By Lisa Campanella
The seeds of the opioid crisis were planted in the 1990\’s by big pharmaceutical companies like Purdue Pharma that ruthlessly and criminally promoted the use of opioid drugs knowing the drugs were highly addictive, without sharing that information with health care providers who legitimately prescribed the drugs for pain or the patients who received them. Once the patients were hooked, the sources for their opioids often dried up, when physicians no longer prescribed the drugs or because the opioids became too expensive. The person switched to much cheaper and readily available heroin often laced with fentanyl, an opioid 50 times more powerful than the original opioids. (Four out of five heroin users began with opioid painkillers.) The result has been a country-wide health emergency, perhaps the biggest health crisis of this generation.
In 2018, there were 72,000 deaths throughout the U.S. In NJ, 3,118 people died of a preventable opioid overdose with over 14,827 naloxone administered (NARCAN, the opioid overdose reversing drug). These deaths in NJ exceed the number of people who died in car accidents last year. To make matters worse, many counties in southern NJ, including Cape May, Atlantic, Ocean, Monmouth, Cumberland, Gloucester, Salem, Burlington, and Camden Counties are at the center of the crisis. From January 1 to May 19, 2019, there have been 874 overdose deaths with almost 400 of them in south Jersey.
Our families and friends struggle to get access to quality evidence-based treatment (because for many this issue is personal, as one in five of us has a family member with an alcohol or drug problem). Only 41% of those seeking treatment in NJ received it and 90% of those people sought treatment before. Among the incarcerated population, 70% have an addiction issue and while treatment is available throughout NJ prisons, the relapse rates post-incarceration, where treatment options dry up, is staggeringly high. Why? One source said NJ\’s system was a \”fractured system of chaos,\” a lack of access to services and a lack of treatment options – especially for people on Medicaid and without insurance.
Although many funds from both the federal government and the state of NJ targeted the problem, not all the money appropriated has been utilized. For example, of the approximately $11 billion from the federal government in FY 2017 and 2018, only about $2 billion has actually reached the states. NJ received $74 million in FY 2017 and $118 million in FY 2019. Moreover, the Murphy Administration has pledged $100 million to fight the crisis. What programs have been created though?
The money\’s supposed purposes span the entirety of the continuum of care, including prevention, treatment and recovery, research, criminal justice, public health surveillance, as well as supply reduction efforts. While these are well-intentioned appropriations, they have had little impact on reducing the crisis or the number of fatal overdoses. It also remains unclear how the state of NJ is utilizing the money. The lack of transparency and accountability remains frustrating.
Why are so few people receiving treatment? One of the stumbling blocks is stigma, the notion that addiction is a moral failing or character flaw rather than the brain-based, manageable and treatable chronic illness it is (like diabetes or asthma). Whether it\’s medical providers, law enforcement personnel, family members and friends or the individuals struggling with substance use disorder themselves who succumb to the notion of addiction as personal failure, stigma remains a roadblock to appropriate treatment.
This attitude about stigma also prevents access to the one scientifically proven course of treatment which has been shown to significantly cut both overdose rates and relapse rates, which is Medication Assisted Treatment (MAT). This form of treatment includes the use of medicines like Buprenorphine, Methadone, and Vivitrol which helps curb withdrawal symptoms and decreases the cravings associated with addiction. It is usually paired with some form of therapy to support the person\’s recovery. MAT is now considered the gold standard and most effective form of treatment.
Making such treatment services available in all our communities is vital, that is, individualized treatment to fit each patient\’s needs, especially for people with Medicaid and those who are uninsured. The state of New Jersey is failing miserably in providing that access, although as of July 1, any facility that takes Medicaid must offer MAT.
Finding a provider legally allowed by the federal government to prescribe MAT, affording the treatment, and having transportation to get there remain hurdles for many seeking treatment. A clinic offering the treatment may be hours away. In more rural areas without public transportation, patients can\’t get there on a daily basis. Cost remains a burden, especially for those who remain uninsured, including homeless people with addiction issues (Some treatment places even require the user to pay cash).
Our loved ones and communities deserve better. Overdose is preventable and recovery is possible only if we have access to the resources necessary. In order to end the crisis our communities need:
- Increased Transparency and Accountability on how NJ is addressing this crisis and the amount of funding invested in access to evidence-based treatment that is equally available to all New Jerseyans regardless of race, gender, kind of insurance or where they live. The response to the epidemic must be a coordinated one. That means establishing objective, measurable, and attainable goals, something that is also lacking.
- Universal access to Medically Assisted Treatment for people seeking help for substance use disorder immediately, affordably, and in their community so that transportation and funding are not barriers to recovery. The fractured system of care within the state of New Jersey must end.
- Hold big pharmaceutical companies, the healthcare industry, crooked rehabs, and the politicians who enable them instead of fighting for our families first accountable for their contributions to the crisis, profiting off our pain and deaths, and trying to cut programs like Medicaid and Medicare instead expand quality affordable care to everyone.
We’ve got a lot of work to do to win these solutions, but if we stand up and speak out together I know it’s possible.