Wednesday, November 29, 2017

AGAINST LONG ODDS



Homo sapiens are a consistent source of disappointment. I often wonder whether humans can really be Nature’s last word. However, the antidote to this pessimism was served up in full on November 4 at the Summit for NCADD-NJ’s volunteer Advocates held at Rutgers in New Brunswick.

Primarily consisting of people living in recovery and their families, all have endured quite a lot. Into each life, as the poet says, some rain must fall. Almost all at the gathering have been on the receiving end of a torrent, but continue to fight back, and win. It was a day for honing skills, sharing information and expressions of gratitude. What I’ve always found so admirable about our Advocates, is their generosity of spirit. In addition to dealing with health issues, stigma, lack of access to appropriate care, battles with insurance companies, and financial setbacks, amazingly, they have been able to devote some of their strength to the service of others. Much of their effort won’t benefit them. Their noble hearts have directed them to reach down and help others up the ladder. One of the most moving moments of the event, was the graduation presentation by state Senator Patrick Diegnan to Advocate Amalia Papi. The Senator came off his re-election campaign three days before Election Day because, as he put it, “Amelia is forever doing for others and it is fitting that her hard work be finally recognized.” The same could be said for each of the Advocate Leaders.

The relatively recent more refined understanding of the addiction problem both among the general public and policy makers, is attributable in no small degree, to the Herculean efforts of our Advocates. They have put the human (there is that word again) touch on the dilemma. Thanks in large measure to them, the disorder that once dare not speak its name, now won’t shut up. And there have been specific, substantive public policy reforms for which they have been at least partly responsible. Some of these were delineated at the Summit, and include: dedicated enhancements of state budgets to provide treatment and recovery, invitations to appear at public forums and in the media, the Good Samaritan Law, criminal record expungement revisions, evidence-based school instruction on addiction, added recovery housing at university and college campuses, improved drug therapy programs in lock-up facilities, Ban the Box legislation, increased availability of naloxone, and a statewide implementation of needle exchange initiatives. And these only begin to detail the far-reaching improvements to public policies that the Advocates can be most proud.

Meanwhile, it is acknowledged, that the work must continue. As New Jersey sees a new Governor and Legislative Term embark, the struggles go on. After the November Fourth victory lap, it is realized that more needs to be done. Insurance companies must be made to cover more anti-opioid medications, and to reimburse for behavioral healthcare on a par with the manner in which they do for medical and surgical therapies. There needs to be expungement reform for people living in long-term recovery, and not only for people who had the opportunity to complete drug court. Schools, and other public venues must stock and utilize naloxone. There should be an expansion of recovery community centers throughout the Garden State.

Knowing that there is more that needs to be accomplished, and wanting ever to improve the message and its delivery, the two hundred Advocates in attendance spent a good portion of the day in training workshops. Topics included: integration of mental health and substance use disorder, insurance parity, self care for advocates, helping young people, and the role of peer-to-peer support as part of therapy.

So, the Advocate Summit was partly a pat on the back, part educational, and part pep rally. We’re all looking forward to the next one.

Ed Martone
Policy Analyst


P.S. Here are some photographs of the event

Tuesday, November 21, 2017

CANDIDATE SURVEY (REDUX)



57 aspirants for the state Legislature completed the NCADD-NJ questionnaire. 33 of those were elected on Nov. 7, 2017. Of the 33: 18 are Democrats, while 15 are Republicans. The answers reflect a deeper understanding of the addiction problem, along with a more refined approach to solving it.

* 32 view addiction as an illness, rather than a bad choice.
* A large majority favor dedicating the monies collected via the Alcohol Tax toward drug and alcohol treatment. 12 would support raising the Alcohol Tax and earmarking the additional proceeds to addiction therapy.
* A significant majority support the expanded utilization of overdose reversal drugs.
* 27 want to see an expanded presence throughout the state of recovery community centers.
* 32 wish to enhance current drug, alcohol and mental health programs in jails and prisons.
* 29 would vote for continued reforms to more easily allow for criminal record expungement for those in recovery.
* 30 favor alternatives to incarceration for non-violent drug offenders.
* 9 support marijuana legalization and regulation
   17 endorse marijuana de-criminalization
   10 want to keep the present marijuana laws unchanged


This relatively recent sophisticated thinking about substance misuse is due in no small part, to the efforts of people such as NCADD-NJ’s Advocate Leaders who have given a voice and face to the issue for policy makers. The Advocates will now be sought out for practical and substantive ways to deal with this epidemic by decision makers. The volunteer Advocate Leaders, along with their supporting organization (NCADD-NJ) are more than willing and capable of supplying this needed expertise. 

Monday, November 13, 2017

IN LIKE A LAMB … (Opinion)


 There is no reason to doubt Governor Chris Christie’s sincerity of purpose in conducting his part in the battle against substance misuse. With January 16, 2018 looming as his final day in office, he is exiting in a flourish on the issue that he has showcased in his second term – the fight against addictions. Striving to better the lives of men and women struggling with addictions, is not the cause any political consultant would tell their client to take on in order to win the love of the voters. Yet, take it on he has. Just in the past few weeks, Mr. Christie has taken steps to move additional monies in the state Budget to drug programs, implement some of the recommendations of the Governor’s Task Force on Drug Abuse Control, and push pharmaceutical companies to expedite the development of new non-addictive pain medicines and improved medically assisted treatments.

More specifically, the Governor has recently endeavored to:
* Revise EMT guidelines to permit first responders to carry double the dose of the opioid overdose reversal drug, naloxone. This is in response to the added potency of the synthetic drug fentanyl which has become an even deadlier item than heroin
* Expand the Recovery Coach Program statewide
* Create three regional residential treatment centers for pregnant women and new mothers
* Add to supportive housing for adults with SUD
* Ensure a greater use of naloxone, and enhanced utilization of medication assisted therapy, in prisons
* Increase spending for On-Campus Recovery Programs
* Establish an Opioid Education Campaign for Obstetricians
* Hire five additional Drug and Alcohol Counselors at the Juvenile Justice Commission to ensure parolees continue drug treatment once they reenter the community, and
* Erect a partnership between some of the pharmaceutical companies and the Natl. Institutes of Health and U.S. Food and Drug Administration to help erase the opioid epidemic

To be sure, the Governor has not always been right on these questions. He has left much undone. His predilection to govern by ambush – making policy by announcement rather than by consensus, has failed to bring on needed partners in the fight. Indeed, his words have often contributed to the coarsening of the political and governing processes. And his unforgiveable participation in promoting the political career of the Mad Gargoyle who presently occupies 1600 Pennsylvania Avenue in Washington, D.C. will result in less resources for the Garden State in its combat with the opioid scourge.

In a future Blog, I’ll summarize some of the strides forward made by both the state Legislature and Mr. Christie on addictions in the past two years. Another entry will detail some of the further policy reforms that must be undertaken to enhance prevention, treatment, and recovery efforts.

My worry is that we may have reached the zenith of concern and energy for tackling this problem. Despite all that has been done to date, the picture only appears to darken. Also, with Mr. Christie leaving office, it takes the champion off the field. There may be a tendency to regard addictions as “his” legacy – and now it is time to focus on other issues facing the state government. It will be our challenge, to shore up the progress already made, to inspire and guide our policy makers to avoid a feeling of hopelessness, and to focus them on what everyone agrees continues to represent one of the worst health crises of our time.  

Ed Martone
Policy Analyst