Editor's Note: This is the second part of a series looking at the heroin problem in Chautauqua County.
JAMESTOWN - Attack the demand. Chautauqua County and Jamestown law enforcement officials agree that heroin is entangled in a supply-and-demand business; the greater the demand, the greater the supply.
Since heroin-related arrests and incarcerations are increasing every year, treatment centers and services which seek to "cure" addicts are heavily relied upon to stymie this demand, becoming - in effect - a hopeful refuge for the wandering sick.
Unfortunately, critics regard the recovery process as far from perfect, insisting that local treatment for addicts is not only grossly insufficient, but more alarmingly, ineffective.
"The system is broken," said Rick Huber, executive director of the Mental Health Association of Chautauqua County. "It's not designed for people to get well."
"The system is broken. It's not designed for people to get well."
Huber, who values the peer-driven nature of his organization, claims that other programs fail to connect with addicts in a more personal, individualized fashion - a frustration echoed by many addicts themselves during a recent class at the association.
"The education has not been done (by these programs)," Huber said. "Addiction is a disease ... and they treat it like a moral failing. "(Worst of all), if the addict relapses, they're kicked out of the program. That's like if your cancer went into remission, and then came back in three years ... and you were denied treatment. It shouldn't work that way."
Huber also addressed the difficulty of getting into an adequate detox and rehabilitation program, claiming heroin addicts, in particular, are not likely to recover through outpatient services alone.
"If a person is ready and wants to quit, you've got to get them in now," Huber said. "You can't say they've got to go to outpatient counseling and fail twice (before they can get admitted) ... they're going to lose the desire to quit, or even die the next day."
Such indictments strike to the very heart of the drug rehabilitation system in New York state, which is not only outpatient-centered, but very much beholden to insurance companies and the list of requirements necessary for coverage.
According to Andrew O'Brien, director of the WCA Hospital chemical dependency unit, if a 90-day or six-month rehab were opened today, no insurance company would pay for it.
Moreover, though heroin withdrawal symptoms are excruciating, they are often assessed as non-life-threatening, convincing many insurance companies that inpatient care is not necessary at all.
"That becomes part of the dilemma," O'Brien said. "What makes a person "sick enough" (to receive insurance coverage)?"
O'Brien, however, still sees promise in the system, insisting that outpatient care and short-term detox programs are still effective in treating opiate addiction.
"Most people in New York state don't need anything other than an outpatient program, but there is a smaller group of people whose addiction is so bad that they need detox services or rehabilitation or both."
In response to Huber's criticism of outpatient care and its inconsistency, O'Brien emphasized the importance of a "controlled environment," in which recovering addicts can move from detox to another level of care where there is peer support, supervision and conditions that make it difficult for somebody to bring in drugs.
Moreover, while Chautauqua County doesn't have any long-term rehab facility or "halfway house," the treatment system developed by the New York State Office of Alcohol and Substance Abuse Services does have two licensed outpatient clinics - WCA Hospital and the Department of Mental Hygiene, both of which have clinics in Jamestown and Dunkirk. WCA Hospital also has an inpatient clinic in Jamestown.
Other agencies include The Resource Center and the Chautauqua Alcohol/Substance Abuse Council, the former having certified physicians who can prescribe suboxone, and the latter tackling drug prevention.
These services notwithstanding, Huber remains committed in his efforts to improve the system even more, advocating for interagency cooperation and continuing - more than anything else - to voice the concerns of those whose voices are slowly being diminished.
"We've got the resources here in Chautauqua County to change this (problem)," Huber said. "We've got everything here that we need to do it right ... we just haven't had the leadership to change."