All Posts tagged good samaritan New Jersey

N.J. addicts suffer from shortage of drug treatment facilities

N.J. addicts suffer from shortage of drug treatment facilities – See more at:


Three months after fleeing a Florida rehabilitation center, Amanda, a 24-year-old from Woodcliff Lake, was using heroin again. She stole her grandmother’s credit card, bought thousands of dollars worth of electronics and sold them in Paterson for drugs.

Which is how Amanda’s parents came to spend a Friday evening this July driving across New Jersey, their strung-out daughter in the back seat, looking for a facility that could treat her.

“We called eight or nine places,” Amanda’s father, James, recalled. “Nobody had a bed. Nobody.”

Insurance wouldn’t cover detoxification in an emergency room, rehabilitation clinics wouldn’t take her until she was clean, but every detoxification unit had dayslong waits for admission, James said. At a hospital in Summit, James encountered hallways full of “moaning and groaning” addicts waiting for beds and insurance clearance, he said. James was told at the front desk that if he paid cash, there might be a bed for Amanda the next morning.

A friend gave Amanda some Suboxone, a drug used to treat opioid addiction, so she could spend the night at her parents’ house. The next morning, they found a facility in Kearny that could take her.

Amanda’s story is typical. As heroin and prescription painkillers ravage parts of the state, at least a third of New Jersey addicts seeking treatment cannot get it. A shortage of treatment facilities, coupled with high costs and insurance hurdles, leaves tens of thousands each year without adequate or timely care, and their families scrambling for help. In 2009, the latest year for which state figures are available, at least 30,000 adults and 15,000 adolescents were turned away from treatment.

Thousands more do receive treatment, only to cycle in and out of emergency rooms and rehabilitation programs, their inpatient stints cut short by insurance plans, lack of cash, or relapse. Even the most comprehensive insurance plans tend to limit coverage of inpatient care to 14 days or less, leaving families to choose between paying thousands of dollars out-of-pocket for the standard 28-day treatment or pulling an addict out of care.

“There is without doubt a treatment shortfall in this state,” said Dan Meara of the National Council on Alcoholism and Drug Dependence, who estimated that some places turn away half those seeking treatment. “There is not enough funding, and there are not enough beds.”

And the situation is growing worse, placing a burden on the state’s hospitals and criminal justice system. Over the past five years, the number of emergency room visits for behavioral health issues has nearly doubled — much of that increase attributed to substance abuse. The number of drug-induced deaths is also on the rise, with hundreds throughout the state and thousands nationwide dying from prescription painkiller and heroin overdoses.

This surge, coupled with concern over crime and violence associated with drug addiction and mental illness, has spurred the federal government into action. Health care reform is expected to extend substance abuse treatment benefits to 62.5 million more Americans by 2020. And on Friday, the Obama administration announced regulations that will require insurance companies to cover addiction and mental health care in the same way physical illnesses are covered.

But it will take time for these regulations, which do not extend to Medicaid managed-care plans, to become part of the health care system, which is fraught with delays in all areas of treatment. With addiction — when even small gaps in treatment can mean relapse or death — these interruptions are demoralizing, terrifying and sometimes fatal.

In New Jersey, middle-class families may be hit hardest by the cost of addiction treatment. They often do not qualify for public services that serve the uninsured and indigent, and which can be more rigorous than private rehabilitation. Nor can they afford to pay out-of-pocket for treatment, which can cost more than $1,000 a week for private inpatient care.

“The middle class is the one that gets squeezed,” said Frank Greenagel Jr., recovery counselor at Rutgers University and chairman of a state task force on heroin and opiate addiction. “They have insurance, but maybe insurance doesn’t cover it all.”

Even families like Amanda’s that have resources — financial stability, good insurance, patience — find that it is extremely difficult to break the grip of addiction. By this summer, Amanda’s 27-year-old brother had already been through eight facilities, from California to Maine, for his addiction to prescription painkillers and heroin. James, who asked that the family’s last name not be published because of privacy concerns, has estimated that he has spent $400,000, not including travel and legal expenses, on his children’s addictions. They went through treatment centers so often that they now gets “alumni” discounts.

Take Judy Castiglione of Jefferson: She is $90,000 in debt after three years of trying to keep her son William off heroin. “Finding an open bed was almost impossible,” she said, and insurance rarely paid for it. In the meantime, she said, she was “Crazy Mom”: She had GPS built into her son’s car, monitored his phone and wound through downtown Paterson in a white minivan, armed with a baseball bat, searching for dealers.

Or Joe Sardonia, who works for the Monmouth County Parks Department, who said caring for his 20-year-old daughter, a heroin addict, has left him frustrated and broke.

“In most cases, when my daughter wanted help, she couldn’t get it,” Sardonia said.

And then there is Kim Kaupp of Mendham: Kaupp pretended to be his son, Jack, while on the phone with the insurance company, claiming to be high in order to secure treatment. Jack Kaupp died at age 26 in February 2012: His father found him in a Morris Plains welfare hotel, a needle in his arm.

Their stories, along with interviews with dozens of parents, clinicians and authorities, portray a broken treatment system that often compounds the misery of addiction. They show the challenges that New Jersey and the United States face in translating policy into effective and affordable care.

But there are also success stories: programs that work, addicts now sober. Officials at Bergen County public services try to find a bed for any resident who needs it. State officials are mobilizing to stem the tide of addiction. For the parents whose children have turned a corner, this is cause for hope and cautious optimism.

Fewer hospital sites

The path to recovery begins with detoxification. But even as more New Jersey residents — particularly suburban young adults — are seeking help for heroin and opiate addiction, fewer hospitals offer treatment.

Bergen Regional Medical Center now has the only designated detoxification facility in the county; its 54 beds are almost always full, with 12 to 18 new patients arriving each day, said Thomas Rosamilia, vice president for behavioral health services.

“There is nothing harder than sending somebody home without a bed,” he said. “You never know if they’re going to come back.”

The number of behavioral health cases in New Jersey emergency rooms jumped from 289,851 in 2007, to 521,518 in 2012 — an 80 percent increase, said Kerry McKean Kelly of the New Jersey Hospital Association. “The physicians and nurses in our ERs will tell you pretty consistently that substance abuse is a major contributor to the overall growth.”

Emergency rooms will stabilize patients and release them even though the patients have limited access to further treatment, Kelly said. Statewide, families and clinicians alike report that long-term inpatient and outpatient treatment programs often cannot take them.

“At that point, once you’re clean, where do you go?” said Sue Debiak, coordinator of the Bergen County Office of Alcohol and Drug Dependency. “It is astounding to me that people can’t get help. People are driving around looking for a place to put their son. You don’t see hospitals closing diabetes or cancer care services.”

From July 2009 to July 2010, state-licensed treatment facilities admitted 78,313 patients. In the 12 months before July 1, 2013, that number was nearly 85,000. Some 45 percent were for heroin and opiate addiction, more than any other drugs.

At the same time, the state’s expanding drug court program — which aims to treat, rather than incarcerate, certain drug offenders — is sending more people into mandatory care, further increasing the squeeze in publicly funded treatment centers. Officials say the 102 state treatment facilities may be near a saturation point.

Jennifer Kaupp said finding a bed for her son, Jack, was a “full-time job.” The Kaupps spent upward of $300,000 on a “merry-go-round” of treatments for Jack, maybe 10 percent of which was covered by insurance.

“They know you are desperate, they know you will do anything,” said Jennifer Kaupp. “You are watching your kid kill himself.”

In the end, the Kaupps let Jack go — he spent his last months homeless, moving between shelters and charity facilities.

“The professionals said you cannot keep enabling him,” Kim Kaupp said. “Just let him hit bottom, and he’ll eventually come back.”

“But he never did,” said Jennifer Kaupp.

Judy Castiglione still weeps when she remembers reporting her son, William, to the police. And how he cried out for her as he was led down the driveway in handcuffs. “Part of me regrets it because now he has a felony record,” Castiglione said. “But part of me doesn’t because I think he would be dead today.”

The criminal justice system is now seen as the best way to get somebody into treatment, parents say — especially drug courts, which are tough and thorough.

“In New Jersey, the only way to get help is if you commit a crime,” said James, whose son is now in the drug court program.

Insurance issues

Part of the disconnect between insurers and treatment stems from the nature of addiction, clinicians say. Mental illness is poorly understood and politically sensitive. And addiction, in particular, is replete with undertones of morality, responsibility, entitlement. Success in treatment can be difficult to measure, and relapse is common.

From the parents’ perspective, insurance companies perpetuate a cycle of ineffective treatments, James said. “They keep paying for you to stay two weeks, 20 times, instead of sending you away for six months. He gets out, big hugs, doing OK, goes back to work. Two weeks later, relapse.”

Insurance companies have seen a “heavy trend toward opiate use in the Northeast,” said Mary Mcelrath-Jones of UnitedHealthcare, adding that the insurer was working to “increase access to effective evidence-based treatments.”

“We always err towards as much rehabilitation as possible in the environment that most closely mirrors the environment in which the person will live,” said Susan Millerick, a spokeswoman at Aetna. An addict may need in-patient treatment, “but to the extent that we can get them home or community-based and provide them with support, then that’s typically what will be covered.”

But that goes against the counsel of addiction experts, treatment programs and families themselves, who say long-term treatment that removes addicts from their environment is often most effective.

Addiction care is also expensive.

“There has to be a check on the appetite for coverage,” Ward Sanders, president of the New Jersey Association of Health Plans, said. “You can’t just close your eyes and say this is appropriate coverage — coverage would be unaffordable for everybody.”

A rehabilitation center told Joe Sardonia that his daughter needed long-term residential care; but insurance would only cover intensive outpatient, he said. “It appears that they do their best to get people out of rehabilitation as soon as possible,” he said. “She wasn’t home 24 hours before she overdosed.”

Sardonia said he understands that both sides have financial concerns.

“I get it,” said Sardonia, who has already spent $20,000 on treatment. “But it just doesn’t seem like the program is set up so that there is a degree of success.

“Economically, it’s a nightmare,” he added. “Emotionally, it’s a nightmare.”

Treatment shortage

As the Affordable Care Act aims to reshape treatment nationally, Governor Christie, an advocate for drug courts and substance abuse treatment, recently announced that the state-employee benefit program would provide for mental health parity, including addiction coverage.

But despite moves to expand coverage, there remains a statewide shortage of facilities and qualified clinicians. And after addicts are released, they often cannot find housing, employment or education — barriers that sometimes challenge sobriety.

“Every time he went to rehab, and got out, now what?” Jennifer Kaupp said. “There is no care for these people after they go through these programs.”

The Kaupps, like many parents, fear that an entire generation of young adults will be lost to opiate addiction. They estimate that their area has buried a half-dozen people Jack’s age in the past few years. This year, Bergen County has lost more than 20 people to overdoses. Ocean County has seen nearly 100 heroin- and prescription pill-related deaths so far in 2013.

But there are many more casualties of the statewide epidemic of heroin and prescription-painkiller abuse. Sardonia’s daughter recently moved into a halfway house but has few prospects for the future.

“She has no money of her own, no resources, no education, no job,” Sardonia said. “It’s sad, it’s very sad.”

James said his two children are now in recovery; his son recently landed a new job in New York. “There is hope, because I’ve seen it,” James said. September was the first month in three years he had not paid a bill for rehab.

William Castiglione is now living in a group home for recovering addicts and has been clean for more than 60 days, he said. “Some days it’s easy, some days it’s not,” Castiglione said. Today, Castiglione has a broad, muscular build; at the height of his addiction, he said, he weighed 135 pounds.

Castiglione has seen the insides of jail cells and rehab facilities from Florida to New Jersey. In the end, he said, it’s not the location that matters — it’s the addict’s desire to get clean.

“Jail is just as good as a rehab, if you’re ready,” Castiglione said. “If not, the best place in the world isn’t going to make you stop.”

– See more at: : News
N.J. addicts suffer from shortage of drug treatment facilities
Sunday, November 10, 2013 Last updated: Sunday November 10, 2013, 4:32 PM
The Record
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William and his mom, Judy Castiglione.
William and his mom, Judy Castiglione.


Attention Parents in Monmouth County: Teens Are Dying


Attention Parents in Monmouth County: Teens Are Dying

(photo by taliesin, morguefile)

It’s been an epidemic in Ocean County this year, and now it’s being called an epidemic in Monmouth County. And it’s killing teens.

Heroin. Ten dollars a pack. Easy for your kids to get a hold of. Addicting and deadly. So…you might want to say ‘not my kid’ but you will be shocked at the information below:

In the Freehold Regional High School District alone, 721 kids have sought professional help for a heroin addiction. At Manasquan High School, 164 teens are hooked on heroin. 37 young people have died from a heroin overdose so far this year. And it’s everywhere around these beautiful Jersey Shore towns.

So how are your teens’ friends and fellow students getting hooked on heroin? 80 percent begin using with their friends, and then get hooked on it and will hide the addiction and the heroin, using alone…until they overdose.

The Monmouth County Prosecutor’s Office is starting to hit the schools to tell parents and students what is going on and spread the word. Ocean County Prosecutors are doing the same….even more young people have died there from heroin.

And to make matters even worse, the heroin in our area is stronger than around the rest of the country, making it even more deadly.

Here’s what can save your child: Communication. Keep talking about saying NO to drugs. And tell your kids how much you love them. Because of those kids in a recent study who stayed drug free, most said they did so because they did not want to disappoint their parents.

So, next time your kids say they’re ‘hanging out’……don’t assume that everything is okay. Don’t say ‘it’s not my kid.’ Keep your eyes and ears open. Get your kids talking. Love them. And please keep them safe the best way you can.

For more information, click here.


Our local radio stationn: What you should know Good Audio

Prescription Medication and Drug Abuse in NJ – What You Should Know [AUDIO]

Jim spoke about this topic at great length yesterday (7/11). It started out as a discussion on the drug problem in NJ and morphed into a “what you need to know” segment regarding prescription medication.

Prescription Drugs
Flickr User Charles Williams

The entire segment started yesterday with Jim discussing the plight of a caller named Linda, who has frequented the show. Linda has a son who has been in trouble in the past  due a bad dug problem and actually got assistance for her son by calling in to Jim’s show and the Ask the Governor program.

The following is the audio of Jim beginning the discussion:

Audio clip: Adobe Flash Player (version 9 or above) is required to play this audio clip. Download the latest version here. You also need to have JavaScript enabled in your browser.

Right after Jim started discussing the topic, Linda called in to give an update on her son and the feedback she has received from other parents since reaching out for assistance for her son.

You can listen to Linda’s segment with Jim below.

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Jim went on after the discussion with Linda to discuss the addiction so many have to prescription drugs. Below are some articles to educate yourself about prescription meds and places where you can drop off expired or unwanted medication locally in NJ.

Smart Disposal

National Take Back Initiative


Ocean County Proper Medication Disposal Information


Monmouth County’s Medication Drop Off Locations:



It’s happening in your backyard!!


Heroin Addiction Takes Toll in Suburban New Jersey



New Jersey officials report a rise in heroin addiction, drug-related crime and deaths among young people in suburbs. Many became addicted to prescription painkillers, and switched to heroin because it is cheaper, potent and widely available, according to The Record of Woodland Park.


The growth of heroin use among young people in the suburbs is being seen nationwide. According to the 2011 National Survey on Drug Use and Health, the number of people who were past-year heroin users in 2011 (620,000) was higher than the number in 2007 (373,000).


New Jersey is a center of heroin use in part because of its ports and highways, which are conduits for South American heroin, the article notes. Heroin found on New Jersey streets today is at least five times more pure than it was several decades ago, law enforcement officials say. The increased potency leads to quicker addiction, they add.


“Heroin is much more commonplace than it’s been in years,” Ellen Elias, Director of the Center for Alcohol and Drug Resources in Hackensack, told the newspaper. “We see it all around. It seems like the population in which heroin is most prevalent is that 18- to 25-year-old population.”


Police in Bergen County, in northern New Jersey, report increases in shoplifting, home invasions, burglaries and armed robberies, by people addicted to heroin who are seeking money to buy drugs.


Last week, New Jersey Governor Chris Christie signed into law a measure that encourages people to report drug overdoses. The law allows people to call 911 to report a drug overdose, without the fear of getting arrested for drug possession themselves.


Commentary on the Drug Epidemic

This was written by a friend Frank Greenagel Jr. via facebook

Another article on the opiate epidemic and the problems with insurance companies that make it difficult for their customers to get treatment. I’ve been beating the drum on this issue in newspapers, online and on the radio for over a year now.

The passage of the Good Samaritan law was a major victory. That said, we still have a high rate of overdose deaths, continued difficulty with getting insurance to pay for treatment and still FAR too many people getting their hands on prescription painkillers.

We need a lot of help. I’d like to see a recovery high school in New Jersey. We need a forward thinking superintendent to take a chance on creating an alternative school (it’s foolish to send a kid to rehab and then have them return to the very school where they were abusing drugs and/or booze). We need more Recovery College programs (even though it is an incredibly successful niche for Rutgers and myself, I desperately want to see more in NJ and throughout the USA). We need to drug test those that are getting prescription painkillers (to see if they are on other drugs, and more importantly, to see if they are actually taking the drugs they are prescribed (and not selling them) –>that’s an idea from 2 leading insurance companies, not mine). We need more training on this issue for tweens, teens, parents, teachers and clinicians. We need to expand the prescription drug monitoring program (which is already incredibly successful). We need more treatment options. Each dollar spent now saves between four and seven dollars down the road (criminal justice, healthcare, diminished work capacity, etc…).

Please spread the word. Educate one other person. If you are supremely motivated, call your state legislator and pass on whatever suggestions I made above to them. Change can happen from the ground up.

(mic drop)


NJ Passes the 911 Good Samaritan Law

I advocate on issues that pertain to substance abuse.  I along with some other amazing parents, have worked hard to get this bill passed in the state of NJ.  Well, the day finally came, and our Governor along with Jon Bon Jovi, signed this new bill.  That’s me in the background…This would have not been possible without due diligence from Patty DeRenzo.  She is an amazing woman who has made a huge difference in saving lives!!


Gov. Christie signs ‘good Samaritan’ overdose bill into law, with Bon Jovi

Posted by: Jerry DeMarco    Tags:  , , , , , ,     Posted date:  May 2, 2013  |  No comment



YOU READ IT HERE FIRST: With Jon Bon Jovi joining him, Gov. Christie today signed the bipartisan Overdose Protection Act into law at a drug rehab center in Paterson — providing protection from prosecution to those who help overdose victims or those who administer antidotes in life-threatening situations.

New Jersey’s General Assembly on Monday approved the compromise Good Samaritan law, which  legislators said is aimed at helping to save lives and prevent drug overdoses.

The 68-2-6 vote came on a new measure that incorporates components of both the bill known as the “Opioid Antidote and Overdose Prevention Act,” which was conditionally vetoed by Gov. Christie that same day and the “Good Samaritan Act,” which he conditionally vetoed last fall.

The new measure provide s immunity for witnesses and victims of drug overdoses in order to help get timely medical treatment.

It also provides civil, criminal, and professional immunity for health care professionals involved in prescribing, dispensing, or administering naloxone or any similarly acting, FDA-approved drug for the treatment of an opioid overdose.

“No life is disposable, and this bill represents a giant leap forward in New Jersey’s commitment to protecting and preserving all life, particularly when people need it most,” said Governor Christie. “As elected officials, it’s our obligation to ensure that we are doing everything we can to prevent tragic deaths from drug overdoses, and I believe this bill will do that.

“I’m grateful that we were able to come together and reach this bipartisan compromise and take meaningful action on this very important issue today.”

Bon Jovi reportedly has a daughter in college who wasn’t charged after an apparent overdose last year thanks to a similar law in New York state.

Patty DiRenzo of Blackwood, who also attended, had a much deeper reason: She fought hard for a good Samaritan law after her son, Salvatore, died of a drug overdose at 27.

“If people are no longer afraid of getting arrested in overdose situations, they will be more likely to call 911 and get help,” she said. “This new law will save lives, and I am grateful to Governor Christie and the legislature for all their efforts in making it possible.”

Her son’s death, “like so many others in New Jersey, could have been prevented if the people he was with had called 911 for help,” DiRenzo said. “But they didn’t, most likely for fear of arrest. Instead, Sal was left alone to die.

Most overdose victims don’t die until hours after they’ve taken a drug, studies show. Supporters of good Samaritan laws say that’s because those people — as well as those who know or are with them — often are afraid they’ll be arrested and prosecuted if they call police.

“Deaths from drug overdoses are the leading cause of accidental death in New Jersey, but many of these deaths could be prevented if medical assistance were sought immediately without the fear of arrest or prosecution,” state Assemblywoman Connie Wagner of Bergen County said.

“It’s my hope that this legislation will not only save lives, but also provide a moment of clarity to help many with substance abuse problems turn their lives around,” Wagner said.

New York and Connecticut are among a small number of states that already have similar laws in place.

In incorporating the components of the Good Samaritan Act, the New Jersey measure protects a person from arrest, charge, prosecution, or conviction if he or she sought medical assistance for someone experiencing a drug overdose and the evidence for the offense was obtained as a result of the person’s efforts to obtain the medical assistance.

The same prosecutorial immunity would also apply to a victim of a drug overdose who sought medical assistance or was the subject of a good faith request for such assistance.

State lawmakers also noted that naloxone is an inexpensive and easily administered antidote for an overdose of opioids such as morphine, heroin, OxyContin, Percocet and Vicodin. Specifically, naloxone is used to counteract life-threatening depression of the central nervous system and respiratory system, allowing an overdose victim to breathe normally.

In addition to providing immunity for health care professionals who administer the antidote, the bill would also provide immunity for other individuals if the action was taken during an emergency — and the person believed in good faith that another person was experiencing an opioid overdose.

“Statistics show that states without an opioid overdose prevention program have far higher overdose death rates than others,” said state Assemblyman Thomas Giblin, who represents Passaic and Essex. “[I]n the case of an overdose, fear and panic often cloud a person’s judgment.”

According to a study released last year by the Centers for Disease Control and Prevention (CDC), naloxone has reversed 10,171 drug overdoses, saving thousands of lives, since 1996.

The CDC also noted that 19 of the 25 states with drug overdose death rates higher than the median and nine of the 13 states in the highest quartile didn’t have a community-based opioid overdose prevention program that distributed naloxone.

“The Overdose Protection Act will help people get treatment faster in life-threatening situations. It is an important tool in our ongoing efforts here in New Jersey to prevent senseless deaths and to get people into treatment” said Dr. Manuel Guantez, CEO of Turning Point, an addiction treatment program in Paterson that treats more than 2,700 men and women each year.

The measure doesn’t promise blanket immunity. You can still be charged if police find evidence of a serious crime. They also can seize drugs, paraphernalia and other contraband.

“This is not about turning a blind eye to drug use, but hopefully saving lives during a potentially fatal overdose,” said state Assemblyman Angel Fuentes of Camden. “And once they are in the hands of medical professionals, hopefully they will receive the additional help they need to overcome any addictions.”