mycentraljersey.com: Opioid abuse is in everyone's backyard

10/16/2017

BERNARDSVILLE - Unless you have had your head in the sand for the last year, you know that the problem of opioid abuse exists everywhere, including your backyard.

That's the opening message Somerset County Prosecutor Michael Robertson had Tuesday night for the attendees at the Partnership for a Drug-Free New Jersey's Knock Out Opioid Abuse Town Hall series, co-sponsored by the Horizon Foundation of New Jersey at Bernards High School.

Robertson served on the panel with Assemblyman Jack Ciattarelli, R-16th District, Dr. Michael Gerardi, Morristown Medical Center adult and pediatric emergency medicine physician, Jody D'Agostini, Community in Crisis founder, Michael Pittman, Humble Beginnings Recovery Center outreach coordinator, and Gregg Benson, a licensed clinical alcohol and drug counselor.

Robertson said he was recently at Robert Wood Johnson University Hospital in New Brunswick, where an emergency room nurse told him she was tired of seeing young kids from Basking Ridge, Bernardsville, Peapack and Far Hills coming in who had overdosed on opioids or heroin.

 

"That hit really close to home because that is my home, this is my neighborhood," said Robertson, of Basking Ridge, at the ninth of 17 scheduled town hall meetings in communities throughout New Jersey to address the opioid epidemic and develop solutions.

"In New Jersey, opioid addiction has claimed an estimated 5,000 lives in the past decade, with more people dying in New Jersey in 2016 from drug overdoses than from guns, car accidents and suicides combined," said Suzanne Kunis, director of behavioral health for Blue Cross Blue Shield of New Jersey.

According to the Office of the New Jersey Medical Examiner, there are between 2,090 and 2,250 drug-related deaths in 2016, up from 1,587 in 2015, she said, adding that New Jersey has the sixth-highest rate in the nation of visits to the emergency room due to opioid abuse. And naloxone, a medication designed to rapidly reverse an opioid overdose, has been administered more than 25,000 times in New Jersey since 2014.

In 2015, 417 New Jersey residents died of fentanyl overdoses, up from 42 three years earlier. 

 

Somerset County not immune

Robertson said New Jersey is known for having the best and purest heroin because it's not cut with anything when it arrives in the Newark and Elizabeth ports. He said some of the cargo boxes near the ports have heroin and are shipped on trucks along Interstate 78 into neighboring towns as well as out to California.

"It's almost impossible to stop the distribution of it," said Robertson, who encouraged residents to talk to their children and family and social groups about the problem. He said Ocean County is ground zero for the opioid problem, with two to three people there dying each day.

 

In Somerset County from January to September, Narcan, or naloxone, was used 360 times to reverse an opioid overdose, Robertson said. But the medication works only with heroin, and his office is seeing more fentanyl overdoses.

"There is nothing we can do to bring back someone suffering from a fentanyl overdose," said Robertson, whose office is working with a company on a cellphone app to use if someone sees or hears of someone suffering from addiction and they can anonymously contact the Somerset County Prosecutor's Office.

"We're trying things like that to get the community involved and tell us what's going on," he said.

 

And in that way, he's hoping to get a handle on the problem, said Robertson, who also encouraged audience members not to judge others dealing with the addiction.

Gerardi said nerve blocks, rather than opioids, are now being prescribed to patients to treat pain following surgical and other procedures.

Increased laws, funds

Ciattarelli said awareness has increased, and laws and funding have been provided. Most significant he said is if someone shows up in a doctor's office suffering from substance abuse, they cannot be denied treatment and are not required to provide prior authorization from their insurance company. And if a person needs medical treatment for six months, the insurance company must cover the services provided for that time.

"Let's save lives, one person at a time, one addict at a time," he said, adding that new pain management prescriptions are written for only five days. 

Lorraine Borek, Hillsborough school district nursing supervisor, asked about individuals who are uninsured or underinsured and don't have access to care or referrals.

Ciattarelli said those uninsured or underinsured need to get to a health care professional and that he understands under the Affordable Care Act they cannot be denied care. He added that Gov. Chris Christie has pressed President Donald Trump to make the opioid crisis a national issue in the hope that there will be federal legislation to help deal with these issues.

 

Eliminating the stigma

Agostini said Community in Crisis works to take the stigma out of addiction, prevent people from becoming addicts and help those struggling to maintain their sobriety. She said CVS and Walgreens stores have naloxone, so without a prescription, people can have the opioid reversal drug in their home.

She reminded people to participate in the Oct. 28 Operation Take Back New Jersey in which residents are encouraged to clean out their medicine cabinets of unused, unwanted and expired prescription drugs and dispose of them at their local police station.

Pittman said recovery is possible and he will have three years clean and sober at the end of the month. He said the stigma comes with the belief that addicts can just stop, and it's a moral failing.

 

"It is a disease, it is not a moral failing," Pittman said. "We have to view it as every life matter, from the guy under the bridge to the guy in the boardroom. Every life is worth saving."

Benson said drug cartels are businessmen who have expanded their market by providing lots of supply, high-quality and low-priced heroin and changed from injecting it with a needle to snorting, similar to cocaine, and the perception of harm decreased.

"We are opioid addicts from birth. We use them every day of our lives, our brain is hardwired to receive them, it's part of our survival system for our pain regulation both physical and emotional pain," he said, adding that it's an endorphin, like a runner's high that is made in the brain, or a person who hurts their leg and then walks 10 miles to get to safety because the brain floods itself with its own opioids.

"And what opioids do is block our perception of pain," said Benson, adding that the opioids made in the brain are of low potency but what is put into the brain through drugs is of very high potency. "And once it gets in there, the brain is having a party."

And with continued use of opioids, the brain become used to the drugs very quickly, and in a young person, it takes just four or five days to become addicted.

"It's changes the way the brain operates, it changes the nerve chemical response system. And that can happen permanently," he said.

He said the desperation that sets in drives the addiction to the point where the only thing that matters is survival.

To find a location site for the 14th National Prescription Drug Take Back Day on Oct. 28, visit www.deadiversion.usdoj.gov/drug_disposal/takeback/.