NJ’s Opioid Crisis: Part IV: “It takes a village”

Bumped. Thirty years ago, Bill Orr started NJCRI, originally for people with HIV, expanding its help for those involved with drugs. Some of these services are things a group you’re involved with can also do near you. To catch up on the series so far click here. The next & last final Part V will briefly address other concerns, including mental health issues, Medicaid, access to services, a new initiatitive, and specific help for those continuing too long on prescribed opiates. – Bumped by Rosi

Most people today refer to our crisis using a fancy word, “opioid.” Those in the community working one-on one with people dependent on prescription opioids or drugs like heroin speak of “pain and relieving pain,” – the trauma affecting these individuals.  It is the workers in the field daily treating people who appreciate their suffering and provide invaluable assistance. We need more of them.

The concept of “Empathy for the Other” has long been in short supply for this population, particularly when accompanied by co-concurrent mental health issues. Nonetheless, as the public’s attitude slowly changes to appreciate the medical, mental, behavioral and social issues involved and to realize that good treatments are available, we also need more individuals to speak out and get involved locally. The title of the above preview illustration from the article Herointown is “They just don’t seem to care.” More people have to start caring and take action.

NJCRI staff

“Herointown” now is not just one or a few places. What we call the “Opioid Crisis” is a reality in every nook and cranny of New Jersey. Bare in mind also that many of those most affected are among the most vulnerable – often low income people with less access to jobs, education, healthy nutrition, recreation and living in violence-prone areas, particularly in our urban and rural areas.

More local social/medical/mental heath groups have an opportunity to expand drug-related services to meet the needs of their clients and even to redirect those at risk into more healthy behaviors and activities. Below is an example of what one such organization offers. 

Newark’s NJCRI founded 30 years ago (disclosure: by me) was originally established to provide clinical trials for people with HIV, but rapidly realized that a broad range of services for those at risk or already dependent on drugs was essential. Below are services for this population which NJCRI provides today. Many of them can be adopted as ancillary activities by local organizations.

NJCRI LGBT youth group

Fairly easy but helpful ancillary services include;  

  • Transportation: Use a van to take people to and from treatment sites and other key providers.
  • Food Pantry:  Local/county food banks are eager to provide fruits, vegetables and other staples.
  • Drop-in-Center: The homeless must leave their shelter during the day and are allowed back in during the evening, so a supportive place during the day is helpful.
  • Shower, washing machine: Those who aren’t in shelters appreciate this benefit.
  • Narcotics Anonymous: Make space available for NA or a similar organization to hold group meetings.
  • Narcan (Naloxone): It’s an inhaled drug that blocks the effects of opioids and is designed to reverse an overdose. It’s easy to train someone to administer this life-saving medication. Hopefully the State will provide more free Narcan as many users are at risk of overdose.
  • Resource Guides: All agencies should provide such guides which refer clients to other key providers, including to local drug treatment/prevention/harm reduction organizations.
  • Re-entry services for those released from prison or jail which can be a as simple as helping them get their birth certificate, State I.D. or other essential documents they have lost.
  • LGBT youth: They are at higher risk for HIV as well and benefit from a supportive facility.

Other services NJCRI provides, which require more expertise and funding include:

  • Outpatient substance abuse disorder treatment program: At NJCRI it’s an intensive out-patient program which provides group and individual counseling with weekly drug urine screening and medical help. 
  • Youth and adult primary care: It’s not easy to set up, but facilities which already offer this service should do outreach to the injection drug population and those dependent on prescribed or illegal opioids, and consider offering Suboxone or other medicines used to treat adults who are dependent on heroin and opioids.
  • Pediatric primary care: Even kids, some born of a mother dependent on drugs, need special care.
  • Screening/counseling for drug use, HIV, Hepatitis and other sexually transmitted illnesses – important particularly for those dependent on drugs.
  • Needle/syringe Exchange: It’s an important harm reduction service under threat in Atlantic City by people who don’t want it there and now closed in Paterson.
  • Mental Health and psychiatric care: According to a  government study (SAMHSA) 39% of those with substance abuse disorder had co-occurring mental health issues.
  • Health Education (prevention): The CDC and State Department of Health provide such programs, and local groups sometimes develop their own material and approach.
  • Health Studies: Conduct State Department of Health / CDC epidemiological data collection on injection drug users.
  • Clinical Trials: For sites with a physician interested in clinical research there are opportunities to conduct FDA-approved pharmaceutical studies on new medications.
  • North Jersey Career Academy: Workforce development job related skills training.
  •  On-site (separately operated) Towntotal Pharmacy and LabCorp (blood drawing/screenings.)

It was not easy for NJCRI to amass this large variety of services, but almost any organization can decide to undertake one or more of them. 

We can’t rely on the government for everything. Many people afflicted or at risk, start as youths who raid their parents’ medicine cabinets for prescribed painkillers, and others who start with a variety of gateway drugs and soon move toward easily available and inexpensive, but dangerous, heroin now mixed with deadly fentanyl. It calls for the general public to get involved, to advocate for change, to offer support for someone who appears at risk, suffering the pain of addiction, or in recovery, and to help local organizations provide more and better services. Or as Hillary Clinton said, “It takes a village to raise a child.” 

Particular thanks for help on this post to NJCRI’s Director of Behavioral Health Henry Iwuala and Director of Community and LGBTQ Services Julio Roman.

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