No care centers for drug-addicted babies

MONTICELLO, NY -- A bill to build more care centers for drug-addicted infants passed unanimously. So why did the governor veto it?

“It’s ridiculous,” said NYS Assemblywoman Aileen Gunther (D, 100), the primary sponsor of the bill. It calls for at least four maternal-infant care centers to be established in areas where infants suffer withdrawal from the drugs they are exposed to in utero. 

Gunther told the River Reporter she met with Hochul last month to discuss the bill and was “extremely disappointed” the governor, Kathy Hochul, nixed it.

Maternal-infant care centers serve pregnant women, new mothers, and their infants. They support families during the perinatal period to help ensure safe deliveries.

Gunther said her office is still waiting for more information from the governor about her recent statement. Hochul said the health department will see if current programs and services can be further developed “to provide necessary care to mothers and infants.” 

“Okay,” said Gunther, “they’re saying that we don’t want to do this now. We’re going to look and find out if there are any maternal-infant care centers that are already in existence. Well, if that were the case, I wouldn’t have written the bill.”

Gunther’s office had yet to hear from Hochul’s office despite being promised a response earlier in the day. Just the day before, Camille O’Brien, coordinator of the Sullivan County Drug Task Force, told the county legislature that, because of a recent policy change, babies and mothers can no longer be tested for drugs without consent. Providers expect “a false deflation” of new data tracking babies born positive for drugs or with neonatal abstinence, she said. 

Sullivan County has more drug-addicted babies per capita than any other county in the state. A grand jury report said 57.1 out of every 1,000 babies are born positive for drugs or with neonatal abstinence. The next-highest county, Oswego, isn’t even close at 45.9 per 1,000. In Broome County, which is similar in size to Sullivan, the number is 31.9. The grand jury report was issued last year in response to the death of an infant from a fentanyl-xylazine mix at the Knights Inn, where the county houses the indigent.

Persistence of xylazine 

Heather Guinan, co-chair of the task force’s Medical Pillar, first confirmed at their last meeting the growing prevalence of fentanyl-xylazine mixes. Xylazine is a potent tranquilizer used by veterinarians, and fentanyl is a synthetic opioid up to 40 times more potent than heroin.

Guinan now says she’s starting to see xylazine-related wounds—severe sores that are scaly and dark, covered with dead skin known as eschar that more commonly appears on wounds from burns or gangrene.  

Guinan said she has been seeing these wounds for the past month. “This is concerning from a treatment standpoint and medically important,” she said. “Xylazine wounds are there and pose another layer of challenge for the fatality rate.” 

Polysubstance abuse has gone up and goes hand in hand with xylazine use, according to Tim Hunt of the Columbia University School of Social Work, who served as intervention lead of the HEALing Community Study.

“We’re still working on how to test for xylazine consistently,” Guinan said. “When a sample is fentanyl-positive, the lab is not automatically testing for xylazine. But we’re working through it.”

According to the lab, which works across the state, including the tristate area, everything they’re seeing that tests positive for fentanyl is also testing positive for xylazine.

Vivitrol shortage 

Further complicating the drug crisis, Guinan said, is the nationwide shortage of Vivitrol, a long-acting injectable medication that treats both alcohol and opioid addiction. She blamed “pharmaceutical greed” for the shortage, which makes it “more difficult to get people started on that for more medication-assisted treatment.”

The task force is not able to obtain the oral form of the drug “that you would often want to have somebody try before switching over to a long-acting injectable form,” said Guinan.

Undersheriff Eric Chaboty said jail occupancy was at 86: 79 men and 7 women. Thirty one inmates—more than 36 percent of the jail population—rely on medically assisted drug treatment programs, he said.

Overdoses trending down

There is some good news locally amid the bad reports: Overdoses are getting fewer. 

“The numbers wouldn’t be trending this way without the work you all do,” John Liddle, Health and Human Services Commissioner, told his fellow drug task force members.

Data is not yet available from the HEALing Communities Study by the National Institutes of Health, which investigates the efficacy of tools for preventing and treating opioid use disorders at the local level.

Melissa Stickle, director of Sullivan County Community Services, said the data helps guide what interventions are helping and where improvements are needed. She said her department wants to create an overdose fatality review board to gather additional information about overdoses in the county. 

See related story, “Latest scourge makes fentanyl even deadlier."