New York Public Health Now
Join New York State Department of Health Commissioner Dr. James McDonald and Executive Deputy Commissioner Johanne Morne as they explore the critical issues, innovations, and initiatives that shape the health and well-being of the people of New York.
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New York Public Health Now
s3e01 Navigating the Opioid Crisis: A Conversation with Dr. David Holtgrave
In the season three opener of the New York Public Health Now podcast, Department of Health Commissioner Dr. Jim McDonald and Executive Deputy Commissioner Johanne Morne have a conversation with Dr. David Holtgrave, our newest senior policy advisor at the New York State Department of Health.
The discussion delves into the department's efforts to address the ongoing opioid epidemic, with Dr. Holtgrave providing his expansive expertise and insights.
The conversation covers topics such as the mechanics and history of opioid antagonists like naloxone, the emergence of alternatives like nalmefene, and the latest trends in fatal overdoses across the nation and here in New York State.
Listeners will gain a deeper understanding of the multifaceted approach the New York State Department of Health is taking to combat this public health crisis to help save lives.
If you have an idea for topics we should discuss, please let us know: PublicHealthNowPodcast@health.ny.gov
Why hello, welcome to season three of New York Public Health now podcast. Of course, we missed you! It's good to be back here. On our podcast, we talk about the why so you can decide what to do. Hello. I'm Dr Jim McDonald, the Commissioner of the New York State Department of Health. By the way, today we're not coming to from the 14th floor of Corning Tower. I'm actually in my home today. A little bit more about that later, but I do want to reintroduce our co-host, Johanne Morne, and Johanne, how are you today?
Johanne Morne:I'm doing great. Thanks so much. And I'm excited for season three of our podcast. We definitely have some exciting episodes ahead.
Jim McDonald:I'm excited about season three as well. You know,
Johanne Morne:Well, you know, as we've been saying all along, we're gonna be talking to a lot of experts about a lot of different topics. We'll be talking about bird flu, talk about why the Department Health is so vigilant about this. We're gonna talk about our changing climate as well, with a very we really have a great season lined up, and hopefully our special guest. You have to tune in to find out who that's gonna be. And we're gonna talk a little bit about sepsis this season as well, you know, infections that threaten people's lives. And we're gonna talk about some opportunities for vaccines with flu, RSV and COVID. We're gonna talk as well this season about long COVID as well, what we've discovered and audience is going to stay tuned with us so that they can benefit how much more we still did learn. And there's some other topics we're gonna grab onto as well. from all the information we'll be sharing.
Jim McDonald:Yeah, thank you, Johanne, and I did mention I'm recording this from home today, and the reason being is I'm working from home because I'm getting over a cold. I don't have COVID, but because I can work from home when I'm getting better from a cold, I decided to work from home today and not spread any illness at work. You know, one of the things that's important sometimes, if you can isolate when you're at home, it's a good thing to do because, quite frankly, not everybody can. So today, Today is August 26, it's Monday. You know, it's interesting, when I look at our COVID cases, they're slightly down from our summer peak, and we do expect cases to increase again over the fall as we get into our next surge. You know, I think one of the things you've seen about COVID is you get a winter peak and a shorter summer peak. I think it's important that if you can isolate when you're contagious, it's great if you can, and if you can't, then you do what you can do to not spread disease to others as well. Having said that, Johanne, we have a special guest today who is our guest we have with us today?
Johanne Morne:We do. We do. and I'm really excited to welcome a newest member to our Executive Leadership Team here at the Department of Health. That's Dr. David Holtgrave. He's now serving as a special advisor, and he comes to us with a very impressive history.
Jim McDonald:Yeah, it is great to have Dr. Holtgrave on our team. He most recently served in the White House Office of National Drug Control and Policy under the Biden administration. Before that, he was a dean of the School of Public Health here in Albany. He's also a distinguished professor and a SUNY Empire Innovation Professor at the University of Albany School of Public Health. And before that, he was working on the federal level, serving under the Obama administration as a member of Vice Chair of the President's Advisory Council on HIV/AIDS, and with that Good morning. Dr. Holtgrave, thank you for joining us today.
David Holtgrave:Oh, it's my great pleasure to join you on the podcast today Dr. McDonald and Johanne and to get this opportunity to further serve the people of New York.
Jim McDonald:Yeah, Dr. Holtgrave, maybe you could just start off by telling us a little bit about yourself beyond you know what I talked about with some of the specifics on your CV earlier.
David Holtgrave:Well, I'll start by saying I'm a first generation college student. So as I worked my way through college, I got my doctorate from the University of Illinois at Urbana Champaign and quantitative psychology. And what that meant was much of my studies was on research methods, alternative designs to randomized control trials, how to do mathematical modeling to estimate maybe the spread of an infectious disease or some other process that we were interested in. So it was really about research methodology, doing the strongest kinds of studies that we could to get the most information out of the data that we could. It also included things like coursework on how to do surveys to get the most valid and reliable answers, and I got very interested in applying these methods to health applications. I had the good fortune of collaborating with a couple of people from medical school there, and we published a paper on hepatitis B screening in institution that serve mental health services. And then I also got the privilege of doing a postdoctoral research fellowship at the Harvard School of Public Health, and that really helped cement my career start in public health. As you noted, I worked at the Centers for Disease Control and Prevention for the federal government. Previously there, I directed their HIV Prevention Division, and after that's founded the department at Johns Hopkins University School of Public Health called health behavior and society that brought together the social sciences, behavioral sciences and public health. And during that time, I also had the privilege of serving as a member and then the vice chair of the Presidential Advisory Council on HIV/AIDS in the Obama/Biden administration. And after that, the great fortune of getting a chance to serve as the dean of the University at Albany School of Public Health. And there's such a great partnership between UAlbany School of Public Health and the New York State Department of Health, it was a great privilege to get a chance to work at that intersection. And then, most recently, at the White House Office of National Drug Control Policy largely focused on translational issues of how to take the best data that we had on substance use in the US and translate it into the strongest policies that we could. Outside of some of those issues, outside of work, I'm a big supporter of dog rescues, and especially German Shepherds and mixes. I've done some voluntary work at the German Shepherd rescue of New York, and since living in the Albany area, have adopted four German Shepherds, two of whom have passed, I have two now, and they're just such great, great beings, and really, really enjoy doing whatever we can to support our friends that are rescue dogs.
Johanne Morne:Okay, so, Dr. Holtgrave, if you have to indulge me for just a moment. First, I really am interested in understanding what does it mean to be a first generation college student. And then second, really would love to hear a little bit more about your dog rescue work. I don't know if you realize, but today's National Dog Day, and I'm also a huge dog lover, so curious on both fronts.
David Holtgrave:Great, thank you. Johanne. By first generation college, what I really mean is first person in my immediate family to attend college. And in fact, some of my first college credits were at a community college and I and then went on to a state undergrad and then a State graduate school. And I just want to say the community college experience was really helpful for a first generation college student, at least I found that to be the case to help me better understand what I wanted to do, what I wanted to focus on, and how to go to college, what that experience was like. And also at UAlbany, I had a poster on my door that I proudly displayed that said I was a first gen college student and then a faculty member, and really invited if students who were first gen wanted to come by and chat about that experience, what that meant their career. Was very happy to do so. Going back to the German Shepherds, yes, I think rescue dogs always have their own histories. They can't tell us in words, but if we listen hard enough and long enough, they will tell us what their experience is like. And I could go on and on about those stories. Just say one of the dogs that we adopted, we thought she had three or four weeks to live. We adopted her. She was quite older, quite an ill health and we adopted her thinking that we would give her a dignified and respectful place for her last few weeks. But good nutrition, good veterinary care and a loving family was enough that she lived for about three years after that, before her health issues caught up with her. So I think there's a lot we can do in the life of rescue animals as well, too. So I could go on and on in this and if this were video, I would show you one hour's worth of pictures of the German Shepherds.
Johanne Morne:Wow, well, you know both, both are just really amazing accomplishments, and so grateful to you for what you're doing, both as it relates to our work and certainly for the rescue. You have such a long, diverse career. What made you come to the New York State Department of Health?
David Holtgrave:You know, I think I've been a fan of the New York State Department of Health for at least a quarter century now. In fact, when I was at CDC, I got to know the New York State Department of Health, AIDS Institute very well, and it was really a pioneering organization that very early on, as you all know from your amazing work in the AIDS Institute, was really one of the first in the country to look at how is it possible to think about ending the HIV epidemic, And for many years, has been such an important leader around HIV and AIDS issues. So that began my membership of the New York State Department of Health fan club, and I was reflecting. I visited carning tower in 2007 when I was at Hopkins and wrote a paper with Susan Klein and others from DOH on hepatitis C, and this was kind of early on with new treatments and so on, and thinking about, how could we eliminate hepatitis C in the country? And that was in 2008 and as I noted earlier, when I was at UAlbany, we worked really closely with The Department of Health. In fact, Dr. David Axelrod, an earlier health commissioner in New York State, viewed the creation of the public health school at the University at Albany as kind of an experiment how to get academia and health departments working together. And that was certainly the case during COVID just really close partnerships working between the faculty, students, and the amazing professionals at DOH, everyone coming together. And now, because of all of those reasons, and its long standing commitment to health equity, to using data to inform policy and to making the biggest impact we can, I'm really honored and excited to be partnering now here in New York State Department of Health on translation work especially focused on substance use policy,
Jim McDonald:Yeah, as we continue our conversation with Dr. David Holtgrave, Senior Policy Advisor here at the New York State Department of Health, you know Dr. Holtgrave, one of the foundational concepts of this podcast is we talk about the why, so people can decide what to do and I always like to build a foundation for our conversation, and we're going to talk a little bit about your work here at the Department of Health regarding the overdose epidemic, not just in New York, but what we see nationally. But maybe we could just start with something really straightforward. Why don't we start with an opioid antagonist? Can you explain what is an opioid antagonist? Because I think people hear the word Naloxone a lot, but I don't think people really maybe have a sense of what an opioid antagonist is/
David Holtgrave:Absolutely, Dr. McDonald, so opioids that we hear so so much about it have affected many people's lives. Opioids bind to receptors in the brain to give pain relief and and often can pleasant, pleasurable feelings, and opioid antagonists disrupt that binding of the opioid to the receptor. And opioid antagonists might bind to those receptor cells themselves, preventing the opioids from from binding, or in some cases, knocking the opioid off of the receptor so the main thing to remember when we hear an opioid antagonist is it's trying to disrupt that binding of opioids to those receptor cells.
Jim McDonald:Yeah, and I think that's a great way to look at it. You know, when you've kicked the opioid off the receptor cell, the opioid can't do what it would do whether it's a prescription opioid or whether it's an illegal opioid. The nice thing about opioid antagonists is they really do work against any opioid type drug. So what is naloxone? We use the word Naloxone, Narcan a lot. Why don't you just talk next about what is naloxone?
David Holtgrave:So naloxone is an opioid antagonist that's been especially useful for reversing the effects of an opioid overdose when it occurs. Naloxone has been widely used in the United States. Emergency Medical Service professionals alone, just just EMS professionals alone, administered at roughly 400,000 times in 2023 according to data from the National Highway Traffic Safety Administration. And besides those administrations of 400,000 times or so, there's millions of doses that have been distributed in the nation. And I make that distinction between how many have been distributed and how many have been used or administered, because you don't always know when and where you'll next need it. So you have to distribute more than you actually use. And one way to think about that is a lot like fire extinguishers. You want a lot of fire extinguishers in society. You don't know exactly when and where you're going to need them, so you have to make sure that you're distributing enough so that you're planning for where might this emergency occur. And I'm going to have the opioid antagonists available there for me to be able to use.
Johanne Morne:Dr Holtgrave, can you get into a little bit more of the history of naloxone? How long has it been around? How easy is it to use?
David Holtgrave:It's been around quite a long time. As I read the history, it was in 1961 that there was a patent application for Naloxone, and it was approved in 1971 from the Food and Drug Administration, or the FDA. And it's sort of evolved over those years, first being entirely injectable, then moved on to a nasal spray. Even more recently, and about the same time, roughly, as the nasal sprays are auto injectors, and by that, I mean an injector that's set up so that you can easily provide the injection to someone else, or if you've provided it to yourself, it's it can be very, very easy to use. For instance, that nasal spray is quite easy to use, and I think we'll talk a little bit more about that in our conversation today.
Johanne Morne:There are different levels of naloxone. Is that right?
David Holtgrave:It is. So they range in terms of dose from about 0.4 milligrams all the way up through eight milligrams. So, there's a fair range of naloxone out there.
Johanne Morne:Are there any concerns as it relates to the different dosage levels?
David Holtgrave:You know there, are. So typically, one would think about four milligrams of naloxone as being typical. When we think about Naloxone, often we think about that nasal spray that's typically a four milligram dose, and that's kind of what comes to mind often when we think about work in this area. The four milligram dose is active for about a half hour to maybe two hours after it's administered, and during that time, after the person is revived using naloxone, from the overdose, they might experience some symptoms of opioid withdrawal, because during that time when it's still active, there may be a sense of wanting to use drugs again, trying to address that feeling of withdrawal, and by withdrawal, I mean things like agitation, vomiting, nausea, this feeling one was addicted to like opioids, feels like it has been taken away, and there's this feeling of withdrawal. But that, as we'll talk about, that time frame of one and a half to two hours is not so very long. We'll talk about other things that last longer. So the issue now is the larger the dose, like eight milligrams or so on, is active longer, and that may heighten that frequency and experience of an opioid withdrawal symptom. So there is that concern, and one of the things that New York State Department of Health did was a study in the Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report on four versus eight milligrams. And I won't go into much detail because you had a whole other podcast devoted to that particular study. It's a great and important podcast that showed that four milligrams versus eight milligrams both had similar power to revive someone who's experiencing an overdose, but eight milligrams seem to show more withdrawal symptoms, especially symptoms of withdrawal overall, including vomiting. So again, I refer to that paper and to that other podcast in this series for more detail.
Jim McDonald:Yeah, thank you, Dr. Holtgrave, and I think it's much more popular now than it was when I started in medicine. It's interesting, when I started out, there was just the injectable Narcan, at .4 milligrams, and now there's, there's a lot of brand names for Naloxone out there. Could you walk us through some of them and how they're available?
David Holtgrave:Narcan now we often think of as the four milligram nasal spray. And as of 2023 it was approved by the Food and Drug Administration to be available over the counter. Also, I would note that usually if you acquire Narcan, you would get the four milligram nasal spray, and there would be two plungers in the same pack. So if you used one and then there was a need to use another, it would be available. So these often come in two packs. More recently, there's been a five milligram injectable product called ZIMHI® if I'm pronouncing that correctly. There's also generic injectables that range from 0.4 to two milligrams. KLOXXADO® is a brand name for an eight milligram nasal spray. And Revive® is a three milligram nasal spray approved in July of 2023 so a number of brand names out there, number of different dose levels, I think if people are interested in those different brand names and doses, that's great, but if one wants to sort of get to the core of it, just remembering that naloxone is the basic underlying medication that we're talking about here for opioid overdose reversal, that's really the main thing that spans all of these brand names that I just mentioned.
Johanne Morne:Can you continue to talk a bit about the training. So how does an individual use it? What are the ways in which an individual can can be trained? Why is calling 911 followed by use of Naloxone and protecting the airway a critical set of steps for everyone to know?
David Holtgrave:You know, I think there's a lot of online You know, as we said at the beginning of our conversation, training that one can take. Also, a lot of community based organizations that work in this space offer it. And in fact, if you said, you know, today, I would like to get some training from New York State Department of Health or the office of addiction services and supports. Literally, if you Google "New York State how to use Naloxone", you'll pop up with some options right away, so it's easy to find. Even though different training modalities might present just a little bit differently, the main things to remember are at the outset, if you're encountering someone who is experiencing an overdose, that really, time is of the essence. You want to call 911 right away. And you want to administer Naloxone. If your phone is right there, call 911 first. If the naloxone is right there, administer Naloxone first. But you want to move quickly on those two fronts. And for instance, if you've got the nasal spray plunger, you can use that straightforward squeezing the nasal spray injector into one nostril, holding the person's head at the neck just up a little bit so that their head is tipping backwards slightly when you're administering it. And if you're comfortable in maybe you've had first aid training in providing rescue breathing, so either using chest compression or what might be called mouth to mouth resuscitation, but using rescue breathing, one can do that. And in part, you want to protect the person's airway so that they can breathe easily as they revive, but also should as they revive if they vomit, you want to make sure you're avoiding choking, so protecting the airway matters. And if two minutes passes and you need to administer another dose of naloxone, you can after those two minutes are gone. For a reason I alluded to earlier, if the person hopefully has revived, but it's important to stay with that person until medical assistance is there. You want to explain to the person what they may have just experienced, what they may be feeling like, and that help is on the way that medical providers will be there shortly. And I think that really matters. Those are some really key basic steps to keep in mind, everyone can do that, and it's a great place to jump in. I will say that the trainings are getting a little bit more complicated as time goes on, because the drug supply is changing. Much of the illicit opioids that we're talking about are really fentanyl, but fentanyl now is increasingly being adulterated or mixed with other compounds. And one, one of the other things that fentanyl is being mixed with, including in New York State and in other parts of the country, is something called xylazine. It's an animal tranquilizer that's used in veterinary medicine quite quite a bit actually. The complicating factor is that xylazine is not an opioid, so if you have fentanyl that's been combined with xylazine, you still want to use Naloxone, because you still want to try and use that opioid antagonist to break up the effects, if you will, of fentanyl. But since xylazine is not an opioid, it really has a major effect on someone's respiration, on their breathing. So having supportive breathing, putting somebody in the rescue position, which means putting them on their side, almost like it looks like they're sleeping on their side as a way to help protect their airways, matters. And then also calling 911, is critically important, because if it was fentanyl adulterated with xylazine, you're addressing the overdose from the opioid, but you're also addressing the effects of this veterinary tranquilizer at the same time. So the world is changing. The drug supply is changing, and it's it does get more complicated over time, but those basic steps are still the same in the in responding to the overdose. we certainly have continued to advance also, as far as alternatives to Naloxone. What are some of those alternatives? Sure, so most recently, there's a drug called nalmefene, which is one of those. And namafame works similarly to Naloxone. It's an opioid antagonist, but it binds even more strongly to the opioid receptors, and one major difference is that its active period is somewhere around 11 hours or so. We said for Naloxone, it was more like 30 minutes to maybe two hours. This is about 11 hours or so, and if we look at the product label for this medication, it adds one more thing to be mindful of, and that is the risk of opioid overdose from attempts to overcome the blockade. And by blockade, meaning that disruption between the opioid and the opioid receptor cells. The warning that's given on the product label is that taking large or repeated doses of opioids could occur in order to overcome that blockade. And if that is the case, during this somewhat longer period of up to 11 hours or so could lead to opioid intoxication, maybe even a fatal effect of that opioid intoxication. So I think the binding strongly to the receptor cells is really important. The length of time is this challenge that has been raised in this inclusion on the on the product label. Also to just say nalmefene, as I understand the FDA approval is for 12 year old and older persons for it to be used.
Jim McDonald:Yeah, thanks Dr. Holtgrave. And I think we'll talk a little bit more about our concerns about that as well. You know, one thing's just true for every drug is, you know, when a drug has a half life, what that really means is, how long does it take for half of the drug to be metabolized from someone's system, if you will? And every drug takes about five half lives to leave someone's body completely. So obviously, the longer a drug is active, the longer it's doing its thing, and sometimes that's a great thing, and most times it is. Other times it can be a problem. And with nalmefene having that half life of almost 11 hours, it's just different than Naloxone, for example, which is usually around 30 minutes to two hours. So why don't we just talk a little bit about nalmefene a little bit more like, what is its brand name and how is it developed and approved by the Food and Drug Administration? Because it's really quite an old drug.
David Holtgrave:It is, Dr. McDonald. So it was first approved in 1995 under the name Revex. As I understand it, that was withdrawn from the market in 2008 for commercial consideration of a volume of sales and so on. So it was that was removed. And then more recently, the FDA approved a nasal spray nalmefene, nasal spray with the brand name Opvee, in 2023. In that approval process, what was required was to show that this nasal spray was equivalent in some ways, to the previously approved injectable from back from 1995. So it was, the requirement was to show that that nasal spray was similar in a number of ways to the earlier injectable. And then now, just in the last few weeks, the Food and Drug Administration has approved Zurnai, which is an auto injector, kind of the device that makes it easy to inject yourself or someone else with namoffen. And that's again, just been approved, and I believe that its availability won't be happening until 2025 even though that has just been okayed by the FDA.
Jim McDonald:Everybody wants to do what we can to reduce overdose deaths, and it's certainly laudable. But there's some controversies right now about the various dosages and medications we've been talking a bit about. You know, what does the American College of Medical Toxicology say about all of this?
David Holtgrave:It's really an important balancing act, I think that people are discussing now, one wants to have enough opioid overdose reversal medication, and I'm introducing another term here. This was one we used a lot in my last job of opioid overdose reversal medication, or OORM for short, meaning all kinds of opioid antagonists that might be used for reversal of an overdose. But the balance here is you want to have enough of such a medication to revive the person successfully, but not so much as to precipitate severe withdrawal and potentially a very strong desire to use drugs again, and potentially there could be another overdose following that. So that's really the balancing act, I think in many ways. The other thing that I would just add personally is, whenever there's a new product that comes on, on the market, there's always in this space and well beyond, in other areas of medicine, I think there's a differentiation to be made between a specific medicine and a public health program to deliver that medicine. When should it be used with what dosage and what's the training look like? Who's going to administer it? That's always something when one scales up from saying a product, and again, in any area, is available to what's the public health program for that delivery? What does the training look like? Maybe, in this case, what's the training look like, so that someone who's providing assistance knows how to deal with that prolonged period of activation of the of this drug. So I think that's the other thing that's a discussion now. And I illustrate that in part by saying the American College of Medical Toxicology has published an article in Clinical Toxicology and issued a statement in this exact area, and they're really focusing on this issue of successful resuscitation versus precipitated withdrawal symptoms, and one can look at those sources to get their exact quotes. The main thing I would say is they're really the American College of Medical Toxicology is really calling for additional data that speaks to this issue of what happens in the "real world," if you will, as you're delivering it in a more public health setting. So in fact, they're calling for more information about how to determine the effectiveness of nalmefene in clinical and public health settings, both in medical settings and in community settings. Also they've asked for more information looking at acute respiratory distress syndrome, and also this point we've been discussing on prolonged precipitated withdrawal. And then the college also talks about doing studies that are comparative with Naloxone to determine even further differences in effectiveness, adverse outcomes, length of emergency department stay, initiation of medication for opioid use disorder, and overall utilization and resource utilization in the healthcare system. So I kind of take as a theme from the specific things that the American College of Medical toxicology is calling for. Is more information on some of these points as something goes from being a medicine to a public health program.
Jim McDonald:Yeah. Thank you, Dr. Holtgrave, and as we, as we continue our conversation, what are the recent trends we're seeing with fatal overdoses, perhaps in the United States and in New York State in particular?
David Holtgrave:Absolutely, so I think nationally, if one looks at fatal overdose or fatal drug poisonings nationally, from 2019 through 2021 you saw a period of really quite dramatic increase in the country. And then starting later in 21 beginning of 22 saw a period of relative flattening. And now nationally, you're starting to see some decreases in the number of fatal overdoses in the nation, and I think that's a really important trend to visualize as we're talking about this in the podcast of, it's almost like turning around an ocean liner, if you will. You can't turn it around like a speedboat. Increases were going up. You have to flatten that and then you have to get the curve to start to come downward, and that's been very important progress. It does not mean that all the work is done. It just means that efforts that are being put into addressing fatal drug overdoses are really beginning to pay off, and that are really critical, and the nation has a goal of trying to get down to no more than 81,000 new fatal drug overdoses in the year 2025 it's now a little over 103,000 and so there's there's definitely still work to be done, both in general and to meet that national goal, but the trend is starting to move in the right direction. In New York State, there's really been good news as well too, I think, showing that this movement is starting to move in the in the right direction. If you look at the 12 month period ending in March of 2024 and compare that to the 12 month period ending in March of 2023 that's the most recent data from CDC that compares a full year to an earlier full year. What we see is that in New York City, it's down about 3.1% and in the rest of New York State, it's down about 9% so in both cases, not increasing anymore, not just the flattening, but beginning to show that decrease. And I think that's really critical, because one had that change not occurred during that period, there would have been about 420 more New York lives lost during just that 12 month period. So because of those changes, 3.1% in New York City, 9% rest of state, there's 420 more New Yorkers at the dinner table, with their family, with their friends and their community, and that's really important, because every life is so precious. But of course, it means that of the bit over 6000 fatal drug overdoses that still occur in New York, we've got more work to do, and we've got to be able to double down on our efforts and still address that, but an important turn, I think.
Jim McDonald:Yeah, thank you, Dr. Holtgrave Thank you for
Unknown:I'm really honored to be here. It's really a great joining us today for our conversation. You know, we're thrilled to have you. It's great to have you part of the New York State Department of Health Executive Leadership Team, and pleasure to get a chance to work at New York State Department of looking forward to see the great impact you're going to have here as a senior policy advisor, particularly focusing on our overdose prevention work. One of the things I think about, there's so much going on at the New York State Department of Health with overdose work, you know, one of the things which was really important to me was just to have someone who could put it all together, but translate what we do and actually move it into the world of the public, so people do what we're doing, but also, make sure everything we're doing here at the New York State Department of Health is coordinated, not just with ourselves, but with other state agencies and community based organizations and other partners and stakeholders as well. Health in this area, and I have very much enjoyed the discussion today on this podcast. Thank you for both opportunities, and I'm just really enjoying beginning my fourth week on the job here. So thank you again. Dr McDonald, I'm enjoying it.
Jim McDonald:So season three is underway, officially today. Our first episode is in the books, as it were. So thank you for joining New York Public Health Now Podcast. As always, if there's a topic of interest you'd like to hear us talk about, please let us know by email at PublicHealthNowPodcast@health.ny.gov
Johanne Morne:And to everyone joining us, keep an eye out for the latest in New York Public Health Now Episode on your favorite podcast player, whether that's Apple podcasts, overcast, Spotify, YouTube and Google podcasts, search by our podcast title, New York Public Health now, or by keyword NYSDOH, then tap the subscribe or follow button to be notified when we release a new episode that occurs about every other week.
Jim McDonald:For the New York Public Health now Podcast, I'm Dr. Jim McDonald.
Johanne Morne:I'm Johanne Morne.
David Holtgrave:I'm David Holtgrave.
Jim McDonald:And thank you for listening!
Monica Pomeroy:New York Public Health now is a production of New York State Department of Health's Public Affairs Group. Michael Wren is the executive producer and engineer, with additional production support provided by Sarah Snyder, Genine, Babakian, Barbara Stubblebine, Alicia Biggs, Monica Pomeroy and Kyle Kotary. Copyright 2024, All rights reserved. We welcome your feedback. Please email us at PublicHealthNowPodcast@health.ny.gov.
