Overdoses in obits: A lifting of the veil

Considerable gains have been made in the recent past to erode the stigma facing people with addiction. Science and the recovery movement have collaborated to improve public understanding about addiction as primarily a health issue. Even so, one does not have to look far to see the persistence of attitudes that fault the person with an addiction as well as their families.

Scanning addiction’s history, one finds it freighted with concealment, a silence that deepened the problem for all concerned. For decades, families and friends would go to great lengths to keep a loved one’s addiction from surfacing. At the root of this covert conduct, of course, lay stigma.


With the current opiate crisis and its pestilential number of overdose deaths, however, something very different has begun to happen. More and more families in these cases have responded with an act marked by selflessness: putting the cause of death in obituaries.


Many of the recent heroin deaths have been young adults, leaving parents with the ordeal of laying a child to rest. Some of these parents have summoned the strength to look past their heartbreak and set aside concern about stigma in hopes of sparing others from having to bury a son or daughter. In doing so, they have rejected despair.


This disclosure of overdose deaths in part reflects the depths of the opiate crisis. A parent who discloses they lost their child to an overdose knows they are in the company of thousands of others. And while overdose fatalities nationwide are unsettling, New Jersey’s drug-related deaths are three times the national average, according the U.S. Centers for Disease Control.


A New York Times article recently took note of this change in revealing overdose as the cause of death. The article noted that obituaries of a person who died of drug use were long couched in vagaries, saying that the individual died “suddenly” or “in the home.” Now, the silence has begun to be broken. One recent obituary spoke to how widespread addiction is, urging people not to ignore the signs. The family included in their son’s obituary the following admonition: “Someone you know is battling addiction; if your ‘gut instinct’ says something is wrong, it most likely is.”


A father interviewed on NPR spoke of his reason for including his daughter’s heroin overdose in her obituary. He spoke of having read many obituaries for people in the 20’s or 30’s or 40’s, all dying abruptly. He said that doesn’t happen on this scale to people those ages, not without there being a blight of some sort.


This father said if putting the cause of her death in his daughter’s obituary saved one life, it would give him solace. That he could show such understanding amid his deep sorrow reveals how a magnanimous heart allows hope to emerge from the ashes.



By Dan Meara, Public Information Manager

Legislative Round-up

After a hectic spring, the N.J. Legislature settled into its Summer Recess. This then is a time to catch our collective breath and take stock of how far our issues have come. The entire Assembly is on the ballot this November 3. Subsequently, the last two months of 2015 will constitute the “Lame Duck” session of the 2014/15 legislative Term. This is a period in which many of the pending bills that are outstanding in the Lower House will be acted upon before beginning the new 2016/17 Term. NCADD-NJ will continue to be a presence in the hallways of the Statehouse, as well as, in the District offices of Senators and Assembly members, advocating for quality treatment and recovery services for those seeking a respite from the disease of addiction.

Thanks in large part to the efforts of our Advocate Leaders, the message of addiction as an illness has resonated with a majority of our state’s decision-makers. The result of that refinement of thinking has been that we spend most of our time pushing for enhancements to public policies instead of battling to block negative measures. The following are some of the proposals that NCADD-NJ has been supporting:

S.2381/A.3723 – Permit the use of medication-assisted treatment in drug court, prisons and jails – Signed into law

A.3719/S.2377 – Directs all public, four-year colleges and universities, in which at least 25% of undergraduate students live in on-campus housing, to establish a substance abuse recovery housing program. The purpose of the recovery housing is to provide a supportive substance-free dormitory environment. – Signed into law

S.2058/A.3738 – Authorizes establishment of three pilot recovery alternative high schools that provide a secondary school education and support a substance dependency plan of recovery – Passed Legislature, Governor’s Conditional Veto

A.3602 and S.3164 – Would initiate a Certificate of Rehabilitation – On Assembly Floor, in Senate committee

A.206/A.471/S.552 – Would automatically expunge the convictions of a person who successfully completes Drug Court – Passes Assembly, on Senate Floor

SJR56/AJR87 – Establish an Opioid Antidote Commission to study and report on procedures to be used following the administration of an opiate blocker to a hospital patient – In committee

S.53 – Requires correctional facilities to provide inmates with medication that was prescribed for chronic conditions existing prior to incarceration – In committee

A.2982/S.478 – Allow persons on parole and probation to vote – In committee

A.3159/S.2457 – Provides that an inmate in a state prison who is otherwise eligible for drug treatment cannot be denied access to an on-site program solely based on that prisoner having any detainer or open charge issued against her/him – In Senate committee, on Assembly Floor

S.2806 – Removes restrictions on certain convicted drug offenders receiving General Assistance (formerly Welfare) benefits under Work First NJ program – In committee

S.52/A.3730 – Would require certain doctors working in jails or prisons to take a course recommended by the state, in how to deal with individuals with addictions – In committee   

By Ed Martone, Policy Analyst

While ACA subsidies stand, so do BH challenges

When I read about the Supreme Court ruling upholding the Affordable Care Act in King Vs Burwell, I thought of the impact from two perspectives. First, a general sense of relief that millions of people would not lose their health insurance subsidies, and then a more specific focus would affect those suffering from behavioral health issues.  Sometimes these numbers hit me with great force. Nine million Americans suffer from a mental health or substance abuse disorder.  I begin to wonder, of those millions, how many would be affected if the ruling was not in favor of the ACA

Then I inadvertently came across this story http://www.cnn.com/2015/06/23/living/feat-cnn-parents-facebook-chat-mental-health-addiction/index.html and was happy to see that there are parents using social media as a means to spread the word and be solution-oriented toward behavioral health issues. These parents are communicating wonderfully with each other.  Communication, in my opinion is half of the reason for dysfunction in families to begin with. For many parents, including myself, when we come across an article that talks about education and leading by example as part of the solution to prevention or reduction of behavioral health challenges, I feel incredibly frustrated for the parents out there who do everything right and their child still struggles. While I think it is important to promote parental education, it is also important to say that there are some people who will struggle in spite of this. We as parents want to believe our influence is so much greater than our own child’s innate wiring.

I am finding in any discussions around ACA, people tend to think of behavioral health treatment as some sort of residential stay. At least most people I talk to that are not in the Behavioral Health field seem to have this perception, when most addiction treatment is outpatient and consists of many hours of group and or counseling. Even this clinically lower level of care is extremely costly to someone who has no insurance. A licensed therapist alone will cost anywhere from $150-$250, depending on their credentials. See http://addictionblog.org/FAQ/costs/how-much-does-addiction-counseling-cost/

Now I consider of those nine million affected by behavioral health. How many have co-occurring medical illness that requires ongoing or acute care. The healthcare system has a long way to go in addressing solutions such as treatment capacity and equal care for mental health and addiction, but cutting off subsidies over a few ambiguous words would only have further exacerbated a broken system.

Dorene Kinloch

Communications Specialist 

NCADD-NJ

MENDACITY AND SERENDIPITY

Try this one on for size. The junior Senator from Texas (Republican Ted Cruz) signed himself and his family up for Obamacare, saying that it “was a good deal” for them. This coming from the person who led the effort in Congress to shut down the government (and cost the U.S. economy $25 billion) in an attempt to force a repeal of the very same program! And if you really want to get me started, how about the politicians who get plastered at fund-raising cocktail parties and devise ways for the government to get tough on drugs?

Quite randomly, the last five books I’ve read have all (to a greater or lesser extent) employed this theme of hypocrisy. Forty-six years out of high school, and I re-visited J.D. Salinger’s CATCHER IN THE RYE, Tennessee Williams’ CAT ON A HOT TIN ROOF, Billy Shakespeare’s ROMEO AND JULIET,  and Dr. Seuss’ YERTLE THE TURTLE. Salinger’s Holden Caulfield rails throughout the opus of his contempt for “phonies.” Both Brick and Big Daddy in CAT complain of being “surrounded by lies and liars.” The tragedy of R and J is assured by the self-deluded Montagues and Capulets who opaquely conceal their petty vindictiveness behind a veneer of respectable civic leadership. Finally, it was Dr. Seuss’s genius to create Yertle who, while fancying himself a benevolent king of the pond, actually used his compliant subjects as expedient objects to satiate his outsized ego needs.  

All of this leads me to the fifth literary work, CHASING THE SCREAM (subtitled THE FIRST AND LAST DAYS OF THE WAR ON DRUGS) by British journalist Johann Hari. Jaded and world-weary as I am, when I first spotted the book at the Strand in NYC, my reaction was that no one could tell me anything  I didn’t already know about the War on Drugs. After all, it struck me as a bad idea back when the drug and alcohol-addled Richard Nixon announced it, and it has turned out to be even worse than imagined in its implementation. What Mr. Hari clearly shows, is that by traveling back to the Drug War’s Big Bang in the 1930s with the creation of the Federal Bureau of Narcotics, the War on Drugs always exhibited the characteristics of a lovechild conceived from a chance encounter between racism and political ambition.

The villain in this piece is Harry Anslinger who served as the founder and Director of the Bureau until the 1960s. Anslinger was responsible for the torment and death of countless thousands of people, including the singer Billie Holiday,  whose demise owes not a little to the harassment and cruelty he visited on her. Harry wrote memos to his colleagues in which he referred to Ms. Holiday as a “niggress” who had to be destroyed. When he wanted to expand his office’s budget, he testified to Congress about the need to stop Mexican men, whose marijuana use was whipping them in to a sexual frenzy, from crossing the Rio Grande and raping our white women. Later during the Red Scare of the late 40s and early 50’s, Harry would get his blank checks from Congress by claiming that drugs were being sent into our nation by the Kremlin. If there was a Mt. Rushmore for ignominy, Harry Anslinger’s face would surely be carved in to that hillside. His drug war was first and foremost a contrivance.

CHASING THE SCREAM is a work that examines much more than the vulgarities of the aforementioned Mr. Anslinger. The author gives us the experiences and perspectives of drug gang members, people suffering in the grip of addictions, law enforcement and treatment providers. I thought I knew all that was needed about the War on Drugs before picking up this work; but I was wrong. Yes, the War is stupid and destructive; however it is so much more. Every page turned in CHASING THE SCREAM is like Humphrey Bogart slapping Elisha Cook, Jr. in THE MALTESE FALCON, right up to the explosive last few pages. If you enjoy a book that grabs you by the lapels and gives you a deeper insight into something you thought you understood – then CHASING THE SCREAM is just what the doctor ordered.

Ed Martone

Policy Analyst

Make Naloxone a Bridge to Treatment

Last year, with New Jersey in the midst of a worsening heroin and prescription drug problem that daily left overdose deaths in its wake, policy-makers reacted with a harm reduction effort that has since kept many from perishing. The response provides police and first-responders with the drug naloxone, which reverses the effects of an opiate overdose. Yet this measure stops just at the point when it could set many on a path away from the drug use that nearly killed them.

The National Council on Alcoholism and Drug Dependence-NJ (NCADD-NJ) is pressing law-makers to take the next, vital step, namely to refer to treatment anyone who been resuscitated with naloxone, and do so as soon as possible following the overdose. Failing to make such a treatment referral only returns the person to the stranglehold of addiction. The possibility of another overdose is not small, and the next time EMTs may not arrive in time to revive the individual.

Local officials close to the opiate problem have been struck by the shortsightedness of squandering the chance to use naloxone cases as a springboard to treatment. One of these, Howell Mayor William Gotto (R), whose town and county (Monmouth) have suffered a great many opiate overdoses, said the current system amounts to a “revolving door” in emergency rooms.

A new study from Yale University offers insight into a treatment model that can put an end to having people with an addiction cycle through the ER and back into opiate use. Outcomes from the study indicate that of three options, the best course is a treatment regimen including buprenorphine, a medication that eases cravings for heroin and helps prevent relapse. Because buprenorphine quiets the withdrawal pangs an opiate-addicted person experiences after receiving naloxone, it is particularly well- suited to such patients.

New Jersey has a precedent in translating a harm reduction outreach into an opportunity of guiding people into treatment. The state introduced a syringe access initiative, now known as the Medication Assisted Treatment Initiative (MATI), which operates in five cities, offers a template for making treatment through a program whose first aim is keeping participants safe in the near-term.

The MATI arose from the goal of providing opiate-addicted individuals with clean syringes to prevent the spread of HIV. Supporters of this measure recognized early on that it presented an ideal opportunity to introduce treatment to many of those who came to one of the program’s mobile units for a clean syringe. When a participant approaches one of the program’s mobile units for a syringe, MATI staff provide them with treatment information and, if they agree, referrals to treatment.

As the MATI demonstrates, many addicted to opiates will consider treatment if it is presented under the right set of circumstances. The worst-case scenario in the MATI saw one in two embracing the chance for treatment; the best, nine in ten. One would expect people revived from an overdose with naloxone to respond at least as well. As a result, people referred to treatment will enter recovery and in time build families and careers. In itself, Naloxone fends off death; as a conduit to addiction treatment, however, its potential is to allow many to begin lives in which they will fulfill theirs.

Dan Meara

Public Information Manager

NCADD-NJ

The Comprehensive Addiction Recovery Act

On February 12, 2015, the bipartisan Comprehensive Addiction Recovery Act (CARA) was re-introduced in both the Senate and House of Representatives. CARA was initially introduced during the last legislative session, in the Senate, on September 17, 2014. However, the bill failed to gain any movement. However, introducing the bill that late in the session was strategic (and not an uncommon legislative tactic) – even though it had little to no chance of making its way through the meat-grinder that is Congress last session, in less than three months. Because now, moving into a fresh, new legislative session, the bill has momentum: CARA has more cosponsors than it initially had last session, significant support and public awareness of the bill has been raised, thereby creating a greater societal demand, and upwards of 100 organizations are advocating for the passage of CARA.

The Comprehensive Addiction and Recovery Act of 2015 would:

• Provide between $40 million and $80 million in funding for prevention and recovery
• Launch an evidence-based opioid and heroin treatment and interventions program.  While we have medications that can help treat addiction, there is a critical need to get the training and resources necessary to expand treatment best practices throughout the country
• Strengthen prescription drug monitoring programs to help states monitor and track prescription drug diversion and to help at-risk individuals access services
• Expand prevention and educational efforts—particularly aimed at teens, parents and other caretakers, and aging populations—to prevent the abuse of opioids and heroin and to promote treatment and recovery
• Expand recovery support for students in high school or enrolled in institutions of higher learning
• Expand and develop community-based recovery services in communities across the country
• Expand the availability of naloxone to law enforcement agencies and other first responders to help in the reversal of overdoses to save lives
• Expand resources to identify and treat incarcerated individuals suffering from addiction disorders promptly by collaborating with criminal justice stakeholders and by providing evidence-based treatment
• Expand disposal sites for unwanted prescription medications to keep them out of the hands of our children and adolescents

Why Advocacy Matters

Policies regarding alcohol and drug dependence are going to get made (or not made) with or without the input of people such policies affect most. These are policies that affect access to and quality of resources that are integral to maintaining a person’s ongoing recovery. Needless to say, we need to be at the table – rather than merely on the menu. We need to make sure that our interests are being advanced in the policy arena. CARA is the first bill of its kind to address addiction in such an expansive way, and begin to effectively bridge the large gap between science and practice, and expand community support and educational resources.

The legislative process is long – and grueling. Statistically, only 4% of bills ever become laws. Decision-makers are constantly inundated with interests from every faction of society, which understandably (but unfortunately) makes it easy for bills to just fall by the wayside. To prevent CARA from a similar fate, advocates and supporters must be regularly heard through the torrent of other interests being launched at decision-makers on a daily basis.  This is why ongoing advocacy throughout the legislative process is so important – and will be crucial to getting CARA passed. 

 Advocacy efforts from constituencies across the country must be steadfast and diligent. CARA supporters and advocates have that ability. Over just the past five months, CARA’s supporters are becoming a constituency of consequence, wielding a sizable and growing level of influence. In all, the Recovery Movement at large has come to represent a large voting bloc in districts across the country. As another old saying goes, there’s “power in numbers”. And that’s no more readily apparent than when advocating for social change through legislative means.

Mariel Harrison

Advocacy Field Organizer

NCADD-NJ

411 Before 911

This morning I was helping my ten-year-old daughter with her social studies homework. I fought the urge to turn to Google for  a hint to the answer, but lost. Feeling slightly ashamed, I recalled my own fifth grade projects and library trips, which did not include such instant access to information. I couldn’t help but think of the immeasurable impact the information age has had on our lives.

Twenty years ago, if someone needed help with a substance misuse or mental health issue I remember the amount of research and phone calls setting up treatment or support required. In fact, if you didn’t know someone in the field or have a therapist, it was nearly impossible to network. And maybe, just maybe, if you found you way to a 12- step meeting you might find some resources.

This astounds me today as I edit video clips that will be posted to our youtube channel, potentially reaching thousands of people. I watch parents of addicts tell their story in hopes of reaching those out there who need to see it. We comb through vital links that could be of great service to many such as http://www.njconnectforrecovery.org/ ,  a 24-hour help line created by the Mental Health Association-NJ for those that suffer from opiate addiction (both heroin and prescription opiates).

Speaking of prescription drugs, this epidemic did not exist 20 years ago either. It is a startling fact that 46 people die from an overdose of prescription painkillers in the United States every day. In an effort to reduce the number of fatalities, New Jersey lawmakers are trying to enlist practitioners, the ones who give the prescription to the patient in the first place. Senate Bill S-2366 requires practitioners to have a conversation with patients to make them aware of the risks of addiction that are associated with opiate painkillers. This bill passed the Senate in December of 2014 and is waiting to be introduced into the Assembly. For updates on this bill visit http://www.njleg.state.nj.us/bills/BillView.asp?BillNumber=S2366

To take action on addiction- and recovery-related issues and help to advocate on bills like this so they become law, you can be a Think Advocacy member by emailing:  info@ncaddnj.org

Dorene Kinloch

Communications Specialist

NCADD-NJ

How Far We’ve Traveled

There is a scene in the 1939 film, “Wizard of Oz,” in which the tornado drops the house carrying Dorothy and Toto in to (and onto) Oz. As the front door opens, Dorothy observes with amazement that they are no longer in Kansas. At that point, the movie goes to color from black-and-white. Newspaper accounts at the time noted audible gasping at that juncture of the film nationally among theater audiences, many of whom were experiencing Technicolor for the first time and in a way were themselves transported to a new world.

I have had similar moments in my work at NCADD-NJ. At the latest legislative hearings, as well as in reading the speeches of Governor Chris Christie, our message of addiction as an illness requiring a public health response is not only resonating, but we find ourselves on the receiving end of this mantra from many of the same policy-makers who might have reacted with either hostility or indifference not so many years ago.

The reason for the change is apparent. Decades of a fruitless and misguided drug war have only resulted in broken lives and decimated public budgets. Officials and the general public are frustrated and eager to hear of tangible solutions to the problem of substance misuse. When I hear legislators talk openly at public forums of their personal experience with addictions among some of their family members, it tells me that they now get it. Further, they realize that the majority of the electorate is on board as well, and that speaking in a sympathetic and supportive manner with and about addicts is no longer the Third Rail politically it once was.

This has made me reflect on the black-and-white days of our movement. This June 10 will mark the 80th Anniversary of the founding of Alcoholics Anonymous. How different a world our pioneers such as Marty Mann and Bill W. lived in on that day, which marks when Dr. Bob had his last drink. Not only have we seen incredible advances in our understanding of the brain and the best approaches to treatment, but the refinement level of the public and their elected leaders has likewise come so far that today’s environment would be unrecognizable to the pathfinders of decades ago.

Now the burden is on us to raise, on behalf of people seeking, and living in, recovery, the level of our “ask.” We must meet the more developed insight about addictions with more sophisticated requests of our policy makers. At a recent N.J. Senate Budget Hearing, a number of legislators complimented the drug treatment participants present for their “courage” in speaking out. This was a sincere and well-intentioned gesture and it is much appreciated. However, that admiring comment was not also extended to the advocates who were there arguing for more funding for diabetes or cancer research. As long as it is generally acknowledged that raising the problem of addiction disorders requires “courage,” then it also serves as a reminder of the stigma that surrounds this sickness that doesn’t adhere to other diseases.

NCADD-NJ, with its Advocacy, Communications and Policy divisions,  is well-positioned to carry the effort to the next step. The sympathy and respect for our constituency is genuinely welcomed. However, it won’t prevent that youngster from experimenting with illegal substances, nor open up a treatment slot for someone in distress. The pity and best regards of officials will just be mood music if we fail to take advantage of this new attitude to secure a better life for our brothers and sisters. With approximately 800,000 Garden State residents struggling with this disorder, it is incumbent upon our government to do everything it can to eliminate barriers to good health by fully supporting high-quality prevention, treatment and recovery services for all who need them. And let us dedicate this extra effort to Marty, Bill, Bob and the other homesteaders who helped deliver us here.

Ed Martone

Policy Analyst

If only someone had asked

The young invincible is an apt term that refers to the segment of the population that believes itself to be impervious to illness or harm. The attitude of invincibility is commonly found in adolescence and early  adulthood and explains all sorts of risky acts seen in those years. Some in that age group experiment with opiate painkillers, and New Jersey has seen the consequences. Before long, their imagined invulnerability is replaced with a desperation to meet the need for opiates that have taken hold of their bodies and brains.

It need not have reached this point. A fairly straightforward series of questions might have identified an emerging drug problem before full-blown addiction occurred. The full-name of the model is Screening, Brief Intervention and Referral to Treatment, SBIRT for short. NCADD-NJ is working with NJ Citizen Action to promote the use of SBIRT for people ages 15-22. In cases where questions indicate drug or alcohol misuse, the second component of the model, intervention, is triggered. It uses motivational interviewing to encourage an honest look at where drug use or drinking will lead.

To his great credit, Senator Joseph Vitale has agreed to include SBIRT in the broad array of legislation on the state’s opiate problem that he has spearheaded. The Senator took part in a forum on March 9, during which he provided updates on legislation designed to curtail drug use and provide treatment. The event included an SBIRT presentation by a team from Inspira Health, which has conducted a successful program for adults. The Inspira team acknowledged the need to expand it to youth.

Some say if this questionnaire is done in schools, it will be interfering in a role parents reserve for themselves. Holding on to parents’ rights so blindly could produce disaster. Even the best of parents can miss the signs of drug use in their children, oftentimes because they do not want to see them.

Other states have implemented the screening model. In Georgia, the materials used to spread the word about SBIRT quotes a student who become deeply involved with drugs and laments, “if only someone had asked.” It’s time that we in New Jersey start showing the state’s young people that we care enough about them to ask the difficult questions and be prepared hear their more difficult answers. 

Dan Meara

Public Information Manager

NCADD-NJ

New Jersey's First Recovery High School!

There is a new movement in America. Recovery High Schools. So, the questions is, “What exactly are these?” Well, they are exactly what they sound like. They are schools that are devoted to teens who struggle from the disease of addiction. These schools provide a safe, sober and supportive school environment; and do this without throwing education to the wayside.

As we all know, addiction has penetrated our youth in a way previously unheard of. Kids are getting addiction to alcohol and drugs earlier and earlier. I myself have a dear friend who has a fourteen year old daughter who is addicted to heroin. So obviously the question is, “What are we doing wrong?” Addiction is a real disease and it is not going anywhere. The sheer number of high school age children abusing drugs are astounding. According to a report by the National Center on Addiction and Substance Abuse at Columbia University, of the 76% of high school students who have used tobacco, alcohol, marijuana or cocaine, one in five meet the medical criteria for addiction.

What can we do differently? Prevention and treatment are both absolutely fundamentally important. But the biggest thing is recovery support services.

Relapse rates are astronomical, especially in teens. And I don’t find that surprising. Here we take an adolescent who is struggling already with growing up and their hormones – disliking their bodies, wanting to fit in, being unsure of who they are or where they’re going… and add alcohol or drug addiction on top of that! Talk about confused. Kid wants treatment, so then we institutionalize them and separate them for 30 days. Then, we throw them right back into the environment where they were originally using in with the people they were using with. Who wouldn’t relapse?

So, in response to these high rates of relapse among adolescents who returned from treatment to traditional high school settings and quickly resumed old patterns of behavior, recovery high schools are emerging all over the nation.

New Jersey has been trying to get a recovery high school for a long time. There were a lot of naysayers, a lot of “Not In My Backyard” and a lot of roadblocks. The organizations two biggest champions were Pamala Capaci Executive Director of Prevention Links and the schools namesake New Jersey Senator Raymond Lesniak. Lesniak, who recognized the “compelling need” for the specialized education provided by a recovery high school. “The biggest issue [was] funding streams,” notes Capaci.“Education [funding] takes care of education [needs], health and human services takes care of health and human services, and they don’t mix well.”

The combined efforts of Capaci and Lesniak overcame such roadblocks, and the necessary financing was secured through fund-raising by Prevention Links, and from the home school districts of each student. In September of 2014, New Jersey The Raymond J. Lesniak Experience Strength and Hope Recovery High School (E.S.H.) came to fruition as the first public recovery high school in the state of New Jersey. E.S.H.’s mission is to create an environment where education and recovery go hand in hand. The Raymond J. Lesniak Experience, Strength and Hope (ESH) Recovery High School, located on the Union County campus of Kean University currently serves two area students who have been through treatment programs. Organizers and administrators hope to accommodate many more in the coming years.

A colleague and good friend of mine Morgan Thompson, secretary of Young People in Recovery – New Jersey, and the mentor coordinator at the high school is a young person in long-term recovery herself, at age 24 and sober five years. Morgan says, "If we truly want to empower young people to maintain their recovery, it is essential to provide a full and comprehensive continuum of care. Recovery high schools are one of many recovery support services that will promote sustained recovery."

Again with the idea of supporting recovery. If we are to look at addiction as the disease it is, then we must have supportive services. I believe that having a true continuum of care includes: recovery high schools, collegiate recovery centers such as the incredible one at Rutgers, long-term counseling, academic support and peer support services. Bottom line recovery is hard. Support is vital for success and no one needs more support than the young person in or seeking recovery.

This will in turn not only have an effect on those suffering with addiction, young or old; but have a much broader effect on the community.

A recovery high schools mission, unlike a traditional high school, is to support both a student’s recovery as well as their academic attainment. Students enrolling in a recovery high school have already established their motivation to achieve and maintain their sobriety.

Attending a recovery high school is not punitive. There is power in this alone because the students want to be there and want to get better.

Although the exact combination of activities for a student depends on that individual’s needs. 

Examples of activities that are contained on a student’s recovery plan:

•     Participation in self help groups such as AA and NA

•     After school one on one counseling

•     After school group counseling

•     Mental health counseling

•     One on one counseling with school recovery counselor

•     Medication assisted treatment

•     Family therapy

These recovery high schools popping up all over the nation all fall under the umbrella of the Association of Recovery Schools. ARS prepares and inspires starters and operators of Recovery High Schools to perform at their very best. Giving each state the tools to most effectively serve their individual populations. They believe that while addiction thrives in isolation, recovery is a process of hope and healing that thrives in the positive peer communities of recovery schools. Kristen Kelly Harper executive director says, “We believe that every student in recovery is of value and worthy of an opportunity to be educated so they can heal, grow and ultimately discover how to live their very best life.”

If we believe addiction is a disease, then we must treat it as such. And in treating it as such, we must have a comprehensive continuum of care. Recovery high schools are one very important piece in the puzzle which is addiction.

Mariel Harrison,

 NCADD-NJ Advocacy Organizer

 If you want to get involved with advocacy in New Jersey please e-mail mharrison@ncaddnj.org

Taking the Temperature of Advocacy Efforts in New Jersey

The New Year is always an important time for us to take a look at our own lives and see where we want to improve.  We tend to review the prior year, revisit memories, and challenge ourselves to improve different aspects of our lives.

That got me thinking about the advocacy efforts in New Jersey as a whole, and I was able to take a look at where we began, where we are now, and hopefully where we can go in the future.  

January 1^st 2010 was my first day working as an NCADD-NJ Advocacy Field Organizer.  Five years ago I moved out of a state I lived in my whole life (Rhode Island), away from my family, friends, and band, to be a part of building a grassroots constituency in New Jersey.  NCADD-NJ is, to my knowledge, the only organization that has field organizers responsible for advocacy that aims to highlight addiction solutions.  All I knew moving here five years ago was that it was unique and I was in store for something that could be really special.

Turns out that feeling was right, and here is why.

I knew only a hand full of people in New Jersey, but I came to Jersey with a plan. 

I called it the “Ease (E’s) of Evolution” plan, and I wanted it to outline how we can effectively produce change together that can help generations of individuals to come. 

The “Ease (E’s) of Evolution” plan is simple if everyone plays a role

(E)mpower

(E)ducate

(E)volve 

Let’s take a look at the first two steps of the plan-(E)mpower and (E)ducate

Through the opportunity to run an advocacy program I have met hundreds of dedicated individuals in recovery, family members, specialists in the prevention/treatment/recovery field that have participated in the progress we have seen in Jersey. 

That is YOU.  Without you, the whole Ease of Evolution plan is not easy at all - in fact, it is impossible.  There is a reason Empower is the very first step in this plan because the people NCADD-NJ has attracted are dedicated to volunteerism, to treating addiction as a health issue, and to forwarding social change.  If this voice could be developed and advocates could be empowered we had a beginning.

We had to find like-minded advocates who could be a face and voice as a recognized and organized constituency.  I think in the work we do as advocates, it is easy to feel alone in our efforts, and sometimes as individuals we feel like we  don’t/can’t really make a difference.  The reason I’m writing this blog post is to show you how you do make a difference individually and collectively.

I had no idea that the advocates so far were more than capable to raise the bar in New Jersey.  In fact, when I travel out of state, there are people who know of and recognize the grassroots efforts and victories seen here in New Jersey.  Knowing that others are paying attention makes the work we do every day as advocates even more important.

In the past five years I have seen advocates in Jersey do the following:

·         Organize over 60 community events in New Jersey that highlight solutions to addiction issues they care about focusing on overdose prevention, reducing stigma, addiction as a health issue, access to care, insurance discrimination, reducing recidivism, many pathways to recovery (just to name a few)

·         Attend over 300 regional advocacy team meetings (averaging about 8 a month)

·         Provide public testimony HUNDREDS of times to the Department of Human Services as well as at the statehouse and public budget hearings.  We now see legislators tracking advocates down after testimonies to get a better feel for their solutions and ideas.

·         Make April’s Alcohol Awareness Month and September’s Recovery Month meaningful advocacy opportunities to create awareness

·         Attend countless legislative office visits

·         Partake in non partisan civic engagement during election season (voter and candidate education, as well as voting)

·         Go to the State House to share their story with legislators.

·         Work tirelessly to get the life saving opiate overdose reverser NARCAN into the hands of family members with at risk individuals in their house, first responders, law enforcement and anyone who can one day save a life from overdose.

·         Attend more than 50 NCADD-NJ trainings that were offered over the years throughout the state.

·         Embark on letter writing campaigns to elected officials

·         Deliver thousands of postcards to legislative offices and the Governor’s office on why increased funding on addiction services matters.

·         Work within schools to reach young populations to share experiences on solutions to addiction and alcoholism.

·         Advocate for the opening of NJ’s first Recovery High School, collegiate recovery spaces, and more peer to peer Recovery Community Centers.

·         Submit Letters to the Editor

·         Start their own advocacy efforts and get involved with other amazing groups/efforts that are doing amazing work in New Jersey. (Help not Handcuffs, Young People in Recovery Chapters, The Overdose Prevention Agency Corporation, Parent to Parent, Overdose Prevention Campaign)

·         Provide grassroots support for legislative victories like the Overdose Prevention Act, Expungement Legislation, State Parity Laws, Road to recovery Campaign advances http://cqrcengage.com/ncaddnj/R2R , policies that expand the continuum of care for people struggling with addiction, drug court expansion, legislation that addresses the prescription drug epidemic, and bills that help people in recovery overcome barriers like the Opportunity to Compete Act.

This is what the premiere grassroots advocacy organization looks like in New Jersey.

Everything that advocates have done locally adds up.  I am fortunate to travel the state and work with ten different volunteer advocacy teams across New Jersey, so I get to witness the bigger picture.  We have even added new staff to the advocacy program (Hi Mariel Harrison!) because the program has grown out of its shell, as we went from eight teams to ten, with advocates in every legislative district in the state. 

These advocates in the process of speaking out have educated the public, lawmakers, and community decision-makers like law enforcement officers, and even people working in the courts or school system.  They are a resource to those making decisions on their behalf.

These advocates who have contributed in one way or another over the years to changing the landscape are amazing.   

And they won’t ever stop because they know that somewhere right now someone is struggling with addiction, or that advocacy helps their own recovery, or some young person is taking their first drink, or a family member lost someone they loved and their lives will never be the same as a result. 

Let’s get to the last step

 (E)volve

This is the slowest part to the entire plan, isn’t it?

When so many people’s lives are affected by addiction, solutions can never come fast enough.  It is so easy to get frustrated in the process of social change, because we often feel defeats spread out between victories.

I saw a presentation not too long ago that was talking about the elements of social change.  The presentation stated that you needed three elements to be working together in harmony to get any sort of social change.   The three elements were Policy, Electorate, and Grassroots. 

I do think that we have a unique climate in New Jersey today as a result of good advocacy, and elected officials starting to take the addiction epidemic seriously and work together towards reform to curb overdoses and fund important prevention, treatment expansions and recovery support services.   We have an approach being advocated for that brings together everyone from the electorate, to the family members, to the police officers, to health professionals, to the court system, to the people in recovery, and even educators and faith based community.  It is an effort that everyone can be a part of and pitch in towards solutions towards good sound public policy that will save lives.

When I think about evolving we have to really think about vision.

Imagine a New Jersey that:

Has recovery friendly environments like peer-to-peer recovery centers in every county, or more recovery supportive environments for young people at the middle school, high school, and college levels;

Has NARCAN in every first aid kit in every household in the state, in addition to being in the hands of every possible first responder including all police officers;

Has treatment on demand, and where waiting lists don’t even exist for the level of care someone needs;

Has support for the family members as well as the addicted, or persons in recovery.

Imagine a New Jersey that:

Doesn’t stigmatize people just for having an illness …

Doesn’t have insurance companies that deny people life saving medical treatment because they aren’t sick enough, or they haven’t “failed” outpatient first, or they aren’t considered medically necessary to obtain treatment by someone who has never met them…

Doesn’t lock sick people up for not-violent crimes and deny help for the root cause of the non-violent crime in the first place..

Are we there yet?  No.

Have we made progress?  Most certainly.

The advocates took this plan and made it a whole lot bigger than this guy from Rhode Island ever thought.  And we aren’t even close to done yet, because I know these advocates are dedicated.

Thank you all for being a part and let’s keep moving forward.

One of my favorite parts to the advocacy program has always been that the advocates designate what gets worked on. 

What do you want your New Jersey to look like?  

Now let’s make it happen together. 

I am happy to announce that NCADD-NJ have found organizations that believe in your advocacy efforts so much that they have agreed to sponsor the first ever statewide advocacy summit at the end of 2015.

Have you ever wondered what it would look like to get all of us in the same room?  I have, and at the 2015 Advocacy Summit we will make that thought a reality.

 This summit will be for you, the grassroots advocate. 

More news to come.

Aaron Kucharski is the NCADD-NJ Advocacy Coordinator

If you want to get involved with one of the advocacy teams in New Jersey just email 
Akucharski@ncaddnj.org or mharrison@ncaddnj.org

Talking Behavioral Health- When Bringing your Work Home is Okay

 As the communications specialist for NCADD- NJ, I see the many facets of addiction issues; from prevention to recovery supports, and all the obstacles in between. We try, on a larger scale, to address addiction from a moral standpoint by fighting stigma while promoting addiction as a brain disease rather than as a moral weakness. We work at the legislative level to increase addiction treatment funding and have hundreds of advocates working together for effective change.

As we do these things, it becomes increasingly clear to me that part of the reason we have our work cut out for us is that in order to create societal movement on a macro level, we need to change things on a micro level first, and consistently.  Among the public awareness efforts is the Screening, Brief Intervention and Referral to Treatment grant, an early intervention model, which is geared toward 15-22 year olds, and the Consumer Voices for Coverage grant that assists individuals to get health care coverage. At different times during the day, I become acutely aware that educating my own children about these issues is much more difficult than educating the public.

A Family History

Our genetics, sometimes fortunately and sometimes unfortunately, can determine our fate.

When I went to my last physical, my doctor’s office had gone digital, so I was asked for my family history once again. No problem. I thought it may need to be updated after a decade anyway. I couldn’t help but notice that there were no questions about behavioral health. Odd, I thought to myself. It so greatly impacted so many of my family members. This led me to think of my oldest child, my 14-year-old son, who has bi-polar disorder. I can easily tell him that addiction and mental illness runs in his family, but might it have a greater impact to him if it were on the family history portion of his health record as an illness? After all, he voices concern over diabetes in our family. If behavioral health- or behavioral illness- cost our health care system so much money, why wouldn’t that question be on health records? At least we would be starting somewhere to raise awareness.

This link on integrated care is from the Substance Abuse and Mental Health Services Administration: http://www.integration.samhsa.gov/about-us/what-is-integrated-care

My son recently learned that two family members took their lives as a direct result of behavioral health issues. So I came out and said it: “Look, if you choose to ever drink alcohol or use substances, you are taking a big risk and that is fact. We have proof there is a strong genetic component to addiction and quite frankly, the odds are not in your favor.  This is not I am making up to scare you out of doing something bad. If heart disease was in the family I would be telling you the same thing.” It drives me crazy that as far as we have come technologically, we (the powers that be) still don’t integrate health care or see human beings as a comprehensive puzzle.

http://pubs.niaaa.nih.gov/publications/arh312/111-118.pdf

I don’t know if my candid talk will actually help him make healthy decisions in terms of substances or not, but I know that my conscience is clear since I have started down a path of open communication with my son. There are times when one may think it is easier to avoid these harsh truths. But at what cost?

Christie’s Speech Offers Promise on Addiction; Now Comes the Hard Part

 Governor Chris Christie’s fifth State of State was expected to signal his run for the presidency, and that it most certainly did. But it also concentrated on addiction in considerable detail. While the governor touched on basic Republican themes of smaller, more efficient government and tax breaks for corporations, he devoted a quarter of the speech to steps taken to date to address addiction (drug court) and what will be done in that area in the coming year.

His emphasis on addiction being a disease, a statement that has echoed throughout his tenure, was sounded again in his State House address. That New Jersey’s governor, let alone a presumptive candidate for president, would speak at length on this issue is something addiction advocates would not have believed. Beyond the state’s borders, his giving so much of a speech that confirmed his national aspirations could well mean this subject will getting a hearing during the Republican primary season. 

The governor spoke several times of ensuring the level of treatment provided is appropriate to the patient. He described a system “utilizing services that don’t actually work” for people. This is a vital point about addiction that gets heard far too seldom. Having treatment suited to the individual relates both having the best chance of having a good outcome and to making the best use of limited resources. NCADD-NJ has advocated use of the American Society of Addiction Medicine’s Placement criteria in diagnosing a patient to ensure he or she is placed in the right care level.

Critics of the governor’s speech were quick to note that treatment dollars are greatly lacking in New Jersey, as they are elsewhere, and the governor was vague at best in identifying how the treatment would be paid for. He talked about replacing a “bureaucracy of options” with a single point of entry approach and that, by coordinating programs and services, the state will “maximize resources.”

Yet Assemblyman Herb Conaway, who is a doctor, observed that “Whenever something is underserviced in healthcare, it is most of the time because there is too little money going to it.”

The governor has prided himself on being an atypical politician. For him to truly stand apart, he needs to acknowledge that in and of itself efficiency with existing resources will not be adequate to meet the addiction care shortfall seen in New Jersey. If and when he takes that difficult step of putting principle and funding behind his words, he will lift more lives out of addiction and at the same time he may lift his chances for 2016.

By: Daniel J Meara

Public Information Manager

NCADD-NJ

NJ Senate Should Look Once, and Think Twice, at a Misguided Heroin Bill

I saw someone’s funny company tee shirt the other day. It read, “The beatings will continue until morale improves.” A similar sounding motto might well be descriptive of the NJ Assembly’s approach to mitigating the state’s opiate crisis, “The punishment will continue until you get well.” In a shocking display of willful ignorance and inverted logic, the Assembly last month voted 66 yes, 2 no, 5 abstain and 7 not present, to increase criminal sentences for heroin.

The bill’s objective is to permit prosecutions for drug distribution (and intent to distribute) to proceed using a lower standard of “units” as opposed to the current “weight.” While the stated goal is to facilitate the imprisonment of “drug kingpins,” the result will be more addicts who are hoarding heroin for later use, getting locked up. Merely re-classifying someone a “distributor,” rather than a “possessor,” will do next to nothing in enhancing any effort to round-up heroin sellers. Instead, the list of negative consequences of this measure is as long as your arm.

• The drug laws have already exacerbated the racial disparate impact that is rife in our criminal justice system while this proposal will largely just place more black and brown people behind bars.

• It is well understood that jails are the least effective and most expensive method in dealing with addictions. This legislation would put more folks in to detention and out of treatment. Speaking of cost, the Dept. of Corrections estimates this proposed law will incarcerate an extra 179 inmates to the tune of up to $7.7m. Meanwhile, the Office of Legislative Services’ projection suggests that that figure is too low! The OLS, however, did not weigh in with its’ own fiscal impact number.

•  Certain persons convicted of drug possession offenses are able to receive General Assistance (welfare) benefits and emergency housing help upon release from prison. People with drug distribution charges are ineligible for these programs.

• Certain persons convicted of drug possession offenses can participate in a drug court program. People with drug distribution charges are ineligible. Thus, some people who might have benefited from the treatment discipline of drug court, will instead become wards of the state.

So, A.783, and its’ companion bill in the Senate (S.211), represents bad fiscal policy, bad corrections policy, bad drug treatment policy, bad social and racial policy, and bad prisoner reentry policy.

One can only hope that the Senate will look at this wrong-headed legislation with a better informed and refined thinking.  

Ed Martone
Policy Analyst
NCADD-NJ