How the Department of Human Services (DHS) of NJ Addresses Addiction

checklist

Article Overview:

The rate of addiction in New Jersey has been called “terrifying,” spreading across rural and suburban communities, and leaving devastated families and dreams broken in its wake.[1] After initially being put on the defensive, the Department of Human Service’s Division of Mental Health and Addiction Services is working overtime to address addiction and turn the tide against an epidemic that threatens to claim an entire generation of New Jersey residents.

The Department of Human Services and the Division of Mental Health and Addiction Services

In 2011, the New Jersey government merged the Division of Mental Health Services and the Division of Addiction Services together, officially forming the Division of Mental Health and Addiction Services. This was done because of advances in medicine and psychology that revealed how closely substance abuse and mental health are connected, and that treating them together was more effective than to do so separately. Specifically, combining services for mental health and drug abuse treatment is instrumental in combating the stigma that surrounds both conditions, and covers much ground that a separate and distinct treatment methodology would miss.

When the Division of Mental Health Services and the Division of Addiction Services were brought together, it gave New Jersey’s Department of Human Services the chance to improve how the program supports New Jersey’s residents.

Pooling resources creates a bigger, better system to tackle the plague of drug abuse and the mental health concerns that play a significant factor in what compels people to abuse chemical substances. The Division of Mental Health and Addiction Services is responsible for the planning, tracking, evaluation, and regulation of how New Jersey tries to prevent drug use, and how the state offers treatment and recovery for clients.

Additionally, the department is responsible for the state’s system of community-based behavioral health services for adults, which is currently offered through third-party providers and private, nonprofit agencies. These agencies offer the basics of treatment and rehabilitation:

  • Substance abuse prevention
  • Early intervention
  • Emergency screening
  • Outpatient and intensive outpatient services
  • Partial care and partial hospitalization
  • Medication-assisted treatment
  • Short-term and long-term residential services

New Jersey’s Division of Mental Health and Addiction Services is responsible for ensuring that the facilities, staff, and operations of these agencies are up to standards and regulation.

In order to combat the heroin problem that has hit New Jersey, Governor Chris Christie made the work of the division a priority, creating a 24-hour hotline, funded by state and federal money, to put individuals and/or their families in touch with the most appropriate service for the condition in question.

New Jersey’s Challenge

But more work needs to be done, and quickly; there is not enough money to treat everyone who needs addiction help, and there is not enough to hire the necessary number of doctors and psychiatrists to treat the patients already in the system. As a result, many treatment centers have long waiting lists of people who desperately need to get in, forcing some families to drive for hundreds of miles until they find an available bed and doctor.[2]

Much-needed help may be on the horizon. In 2016, the federal government promised to make upwards of $22 million available for prevention and treatment programs in New Jersey. If Congress approves, the money would be distributed by the state’s Department of Human Services, which collected some sobering data that highlights the extent of New Jersey’s problem:

  • There were 781 deaths related to opioid abuse in 2014, almost double the figure recorded a few years prior.
  • Over 28,000 people in New Jersey checked into treatment centers across the state, and almost 50 percent of them needed help for heroin or other forms of opioid abuse.[3]
location

the federal government promised to make upwards of $22 million available for prevention and treatment programs in New Jersey.

Additionally, Christie extended the supply of naloxone, a nasal spray that can reverse an opioid overdose, often buying a drug user enough time to be admitted to hospital. Naloxone bottles are now standard carry for police officers and other first responders.

Christie has also expanded drug courts, which work with state and private treatment facilities to provide more productive alternatives for people to receive counseling, and not go to jail, for a first-time or minor drug offense.

Christie has also strengthened New Jersey’s Prescription Monitoring Program, to ensure that doctors are not prescribing powerful and addictive painkillers to people who are on record as having demonstrated a likelihood for drug abuse.

Addressing Addiction through Needle Exchange Programs

A radical, and controversial, plan to deal with the scope of heroin abuse in New Jersey is to give heroin users safe spaces and materials to shoot up. So-called “syringe access programs” are seen as way to make a connection with drug users who are so deep into their addiction that other forms of treatment will have to wait.

In 2008, New Jersey tried out a program whereby addicts would be given clean syringes, to dissuade them from discarding contaminated syringes in public places. The catch was that the addicts would also receive on-the-spot counseling and an invitation to a treatment program. Of the 4,482 people who participated in the program, 998 of them continued with residential rehabilitation.

location

Private community agencies took 295,736 needles off the streets

The results were encouraging but not encouraging enough for New Jersey’s government, which declined to offer funding to the five municipalities that adopted the program: Atlantic City, Jersey City, Paterson, Newark, and Camden. Private community agencies (approved of by the Department of Human Services, but not financially or materialistically supported) took 295,736 needles off the streets.

The Department of Health’s Division of HIV/AIDS Services, as well as the University of Medicine and Dentistry of New Jersey’s School of Public Health and the Drug Policy Alliance of New Jersey, were in favor of what they called the “excellent start” of the syringe access program and called for the program to continue.

As more results came in, momentum grew. Newark’s North Jersey Community Research Initiative provided services to 1,250 heroin users between 2008 and 2010, and 25 percent of them agreed to seek treatment for their addiction. In Paterson, 998 drug users made use of the local needle exchange program, of which 259 stayed on to receive treatment.

The program was endorsed by the former New Jersey Health and Senior Services Commissioner, who, in her capacity as a doctor, praised syringe access programs for reducing the scope of the dangerous behavior of drug users.[4]

Howell Township

When funding ran out, Governor Chris Christie signed legislation in 2016 to raise $200,000 to provide the five existing needle exchange sites in New Jersey with clean needles and other resources they needed (educational and testing materials), as well as laying the groundwork for more cities and municipalities to implement their own sites.[5]

location

Reported heroin abuse cases dropped to 126 from 153

The collaboration between community groups, law enforcement, and other organizations, through the auspices of the Division of Mental Health and Addiction Services, is making a dent in the hitherto unstoppable wave of heroin overdoses and fatalities. In 2013, Howell Township ranked 20th on a list of New Jersey towns with the highest rate of heroin abuse (153 reported cases); in 2016, it hasn’t even made the top 30, with its tally of reported heroin abuse cases dropping to 126. The numbers were compiled by the Department of Human Services, which based the figures on the number of people who sought treatment for heroin addiction. A community advocate attributed the success to tireless work and increased partnership between local government, police, and residents to “create a recovery-sensitive community.” This entails working with the school system, ensuring that prevention programs remain funded and that parents are given educational opportunities to learn about the challenges facing their community.

The Opiate Abuse Initiative

Other programs launched with the blessings of the Department of Human Services include Howell Township’s drug task force, administered by two members of the police department. From January to June 2016, arrests made on the basis of drug charges rose from 36 percent to 60 percent. In Monmouth County, law enforcement and first responders reversed an average of 44 overdoses with the naloxone nasal spray. Howell Township had the highest number of such reversals in March 2016 alone, which prompted the police chief to create a special Opiate Abuse Initiate to focus on relapse prevention and aftercare treatment. It does this by sending certified recovery coaches to opioid-abuse related emergency situations, like overdoses, where they are qualified and empowered to reverse the overdose, and offer on-the-spot treatment and counseling, long enough to keep the drug user alive for further medical attention and to make a pitch for long-term residential treatment.

Since the Opiate Abuse Initiative was launched, over 80 percent of the calls that involved the presence of recovery coaches resulted in treatment enrollment and long-term recovery. The success of the program encouraged Howell Township’s police chief to expand its scope, so that recovery coaches are trained and deployed to offer family counseling.

Other police chiefs across New Jersey liked what they saw, and the program has been adopted in their respective townships.[6]

Who Does the Department of Human Services Help?

In 2015, the New Jersey Department of Human Services offered treatment for drug and alcohol abuse to more than 3,800 people, a 6 percent increase from 2014. Nearly half of them needed help for addictions to heroin and opioids, another increase from 2014.

The shadow of heroin abuse is one that covers the entire state, and it is a top priority of the Division of Mental Health and Addiction Services. According to a 2015 report issued by the department, over 27,000 Garden State residents were admitted to treatment centers for heroin addiction, and another 5,000 sought help for addiction stemming from other forms of opioid abuse, such as prescription painkillers.[7]

location

Over 27,000 Garden State residents were admitted to treatment centers for heroin addiction

Heroin- and opioid-related deaths dominate the landscape of substance abuse treatment in New Jersey. The mortality rate of such overdoses across the state is three times that of the national average; in certain parts of the state, it is seven times higher.

In New Jersey, heroin kills more people than suicide, HIV/AIDS, or even car accidents.[8] The rampant overprescription of opioid-based painkillers has changed the demographic of drug abuse across cities, neighborhoods, and communities across the state.[9]

The problem is such that if all the people who need help for heroin or prescription painkiller abuse got together, they could fill a city that would be the fourth largest in a state that is already famous for its population density. As an example of the spread of heroin throughout New Jersey, NJ.com says that the residents of this city – dubbed “Herointown” – would not be the stereotypical low-income minority person but rich, well-educated, and white.[10] The JAMA Psychiatry journal calls this “the changing face of heroin use in the United States,” and this evolving reality is the situation that is confronting the Division of Mental Health and Addiction Services.[11]

Heroin is not the only drug that brings people to treatment facilities across New Jersey. Between 2014 and 2015, the number of clients needing help for other substances, like alcohol, marijuana, cocaine, and crack cocaine also increased.

Increasing Treatment Exposure

In Ocean County, 4,000 people have sought treatment for addictions to heroin and opioids. It was the only county in the state that had more than 7,000 admissions for treatment for all chemical substances. But it is Cape May and Atlantic Counties that have the Department of Human Services most worried. In Cape May, 17 of every 1,000 of its 94,727 people were enrolled in drug treatment; six out of every 1,000 needed help for alcohol addiction. In Atlantic County (population 275,862), 13 per every 1,000 people needed treatment for drug addiction.

Optimistically, the growing treatment numbers reflect the greater availability of treatment services, and that education and outreach programs are having an effect in convincing people to seek professional help.

Another step forward is the development of the Opioid Overdose Recovery Program, which was funded by a grant from the Division of Mental Health and Addiction Services. Like Howell Township’s Opiate Abuse Initiative, the program connects recovery coaches with people who have been revived from opioid overdoses, usually by means of a first responder, with the use of naloxone, the nasal spray. The coaches themselves are all recovering addicts, so they are very familiar with the situation and experience of being addicted to a crippling drug. They spend as long as they need with the revived user, providing comfort, conversation, a sympathetic ear, and whatever else is necessary, to convince them to seek professional drug addiction treatment. Many do, and they are transported to a detox center immediately, with plans for a bed at a residential facility put into motion. Those who decline are encouraged to stay in contact with their recovery coach nonetheless, to keep the lifeline of treatment open and to have an emergency contact in case of an overdose or other incident.

Pioneering programs like the Opiate Abuse Initiative and the Opioid Overdose Recovery Program, with help from the funds from the Division of Mental Health and Addiction Services, have created a standardized operation that allows healthcare professionals, law enforcement, and policymakers to communicate on a shared, focused goal: offering treatment and recovery for the people who have fallen sway to heroin and opioid abuse in New Jersey.

A primary focus will be on helping low-income victims of the opioid epidemic. The Division of Mental Health and Addiction Services reports that New Jersey’s coffers fund 619 inpatient treatment beds specifically for economically disadvantaged clients. In 2010, the number was as high was 1,098.[12]

Accessing Help and Recovery in New Jersey

One of the biggest efforts to connect New Jersey’s drug users with the treatment they need has been to make police officers “a point of access for help and recovery.” Those are the words of Chris Christie, who signed legislation in October 2016 that creates a statewide standard for police departments to set up specific programs that move away from criminalizing drug use and treating addicts as criminals, and toward helping addicts receive mental health and medical assistance.

To that effect, the Division of Mental Health and Addiction Services is working with the state attorney general’s office to create regulations for both county and municipal police departments. The regulations will include points like:

  • Making appropriate drug abuse and mental health training and recognition guidelines part of training for new officers and community volunteers
  • Establishing and improving communication between treatment programs and police programs
  • Bettering relations between drug users and law enforcement officials, so people needing help are treated with more compassion, and they are not scared of going to the police for help
  • Setting requirements for eligibility for those who want to be part of treatment programs[13]

New Jersey still faces a lot of challenges with how it addresses addiction. Many residents and community leaders are leery of tackling their local battles of the heroin epidemic in a way that can draw attention to the problems in their towns and municipalities or in a way that builds a bridge toward drug addicts. But perhaps realizing that the fight to save the next generation of New Jersey residents requires unconventional and challenging approaches, the Department of Human Services and the Division of Mental Health and Addiction Services are, slowly but surely, empowering advocates and police departments to change the nature of the fight.

Citations

[1] “Heroin in New Jersey: By the Terrifying Numbers.” (June 2016). New Jersey 101.5. Accessed November 13, 2016.

[2]N.J. Addicts Suffer from Shortage of Drug Treatment Facilities.” (November 2013). NorthJersey.com. Accessed November 13, 2016.

[3] “Feds Offer $22 Million to Bolster NJ’s Battles Against Opioid Addiction.” (June 2016). NJ Spotlight. Accessed November 13, 2016.

[4] “Needle Exchange Pilot Programs in N.J. Are Successful, Health Department Finds.” (April 2010). NJ.com. Accessed November 15, 2016.

[5] “Christie Saves N.J. Clean Needle Program for Addicts.” (August 2016). NJ.com. Accessed November 13, 2016.

[6] “Community’s Work Has Brought Recovery from Howell’s Heroin Crisis, Groups Say.” (November 2016). Patch. Accessed November 15, 2016.

[7] “Interactive Map: More Addicts, More Drug Treatment Options.” (October 2016). NJ Spotlight. Accessed November 14, 2016.

[8] “N.J. Heroin-Related Death Rate Among Worst in The Country | Your Questions Answered.” (July 2015). NJ.com. Accessed November 14, 2016.

[9]Heroin: Suburbia’s Deadly Secret.” (April 2015). North Jersey News. Accessed November 14, 2016.

[10]Welcome to Herointown, New Jersey’s 4th Largest City.” (n.d.). NJ.com. Accessed November 14, 2016.

[11] “The Changing Face of Heroin Use in the United States: A Retrospective Analysis of the Past 50 Years.” (July 2014). JAMA Psychiatry. Accessed November 14, 2016.

[12] “Congressional Bills Would Help Families Pay for Heroin Treatment, MacArthur Says.” (October 2016). Patch. Accessed November 14, 2016.

[13] “New Law Will Help Police Help Addicts.” (October 2016). Asbury Park Press. Accessed November 15, 2016.