Opioid addiction is a fast-growing threat both in New Jersey and across the country, with the toll of lives lost and families left bereft climbing daily. In 2014 alone, for example, there were 600 fatal heroin overdoses.
New Jersey is fighting back, enacting legislation and implementing programs that it hopes will stem the tide of addiction, crime, and death. There are currently three bills on Gov. Chris Christie’s desk related to opioid abuse and its consequences, and other bills are under discussion. What’s more, a package of 21 bills was announced last year, in hopes of slowing the number of fatal ODs.
One of the most controversial of these measures (S-2366/A-3712) would require doctors to talk with patients about addiction when they prescribe opioids.
The three bills on Christie’s desk would require doctors to check a state database of all opioid prescriptions when writing new scrip; allow those in drug court to receive medications like methadone to assist in their treatment; and compel state colleges to build housing to serve students who are recovering from addiction.
If enacted, these measures would build on earlier laws that extend the immunity offered by the state’s Overdose Prevention Act to protect healthcare professionals; require the state to develop a plan to treat inmates’ mental and substance-abuse issues; and authorize the attorney general to direct a statewide effort to fight opioid abuse. Supporters argue that it’s important to build on the earlier laws, citing a recent study finding that many doctors still don’t understand the dangers posed by certain opioids.
Sen. Joseph F. Vitale (D-Middlesex), the sponsor of many of these measures, said legislators decided to pursue a piecemeal approach to the bills both to increase their chances of being enacted and because it was important to address every aspect of the problem, including addiction prevention, treatment, recovery, and education. While this has led to significant bills advancing, it leaves the fate of the remaining measures uncertain.
Angelo Valente, executive director of Partnership for a Drug-Free New Jersey, said the bill requiring doctors to talk with patients about the dangers of addiction is “absolutely necessary.”
He noted a recent Johns Hopkins University Bloomberg School of Public Health study that found that nearly half of internal-medicine, family-practice, and general-practice doctors incorrectly believed that abuse-deterrent opioids — such as those that are formulated to prevent their being crushed, snorted, or injected — are less addictive than their standard counterparts. While they may be more difficult to abuse in some circumstances, they are equally addictive.
[related]In addition, one-third of these doctors erroneously said that most prescription drug abuse is by means other than swallowing the pills as intended. Studies have found that between 64 percent and 97 percent of abuse is by people swallowing the bills, not snorting or injecting them.
Valente noted that the bill, in addition to requiring both the patient to sign a form acknowledging that the doctor explained addiction risks, also requires doctors to consider alternate forms of pain treatment to reduce the risk of drug abuse or dependence.
“I think that both parts of the bill will go a long way to curb the unfortunate increases we’re seeing in heroin abuse and Rx (prescription) abuse across the country and across New Jersey,” Valente said.
Valente noted that his organization has hosted six continuing-education symposiums for doctors.
“We found that … many doctors were not as informed as they need to be about the issue” of opioid abuse, Valente said. In surveys completed after these events, the doctors “indicated that they will be looking at their prescribing habits in a different way now that they’ve become aware” of the potential consequences. The organization will host more symposiums in September and November.
In signing several measures aimed at curbing overdose deaths, Christie has cited his personal experience on the board of Mendham-based treatment center Daytop Village, as well as the overdose death of a longtime friend last year.
Vitale said he’s hopeful that Christie will sign the three bills on his desk, based on the governor’s support for the previous measures.
The bill allowing those in drug court — a program that allows people arrested for nonviolent crimes to receive treatment instead of jail time – to be treated with medication is important, Vitale said. This would affect drugs like methadone and buprenorphine.
“It’s a medicine like any other medicine that a person with a chronic disease would receive without any judgment,” Vitale said. “It should not prevent them from graduating” from drug court.
Vitale agreed with Valente that it’s important to enact the bill — which Vitale sponsored — mandating addiction information for patients receiving opioids.
“Far too many times, patients are not aware of the dangers of prescription opioids and their potentially addictive properties,” Vitale said.
The Senate passed the bill on a 36-1 vote. Sen. Joseph Pennacchio (R-Essex, Morris, and Passaic), a dentist, cast the only “no” vote. However, in the Assembly, it’s been referred to the Health and Senior Services Committee. While technically a sponsor of the bill, Committee Chairman Herb Conaway Jr. (D-Burlington) is a critic of measures like the bill, which he sees as interfering with the patient-doctor relationship. Conaway is a doctor.
Conaway has promoted other measures to curb opioid abuse, including a bill, A-4271/S-3036, requiring insurers to pay for abuse-deterrent medications.
Vitale said he remains hopeful that a version of the bill on providing patients with addiction information will find “its way through the Legislature.”
Valente added that he’d also like to see the state add more funding for abuse prevention. A bill that would increase prevention funding by $5 million has stalled.
“We know that prevention works,” Valente said, adding that the effort will be “crucial in preventing future generations from going through the same” addiction problems.