The drastic increase in prescription painkiller consumption in New Jersey over the past decade has led to a statewide heroin epidemic, which legislators are grappling with by applying inefficient and underutilized solutions that are failing young addicts.
A report released last week by the Task Force on Heroin and Other Opiate Use by New Jersey's Youth and Young Adults identifies heroin and opiate abuse as "the number one health care crisis" confronting the state. It notes a five-year increase of more than 200 percent in the number of admissions to licensed or certified treatment programs for prescription drug abuse, and a 700-percent increase over the last decade.
From 2010 through 2013, New Jersey saw some 4,300 drug-related deaths. Nearly 40 heroin overdoses were reported last month around Camden alone.
On Tuesday, authorities in New Jersey seized more than 300 bricks of heroin, and two suspected heroin mills in Paterson were dismantled as part of the investigation led by the state police.
It Starts With a Scrip
Acting Monmouth County Prosecutor Christopher Gramiccioni attributes the root of the state's problem to the widespread over-prescription of painkillers.
"There's a great deal of prescription drug use," Gramiccioni told VICE News, citing the widespread over-prescription of painkillers. "People take those pain pills and get hooked."
When they can't refill those prescriptions, desperation sets in — and that's typically when they hit the streets and look for heroin, which is much cheaper to get than pills that, depending on what you're looking for, can cost as much as $35 each.
Take the case of Daniel Regan, co-founder of CFC Loud N Clear, a non-profit recreational support group for addicts. He was over-prescribed pain medication for injuries following a bike crash and was soon addicted.
"I was hitting five or six different doctors and getting over 400 oxycodone pills a week to sell and use," he told VICE News. Regan was eventually arrested and lost his prescriptions. "There was just no way I could afford $30 to $35 per pill for OxyContin. So switching to heroin, which all my friends were getting for $5 a stamp — about the equivalent of one pill — was really easy."
Regan added that he fell into drug abuse in part because it was so common in his hometown of Howell. At one point, he thought nothing of snorting some heroin before a party.
"I just started snorting it in front of this kid, like it was no big deal," he said. "Because in my mind, it wasn't. It's just what everyone does. I mean, my whole entire high school class was doing it."
The Purest Dope
New Jersey is home to some of the purest heroin in the nation. Michael Pasterchick, Monmouth County's chief of detectives and a former DEA agent, told VICE News that although the levels vary, the purity of street samples can be as high as 95 percent.
To put this in perspective, the national average for heroin purity is a little above 31 percent, according to the Monmouth County prosecutor's office. The average purity level in New England is about 15 percent. But in New Jersey, the average purity is anywhere from 40 to 48 percent.
US Attorney General Eric Holder warned heroin overdose deaths increased 45% between 2006 and 2010 creating an 'urgent' public health crisis.
This is partly because New Jersey is at the center of one of the world's largest import zones for heroin, much of which enters through Port Newark-Elizabeth Marine Terminal and Philadelphia. As it works its way out of the state, it gets cut more and more.
In addition to Tuesday's seizure, last week police busted a drug ring that trafficked heroin into Monmouth and Ocean counties, charging 21 people. Earlier in March, police raids in Neptune City and Asbury Park resulted in the arrest of 16 others and the seizure of 52 bricks of heroin, making up some 2,600 individual bags.
But where is this high-grade heroin coming from?
"Most of it is coming out of the Andean region of South America," Camden County Police Chief J. Scott Thomson told VICE News, "which means it's coming from Colombia and Peru, and it's working its way up through the Mexican cartels."
"The Colombians have the best chemists in the world refining the opiates from the poppies and making heroin," Pasterchick said. "There are plenty of Colombian drug trafficking organizations that are sending heroin into the United States."
Fighting the Dragon
In order to help curb prescription drug abuse, New Jersey legislators recently launched the Prescription Monitoring Program, which keeps track of prescribers, dispensers, and patients. While it's a positive step, there's a problem: use of the database is voluntary, meaning most professionals don't bother to consult it when prescribing or dispensing medicine. Less than 18 percent of eligible doctors and pharmacists have registered to use it, according to the task force's report.
Louis Cappelli, Jr., the director of Camden County's Freeholder Board, told VICE News that this needs to change.
"We need to get our doctors and pharmacies sharing information throughout the state, so we know who's being prescribed what," he said. "This problem begins with prescription drug abuse, which then leads to heroin abuse. I think participation needs to be mandatory among doctors and pharmacies."
The system should help ferret out prescription fraud and abuse, assisting law enforcement in what can be a legal gray area.
"The challenge that you find with policing prescription drugs is that it's quasi-legal, in that there can be prescriptions for them," Thomson said. "It's not as easy to target, investigate, and route out distribution networks when a lot of them are coming out of doctors' offices and pharmacies. It's a completely different ball game than a guy who's walking around with 15 bags of heroin in his pocket."
In order to combat the fatality rate of overdoses, Governor Chris Christie's office, the state attorney general, and the Department of Health and Human Services are allowing first responders to carry and administer naloxone. Marketed as a nasal spray under the name Narcan, the drug is used to temporarily counter the effects of opioid overdoses.
"If a first responder comes upon somebody who's overdosing, you just give them two sprays in each nostril and it immediately reverses the effects of that overdose," Gramiccioni said.
And in 2013, Christie signed into law the Overdose Prevention Act, which gives immunity to those who witness an overdose and call the police for assistance, as well as to the person suffering from the overdose.
The Drug Court Drawback
"The traditional police approach is 'let's slap handcuffs on them and start to get people in custody,' but arresting an addict doesn't stop them from purchasing more drugs," Thomson said. "It's not going to be a unilateral fix."
New Jersey law enforcement is proud of the state's drug court program, which can offer offenders court-ordered terms in rehabilitation facilities instead of mandatory prison sentences.
While this therapeutic alternative is great, Janet Engel, the founder of a program for recovering addicts called Save Our Sobriety, told VICE News that people who voluntarily seek help are often turned away because rehabilitation facilities prioritize drug court recipients.
"Many active users who are seeking treatment aren't able to get into detox centers or rehab facilities if they haven't been arrested and funneled into drug court," she said.
Patty DiRenzo's son Salvatore went from abusing pills to using heroin around the time of his grandmother's death. He could never find more than a few days in any one facility, and died while he was waiting for an available slot.
"He'd be there for maybe seven days, eight days, before he'd be released," she told VICE News. "It was just a revolving door of treatment centers, and never getting the full help he needed."
Salvatore's last stay in detox ended after he was denied an extension of county funding. While waiting for a spot to open in another facility, he spent the next two months going to local recovery groups and trying to stay clean. He was on his way to a recovery group the night he died.
New Jersey's heroin epidemic didn't stem from a lackadaisical police force, an ignorant administration, or indifferent parenting. But people like Salvatore are dying at a shocking rate, and until government and law enforcement officials quell the drug's availability and release its chokehold on New Jersey's citizens, it will continue to dismantle its families and jeopardize its future.
Follow Maxwell Barna on Twitter: @Maxwell_BarnaNJ
Photo via Wikimedia Commons