Education

Bergen Officials and Professionals Team-Up to Knock Out Opioid Abuse

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Joel Pomales, director of Clinical Outreach & Advocacy, director for SOBA College Recovery, speaks at May 31 town hall to "Knock Out Opioid Abuse" at Bergen County Community College, Paramus. Credits: Rebecca Greene
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PARAMUS - There were no sad stories, only sad statistics at the town hall meeting to address the growing opioid abuse "epidemic" today at Bergen County Community College.

"Not a day goes by when we don't feel the impact, see the misuse or how it touches families," Angelo Valente, executive director of the Partnership for a Drug-Free New Jersey, said in his opening remarks of the two-hour seminar.

It was the fourth of 17 town hall seminars held in communities statewide about opioid abuse.

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Opioids, such as Morphine, Oxycodone, Fentanyl and Tramadol, are substances that produce morphine-like effects. Opioids are most often used medically to relieve pain.

Presenters were not shy about labeling opioid and the cheaper heroine abuse that often follows as a problem that escapes no population.

Tracy Parris-Benjamin, LMSW, Clinical Design Liaison for Horizon Blue Cross Blue Shield of NJ—a co-sponsor of the event, along with the Partnership for a Drug-Free New Jersey, said as a social worker, she sees how the abuse has affected "the young, the old and all types of socioeconomic groups."

After praising the private sector's help, Bergen County Executive James Tedesco III said in spite of government and law enforcement efforts, "We have not been able to slow this down. We haven't been able to come up with a solid way to treat it."

But, he insisted, "one person can make a difference."

Tedesco asked for legislative support, specifically funds, to support treatment centers, such as Bergen Regional Medical Center which now has 84 detox beds.

"This way people can stay here instead of having to go away to places in Pennsylvania to be treated, near family," Tedesco said.

Dr. Michael Kelly, a board-certified orthopaedic surgeon at Hackensack University Medical Center and chairman of the Department of Orthopaedic Surgery, blamed himself, in part, for the problem.

A knee specialist, Dr. Kelly said prescribing opioids before and after surgery was a popular treatment several years ago.

When he was asked to lecture on the opioid abuse three years ago, he said his research led him to an uncomfortable conclusion.

"I'm part of the problem," he said. "It was time to look at alternative pain management solutions."

Of those who are prescribed post surgical pain medications, "one in 15 go into long term abuse," Dr. Kelly said.

"We were giving too much medicine, mainly because we knew when we would get that call on a Saturday night, there was no way for the patient to go out and get more relief," he said.

Current legislation, among the strictest in the country, allows just five days of medication, where in the past, there was no limit. Practitioners are permitted to prescribe more medicine under certain conditions.

According to the New Jersey Academy of Family Physicians, physicians, dentists, optometrists, podiatrists, physician assistants, certified nurse midwives, or advanced practice nurses are authorized to prescribe controlled substances.

The law, which Governor Chris Christie signed in February, does not apply to those in active treatment for cancer, to those receiving hospice care from a licensed hospice or palliative care, to those who are residents of a long term care facility, or to any medications that are prescribed in the treatment of substance abuse or opioid dependence.

The law has affected drug abuse, drawing with it a stigmatization of those affected and treatment, not to mention punishment.

According to Gurbir Grewal, Bergen County Prosecutor, there has been an attempt over the last few years to change that.

"Since 1999, prescriptions for opioids have quadrupled," he said. "So have the amounts of overdoses."

There were 308 overdoses in 2016 in Bergen County.

Narcan™, which law enforcement now possesses, reverses the effect of an overdose. When a person is overdosing on an opioid, breathing can slow down or stop and it can be very hard to wake them from this state according to the state of NJ website. Narcan™ (naloxone) is a prescription medicine that blocks the effects of opioids and reverses an overdose. It cannot be used to get a person high. If given to a person who has not taken opioids, it will not have any effect on him or her, since there is no opioid overdose to reverse.

"We can't arrest our way out of a public health problem," Grewal said. "We are going after the distribution side, though."

When someone is arrested for use, Grewal said treatment options are now offered.

"Out of 42 arrests, 15 took us up on a five-day detox program and then 15 more took us up on it because we were persistent," he said.

Samantha Harries, director of the Center for Alcohol & Drug Resources, said that all such things help, but there is no "one magic bullet" that treats the problem.

"We all have to work together," she said, recognizing law enforcement and medical efforts.

"It used to be using alcohol when you were young was a rite of passage," she said. "But we now know the younger someone starts using, the more likely it is to become a problem for them later on."

Joel Pomales, director of Clinical Outreach & Advocacy and director for SOBA College Recovery, said he knows that to be true first hand.

At 15, he had a substance abuse problem that he nor his family understood.

"I had this picture of addiction, a homeless person walking around with a brown paper bag," he said. "There was that stigma, that someone because of the addiction, you were a bad person."

Pomales said after he learned it's a "chronic brain disease," he was able to see the proper treatment and has been in recovery since July 2011.

"When addiction was criminalized, the whole 'just say no' movement," he said. "What many people don't realize is you don't have the ability to say no."

Pomales said there was shame and hiding attached to his illness.

"Parents think they did something wrong, but there so much more to it," he said. "I learned that when I don't talk about it, I let other people define who I am."

The final speaker recognized the hard work required by addicts.

Sue Marchese-Debiak has spent 27 years in addiction treatment. She is the executive director of Spring Halfway House for Women, and the Bergen County Coordinator of the Office of Alcohol and Drug Dependency Services.

"Spring House is that long-term continuum of care that is a key in effective treatment," she said.

Once the initial treatment is concluded, there is "how to live sober," she said. "We teach women nutrition and push and promote the 12 steps of recovery."

Marchese-Debiak said she wants to bring the same program to the county for men, hopefully in the coming year.

"We need to live without judgment and the stigmatization," she said. "We need to be supportive."

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