Fighting the opioid epidemic door to door

Fighting the opioid epidemic door to door / NJ Spotlight / June 5, 2023

By Bobby Brier

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On a Sunday afternoon in late May, Kristin Castagna stood in front of her house in the Upland neighborhood of Mystic Island and spoke about the impact of the opioid epidemic on her town.

“There was an overdose down there a couple years ago (and) one on the corner right here a couple years ago,” she said.

Castagna, 42, grew up in a house across the street and is now raising her 10-year-old daughter in the same neighborhood. But she said the town is not the same as the childhood place she grew up in.

“There’s a beautiful park up the street. I won’t take her (because) there’s heroin needles in the park,” she said. “The corner up here is where my daughter gets on a bus for school … and there will be heroin needles there occasionally.”

Castagna was one of several residents of the small fishing community in southern Ocean County who spoke recently with members from the Not One More NJ campaign about the epidemic that continues to ravage this rural town of less than 9,000 residents. In 2022, there were 186 suspected overdose deaths in Ocean County and 748 disbursements of naloxone, a medication designed to rapidly reverse opioid overdoses, according to the state attorney general’s office. Across the state, there were 910 suspected drug-related deaths between Jan. 1 and April 30 this year.

Rescue kits

The Not One More campaign is made up of people from a number of statewide organizations, including the New Jersey Organizing Project, the New Jersey Resource Project and Sea Change Recovery Community Organization. Through the campaign, which was started in 2019, these community organizers work to provide advocacy and services to people who have been impacted by the opioid epidemic in Ocean and Monmouth counties, hoping to end the overdose crisis and the stigma of substance use disorder.

’There has to be better access to rehab for the people that want to get clean and maybe even safe injection sites.’

Kristin Castagna, Mystic Island resident

On the Sunday in late May, Jody Stewart, Elissa Tierney and Jennifer Collins-Fonseca, organizers and advocates with the campaign, walked the streets of Mystic Island with drawstring backpacks filled with opioid overdose rescue kits provided by the New Jersey Harm Reduction Coalition. The kits included naloxone nasal spray, also known as Narcan, Xylazine testing strips, a fact sheet about the signs of an overdose and a CPR breathing mask. They also brought along fentanyl testing strips. 

Along with all of the struggles of dealing with an opioid use disorder, residents of Mystic Island in recovery must deal with another challenge: a lack of access to reliable transportation for services and to mental health professionals who can treat both the addiction and the underlying mental health disorder. As the Not One More members knock on doors to offer support and more, they also work to connect people with resources.

“Addiction is behind closed doors most days in these areas,” said Stewart, 65, who has lived in Mystic Island since 1989 and is a senior organizer for the New Jersey Organizing Project. Many of the people involved in the Not One More campaign are in recovery from substance use disorders themselves, or have family members who are, and know what it is like to live through addiction.

‘I’m tired of people dying where maybe we can give them life.’

Jody Stewart, New Jersey Organizing Project

The primary goal of the campaign is to give people who have been directly impacted by the epidemic “the ability to stand up and speak out” on their own behalf and to be the experts on what’s needed in order to ensure that opioid settlement funds are not misappropriated, said Elizabeth Burke Beaty, the founder and chief executive officer of Sea Change Recovery Community Organization.

Pharma settlements

Last March, state officials announced New Jersey is set to receive $641 million from settlements with New Brunswick-based Johnson & Johnson, which manufactured opioids, and the country’s three largest pharmaceutical distributors, McKesson, Cardinal Health and AmerisourceBergen. The settlement funds will be paid through 2038 and are set to fund state and local programs focused on treatment and prevention in New Jersey.

The $641 million comes from the state’s share of a $26 billion federal court settlement reached in 2021 between 46 states, thousands of municipalities and several tribal nations and the defendants, Johnson & Johnson and the three pharmaceutical distributors. 

New Jersey officials, along with members of the Opioid Recovery and Remediation Advisory Council, are currently seeking public input on the ways to spend the state’s share of the $641 million by hosting several “listening sessions” across the state. The first two of these sessions were held virtually at the beginning of May and then in person at Mercer County Community College in West Windsor. Two additional in-person sessions are planned for June at Camden County College in Gloucester Township and at Essex County College in Newark. The final public listening session will be held virtually in late July.

Members of the Not One More campaign would like to see Ocean County build a drop-in center where people can get access to resources, recovery support and harm-reduction supplies.

Nearly all of the $641 million will be divided evenly between state and local governments, with half going directly to the state’s 21 counties and 241 municipalities that qualify for money under the settlement. Local officials will then decide how the money is spent to offset the impact of opioid use. 

In addition to this settlement agreement, all 21 counties and 241 municipalities in New Jersey eligible for direct distributions have joined the state in signing onto the nationwide settlement agreements with the CVS, Walgreens and Walmart chains and drugmakers Teva Pharmaceuticals and Allergan for their alleged roles in the country’s opioid crisis, according to the state attorney general’s office. Because of this, the state and the eligible counties and municipalities are set to receive over $500 million from $20.1 billion nationwide opioid settlements with the pharmacy chains and drugmakers. 

The pharmacy chains and drugmakers are expected to announce by June 8 whether their settlements will go forward, which will depend on whether enough local governments from around the country have signed on, according to the state attorney general’s office. 

Funding from legal settlements

Ocean County is reported to receive $15 million over the next 18 years from the state’s $641 million share of the nationwide settlements with Johnson & Johnson and the three pharmaceutical distributors. 

With some of the current funds from the settlement, the Not One More campaign would like to see the county build a drop-in center where people can get access to resources, recovery support and harm-reduction supplies, according to Elizabeth Burke Beaty. The campaign is also hoping to see this money go toward affordable and accessible transportation to and from treatment and for improved hospital care for people with substance use disorders. 

But challenges still remain for people in Mystic Island when it comes to accessing recovery services for opioid treatment.

“I’ve lived here for my entire life and it’s definitely gotten worse the past ten, fifteen years with the heroin, the meth, the pills, everything,” said Kimberly McNab, who lives in the Upland neighborhood. 

And while residents of the town have access to New Jersey Transit buses that can take them to Atlantic City or Toms River, riding them can pose a risk, according to Castagna. For people looking to get clean, there is too much access to drugs on the buses, she said.

Difficulty getting to rehab

“There has to be better access to rehab for the people that want to get clean and maybe even safe injection sites,” Castagna said. 

As for Stewart, she would like to see the local community center in Mystic Island offer a space for people coming out of rehab to be around other people trying to stay sober. Right now, there are no services like that in the area and that can lead to relapses, according to Stewart. Additionally, there is a need for more therapists who can treat both substance use disorder and co-occurring mental health issues, Stewart said.

“We need mobile MAT (medication-assisted treatment) units to go out to these communities. There’s not enough treatment centers,” Stewart added. “I used to have to drive my daughter from here to Toms River on (Route) 37 to get her to a methadone clinic. … That’s absurd,” she said. 

Mobile medication-assisted treatment vans give people in underserved areas of the state greater access to substance use disorder treatment medications.

In June 2022, the state Department of Human Services awarded contracts to Integrity, Inc. in Essex County and John Brooks Recovery Center in Atlantic County to buy mobile outreach vans to increase treatment services in underserved areas.

These vans run in addition to five that operate in Atlantic, Passaic, Mercer, Camden and Union counties, according to the human services department. A spokesperson for the department did not return a request for comment about whether the state offers mobile outreach programs for people with opioid use disorders in Ocean County. 

“I’m tired of people dying where maybe we can give them life,” Stewart said. 

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Watch the accompanying video segment here: Addressing opioid epidemic in Ocean and Monmouth counties on NJ Spotlight.