GLEN RIDGE, NJ — The Essex County Prosecutor’s Office held a public discussion at the Glen Ridge Congregational Church on Wednesday, Aug. 15, about the proliferation of opioids in New Jersey.
Opioids are a class of drugs derived from the poppy plant, similar to morphine and heroin. Opioids are also made synthetically and prescribed to control pain.
At the discussion, an audience of 20, including Glen Ridge Police Department officers, was welcomed by Essex County Executive Assistant Prosecutor Gwendolyn Williams. The Rev. Damien Lake, interim pastor of the church, offered a prayer acknowledging the opioid problem in Glen Ridge while asking residents to confront it. Acting Essex County Prosecutor Robert Laurino then introduce the topic and a panel of four experts who presented their perspectives on the epidemic.
“No one wakes up and says, ‘I want to be an addict,’” Laurino began. “It’s a long process.”
He said the opioid crisis began with painkillers prescribed by doctors.
“Unfortunately, we have doctors prescribing in large amounts,” he said. “What happens when the drug runs out?”
What happens, he said, is that people turn to the black market. Legal opioids are inexpensive, but costly on the black market. This expense compels individuals developing an addiction to purchase a cheaper substitute: heroin. Laurino said a bag of heroin can be obtained for one-quarter the price of a single opioid pill, which is approximately $25.
“New Jersey has the cheapest and purest heroin in the country,” he said.
Fentanyl, a synthetic opioid, is often mixed into the heroin, and is 15 to 20 times more powerful than just heroin. In Nebraska, where capital punishment is legal, he said the drug is used to execute the condemned.
“Two years ago, 2 percent of opioids contained fentanyl,” Laurino said. “Today, 41 percent do.”
But Laurino said there are more powerful adulterants. Carfentanil, used to tranquilize elephants, is one and it is 100 times more powerful than fentanyl.
The first panelist to speak was Joel Torres, the director of ADAPT, the Alcohol and Drug Abuse Prevention Team of Essex County. Torres is also a member of the Hudson County Board of Chosen Freeholders, representing the 4th District as a Democrat. Torres reiterated what Laurino said, that an opioid addiction starts with an injury. The victim goes to the doctor and is given relief.
“People think, ‘It’s not happening in my family,’” he said, “and you let your guard down. But someone you know will steal from you. When homes go on sale, people pretend to be homebuyers during open house events, but they are really looking for drugs to steal.”
He said that ADAPT, with local police department assistance, promotes establishing drop boxes so that residents can safely rid themself of unneeded, prescription drugs. The organization also goes into senior housing to collect drugs for disposal.
Laurino interjected that Glen Ridge had a drop box. It is located at the police station, on Herman Street.
“A doctor cannot prescribed an opioid for more than five days,” Laurino said. “If the prescription is longer, there must be personal contact with the patient and the dosage is lower.”
He also said that anyone having an overdose, or witnessing one, can report it to authorities without fear of prosecution.
“It’s more important to save a live than prosecute,” he said.
People who are not customarily health care providers can now administer Narcan, he said, which is an opioid overdose reversal medication. He said the use of Narcan has increased 40 percent in recent years.
“Law enforcement has been thrown into this, but it’s not a police problem,” he said. “It’s a public-health problem.”
The second panelist to speak was David Kerr, founder of Integrity House, which provides programs to help individuals overcome drug addiction.
Kerr said the biggest step forward an addict can make comes with the assistance of a “coach” willing to devote considerable time to help the addict become a functioning member of society.
“When addiction becomes a lifestyle, it’s very hard to change,” Kerr said. “You cannot change it, they must change it. A coach must encourage change.”
Regulations require addicts to be assessed for treatment, Kerr said, but an assessment is a label.
“Throw the negative aside and assess the good qualities,” he said. “Addicts don’t see the good in themselves. Just ask them what’s good about them. That’s called strength counseling and it started in the ’80s.”
Hard-core criminals who are “sober” make the best coaches, according to Kerr.
“It takes an average of five years of coaching to help a person,” he said. “Encouragement of self-worth and being part of the community are the two most important things for an addict.”
But he said the most important question for a potential coach to answer is if they could make a covenant with someone coming out of prison.
Eileen Fishman, a pharmacist and the director of the Essex County Division of Community Health, was the third speaker.
Fishman said the opioid epidemic began in the ’90s with the proliferation of pain management clinics. At these clinics, doctors would ask patients how much pain they experienced and then prescribe an opioid for that level of pain. Class II narcotics, such as fentanyl and oxycodone, were given monthlong prescriptions with two additional months available. She said the opioid problem is reminiscent of the AIDS epidemic 40 years ago — but it causes more deaths.
“You need to start in kindergarten,” she said, “how to respect drugs and what they are used for.”
The Division of Community Health, she said, provides recovery support for addicts.
“A lot of these people don’t have an ID,” she said. “We get them a birth certificate.”
Housing and employment will be found for a recovering addict so they can see themselves as a contributing member of society.
“Senior citizens,” Fishman said, “are probably the biggest group with increasing addiction.”
She said their problem begins by falling and getting hurt.
The fourth speaker was Nicholas Bean, a “patient navigator” for Hudson and Essex counties, in the Substance Abuse Navigator Program, for Robert Wood Johnson Health.
At one time, if someone suffering from a drug overdose went to a hospital emergency room, they would receive little attention, according to Beam.
“Junkies are at the bottom of the list,” he said.
Realizing this, St. Barnabas Hospital conducted a survey to learn how many people who have suffered from drug overdose actually received emergency-room help. They found that of the 300 “junkies” that went for help, only one received it.
Responding to this, Beam said the hospital created its Essex County Peer Recovery Program in 2016.
“Barnabas has trained former addicts to meet with junkies once they are getting treatment,” Beam said. “The program provides recovery specialists. It has changed the way substance abuse is perceived in a hospital. Now you don’t have to die to get help. All you have to do is walk into a hospital.”
He said the youngest person to benefit from this program was a 12-year-old; the oldest was 92.
“It wasn’t her fault,” he said. “She read the prescription wrong.”
He said that in 2017, drug overdoses caused 72,000 deaths in the United States.
Laurino said the opioid discussion was the second in a public series presented by the N.J. Office of the Attorney General. The first discussed the use of force by the police; discussions on immigration issues and bias crimes are to follow.