Posted December 2011

Dear Colleague:

Recent data indicate that the number of opioid users in New York State continues to grow among young people, one of our most vulnerable populations. The escalating number of adolescents and young adults under age 30 using opioids has been reported by medical providers and substance use treatment facilities (see Attachment #1). Across New York State, acts of violence, injuries, and deaths associated with opioid use have been recently reported in the media. To enable us to mount a cohesive and effective response to this growing crisis, a commitment from all community partners is needed. Given that these are times of limited and dwindling resources, we must also be innovative in identifying new partners, as well as maximizing all existing resources.

Reports indicate that opioid addiction among adolescents and young adults may be driven by early use of prescription medication, notably oxycodone. An inability to obtain prescription medication on an ongoing basis, or to pay the high cost of prescription drugs being sold on the street, may result in youth seeking other more available opioids to satisfy their drug addiction. Unfortunately, heroin is readily available and comparatively less expensive than oxycodone. Most young people initiate heroin use by “snorting” and some will then progress to injecting heroin.

As we well know, injection drug use once drove the HIV epidemic. The success that we have had through harm reduction, syringe exchange, and expanded syringe access programs is laudable. While we can now say that injection drug users have a higher risk of contracting HIV through unprotected sexual contact than by injection, the fate of the emerging population of adolescent and young adult injection drug users is a major concern. Our greatest fear is repeating history. The risk of transmitting blood borne pathogens, particularly HIV and Hepatitis C, is of paramount concern. Public health demands that we respond to this emerging crisis.

I am appealing to all providers funded through the AIDS Institute to reexamine your program(s) and seek opportunities to provide prevention interventions to adolescents and young adults at risk. We must address the needs of youth who may not fully understand the risks of disease transmission and may be too afraid to address their own drug use or to recognize addiction. Community mobilization of government partners, schools, parents and peers is needed to educate youth regarding disease transmission, to promote harm reduction and safer sex practices, and to encourage substance use treatment. In addition, I am asking that you advocate in your community for more substance use treatment options and availability and access to chemical dependency treatment placement. The need for treatment and care for substance-using adolescents and young adults in rural, suburban and urban areas is urgent.

Please work with your contract manager(s) to seek appropriate opportunities to incorporate outreach, prevention and intervention services focused on adolescents and young adults at risk. Attachment #2 provides some initial contacts for further information on referral and resources on addiction. This is an important beginning to initiate a long term strategic plan to respond to this crisis. More work must be done as we seek to further develop a continuum of care for adolescents and young adults in need of our services.

Thank you.

Sincerely,

Humberto Cruz
Director
AIDS Institute