Task Force Urges Swift Action as Heroin, Painkiller Deaths Climb

Andrew Kitchenman | March 19, 2014 | Health Care
Report calls for expanded treatment, mandatory tracking of prescriptions, and special high schools for young addicts in recovery

Frank Greenagel Jr., chairman of state task force addressing the rising number of deaths from heroin overdoses and prescription painkiller abuse.
With the death toll rising from heroin overdoses and abuse of prescription opioid drugs, a task force is calling on lawmakers and state officials to make it easier for those addicted to drugs to receive treatment.

The task force, which focused on abuse and addiction among adolescents and young adults, also recommended that the state consider launching “recovery high schools,” where students in recovery could study without having to return to the environment where they became addicted.

The panel’s list of 18 recommendations also calls on the Legislature to require doctors to participate in the New Jersey Prescription Monitoring Program, which tracks all prescriptions for dangerous drugs, and to review whether insurance practices impede access to treatment.

The task force was launched in March 2012 to develop recommendations for the Governor’s Council on Alcoholism and Drug Abuse (GCADA), which advises Gov. Chris Christie and the Legislature.

The urgency of the issue has grown as pace of fatal overdoses in New Jersey has risen to more than one per day. State legislators are preparing a comprehensive set of bills designed to address addiction prevention, treatment and recovery, while nonprofits like the Nicholson Foundation have made the issue a public health priority.

Task force Chairman Frank Greenagel Jr. said he hopes the report will help rouse officials to take action.

Greenagel said that much of the coverage of the problems of addiction, while helpful, has failed to address the steps necessary to combat the problem.

“It gives people a guide and a grade book to see how we’re doing six months and a year from now,” said Greenagel, an addiction recovery counselor and adjunct professor with Rutgers University. “If nothing else, no one that’s either a parent, social worker, educator or elected official can say that they weren’t told and that no one ever offered them solutions.”

The Christie administration will consider the report’s recommendations, according to Christie spokesman Kevin Roberts.

“We will review the report’s recommendations, which will inform our thinking and policy recommendations going forward,” Roberts said in an email.

Task force members said the report involved a series of compromises as the members worked to find common ground on issues ranging from having the GCADA work with lawmakers to deal with towns that use zoning to keep out treatment facilities to updating the state’s school curriculum on substance abuse.

Greenagel said that while all 18 recommendations are important, it’s particularly vital that the state require all doctors to participate in and use the PMP. The PMP, which includes all prescriptions filled at pharmacies in the state, could be used to detect patients who go to multiple doctors for pain medications, as well as doctors who are recklessly overprescribing.

Doctors have expressed concern about additional state mandates, saying doctors rarely fill large prescriptions for pain medications.

This position has gained support from powerful policymakers, including Assemblyman Herb Conaway Jr. (D-Burlington), who has said that he sees the proposal as legislating how doctors practice medicine. He’s also expressed concern that the legislation might result in a swing toward undertreating chronic pain conditions.

But Greenagel said doctors should be willing to do a small amount of additional work for the large potential benefit of reducing the risk of addiction.

While Greenagel said the Legislature could act quickly on the PMP proposal, he said he expects a “long, nasty battle” over examining insurance practices. He said insurers should stick more closely to the recommendations of treatment specialists in deciding whether to cover treatment.

“It’s my hope that state legislators take the lead here and there are members of both parties who’ve expressed very strong interest in supporting a number of the proposals,” Greenagel said, citing Assemblywoman Mary Pat Angelini (R-Monmouth), who is the executive director of Prevention First, a nonprofit devoted to keeping children “healthy, safe and drug-free,” and Sen. Joseph F. Vitale (D-Middlesex) as examples.

Task force members came from a variety of backgrounds, including treatment specialists, law enforcement, and parents of overdose victims.

Paul Ressler, a Hamilton CPA, joined the task force after his son Corey died in 2010, at the age of 22, from an overdose of heroin and other drugs.

Ressler had previously expressed concerns that the task force’s report was taking so long to be released even after most of the work on it had been completed.

He expressed relief yesterday that the report had been released and said he is eager to move forward.

“It’s out and we need to start acting on it,” Ressler said.

Ressler sees a lot of potential in the idea of recovery high schools, which he said could be funded by the state under existing special-education and charter-school laws.

Returning to their old high schools after having received addiction treatment “is just a bad environment for them,” Ressler said of the young recovering addicts.

Ressler also highlighted the report’s recommendations that the GCADA work with the state’s pharmaceutical industry to develop educational materials.

“New Jersey supplies the whole world with opiates and I really think that they should be taking some of their huge profits and investing them back for education and treatment of addicts,” Ressler said.

Vitale said he would consider the recommendations as he finishes work with other legislators on a set of bills addressing addiction.

“It has to be a comprehensive approach,” Vitale said, noting that any particular proposal presents interlocking challenges. For example, if the PMP led to fewer inappropriate opioid prescriptions, more people might get their pills or heroin on the street.

Vitale said he plans legislation addressing many of the issues raised by the task force, as well as three issues related to Medicaid: How to spend the state’s scarce Medicaid funding; addressing inadequate Medicaid rates for addiction treatment; and problems with providing Medicaid-funded addiction services to jail inmates.

“I think the report is excellent,” Vitale said, adding: “Its an overwhelming problem and it’s a crisis, so it has to be met with equal or greater force – we have the will to do this, but we have to back it up with necessary resources, or we’ll be kidding ourselves about addressing this in a meaningful way.”

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