White, middle-class America has been rightly accused of neglecting the problems besetting people of color and families in poverty. The opioid epidemic has served as a wake-up call for complacent suburbia as this is a scourge that knows no class boundaries.
The state Department of Health reports that opioid-related deaths in Monroe County totaled 20 in 2003. While dramatically less than the 159 deaths reported for 2016, Monroe’s 2003 rate was already fourth-highest among New York’s 20 largest counties. Nor is the opioid epidemic particularly severe in New York City, as many upstate residents might assume.
Upstate rates of opioid deaths far exceed the rates experienced in New York City’s largest boroughs—Brooklyn, Queens, Manhattan and the Bronx. More suburban Staten Island reports rates comparable to large upstate counties. Neighboring Erie County (Buffalo) has been worst hit by the epidemic.
The problem is labeled an epidemic for a reason: The growth in the rate of deaths due to opioid overdoses is, frankly, terrifying and has properly spurred a strong response from public health authorities. As the chart below shows, the rates in Albany, Onondaga, Monroe and Erie counties were roughly comparable in 2010 but have risen and diverged since. (Note: For comparability across counties, the figure shows opioid-related deaths per million population, not the number of deaths.)
As a member of the Health and Public Policy Committee of the NYS Chapter of the American College of Physicians I have traveled many times to Albany to meet with the Assembly and Senate powers that be regarding what is now the iSTOP registry of all controlled substance prescriptions in NYS — the viewpoint being that such regulation would only lead to increased usage of uncontrolled street drugs. Voila!
Couple this with increased heroin production and lax police enforcement and you have our current situation — heroin is cheap and readily available on the streets. An in-depth look at the opioid crisis statistics demonstrates that most of the increased deaths result from heroin overdosing.
Not to neglect the increase in deaths attributable to non-heroin opioids — also now cheaper on the street than they were in comparison year 2010.
When the majority of opioids were via physician prescription there was a huge check in place regarding prescription provision and medication usage — i.e. the physician. Having removed the physician from the equation we are now dealing with what is not just an opioid crisis but more accurately a street drug crisis with no controls.
The “cure” lies not with providing antidote Naloxone to anyone who knows an addict, nor in pouring money into rehab facilities, nor in a narcotics court, but rather in national police enforcement of the importation, transportation, and distribution of heroin and other opioids for street sale and consumption.