As a nation and locally, we have progressed since the era of “Just Say No.”

In the 1980s and 1990s, that catchphrase embodied a simplistic approach to stopping drug addiction. It, perhaps inadvertently, created a divide between “them” and “us,” promoting the notion that, since it was easy to say “no,” those who became addicted were somehow lesser, weaker, not deserving of our empathy.

We, at The Enterprise, have watched a sea change unfold locally over the past few decades just as it has unfolded nationally.

We wrote, for example, in 2014 about a white, middle-class kid from a loving home in Guilderland who had ruptured his spleen in a snowboard accident, and then became hooked on the prescribed pain meds. When requirements tightened for oxycodone, he turned to heroin.

As a young adult, he couldn’t hold a job and eventually lost his apartment. He’d used up his days for treatment and was living in the city mission. He stole to support his habit, was arrested, put in county lock-up, asphyxiated himself in his jail cell — and died in a hospital emergency room

This was not a problem of others; this was our own.

Politicians and policy makers have become more enlightened. We suspect it’s because they, like the rest of us, now know people who suffer from drug addiction.

Eight years ago, in 2015, we interviewed the two candidates running in the Democratic Party primary for Albany County executive — the winner in the primary was sure to be the victor in the November race since the county is dominated by Democratic voters.

When we asked a routine question about how to stem the heroin epidemic, one of the candidates, Daniel Egan, who was an administrator in the state’s Department of Health, caught us off guard with his answer.

“One of my sons is an addict,” he said, noting the issue was personal for him as his grandfather had been an alcoholic.

Egan said of addiction, “Law enforcement is the wrong approach. It’s a medical problem. If someone had cancer, you wouldn’t judge their character. You would do what you could to help.”

Egan reiterated that addiction is “a medical and a public-health problem, not a character flaw. It’s not about ‘bad people,’” he said, making quotation marks with his fingers. “Most people in jail have substance-abuse problems. Both the county and the state need to work on this.”

The solution, he said, comes with jobs and economic development. “If you live in a community where there’s no opportunity to meet basic human needs like feeding your family,” Egan said, it’s likely you would turn to crime.

Egan lost that 2015 primary to Daniel McCoy, who is still the county’s executive and who himself has spoken empathetically of people with addictions.

During the daily press conferences McCoy held as the pandemic raged, he mentioned with pride someone he cared about who had overcome addiction and he frequently spoke of how difficult the pandemic was for those in 12-step programs or getting counseling to overcome addiction since, with COVID restrictions, they could not meet in person.

Perhaps even more than the rest of us, addicts suffered during the pandemic from the stress brought on by isolation and dislocation from daily routines. Drug-overdose deaths surged in Albany County during the pandemic as they did in the rest of the nation.

“A lot of our community members are dealing with addiction,” said McCoy at one of those press conferences, in June 2020. He said it is a daily struggle to fight addiction.

A featured speaker at the conference was Kellie Roe, who described herself as “a person in long-term recovery.” She is also the director of Second Chance Opportunities Inc., a not-for-profit janitorial company that employs people in recovery from substance use disorder. Second Chance, located on Colvin Avenue in Albany, offers financial rehabilitation, recovery coaching, housing opportunities, and medical referrals.

“The one thing these people depend on is meetings,” McCoy said at the time. “They depend on seeing people. For some, the Zoom meetings work. The others just need to see people and know they have that support mechanism, that they have someone they can lean on.” 

McCoy noted that, even when an addict is in recovery, the addiction is “something you have to deal with your whole life.”

Another reason for the spike in overdose deaths, here as nationwide, is the increase in the synthetic opioid analgesic fentanyl.

“It shows up in 88 percent of those who died in 2020 ...,” said McCoy in October 2020. “It can be 50 to 100 times more potent than heroin. It can kill you in a heartbeat.”

Heroin was often laced with fentanyl, McCoy said, and increasingly it’s being found in cocaine and methamphetamines.

In 2019, before the start of the pandemic, Albany County suffered 62 overdose deaths. That grew to 100 in 2020, to 110 in 2021, and to 132 last year.

In recent years, there has been a parallel shift in law enforcement both here in Albany County and across the nation.

We vividly remember a program hosted five years ago by Albany County Sheriff Craig Apple because, he said, deaths from heroin overdoses had doubled.

“We’re more likely to maintain sobriety when we receive support from society,” the sheriff said at the 2017 forum. “I was a lock-’em-up guy 10 years ago. We lost.”

Apple spoke to about 100 people who had gathered at Voorheesville’s middle school to hear from a series of experts on the scourge the sheriff said had “been plaguing our community.”

Apple said there were people in the crowd “who had lost a loved one” to heroin as well as people who had family members in jail, battling addiction. “It’s everywhere,” he said.

This sea change in attitudes towards addicts has led to a host of county programs, which we’ve detailed in stories over recent years, and also in federal changes, which we are focusing on here.

Earlier this month, a drug that serves as an antidote to opioid overdoses, naloxone, widely known by the commercial brand name Narcan, was for the first time made available nationwide without a prescription.

The drug has been available for use by non-medical personnel to prevent overdoses in New York state since 2006, and has been easier to obtain since August 2022 due to a statewide pharmacy standing order.

As early as 2014, we covered Guilderland’s medical director for emergency services demonstrating how to administer a dose of naloxone with an atomizer and this year, after after the rural Hilltowns had two opioid overdoses on the same day, Feb. 17, we wrote about a demonstration at the Westerlo Public Library on how to administer naloxone. Both of the people who overdosed on Feb. 17 were saved with Narcan.

While it is likely that not all naloxone administrations are reported, over 35,000 naloxone administrations have been reported to the state’s health department.

Last year, 132 people died of drug overdoses in Albany County, more than triple the number since 2015. This summer, the Centers for Disease Control and Prevention reported that there were an estimated 110,000 fatalities from drug overdoses, numbers consistent with rises in recent years.

This current focus on harm reduction rather than solely on abstinence is a welcome one. After all, addicts can’t come clean to lead productive lives if they are dead.

Some addicts are homeless or unemployed and cannot afford the roughly $45 that the two-dose over-the-counter box of Narcan costs, but there are free lifesaving alternatives. Free naloxone, as well as fentanyl and xylazine test strips, can be ordered through a new ordering portal on the state’s Office of Addiction Services and Supports website. The agency also offers free virtual naloxone training.

What if you don’t have a computer or phone to access these? Public sites throughout Albany County offer free Narcan in dispensers, no questions asked.

We were thrilled in April to report on one of the Narcan dispensers being placed in the front lobby of the Guilderland Public Library.

The library’s director, Timothy Wiles, struck just the right tone when he motioned to nearby collection boxes for the food pantry and the Caring Closet, which provides hygiene products to people in need.

“This is just the next step,” he said of helping people who need Narcan. No stigma. No judgment. Just free help when you need it.

Guilderland’s supervisor, Peter Barber, made it clear the problem is here and immediate — not for others to solve, but for us. “This is in our community and is raging in our community,” he said.

Barber also embraced the sea change in our attitudes towards addicts, noting, the Guilderland Police have decriminalized their approach to dealing with addiction.

Finally, the county’s health commissioner, Elizabeth Whalen, gave her trademark practical advice — how to use Narcan. You insert the tip of the nasal spray into the nostril of the person who has overdosed and press the plunger.

“Just one sniff into the nose,” said Whalen, “can make the difference between life and death.”

Whalen said Narcan has “no downside” but advised calling 9-1-1 after using the drug since it is “not the end of medical treatment.”

“Prevention is the most effective strategy,” said Whalen of quelling the epidemic. She urged parents to talk to their children about drug use and she also spoke of the importance of keeping needed medication in “a safe spot” while disposing of unused medication.

“We really need to remove stigmatization,” said Whalen.

She noted that Stephen Giordano, the county’s commissioner of mental health, oversees the Mobile Outreach Treatment and Overdose Response team, known as MOTOR, which encourages people to get the help they need.

Such treatment, Whalen said, can change lives.

While we work to change the root causes leading to addiction — like the jobs and economic development that Egan referenced eight years ago — we would be wise, each of us, to buy a now readily available box of Narcan in case a neighbor or friend might need it.

As the health commissioner said, it could make the difference between life and death.