Opioid Crisis in Essex County: Experts Explain the Epidemic

Acting Essex County Prosecutor Robert Laurino Addresses Attendees at Community Meeting

Acting Essex County Prosecutor Robert D. Laurino hosted a Community Meeting on the opioid crisis on Wednesday, August 15 at the Glen Ridge Congregational Church.

The event was co-sponsored by the New Jersey Attorney General’s Office and included speakers from RWJ St. Barnabas Health Institute for Prevention and Recovery, the Essex County Department of Health, and two nonpofits, Integrity House, and ADAPT (Alcohol and Drug Abuse Prevention Team).

Personnel from the organizations provided literature on addiction-related subjects and spoke with attendees as they came in.

Gwendolyn Williams, Assistant Essex County Prosecutor, first introduced Reverend Damien Lake of the Glen Ridge Congregational Church, who opened the meeting with a prayer.

Prosecutor Laurino spoke next. He explained these events are part of the 21st Century Community Policing Project initiated by the Attorney General. He said they would be holding an event once a quarter. The previous meeting dealt with police use of force, and the next one will address immigration issues. The final community meeting will cover bias crimes.

Prosecutor Laurino explained that opioid abuse is a national problem as well as a state issue. He said opioids were initially promoted as a breakthrough form of pain relief. But when pharmaceutical companies promoted these drugs they didn’t discuss how addictive they could be. Doctors prescribed them in large quantities, and then patients discovered they couldn’t get off them when the prescriptions were finished

He said that the drugs are relatively inexpensive as prescription drugs, but once they are on the black market, a drug like oxycodone can cost $20 to $25 per pill. As a result, people who have become addicted then look for a cheaper alternative to the pills: heroin, which costs only $5 to $10 a dose.

Most recently, fentanyl has come into the market because it is even cheaper and provides a much more powerful high than heroin. Fentanyl is 15-20 times more powerful than heroin and costs just $20-$40 an ounce. So dealers started adulterating heroin with fentanyl. There is another drug called carfentanil that is 100 times more powerful than fentanyl that is also used to cut heroin.

Joel Torres from ADAPT spoke next. He explained their group consists of volunteers who work on drug and alcohol prevention throughout Essex County. They collaborate with schools, the religious community, the county prosecutors office, and nonprofits to build relationships and decrease duplication of services and programs. ADAPT is a nonprofit organization funded by grants.

Joel Torres of ADAPT

Torres explained that sometimes addiction starts with someone having an injury, and being prescribed painkillers. The next thing they know they find they need the drug to continue feeling a certain way and then have to buy it in the streets. The goal of his group is to prevent it from happening in the first place.

One method to reduce access to prescription drugs is the prescription drug disposal/drop box program. This consists of mailboxes inside police departments and some pharmacies where people can drop off old or unused prescription medication.

ADAPT works with the community to raise awareness of the importance of monitoring, securing and disposing of narcotics. Torres also stressed the importance of keeping lines of communication open within families so that young people – children or even grandchildren – will feel comfortable talking to their families rather than a peer who may be a bad influence.

Prosecutor Laurino spoke about recent changes to the law regarding prescription drugs. He said doctors can no longer prescribe opioids for more than five days and it must be at the lowest possible dose. If there is a need for additional prescriptions, they need to have a personal contact with the patient before renewing a prescription.

He also said that there is an immunity provision in criminal law for those who experience an overdose or witnessing someone having an overdose. If they report it to the police they will be immune to prosecution.

The law now allows a non-healthcare provider to use Narcan, an antidote to opioids that can reverse an overdose. It is administered through a pump, as a nasal spray, and is extremely effective in reversing overdoses. He said that for several years the use of Narcan (Naloxone) has increased by 40% a year. In 2017, over 14,000 doses were administrated. Through May 31, 2018 it has been administered 590 times in Essex County alone.

David Kerr, founder of Integrity House in Newark and a member of the Glen Ridge church congregation, spoke next.

David Kerr

Kerr talked about addicts coming out of prison and having to readapt to the world, and said establishing a relationship with a coach after being released is a key step in an addict’s recovery.

He explained that chronic drug abuse causes long lasting brain changes that contribute to an addicted person’s compulsion to use drugs despite catastrophic consequences. These changes persist long after the drug use has ended. It needs long term help, and the person has to be motivated to do it. He believes in “strength counseling,” where those being counseled are encouraged to talk about their strengths and advantags rather than their failings.

He also said that former criminal addicts that have been sober for 7-10 years are the most powerful force to help a recovering addict, as they are living examples of what can be accomplished. He said that a sense of self-worth and belonging to a positive group are critical to recovery.

Eileen Fishman, Alcoholism & Drug Abuse Director of the Essex County Department of Health & Rehabilitation, spoke from her perspective as a pharmacist. She said the timing of the epidemic really began in the early 1990s when pain clinics and opioids came into vogue. She said the doctors were asking patients what their pain levels were, and depending on the answer, some would be prescribed opiates. They were getting multiple months of medication to address their pain. Unfortunately, she explained, one person could take the same amount of medication and not become addicted, but someone else will.

In pharmacies, she said, “We used to do a 30-day prescription with no refill. Now with pain management clinics and physicians, we were told by the Board of Pharmacy that we could give a 3-month supply…And now we’re here today at epidemic proportions. From my perspective, it’s as bad as the AIDS epidemic in terms of deaths.”

She explained the importance of Narcan as a crucial part of what they do. The reported numbers only reflect some of the usage of the antidote. They do not include the families who administer it at home to a family member or visitor.

She said that the county now has a van at Newark Penn Station called the HOPE Van, working with the Newark Police Department. The idea originally started in Morris County. The sheriff there took money from the funds from drug busts and revamped a van. In the van he has a recovery specialist, a social worker and a police officer plainclothes. They go into areas of Morris County where there are problems with addiction, talk to the people, give them coffee and donuts, and invite them to go into recovery. The program recently started in Newark as a new step in fighting addiction.

They are also in the schools with programs, including in Montclair, Newark, and Bloomfield. Her department also funds treatment, including detox and halfway houses, as well as intensive outpatient programs. As part of patients’ recovery, they also get their identification papers in order, find them housing, and help them with a reentry program to find a job. Those services are located at 50 South Clinton Street in Newark. “That is the recovery support process,” she said. “It’s not only about getting to the stage of recovery. Once you get there, you can fit into the community and be a contributing member of society.”

The last speaker, Nicholas Beam, Case Navigator of the Barnabas Hospitals’ Opioid Overdose Recovery Program, spoke about the resources available through the Barnabas Hospital system for substance abuse.

Nicholas Beam

Beam said that the genesis of his program began in 2014, when Barnabas tracked what happened to people who had overdosed, were revived with Narcan, and brought to the emergency rooms of their hospitals in Monmouth and Ocean Counties.

At that time, once they were deemed recovered, these people were sent home with information about treatment programs. In following up, Barnabas found only one person sought further help after being treated at the emergency room.

Therefore, Beam explained, they started a program whereby “recovery specialists” would visit those who were brought in to the emergency room after overdosing. These recovery specialists are all former substance abusers who have been in recovery for at least four years. They are trained and then sent to the hospitals. Because they have been addicted and gotten out, he said, they are able to have a conversationir that a doctor would not.

If the bedside engagement goes well, then the clinical navigator comes in, does an assessment and walks them into treatment. Each person is treated for a month and goes home, followed by eight more weeks of contact, including calls, check-ins, etc. Even after the case is closed, the counselor is available if needed.

Beam, who is in long-term recovery himself, said that the program has now been expanded into all 21 counties in New Jersey. It expanded to Essex County in 2016. The RWJ Barnabas hospitals in Essex County are St. Barnabas in Livingston, Beth Israel in Newark, and Clara Maass in Belleville. Funded by grants, the services offered are free to both the hospital and the patients.

The program recently expanded to enable anyone who struggles with addiction to come to the Barnabas hospitals and get help, even if they have not been the victim of an overdose. There are recovery specialists on duty on all shifts, and the clinical navigators are available daily during the week.

Another new initiative is the Support Team for Addiction Recovery (STAR) program. After a patient goes through initial treatment, STAR provides a full time recovery specialist who guides the person through the path to recovery, with a case manager to help with finding housing, vocational training, and ultimately, employment.

Beam ended with a chilling statistic: In 2017, there were 72,000 deaths due to overdoses – more than the number of soldiers who died during the entire Vietnam War.

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