving.”

Mr. Rivera said he hopes the new package of legislation is just the first step in a new era of addiction treatment.

“This package of bills… will allow our state to allocate important resources to the implementation of preventive and rehabilitative measures, instead of punitive ones,” he said. “I look forward to continue working with the Legislature to expand these proposals and include further measures to address the heroin and opioid crisis.”

Dr. Stein said that one of the changes she hopes to see is a move away from trying to make recovering addicts totally independent from opioid substances. 

“I think that we need to really work on increasing the awareness of opioid dependence as a long-term health issue,” she said. “I provide medication-assisted treatment. The medication I use most commonly is methadone, but we also use [buprenorphine]. Those medications help people to prevent withdrawal and keep steady their lives. Getting them off the meds is not the goal.”