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LETTERS TO THE ED: Emphasis Must be Placed on Preventing Opiate Addiction in the 1st Place

We are pleased to see Governor Christie expand on the growing problem of opiate Imagesaddiction in his recent State of the State Address. The attention the Governor is focusing on this issue and his proposals for improving treatment and making it more accessible are important steps forward. We also applaud the Governor’s efforts to equip law enforcement officials and other first responders with Narcan, a drug which, if taken in, time can prevent accidental deaths from overdoses of painkillers or heroin.

It is critical, however, to couple these steps with measures that prevent opiate addiction from occurring in the first place by attacking the problem at its source; namely, the over-prescribing of opiate-based prescription drugs. The Centers for Disease Control and Prevention (CDC) has reported a threefold increase in the number of prescriptions issued for opiate-based painkillers, such as Vicodin, as well as a major step-up in dosage over the past twenty years. Health care providers wrote 259 million prescriptions in 2012 alone; Even physicians agree that this is too many .In a recent national poll conducted by the John Hopkins School of Public Health, 85% of doctors say opiate-based painkillers are over-used.
Further, it has been well-documented that some people, when they can no longer get access to prescription painkillers, feed their opiate addiction by turning to heroin. Heroin is opiate-based, and, as a result, works on the same brain receptors. In other words, prescription opiates are often a gateway to heroin addiction. The New Jersey State Commission on Investigation(SCI) report, ‘Scenes from an Epidemic’ richly describes this downward spiral.
The costs in lost and ruined lives from what the CDC refers to as a “national epidemic” of opiate addiction continue to rise. Drug overdoses are the number one cause of accidental death in New Jersey and the United States, Nearly 20,000 people died from an overdose of opiates in 2010 nationally--nearly 17,000 from prescription painkillers and an additional 3,000 from heroin. It is time for effective steps aimed at prevention. This requires addressing the over-prescribing of prescription painkillers and the under-informing of patients about the risks of this medication and possible alternatives.
There is legislation moving through the New Jersey legislature that does exactly that. Senator Loretta Weinberg(D-37) and Senator Joe Vitale (D-19) have put forward two essential proposed laws to arm patients and doctors with the essential information required to prevent opiate addiction. The first law (S 2366) provides adult patients and parents of younger patients with the critical information they need to make an informed decision about whether to take an opiate-based prescription painkiller or use a non-addictive alternative. From the harm that too many of our children and families have experienced because a teenager becomes addicted to opiates, we know just how important providing this knowledge can be.
The second bill (Senate Committee Substitute 1998) would give the State’s Prescription Monitoring Program (PMP) real teeth by requiring all doctors to participate in the program. The current voluntary approach has not been able to attract sufficient participation to make it truly effective. This legislation ensures that Doctors check the state database to identify patients that are doctor-shopping to feed their addiction habit.
The patient notification legislation recently passed the State Senate by a bipartisan 36 to 1 margin. We are expecting a similar result on the proposed law to strengthen prescription monitoring, as these two bills are key components of a comprehensive package of bills aimed at taking on New Jersey’s addiction problem.
Still, there is a long way to go before final passage through both houses of the legislature and it will require all of us to make our voices heard. While many individual doctors recognize the need for these kinds of common sense measures, the Medical Society of New Jersey has not yet voiced their support of these bills. Their refusal to support these bills in light of the fact that they are strongly opposing legislation allowing NJ Optometrists to continue to prescribe prescription ‘painkillers, professing their concerns about the potential to worsen the addiction problem is odd. Of course, they wouldn’t be the first interest group or trade association to take inconsistent positions that can only be squared by understanding the age-old motivation of self-interest.
To counter the potential opposition to the Medical Society and any other special interests, it is particularly important for people to communicate their support to their Assembly members.  We  look forward to an open and fair discussion of this legislation in the Assembly Health Committee Chaired by Assemblyman Herb Conaway (D-7) soon.
These two proposed laws, authored by Senators Weinberg and Vitale, are essential to a comprehensive approach to preventing opiate abuse in New Jersey. . Treatment after the fact is still important to do, but because of the brain changes caused by opiate addiction, it is a hard, difficult and sometimes impassable road to recovery for too many. Treatment remains a hit or miss proposition.  Preventing addiction in the first place is critical to saving lives and these two bills will equip New Jersey families and the medical community with the tools they need to do so.
Elaine and Steve Pozycki
Elaine and Steve Pozycki are Board members of the Partnership for a Drug-Free New Jersey with Elaine serving as Co-Chair. Steve Pozycki is the Founder, Chairman and CEO of SJP Properties