Legislators Poised to Combat Deadly Rise in Opioid Abuse and Heroin Use

Andrew Kitchenman | April 29, 2014 | Health Care
Initiatives include targeting illegal prescriptions for painkillers, making drug treatment more available and effective, and fostering anti-abuse awareness

Celina Gray, acting executive director of the Governor’s Council on Alcoholism and Drug Abuse.
Now comes what may be the most difficult part of the fight against often deadly abuse of opioids and use of heroin – following up talk with effective action.

Using tax money from electronic cigarettes for anti-drug abuse initiatives, freeing up the use of empty hospital beds for drug treatment and updating the drug-prevention curriculum in schools are among ideas being put forward by legislators.

In addition, Gov. Chris Christie’s administration is working on several proposals to address drug abuse, according to Celina Gray, acting executive director for the Governor’s Council on Alcoholism and Drug Abuse. She discussed the issue at a Senate Health, Human Services and Senior Citizens Committee hearing yesterday.

Gray said council officials are in discussions to establish a heroin and prescription drug abuse “warm line,” a phone line dedicated to providing information to the public.

She noted that a recent council task force report recommended giving drug treatment providers more information about medications used to treat addiction, such as methadone and buprenorphine. It also recommended reviewing insurance practices that impede access to treatment and local zoning that prevents drug treatment facilities from locating in many areas.

In addition, the council is set to launch a major statewide addiction awareness campaign, with an initial focus on the prescription drug abuse and heroin crisis, Gray said.

“This campaign also strikes at the heart of stigma, which is often a significant barrier to prevention, treatment and recovery,” Gray said.

Parents of children who died of overdoses or who were in recovery said they have heard negative terms like “junkie” to describe those with addictions – language that was very different from the positive words like “sensitive” and “loving” that the parents themselves applied to their children, Gray said.

“Addiction is a disease affecting real people,” Gray said, adding that the term “addict” is dehumanizing. “They’re people, living and struggling with a disease.”

Gray noted progress being made on other task force recommendations, including discussions with school officials in Ocean County about updating curriculum dealing with drug addiction.

In addition, a pilot program will launch the first “recovery high school” in Union County in September. The school will allow students in recovery to attend without returning to the same school environments that contributed to their addiction.

Versions of these proposals may make it into a legislative package being prepared by Sen. Joseph F. Vitale (D-Middlesex), who said he is working with legislators from both houses — as well as the administration — on legislation to be introduced next month.

“There are no simple solutions – there are going to be long-term strategies,” Vitale said.

Vitale said the e-cigarette tax included in Christie’s budget proposal should be extended to various forms of smokeless tobacco, with the revenue divided between drug treatment, smoking-cessation programs and the rest of the state budget. Christie proposed using the entire amount for the general budget, without dedicating it for specific programs.

The comprehensive legislative package envisioned by Vitale – spurred on by a continuing increase in alcohol- and drug-overdose deaths in New Jersey — would bring to a head the policy discussion that has been intensifying since last July, when a State Commission of Investigation report found that some doctors had been bilking Medicaid by wrongfully prescribing painkillers.

Sen. Robert W. Singer (R-Monmouth and Ocean) noted that there were more than 100 drug overdoses in Ocean County in 2013.

“It is a crisis situation in suburbia that is getting frighteningly worse,” Singer said. He said that on “any day of the week” there are teenagers in county hospitals waiting for inpatient treatment, but insurers provide barriers to treatment.

“We have turned strictly to outpatient to solve everyone’s problem,” said Singer, adding that continuing to do the same thing when it isn’t working is the “definition of insanity.”

Sen. Jim Whelan (D-Atlantic), asserting that any real solutions will depend on funding, asked Gray if the Christie administration will commit to funding the various efforts listed in the task force report. Gray said the council is considering what steps to recommend.

Sen. Robert M. Gordon (D-Bergen and Passaic) suggested that there be a limit on the number of opioid pills in each prescription.

Vitale warned against “ratcheting down” too hard on those addicted to prescriptions, pushing them toward cheaper drugs like heroin. He also said that the state should not interfere with the ability of patients with chronic pain to get access needed pain relievers, a point raised by doctors in recent months.

But Vitale also said that the state should take steps to track which doctors are writing the most opioid prescriptions, while also better educating doctors about the dangers of prescribing many pills for minor conditions.

Sen. Ronald L. Rice (D-Essex) expressed dismay that policymakers are focusing on heroin and opioid abuse only after it began to affect suburban areas, while those same drugs have ravaged cities for decades.

Vitale echoed the point, adding that both inpatient and outpatient treatment are underfunded. He said the only option for some parents to get treatment for children who are addicted is to turn them over to law enforcement.

“If that’s what it takes for children in New Jersey to get treatment, that’s a pretty sad thing,” he said.

Whelan said more drug treatment facilities should be located outside of cities. Gray said addressing the issue would require bringing the “right stakeholders” together and educating them and the public about the need.

Vitale added that addiction must be treated as an illness in the same way as heart disease and cancer are treated. He added that inpatient treatment could be provided at hospitals by modifying their licenses.

To treat those with addiction differently than other patients is “Stone Age thinking,” Vitale said.

Sen. Diane Allen (R-Burlington) said the state should look at new drugs that are used to manage opioid dependence, while Vitale expressed concern about the high out-of-pocket costs for prescriptions for drugs like buprenorphine that are used to treat opioid addiction.