Monroe County Executive Cheryl Dinolfo announced a new Monroe County Opioid Action Plan to combat the nationwide heroin and opioid crisis in our area. Dinolfo was joined by Monroe County Public Health Commissioner Dr. Michael Mendoza, experts in the medical community, County Court Judge John DeMarco, Sheriff Todd Baxter, and on behalf of District Attorney Sandra Doorley, Matthew Schwartz, Chief of the Special Investigations Bureau.
"The sad truth is that everyone knows someone who has been impacted by opioid addiction. It could be the student athlete who ends up hooked on a prescription they were given for a sports injury, the son or daughter who takes an expired prescription from the medicine cabinet, or any number of everyday families here who have been devastated by this deadly crisis," said Dinolfo. "That is why we are today launching our Opioid Action Plan, a wide-ranging approach that recognizes the important role that county government can play in supporting prevention, treatment, recovery and law enforcement moving forward."
The opioid crisis has placed a significant financial burden on local governments and taxpayers. Earlier this month, Monroe County retained the counsel of Simmons Hanly Conroy, a national law firm with extensive experience in large-scale opioid litigation. The firm today officially filed a lawsuit against several makers and marketers of opioid drugs in New York State Supreme Court on behalf of Monroe County.
"The opioid epidemic has taken a heartbreaking human toll in every corner of our community and has placed a significant financial burden on local taxpayers," said Dinolfo. "Monroe County today officially filed our lawsuit against the makers and marketers of opioids who fanned the flames of addiction across our nation. We intend to hold these companies accountable for their actions in order to recoup costs for taxpayers and reinvest in increased prevention, treatment, and enforcement moving forward."
With the assistance of Simmons Hanly Conroy, Monroe County will now begin calculating its costs associated with the opioid crisis in the areas of treatment, healthcare, criminal justice, lost productivity, and more.
The defendants cited in the lawsuit are: Purdue Pharma L.P.; Purdue Pharma, Inc.; The Purdue Frederick Company, Inc.; Teva Pharmaceuticals USA, Inc.; Cephalon, Inc.; Johnson & Johnson; Janssen Pharmaceuticals, Inc.; Ortho-McNeil-Janssen Pharmaceuticals, Inc.; Janssen Pharmaceutica, Inc.; Endo Health Solutions Inc.; Endo Pharmaceuticals, Inc.; Insys Therapeutics, Inc.; Dr. Russell Portenoy; Dr. Perry Fine; Dr. Scott Fishman; and Dr. Lynn Webster. The lawsuit alleges the defendants sought to create a false perception in the minds of physicians, patients, health care providers and the public that using opioids to treat chronic pain was safe for most patients and that the drugs' benefits outweighed the risks.
This filing follows similar action taken by Simmons Hanly Conroy on behalf of 11 other counties in New York. The lawsuits, which were filed in each county’s state supreme court, have been consolidated in Suffolk County Supreme Court and are being heard by State Supreme Court Justice Jerry Garguilo.
The lawsuit will have no net cost to the County.
Through the new Opioid Action Plan, Dinolfo asked Monroe County Public Health Commissioner, Dr. Michael Mendoza to convene a new advisory panel with a goal of identifying and removing barriers for those seeking treatment for heroin and opioid addiction. The Commissioner’s Advisory Panel on Opioids will include leading local medical experts, who will share their insights and suggestions on how to better improve treatment services in our area.
"More can and should be done to remove barriers for those who are seeking treatment for opioid addiction," said Dinolfo. "I have asked Dr. Mendoza to convene a brand-new Advisory Panel on Opioids, where some of our area’s foremost medical experts will share their opinions and suggestions on how we can better improve the continuity of treatment in our community. I am grateful for the leadership of Dr. Mendoza and Drs. Grams, Kamali, Akmese, and Russell, plus the many others who will volunteer their time and talents to this important cause."
The Commissioner's Advisory Panel on Opioids will be comprised of two committees. The first will examine emergency and urgent care and will be co-chaired by Dr. Keith Grams, Chief of Emergency Services for the Rochester Regional Health System, and Dr. Michael Kamali, Chair and Professor of Emergency Medicine for the University of Rochester Medical Center. The second will examine primary and transitional care and will be co-chaired by Dr. Fatma Akmese, Medical Director of Federally Qualified Health Centers for the Rochester Regional Health System, and Dr. Holly Russell, Co-Director of Addiction Medicine for Highland Family Medicine.
Now that the panel has been convened, Dr. Mendoza and his Committee co-chairs will be identifying and contacting other local medical professionals to seek their participation.
- Monroe County Department of Public Health
- Rochester Regional Health System
- Emergency Medicine for the University of Rochester Medical Center
- Highland Family Medicine
Update: The Department of Public Health will also expand access to Suboxone training for primary care providers in both major health networks in Monroe County – University of Rochester Medical Center (URMC) and Rochester Regional Health (RRH). Working with colleagues on the Commissioner's Advisory Panel, Dr. Mendoza will support and expand existing training efforts with the goal of increasing the number of clinicians able to prescribe medications like Suboxone for medication-assisted treatment (MAT). Additionally, Dr. Mendoza will work with practices to address barriers to prescribing MAT for those who are already certified.
Monroe County has already begun conversations with local partners in law enforcement, EMS, and the public safety community with a goal of streamlining and centralizing overdose data, some of which these agencies may be collecting during the course of their normal duties already. Those conversations have centered on learning more about what data is being collected now, if data can be better shared across agencies, and how that data could be consolidated and coordinated to help guide our community’s response to the opioid crisis.
"Data continues to be an important tool in the fight against addiction. Statistics show that a person who is treated for a heroin or opioid overdose is five times more likely to die from an overdose later," said Dinolfo. "The first step is identifying what data is available now and if the County can play a role in consolidating and sharing that data with our partners. Then we will develop ways to collectively use that data to combat the crisis, whether through education and awareness, treatment and recovery, enforcement and prosecution, or advocacy."
However, certain legal barriers may prevent the sharing of select opioid overdose data, including some HIPAA privacy standards. Under the Opioid Action Plan, the County will be working to identify any unnecessary regulations that prevent the collection and coordination of this data and will then take recommendations to federal and/or state policymakers and advocate for changes to the necessary laws/regulations as soon as possible.
Update: The Monroe County Department of Public Health is also expanding its existing outreach efforts to include individuals who have recently survived an overdose, locating them using data provided by law enforcement and integrating those data with clinical data made available by local hospitals. As part of the outreach, Public Health staff will make Narcan available, as well as provide information and connection to long-term treatment and recovery options beyond the scope of short-term detox beds. By promoting long-term recovery, individuals struggling with addiction can access a wider array of services intended to break the dangerous cycle of relapse.
The opioid crisis has triggered a surge in postmortem toxicology cases handled by the Monroe County Medical Examiner’s Office, a trend reflected in Medical Examiners Offices all across the nation. To address this challenge, Dinolfo’s 2018 County Budget reflects funding to support the hiring of two additional Toxicologists in the Office of the Medical Examiner, which will be added to its fully-staffed toxicology department. These new Toxicologists will help offset growing caseloads and accelerate the completion of postmortem toxicology reports.
The increased staffing will also complement the County’s previously announced Medical Examiner Fellowship Program, an innovative collaboration with the University of Rochester. Under the program, fellows employed with the University of Rochester will spend a full year at the Monroe County Office of the Medical Examiner under the tutelage of Dr. Nadia Granger. The Fellow will receive hands-on experience in forensic pathology, odontology, anthropology and forensic toxicology.
Currently, residents at the University of Rochester hoping to pursue a career in forensic pathology must look elsewhere to conduct their mandatory one-year Fellowship. The Monroe County Fellowship will be only the second in New York State and the first in Upstate, as the only other Forensic Pathology Fellowship Program in New York State is located in New York City.
Update: As of Spring 2018, the hiring of two additional Toxicologists to work in the Office of the Medical Examiner has been completed.
Monroe County has already taken an aggressive approach to combating the opioid crisis by investing heavily in awareness, education, and prevention. In the past six months alone, the Monroe County Department of Public Health, in partnership with the Monroe County Legislature, has hosted over a dozen informational seminars in local school districts.
Launched in 2016, the program has attracted significant interest from parents, teachers, and students who attend to hear panelists from the Monroe County Sheriff’s Office, the Monroe County Public Health Department, and other agencies. In addition to local schools, Monroe County will also be expanding these presentations to other community partners in 2018, including the Rochester Public Library, the Chamber of Commerce, Lollypop Farm, the Rochester Rotary, local churches, and more.
Update: To date, Monroe County has conducted more than 100 informational seminars for school districts, businesses, local governments, businesses, non-profit organizations, and county residents.
Under the new Opioid Action Plan, the Monroe County Department of Public Health is expanding the availability and use of Narcan, a safe and effective emergency nasal spray that can be easily administered to stop an opioid overdose.
"In many cases, Narcan can mean the difference between life and death at a time when seconds count," said Dinolfo. "Through our Opioid Action Plan, Monroe County is expanding the availability and use of Narcan, along with training on how to safely administer it. These seminars will be open to anyone who is interested and there is no cost at all to participate."
The Monroe County Department of Public Health will provide Opioid Overdose Prevention Training, typically on the fourth Wednesday of the month, with sessions both in the morning and evening. Training is open to the public and there is no cost. The sessions are hosted by the Monroe County Health Department at 111 Westfall Rd, in Room 142. Participants will learn how to administer the new single step Narcan (Naloxone) and also how to utilize Narcan standing orders in pharmacies. A prevention kit will be provided to all participants.
Update: To date, more than 1,000 Narcan kits have been distributed to residents, businesses, and other organizations throughout Monroe County.
Monroe County in partnership with Supervising Judge John DeMarco and the Rochester Drug Court has recieved a $1.8 million state grant that would help to support a Opioid Response Partnership in our region. The program expands case management services, creates a streamlined system for treatment and detox referrals, and enhances access to and quality of treatment for low-risk, non-violent defendants who are diverted to Drug Court.
"The Rochester Drug Court has a proven record of lowering recidivism, reducing crime, and improving outcomes for those it serves," said Dinolfo. "This grant would be a welcome complement to the Court’s already impactful programming and I hope to see it come to fruition in the near future."