People are dying of opioid drug overdoses in Erie County at a rate of more than one a day. Those deaths are occurring despite a lengthy list of ambitious addiction-fighting programs and the ambitious spending of hundreds of thousands of local tax dollars.
So what does it take? What does it take to stop a death spiral that seems to be gaining, not losing, steam.
That was the question Erie County legislators spent an hour discussing and debating with public health officials and drug treatment providers on Thursday.
The conversation dredged up everything from the lack of front-line doctors, nurses and therapists to treat addiction, the lack of long-term treatment beds, and the need to better market recovery services, to the simple fact that more potent drugs are hitting the streets and killing people before anyone has time to save them.
"When you peel back the layers, it just gets worse and worse," said Legislator Kevin Hardwick, R-City of Tonawanda.
No one denied that. In the first 109 days of this year, the county's Medical Examiner's Office has recorded 129 suspected or confirmed opioid-related deaths.
Erie County's death rate is higher than many other communities in the state, according to Daniel Rinaldo, drug intelligence officer with the federal High Intensity Drug Trafficking Area. Fentanyl and other highly potent opioid drugs are overshadowing heroin as street drugs, and killing more people, because these substances are vastly cheaper to produce than heroin. Lower cost and higher profits also means higher death tolls.
Anne Constantino, president of Horizon Health Services, agreed that the overdose drug crisis was getting worse and struggled for a silver lining.
"There are more people engaged in treatment today than there were a year ago," she said. "If we can keep people alive long enough, then there's every chance to believe they will go into recovery and be equally functioning members of society."
That didn't seem to cheer up many legislators.
The county lawmakers expressed particular concern that Erie County is spending $301,000 a year to staff a 24-hour addiction hotline, designed to connect addicts with treatment and be a one-call resource for drug treatment referrals and advice. The hotline number is 831-7007.
Despite the investment in the hotline, legislators complained the phone line was only getting about seven calls a day. Health Department officials said the numbers have recently increased to an average of eight to 10 calls a day. Again, legislators remained concerned.
"If the money isn't being spent properly, if it isn't being spent in places that are actually having an effect on a problem that continues to grow, what can we do?" said Majority Leader Joseph Lorigo, C-West Seneca. "Everybody in here wants to have it fixed. Everybody wants to have a solution. I would argue, at this point, the hotline hasn't been a success."
Health officials responded that since the hotline went up in August, addiction counselors have fielded 1,903 calls. They compared that figure to Suffolk County, which is much larger than Erie County. That hotline had fielded only 516 calls between April of last year and February.
They also stated that greater efforts were being made to market the hotline phone number, which is also being given out on cards by first responders. Legislators recommended that ads for the hotline should be placed at bus stops, community centers and Department of Social Services offices.
Legislator Patrick Burke, D-Buffalo, has introduced a resolution to earmark another $1 million in county savings to create greater access to treatment and pushed for his resolution to be approved by the full Legislature. The money would be given to the Health Department to allocate.
Other legislators said they had no opposition to earmarking more money to fight the problem, but they want to know that the money is going to where it could best be used. Among the suggestions:
- Extending the hours that drug treatment counselors are available to meet with and screen addicts who call the addiction hotline. Currently, hours are limited to 8 a.m. to 4 p.m.
- Starting a college loan forgiveness program for doctors, nurses and therapists who finish college and commit to doing front-line addiction recovery work that is "exhausting, frustrating, sad and hard," said Constantino.
- Establishing a 24-hour help center where addicts can come for immediate help and screening
Burke raised concerns that the Legislature will be slow to act while spending time deciding what best practices are worth the money.
"There should be some sense of urgency," he said. "People are dying."
"I do think there's a sense of urgency," responded Legislator Lynne Dixon, I-Hamburg, who chairs the Health and Human Services Committee. "I think now we have to talk to each other and say what's the next best step to take."
Rinaldo, however, said everyone should recognize that whatever steps they take to address the problem, no true solutions will be created overnight.
"This is a 10-year struggle we're going to be in," he said. "This is a 10-year plan we should have. We're in a long struggle here, and there are no easy answers."