Contrary to media reports, the opioid epidemic on Staten Island is not confined to affluent young white residents, and affects all neighborhoods, races, ages, and socioeconomic backgrounds. The study by researchers at Columbia University’s Mailman School of Public Health and the School of International and Public Affairs (SIPA) was published in a report titled, “Staten Island Needs Assessment: Opioid Addiction Prevention and Treatment Systems of Care,” issued by the District Attorney’s Office for Staten Island. The findings were presented by the Office of the District Attorney – Richmond County on September 20th.

The researchers conducted a case study based on interviews with 61 individuals in Staten Island affected by the crisis, supplemented by a literature review and assessment of treatment capacity and distribution of services on the island.

While the problem was sometimes described by interviewees as primarily impacting youth, in 2016, the median age of overdose was 37. “People addicted to opioids on Staten Island come from all neighborhoods, races, ages, and socioeconomic backgrounds, a finding that goes against reports by local media, portraying the epidemic as one that primarily affects white youth in the more affluent neighborhoods,” said Silvia Martins, MD, PhD, associate professor of Epidemiology at the Mailman School of Public Health. “It is critical to provide opioid addiction services where they are most needed.”

Martins and colleagues found that some areas with the most overdoses are also the most underserved in terms of opioid addiction treatment clinics. There are only two methadone providers on the island and three inpatient clinics, and only one offers detox. Both the methadone and inpatient clinics were typically at full capacity, suggesting an opportunity for expansion of these services.

“In addition to expanding methadone services and detox capacity, the importance of individualizing care through customized health plans, as well as strengthening aftercare cannot be overstated,” observed Martins.

“Helping people manage opioid dependence is a vital area of improvement on the island,” said Lisette Nieves, EdD, MPA, a partner at Lingo Ventures, a non-profit consultancy, and an adjunct faculty member at SIPA. “After an individual has returned home from rehabilitation services, they need ongoing support, either through official counseling or support groups.”

Other report recommendations:

• Sponsor physicians to become buprenorphine-certified, and establish standards for reporting clinic performance.
• Develop a social media campaign to educate communities about opioid addiction and aimed at reducing stigma.
• Increase awareness of actions family members can take.
• Create a searchable website with information on where opioid addiction services are available.
• Draw on the unique lived experiences of people in recovery, place them into leadership roles on local boards and taskforces, and encourage them to work as peer advisors.
• Build on opioid training programs for police and justice officials, including naloxone training and usage and the District Attorney’s Opioid Response Initiative

Co-authors: Myrela Bauman is a dual degree student at the Mailman School of Public Health and SIPA; Raoul Bhatta, Kirsten Kierulf-Vieira, Erin Kuller, Patricia Wendt, and Mon Yuck Yu are recent graduates of SIPA.