As the number of heroin overdose deaths in the U.S. continues to climb, the White House is funding efforts to prioritize treatment over punishment for heroin users.
A $13.4 million grant from the Office of National Drug Control Policy will partner public health and safety officials to trace the origin of the drugs and its distributors.
The project will be funded for one year and will target high intensity drug trafficking areas, or HIDTAs in Appalachia, New England, New York, New Jersey, Philadelphia, Washington and Baltimore, among others.
“The new Heroin Response Strategy demonstrates a strong commitment to address the heroin and prescription opioid epidemic as both a public health and a public safety issue,” National Drug Control Policy Director Michael Botticelli said in a news release. "This Administration will continue to expand community-based efforts to prevent drug use, pursue 'smart on crime' approaches to drug enforcement, increase access to treatment, work to reduce overdose deaths, and support the millions of Americans in recovery.”
This effort will include the naming of public health and law enforcement regional coordinators to oversee development and operation of Heroin Response Teams. The public health coordinator will be called upon to gather heroin overdose data and alert health authorities to particular threats. The response teams will also be responsible for distributing the overdose intervention drug Narcan (or Naloxone) in hard struck areas.
Mary Ditri, the New Jersey Hospital Association's director of professional practice, said she doesn't yet know how much money her organization's member hospitals will receive. But she noted that a number of them are already distributing Narcan.
New Jersey has sought to address heroin and opioid addiction with a comprehensive package of more than 20 bills.
Gov. Chris Christie signed two of them earlier this month. One directs four-year public colleges to establish substance abuse recovery housing programs and another allows the use of medication-assisted treatment during probation for drug court offenses.
“The need is great—our rate of heroin-related deaths is three times the national level,” said Kerry McKean-Kelly, NJHA spokeswoman. She cited 2013 statistics from the Centers for Disease Control and Prevention that found New Jersey's heroin-related death rate was 8.3 deaths per 100,000 while the national rate was 2.6.
Ditri told of how psychiatrists and emergency department staff at three competing health systems have worked together with local prosecutors and law enforcement on a program to tackle heroin as a public health issue.
Barnabas Health in West Orange, CentraState Healthcare System in Freehold, and Neptune-based Meridian Health are the participating systems.
Under the program, patients who come to an ED for an overdose receive Narcan, are stabilized and then linked “almost immediately” to an inpatient or outpatient addiction-treatment program, Ditri said. She added that admission into a treatment program is completely voluntary and that, previously, patients would be discharged after being stabilized and there wasn't always follow up for them.
“It's a population that needs to be worked with closely, not everyone who comes in after an overdose wants to get into a long-term treatment program,” Ditri said. She noted that following treatment, patients receive social work at the ED that can be almost as important as their medical care.
It's unknown whether the program will be expanded or get some of the money just released by the White House.
Another part of the package released Monday by the White House includes almost $4 million to be split between 18 HIDTAs and used on prevention efforts and partnerships between law enforcement, public health and education.
The five HIDTAs along the U.S.-Mexico border will receive $1.3 million and almost $500,000 will go toward programs on tribal lands in six states.
One way states have sought to control opioid abuse has been through prescription-monitoring programs, but a new study posted on the JAMA Internal Medicine website found that Florida's program, implemented in 2010, had only "modest" success.
The study found the program and a "pill mill" law together resulted in a 1.4% decrease in opioid prescriptions between July 2010 through September 2011. There was also a 2.5% decrease in volume of opioids prescribed.
The study was conducted by Johns Hopkins University researchers and funded by the Robert Wood Johnson Foundation Public Health Law Research program and the Centers for Disease Control and Prevention.