Experts with the Sullivan Allies Leading Together, or SALT, coalition say the factors to consider when assisting someone with opioid addiction vary widely. Any combination of a lack of a mailing address, healthcare or transportation, can make access to services difficult.
Lori Orestano-James is the state president of the New York State Council of Educational Associations. At a recent meeting at the Cornell Cooperative Extension in Liberty, she described addiction as a family struggle. She has two brothers who have struggled with addiction. One of them died two years ago. She says, “once you are recovering you are always recovering.”
She also says rural communities like those in Sullivan County often get overlooked for state and federal resources.
“We have the issues coming back at us tenfold because the reality is we have the same issues as those other places. We have those issues with our opioid crisis. We have those issues with our health care crisis. We have those issues with regard to middle-income families really no longer being middle income. We used to have higher middle and lower middle income. There's such a huge disparity now in our community just because of what's going on economically,” Orestano-James said.
Christina Ruiz, with Catholic Charities, says, since COVID, it seems like mental health has become a crisis. Their phones are ringing nonstop.
“People owe a thousand dollars in utilities and they can't afford they're picking between whether to pay their car or whether to lose their car or to lose their home in certain areas. They don't know where to balance what to pay at moments. They're getting lost. They're feeling that void of what do we need,” Ruiz said.
Valeria Henry works for MVP Healthcare enrolling members in health insurance plans. She is also a longtime Sullivan County resident. She explains that a lack of mailing address makes it hard for people who are unhoused to get the services they need.
“So, they lose eligibility very quickly and they get disenrolled. And these are also at times members that are receiving treatment and that gets interrupted because they only realize that they've been disenrolled when it's time for them to go to a new consultation or pick up a prescription,” Henry said.
Village of Liberty Police Chief Steven D’Agata says sometimes people who are unhoused will use the police station as their mailing address. D’Agata suggests that other police departments could help in this way.
Tracy Broyles is youth program coordinator at the Cornell Cooperative Extension. She says lots of Federally Qualified Health Clinics (FQHC) and medical professionals have left Sullivan County in the past five years. She thinks it could be because Medicare reimbursement rates for physicians are too low.
Congressman Paul Tonko also attended the meeting, despite Liberty not being in his district. He said he has been working for years to pass legislation that would make buprenorphine, a medication used to treat opioid use disorder, more accessible.
He said many of the cuts to healthcare due to the One Big Beautiful Bill Act, which Congress passed last year, will come after the midterms next week.
In January, many work requirements for Medicaid recipients will begin and some legal immigrants will lose Medicare. He also confirmed that his office has heard that low reimbursement rates and prior authorization denials make it harder to access medications for opioid use disorder.
“I've been in rural areas that are beyond my district in New York. They're closing hospitals or they're threatened with those closures. How far are people going to have to travel to get their healthcare? This is an unrealistic demand and an unrealistic expectation, and it's cruelty. I see this all the time and the efforts that this administration does. It the work first is cutting, slashing, burning, but it's accompanied by cruelty,” Tonko said.
That being said, the whole room agreed that one of the biggest challenges in tackling the crisis is stigma.
“Why not me? Why them?” Orestano-James said still grapples with the loss in her family and says stigma is particularly harmful. “The bottom line is we never know who it's going to go after and we have to stop putting this stigma behind it, both culturally, both socioeconomically, all of it. The stigma has to stop because it's in all walks of our community. Some are hidden a little bit better than others, but it's there, and we need to be very much aware of the fact that today you may say ‘it's not me, it's them’ and tomorrow it might just be you.”
