MONTICELLO, NY — The fight against the opioid crisis requires participation from a wide range of community groups. 

Rep. Marc Molinaro recently held a roundtable with groups across the Sullivan County spectrum to discuss the county’s response to that crisis. 

During Molinaro’s time as county executive, Dutchess County built a network of community services to combat the opioid crisis there, including a dedicated support help line and a stabilization center. The network offered education and training about substance use disorders to the people in the community best positioned to help, from pharmacists to security guards, from doctors to public school janitors. 

The opioid crisis was “likely the public health crisis of our lifetime,” said Molinaro. “If it were not for COVID, this would be the only thing we’re talking about in the sphere of public health.”

On September 5, Molinaro discussed his experience, and asked Sullivan’s partners what they needed to make a difference in the community. 

Outlining the problem

Assemblywoman Aileen Gunther emphasized the importance of long-term support and treatment. 

“We always have to remember it’s an illness,” said Gunther. “People don’t want to be addicted.”

The different approaches to the opioid crisis, represented by the multiple groups—called pillars—represented in the Sullivan County Drug Task Force, all have importance, said Sheriff Mike Schiff. 

Drug dealers need to be arrested, and the district attorney’s office needs funding to prosecute them, but the law enforcement pillar isn’t the only crucial one, said Schiff; there’s a mental health component, a rehabilitation component and a follow-up component to the issue as well. 

“We can’t arrest our way out of this situation,” added undersheriff Eric Chaboty. He emphasized the importance of educating the county’s youth about the dangers of addiction. 

Acting district attorney Brian Conaty highlighted the dangers of fentanyl, and said his office had an initiative in place to target the people causing overdoses and to get their product off the streets. 

The county also needs more treatment and rehabilitation resources, said Conaty. Insurance often covers less than a month of treatment, even when people need a much more extended course of rehabilitation. 

The county needs to start talking about why there’s a demand for substances in the first place, said Martin Colavito, representing Sullivan Allies Leading Together (SALT). 

Colavito has seen an epidemic of evictions, often executed without proper legal authorization: “if somebody’s homeless and they’re in pain, why wouldn’t they use?”

“From the emergency medical services side, I think what we’re seeing is fatigue, first-responder fatigue,” said Alex Rau, EMS coordinator with Sullivan County. “[Responders] are going continually to the same addresses, [for] people that are using over and over.”

Mental health and opioid calls have been a huge segment of the community’s 911 calls in the past few years, said Rau. 

Matthew Kleman, representing Action Towards Independence, spoke to the stigma of substance use disorders. Many of the vets that Kleman deals with believe that no one is out there trying to help, even though that’s not true, he said. 

Housing and transportation are two areas where people especially need help, Kleman added. 

Camille O’Brien, representing the Sullivan County Drug Task Force, emphasized the importance of supportive housing. People are more resistant to treatment “if they know they’re going to come back to the same housing, the same situation, the same friends, the same family that gave them the reasons to use in the first place,” she said. 

O’Brien also mentioned the lower medical reimbursement rates that apply to Sullivan County compared to its peers, making it harder for medical providers to operate. 

Sullivan County Coroner Alan Kesten described the importance of collaboration between different agencies working to address opioid issues. “We collectively, around the table here, have identified every one of the individual problems. I don’t think we have collectively figured out how to address any of them.”

Kesten advocated as well for a change in the state law to combat the first-responder fatigue described by Rau. If ambulance crews could take people to the hospital once they administered NARCAN, even if the person affected didn’t want to go, that person could have a better chance of ending up in treatment. 

Last year was the first year that showed a decrease in the number of overdose deaths nationwide, said Martin Kron, an addiction psychiatrist with Garnet Health. “The belief is that that’s due to the role that naloxone played.”

Kron emphasized as well the importance of peer support and of supportive housing. 

Rob Doherty, Sullivan County Legislature chairman, focused on tallying up the county’s resources. “What do we have? What are our assets? What are our limitations?” he asked. 

Doherty said it was important to reach people at the point in their lives when they tended to fall into addiction. 

Lindsay Wheat, representing Sullivan 180, reemphasized the concept of supportive housing. 

Volunteers do a great job of getting people in to treatment, Wheat said, but “after they’re let out, they’re right back where they started.” Currently, these efforts take place at stabilization centers out of county, she said; it would be incredible to have something closer available for use. 

What’s next?

Molinaro closed the roundtable by identifying specific action points with which his office could help. 

Conaty requested additional information about the High Intensity Drug Trafficing Area (HIDTA) designation recently received by Sullivan County, and about the resources that designation unlocks. Molinaro said that his office could arrange a training session on that designation. 

In addition, Molinaro offered to arrange a visit for Sullivan County officials to go to the Dutchess County stabilization center, to meet Dutchess County officials and see if they could learn anything from Dutchess County’s model which would work in Sullivan.