LOCAL

ITHACA PLAN: 'We must do something different'

Kelsey O'Connor
koconnor@ithacajournal.com | @ijkoconnor

Ithaca is moving forward with an approach to drugs and drug policy that crosses new territory for the city, New York and the United States.

Ithaca's new plan will target four areas, or "pillars," including prevention, treatment, harm reduction and law enforcement. It calls for a methadone clinic, more suboxone prescribers, a Law Enforcement Assisted Diversion Program, community development and many other changes.

One of the most controversial aspects of the plan is a Supervised Injection Facility, where heroin users could shoot up (their heroin) in a facility under the supervision of a nurse. It's modeled after successful facilities in Vancouver, Europe and Australia, but will face immense legal hurdles, as no such facility exists yet in the United States.

A 64-page report called "The Ithaca Plan: A Public Health and Safety Approach to Drugs and Drug Policy" was released Wednesday. It is the culmination of a year and a half of work after Mayor Svante Myrick convened a group of community experts and leaders in April 2014.

Ithaca Mayor Svante Myrick answers a question Wednesday morning during a news conference to announce a comprehensive plan to fight heroin and drug addiction.

"Two years ago, when I asked the community if they saw what I saw, and asked the community if they knew what I knew, which was two things," Myrick said. "First, we have a drug problem in this city. We have a drug problem in this country. Too many folks are suffering from drug use; too many people are dying from drug use. And they said yes, they saw that. But I asked them a second question: I asked them if people were also suffering, if people were dying, if people were struggling because of drug policy, and the failed tactics of a drug war that has cost this country billions of dollars, incarcerated people at a rate unheard of in human history, and used as a tool of oppression and racism and accomplished absolutely nothing. And the community said they saw that, too."

Myrick seeks backing for heroin facility

At the first presentation and discussion of the plan Tuesday night, the back theater of Cinemapolis in Ithaca was packed. Again Wednesday morning for the news conference, the Borg Warner Room of the Tompkins County Public Library in Ithaca was packed with reporters and community members.

Heroin is an epidemic in the Ithaca community, officials have repeatedly said. It is seen daily by people across the community, police officers, firefighters, EMTs, counselors and doctors at Cayuga Medical Center.

"We don't treat anyone at all until it's an emergency," Myrick said at the news conference.

According to the report released Wednesday, in less than 10 years, overdose deaths have more than tripled in Tompkins County, and drug-related hospitalizations now number 15.5 per 10,000 people, up from 14.4 during 2009-11.

The Municipal Drug Policy Committee, or MDPC, was charged to identify and describe the drug-related problems in Ithaca, and recommend policies and practices to adopt in response. As a result of the process, Myrick said, "We do have solutions now."

The solutions are a result of the work of about 40 committee members, 350 community members and dozens of others, Myrick said.

Police Chief John Barber, left, listens to Ithaca Mayor Svante Myrick during a news conference Wednesday morning to announce a comprehensive plan to fight heroin and drug addiction.

The Supervised Injection Facility falls under the harm reduction category. Myrick said Wednesday it is a strategy that he believes in "and will not back down from." While the strategy sounds outrageous, he said, it will save lives.

"This is a strategy that sounds as outrageous as the strategy that we came up with to provide sexual education to teenagers, something that was unthinkable in the '70s and '80s, something that people were just so sure were going to lead to more people having sex. Well, it didn't. What it led to was fewer people with illnesses, fewer people dying and fewer people with unwanted teenage pregnancies," Myrick said.

He said that same thinking led people to ignore the AIDS epidemic. "To allow people to die in their beds and to die in the streets because we did not believe that clean needle exchanges would send the right message. One hundred and twenty-five people will die in America today, today, from an opioid overdose. A hundred and twenty-five people will die in the streets and will die in their homes and will die in gas station bathrooms. That is the message we're sending. So, I would ask the critics and the cynics, what is your nightmare scenario? Because I'm living my nightmare scenario. This is the nightmare scenario. We must do better, and to do better, we must do something different."

The Ithaca Plan is that, Myrick said. Everything in the plan is based on science, rationale and data, he said.

The MDPC was co-chaired by Lillian Fan, of the Southern Tier AIDS Program, and Tompkins County District Attorney Gwen Wilkinson. She could not attend Wednesday, but Fan read a statement by her that said with the launch of The Ithaca Plan, Wilkinson is "prouder than ever to be an Ithacan, because we are a community willing to say 'No more war,' and to embrace a new approach to municipal drug policy."

Wilkinson's statement said law enforcement has carried the burden of dealing with substance abuse for years without sufficient tools to do more than arrest offenders and seize drugs.

"Now, law enforcement agencies are taking a new approach to direct drug users to find treatment outside the criminal justice system. The Ithaca Plan recognizes that addiction must be addressed as a public health issue and that treatment must be more accessible than jail," Wilkinson stated.

Ithaca will take on a Law Enforcement Assisted Diversion Program, or LEAD, which was piloted with success in Seattle. Essentially, the program would allow police officers, instead of booking a person on a drug offense and sending them directly into the criminal justice system, to divert them directly into the social service system, Myrick explained. According to The Seattle Times, LEAD has reduced the criminal-recidivism rates by up to 60 percent "for the poor, chronically homeless, low-level drug dealers, users and prostituted people."

With LEAD, officers will be able to direct people to treatment, housing and job placement programs.

Ithaca Police Chief John Barber said a lot of crime committed in the community — especially property crime — is related to addiction. He said he is excited about the idea of LEAD.

"It's a program that I think with effective funding, and with people on board who are willing to make a difference, it could work very well in our community," Barber said.

However, Barber is not supportive of the Supervised Injection Facility because he said he took an oath to uphold the law, and heroin is illegal.

"Right now, heroin is considered an illegal substance under the law, and I cannot condone any behavior related to the use of heroin, whether it's supervised or not," Barber said.

If the law changes to allow a Supervised Injection Facility, Barber said he will revisit his stance after doing more research. "We'll cross that bridge when we get to it."

A panel of people who deal with addiction in different ways in the Ithaca community addressed questions and their perspectives on new drug policy during the news conference. People from outside the community also have influenced the plan, including Donald MacPherson, of the Canadian Drug Policy Coalition, and Kassandra Frederique, of the Drug Policy Alliance.

Frederique, who is the director of the New York policy office, said Ithaca is the first in the U.S. to say, "This is what we want to do with drugs" and has the willpower to do it.

Fan, the co-chair of the committee, has worked in harm reduction in Ithaca for several years and has worked daily with people who use drugs. She said she has seen first-hand how harm reduction and compassionate care have prevented "illness and death."

"The recommendations within this plan are not new," Fan said. "Many of them have been used successfully around the world, and this is our opportunity to take their success and translate it into ours. We can do a lot for our community, and it starts here."

A new approach to Ithaca�s drug crisis

Miss the live press conference? View the full conference here.

Recommendations of The Ithaca Plan

Here's a brief overview of the plan's recommendations, which were made across five categories.

  • Governance and leadership — Goal: "Create a mayoral-level office tasked to reduce the morbidity, mortality, cost and inequities associated with illicit drugs and our current responses to them."
    • This recommendation calls for an Office of Drug Policy, which Myrick has said is the first step to implementing the full plan.
  • Education — Goal: "Key stakeholders and all Ithacans should have access to evidence-based practices and education around drugs, preventing problematic use, reducing harms associated with drug use, and helping oneself or others who have a drug use problem."
    • Some education items included general awareness events around drugs and drug policies, Narcan and overdose response, education for law enforcement, cultural competency and sensitivity trainings.
  • Recovery-oriented treatment, harm reduction and ancillary services — Goal: "Create a recovery-oriented treatment continuum that offers access to timely, individualized and evidence-based, effective care, through services that are people-centered and able to meet the needs of individuals no matter their current relationship to drug use or recovery."
    • This recommendation calls for an on-demand centralized treatment resource system to the existing Ithaca 211 directory. It would provide referrals for treatment centers in Ithaca with up-to-date inpatient bed numbers, create a parent/loved one hotline and connect people to a treatment navigator.
    • A freestanding 24-hour crisis center in Ithaca to be established, with medication assisted and supervised outpatient detox, with case management services available on site.
    • The Supervised Injection Site falls under this recommendation. There are also a number of others, like encouraging the Tompkins County Department of Health to implement an aggressive public education campaign, or increasing awareness in general of the New York State 911 Good Samaritan laws. 
    • This section also calls for a "Housing First" non-contingent needs model for Ithaca to increase access to housing, nutrition and health care services without requiring abstinence or participation in treatment.
    • Increase availability of medication-assisted treatment in Ithaca, including opening a methadone clinic and increasing the number of office-based buprenorphine (Suboxone) prescribers. (Currently, there are four.)
  • Community and economic development — Goal: "Support and expand existing efforts to improve youth and family development, economic opportunity and public health of communities, targeting vulnerable communities as immediate beneficiaries and ensuring that all Ithacans have the same access to resources and investments."
    • This part of the plan calls for partnering with alternatives to incarceration programs that connect low-level users and sellers to jobs programs. It also calls for an apprenticeship program in conjunction with the Downtown Ithaca Alliance and Tompkins County Chamber of Commerce, and community outreach workers to encourage youth employment.
    • Pass "Ban the Box" legislation for private- and public-sector jobs in Ithaca, and encourage Tompkins County to do the same.
  • Public safety — Goal: "Redirect law enforcement and community resources from criminalization to increasing access to services. Encourage a shared responsibility for community health and safety that extends beyond the Ithaca Police Department."
    • The biggest part of this plan is the Law Enforcement Assisted Diversion Program, modeled on the successful Seattle program.

Read the full descriptions of the recommendations in the plan. (Below)

Follow Kelsey O'Connor on Twitter @ijkoconnor.

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