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Opioids in New York: How Monroe County is dealing with a statewide crisis.

There is a negative correlation between cases of opioid overdose and the topic’s frequency of being discusses, resulting in increased cases and fatalities if not set in the agenda.

“Addiction is a very, obviously personal, thing for me,” Michael O’Connor, a recovering addict, explained. “It’s also very alarming to me because we see that more and more people are becoming addicted to opioids and we see that a disproportionate amount of those people are suffering due to overdose as well as the other major consequences.”

The dataset, titled “Vital Statistics: Opioid-Related Deaths by County: Beginning 2003,” not only displays an increase in the amount of opioid-related deaths statewide, from 279 in 2003 to 2185 in 2015, but also in a majority of the state’s counties.

“The opioid epidemic spawned from the over-prescription of opioids during the ‘80s, ‘90s and early 2000s when pain management was a primary reason for people to visit doctors and, at a specific time, pain management wasn’t a big thing,” O’Connor explained. “It was considered the 5th vital sign where it was just that important.”

One of the many New York counties affected by the opioid crisis is Monroe, where 740 heroin overdoses and 140 opioid-related deaths have taken place in 2017 alone, according to the Democrat and Chronicle. Additional information within that article also revealed that 112 overdoses and 17 fatalities took place in the first six weeks of 2018.

However, if upon observing a visualization of a data, Monroe County has fewer cases than many others, including the Long Island counties of Nassau and Suffolk, having more than double the amount of deaths than Monroe County each in 2015.

“I think that this could be part of how drugs are coming into New York State,” Kayla Macano, a research associate on opioids at the Rochester Institute of Technology’s Center for Public Safety Initiatives, explained. “I believe that Nassau and Suffolk counties, being on Long Island, have more ports to the water where a lot more drugs can get in easier and then, I think a lot of that is also with the increase in fentanyl being used in mixing in heroin and other opioids.”

“The reality is that the per capita mortality in a particular county is not entirely a function of the prescription opioids that are present,” explained Dr. Michael Mendoza, commissioner of the Monroe County Department of Public Health. “The most common predictor of opioid-related mortality per capita is the presence of synthetic and lethal fentanyl and heroin and other street drugs.”

Jean Bidlack, a University of Rochester Medical Center researcher on treating opioid addiction, compared opioid consumption to that of a candy bar in an interview for a Democrat and Chronicle story.

“Pleasure is pleasure.” Bidlack explained. ”A candy bar will give you a little bit of dopamine release and give you pleasure. Drugs of abuse like opioids will give you a very high dopamine level. The brain adapts and says ‘I want that high dopamine level all the time.’ And then when you don’t have it, that’s when the craving is very, very strong.”

Labelling the addiction to opioids as a “disease of more,” O’Connor provides a similar, yet thorough, explanation as to why individuals like himself deal with and become addicted.

“The addict, or the person suffering, always tries to re-experience that first rush, when their body didn’t know what an opioid was, took it for the very first time and experienced that intense euphoria. They spend countless time, money and energy always pursuing that original high, which was never obtainable as your body adjusts, even after the first dose.”

O’Connor was unaware of his addiction to opioids when it started in 2008, but later found out well into his addiction when the consequences started to appear.

“Things like honesty issues in my immediate family, my performance as a student, my performance as an instructor, all lows were starting to reveal themselves,” O’Connor explained. “The consequences of using while these actions were starting to reveal themselves. After I fully realized it, those consequences are still there. My use was still there, but at the same time, I was trying to pursue recovery.”

O’Connor, unable to recover from his addiction alone, has since attended Alcoholics Anonymous meetings from 2013 onwards so it can be treated.

“People are afraid to come out and say ‘I’m an addict,’” O’Connor explained. “They are afraid to go to their doctor and say ‘I need help because I’m abusing this.’ A lot of people even don’t know they are in deep of trouble they might be in.”

According to the National Institute on Drug Abuse, the U.S. Department of Health and Human Services is responding to the crisis by improving access to treatment and recovery services, promoting the use of overdose-reversing drugs, by strengthening their understanding, providing support for research, and advancing better practices for pain management.

Additionally, Monroe County is responding to the crisis through multiple perspectives. The county’s Department of Public Health, for instance, is seeking access for treatment.

“Treatment really ought to be on the foundation of a solid primary-care relationship with regular general primary-care physicians,” Mendoza explained. “We want to integrate it with primary care, we want to do everything we can to eliminate the stigma around opioid use, and then we want to treat it like an illness. As far as overdose goes, we want to educate people about the signs and symptoms of overdose and do what we can to prevent them.”

The county has also taken a stance against the crisis from a law-enforcement angle. According to a Democrat and Chronicle story, major initiatives have been announced to help curb opioid abuse, including the Monroe County Heroin Task Force, where officers and deputies responding to overdose cases will have to fill out two-page forms that are later sent to the Monroe County Analysis Center, and then to a sheriff’s command post so agencies can be deployed within 24 hours.

“I know that addiction can be a very controlling disease,” Macano explained, “and that drugs that people may get out on the street are not always pure and that’s why there’s a lot more overdoses occurring.”

Macano has also proposed her own solution to this issue at a prevention angle by educating middle schoolers on the many dangers of opioid consumption by ways other than a D.A.R.E. style program.

“I think that educating them on how prescriptions can be just as dangerous and lead you to heroin use and possibly opioid addiction is a great place to start,” said Macano. “I think that a lot of kids are also seeing their parents use heroin and opioids, so we need to educate them on that as well and really just increase the number of treatment facilities and treatment beds to get people the help that they need.”

“This is a disease of ignorance, not in a pejorative sense,” O’Connor explained, “but not a lot of people know about addiction. When you say the words ‘addict’ or ‘alcoholic,’ you think of someone under the bridge holding a bottle in a paper bag, but that’s not the case anymore. I attend Alcoholics Anonymous meetings to treat addiction and I know just as many people who are homeless as I do physicians in my program, so it’s no longer that person under the bridge, but it’s just every profession, every school, every family knows, if not has, an addict with them.”

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