The mayor of Ithaca, NY has not seen his father since he was 6 years old due to his father’s struggle with a crack addiction. As mayor of an educated and forward-thinking town, he acted decisively to address addiction head-on, as a whole community. He assembled the Municipal Drug Policy Committee and told them to come up with the most ideal solutions they could based on latest evidence.

“Don’t think about money, don’t think about politics, don’t think about anything except for solutions … Whether you like an idea or not, that doesn’t really matter. Figure out what it is you can support and be part of it. If you don’t support a part of it, don’t fight it. What if it saves a life?” Travis Brooks, of the Greater Ithaca Activities Center, reported about his experience on the committee.

The report the Municipal Drug Policy Committee came up with is 64 pages long and titled “The Ithaca Plan: A Public Health and Safety Approach to Drugs and Drug Policy.” In an interview with the Ithaca Journal, Mayor Myrick describes the plan as having four pillars: prevention, treatment, law enforcement, and harm reduction.

Prevention in The Ithaca Plan is not limited to efforts people have made in the past to scare kids away from drugs, such as D.A.R.E. or “Just Say No.” Myrick explains that these programs have not been effective because they do not address the underlying problems that put people at risk for addiction, such as poverty and mental illness.

“So instead of just telling kids “Don’t do drugs,” if we could make sure that they were more engaged, maybe we wouldn’t even have to tell them not to use drugs. They wouldn’t want to in the first place. The same thing with drug dealing, because often the people engaged in drug dealing are doing it because they’re locked out of the mainstream economy.”
– Mayor Myrick, quoted in the Ithaca Journal

The Ithaca Plan stresses that treatment for opioid addiction must include medications and a detox facility in town. Presently the nearest facility is in Syracuse, NY, an hour and a half drive away.

Law enforcement is included in the plan not to put more people behind bars, but rather to engage officers in helping direct people into treatment instead. The Ithaca Plan models their law enforcement approach after the LEAD program in Seattle, WA.

The Municipal Drug Policy Committee is already working on their fourth pillar, harm reduction, proposing that the first safe injection facility in the US be opened in Ithaca. Safe injection, while not providing drugs, gives people with opioid substance use disorders a place off the streets to shoot their drugs in safety, with clean needles (a harm reduction measure known to reduce disease transmission) and a staff of nurses at hand. Safe injection facilities would give people a place to enter treatment when they are ready with a full set of options on hand, as well as a place to have other maladies addressed.

“They will have just had their fix, so that won’t be their first priority, and they might say to the doctor there, ‘Actually my tooth has been hurting and I have a puncture wound that has gone bad,’” Mr. Myrick said. “You can begin to treat the other physical things and get them prepared for their moment of clarity.’’
– Ithaca’s Anti-Heroin Plan: Open a Site to Shoot Heroin, The New York Times, 6/22/16

Mayor Myrick expects that many parts of The Ithaca Plan will require jumping legal and financial hurdles. The full Plan is anticipated to take years to enact.

“I think we need a comprehensive plan because I think every community does. I think the federal government needs a different plan, but they’re not doing it, and the state’s not doing it. So we sort of had to do it ourselves. And we did it ourselves not because we’re the heroin capital of America — our problem is no worse than anywhere else — but we do lose people just like you’re seeing everywhere across the country.”
– Mayor Myrick on why Ithaca needs such a comprehensive plan

Those hoping to follow Ithaca will note that the process was gradual, gentle, and non-exclusive. Before the Municipal Drug Policy Committee wrote The Ithaca Plan, Ithaca’s mayor introduced the issue to the public, expressing the community’s great need for action and explaining why he had formed the Committee seven months prior. The Ithaca Plan’s unveiling was a public event, complete with an invitation to Ithaca citizens to attend. Mayor Myrick and the Municipal Drug Policy Committee acted in a way that speaks to their faith in Ithaca’s willingness to learn and to keep open minds to new solutions, no matter how controversial.

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In her presentation “What’s a Town to Do About Addiction?” in Blacksburg, Virginia on August 3, 2016, author Maia Szalavitz referred to community initiatives to address addiction in Ithaca, New York.  This post is follow up on her suggestions.

A video and transcript of Maia Szalavitz’s presentation is here.