Experts say Opioids Are as Available in Suburbs as They Are in Cities

Andrew Kitchenman | March 10, 2014 | Health Care
From heroin to marijuana, prevention network works to head off drug use and addictions

drugs substance abuse
New Jersey drug-prevention and law-enforcement officials who deal with the growing use of heroin and other opioids say they are now as available in the suburbs as in cities.

That was part of the message at the recent annual New Jersey Prevention Network conference in Atlantic City, a gathering of professionals who work to prevent addiction.

The ready access to these drugs is reflected in the list of the 10 towns in 2012 with the most heroin and other opioid-abuse cases. Listed in descending order according to the number of cases, they are Newark, Jersey City, Paterson, Atlantic City, Camden, Brick, Elizabeth, Toms River, Vineland, and Trenton.

“Heroin is as easy to obtain in Ocean County as it is in cities,” said Douglas Collier, drug initiative coordinator for the state attorney general’s office, who made a presentation that included in the list.

Collier said roughly one person is dying each day in the state from a heroin or other opioid overdose.

“This got far ahead of us and we’re trying to catch up to it,” said Collier, a former Drug Enforcement Administration agent. “It’s being fueled by prescription drugs.”

Collier noted that some young people’s problem begins when they use prescriptions due to a sports or other injury. After becoming addicted, they seek these drugs any way that they can and ultimately may turn to heroin, which is cheaper and more powerful. Of state residents younger than 25 who are being treated for addiction, 31 percent were using heroin and 40 percent were using other opiates, according to Collier.

Collier put some of the responsibility on what he described as “rogue doctors” who are irresponsibly prescribing potentially addictive medications and refusing to comply with the state’s prescription monitoring program (PMP). This initiative can show that some doctors are prescribing controlled substances irresponsibly.

Collier described the attitude of these doctors: “I need to see 50 patients a day — I’m not going to police every single patient — that’s not my job.” But he said this attitude is changing, with greater awareness of the pervasiveness of prescription abuse and pressure from law enforcement.

Dr. Frederick Kahn, a Fair Lawn-based psychiatrist who participates in the PMP, said doctors are beset with a large amount of paperwork and asked if there was a way that doctors could comply with the program in a way that would cause as little disruption as possible.

The state is also using other strategies to combat opioid use, including Project Medicine Drop, a program in which residents can drop off dangerous unused prescriptions. Last year, the program collected 11,000 pounds of drugs with a street value of $33 million, Collier said.

Collier said much of the problem stems from the attitude that society gives to children that prescription drugs are not dangerous.

“We really send the wrong message to kids,” Collier said, noting that residents who leave unused prescriptions in their medicine cabinets are leaving them vulnerable to theft by young family members.

Collier described “not my kid” as the three “most dangerous words.”

He warned that the opioid Zohydro — recently approved by the Food and Drug Administration — “is going to be the new OxyContin.”

He also noted laboratory tests that have found that the purity of the heroin in New Jersey is among the highest in the United States.

Rebecca Alfaro, prevention and training director for the Governor’s Council on Alcoholism and Drug Abuse, said opioid abuse has occurred in three waves, linked to time periods when a gap opened up between expectations and reality: among middle-class white women in the early 20th century; among urban African-Americans in the 1960s; and among suburban, white working-class adolescents beginning in the 1990s.

Alfaro said many in the state are vulnerable to addiction following the trauma caused in many people’s lives by Hurricane Sandy. She pointed to research showing that large-scale traumatic events can lead to a wave of addiction in their aftermath.

“This is around that time that we’re going to see that explosion,” Alfaro said, adding that the state saw something similar after the September 11, 2001, attacks.

Collier noted that nearly five times as many state residents are dying from opioid overdoses annually as the number who died from Sandy.

Audience members at a March 7 workshop led by Collier and Alfaro asked how they could increase awareness of the problem in the community. Alfaro encouraged prevention workers to provide information in places in their community where residents congregate and are likely to see the message, such as church bulletins or the entryways of groceries or videogame stores. One effective poster says “Heroin deaths of 18- to 25-year-olds in New Jersey rose 24 percent — they didn’t all start at 18 . . . Are you talking to your kids yet?”

Collier will be working on events from June 10 to June 12 at Cooper University Hospital and Monmouth and Morristown medical centers, informing doctors about the PMP. This follows up on a similar program in October at Hackensack University Medical Center.