Despite Statewide Efforts, Fentanyl Prevents Progress
When the opioid crisis swept across the United States, New Jersey was one of the hardest hit states in the country. New Jersey was also one of the first states to react to the crisis in a meaningful, substantive way. Then Governor Chris Christie enacted plans to mitigate the harm caused by the crisis. He was later appointed by then President Trump to spearhead the national response to the opioid crisis.
When Governor Christie left office, Governor Phil Murphy picked up where he left off, without missing a beat. Currently, the State of New Jersey manages a comprehensive, evidence-based, data-driven response to the opioid crisis.
In January, the Governor’s office released a press release – Governor Murphy Signs Legislative Package to Expand Harm Reduction Efforts – detailing the latest statewide efforts to help residents of New Jersey react to this ongoing public health crisis.
We’re relieved to learn the state government still has their eyes on this crisis. While the nation was preoccupied with the COVID-19 pandemic, the opioid crisis did not disappear. In fact – in most states – it got worse.
We operate opioid treatment programs in three counties in New Jersey where there is significant treatment need:
- In Warren County, we offer medication-assisted treatment for people with opioid use disorder at Stateline Medical in Phillipsburg, NJ.
- In Mercer County, we offer medication-assisted treatment for people with opioid use disorder at Hamilton Treatment Services in Hamilton, NJ.
- In Monmouth County, we offer medication-assisted treatment for people with opioid use disorder at Middletown Medical in Red Bank, NJ.
We’ll share the data rates of treatment in those counties in a moment, which will explain why we highlight these counties. First, we’ll outline the latest statewide initiatives included in the legislative package passed earlier this year.
The Opioid Crisis: Timeline and Overdose Deaths in New Jersey
To understand the why behind the current state-level response to the opioid crisis in New Jersey, it’s important to understand the what and how behind the nationwide opioid crisis. To that end, we’ll provide a quick review of how we got to this moment. What many people may learn here is that the opioid crisis did not happen overnight. It developed over decades. Yes, that’s not a typo: most of us first heard of the opioid crisis around 2015, and most of us probably thought it was new – which is not an accurate understanding of the situation.
Here’s the real timeline, as reported by the Centers for Disease Control (CDC):
1990s – 2010
Overprescribing of opioid medication resulted in a gradual increase in overdose deaths between 1990 and 2000, and a sharp increase between 2005 and 2010.
2010 – 2013
Around 2010, lawmakers began to enact rules around prescription opioids. This caused users of prescription opioids to turn to illicit heroin, in what’s called the prescription to addiction pathway. This, in turn, led to an increase in heroin-related overdose death across the country.
2013 – Present
Called Wave 3 by the CDC, this phase of the opioid crisis is driven by the presence of synthetic opioids such as fentanyl. Fentanyl is a significant problem in New Jersey. Data shows fentanyl is involved in a majority of recent heroin seizures and opioid deaths in New Jersey.
Now let’s look at the suspected drug overdose deaths in New Jersey since 2018. The data here comes from the Opioid Crisis Dashboard, one of the earlier efforts instituted by Governor Christie to help state and local officials use data to target their efforts to reduce the harm caused by the opioid crisis.
Here’s the data:
- 2018: 3101 suspected drug deaths
- 2019: 2995 suspected drug deaths
- 2020: 3050 suspected drug deaths
- 2021: 3124 suspected drug deaths
- 2022: 1005 suspected drug deaths as of May 5th, 2022
That’s why New Jersey needed to expand their efforts to counter the negative impact of the opioid crisis: things are getting worse.
The Opioid Crisis 2022: New Jersey Reacts
Governor Murphy announced the passage of this legislation with the following message to the citizen of New Jersey:
“Harm reduction is a cornerstone of our strategy, and through this legislation, we are paving the way for long-overdue expansion of…critical services to help people with substance use disorders stay healthy, stay alive, and thrive…we are acknowledging that this crisis cannot be ended through criminalizing critical harm reduction that prevent[s] fatal overdose and transmission of disease.”
To learn more about harm reduction in the treatment of opioid use disorder, please read our article:
Now let’s look at the bills that were just signed into law in New Jersey:
This bill authorizes the expansion of harm reduction services that provide on-the-ground support to people who use drugs intravenously, in order to mitigate the spread of IV-related infectious disease
This bill expunges previous criminal records around the possession of intravenous drug paraphernalia and decriminalizes possession of supplies – e.g., syringes – related to IV drug use.
This bill establishes funding for local overdose fatality review panels. These panels will use data to help target funding in areas with citizens most vulnerable to opioid use disorder, opioid overdoes, and fentanyl related overdose involving additional drugs, such as methamphetamine and cocaine.
It’s clear the current focus in New Jersey is on harm reduction.
Because New Jersey has already taken proactive steps in every other area related to the opioid crisis. To read about the programs already active in New Jersey, please navigate to the NJ CARES website. Here are the five primary ongoing efforts in the state, as reported by the Office of the Attorney General of New Jersey:
The Attorney General (AG) brought lawsuits against “…corporations and individuals most responsible for the opioid crisis, including the country’s largest opioid manufacturer.” This shows that the state government in New Jersey is not intimidated by the resources these companies can marshal in response to these lawsuits: one of the companies named is the largest corporation in the state.
State, local, and federal law enforcement officials have prosecuted individuals and groups involved in trafficking heroin, fentanyl, and other illicit opioids to the state of New Jersey. In 2019, NJ police shut down heroin production sites linked to more than 350 overdoses and over 100 overdose deaths. In addition, police have pursued any and all people involved in opioid diversion, including physicians selling pills on the black market and “…other white collar criminals…” who have caused harm to the people of New Jersey by distributing prescription pills illegally.
Treatment and Recovery
In 2018, the NJ CARES program, in coordination with local officials, expanded a program called that began in 2016 called Operation Helping Hand (OHH). OHH is a program whereby law enforcement officials such as police officers can connect people arrested for heroin possession – or other drugs – directly to drug treatment programs, which helps get these individuals out of the criminal justice system and into effective, evidence-based treatment programs. In addition, OHH has been directly involved in the distribution of over 2000 doses of the life-saving overdose reversal drug, Naloxone, by police, community organizers, and other first responders.
The state of New Jersey initiated and maintains a robust Prescription Monitoring Program (PMP). This program does two things. First, it enables doctors, pharmacists, and police to identify where and how legal opiate medication is diverted for illegal purpose. Second, when evidence shows medical professionals overprescribe or divert opioids, the AG works to revoke their accreditation and professional licensure.
Data-Driven State Programs
Click on any of the New Jersey websites above and it becomes clear the state is serious about collecting, disseminating, and using data on the opioid crisis to help mitigate its effects. In addition to the public resources we mention, the state created the Integrated Drug Awareness Dashboard. Here’s how the state describes this platform: “Public health and safety entities seeking to more effectively advance their respective missions are given role-based and right-to-know access to IDAD data so that they can conduct statistical and spatial analyses to bolster their understanding of the drug environment.”
Those five programs put New Jersey at the leading edge of the curve in our nationwide efforts to address the opioid crisis in the U.S. However, there is still work to do. The recent influx of fentanyl has exacerbated the situation. In fact, data from 2019 shows that fentanyl was present in 75 percent of overdose deaths in the state.
What that means to us is that we need to enhance our efforts to treat people with addiction disorders who need treatment. That brings us back to something we mentioned at the beginning of this article: our presence in three counties where there is a significant, demonstrated need for treatment services.
Treatment Programs Focus Efforts in Vulnerable Counties
We mentioned three specific counties where we operate addiction treatment centers. We’ll discuss those locations again, and include the latest data on the need for treatment in each county.
- Stateline Medical in Phillipsburg, NJ offers medication-assisted treatment for people with OUD.
- Warren County, Percentage of Unmet Demand for Treatment:
- 2018: 35%
- 2019: 37%
- 2020: 75%
- Hamilton Treatment Services in Hamilton, NJ offers medication-assisted treatment for people with OUD.
- Mercer County, Percentage of Unmet Demand for Treatment:
- 2018: 39%
- 2019: 37%
- 2020: 83%
- Middletown Medical in Red Bank, NJ offers medication-assisted treatment for people with opioid use disorder.
- Monmouth County, Percentage of Unmet Demand for Treatment:
- 2018: 38%
- 2019: 39%
- 2020: 82%
We can see the trends from the last five years in the data above. Efforts to support the citizens of New Jersey began to take hold – and yield positive outcomes – in 2018 and 2019, but the pandemic reduced the number of people in need of treatment who received treatment. Experts call that the treatment gap. Between 2019 and 2020 in those three counties, the percentage of unmet need doubled. In Warren County, 75 percent of the people who needed treatment didn’t get it. In Mercer County, 82 percent of the people who needed treatment didn’t get it, and finally, in Monmouth County, 83 percent of the people who needed treatment didn’t get it.
That’s why we’re there.
Our mission is to offer evidence-based addiction treatment to the people who need it most. We meet people where they are, and offer compassionate, lifesaving treatment. Right now, the people of New Jersey need our support. We have a saying here at Pinnacle: Any door you come through is the right door.
By Jennifer Skokowski, MS, CADC, Regional Director, New Jersey, Pinnacle Treatment Centers