NJ’s Opioid Crisis: Part II: Better approaches

“Ending the opioid crisis will require better coordination of care, community involvement in finding solutions, and more consistent use of improved pain-control options. Responses must overcome limited resources, societal ills that fuel addiction, and the stigma attached to illicit drug use.” – Seeking Solutions to the Opioid Crisis

A NJ woman who was questioned by police officers about possession of heroin. Credit; Jessica Kourkounis for NYT

New Jersey’s greatest public health threat is the widespread availability of opioids including illegal drugs, such as heroin, and legal prescription painkillers like oxycodone and hydrocodone.While NJ ranks 39th in the nation when it comes to overall substance abuse rates, the state leads the nation in the number of teenagers who say they’ve encountered drugs at school. According to a 2017 study, 30.7% of New Jersey high school students reported either buying, selling or being offered illegal substances while on school property. Drug overdose is the leading cause of accidental death in New Jersey. The rate of heroin overdose in our state is 3x the national average. 

N.J. drug overdose deaths in 2018 are on a record-shattering pace. In 2000 there were about 500 deaths in NJ. They are now on pace to reach about 3,000 this year.  

BETTER APPROACHES

  • More effort to reduce demand rather than supply. The “War on Drugs” started in the Nixon administration has been a failure that has ruined lives, filled prisons and cost a fortune. Its idea that drugs should be difficult to obtain and that police and DEA can solve the supply problem has proven invalid.
  • Declare that we must abandon the futile goal of a drug-free society. “Just say No,” the absolutist approach touted by Nancy Reagan and still used by some today is totally unrealistic.
  • Use appeals based on positive emotions such as love, excitement, sex and hope. Scare tactics, a long-used approach, particularly for teens may just increases the allure of drugs, trigger the behavior they are designed to prevent and alienate or demonize the people you are trying to help.
  • Our new Commissioner of Education Dr. Lamont Repollet should review and possibly modify Christie’s Curriculum Resources for Educating Children about the Dangers of Substance Abuse. The emphasis just on “dangers” is, perhaps, not the right way to start.  
  • Take meaningful steps to address inequality and absence of opportunity. “Addiction rates are higher in poor people because they are more likely to experience childhood trauma, chronic stress, high school dropout, mental illness and unemployment, all of which raise the odds of getting and staying hooked.”
  • Strengthen further education of primary care providers  on chronic pain management and safe opioid prescribing, building community coalitions, preventing overdoses, and reversing overdoses with rescue medication,
  • More education for Emergency Department personnel on what to do after treating an addict.Coordination and follow-up are essential. The hand-off to other services must improve, and primary care doctors need more help getting people into treatment.
  • Continue increasing access to Naloxone (Narcan) the life-saving medication designed to reverse opioid overdose rapidly.
  • Fund more long-term treatment beds for the many in NJ who cannot afford them. Although these programs are far from fool-proof, they remain an important component.
  • Encourage local community health and social services organizations to integrate addiction programs such as education, prevention, harm reduction (needle exchange), and use of Buprenorphine (a partial opioid agonist prescribed by a physician), plus, establish referral agreements with the treatment centers.
  • Strengthen services for the incarcerated. While treatment for minor offenders through our drug courts is preferable, those incarcerated would benefit from more psychiatric, medical and prevention services plus enhanced re-entry assistance with referrals to agencies that can help them. Further training of correction officers is important.
  • More housing and half-way houses for recovering addicts should be accessible. These are places where drugs can be strictly forbidden and where the other residents are also recovering — people who understand the trials of staying straight and support each other in the effort. The alternative of shelters, where drugs are omnipresent, or living in the streets is a disaster for them. 
  • Rather than highly addictive prescription opioids, promote the alternative of medical marijuana where indicated. Under Gov. Murphy this program is expanding.
  • Move toward legal regulation of heroin and other currently illegal drugs to protect users from unwittingly consuming the hazardous combinations often sold on the streets, and to reduce the violence involved in trafficking of drugs.

You can choose to promote one or more of these approaches, even the one the left. Also feel free to mention below other approaches that you feel are important.

You can read Part I of this series here. Part III coming shortly.

Preview image above via Anna Vignet, for NJ Advance Media

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