Opioid addiction is a powerful enemy and New Jersey has deployed many forces against it, including readily available drugs to reverse overdoses, more treatment beds, the nation’s first rehabilitation prison and addiction counselors in emergency rooms.
More tools will be needed before the opioid crisis is conquered, and one that states are seriously considering is committing overdose patients to treatment even if it’s against their will. New Jersey should get involved with that effort now so it’s ready to act when the tricky details of involuntary treatment are worked out.
There is already mandatory drug rehabilitation in New Jersey for those convicted of nonviolent crimes, thanks to a first-in-the-nation law signed by Gov. Chris Christie in 2012.
Now states are working toward allowing hospital staff to order overdose patients into treatment, typically for three days. That’s considered long enough to ensure they’re no longer a danger to themselves and others, and to increase the likelihood that they’ll agree to enter a full addiction-recovery program.
Currently, drug users who almost die from an overdose are released, and too often wind up overdosing again. A study at a Boston hospital published in October found that one in 10 overdose victims who had been revived with nalaxone died within a year.
The widespread use of nalaxone, also known by its brand name Narcan, has saved many addicts but also raised questions about whether it also encourages bad behaviors.
New Jersey has ensured that the injectible or inhaled medicine is available to first responders, schools and the general public. A law Christie signed in June made it easier for independent pharmacies to sell it over the counter.
A reform making its way through the Legislature, led by Assemblymen Vince Mazzeo, D-Atlantic, and Dr. Herb Conaway, D-Burlington, would enable first responders to administer nalaxone up to three times to patients whose fentanyl-laced overdose doesn’t respond to a single dose.
Overdoses killed 2,100 people in New Jersey last year. In the past three years, more than 12,000 people overdosing on opioids have been administered naloxone to keep them alive.
Pennsylvania, Massachussetts, New Hampshire and Washington state are considering laws that would add drug overdoses to the mental illness conditions that allow involuntary commitment.
Lawmakers in those states are grappling with how to legally define such overdoses, in which the exact narcotics abused are seldom known, and how and by whom the treatment requirement would be executed. States also are trying to anticipate the extra treatment capacity they would need.
In addition to the mandatory treatment bill in the Pennsylvania legislature, there is a proposal to create eight regional detox centers with tobacco settlement funds. There is also a bill to reinstate the criminal liability of those who overdose.
New Jersey also exempted such liability in 2013 to prevent possible reluctance to seek emergency help in countering an overdose. Revived drug users can’t be charged with a crime even if they’re still in possession of illegal drugs.
But before that, an overdosing addict could be charged and sent to New Jersey’s effective drug courts, where treatment could be ordered instead of jail time. A Pennsylvania police chief said the ban on criminal charges took away a tool to help drug addicts and resulted in almost a safety net for opioid users.
Addiction to powerful opioids deprives people of their ability to make choices in their best interests. New Jersey should join these other states in developing a method for making some of those choices for them if necessary.