Stigma extends to lifesaving treatment, medical experts say

By: Kyle Morel
Newton Jersey Herald
USA Today Network - New Jersey

..... The stigma associated with opioid drug abuse and overdose deaths has spread to the treatment that has saved thousands of lives.
..... Treatment experts say the harmful attitude aimed at those addicted to opioid now extends to the use of naloxone, a lifesaving medication commonly known by the brand name Narcan.
..... "Addition doesn't discriminate at all. It doesn't matter what race you are; it doesn't matter where you come from," said Tim McClain, a Newton man who is in long-term recovery for his addiction. "People don't understand it's one bad decision away. It only takes one time."
..... Shannon Derstine, marketing miscommunication coordinator for the Sussex County-based Center for Prevention and counseling, frequently advertises free training on how to administer naloxone on local Facebook groups. That's where she sees the hateful comments.
..... In one post earlier this year, [2022] two responses called the idea of using the medication to revive overdose victims "insane" and "a joke." Another referred to deaths caused by addiction as "population control."
..... The negative attitude toward the lifesaving drug and the people who need it is a significant hurdle, Derstine said. The center employees and patient hope to educate those who question the drug's use in an effort to help those with substance sue disorder.
..... Naloxone was administered in 30,401 incidents in New Jersey between 2017 and 2022. Each incident is described by the state as an individual receiving at least one lifesaving dose by emergency responders. It does not include doses administered privately.
..... The most administered in that same time were reported by Camden County emergency personnel with 4,788, followed by Essex with 4,385 doses were administered, in Bergen County 1,356, in Morris County 702 and in Sussex County 246.

Opioid toll

..... Opioid overdose deaths in New Jersey have more than doubled in the past eight years.
..... New Jersey recored 3,101 drug deaths in 2018; 2,995 in 2019; 3,050 in 2020; 3,125 in 2021; and 1,277 so far this year. [2022]
..... In one week,between May 30 and June 5, [2022] New Jersey reported 57 suspected drug overdose deaths. The most were reported in Essex County with 12, Camden County with nine, Atlantic County with seven and Monmouth County with five. Middlesex County had four; Passaic, Cumberland and Burlington counties had three each. The other counties had either one each or none.
..... New Jersey is not alone. The Centers for Disease Control and Prevention reported 92,000 drug overdose deaths in 2020. Of them 75% were caused by opioids.
..... Local health experts and people dealing with the addiction say the stigma is a key roadblock in getting help for the disease, as many have misconceptions about those addicted to opioids.
..... "They think we can just stop, and that's not it," McClain said. "If we could stop, we would stop in an instant. We don't want to do this; we just can't stop, as much as we try."
..... Statistics form the new Jersey Attorney General's Office show that state overdose deaths increased very year over the past decade, from 1m223 in 2012 to 3,050 in 2020. In a March 11 [2022] round-table discussion, Governor Phil Murphy said the number increased to 3,124 in 2021, an average of more than eight deaths per day.
..... The local trend mirrors the state's
..... Sussex, Morris, Passaic and Bergen counties all reported the most suspected fatal overdoses in 2020 since at least 2013. In Sussex County, there were 32 suspected overdose deaths in 2021, more than twice the 13 reported in 2013.

Then came COVID

..... Health experts say they were beginning to see some positive signs as the number of individuals addicted to opioids was leveling off in recent years. Then, COVID-19 hit.
..... The pandemic had a significant impact on the recovery of people dealing with opioid addiction, Meetings with counselors went form in-person to remote, and the stress of the virus meant many patients struggled to stay away from harmful substances.
..... "These are people that were not necessarily having a hard time," said Amber Milne, a peer recovery specialist at the Center for Prevention and Counseling. "They were really stable for an extended period of time, but as these changes during the pandemic limited people's access to help I really think that, coupled with isolation, loss of employment, all these changes, really impacted people."
..... Lori Bubigheit's son Connor was one of the victims of addiction and COVID-19.
..... He was sober for 20 months, his mother said, but relapsed after being furloughed form his job in April 2020. he died of an accidental overdose in December at the age of 30. [2021]
..... "He did not have a backup plan for ;how do I take my recovery going forward, ' " said Bubigkeit, of Newton.
..... "I think the people that we should worry about are the people that were all isolated and maybe didn't have a problem before, but do now" she said.

Social stigma

..... Those who have witnessed or experienced opioid addiction said the social stigma is a major deterrent for many struggling to get better. Many still believe the disorder affects only some segments of society.
..... "It's hard for people to develop empathy when they've been fed this image of what substance sue disorder looks like," said Milne, who along with many of the other specialists at the center is in long-term recovery herself. "I think the more people that are vocal about their process and about their recovery and about what their addiction looked like, the easier it is for people to develop an understanding and compassion toward this population."

Biggest concern

..... Morris County Sheriff James Gannon said he realized the scope of opioids' effect on the community during his 2016 campaign.
..... At a recent symposium on substance abuse, he talked of how he knocked on doors throughout the county to discuss issues before the election. For many residents he talked to, addiction was their biggest concern, he said.
..... "When I saw a senior at the door, it was their grandson" who was affected Gannon said. "If I saw younger folks at the door, it was their mom and dad. If I saw a husband, it was his wife. Addiction and opioids were at the forefront of their mind."
..... Gannon started the Hope One mobile outreach program in Morris County in 2017, and the initiative is now offered in nine other New Jersey counties. Four times a week, a team that includes a sheriff's officer, mental health professional and peer specialist travels in a Hope One van throughout the county to people naloxone training and provide resources to people struggling with addiction.
..... Annmarie Shafer, the Center for Prevention;s director of recovery support services, said misunderstanding about opioids are prevalent even among the medical community. The center has learned that educational training on substance use disorder is often confined to a small section that covers only the psychology of drug addiction.
..... The limited knowledge mens that even when there is medication available to help opioid users, there is push-back from the public.

Naloxone

..... Narcan is the brand name of the nasal spray form of naloxone, and it is administered to people experiencing an overdose. It takes about two to four minutes to start working once administered and is effective for about 30 to 45 minutes before it starts to wear off.
..... Katie Walker, recovery specialist supervisor at the center, said Naloxone is safe and has been used by medical professionals going back several decades. There are no harmful side effects even when administered to a healthy person, so health experts recommend using it if there is any suspicion that someone has overdosed.
..... However, nalonxone has become a source of controversy. Some wonder why it is administered for free while other medications are not.
..... Walker explained that a variety of grant-funded programs help pay for naloxons and offer training. she equated the process to classes for first aid and CPR - both of which are also provided for the benefit of society.
..... "I think we need to, as a community and as a culture, just stop comparing what illness are worse than others and what deserves more attention," Walker said. "If people are having a medical emergency, let's get then help regardless of what the cause is."
..... Bubigheit said she often reads Facebook comments comparing naloxone with insulin - a comparison she does not understand given that both are necessary, lifesaving measures.
..... "Anything we can do to save any one of our loved ones from whatever they're suffering from, we would do in a heartbeat," Bubigkeit said. "It's the one thing that we can do to give someone another chance at life, and everyone deserve that. Every mother, every father would do it for their son and daughter, brother, sister, aunts and uncles.

Resources available

..... There are an increasing number of community initiatives to battle addiction as the social stigma has subsided some what in recent years.
..... The Sussex County C.L.E.A.R. (Community Law enforcement Addiction Recovery) program, founded in 2016 by the center and Newton police, allows individuals with substance sue disorder to seek help without fear of criminal charges. Officers hand out cards in police stations and go door-to-door in neighborhoods offering treatment to residents who need it.
..... Other programs such as Operation Helping Hand - founded by former New Jersey Attorney General and Bergen County Prosecutor Gurbir Grewal - and the S.T.A.R. (Support Team for the Addiction Recovery) program connect opioid users with recovery coaches. The Opioid Overdose Recovery Program, which provides a path to recovery for people hospitalized for drug use, is available in every New Jersey county.
..... Events such as the Changing the face of Addiction walk, held each summer in Franklin, provide a stigma-free space for individuals and families who have experienced the effects of opioid abuse.
..... The walk was founded in 2015 by Sussex County residents Mary Burns and Elaine Tizzano. They both lost their sons to drug overdoses. The day serves as a platform to discuss addiction, and proceeds help the center provide resources to those in need.
..... Bubigkeit highlighted the importance of promoting the various treatment programs, as many people she talks to are not aware they exist. She recalled how helpful Newton police officers were with Connor after he walked into the department one day, treating him with care and taking him to the center to start his recovery journey.
..... "That was the first time in years that he had really that one-on-one compassion of someone really trying to help him, Bubigkeit said.
..... Newton Police Chief Steve Van Nieuwland, a 22-year veteran of the department, said he and other longtime officers have formed :almost a quasi-friendship" with the people they have helped throughout their tenure.
..... "When you go to these calls and you see these people that you have this bond with, you know that they can do so much better and they can be who they should be, and they have this addiction that's blocking that," Van Nieuwland said. "We;re human beings. We want everybody to strive to do better and be better for the community, so that's why we're always trying to reach out and help provide these services."
..... With more resources becoming available, people are learning the best way to deal with a loved one who is battling opioid abuse and addiction.
..... Shafer, the center's recovery support services director, stressed the importance of early intervention. The historical strategy has generally been to wait until a user hits rock bottom and asks for help, an approach she called "really misleading, unhelpful, outdated and dangerous." The correct method, she said, is to encourage the person to seek help while maintaining a kind, positive and supportive nature.

Legislation

..... Legislation is beginning to address the issue of opioid addiction on the state and federal levels.
..... In January [2022] governor Phil Murphy signed a series of bills into law expanding harm reduction efforts for those fighting addiction. The bills provide support services to people using drugs intravenously, decriminalize possession of syringes and establish drug overdose fatality review teams to identify potential intervention n opportunities to prevent future deaths.
..... "We are paving the way for long-overdue expansion of syringes access and other critical services to help people with substance use disorders stay healthy, stay alive, and thrive," Murphy said a the time. "By decriminalizing syringes and fentanyl test strips, we are acknowledging that this crisis cannot be ended through criminalizing critical harm reduction supplies that prevent fatal overdose and transmission of diseases."
..... New Jersey has entered into a nationwide opioid settlement agreement against pharmaceutical companies in which it could receive more than $641 million. The settlement faults Johnson & Johnson and their distributors - McKesson, Cardial Health and AmerisourceBergen - for promoting the use of opioids and contributing to the ongoing crisis.
..... Matt Platkin, the state's acting attorney general, said the money will be spent "almost entirely" on treatment, recovery, prevention and other strategies to combat the epidemic. Most of the funding will be divided evenly between state and local governments and directly reach communities where it is most needed.
..... "We remain committed to working across departments with service providers and alongside our legislative, county and municipal partners," Murphy said. "We recognize that criminal prosecution of those suffering form addiction and returning to the failed war on drugs will not solve this problem. Instead, we must ensure that people have access to treatment and compassionate care."

Future outlook

..... Despite the increase in overdose cases and deaths over the past few years, health officials believes the public perception of substance sue disorder is changing - and thus, the statistics will start to change, too.
..... Public health officials have noted that the partnerships with police and decriminalization of opioid use, now commonplace, are a sign of how the battle against opioids have evolved over time.
..... "Times have changed, and they're changing quickly," said Craig Sashihara, counsel for the New Jersey Coordinator for Addiction Response and Enforcement Strategies initiative (NJ-CARES). "Just a few years ago, the notion of law enforcement using its considerable power and discretion to help people with addiction get on the path to recovery p instead of just taking them off the street and locking them up - would have struck many as edgy and provocative. To some, it might seen like a waste of resources and even counterproductive, but today it;s gaining universal acceptance."
..... The approach has helped people like McClain, who credits the center and Newton police for saving his life after several Narcan revivals. Having been clean for more than a year now, he has his own apartment and a strong family support system, particularly his nephews, motivation him to stay away from opioids.
..... "My life is awesome today. I must say, it's great," McClain said. "Honestly. I don't think I'd be alive today if it wasn't for Narcan."
..... With increased collaboration and changing public perception of opioid sue, health experts and law enforcement officials say they are optimistic their efforts will continue to make a difference.
..... With increased collaboration and changing public perception of opioid use, health experts and law enforcement officials say they are optimistic their efforts will continue to make a difference.
..... "I believe in the capacity of people recover," Milne said. "Any time I interact with somebody new or even somebody that I've worked with for a long time, I hold the belief that they will achieve their goals and get to where they want to be. As long as we keep pushing forward and try to stay positive, I think that things will turn around again, and hopefully soon."

Getting help

..... For information on opioid recover or to get help for drug addiction, visit the following North Jersey sites.

* The Center for Prevention and Counseling, 61 Spring st, Newton, NJ 07860 - www.centerforprevention.org - 973-383-4787.

* Morris County Prevention is Key, 25 West Main Street, suite A, Rockaway, NJ 07866 - www.preventioniskey.com - 973-625-1998.

* Children's Aid and Family services, 200 Robin Road, Paramus, NJ 07652 - www.cafsnj.org - 201-261-2800.

* Family Guidance Center of Warren County, 492 route 57 West, Washington NJ 07882 - www.fgcwc.org - 908-689-1000.

HOME