With Liberty & Justice For All… Even Drug Addicts

I regained consciousness in a crowded hallway of patients and nurses with what felt like the worst flu of my life. Where is my car? How did I get here? Where are my bags? I came to the realization on my own that I had overdosed. A nurse later confirmed this suspicion after telling me that all of the available rooms were full, and handing me a sheet of paper with a methadone clinic address on it before sending me on my way. No phone call was suggested to be made. No ride was arranged. No assessment other than a minimal physical evaluation took place. I left that hospital, disoriented and dope sick, and returned to the same drug dealer that supplied me with the substance that earned me my unexpected hospital visit. Chances are, you are asking yourself one of two questions: How could you could be so dumb? OR How could that nurse expect anything else to happen?

Survivors of opioid overdoses, just like me, have 24 times higher death rates than the general population in the year following an overdose. Too many of these overdoses have been fatal in New Jersey in recent years. The rate of heroin overdoses in our state is 3 times the national average, and this drug’s use has increased amongst men and women, varying age groups, and all income brackets. Although overdose deaths continue to climb, meaningful efforts have been made to combat the crisis including increased availability of opioid antagonists and access to treatment for vulnerable populations. Whether opioid use disorder is a disease or it isn’t, our family members, friends, and neighbors are suffering all around us. Where does our allegiance lie as residents of a state in crisis with communities divided by differing opinions? Are we committed to standing together to promote liberty and justice for all?

NJ Bill S480 requires anyone administered an opioid antidote for a drug overdose be provided with information about resources and treatment programs. The concept of offering such information at what may be the most vulnerable time for someone suffering from opioid use disorder seems like a long overdue mandate. This informational material provided after overdose reversal will be created by the Commissioner of Human Services and include both means of treatment and information about access to opioid antidotes. This bill has been introduced and amended and reintroduced for years. After contacting several sponsors and co-sponsors of the bill and even substance abuse prevention alliances and departments throughout the state, I feel the frustration of the hurdles involved in creating real change.

Senator Joe Vitale is the prime sponsor of the bill and the chair of the Senate Health, Human Services, and Senior Citizens Committee, where the bill has been referred. According to the legislative history, the same bill was signed into law at the end of the legislative session on January 16, 2018. The legislature is permitted to pre-file a limited number of bills prior to the start of a new legislative session. It appears that Senator Vitale may have pre-filed S480 in anticipation that it would not be signed into law before the session ended. As a NJ resident, I am amazed by the lack of understanding of current status and opioid related topics among those involved directly with this bill. I also sympathize with the financial and operational difficulties of moving this directive along.

With a wide spectrum of perceived treatments for opioid use disorder, I am curious as to what resources will be provided if this post-overdose intervention is enacted. Who will train first responders to treat people with opioid use disorder with respect, remembering that they are people first? For some insight, I visited the Division of Mental Health and Addiction Services section of NJ’s Human Services website. I must admit that the resources are astonishingly difficult to navigate. From dead links including the realtime dashboard of opiate data and unclear directions on the New Jersey Substance Abuse Monitoring System(NJSAMS), it is no surprise that individuals seeking recovery and their families often don’t know where to begin. A new state office called NJ CARES was developed to marshal resources more efficiently and provide transparency of overdose deaths and Naloxone administrations segmented by county. This strategy undoubtedly reduces the ignorance which adds to the complexity of tackling the epidemic. I hope that a collaborative effort to more clearly lay out this information is underway, although I cannot seem to get a clear answer about when this will happen or what it will look like.

This epidemic has lead to immense financial burden, widespread outbreaks of infectious diseases, decreased productivity, increased criminal justice costs, and most importantly the loss of precious, irreplaceable lives including many of my dear friends. But there is hope and recovery does happen. I reflect back on my experience in that hospital six years ago as a changed woman who is a sober, productive, tax paying member of society. Today, I am a daughter, a sister, a godmother, an employee, a public health student, and a resident eager to help facilitate change. NJ senators should not be surprised to receive calls from residents inquiring about the status of bills and eager to offer support. As an individual facing this epidemic, it feels like the world is on fire and all I have is a bucket of water. Together, we can make a real impact by preventing overdoses, encouraging recovery, and offering our support to help NJ continue to change in understanding and effectiveness of this crisis.