Tuesday, March 22, 2016

Fighting Heroin, Ithaca Looks to Injection Centers

Officer Dana Haff and other law enforcement personnel removing drugs found after a raid at a home in Ithaca, N.Y., this month.

MARCH 22, 2016

ITHACA, N.Y. — Even Svante L. Myrick, the mayor of this city, thought the proposal sounded a little crazy, despite the fact that it was put forth by a committee he appointed. The plan called for establishing a site where people could legally shoot heroin — something that exists nowhere else in the United States.

“Heroin is bad, and injecting heroin is bad, so how could supervised heroin injection be a good thing?” Mr. Myrick, a Democrat, said.

But he also knew he had to do something drastic to confront the scourge of heroin in his city in central New York. So he was willing to take a chance and embrace the radical notion, knowing well that it would provoke a backlash.

And it has.

Ever since Mr. Myrick unveiled a plan last month for what he called a “supervised injection facility,” critics have pounced on it as a harebrained idea that would just enable moredrug abuse. A local Republican state legislator, Tom O’Mara, called it “preposterous” and “asinine,” and a Cornell University law professor, William A. Jacobson, likened it to a“government-run heroin shooting gallery.”

Svante L. Myrick, the mayor of Ithaca, said his father’s battle with crack cocaine helped inspire him to confront the city’s heroin problem.

But others, including workers on the front lines of the heroin epidemic and some law enforcement officials, viewed the proposal as an important tool in the battle against addiction and overdoses, a way to keep users alive long enough to connect them to treatment. In the plan, users would be under medical supervision and could inject only a small amount of heroin.

The plan would need state approval, and it faces a steep climb in the arena of public opinion. But the unorthodox idea has drawn attention at a time of intense concern about the growing toll of heroin abuse, which, along with prescription opioid painkillers, kills 78 people a day, according to the federal Centers for Disease Control and Prevention. Many of them are overdosing not in squalid rooms but in public places.

Since announcing the plan on Feb. 24, Mr. Myrick, 29, has taken pains to explain to the public that a supervised injection center is only one pillar of a four-part plan that also addresses prevention, treatment and law enforcement.

Mr. Myrick’s father battled crack cocaine addiction, he said, which helped inspire him to create a committee and confront the heroin problem.

Though unheard-of in the United States, supervised injection sites have existed in Europe for years — one of the first was in Switzerland, 30 years ago — and in Vancouver, British Columbia, the only city in North America where the practice is allowed. They have been linked to a reduction in harm from heroin abuse: In Vancouver, fatal overdoses dropped 35 percent in the community surrounding its main injection site in the two years after it opened in 2003 and fell 9 percent citywide.

Buffalo Street in Ithaca. In a span of a week and a half in 2014, there were more than a dozen heroin overdoses in the city, three of them fatal.


Here in Ithaca, a city of 30,000 in the Finger Lakes region, there were more than a dozen heroin overdoses, three of them fatal, in a span of a week and a half in 2014, shortly after Mr. Myrick appointed the committee that proposed the injection center. The Tompkins County Health Department does not break out overdoses by municipality, but in 2014, the most recent year for which data is available, there were 14 fatal overdoses in the county, where Ithaca is the only city.

The proposal for an injection facility, part of “The Ithaca Plan: A Public Health and Safety Approach to Drugs and Drug Policy,” would require changes to a number of state and federal laws, according to state health officials.

Gov. Andrew M. Cuomo, a Democrat who has mounted a forceful response to the heroin epidemic, told reporters at an unrelated news conference recently that he was unfamiliar with the details of the Ithaca plan and would not offer his opinion.

Much of the Ithaca drug plan has been embraced by a cross section of the community. The plan calls for more drug education, both for children and adults; improvedmental health screening; a detoxification center; and a methadone clinic. But the supervised injection program has divided local law enforcement.

Ithaca’s police chief, John R. Barber, said he could not support the proposal because “right now, heroin is considered an illegal substance under the law.” But Gwen Wilkinson, the district attorney for Tompkins County who helped lead the committee that formulated the plan, said after its release that she was “prouder than ever to be an Ithacan.”

Graphic | How the Epidemic of Drug Overdose Deaths Ripples Across America Drug deaths have surged in nearly every U.S. county, reaching a new peak in 2014.

And Assemblywoman Linda B. Rosenthal, a Democrat who leads the Committee on Alcoholism and Drug Abuse, has endorsed the proposal for the injection facility, saying she would work on legislation to allow it.

Mr. Myrick, a 2009 graduate of Cornell who was elected mayor at 24, said the injection site would address three problem areas: slowing the transmission of blood-borne diseases like hepatitis and H.I.V.; reducing the public nature of heroin addiction, with people increasingly shooting up in parks and public bathrooms; and creating “pathways” to treatment.

Addicts would be allowed to carry small amounts of heroin into the injection center where a nurse would explain treatment options. They would also have access to general health care, an important component, Mr. Myrick said, since addicts sometimes forgo medical treatment because of the all-consuming need for heroin.

“They will have just had their fix, so that won’t be their first priority, and they might say to the doctor there, ‘Actually my tooth has been hurting and I have puncture wound that has gone bad,’” Mr. Myrick said. “You can begin to treat the other physical things and get them prepared for their moment of clarity.’’

In Vancouver, the injection facility stirred controversy when it was first proposed as part of a comprehensive drug plan in 2001. According to Donald MacPherson, director of the Canadian Drug Policy Coalition, the addicts who have availed themselves of the program are 30 percent more likely to access treatment and other health services than those who do not.

Herebeorht Howland-Bolton, 26, a self-described heroin addict who has had three roommates die from overdoses, said the plan was “common sense.”

Mr. MacPherson, who was an informal adviser to the Ithaca committee, served as Vancouver’s drug policy coordinator from 2000 to 2009. The impetus for the program, he said, was about 1,000 fatal overdoses that occurred over six years in the 1990s. Medical staff at the city’s two injection sites use both oxygen and the medication Narcan to reverse an overdose.

“There are lots of people who have gotten much better,” he said, referring to addicts who used the injection facilities. “They’ve gotten onto methadone and into housing. It’s a place of empowerment.”

In Ithaca, Herebeorht Howland-Bolton, a 26-year-old self-described heroin addict with a shock of auburn hair, said he would welcome a place to use heroin under the watchful eyes of medical staff. He started using heroin when he was 14, has been in and out of jail 16 times and through rehab twice. In mid-February, he overdosed on heroin and wound up in a hospital.

“It’s common sense,” he said, after visiting a needle exchange program here. “You give somebody the option to save their life. My last three roommates have died from overdoses.”

Mr. Myrick said he was gratified that the proposal had ignited a discussion. The idea to devise a citywide drug plan was prompted, in part, by his own experience. His father was a crack addict when Mr. Myrick was born, robbing him of a critical role model. His father now lives in Florida, and while Mr. Myrick has occasionally heard from him in the past few years — after 15 years of “radio silence” — he has not set eyes on his father since he was 6.

“I learned at a very young age that this was a disease and that it was a powerful one,” he said. “I’m just glad people are talking about it. This has been a quiet epidemic for far too long.”

No comments: