ALBANY — Luke Grandis was seven years into recovery from opioid use disorder when he started using again last spring.
Pushed to the brink by ongoing health problems, depression, pandemic-induced isolation and a dwindling supply of Suboxone that helped keep his cravings at bay, he turned to the black market to get his fix and avoid the painful withdrawals he knew would occur when his medicine ran out.
The 32-year-old, who has worked in the addiction and recovery field for years, knew the drug supply would be riskier this time around. More illicit drugs were being laced with fentanyl now and the supply had grown increasingly volatile throughout the pandemic as travel restrictions disrupted traditional trafficking routes.
“I've had lots of bouts of drug use in my life,” Grandis said. “Using drugs during the pandemic was definitely the time where I was most acutely aware that I was possibly going to overdose and die. Just because of how bad the supply was, how inconsistent it was.”
He drafted an “In case I overdose” note in his phone and told the people he loved where to find it. He used fentanyl test strips to see if his drugs were laced with the highly potent synthetic opioid — responsible for a third wave of overdose deaths in the U.S. after prescription pills and heroin — and adjusted his use based on the results. Because his veins were shot from earlier-in-life drug use, he snorted his supply instead.
“I honestly think what kept me alive was that I wasn't able to inject this time,” he said. “I used harm reduction methods to mitigate my risk and thankfully I survived that summer. But it was definitely the scariest experience for me, drug use wise.”
He wasn't alone.
Millions of Americans turned to drug and alcohol use to cope with the stressors brought on by the COVID-19 pandemic. People who were already using substances used more. People who were in recovery relapsed. And people who had never had a drug or alcohol problem suddenly found themselves using to the point of dependence.
The most recent federal data show just how bad the crisis has grown. More than 100,000 U.S. residents died of a drug overdose in the most recent 12-month period measured by the Centers for Disease Control and Prevention — the highest one-year total on record. Meanwhile, alcohol-related deaths soared to over 99,000 in 2020 — a 25 percent increase over 2019, according to a recent study in the Journal of the American Medical Association. That compares with an average annual increase of just 3.6 percent between 1999 and 2019.
An unstable drug supply, coupled with reductions in treatment and harm reduction services, has made the pandemic a particularly dangerous time to use substances. Where the overdose crisis was for a long time driven by prescription pills and then heroin, today it is being fueled by illicitly manufactured fentanyl, fentanyl analogs, cocaine and methamphetamine — often in combined or adulterated forms.
“We’re watching the legacy of Cuomo’s 10 years of underfunding, cutting funding, neglecting legislation, rejecting evidence-based solutions play out in real-time — on top of an unstable drug supply, on top of the legacy of 50 years of the drug war,” said Jasmine Budnella, director of drug policy for VOCAL-NY, a group that advocates for evidence-based drug policy.
“We’re trying to untangle this and make sure people are staying alive,” she continued. “But we're constantly fighting stigma and politics because we're going into an election year where often people are like, ‘Oh, we can't talk about overdose or drug users and keeping people safe because, you know, we want to keep our seats.’”
There is growing recognition among decision-makers, however, that the overdose crisis can no longer be met with half-measures. With more New Yorkers dying of drug overdoses in a 12-month span than car accidents, suicides and homicides combined, advocates say the time for drastic action is now.
On Monday, VOCAL-NY will deliver a letter to state Sen. Majority Leader Andrea Stewart-Cousins and Assembly Speaker Carl Heastie calling for passage of the Safer Consumption Services Act — a bill that would authorize overdose prevention centers (OPCs) around the state where people could consume pre-obtained drugs while under medical supervision and be connected to services when they are ready to seek help.
While highly controversial, OPCs have been around for decades in other parts of the world with proven track records of saving lives. Two centers opened in New York City late last year as part of a pilot program and have already helped reverse over 185 overdoses, exceeding the city health department’s predicted yearly estimate of 130 lives saved, the letter states.
"It's hard to argue with lives saved," Budnella said.
The letter was signed by 230 directly impacted community members, faith leaders, health care providers and grassroots organizations around the state, including the Albany Damien Center, Albany Medical Center, and Catholic Charities Care Coordination Services in the Capital Region.
“All data sets and recent trends suggest that fatal overdoses will continue to break records year after year unless our government takes significant action to implement evidence-based solutions,” the letter states.
In addition to overdose prevention, OPCs offer sterile supplies that help cut down on blood-borne infections and injection-related wounds. They also reduce rates of public injection and litter from used needles. Most importantly, proponents say, they are linked to treatment and counseling services and a non-judgmental space for drug users to turn to when they are ready to stop using.
Grandis, who serves as upstate lead organizer for VOCAL-NY, admits he would have felt much safer using drugs at an OPC than on his own. He recalled a day last summer when he was slumped over in his bathroom, heavily sedated and unable to move after using but still conscious.
Luke Grandis, outside his Albany apartment, is among those advocating for drug policy reform in New York that would allow overdose prevention centers (OPCs) around the state where people could consume pre-obtained drugs while under medical supervision and be connected to services when they are ready to seek help.
Lori Van Buren/Times Union
Luke Grandis, outside his Albany apartment, has worked in the addiction recovery field for years and was among people in recovery who relapsed during the pandemic. Millions of Americans turned to drug and alcohol use to cope with the stressors brought on by the COVID-19 pandemic. The most recent federal data show just how bad the crisis has grown. More than 100,000 U.S. residents died of a drug overdose in the most recent 12-month period measured by the Centers for Disease Control and Prevention — the highest one-year total on record. Meanwhile, alcohol-related deaths soared to over 99,000 in 2020 — a 25 percent increase over 2019, according to a recent study in the Journal of the American Medical Association. That compares with an average annual increase of just 3.6 percent between 1999 and 2019.
Lori Van Buren/Times Union
Luke Grandis, outside his Albany apartment, relapsed when he lost access to a prescription for Suboxone because his insurance wouldn't cover it. Grandis was eventually able to stop using after he started receiving medication-assisted treatment from Camino Nuevo, a methadone clinic on Albany’s Central Avenue. He had to go six days a week to get his daily dose and, depending on the day and staffing levels, it could take anywhere from 15 minutes to two hours. Thankfully, because he works in the addiction field, his employer was understanding, he said. But he’d watch as others who were unable to wait that long would leave to go score.
Lori Van Buren/Times Union“My cat found me there and looked at me like I was dead and actually got one of my neighbors’ attention by meowing at my door,” he said. “Me being fully conscious and seeing that go down, that was a scary moment for me. If I had access to an overdose prevention center, I absolutely would have used one.”
Grandis was eventually able to stop using after he started receiving medication-assisted treatment from Camino Nuevo, a methadone clinic on Albany’s Central Avenue. He switched to methadone, which also treats opioid use disorder, after struggling to find a Suboxone provider, he said.
He had to go six days a week to get his daily dose and, depending on the day and staffing levels, it could take anywhere from 15 minutes to two hours. Thankfully, because he works in the addiction field, his employer was understanding, he said. But he’d watch as others who were unable to wait that long would leave to go score.
“The reality is a lot of people that are there are like myself and work full time,” he said. “And there's just so little respect or even basic dignity for people who use drugs. It’s like, ‘oh, you either don’t have a job or if you do, well, you never should have used drugs in the first place and that's why you're here’ kind of attitude.”
Jasmine Guerrero-Wiggs, operations manager for St. Peter's Addiction Recovery Center in Albany, said policymakers need to ensure drug users can access medication-assisted treatment without having to meet numerous requirements first.
"It can't just be, 'OK, you need to go into treatment, you need to do this first and that first before we end up giving you the medication,'" she said. "That has not been our approach. Our approach is medicating them, making sure they're stable and then we work on the treatment afterwards."
VOCAL-NY is also pushing legislation that would decriminalize possession of buprenorphine (the generic for Suboxone), which is currently only legal for those who hold a prescription. Doctors have to receive a federal waiver to prescribe it and laws cap how many patients they can write prescriptions for. Insurers also don’t always cover it; Grandis lost access to Suboxone after his provider informed him his insurance wouldn't cover it.
With addiction on the rise, demand for buprenorphine continues to be high and many people wind up seeking it on the black market because they struggle to obtain it legally.
Efforts are underway at both the state and federal level to make medication-assisted treatment like buprenorphine much easier to access legally. But decriminalizing it is a first step, VOCAL-NY argues, because even when taken without a prescription it increases a patient’s retention in treatment, improves social function and reduces a person’s risk of infection, involvement in the criminal justice system and — most importantly — fatal overdose.
Vermont decriminalized possession of buprenorphine last year after a move by the Burlington Police Department to stop arresting people for possession helped contribute to a 50 percent drop in overdose deaths in their county.
“The crisis is getting so bad and it's so visible now,” Budnella said. “This whole state is just in massive mourning, I think, from living through really hard times. But we're losing a lot of people that no one talks about. So I think things like overdose prevention centers can be a beacon of hope.”
While stigma and opposition remain among those who fear harm reduction measures like OPCs simply facilitate and enable drug use, Grandis hopes people will think of them another way. There’s two questions his coworker often poses, he said, when something rubs someone the wrong way.
“Is this going to help save lives and does this hurt me personally in any way?” he said. “If the answer is yes to the first one and no to the second one, why wouldn’t you support it?”
April 03, 2022 at 06:10PM
https://www.timesunion.com/news/article/It-s-hard-to-argue-with-lives-saved-As-17050912.php
'It's hard to argue with lives saved.' As overdoses soar, calls for prevention centers grow - Times Union
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