The best moment of Gov. Chris Christie’s presidential campaign came during a town hall in New Hampshire. It was October 2015, and the one-time frontrunner was doing so poorly in the polls that he was relegated to the “kid’s table” for the fourth national debate. Then he shared two well-worn stories about his personal connection to addiction.
“My mother was a smoker. She smoked her whole life. She was addicted to nicotine,” Christie began. At 71, she was diagnosed with lung cancer. “No one came to me and said, don’t treat her because she got what she deserved.”
Christie also told the story of a close friend from law school who overdosed in 2014 after a 10-year struggle with pain killers. It’s a long story; by the time he got to its emotional climax, his voice was raised.
“And when I sat there as the governor of New Jersey at his funeral and looked across the pew at his three children sobbing because their dad is gone — there but for the grace of God go I.”
The video of that town hall was viewed more than 14 million times. For a few days, it looked like Christie’s presidential campaign might make a comeback. But his star once again faded and in short order, he was pushed off the debate stage and returned to governing New Jersey.
Since then — widely scorned by his constituents and bypassed for a post in the Trump cabinet — he has largely focused his attention on one issue: the opioid epidemic. And that issue has brought him rare kudos. Treatment advocates in the state uniformly praise him for destigmatizing drug addiction and expanding treatment options. President Donald Trump recently tapped him to lead a national commission on the issue.
But though his work on addiction is getting high marks, it’s not erasing the perception of Christie in New Jersey that he is more focused on his political ambitions than being governor.
In his State of the State address in January, Christie spent 40 minutes of the 50-minute speech on addiction.
“My staff and I were listening to the State of the State and we were looking at each other and saying we could have written this thing,” said Wayne Wirta, president of the New Jersey chapter of the National Council on Alcohol and Drug Dependence. “It’s stuff we’ve been saying for the last 10 years — unbelievable that we’re hearing this governor say it.”
As a federal prosecutor, Christie talked tough on crime. But on the issue of drug addiction, he has struck a decidedly different tone in recent years. Despite initial opposition, he signed a so-called Good Samaritan law that allows people to assist those who have overdosed without fear of prosecution. He expanded the use of drug courts, which divert people charged with a crime into treatment rather than jail. He turned one prison into a treatment center for those already serving time. And he mandated that private insurers can’t require preauthorization for short-term residential care.
Right decision on Medicaid expansion
But the single most important thing Christie has done, according to treatment service providers, was expand Medicaid coverage under President Barack Obama’s Affordable Care Act. Many Republican governors refused to accept federal dollars to provide healthcare for poor people. Several treatment providers and advocates in New Jersey say the governor deserves credit for making the right decision.
“Across the country, it became a political thing instead of one based on the needs of residents,” said Vera Sansone, director of CPC Behavioral HealthCare in Monmouth County. “But he went for Medicaid expansion and that has made a huge difference, particularly for single adults who weren’t eligible for treatment. So just that one act he did was a great thing for the state.”
Even so, many of these same treatment providers were upset that Christie fell noticeably silent during the fight over repealing Obamacare in March.
“That’s where’s there’s a contradiction for us,” Sansone said. “We feel strongly that a lot of the initiatives he is talking about are really important, but if they roll back Medicaid expansion, it will basically destroy the system that we’ve actually been able to put in place for the last four years, and that would be really horrible.”
The governor did not respond to multiple interview requests for this story.
About half of Sansone’s clients seeking addiction treatment rely on Medicaid, and many of those attend intensive outpatient support groups that meet three times a week. At a recent group therapy session for those struggling with addiction and problems with obsessive compulsions, two-thirds of the patients said they were able to attend because Medicaid funding helped to pay for their treatment.
The new face of drug addiction
The group represents the new face of drug addiction. They are mostly white. They represent a range of ages. And they are made up of more women than men. (The clinic asked that their names not be used because of the stigma associated with drug use.)
They are not particularly impressed with Christie’s focus on improving treatment services.
“I feel like they talk about it, but they don’t really change it,” said one woman. “Because when I went to go get help, it took me forever to get in somewhere. I cried on the phone like ‘I’m gonna die, and you guys are telling me I have to wait three months?’”
A man in his 30s with stylishly cropped hair and a goatee sitting across the table chimed in. “With Medicaid, the options are kinda limited. I tried to call and get on detox,” he said. “Because I only had Medicaid, I was put on a three-month waiting list. I ended up detoxing on my couch.”
Nevertheless, treatment advocates in New Jersey are happy with the progress Christie has made. Roseanne Scotti, executive director of the New Jersey Drug Policy Alliance, spent a decade fighting to legalize needle exchange, a program that provides free clean needles in an effort to reduce the spread of AIDS. Now, she sees change coming swiftly.
“There are a lot of good things that are happening right now,” Scotti said.
The governor has expanded access to Naloxone, a drug that can prevent overdose deaths, and medication-assisted treatment with methadone and Suboxone.
“Just the destigmatizing language that’s being used — talking about people as human beings and not presenting this as a moral failing — that goes a long way,” Scotti said.
In a national context, the flurry of activity hasn’t made New Jersey a leader, but its efforts have put it in line with a majority of states. The changes it’s implemented have been enacted in 29 other states, according to a study published in the journal, Public Health Reports.
Lack of transparency
Despite the progress, some advocates, like Scotti, remain frustrated by a lack of data and transparency from the Christie administration. For example, the state doesn’t break down how much it’s spending on outpatient services compared to residential treatment, or whether it’s methadone-assisted. The administration released numbers on the reduction of wait times for treatment, but there has been no specific information that breaks down the capacity to treat people who don’t have private insurance, which constitutes the largest group of addicts.
“Everyone knows there’s going to be a gap, but we should know what the gap is, but none of us do,” Scotti said.
Some Republican legislators in the state have expressed frustration that the governor is spending more time fighting addiction than tackling issues like high property taxes or school funding.
Christie has also drawn criticism for casting himself in widely broadcast TV and radio ads that promote a hotline. The criticism was reminiscent of what arose over Christie’s post-Sandy ads that featured his family on the beach, just six months before his re-election.
Whether the criticism is fair or not, the governor seems unable to escape the lingering perception that he’s simply angling for a better job. In 2012, he was on Mitt Romney’s shortlist for vice president. In 2014, he was chairman of the Republican Governors Association, and his work looked much like a road test for a presidential campaign a full year before his declared his candidacy.
Polling data suggests New Jersey voters believe he is sincere about fighting addiction, but that they don’t necessarily trust him.
“It’s still being seen as ‘well he’s just making a play for whatever his next job is going to be,’ said Patrick Murray at the Monmouth University Polling Institute. “It’s just too late to not be cynical about what his motivations are right now.”
Editor’s note: After this story was published, a spokeswoman for the New Jersey Department of Health clarified that the television ads promoting a drug addiction hotline were paid for by money from the state general fund and not funds from Women, Infants, and Children (WIC). The story has since been updated.