The heroes and villains of New Jersey’s opioid crisis
New Jersey's heroin crisis did not create itself. Big Pharma, greedy lobbyists, and dimwitted policy makers created the perfect conditions for addiction to take hold and to thrive.
Likewise, the solution to New Jersey’s heroin crisis won't create itself either. This one won’t just work itself out. Luckily, there are heroic people working day and night to bring us back from the brink of our insatiable addiction to opiates like heroin and Percocet.
Today, we’ll get to know the villains who set the table for today’s crisis — and also the heroes working to get us back to good.
Let’s start there.
New Jersey Attorney General Chris Porrino, who we met in a recent episode, first appeared on my radar screen last year for busting shady docs who got rich by unleashing a torrent of deadly, addictive prescription opiates on our state.
Most recently, Porrino, a Chris Christie-appointee, rolled out new rules to curb over-prescribing of opioids in NJ. The new regulation bans prescribers from accepting lavish meals and uncapped compensation for speaking engagements and so-called “consulting work” from drugmakers.
"$60 or 70 million poured into New Jersey doctors from pharmaceutical manufacturers and device manufacturers to physicians (in 2016)," Porrino told me. "And we look at that further and we saw that a very large percentage of that $70 million dollars went to several hundred doctors. And based on investigation that we can’t talk publicly about, we were seeing instances where we believe that doctors were effectively being paid to prescribe."
Porrino’s Office of Consumer Affairs also subpoenaed Janssen Pharmaceuticals “related to some practices in marketing opioids.”
Janssen, a subsidiary of Jersey-based drugmaker Johnson and Johnson, makes and markets fentanyl patches — a version of one of the deadliest, most addictive drug in the history of mankind. Fentanyl — also an increasingly popular street drug — is 60 to 100 times more potent than heroin. There were 417 reported fentanyl deaths in New Jersey in 2015, the last years these stats were available.
But as we learned from Ocean County Prosecutor Joseph Coronato in Heroin Uncut Episode 3, tragically, our fentanyl bodycount is on very much on the rise here in the Garden State:
"Back in 2014 here in Ocean County, 10 percent of our heroin packets had Fentanyl in it. Back in 2015, 30 percent of our packets. In 2016, 65 percent of our packets had Fentanyl in it."
Attorney General Porrino’s willingness to target those who might prosper off addiction and misery is why he’s on the list. He joins Prosecutor Coronato who’s smart to know we can’t arrest our way out of this mess.
And that sets up our first villain.
It's a pair of villains actually: medical lobbyists in Trenton and Assemblyman Herb Conaway, who chairs the powerful Assembly Health Committee in Trenton. He’s the gatekeeper for each and every piece of opiate-related legislation that passes through the New Jersey General Assembly. If he doesn’t like a bill for any reason, the bill dies.
The Medical Society of New Jersey is a lobbying outfit representing doctors, not patients. And many of those doctors enrich themselves by getting our kids hooked on this poison. They, along with Assemblyman Conaway, have for many years championed a no-limits approach to opiates — more pills for more patients of all ages at higher doses for a longer duration. It all equals more cash for drug makers.
That’s their cause and they’re pressing their case each and every day and Trenton. It’s big business and big money.
The days of big pharma (and their lobbyists) calling the shots are waning. The new regulations out of the AG’s office, the ones prohibiting doctors from getting paid to prescribe, are indeed a withering denunciation of the Medical Society, its lobbyists, and its legislative handmaidens like Herb Conaway.
And they know it.
Here’s proof: The lobbyists at Medical Society of New Jersey will host a “strategy panel” next month to discuss how these new regulations will affect their bottom line. They’re faced with losing a $70 million gravy train. And they don’t like it.
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Their invite comes with a warning: “Governor Christie recently announced a regulatory proposal that would severely limit physician relationships with pharmaceutical companies.”
As for Assemblyman Herb Conaway, there are many reasons why he deserves blame for letting New Jersey's heroin crisis rage out of control.
I'll give you three:
1) Conaway and a former aide removed chronic pain from New Jersey’s medical marijuana program when the legislation enabling the program was proposed. By banning a non-opiate-based alternative, Herb Conaway deprived sick and dying patients safer, less-addictive options to manage their suffering. The former Conaway aide cited above is now chief lobbyist for The Medical Society of New Jersey, a.k.a. Big Pharma,, highlighting the borderline incestuous relationship between drug lobbyists and our lawmakers. It’s a revolving door, people. And we’re living the consequences.
2) Herb Conaway repeatedly refused measures placing sensible limits on initial prescription for opioids for acute pain. His approach: no limits. More pills at higher dosages for a longer durations for all ages. That's his track record.
3) Herb Conaway refused to post a bill requiring prescribers to have a cursory conversation with patients about the risks of opioids. Conway said that the doctor-patient relationship is sacrosanct and that lawmakers mustn't interfere even though we know that most heroin addicts get their start legally, often at a doctors office.
"When do we get our sense back?"
Ever since I started writing about my own recovery from IV drug use, I’ve gotten the occasional email or phone call from a parent in crisis. The pace of those messages has definitely picked up since starting Heroin Uncut.
Maybe they just buried their son. Or their daughter is doing sex work to support her heroin crisis. It’s hard to bear witness to that level of grief knowing the forces out there working overtime to keep the opiate pipeline flowing, unencumbered by the sensible regulations. Or any effort to curb NJ’s heroin body count.
It’s hard giving hope to a mom in crisis any real hope knowing the long odds their addicted loved one faces. It's doubly difficult, knowing thegreedy collusion that got here — and especially how avoidable this heroin crisis was in the first place. And yet here we are.
It’s disgusting. And it’s scary and bewildering how insatiable our appetite for this garbage already is.
But I’ll let our next hero, former Gov. Jim McGreevy, make the call:
"It's just so crazy. I mean, we're 5 percent of the world's population and we consume 99 percent of the world's oxycodone. 99 percent. This is insane," the former governor told me. "This is just crazy! It's like ... I don't get it. I don't care if you're a Republican, Democrat, or a communist. I don't get how (in) the United States of America, the greatest country in the world, the Food and Drug administration is legalizing the pain medications to the point where — where does it stop? When it's upwards, in certain states in this country, one out of six in families is ravaged by addiction. ... When do we get our sense back?"
To answer McGreevy’s question — "When do we get our sense back?" — the truth is I don’t really know. In fact, I’m not sure America’s approach to drug policy was ever sensible to begin with.
For McGreevy’s part, he’s devoted his post-political life to combating New Jersey's heroin epidemic. The Garden State is lucky to have him working in the trenches, fighting the deadly opiate menace.
"And so this is happening one family at a time and we need to understand the importance of supporting treatment — particularly medication assisted treatment, drug court and opportunities for people to rebuild their lives and be made whole," he said.
Heroism born from tragedy
Our next hero, Gail O’Brien from Marlton, has endured the unthinkable. Three years ago, a heroin overdose killed her son, Adam. He was 23 years old at the time.
To channel her grief, Gail started the Adam O’Brien Recovery Foundation, both to honor her son and to support treatment and full recovery from drugs and alcohol in New Jersey. That’s its mission, 24/7.
I asked Gail why drives her, why she fights so hard:
“I fight so hard because I truly don't want to see another family suffer such an unimaginable loss. As many losses that I have seen in my community, I also have so many success stories.”
Gail and I met on Facebook after I put out a call for Narcan, the drug used to reverse an opiate overdose. I needed a Narcan kit for a demonstration video. Narcan can be a real lifesaver and it’s really not that hard to use — and let’s be honest, in this day and age. knowing how to recognize and reverse a heroin overdose is basic first aid. How sad is that?
Anyway, we put out the call for Narcan, and the very next day, UPS comes calling with an overnight package from the Adam O’Brian Foundation with not one, but two opiate reversal kits — one for demonstration and another on hand for, God forbid, an emergency. You just never know.
Gail and the Adam O’Brien Foundation do much more than ensure Narcan for anyone who needs it, and I’m excited to fill you in on all that when we interview Gail in a week or two, when we’ll learn from her resilience and honor her personal loss.
But today we’re proud to shout out to Gail O’Brien for what she’s given back to New Jersey's recovery community.
A personal note
Fourteen years ago today, I shot drugs for the last time. The next day, I’d check into rehab for the most rigorous 28-day ass-kicking of my life.
Back then, my long-term prospects were very dark and very dim. If you told me, on this day, 14 years ago that I’d live long enough to afford New Jersey property taxes and have a podcast busting Big Pharma’s balls, i would’ve lacked the capacity to even dream of such a thing.
These are the outcomes we fight for.
Keep up with Heroin Uncut: Thanks for coming on board. Don’t forget to check out our webpage at HeroinUncut.com. Most importantly, subscribe to the Heroin Uncut podcast on iTunes, Google Play or the New Jersey 101.5 app.
Heroin Uncut is sponsored by Carrier Clinic, providing behavioral healthcare services in New Jersey since 1910.
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