When the goal is to help young people in the Garden State better understand and avoid drug abuse, everyone has some learning to do. For teens, there’s the need to understand just how quickly a legally prescribed pill can take over your brain and body; for adults, its helpful to know what kids are calling such drugs, and their effect — percs, xans, drex, lit, leans (translation: Percocet, Xanax, cough syrup, high, very high).
Those were just some of the lessons that emerged from a recent opioid-awareness workshop led by pharmacy experts at Horizon Blue Cross Blue Shield, New Jersey’s largest insurance network. It has teamed up with Rutgers Pharmacy School on a campaign designed to reduce growing drug use among young people.
The outreach, which dates back to April 2017, has involved middle and high schools, churches, and community groups across the state, from Camden to Montclair, and has touched nearly 2,000 students in the process. Last week, half a dozen youth leaders from The Hubb, a community empowerment center in Newark, visited Horizon’s corporate headquarters in their home city to learn how they can help spread this message in their own work with at-risk peers.
“Addiction manifests itself in so many forms and stages that it defies singular remedies, which is why we have funded educational programs and created outreach opportunities for doctors and pharmacists to promote opioid management best practices across the spectrum,” explained Saira A. Jan, director of pharmacy strategy and clinical integration at Horizon and a professor at Rutgers, who led the charge to create the campaign, with help from her pharmacy students.
“Horizon believes that community partnerships are a key solution to this problem,” Jan added. “We must engage multiple stakeholders and address the whole continuum of care, starting from awareness of the problem to prevention and to treatment. Horizon is focused not on some, but all aspects of opioid addiction.”
Some 128,000 New Jersey residents were addicted to heroin or other opioids, including prescription painkillers, in 2015, and more than 315,000 sought treatment for this disease between 2010 and 2014, according to statistics Horizon compiled from federal and state sources. And 40 percent of the individuals that sought treatment were under age 26, the company said, underscoring the need to focus on the younger demographic.
The push to curb addiction also has practical impacts for Horizon, which insures some 3.8 million people in New Jersey, including a large portion of the state’s Medicaid members. In 2015 and 2016 the company spent nearly $309 million to treat substance-abuse issues; in 2016, that included $54 million on opioid addiction alone, of which $40 million went to cover the cost of inpatient care, Jan said. Nearly 2,000 Garden State residents died of drug-related conditions in 2016.
The youth-outreach campaign is just one aspect of Horizon’s efforts to address the disease; in addition to their focus on prevention, the company is working to improve outcomes for those already in treatment and reduce the appetite for opiate-based drugs in the first place. Some research has shown as many as four out of five new heroin users became hooked on prescription drugs, but eventually switched to cheaper and stronger street options.
The framework for Horizon’s work is outlined in an opioid-abuse toolkit the company developed with Rutgers in late 2016. The website boasts dozens of links to resources ranging from posters and stickers for school kids, to FAQs for individuals in treatment, to guidelines for physicians to help them safely dispense addictive painkillers and properly manage withdrawal, when necessary.
For the youth leaders from The Hubb, who head up group sessions on heavy topics like sexual harassment and inappropriate touching, Horizon’s training session started with an HBO Films documentary, Heroin: Cape Cod, USA, and another video about the dangers of prescription drugs. The Hubb founder and CEO, Al-Tariq W. Best, and chief operating officer Denisah Williamson, a trained social worker, joined the youngsters for the meeting.
Identifying types of drugs
When it came to the details, Alex Wiggall, a clinical pharmacist with Horizon, led them through a Powerpoint designed to help the youngsters identify different types of substances (uppers versus downers, naturals versus synthetics), to recognize drug use (agitation, droopy eyes, leaning), and respond to an overdose (stay and call 911; New Jersey’s Good Samaritan Law will protect you from liability if something goes wrong).
One important point was that drug addicts come in all forms, a lesson the kids have clearly witnessed first hand. Quaniyah Thomas, 18, recalled seeing a woman who was “mad pretty and dressed real nice,” but was slumped to one side, nearly on the floor of the local supermarket. “It could be someone up and running with a job and a family,” she continued. “You can’t tell who is on drugs. There’s always a backstory.”
Jan, Wiggal and The Hubb leaders also encouraged the youth to talk about how it felt for them to see friends and family suffer from addiction, and the frustration they may feel when they can’t get them to stop. They chatted about peer pressure and how prom season, street festivals, and concerts are common opportunities for drug use.
“How does it feel when all my friends are smoking weed? How do I stand on this ledge alone,” Williamson asked. Peer pressure is a struggle for youth leaders, not just followers, it appeared.
Mostly, the group strategized about how they would adopt the presentation to their own needs, tweaking the language (adding the word “weed” to the marijuana section; including “munchies” as a side effect) and plotting out how it would work back at The Hubb in a group session format dubbed MTOL, for My Thoughts Out Loud. The organization is also planning a session for parents later in the spring and will kick it off later this month with a block party.
“They really want to impact change,” Williamson said, as Horizon wheeled in a cart full of pizza, salad and other snacks and the youth leaders got down to the important business of lunch.