By Conner Keough
Nick Stahlman was recently stationed outside the Hempstead Transit Center in Central Nassau Guidance and Counseling’s mobile recovery unit. Stahlman, a former opioid addict who has rebuilt his life, now dedicates his time to helping others get clean.
“When we’re in Hempstead, we use the bathrooms in the Transit Center,” Stahlman said. “Fifty percent [of the time] I go to use the bathroom, there’s someone smoking crack inside, and I have to turn around and leave immediately. I have to hold my breath so I don’t breathe it in. As a former addict, it could be triggering to me.”
One day in the mobile recovery unit, the Central Nassau team was not seeing clients because of a staff meeting. Stahlman spotted a woman outside the van, swaying as she sat on a bench.
“I noticed she didn’t look too well,” Stahlman said. “Suddenly, she fell off her chair and was upside down outside our RV.”
Stahlman alerted his colleagues. A team of four peer advocates jumped to the woman’s aid by calling emergency medical services and administering a life-saving dose of naloxone, better known as Narcan.
The story is one of thousands in Nassau County. An estimated 77,000 Long Islanders suffer from drug addiction, according to Central Nassau Guidance and Counseling Services, a Hicksville-based non-profit organization that offers outreach and recovery services.
Deadly potency
The majority of overdoses and overdose deaths are fentanyl-related, according to Central Nassau addiction experts. Fentanyl is a synthetic opioid and one of the deadliest drugs because of its potency. Unlike other commonly used drugs, fentanyl can be fatal after a single use.
“After we administered the Narcan, the woman popped back up,” Stahlman said. “She told me she was doing crack and was confused on why we administered Narcan. I told her, ‘There was fentanyl in your crack because you were just unconscious, and we administered Narcan. It only works if you have opioids in your system.”
“An overdose on heroin can take one to three hours,” said Kathie Lombardi, Central Nassau Guidance and Counseling senior outreach coordinator. “An overdose of fentanyl can be immediate.”
Fentanyl was originally designed as a painkiller and can be prescribed by doctors. It is sometimes prescribed after major surgeries to help ease a patient’s pain, but does carry a high risk of addiction. Patients who take any opioid may feel happier and experience less pain, which can lead them to want more of the drug, according to the National Institute of Drug Abuse. Fentanyl is intended to be used as a last resort for patients who are resistant to other opioids. Fentanyl can be 50 to 100 times stronger than morphine.
“I took the path of painkillers that slowly got stronger,” Stahlman said. “I started with Vicodin, moved to Percocet and finally Oxycontin. I eventually couldn’t afford Oxycontin at $30 a pill, so I was introduced to heroin, which gave me a similar high.”
Opioids can be a gateway drug because oxycodone and heroin have similar chemical structures. Over the last decade, there have been many instances in which cocaine, heroin and marijuana were found to be laced with fentanyl. A 2023 study from Dayton, Ohio, found traces of fentanyl in 65 of 91 methamphetamine users, none of whom had consciously taken the opioid. A deadly dose of fentanyl is significantly less than a fatal dose of heroin, cocaine or even Oxytocin, meaning the smallest dose taken by an unknowing user can be fatal.
“When I was young, a drug was exactly what you thought it was,” Lombardi said. “If you bought cocaine, you were getting cocaine. Now, if you buy cocaine, there’s a chance it could be laced with fentanyl, which is what really kills.”
Peer power
Lombardi and her colleague, Douglas Defranco, both struggled with drug addiction in their youth. They channeled their experiences into service, joining Central Nassau as certified recovery peer advocates to help educate the public. They appeared at the American Legion in Valley Stream on Nov. 6 to train community members how to respond to an overdose. Lombardi has been clean for 35 years and Defranco more than six.
“I got clean and sober at the age of 51, about six and a half years ago,” Defranco said. “I didn’t know what I wanted to do with my life, so I started training as a recovery coach.”
Defranco and Lombardi took their life experiences and dedicated their time to helping others avoid drugs. They each completed classes and 500 documented training hours. Their role as recovery advocates includes leading group therapy sessions, providing mindfulness training and offering patients strategies to maintain their sobriety. All Central Nassau peer advocates have a history with substance abuse, whether it was their own or that of a loved one.
“I took my story, my personal experience, my strength and hope and the training I had and decided I wanted to take the blessing I had received and give back to the people who are suffering,” Defranco said.
Community training
Central Nassau has launched an initiative to reach local communities and educate residents about the dangers of drug opioids. Sponsored by former U.S. Rep. Anthony D’Esposito, the organization has visited high schools and community centers in several different communities to spread awareness and teach how to use Narcan.
D’Esposito and Central Nassau have hosted at least 10 public information and outreach sessions since September in communities including Valley Stream, Seaford, Levittown, Oceanside and Hempstead. Bringing the issue into affected communities has helped residents understand the dangers of fentanyl and how to use Narcan. In areas they don’t host community meetings, their RV and mobile unit appear in different Nassau County communities to provide counseling and therapy services.
Naloxone is a lifesaving-drug that can reverse the effects of an opioid overdose. In recent years, Narcan has become more widely available. In October 2022, New York Gov. Kathy Hochul signed a law mandating all public universities in the state have Narcan in dorms. All resident assistants must be trained on how to administer it. Hofstra University, a private research university in Hempstead, complies with the law.
In 2023, the Food and Drug Administration approved naloxone to be sold over the counter, dramatically increasing access to Narcan. Retailers such as Amazon, CVS and Walgreens might sell Narcan at varying prices.
“I was hired to the team during COVID,” Stahlman said. “During the pandemic, we couldn’t get into the communities. Each year since then, we’ve trained more people on how to use Narcan — about 400 people in 2021 to more than 5,000 this year.”
Central Nassau has trained over 7,000 people in the last few years and has helped concerned Long Islanders learn what to do in emergencies.
“A lot of young people are using drugs,” said Austhmeni Prsaud, a mother of three boys from Valley Stream. “I don’t want [my kids] to ever be like that. I want them to be educated.”
Prsaud brought her three sons, ages 12, 14 and 18, to the Narcan training event on Nov. 6 at the Valley Stream American Legion.
“Nowadays, kids and a whole bunch of people are overdosing on drugs because of increased access,” said Viren Prsaud, 14. “It’s good to know what to do just in case you’re in a situation where you have to save someone’s life.”
Through their work providing greater access to education and Narcan, fentanyl overdose deaths in Nassau County fell from 3,232 in 2021 to 2,301 in 2024.
On Dec. 5, Central Nassau will open a new crisis center in Hicksville, where it will provide counseling services.
