♪♪

>> Funding for the

"Long Island Business Report"

has been provided by...

The JPB Foundation

and the Ford Foundation.

>> Hello, and thanks for joining

us.

I'm Jim Paymar with the

"Long Island Business Report."

The opioid crisis is one of the

most traumatic issues facing

Long Islanders today.

In 2017, statistics show that

the opioid crisis claimed the

lives of at least 600

Long Islanders.

And the numbers continue to

rise.

What can be done to deal with

the devastation caused by

opioids?

As part of our ongoing reporting

initiative, "Poverty and

Opportunity in America: Chasing

the Dream," we're looking at the

challenges created by the opioid

crisis on Long Island.

Here to discuss the crisis is

Dr. Jeffrey Reynolds, president

and CEO of Family and Children's

Association, and

Krystle Stoddard, peer-support

specialist and recovery coach at

Thrive Long Island.

Jeffrey, Krystle, thank you both

for being with us today.

This is just devastating

Long Island, family after

family.

It just seems like no one

remains untouched.

Everyone knows someone who knows

someone who has been impacted by

opioids.

But I don't think that people

really understand what opioids

are all about and what a wide

spectrum of drugs they really

are.

Jeff, can you give us an

explanation?

What are opioids?

>> Absolutely.

And over time, I think it's

really evolved.

Initially, when we were talking

about this crisis, we were

talking about prescription

painkillers, things like

OxyContin and Vicodin and

Percocet.

And then we saw, with the

crackdown on prescription pills,

we started to restrict the

supply, and we saw a wholesale

move over to heroin, which, of

course, is much cheaper than

those synthetic opioid

medications.

And lately we've seen a huge

influx of fentanyl into the

community.

And fentanyl is much more

powerful than heroin.

It's not pharmaceutical-grade

fentanyl by any means.

It's typically counterfeit

fentanyl that comes to this

country from China.

And very often we see all three

in the mix, but over time we've

seen this gradual move from

prescription meds to heroin to

fentanyl.

I think all of us lie awake at

night, wondering what comes

next.

>> You know, but ten years ago,

you never heard the word

"opioids."

I mean, how did this all of a

sudden become an epidemic, not

just on Long Island but across

the country?

>> I think there's a few

reasons.

First and foremost,

pharmaceutical companies realize

that there is a whole lot of

money to be made in prescription

painkillers.

And the marketing was very, very

aggressive.

In the mid-1990s, we saw that

pain was added as the fifth

vital sign for folks receiving

medical care.

Hospital-discharge surveys were

based on that.

The marketing kicked in full

swing.

And at the same time, you had a

huge number of folks in this

country -- and it's still

happening -- who were beginning

to age out, who were gonna be

experiencing pain on a regular

basis.

We see folks with better access

to medical care who are getting

more procedures.

And so, I think it was the

perfect storm.

It's the marketing on the part

of pharmaceutical companies.

It's our quest to adequately and

comprehensively treat pain.

And let's face it.

We've got an aging population

that's more likely to rely on

these types of medications.

For some of those folks, these

pills are heavily addictive.

For 80%, probably not so much.

But for that 10% or 20% that

have struggled with addiction or

kind of are hard-wired along

those lines, these pills work

really great on physical pain.

Guess what?

They work even better on

psychological pain.

For a significant portion of our

population, that's the first

taste of normalcy for them.

Look -- there's nothing any of

us want more than to feel

normal, to feel like we fit in,

to feel like we had a good day.

And for a lot of folks,

prescription pills were the

answer to that.

>> And, Krystle, you used

opioids.

>> Yeah.

>> For a number of years and

became pretty severely addicted.

Can you tell me a little bit

about what happened with you?

>> Absolutely.

So, about ten years ago,

ironically, I was in the

restaurant industry, and

somebody said, "Hey, take this

pill.

It's gonna make you work harder.

It's gonna make you faster,

better."

And just as Jeff was saying, the

first time I took that Vicodin,

it gave me the warm, fuzzy

feeling.

It made me feel okay in my own

skin.

>> Uh-huh.

>> And I loved that feeling.

And from that day, I've been

chasing that feeling, no matter

what it took.

>> And it just made you feel --

>> Like everything was okay.

Like, "Where has this been my

whole entire life?"

>> And so, you wanted more of

that, obviously.

>> Of course, yes.

>> Did it become an everyday

thing?

>> Absolutely.

So, the first time I had taken

it, I ignited something inside

of me that I didn't even know I

had.

I didn't know I had the disease

of addiction.

I had no clue.

I would go out and drink with my

friends, but I was surrounded by

people who were doing the same

thing, so I didn't see it as a

problem.

When I took that first opioid,

that kickstarted this whole,

long journey in my life.

>> Well, how long did you use

opioids?

>> So, I used for about --

>> And was it always Vicodin?

>> No.

So, for me it progressed.

The disease of addiction is a

progressive, fatal illness.

So, for me, when I took the

Vicodin, I started to build up a

tolerance.

And with a tolerance, I looked

for stronger, quicker ways to

get or achieve that feeling that

I wanted that first time I took

one.

>> I see.

So, what did you jump to, from

Vicodin?

>> So, from Vicodin, I went to

taking more Vicodin, and then

someone introduced me to

OxyContin.

>> That's more powerful than

Vicodin?

>> It was very powerful, yeah,

very powerful.

And I know people that would

prescribe these OxyContin were

cancer patients.

It should not have been readily

available on the streets.

>> This is for people who are in

severe pain.

>> Exactly.

>> Right.

>> To relieve that pain.

For me, it gave me this high

that I was on top of the world.

>> Uh-huh.

>> And then it progressed to

these -- they're little blue

pills called "Roxies."

>> And Roxies are what?

>> Roxies are 30-milligram -- I

believe it's OxyContin just in a

different form.

>> I see.

>> Correct me if I'm wrong.

Okay.

So, these little blue pills --

that was it for me.

They gave me the opportunity to

take more and feel amazing.

>> Did you always feel amazing,

or don't you come down and crash

off of this stuff?

>> Well, I would take one thing,

and then I would have to take

another thing.

So, the effect that painkillers

had on me is it gave me energy.

It's different for every person.

But for me, it gave me that

little boost of energy that I

thought I needed to get out of

bed, to take a shower.

It became a point in my life

where I was so addicted that I

physically needed these pills to

get out of bed.

>> Uh-huh.

>> And that's sad.

It was sad, you know?

>> Did then it progress to

shooting up heroin?

>> So, I had lost someone that I

love very much in my life.

He was my best friend.

My best friend, Sean -- we were

neighbors.

He died of a heroin overdose,

and that was the first time I'd

ever heard of heroin, even

around my friends or anybody in

the community.

It was back in 2011.

So, when I was offered heroin, I

said, "No, I don't want to do

that.

I know I just lost someone I

love to that."

So, I did seek out some sort of

help back then, and when I went

into a facility, instead of

identifying with other people, I

compared, and I wasn't like

everybody in there.

I didn't shoot heroin.

I didn't smoke crack.

These are all things, like, I

thought I was better than.

I had this ego, where "That's

not gonna affect me."

>> Mm-hmm.

>> So, I convinced myself that I

wasn't even a drug addict or a

person with a substance-abuse

disorder because my story didn't

go as far as other people's.

But then I should have realized

then that it didn't have to.

>> Uh-huh.

>> But for me, I always called

that my "yets," like, these are

things I had yet to do.

>> Uh-huh.

>> And I never understood what

that meant until I didn't follow

a path of recovery.

I thought I had this thing

kicked, and I ended up picking

up again.

>> Picking up?

>> Using drugs again.

>> And shooting up?

>> So, it started out with the

Roxies again, the pain

medication, and the person that

I was using drugs with 'cause

misery loves company, she had a

history of using heroin.

And so, that's how I was

introduced to it.

And basically she was like,

"You're doing heroin already.

You're doing synthetic heroin.

Might as well just do heroin.

It's cheaper."

And it was easier to access at

this point.

This was in 2013.

It was everywhere.

It was unbelievable that I

couldn't get my hands on a

Vicodin or a painkiller or a

Xanax or anything.

It was like everywhere -- if you

want it, you'll find it.

But everywhere I went, that's

all that I was being offered.

>> Jeffrey, is it everywhere?

It just seems to have inundated

our society.

Kids in our own local high

school have died from this.

How deep is this and how

prevalent is this?

>> You know, Krystle's story

reflects the reality for a lot

of folks, that as long as you're

using prescription pills, they

have that medical veneer on

them.

"It's okay.

I'm using something that's

prescribed by a doctor."

And then you move over to heroin

because at some point in time,

the $40 Roxies, you need 3 or 4

of them in order to stay good

for the day.

And so, someone taps you on the

shoulder and says, "Look --

heroin is only 10 bucks a bag,"

and you're off to the races.

I think one of the reasons this

has spread so quickly is first

and foremost, here on

Long Island, we didn't recognize

this as a problem that was gonna

impact our kids.

Long Island has been a place

that has denied every social

problem it's been confronted

with until it's too late.

And this goes back to the late

1980s, when it comes to HIV, the

crack epidemic, homelessness,

poverty, you name it.

The common denominator here is

that we move to

white-picket-fence suburbia

believing that none of the

problems that impact

New York City can make their way

through the Midtown Tunnel.

And so, we always have this lag

time when we respond.

And addiction is one of those

things, in the individual or in

the community, that if you wait

to address it, it gets

progressively worse.

Layer on top of that delayed

response the fact that we're

talking about a cohort right now

that is between the ages of 20

and 35 that has a much wider

social network than you and I

might have, which means that as

your habit develops, what do you

do?

How do you finance your habit?

Well, you turn your friends on

to it.

And folks of that age have a lot

more friends than you and I

might.

And it spreads like wildfire

throughout the community.

We draw a lot of parallels to

social media, in part because

that's how deals are done.

But when you look at the spread

of social media and the spread

of substance-use disorders,

there's a parallel there, in

that if I'm a kid on a

cul-de-sac with a 10-bag-a-day

heroin habit, I'm selling to 10

or 20 of my friends.

Guess what?

That's what those folks are

doing, too.

And we've just seen this

mushrooming of the problem.

>> Where's it coming from?

Who's bringing it in here?

And is law enforcement doing

anything to stop it?

>> Yeah, well, I wouldn't sit

here and say law enforcement is

doing nothing, but it is

frustrating to me.

I see the TV specials and such

where there's all these border

checks and stuff.

I mentioned to you that I

recently left the country and

came back, and it felt like the

screening and the grilling and

all of that is pretty

aggressive.

Yet there's no shortage of

heroin on our streets, which

comes primarily from Mexico.

There's no shortage of

counterfeit fentanyl on our

streets, which comes from China.

And, in fact, there have been

reports that this stuff is

actually sent through FedEx in

the mail.

And so, there are zero problems

with supply.

And one of the frustrations I

think law enforcement has is

that every time you take a

dealer out, two more pop up in

his or her place.

That's because the demand is

there for this product.

If there was no demand, you

wouldn't have the supply.

And so, I think one of the

things the crisis has taught us

is that it's not law enforcement

versus treatment.

We all need to be working

together, and unless you

simultaneously reduce the supply

and demand, you're not gonna get

to the heart of this problem.

>> And, Krystle, from your point

of view, you were about, 20,

when you started?

>> I was 20 years old when I

started with the pain pills.

I started at 15 with drinking

and smoking marijuana.

But at 20, I was introduced.

>> And it was just easy for you

to get it?

>> Yeah, it was readily

available.

I worked in an industry where

it's kind of almost accessible

because that's the party scene,

a bar, restaurant.

So, I really didn't even have to

dig.

It was there.

People asked me if I wanted it.

>> And weren't you scared?

Weren't you afraid to do it?

>> Not in the beginning.

>> Weren't you concerned about

the repercussions?

>> Absolutely not.

At that point, that feeling that

I got from the pills, I felt

great.

I didn't care about anything

else in the world, and it

started to betray that in my

life.

All of my responsibilities -- it

started to affect my life

quickly.

And then, when I progressed to

the heroin use, I mean...

>> But did your life go

downhill?

>> Absolutely.

I had no motivation.

I didn't go back to college.

All of my other friends were

getting married, getting

engaged, having babies, buying

homes.

And here, my main focus in life

was getting up, how was I gonna

get what I needed to survive the

day?

How am I gonna work to get the

money to get the drugs that I

need?

And it was a never-ending cycle.

>> And how did you finally stop

using?

You went into recovery, and you

relapsed.

But then you went into recovery

again, and it stuck.

>> It stuck.

>> Why?

>> I just got to a point where

I was just done.

I was 29 years old.

I had a little bit of freedom.

Like, I knew that recovery was

possible.

I saw it happening.

It wasn't like that time in

recovery was wasted.

I did learn a lot.

So, I did know that there was

another way to live.

>> Mm-hmm.

>> And I know -- and we spoke

about this -- that help is the

hardest 4-letter word to say.

But it's the word that saved my

life.

>> And, Jeff, help -- where do

people go for help if you're

addicted, if you're using?

Who do you call? What do you do?

>> Yeah, see, the good news is,

there are a lot of facilities

here on Long Island that are

ready, willing, and able to help

you.

What I would say to that point,

and Krystle raised a really

important point, for most young

people, this starts with

alcohol, maybe nicotine, maybe

vaping in this day and age,

moves to marijuana.

There used to be that detour

into prescription pills, which

we see a little bit less of.

But this never starts with

heroin.

For some young people, they're

gonna drink and experiment with

marijuana and other drugs, and

then they'll stop at a certain

point.

For some people, they're gonna

go on to bigger and better

things.

If I had a nickel for every time

a parent said to me, "Well, my

kid smokes pot, they drink on

the weekends, but at least

they're not doing the hard

stuff," I'd be a pretty rich

guy.

The reality is that this is

something that happens gradually

over time, and it happens to

families gradually over time.

And what I always say to parents

is, as you begin seeing those

warning signs, as you begin to

see that experimentation happen,

that's the time to begin the

interventions.

That's also not the perfect time

to start education.

I believe that education on

these issues needs to start in

kindergarten.

In kindergarten.

>> Like, 5 years old.

>> Yeah, that doesn't mean we're

gonna show a 5-year-old a heroin

needle, but it does mean that

we're gonna talk about how

medication is for when you're

sick.

We are gonna talk about how to

express your feelings when

you're feeling depressed or

anxious.

We are gonna talk about how to

lean on a friend when you're

going through some tough times,

those core competencies.

Those core competencies are more

important than the ABCs of drug

use and substance use.

It's the ability to ask for

help.

And as that ramps up, that's

when you begin increasing those

messages.

The mistake we make and many

parents make is they have the

conversation first when that kid

comes home drunk for the first

time.

Our school districts say, "Oh,

the kids are going in to high

school.

We better pack them all into an

auditorium and try to scare

them."

>> Right.

>> That's what we did with

D.A.R.E. back in the 1970s and

1980s.

It didn't work.

So, honest, frank conversations

are really important.

From there, there's a certain

number of kids that will stop

using.

They'll go into college.

Something will happen, and

they'll stop using.

Some will say, "I can't stop."

They'll have a physical and a

psychological dependence on

those drugs.

That's where you need that

intervention.

Like I said, there's a number of

facilities here on Long Island

that are available.

There are 24/7 hotlines.

We even have some apps that are

available now.

I still think folks have some

barriers in accessing care.

But it's more available and

accessible than ever before, and

the key is intervening early,

like any other disease.

>> Now, you work in intervention

today, right, Krystle?

>> More or less.

>> You're helping other people

to get off of drugs.

>> Right.

So, I am a certified recovery

addiction coach at Thrive on

Long Island.

And Thrive is Long Island's

first recovery community and

outreach center.

So, we're unlike anything else

that is on Long Island

currently.

>> So, there's only one.

>> So, there's only one right

now.

We need 10 and 20 more.

>> And there's 3 million people

here.

>> Yeah, exactly.

And that's the problem that is

there.

But right now we do have the

one, and what we do is we are

all peer-run and volunteer-run.

So, if somebody comes in, and

they're like, "I really want to

stop using drugs and alcohol.

I have a problem.

I need help," luckily, because

we're nonclinical, we do have

LICADD in the building.

So, if they do need treatment or

detox, we do have the resource

in the building.

If they do just want to talk to

somebody, I'm able to meet with

them one-on-one and share my

experience, my personal journey

with them to let them know that

"It's okay.

You're okay.

There's still hope, and recovery

is possible."

>> But if they're getting that

high, warm, fuzzy feeling that

you talked about, how do you get

them to say, "All right, I'm not

gonna do it anymore"?

>> Yeah, well, I mean, for me

that feeling didn't last that

long.

I kept chasing that feeling.

And that's what a lot of people

that I know and have worked

with.

Everybody is always chasing that

first high, and you're never

gonna get that ever again.

>> Right.

>> Unfortunately.

>> Yeah, you get the first high,

and you're in seventh heaven,

and you think that every time

that you do it, it's gonna

happen again, and it doesn't

happen again.

>> You know, at first, it could

start out as fun, and you're

with your friends, and you're

partying, but at the end of the

day, if you play that out, it's

miserable.

>> Jeffrey, funding to open more

centers like Thrive, to get more

people like Krystle out there

working.

There was a press conference,

and Trump is cutting

$340 million from the opioid

fight.

>> Yeah.

>> How do we combat this if we

don't fund these kinds of

centers, help the people like

Krystle to help other people?

>> The short answer is, we

don't.

That's no way to fight a crisis.

This President spoke very

passionately about the opioid

crisis while on the campaign

trail, during the State of the

Union address, and in a number

of other venues.

Yet the walk doesn't match the

talk because what we see when he

produces budgets and proposes

budgets is cuts to every federal

agency charged with addressing

the opioid crisis and charged

with assisting folks with

mental-health disorders and

substance-use disorders.

At a state level, we've seen

more action than we had, and the

state is really making some

strong moves along these lines.

There's a part of me that says

this is all really good, but

we're really locked in a race

against time, and this requires

an all-out effort that includes

government, but it's not just

government on its own.

There's a whole bunch of things

that have to happen if we want

our communities to be safer.

Schools need to get more serious

about prevention.

Families need to have some hard

conversations.

The insurance companies need to

stop rejecting coverage for

folks who struggle with

substance-use disorder.

We need recovery centers.

We need recovery high schools.

That if we're gonna mount an

all-out effort that will not

only help us fix this crisis

but situate us better when the

next crisis arrives -- and there

will be another drug right

behind fentanyl -- then we've

got to make some fundamental

changes in the way we address

this crisis.

>> In brief, what's the economic

impact to a place like

Long Island of the opioid

epidemic?

>> Holy cow.

You're gonna talk to both

county executives, and both of

them will tell you the

number-one and number-two budget

items facing the county and the

number-one and number-two

problems are Medicaid

expenditures and law-enforcement

costs.

Both of those cost centers are

being driven by the opioid

crisis, that when you think

about the number of folks that

are showing up in emergency

rooms for three and four and

five overdoses.

>> We're talking tens of

millions of dollars.

>> It's incredible.

Think about the child-welfare

system, but think about this for

private industry.

Think about how many parents and

family members right now are at

work, not doing their jobs but

surfing the Internet, looking

for treatment, trying to reign

their kids in, trying to keep

them alive and talking to people

like us, in terms of "How do I

save my kid's life?"

There are families that do

nothing but that 24/7.

So, the loss to private

industry -- the petty crime, the

incarceration costs, the medical

costs -- are huge.

Solve this problem, and a lot

of the other costs disappear.

>> Right.

And, Krystle, what do you hear

from the parents and what do you

hear from people who are

addicted?

It must be just traumatizing.

>> I mean, it is, and it's

heartbreaking, you know?

I have parents who call us at

Thrive that desperately are

searching for help for their

child.

But at the end of the day, the

parent could do a million and

one things, but it's up to the

person who's suffering to make

that decision, like, "Hey, I

want help," you know?

My mom did everything that she

possibly could, but it wasn't

until I was ready to say,

"Enough is enough, and I don't

want to live like this anymore."

And it's heartbreaking.

>> And it must destroy families.

>> Absolutely.

>> Especially when you have

a death in the family of a

child.

It's just imponderable to me.

But what can we do as a society

to help stop this thing in its

tracks before it just sucks the

life out of us?

>> Well, I think everybody needs

to come together -- I think that

would be first and foremost --

and just take this as a serious

thing.

This is serious, and it almost

became a household name.

Like, heroin is now a

dinner-table talk.

And I don't know when that

happened.

People are so desensitized to

oh, you know, another person

overdosed and died.

I watch it happen.

People don't even blink an eye

anymore, and that is crazy to

me.

>> Jeff, gang-related?

Where's it coming from?

Is there a way to stop it?

We've had Prohibition in this

country.

We've tried to tamp out

marijuana.

We've never been able to stop

drugs from coming in.

>> Right.

I think the connection with the

gangs is a significant one

because the gangs, particularly

some of the gangs that are in

the news, are actually kind of

financing themselves through the

heroin trade, and they're

selling to white kids that live

just north of their communities.

>> And it's white kids.

>> It is.

This is a white, middle-class

phenomenon.

What I would say -- the other

common denominator is kids who

join gangs join gangs because

they want a sense of belonging,

they want a sense of family,

they want to feel good.

This all speaks to how we have

to do more with our young people

and more with the upcoming

generation.

When you look at a generation

that has seen a dramatic decline

in youth services, a dramatic

increase in poverty and

illiteracy, this says to me that

we need to do more to work with

our kids and our families than

we ever have before.

The gangs and opioid issues are

a symptom of a larger problem,

and the larger problem is

finding a way to get people

connected again very early on in

the game.

>> But how do we connect people

again?

It seems like society is just

splintered, splintered,

splintered.

Social media is taking us away

from each other personally.

We're on these things rather

than talking to people.

How do we get people to come

together and say, "Hey, look.

We got some serious problems

here.

People are dying.

Families are being destroyed.

Billions of dollars are being

spent on these drugs, and it's

killing the country."

>> Yeah.

We're starting to see it happen.

There's people like Krystle, who

I think really represent kind of

the new phase in the fight on

this.

And it parallels for me what

we're seeing among young people

in response to gun violence.

There's a new generation that's

kind of rising up and saying,

"Let's have an honest

conversation about what works

and what doesn't.

Let's push government to do the

right thing."

And so, I do see signs of hope,

and I see a whole, new -- you

know, we always talk about, and

I'm the first one to talk about

the 600 deaths that happened

last year.

We didn't talk about the

thousands of people who found a

path to recovery, did we?

That's celebrated very quietly

in church basements.

Maybe that's what needs to

change.

Maybe we need to talk about the

power of recovery, make sure

that people like Krystle have a

voice and make sure that we're

not only talking about the bad

stuff, but what's the good stuff

that's happening?

>> And, Krystle, the final word.

We're almost out of time.

What's the solution in your

view?

>> The solution is recovery.

I'm living a life beyond my

wildest dreams.

And I'm grateful to be a person

in long-term recovery.

>> So, seek out help?

>> Seek out help.

Ask for help.

Don't be afraid.

I still think there's a lot of

stigma and a lot of shame, and

people are embarrassed.

But there's nothing to be

embarrassed about.

It is a disease.

You're sick, and you just have

to get well.

>> And you can overcome?

>> You can overcome it.

Recovery is 100% possible.

There's always hope.

If you woke up today, there's

hope.

>> Okay.

All right, well, thank you both

so much.

We need hours to talk about

this, not a half an hour.

Well, that wraps up our

conversation about the opioid

crisis on Long Island.

And to learn more about the

"Chasing the Dream" Initiative,

please visit...

And for more on the

"Long Island Business Report,"

log on to our website.

And you can also find us on

Facebook and join the

conversation on Twitter.

I'm Jim Paymar.

Thank you for joining us for

this edition of the

"Long Island Business Report."

And we'll see you next time.

>> Funding for the

"Long Island Business Report"

has been provided by...

The JPB Foundation

and the Ford Foundation.

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