Monroe County Sheriff Todd Baxter and Gates Town Supervisor Mark Assini are calling for the appointment of a full-time opioid czar.
Last Friday, Assini shook up the bimonthly meeting of the local Opioid Task Force. Assini railed against what he perceives as a lack of leadership and a losing fight against heroin. Several members of the task force told WXXI News that Assini's outburst was "jaw-dropping."
Jennifer Faringer chairs the task force and says it was like a bomb hit the room.
“It was shocking," Faringer said. "I have never seen anything like it, and it was out of line, and it was attacking all of the blood, sweat, and tears of every person in that room. And you could see tears in the eyes [of task force members]. Our meetings are congenial and supportive. This was unprecedented.”
The task force includes members from law enforcement, treatment and recovery, the medical community, and more. Assini says he did not intend for members to be offended.
“If they are, I am so deeply sorry," Assini said. "I know you care so very much, and I mean that sincerely. I was not intending to insult you. But when I sit in a meeting, and I ask a question like, ‘How many beds do we have? And how many do we need to meet the need of the detox community right now?’ We need a lot of detox beds. How many do we have, how many do we need? And they say, ‘We don’t know,’ that’s not the right answer.”
Faringer says compiling data on available beds is complicated because there are multiple definitions and medical standards. She’s calling on the county and service providers to compile their numbers.
“I don’t believe it’s the crux of the problem," she said. "It’s not the focus of the task force. Our focus is to ensure immediate access, but I get the need to understand beds. So it’s something we will have. It’s not impossible. How useful it will be is questionable, but it’s not something that’s impossible to have, so [Assini's] statement is basically not correct.”
Other members of the task force took a different view, saying that detox beds are a critical component in providing care for people who are moving into recovery. Sheriff Todd Baxter believes that tracking open beds is vital to preventing relapse, and he says it’s time to coordinate data.
“We should know how many beds, and we should know where those beds are," Baxter told WXXI News. "We should have a tracking board, just like we do with emergency rooms. We know who’s red, we know who’s green, so we don’t take people to the wrong emergency room when they’re full.”
David Attridge is executive director of Recovery NOW New York. He was at the Friday task force meeting when Assini went off.
“I think the reaction was – from some people was, ‘Great, let’s talk about some action,’” Attridge said.
Attridge has driven patients all the way to Utica when he couldn’t find available beds locally.
“We don’t have enough beds for detox, and I know they have a waiting list of over a hundred people," he said. "To be able to take somebody, put them through detox, and then say, ‘Sorry, we don’t have anywhere for you to go after that seven days.’ You know, we have a lot of relapse, which is a waste of money, which is a waste of time. It’s not doing anything for anybody.”
Attridge also stressed that local towns are resistant to allowing more detox beds. With better information collection and sharing, Attridge believes that the recovery community can make a stronger case to towns.
Assini says there has to be a single leader in charge, and currently there's no centralized leadership.
“You need a general," Assini said. "You need somebody who is creating strategy, how to defeat a problem – in this case, the opioid crisis.”
Sheriff Baxter agrees.
“We need a drug opioid czar in this county to say, ‘I’m in charge,'" Baxter said. "And people can look to that person for resourcing, for command and control, for direction, for prioritizing what to do next. We need a quarterback. It’s really that simple, or else we’re going to be chasing our tail for a long, long time.”
David Attridge says a drug czar could more quickly get information, like detox bed numbers and availability, and share them across agencies.
“I think we needed somebody in that leadership role a long time ago," Attridge said. "It still infuriates me that the county waited until, you know – there’s probably been over 300 deaths in the last two years – to actually come out and say, ‘Oh, we have a problem.’ Whether it’s drug czar or whatever they call it, it’s needed. We have to have it.”
Monroe County released a statement to WXXI News, saying, “It’s possible the Supervisor [Assini] missed it, but last Wednesday Monroe County unveiled a new Opioid Action Plan designed to combat this nationwide crisis in our community. From prevention, to treatment, to law enforcement, the multi-part Plan promotes a comprehensive approach.” The county also touts the new physicians’ advisory panel that will be convened by County Health Commissioner Dr. Michael Mendoza.
Assini said he's aware of what the county is doing; he's simply not moved by it.
“I’ve done business plans," Assini said. "I assure you, that’s well meaning – they care very much, and I’m so grateful for all their help. But that is not a business plan. That is not a strategy.”
Baxter supports the county’s efforts, but believes an opioid czar could help pull it all together.
“It’s a plan," Baxter said. "It’s definitely a plan. There are actionable items. But again, who’s in charge of that plan? Who’s going to be held accountable if it doesn’t get fulfilled?” The sheriff added that he believes everyone working on the opioid epidemic are "heroes” – from the county executive to treatment providers.
WXXI News spoke to roughly a dozen members of the task force and found a split on whether a drug czar is needed.
"I would be worried about having one person’s perspective or approach versus a collaborative effort and voice," said Yana Khashper, co-founder of ROCovery Fitness. "With so many entities involved in the task force and so many interesting and unique perspectives, having a drug czar might not be in the best interest in our collective effort in the fight against addiction."
Jennifer Faringer says that a drug czar is an over-simplification of a complicated community problem.
“I think it’s not particularly effective," Faringer said. "It could take the sole focus of, ‘We’ll solve this problem by doing X,’ when in fact you need A, B, C, D, E. You need all of the partners.”
If community leaders agree that an opioid czar is needed, there's no clear path to choosing and hiring that person. Attridge said that Assini could fit the role, but the Gates town supervisor told WXXI News that he is not "actively campaigning," and prefers Dr. Michael Mendoza for the position.
"He's absolutely suited to the job," Assini said. "I would do it if asked, but there are others who are more capable. But I wouldn't turn it down."
Sheriff Baxter suggested Dr. Jeremy Cushman, the county's emergency medical director. "He's got all the qualities," Baxter said. Dr. Cushman could not be reached for a response.
Monroe County spokesperson Jesse Sleezer explained that Dr. Mendoza already spends the majority of his work hours on the opioid crisis, and has stepped into a leadership role. Sleezer stressed that the new physicians’ advisory council will bring a wealth of experience and knowledge. He urged all stakeholders to take a closer look at Monroe County's recently released plan.
Sleezer also pointed out that despite its name, the Monroe County Opioid Task Force is not run by county government. The task force is headed by the National Council on Alcohol and Drug Dependence, Rochester Area.
Faringer vows that, drug czar or not, the task force will remain focused and united.
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