Variety of Prosecutor’s Office Programs Put Dent In Number of Opioid ODs in 2017

But Challenges Such as Fentanyl, Insurance and Lack of Treatment Beds Could Reverse Downward Trend
By RICK MELLERUP | May 30, 2018
Photo by: Ocean County Prosecutor's Office

Ocean County is making progress in the war against opioid abuse, but it isn’t out of the woods quite yet. That was the message delivered last Thursday evening by a panel of speakers participating in a Knock Out Opioid Abuse Town Hall at the Calvary Baptist Church in Little Egg Harbor Township.

The panel included people representing law enforcement, the medical profession, and prevention, education, and counseling specialists, reflecting a balanced approach to the problem of opioid abuse. Ocean County Prosecutor Joseph D. Coronato was the official law enforcement representative, although police officers made up a large chunk of the audience of about 100 people. Dr. Muhammad Abbas, a board certified psychiatrist and chief of addiction medicine and medical director of the Partial Hospital Program at Jersey Shore University Medical Center in Neptune who is also clinical-fellowship trained in chronic pain management and addiction medicine from the University of Pennsylvania, represented medical professionals. The prevention, education and counseling world was represented by Lisa DeJesus, director of prevention services at Prevention First, a division of the Preferred Behavioral Health Group, who has extensive experience in addressing the prevention of teen pregnancy, violence and the use of alcohol, tobacco and other drugs, as well as Pastor Mike Dellaperute of Calvary Baptist and Michael Capko, currently the DART Prevention Coalition of Ocean County manager, an alliance of law enforcement and government officials, business owners, educators, substance abuse professionals, clergy and youth.

The town hall-style gathering, hosted in 19 New Jersey counties since 2017, was sponsored by the Partnership for a Drug-Free New Jersey and the Horizon Foundation for New Jersey in association with Calvary Baptist Church and the Ocean County Prosecutor’s Office and was moderated by Rebecca Alfaro, deputy director of the Governor’s Council on Alcoholism and Drug Abuse.

“There is not a day that goes by without hearing or seeing a story in our neighborhood or in the media on the impact of the misuse of prescription medication or heroin abuse,” said Alfaro. “Ocean County is not immune. No family or community is immune.”

Coronato said back in 2013, during his first week as Ocean County prosecutor, the county suffered eight drug overdose deaths in seven days, including one 18-year-old girl who had a 50-packets-of-heroin a day habit. There were 112 opioid OD deaths in the county in 2013, 104 in 2014, 118 in 2015 and 216 in 2016. But since then, he said, a three-pronged approach to the battle against opioids – education/prevention/strong law enforcement – has started to break the cycle. The number of opioid OD deaths in the county dropped roughly 25 percent to 166 in 2017. As of April 30 there had been 57 such deaths in 2018, pretty much matching 2017’s pace.

Of course, there are severe challenges, such as the increased prevalence of fentanyl, a cheap synthetic opioid that is much stronger than heroin and often mixed in with the latter by dealers to increase the potency of their drug packages and thus increase sales while lowering costs. In 2014, said Coronato, 10 percent of opioid OD victims had fentanyl in their systems. By 2017 that percentage had leapt to 65 percent, and so far this year it has been found in the systems of 84 percent of Ocean County’s victims.

Naloxone, sold under the brand name Narcan, was the first aid in the war against opioids. It blocks the effects of opioids, especially their tendency to depress the central nervous and respiratory systems, thus saving lives. Coronato was the first prosecutor in New Jersey and one of the first in the entire county to push for police and other first responders to carry Narcan.

But that first aid has proved to be just that, first aid. Saved, many addicts went right back to using. So Coronato introduced the Opioid Overdose Response Program, in which members go to the hospitals where OD sufferers saved by Narcan are brought, where they can try to convince and then assist addicts in entering recovery and sobriety programs.

Finally, Coronato added his office’s Blue HART (Heroin Addiction Recovery and Treatment) program to the mix. Under the program addicts can turn themselves – and their drugs – in to police headquarters in order to get addiction services without threat of charges or jail.

“In 2017, 373 people walked into a police station asking for help,” Coronato told the Thursday night crowd. “That’s why I think you have a 25 percent reduction in overdose deaths.”

Not to mention a drop in ancillary crimes such as breaking and entering or shoplifting that users resort to in supporting their habits.

The Blue HART program currently has seven participating police departments in Ocean County. The Little Egg Harbor Township and Stafford Township departments in Southern Ocean County are two. People addicted to or having problems with opioid medications or heroin or any other substance can enter those police stations from 9 a.m. to 5 p.m. on Tuesdays and apply for help. A screening will determine if they are eligible for participation in the program, which will hook them up with one of five health care/treatment providers – Sunrise Detox in Toms River, Integrity House in Toms River, Preferred Behavioral Health in Lakewood, Ocean Mental Health Services in Bayville and Life Line Recovery Support Service in Toms River.

On Thursday, Coronato said the Surf City Police Department will soon be joining the network, with hours likely on Wednesday.

Abbas provided an overview of a number of addiction treatments, including three pharmaceutical, a.k.a. medication-assisted, treatments (methadone, naltrexone and buprenorphine) and non-pharmaceutical options such as acupuncture, support and psychotherapy.

DeJesus said she prefers a “Tupperware” approach to prevention. “Knock, figuratively, on every single door.”

“We start in pre-K,” said DeJesus, who added reinforcement must be added through and past college age.

“Brains are still developing up to the late 20s.”

Prevention efforts must also focus, she said, on doctors, telling them over and over again, “No, no pain pills, physical therapy.”

Prevention, she said, can be expensive, but it’s worth it. Every dollar not spent on prevention, she said, could end up costing $20 in cures.

Dellaperute said there are three major barriers to helping addicts.

“One – how can you tell when an addict is lying? As a Salvation Army guy from the Bowery in New York City said, ‘His lips are moving.’

“Barrier two – substance abuse comes with a lot of money problems which leads to stealing, lying, pushing addicts to sell drugs, prostitution. The person you used to take out for ice cream after a Little League game is now a liar and a thief.

“Barrier three – They are not going to get help if they live in comfort. I really believe it takes a crisis. People will come to me and say, ‘Mike, can you guarantee nothing will happen to my child if I kick them out?’ No! But I will guarantee something will happen if you don’t.”

The pastor said he was talking from personal experience. Once upon a time he was heavily into drugs.

“If I could smoke it, snort it, swallow it, I did it.”

Capko said the largest barrier to treatment is insurance issues. Medicaid, he said, will not pay for treatment in facilities with more than 16 beds. Plus there is a shortage of treatment beds in Ocean County.

“In 2017, 40 percent of Ocean County patients had to go out of the county for treatment.”

So Ocean County may have made progress in the war against opioids, but with all the challenges, that could turn on a dime.

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