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Community comes together to discuss state opioid crisis

Speaking at an event during which New Jersey’s ongoing opioid epidemic was the topic of discussion, Ocean County Prosecutor Joseph Coronato said that in 2017, “65 percent of my dead bodies had fentanyl in them.”

Fentanyl is an opioid that is used as a pain medication.

Partnering with Tigger House Foundation, Red Bank, a panel of professionals addressed the national drug crisis that has been reported to claim more than 100 lives per day. The speakers provided individual presentations and recovery options to a community searching for solutions.

Mariel Hufnagel, executive director of the Ammon Foundation and a former addict, served as the evening’s moderator at the event that was held at Brookdale Community College in Lincroft on April 11.

The panel consisted of Monmouth County Prosecutor Christopher Gramiccioni; Seabrook Addiction Recovery Specialist Donald Rogers; Victory Bay Recovery Outreach Coordinator and Recovery Advocate Vanessa Vitolo; Regional Director of Pinnacle Treatment Center Christopher White; Dr. Lisa Forzani of Forzani Chiropractic; Laura Campanile, the co-founder of Recovery Advocates for the Shore; Dr. Victor Almeida of Monmouth Medical Center, Long Branch; Dr. Stephanie Reynolds of Riverview Medical Center, Red Bank; and Coronato.

Almeida, the director of the Emergency Department at Monmouth Medical Center, presented the causes he determined for initial interactions with illicit substances such as heroin, Oxycontin and “the new kid on the block,” fentanyl.

“Why is it that the United States of America, which represents only 4.5 percent of the world’s population, uses 99 percent of the hydrocodone in the world?” Almeida asked. “Someone needs to answer that question.”

According to Almeida, hydrocodone-acetaminophen is a narcotic prescribed to individuals who are suffering from pain. He said the use of the drug could create a dependence problem. 

Almeida emphasized the strong correlation between the human body’s dopamine levels and opioid addiction. He said the “feel good” chemical interaction between the brain and a substance such as cocaine can cause dopamine levels to spike by as much as 400 percent.

“You never wake up and say, ‘I’m going to become a drug addict,’ but it starts somewhere. There are chemical changes that occur in the brain that become difficult to change,” Almeida said.

The increased levels of dopamine that are produced when an individual is on drugs become highly addictive and eventually will cause a dependence on the substance being used to skyrocket a “euphoria,” according to Almeida, who said this is how dependence occurs.

“This is why the country has this problem. In the 1990s, a letter to the editor in the New England Journal of Medicine was published saying it was safe to prescribe narcotics. The essay looked through 11,000 patient charts and claimed to have only found that four people became addicted to the drugs that were prescribed … This is the article that claims it is safe to give patients narcotics. From here, a lot of marketing started occurring and sales skyrocketed,” Almeida said.

According to Almeida, individuals often and easily graduate from medications that have become readily available to them to cheaper drugs found on the street. These drugs turn out to be significantly more potent and are often laced with fentynal, an extremely potent narcotic that attacks an individual’s respiratory system, according to Almeida.

Reynolds, an emergency medicine doctor at Riverview Medical Center,   spoke on behalf of physicians, who she said are to blame for the opioid crisis in the United States.

“In 2012, we wrote a total of 259 million prescriptions for opioid painkillers. That is enough for every man, woman and child in the United States. Now, this number has exploded even further. We are responsible for this,” Reynolds said.

According to Reynolds, the United States drug epidemic traces its origins to 1996 when Purdue Pharma, a pharmaceutical company, began to implement the so-called “wonder drug” Oxycontin in medical practices.

“Some of our colleagues went into business as a pill mill … There’s no exam, there’s no validation and the doctors who conduct this business are often linked to a specific pharmacy,” Reynolds said.

Reynolds explained how physicians are faced with the constant struggle to decipher between individuals who are sincerely seeking help to ease their pain and those who are addicted to narcotics.

She said former Gov. Chris Christie implemented PMP Aware, a guide for physicians prescribing narcotics, that has helped medical personnel control the number of prescriptions that are being filled in New Jersey.

Reynolds said she is a physician who requires her staff to perform backgrounds checks on patients before administering an opioid narcotic prescription.

“If you have an addiction to prescription pills and then you can’t get them anymore, you’re going to buy them on the street. Are you going to spend hundreds of dollars to get the painkillers or are you going to get the bag of heroin for $10?” Reynolds asked.

In order to combat addiction, Reynolds said she began replacing opioid prescriptions with OFIRMEV (intravenous Tylenol), a new pain management alternative she said is safer for patients and significantly less addictive than opioid narcotics. 

“Even after surgeries, IV Tylenol is becoming a go-to medication. This chemical will take care of that pain,” Reynolds said. “I see this as the responsible answer to the problem.”

Reynolds said medicinal marijuana is also a popular alternative that is gaining traction. The use of medical marijuana is currently being pursued by Gov. Phil Murphy, according to Reynolds, who said its implementation in medicine might be seen in the near future.

Coronato said that aside from the medical aspect of addiction, law enforcement agencies have started to hold individuals who distribute illicit substances accountable for their actions, specifically when the distribution of a drug causes the death of another person.

“New kid on the block,” fentanyl, a pain reliever, was tied to a growing number of accidental deaths in Ocean County in recent years, according to Coronato. 

“In 2014, 10 percent of my dead bodies had fentanyl in them. In 2015, 30 percent of my dead bodies had fentanyl in them. In 2016, 60 percent of my dead bodies had fentanyl in them. In 2017, 65 percent of my dead bodies had fentanyl in them,” the Ocean County Prosecutor said.

According to the Drug Policy Alliance, drug overdose is now the leading cause of accidental death in New Jersey.

Through education prevention, drug-induced death laws and partnering with recovery treatment facilities, Coronato said addressing these vital aspects of addiction and overdose will help combat New Jersey’s toxic relationship with narcotics.

He reported that in recent years, law enforcement officers began to carry Narcan, an opioid antidote, with them so that if they responded to a drug overdose they would have the immediate ability to revive the individual.

Coronato sought to reassure those in attendance that the Opioid Overdose Recovery Program, a detox initiative for those who have been “reversed” from narcotic overdose, is also an option for individuals who have been combating addiction.

During the question and answer portion of the evening, the professionals responded to concerns from members of the public, ranging from holistic treatment options to providing hope for addicts who are unresponsive to help.

Campanile, of Recovery Advocates for the Shore, said, We are really appreciative of Tigger House Foundation and Brookdale for putting this event together. It is really important to bring awareness to the epidemic. … It all starts with the pills, but when those become unavailable, the kids turn to the streets where they come across heroin. That heroin is often cut with fentanyl. Done. And then you’re done.”

Recovery Advocates for the Shore, Manasquan, is a new addiction treatment facility that is non-clinical and nonprofit, according to Campanile.

Hufnagel, the evening’s moderator, who is a recovering addict, offered members of the public a few words of advice to those battling addiction.

“You are still valuable. Life is worth living,” she said.

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