Report Praises NJ’s Policies on Prescription Drug Abuse But Cites Shortcomings

Andrew Kitchenman | October 11, 2013 | Health Care
Upcoming state task force recommendations may close gaps cited by national study

Roseanne Scotti, New Jersey state director for the Drug Policy Alliance.
New Jersey stacks up fairly well compared to other states in its attempts to reduce prescription-drug abuse, but there’s room for improvement, a new national report has found.

New Jersey has implemented seven of 10 “promising strategies,” according to the Trust for America’s Health report issued this week, tying it with four other states for 18th place in the rankings.

In addition, New Jersey had the country’s 11th-lowest death rate from drug overdoses in 2010, with 9.8 deaths per 100,000 residents. However, that rate represents a 51 percent increase since 1999, when New Jersey had 6.5 deaths per 100,000. The national rate has also soared over the same time period, driven in large part by a large increase in prescription-drug abuse.

The report, the first national overview of these strategies, comes three months after a State Commission of Investigation report that found that some [|New Jersey doctors were fraudulently issuing dangerous prescriptions].

The report cited three promising strategies that New Jersey is not currently pursuing: requiring healthcare providers who prescribe controlled dangerous substances (CDS) to participate in the state’s prescription monitoring program; requiring or recommending that prescribers be educated about prescription abuse; and requiring or permitting pharmacists to require patients to how identification before receiving CDS.

These issues may be addressed in recommendations scheduled to be released next month by a state task force on heroin and other opiate use.

While task force Chairman Frank Greenagel wouldn’t say what the recommendations would be, he said New Jersey could benefit from the three strategies highlighted by the report that it currently isn’t pursuing. He singled out requiring prescribers to participate in the prescription monitoring plan, which tracks all CDS prescriptions, as a good idea.

These strategies are “good policy and they’re not very expensive,” Greenagel said.

However, the report doesn’t address some of the major causes of overdose deaths, said Greenagel, an addiction recovery counselor and adjunct professor with Rutgers University. He cited a need for more consistent funding of treatment and recovery services, adding that recovery funding is “the true market inefficiency in the field,” since it’s proven to be successful and isn’t costly, but remains underfunded.

Greenagel said he is a “hopeful cynic” regarding how the 2010 Affordable Care Act could affect treatment and recovery payments. “I’m really hopeful it’s going to work, but until I see” treatment paid for, Greenagel said, he remains cautious.

Greenagel also said that teaching children beginning around the age of 10 about prescription-drug abuse would help, noting that children are taught about alcohol, as well as marijuana and other illegal drugs, but don’t learn about the dangers of abusing prescription drugs.

Roseanne Scotti, New Jersey state director for the Drug Policy Alliance, noted that the state’s ranking in the report was improved by the law enacted this year that protects those who alert authorities about heroin overdoses, as well as those who use a heroin overdose antidote. Both of these provisions were counted as “promising strategies” by the report.

“I think they’re going to pay really big dividends down the road,” said Scotti, whose organization advocates for changes to drug laws that reduce harm from both drug abuse and drug prohibition.

“The way to deal with this problem (of drug abuse) is through a public health approach,” rather than a “kneejerk” reaction, Scotti said. “We know that things like removing the barriers for people reaching out for help is really the way to go.”

Trust for America’s Health Deputy Director Rich Hamburg said the report is a “snapshot” of state policies, noting that the overdose death rate isn’t necessarily correlated with whether a state has adopted the so-called “promising strategies.”

That’s because the problems that lead to overdose deaths develop over time, while some of the policies have been adopted recently. For example, New Mexico has the second-highest overdose mortality rate but is one of only two states that have adopted all 10 “promising strategies.”

Hamburg noted that New Jersey also has a relatively low number of CDS sales, which helps lower the state’s overdose rate.

“Clearly it’s a major pubic health problem,” Hamburg said of prescription abuse, adding that the trust – a nonprofit devoted to improving public health — issued the report to call attention to it. “We think that’s important and I think over time it’s going to take a lot of these types interventions to move the ball on this issue.”

Governor’s Council on Alcoholism and Drug Abuse Rebecca Alfaro, director of prevention and training for the Governor’s Council on Alcoholism and Drug Abuse, said the task force recommendations would likely have a major impact on state policy.

“Other state departments have committed to taking on this issue with us, so this is a very unified state effort,” Alfaro said.