NCADD-NJ STATE BUDGET TESTIMONY (Oct. 1, 2020 through June 30, 2021)

Due to the coronavirus epidemic, along with the lack of any financial assistance from the federal government, Garden State lawmakers resorted to adopting an interim state Budget for the period of July 1, 2020 through Sept. 30, 2020. In Sept., the Assembly and Senate Budget Committees accepted written public comments on fiscal year proposals covering Oct. 1, 2020 through June 30, 2021. Our agency, as well as, a number of our volunteer Advocates, submitted comments. The following is the NCADD-NJ organizational testimony:

 

The National Council on Alcoholism and Drug Dependence – NJ (NCADD-NJ) is an incorporated non-profit organization operating in the Garden State since 1982. NCADD-NJ works in partnership with, and on behalf of, individuals, families, and communities affected by alcoholism and drug dependence, to promote recovery. We have been working for more than thirty five years to reduce the stigma and discrimination associated with addictive illness. We have been strong advocates for public policies that increase access to quality treatment and recovery services.

 

NCADD-NJ also operates the Substance Abuse Initiative and Behavioral Health Initiative (SAI/BHI) to help implement the Work First New Jersey welfare-to-work program funded by the NJ Dept. of Human Services. The goal of the SAI/BHI is to eliminate addiction as a barrier to employment. The NJ Division of Family Development funds our Family Violence Option (FVO) project. The purpose of the FVO program is to afford protection to domestic violence victims who are receiving General Assistance or Temporary Assistance to Needy Families help.

 

We also provide substance misuse assessments for youth under the supervision of the NJ Juvenile Justice Commission. This assessment further includes level of care placement recommendations.

 

The present day description of the one-two punch of COVID-19 and addictions is as a crisis wrapped in a crisis. The coronavirus pandemic has exacerbated the psychological factors that are involved in substance use behavior. The medical journal PSYCHIATRY RESEARCH (Aug. 18, 2020) noted that the social isolation, economic hardship, worry, fear, and disruption of normal activities have resulted in increased drug misuse among those with existing addiction disorders, along with a rise in use among former abstainers.  Combine this with capacity limitations, growing waitlists, and reduced hours at many addiction treatment programs and one sees what could have long been expected – a nearly 20% increase of drug overdoses, according to a University of Baltimore study last month. Overdose deaths in New Jersey were averaging around 3,000 per annum for the past several years before COVID-19. It is blatantly obvious the State must find the resources to, not just maintain past levels of funding, but to enhance the response to an escalating need.

 

We are encouraged to see the Dept. of Human Services continue to do more with less as, among other initiatives, it has sustained its naloxone (opioid overdose reversal drug) free distribution to individuals, police depts., libraries, and homeless shelters effort, along with the launch of a program to train EMS first responders on interacting with patients following treatment from a suspect opioid overdose and linking patients to needed services.

 

A final observation – In a report issued by the American Medical Association’s (AMA) Opioid Task Force (July 28, 2020), it was determined that, although opioid prescriptions decreased in the last year, the use of illicit drugs has gone up. This leaves for a future debate the question of whether restricting access to prescribed and regulated medications, rather than decreasing drug misuse, isn’t instead, driving up customers for the illegal trade? In the Governor’s proposed nine-month Budget, he included anticipated revenue from an “opioid tax.” Our belief is that this may well have the unintended and ironic consequence of hurting the effort to mitigate the worsening drug addiction crisis in our state. Two of the drugs utilized as part of a medication assisted treatment (MAT) regimen to treat addictions, are methadone and buprenorphine. Both contain a certain amount of opioid medication (the former 10% and the latter 85%). A tax on their use will certainly make them more expensive, if not entirely inaccessible. Attaching extra costs to therapies that help people to heal seems never to be a good idea. Making it more burdensome for individuals seeking relief from chronic pain and addiction disorders would be foolish.  

A NEED FOR A DRUG CZAR ?

 Would the struggle against the crippling effects of addictive behavioral disorders benefit from a consolidating of initiatives coordinated by one person or office? Does the Garden State need a Drug Czar (my term)? There are three bills pending in the state Legislature that would significantly center addiction prevention, treatment and recovery services under one roof. All three are presently receiving committee consideration.

 

* Assembly Bill 2124 and Senate Bill 2170 would establish an Office of Alcohol and Drug Use Disorders Policy to oversee, direct and coordinate resources, funding and data tracking with all State Departments with regard to the prevention and treatment of alcohol and drug disorders. The Office would be allocated within the Dept. of the Treasury but would be independent of the Dept. and would report directly to the Governor. It would review County Annual Alliance Plans and distribute grants. It would evaluate provider performance and enforce contract compliance. The Office would take over most of the functions of the Governor’s Council on Alcoholism and Drug Abuse. An Executive Director would be appointed by the Governor with the consent of the Senate.

 

* Assembly Bill 3364 would create an Office of Alcohol, Drug and Tobacco Use Control Policy in the Dept. of Health. It would develop a strategic plan to reduce use, oversee the collection of data related to youth use, identify the best municipal youth programs, and develop recommendations to improve the safety and effectiveness of acute pain treatment. The Office would apply for grants to fund itself.

 

* Senate Bill 2079 would create the Office of Coordinated Substance Use Control Policy and Planning in, but not of, the Dept. of Human Services. It is intended that it would be independent of DHS control. The Governor would appoint the Executive Director and his/her Deputy, with Senate consent. The Office would develop a strategic plan, coordinate and oversee all substance use control activities in all state Departments, law enforcement, and local governments, make compliance recommendations, provide agency budget recommendations, audit and evaluate agency performance, biennially review existing laws and regulations to determine consistency with the Strategic Plan, serve as spokesperson for Executive Branch substance use policies, administer appropriate grant programs, assume some of the responsibilities of the current Governor’s Council on Alcohol and Drug Abuse including review of County Annual Alliance Plans, examine extant statutes and make recommendations, hire, appoint, transfer agency staff to implement the Strategic Plan, assign funds among agencies, control the use of agency monies, and operate a hotline to assist the public.

 

Even if it is determined that either of these proposals (or some combination thereof) would improve on the present state of things, would New Jersey government have the will to make it happen? Would the monies be found to carry out this reform in a meaningful way? An argument could be made that every state department should be ready to engage in activities, within its bailiwick, that would help the cause. However, in the world of turf politics, how much authority and funding can it be reasonably expected that extant bureaucracies would voluntarily surrender? And can’t you just hear the howl that would be emitted from the hallowed halls of county and municipal governments when the big toe of state government is seen to be encroaching on its territory?

 

If this organizational shuffling makes effective sense, then like so many meaningful changes, it will have to be a priority of people seeking long-term recovery and their allies in order to get it enacted.

 

Ed Martone

Policy Analyst