The death of a close friend, apparently from a combination of drugs and alcohol, recently led Gov. Chris Christie to emphasize his concern about reducing overdose deaths in the state.
The friend, who Christie did not name, had become addicted to a prescription painkiller eight years ago, at which time Christie participated in an intervention. The man would go on to seek treatment at 12 facilities in three different states, but would die alone at 52 years old in a West Orange hotel, with empty bottles of the prescription painkiller Percocet and vodka on his nightstand.
The governor wants to see doctors willingly use a state prescription database to prevent those with addictions like his friend from “shopping” for opioid painkillers.
Christie said his friend left no note, so “we don’t know whether he did this intentionally or whether it was just the next step in his addiction.” At a May 2 speech to the Medical Society of New Jersey, Christie said he had attended the funeral of his friend three weeks earlier.
“I can tell you that my commitment to this was strong before the last few weeks of my life [and] is even stronger now,” Christie said.
While the event was closed to the press, the medical society posted a video of it on its website and shared it with NJ Spotlight.
Christie said the man was a fellow attorney who was a classmate at Seton Hall University School of Law and the ex-husband of the Christies’ family doctor. Christie said the families would take vacations together every summer and winter before the man’s life spiraled out of control.
The governor’s loss comes at a time when the Legislature is focusing on reducing drug overdose deaths. Christie used the speech as an opportunity to urge doctors to use the New Jersey Prescription Monitoring Program, which is the subject of multiple bills.
Christie said that while he was philosophically opposed to increasing mandates, he warned doctors that he if they didn’t use the PMP, then he or another governor would sign a mandate into law.
“Don’t make it necessary for the Legislature and the governor to require you to do it,” Christie said. “Engage in it voluntarily.”
He said his friend should never have been able to get another Percocet prescription, with a rap sheet riddled with driving-under-the-influence charges, long after his back problems that led to the addiction had subsided.
How a Bill Becomes a Law
“Laws become laws often not always but often when politicians believe society won’t do something without being forced to do so, even if it seems to most well-meaning folks in society that it should be obvious that people should want to participate in a particular course of conduct,” Christie said. “Let’s not make this one of them.”
He said that if government tried to impose a solution without doctors’ willing participation, it would do it in a “ham-handed, awkward and probably less-than-effective way.”
Christie predicted that it would be more efficient if doctors decided for themselves to use the PMP themselves. If not, even if Christie doesn’t sign a mandate, “it’s going to be somebody else who’s going to foist it upon you. Someone much more famous or much more sympathetic than my friend will die,” like the friend of a legislator, leading to a bill “that has somebody’s name on it.” He added that bills that carry personal names are hard not to sign.
“You might skate with me for the next few years, but you never know who’s next,” Christie said.
The percentage of New Jersey doctors who don’t use the PMP, is on a par with other states that don’t mandate use. As of May 6, 12,618 doctors, other prescribers, and pharmacists are registered in the PMP, which is 20.6 percent of all eligible healthcare professionals. State officials said they have been recruiting more participants, adding 2,000 new PMP users in March and April alone. There are roughly 100,000 user searches of the database per month, which has added a total of 33.4 million prescriptions since data collection began in September 2011.
While additional legislation on the PMP appears likely, it’s not clear what form that bill will take, or whether Christie would sign it. One bill, A-3129//S-1998, would automatically register doctors in the program but wouldn’t mandate its use. The Assembly Health and Senior Services Committee advanced that bill earlier this month. It had appeared that the bill had the greatest chance of passing, since committee Chairman Herb Conaway Jr. (D-Burlington) sponsored the measure.
But a separate bill, A-3062 /S-2119, sponsored by Assemblyman Joseph A. Lagana (D-Bergen and Passaic) that would mandate participation is also advancing after being approved by the Assembly Judiciary Committee last week.
While Christie has always talked about drug treatment in personal terms, referring to his experience as a board member of treatment facility Daytop Village in Mendham, he hadn’t talked in detail about his friend before.
Christie has backed several policies aimed at reducing addiction, including endorsing drug courts as a way of diverting nonviolent offenders into treatment rather than jail or prison and offering immunity to those who seek help for overdose victims or administer the overdose antidote naloxone to them. He said the law allowing naloxone use has already led to lives being saved.
Christie noted that his friend had searched for different prescriptions from different doctors, presenting himself as an “upright, respectable lawyer.”
Christie said his friend got the best grades and was the “best-looking” of his close group in law school. He also had success after law school, as the father of three daughters and as a multimillion-dollar “rainmaker” for his law firm. But after he became addicted, he was fired from three firms and his daughters had essentially lost their father six years before he died, Christie said.
“Each of us bright, educated, caring, concerned people did everything we thought we could to try to help cure his illness, but as all of you know both from your professional experience — and personal, I trust — there are some people who get held by this demon and just can’t let go,” Christie said.
Christie said he believes the national “war on drugs has been a failure, a well-intentioned failure, but a failure nonetheless,” adding that there has been too much emphasis on increased penalties and not enough on treatment.
“If we’re spending $500 per second to defeat drug addiction in our society, it seems like we’re spending it on the wrong things,” said Christie, adding: “Politicians in Washington and in state capitals say, ‘Well, if we just make the penalties harsher, that’ll teach ’em.’ That misunderstands this problem, doesn’t it? My friend was not stupid, he was incredibly smart.”
He also said that his friend had brushes with the legal system due to car crashes, but “the legal system never intervened to try to save him from himself.”
Christie criticized the tendency of some officials and residents to distance themselves from overdose deaths, noting that prescriptions deaths are increasing rapidly and now lead to more deaths than heroin and cocaine combined.
“We need to make these policies more personal,” Christie said, adding that training for administering naloxone (also known by the trade name Narcan) is being expanded.
Addressing Other Issues
Christie did not restrict his comments to drug ODs and related topics.
In response to questions about whether he supports efforts to reduce medical school debt, Christie said additional funding would be impossible without addressing growing state employee pension and retiree health benefits. He said next year would be the first time that the state will spend more on retired public workers than on active workers.
Christie also defended his decision to expand Medicaid, while vetoing bills that would have made the expansion permanent.
He offered his response to “conservative Republicans who yell and scream at me about expanding Medicaid.”
“ ‘I say, my job is to be governor of New Jersey, and this is going to be a $220 million-per-budget-year winner for us, when the federal government is paying 100 percent of costs.’”
“And they say, ‘Well, governor, aren’t you concerned about the federal budget?’”
“And I say, ‘No, that’s not what I’m hired to do at the moment,’” Christie said to laughter and applause from the doctors.
Christie also said he was reluctant to support enhanced scope of practice for advanced practice nurses and other healthcare professionals. There are several proposals that would allow these groups to expand their practices with less control from doctors. Christie said he has a “pretty firm feeling rooted in my experience” as an attorney who spent the first seven years of his legal career defending doctors.
“I believe there are other ways we can find efficiencies in the way we administer healthcare to folks and I’m much more of a traditionalist in that regard,” Christie said, adding that he gets “a lot of argument in my policy shop about this,” and he will “never say never” on the issue.
He also disabused the audience that medical liability reform is imminent. He said Senate Judiciary Committee Chairman Sen. Nicholas Scutari (D-Middlesex, Somerset and Union) has described himself as an “ambulance chaser” and that the issue would never get past Scutari’s committee.
While saying the tort system is in need of reform, Christie added that to tell the audience that there was a serious chance of a change would be “bullshit.”