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New Jersey Governor Chris Christie has articulated his stance on the drug addiction via his stated concern for the opiate epidemic in New Hampshire. As detailed in the New Yorker, when Governor Christie was a 2016 presidential hopeful, he traveled several times to New Hampshire, including to a drug treatment facility. The governor’s mother was reportedly addicted to cigarettes, which he says gives him a unique personal insight into addiction in general. Further, Christie is governor of a state steeped in a heroin crisis. Approximate 8.3 in every 100,000 New Jersey residents succumb to a fatal heroin overdose annually, which is a rate greater than three time the nationwide average.
For Governor Christie, compassion and treatment are the most needed public response to the American drug epidemic. Notably, Governor Christie’s political rhetoric subtly emphasizes that heroin abuse is a much a problem for America’s middle class as it is for lower income groups. While it is true that the middle class is his core constituency, he does not protect middle-class use of heroin by covering it up. Governor Christie provides anecdotes to the public about middle-class drug use to draw attention to it and therefore ensure that this group also gets help. The more substance abuse is understood to be the disease that it is, the more public attention can be brought to the full spectrum of individuals who experience it—from the poorest segment of society to the most affluent.
Governor Christie is not alone in his desire for drug rehabilitation for those in need of it. As the statistics provided in this discussion make clear, myriad New Jersey residents are affected by substance abuse. Public and private organizations in New Jersey, as will be discussed, make numerous efforts to ensure that the state’s residents receive help for substance abuse. In addition, the state also has first-rate rehab facilities for residents and individuals who choose to travel to New Jersey for their recovery needs.
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The Division of Mental Health and Addiction Services of the New Jersey Department of Human Services provides illuminating drug use statistics based on data culled from drug treatment admissions across the state. In 2014, the department published the New Jersey Drug and Alcohol Abuse Treatment Substance Abuse Overview 2014 Statewide. The survey findings are based on responses from addiction treatment programs that responded to a state online questionnaire available as part of the state’s Substance Abuse Monitoring System (NJSAMS). Based on the responses, the state learned that, in 2014, there were at least 65,553 drug treatment admissions with 46,441 client admissions (because some were counted more than once). The following are some of the highlights of information gleaned from the questionnaires about these admissions:
Types of Drugs Abused:
Sex, Age, Race, and Financial Status:
People who are navigating the drug recovery process for the first time, either for themselves or a loved one, will naturally want to learn more about drug treatment settings and programs. In terms of a setting, various levels of recovery services (from moderate to intensive) can be provided in drug rehab centers (private or public), hospitals, detox centers (private or public), clinics, doctors‘ offices, halfway houses, or community service settings. The level of program needed may drive the type of setting that is required (for example, a person with a history of long-term heroin abuse may require at least a 90-day residential treatment program).
The survey found 63 percent of all treatment admissions, or 41,065, were in-county (i.e., the admitted person resided in the county). This statistic illuminates that the majority of people in New Jersey who seek help for drug treatment choose a local facility. Although a local rehab service provider may be an optimal selection, or a necessary one given the circumstances, it could be that at least some individuals who select a local program do not have adequate information about their statewide or out-of-state options. Self-educating about the drug treatment recovery process and the various options available — as long as it does not unduly delay entering treatment — is an important part of the overall process.
Per the survey, the following are some of the recovery program types available in New Jersey:
A reported 6,152,634 people have a New Jersey driver’s license, which makes this state 11th highest in the nation by number of driver’s license holders. According to the US Census Bureau, in 2015, there were 8,958,013 people living in New Jersey. When adjusting for New Jersey residents under the driving age, the juxtaposition of these two statistics makes clear that most people of driving age in New Jersey have a driver’s license. In view of this fact, it is especially important for the state to keep the roads safe; unfortunately, drug abuse directly threatens this public need.
New Jersey has not adopted a per se standard that would make it illegal to operate a car after taking an illicit drug (this includes abuse of legal prescription medications). Thus far, this per se standard has been adopted by 17 states. However, section 39:4-50 of the New Jersey Statutes Annotated enumerates drugs that, if present in a person’s system while operating a car, can be used as evidence to support a criminal conviction. Those drugs include any narcotic, hallucinogenic, or addiction-forming drug. Hence, although New Jersey does not have a per se standard, the enumerated drugs cover just about all drugs. Note that the law extends to non-drivers too. If an owner of a vehicle permits another person to drive that car while that person is under the influence of any of the enumerated drugs then the owner can be charged with a crime.
There does not appear to be reliable data available on the prevalence of drugged driving in New Jersey; however, national statistics are available. According to the National Institute on Drug Abuse, in 2013, more than 31 million individuals across the nation operated a vehicle after using alcohol or other drugs. The 18-25 age group was most likely to use alcohol or another drug and then drive a car.
Mothers Against Drunk Driving (MADD) provides statistics on the rate of drunk driving in New Jersey. Per MADD, in 2015, of all traffic deaths, 163 involved drunk driving (driver had a 0.08 BAC or higher). This statistic reflects an 11.6 percent increase from 2014. But there is one good piece of news related to drug abuse in New Jersey. According to a White House report, the rate of drug-involved fatalities in New Jersey is lower than the national average, which includes drugged and drunk driving fatalities.
While the overall number of drug-involved deaths in New Jersey may be below the national average, even one death is one too many. According to the Centers for Disease Control and Prevention, in 2007, there were 797 fatalities in New Jersey that resulted directly from illicit drug use (represents 9.2 fatalities for every 100,000 people while the national average was 12.7 per 100,000).
It is helpful to put this drug fatality rate into context. In that year, drugs claimed more lives than car crashes (719) and firearms (446). In 2007, there were 78 more deaths due to drugs than car crashes. By 2014, the difference grew. According to The Record, there were twice as many fatalities in New Jersey associated with abuse of street drugs and prescription drugs compared to car crashes. These statistics reflect that illicit drug overdoses were the leading cause of accidental deaths in New Jersey in 2007 and 2014.
The Record also reported that Bergen County stands out for its high incidence of heroin overdoses. In 2014, the rate of heroin overdoses in Bergen showed a sharp increase — one of the greatest across all of New Jersey. However, an increasing number of towns in New Jersey, including those in Bergen County, are now providing emergency medical response teams with Narcan, an opioid antagonist that can reverse the effects of an opioid overdose. From January to June of 2015, Narcan was used a reported 60 times in Bergen County and undoubtedly saved numerous lives. Over this period, there were 11 heroin overdose deaths in the county, a significant decrease from the same timeframe in 2014.
Yet Bergen County does not have the highest rate of heroin overdoses in New Jersey. In 2014, Williamstown in Gloucester County had a heroin overdose death rate that was 25 times the national average. In 2014, in Gloucester County, the rate was 17.3 per every 100,000 people. The county did not have the highest rate in New Jersey; it was fourth that year, behind the counties of Atlantic, Camden, and Cape May. Yet, in 2014, Williamstown had a rate of 63.8 heroin overdose deaths per 100,000 people. According to experts, Williamstown’s location may play a significant role in the high overdose count. Reportedly, potent heroin comes from South America to ports in the Philadelphia-area, which are a straight highway ride to Williamstown, New Jersey.
To return to Governor Christie’s point, individuals in the grip of heroin and other drug abuse need compassion and treatment.While it appears that the heroin crisis in Williamstown presents a formidable challenge, different pockets of the community are taking action. For instance, police departments devised a plan. Starting in the winter of 2016, the police departments began to provide drug rehab informational pamphlets to individuals arrested for low-level drug offenses. The information promised to include how to find key resources, such as contact information for drug treatment centers.
While America is a relatively wealthy nation at the state and federal level, there is always greater need in health-related areas than there are allocated resources. According to the White House, in 2010 alone, the US Substance Abuse and Mental Health Services Administration gave New Jersey a grant of $47,103,249 to support services related to drug prevention and treatment. In fact, in that year, the federal government allocated a total of $113,795,702 to New Jersey to fund different programs. However, on the ground level, the reality is that the state could use even more money to expand existing programs and create new ones.
There does not appear to be any available data on the exact number of drug treatment programs and facilities in New Jersey. However, the New Jersey Department of Human Services, Division of Mental Health and Addiction Services (DMHAS) provides the public with an Addiction Services Treatment Directory. Only licensed facilities are listed in the directory, which covers all 21 counties in New Jersey.
To revisit an earlier point, the three counties with the highest rate of heroin abuse, and therefore a considerable need for treatment resources, are Atlantic, Camden, and Cape May. A review of the directory for each of these counties reveals that there are numerous treatment programs that have different funding streams or special initiatives.
Examples of such funding streams and initiatives, which help to cover the cost of rehab for individuals with limited income and assets, are:
A review of these counties and others shows that for individuals who do not experience a financial hardship, the following are some of the payment options or accepted forms of payments that are available (depending on the specific treatment plan):
Although there is federal, state, and local funding for treatment programs, according to The Record, many New Jerseyans cannot get into a treatment program. In 2013, The Record reported that at least 33 percent of New Jersey residents who were experiencing substance abuse sought treatment but could not gain admission to a rehab center. The reasons cited were a shortage of treatment centers, perception of high costs for rehab programs, and challenges presented by insurance companies. According to a 2009 study, at least 30,000 New Jersey adults and 15,000 New Jersey adolescents who sought drug treatment were not able to get it at a specialized facility. It is important to note that the gap between the number in need of drug treatment and admissions to rehab facilities does not owe in all cases to financial hardship.
The Record provides stories from different families in the middle- to upper-income levels. These families have noted that sometimes a bed is not available the moment it is needed. One reality of recovery is that it is important to get a person into treatment when they are ready to go, which can be last minute, but there may not be a bed immediately available at a treatment facility.
Another reality is that relapse is a part of recovery. Some individuals and their families have spent tens of thousands of dollars on rehab programs. These individuals may not be eligible for federal, state, or locally funded programs, which means that paying for these rehab programs may continually rely on savings or private health insurance (which may not cover all services needed). In many instances, individuals or families have gone into debt to pay for rehab. However, the most advisable course of action to take when individuals become addicted to drugs is to have them admitted to a comprehensive addiction treatment program. Oftentimes, staff members can help prospective clients work out payment specifics prior to enrollment.
In addition to rehab centers, there are numerous organizations that are involved in the drug recovery process. Whereas a rehab center can provide a full continuum of care (from detox through primary addiction treatment to aftercare services), there are different contributors that can be of critical assistance. These organizations include New Jersey state or local agencies, nonprofits operating in New Jersey, and community-based services.
The following is a short selection of addiction treatment-related resources available in New Jersey:
The drug problem in New Jersey illuminates different facets of the drug program across the US. On the one hand, there is government funding and many private facilities available to help. On the other hand, the need for treatment outweighs these resources. At the same time, resources must continue to be dedicated to prevention services.
In short, drug use is a complex and multilayered individual and societal problem. Support is, and must continue to be, provided by government agencies, nonprofits, and community-based organizations. For those in need of treatment services, it is critical to learn about the resources available and effectively engage them. Treatment services are available, and recovery is always possible.
