SULLIVAN COUNTY, NY — Three years ago, Sullivan County joined the nation’s largest-ever community-based study of addiction. The county is in crisis.

Sullivan County has the highest per capita rate of fatal drug overdoses in New York State. In 2022, the rate was 49.5 per 100,000 people, 108 percent higher than the statewide average. That year, Sullivan County reported 218 overdoses, including 24 deaths.

And according to a recent grand jury report on the death of an infant in Liberty last year from an overdose of fentanyl mixed with xylazine, Sullivan County has the state's highest number of per-capita drug-addicted babies: 57.1 out of every 1,000 babies are  born positive for drugs or with a neonatal abstinence. The next-highest county, Oswego, isn't even close at 45.9 per 1,000.  In Broome County, which is small like Sullivan, the number is 31.9.

The Sullivan County Drug Task Force, made up of community stakeholders, gathered just before the new year. The group is organized under a pillar system, which recognizes that the many facets of the drug crisis. Under each pillar, experts work on one specific aspect, whether education, policy, treatment, or law enforcement.  

Sullivan County has participated in the HEALing Community Study via Columbia University. Intervention leader Tim Hunt of the Columbia University School of Social Work said the study is being conducted in 67 counties across four states. As the study comes to a close, the task force met to reflect on its progress.

Bringing lifesaving medication closer

Camille O’Brien, the HEALing coordinator, said the benefits of participating in the study include better data collection, wider research, more capital investment, and multiple new harm reduction interventions.

One priority of the study has been to widen the distribution of Naloxone, a quick-acting medication used to treat overdoses. Although it is not a cure for substance use disorder, it is a vital tool in reducing harm.

The Naloxone boxes installed around Sullivan County resemble fire alarm boxes.

“Those Naloxone boxes have saved four lives in the past month and a half," said Melissa Stickle, deputy commissioner of the county’s Health and Human Services. She said the preliminary data from Sullivan County, which is subject to change, says 381 Naloxone kits were distributed and 307 people trained in its use from March to November.  

More than 50 Naloxone boxes have been installed throughout the county, and plans are to install some 110 more. Naloxone boxes offer anonymous and proximal access to life-saving medication. There have been 15 refills, indicating the medication is reaching people, according to the preliminary data.

But Naloxone cannot save people who have overdosed on the latest scourge, xylazine, a tranquilizer that is increasingly mixed with fentanyl for an especially toxic dose, as in the case of the baby who died last year (see related story).

‘No wrong door’ for help seekers

John Liddle, the commissioner of Health and Human Services, talked about the addition of Unite US, which he described as a “closed loop referral network where folks come and present to any member of the network with any challenge they might have that’s health and human service related.”

He said the top five issues are housing, family services, behavioral health, food insecurity, clothing, and household goods.

The intention, he said, is that people in need can “truly come in and have no wrong door where they enter to get assistance from various health and human service agencies and private providers in our community.”

The county says the service is currently funded by the Healing Communities Study grant, distributed through Columbia University, but that it will be funded with opioid settlement funds in the future.

Garnet Health, the county’s largest medical provider, will join the Unite Us network soon, Liddle said.

Unite US does not charge not-for-profit agencies to join the network, and referral services come at no cost to clients and patients.

The final data, once compiled and released, can be used to improve the task force’s work. And although the funding and services the study provided will no longer be available to the county, Health and Human Services will sustain the programming and services for the established pillars, even without the study, Stickle said.

From study to real life

Stickle, of Health and Human Services, pointed out the interconnected nature of housing and the opioid crisis. She positioned the task force to think about housing solutions, starting with the Treatment Program Pillar. The focus for the coming year will be on creating transitional housing options.  

Stickle said there should be a peer serving on the mobile crisis team who is familiar with both substance abuse and mental health. “We have a whole host of services that can be available in the community, but if you don’t have anyone to provide them, that’s a big issue,” she said. “So the conversations have been about not only attracting a workforce to the county but having housing for the workforce.” 

Stickle said in an email to the River Reporter that HEALing was funding Naloxone boxes, vending machines, and website design, and that there are no further expenses associated with these items. As for the Unite Us platform (see sidebar), Stickle said, “Ongoing funding will be through opiate abatement funds and/or other possible funding streams as it becomes more widely used.” 

One of the data specialists on the study, Dan Webb, said the challenge of the transition out of the study is “making sure we are able to sustain these activities perhaps in lieu of funding from Columbia University or federal funding, those sorts of things — or on the flip side, trying to get more funding through the use and leveraging of the data we’ve collected through this study.” 

O’Brien, the HEALing coordinator, said a major outcome of the study is the website, which centralizes county information on opioid treatment, education, resources, training, and volunteering.

Stickle credits the study for the task force’s interdisciplinary approach. “When the healing community study first came on, the first year wasn’t so bad, the second year was very, very difficult,” she said. “We were short-staffed and had a lot of problems, but what we found was everyone in this community is very passionate, everyone sitting at this table here and in the audience. We care about people, and everyone was doing their thing, but it was like herding a bunch of wild cats and trying to get everyone on the same page. This study actually helped do this for us and gave us a really clear direction.”

SOURCES

Sullivan County Social Services: https://sullivanny.us/Departments/familyservices

United Sullivan: https://unitedsullivan.com

The HEALing Community Study, Sullivan County: https://www.healingcommunitiesstudy.org/communities/nysullivan.html

The HEALing Community Study, Columbia University: https://sig.columbia.edu/research-projects/healing-communities-study

This story was corrected on January 17 to reflect the accurate number of years, 3, that the county participated in the HEALing Community Study. Originally it said  1.