Archive for October 2013

TRENTON — Seeking to curb the unprecedented abuse of heroin and opiates in New Jersey, state lawmakers Thursday took the first step toward comprehensive reforms of the state’s approach to substance abuse treatment and prevention.

Experts from the medical field spent more than two hours testifying before the Senate Health, Human Services and Senior Citizens Committee, explaining the yawning gap between science and public policy, and offering recommendations on how to narrow it.

Some of the recommendations were simple enough that they could be implemented with an iPhone, but most others would take time and money.

But committee chairman Joseph F. Vitale, D-Middlesex, said opiate abuse in New Jersey has become a public health crisis and a pressing priority in recent months among legislators.

“People need to know that this is as important an issue in terms of health care as any other epidemic,” he said.

Experts were armed with enough statistics to prove it.

The state has had more than 700 opiate overdose deaths since 2009. Forty-six percent of treatment admissions last year were for heroin or opiates. Overdoses lead all accidental deaths in New Jersey, and of those, opiates have been involved in 75 percent, said Dr. Louis E. Baxter, the president and executive medical director of the Professional Assistance Program NJ, a drug and alcohol counseling services.

Camden, Essex, Middlesex, Monmouth and Ocean counties lead the way in overdose deaths, Baxter said.

With a little more than 6,000 beds for 72,000 people seeking treatment, there is a logjam seeking treatment for “this epidemic (that) has spread,” Baxter said.

He and other experts said there are fundamental flaws in New Jersey’s treatment options and access to them, which they suggested is an indictment of the nation’s approach to substance abuse.

Drug addiction is not about drugs, it’s about brains, said Susan E. Foster, the vice president and director of policy research and analysis at the National Center on Addiction and Substance Abuse at Columbia University. It must be diagnosed early, treated individually and monitored regularly for a long time, she said.

Foster, citing a 2005 study by the center, said 3 cents of every dollar was spent on substance-abuse prevention and treatment in New Jersey, while the remaining 97 cents went to “shovel up after the fact — in our jails, in our health care programs, in our schools, assistance programs and even our workforce.”

A “full treatment experience” — detox, medication, therapy — results in a success rate of about 80 percent and at far less cost, Baxter said. Gov. Chris Christie last week said it costs New Jersey roughly $24,000 to treat an addict through the state’s drug court program, but $49,000 to jail them for a year.

Treatment providers are another area with problems.

Less than 6 percent of treatment referrals come from health care providers, she said. Most referrals come from the criminal justice system, she said, “indicating our failure to prevent and treat the disease until the costly consequences occur.”

Foster said in the U.S. there is no reliable estimate on who is providing addiction care. There are few restrictions on who “can hang out a shingle and say ‘I’m providing addiction treatment,’ ” she said, adding that few medical professionals are well enough trained to provide treatment for addiction.

In New Jersey, as in most states, the largest number of people offering treatment are drug counselors, whose minimum requirements are a high school diploma or its equivalent, she said.

“Addiction care is largely disconnected from mainstream medical practice,” Foster said.

Baxter and Foster also recommended, among other things, requiring addiction education in all health care curriculums, participation in the Prescription Drug Monitoring Program, a campaign to educate the public on opiate abuse, and expanding insurance options to include long-term care.

Vitale, the committee chairman, said the meeting was the first step toward “comprehensive” changes to the state’s approach to substance abuse treatment. He said the Christie administration is eager to discuss options, but comprehensive change will be costly and time-consuming.

“We have to have a blueprint,” he said. “And to say that we can’t do it because of the money — we can do it, but it takes time.”

http://www.courierpostonline.com/article/20131018/NEWS02/310180037/Experts-offer-advice-heroin-abuse-N-J-

counseling service.