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Drug war in NJ turns to recovery

New Jersey State Police Capt. Juan Colon has a new and unlikely ally in the state’s war on heroin. He is teaming with a former addict-turned-drug counselor to trace the deadly poison from the Columbian poppy fields to the drug-dealer stamped packet found on the body of overdose victims.

Colon has been collecting data since 2009 to battle the state’s burgeoning heroin epidemic. Now Colon, who runs the Drug Monitoring Initiative for the state, has turned to John Brogan, a former addict who steers heroin users into treatment, to provide another layer of information that may help save lives.

Brogan, Colon and others in the anti-heroin effort, met for the second time at the Regional Operations Intelligence Center at state police headquarters in Ewing.

Because Colon’s research stopped at overdoses, a good portion of the world of heroin was invisible to him and those who rely on his data. That data help law enforcement agencies reduce what Colon calls “drug harm” — burglaries, gang gun violence and overdoses. That may mean taking down a supplier or tracing heroin deaths to the same dealer to bring stiffer charges.

Brogan will be tracking the path of users who entered into treatment.

“We’re showing the tracking from where they manufacture heroin all the way out to treatment and then the desired result of recovery,” Brogan said.

The information will give Colon and others an idea of why drug harm is going up or down. If arrests are going down, some law enforcement action may be working, Colon said. But an increase in treatments may also be a factor.

“It’s a good indicator,” Colon said. “John is filling in some blanks. He’s into the network of providers, what’s going on in the industry.”

When the heroin epidemic gained momentum in 2009, Colon was receiving requests on data about burglaries, shootings and overdoses independent of each other.

But he saw they were related.

“When we started to do the analysis, the picture started to come together and we started to understand the heroin was driving the violence and the high number of burglaries were being driven by addicts looking to support their habit,” he said.

At the same time, the drug overdose deaths were rising statewide, from 843 in 2010 to 1,336 in 2013.

“If you had 1,336 people who died in plane crashes (worldwide) you’d be concerned,” Colon said, stressing the lack of urgency the epidemic first seemed to generate.

He has since expanded his research to include data from various state agencies, helping with not just enforcement but epidemiology also, which deals with the spreading and control of diseases. And he is tracking activity in other states.

“We identify problem drugs in problem places and problem people,” he said.

The Drug Monitoring Initiative formally came into being in 2012, Colon said.

The information Colon collects can also help health care providers. If the data that is gathered every day shows five or more overdoses in a 10-mile radius over a 12-hour period, “that means something powerful is out there,” Colon said.

An alert will better allow health care providers to marshal their forces to respond to more overdoses, he said.

Brogan was representing 4th Dimension, a new outpatient and recovery center in Toms River, of which he is a principal. He also works for Barnabas Health as a chief recovery specialist.

Brogan said the passing of information runs both ways. Colon’s group will be sharing information on hard hit areas with little treatment available — all in the interest of lessening the hold that heroin has on New Jersey,

Brogan said a formal agreement between the state and 4th Dimension still is being worked out.

Ken Serrano: 732-643-4029; kserrano@gannettnj.com

Christie Touts Recovery Coach Program for Addicts

Recovery Coach John Brogan sat at a roundtable with Gov. Chris Christie and described a kid who he says OD’ed on a mixture of heroin and rat poison. He ended up at Monmouth Medical Center.

“He’s being revived and he comes back to life and there he is. That’s our opportunity to go to the next level. In every case they all have one common thing. Some of them are angry, some of them are sad, some of them are depressed, it depends. When we get down with them on their level and say ‘I know exacly how you’re feeling the tears start,” Brogan said.

Brogan’s also recovering addict — part of the $1.7 million Recovery Coach program that kicked off this January in Monmouth and Ocean counties, where the heroin epidemic’s raging. It pairs Narcan reversal patients with coaches. All the counselors here must be at least four years clean.

“Up until we started this project in January, Narcan reversals were leaving the hospital even though there were attempts on the part of hospital staff to intervene and get them into treatment. It was unsuccessful,” said Connie Greene, Barnabas Health Instructor for Prevention.

“And they’d just start using again. This is the nice thing about this program: trained experts to come in and try to help them break that cycle, try to convince them you’ve got to treat yourself here,” said Monmouth County Prosecutor, Christopher Gramiccioni.

How many successes have there been with this program? “Thirty-eight. We’re running at a 71 to 72 percent success ratio so far,” said Borgan.

And that’s unprecedented. For Gov. Christie — who lost a friend to addiction — it’s a critical step toward stemming the heroin plague. He says the OD antidote — Narcan — has saved more than 8,000 lives in New Jersey since 2014, but that it’s programs like this one that can keep addicts alive.

“This is advice and counseling and help that comes from people that have been exactly where these folks are. And there’s no way to substitute for that,” Christie said.

“We no longer have someone who is alone in their disease that has to negotiate the system. We’re there to hold their hands and help support them through this entire process,” said Greene.

Brogan — who brought his family to bear witness — says he can’t believe he’s a coach.

“After four Narcan reversals and attempted suicide. No way. Five years ago, my three daughters and my wife, they didn’t have a dad, and it was real close,” he said.

The next place that will implement the Recovery Coach program is Eva’s Village in Paterson. The governor wants to expand it to 11 counties by next year, and then take it statewide.

New heroin program offers addicts help

Naloxone, or Narcan, the brand name it’s also known by, saved the then-Seaside Heights bartender that Saturday night in August 2010.

Coming within “inches and seconds” of death didn’t stop his addiction.

Within an hour, driven out of the city by a friend, he shot up again in a patch of woods not far over the New Jersey line. He survived.

It took an epiphany in jail as Christmas approached and the thought of his three daughters for Brogan to change his ways.

Clean nearly five years now, Brogan may reach for that near-death tale as well as his story of redemption when he’s standing over other heroin overdose victims saved by Narcan.

Brogan is the human face of Monmouth and Ocean County’s approach to the New Jersey’s Opioid Overdose Recovery Program, a two-year pilot program administered by the state Department of Human Services.

That approach aims to break through the heroin and prescription opiate abuse epidemic gripping New Jersey and much of the country by using the street sense and drug-use experience of people like Brogan to connect with those in throes of addiction as they recover from an overdose in the emergency room.

“It’s what’s called the teachable moment,” said Ernest Drucker, Senior Research Associate and Scholar in Residence at John Jay College of Criminal Justice in New York who studies drug policy and treatment.

But will it succeed?

It’s hard to find figures on the success rates of opiate rehabilitation. According to the National Institute on Drug Abuse, drug addicts who have entered into rehabilitation have a 40 to 60 percent relapse rate. Advocates stressing drug addiction as a disease say other diseases, like asthma, have higher rate of people going off their medications.

Heroin and other opiate overdoses have killed at least 367 in Monmouth and Ocean counties from the beginning of 2013, with some determinations pending. The youngest: 18. The oldest was 65.

New approach

Five counties will receive a state grant of $255,750 each a year for the two-year program. Barnabas Health is running the program for Monmouth and Ocean counties. Meridian Health and CentraState Healthcare System are partners in the program. At least a dozen recovery specialists like Brogan will be on call 24 hours, seven days a week at five hospitals operated by the three partners.

The recovery specialists will give overdose survivors non-clinical support for at least eight weeks and two “patient navigators” link the naloxone recipients with treatment, although Connie Greene, vice president Barnabas Health Institute for Prevention, said that period of oversight could be longer.

Those revived by naloxone will receive treatment whether they have insurance or not, Greene said. The treatment programs could be those run by companies that will set aside beds under existing contracts with New Jersey or private companies that may take the patients for free – a marketing opportunity in that they would be connected to a new program, she said.

The three other counties enrolled in the program are also hard-hit by the heroin epidemic: Atlantic, Camden and Essex counties.

Naloxone has been hailed as a significant development in the heroin epidemic.

“It’s miraculous,” Drucker said. “It’s the right thing to do – there’s no abuse potential.”

While it saves lives, however, naloxone does nothing to keep those addicted to heroin from going right back on the streets, as many addicts have done.

“We’re on the wrong end of the curve,” Drucker said.

Grim numbers

In Ocean County, the number of overdose deaths involving heroin and other opiates other than unspecified prescription medicines for each of the last three years has remained stubbornly steady. The moved from 64 in 2013 to 73 in 2014 to 54 through mid-October of this year. All drug deaths went from 112 to 101 to 77 through mid-October,.

In Monmouth County, the number of overdose deaths involving heroin and other opiates has gone from 63 in 2013 to 75 in 2014 to 38 as of Aug. 6 of this year, with the determination of some deaths pending. All drug deaths have moved from 75 in 2013 to 93 in 2014 to 54 through Aug. 6.

At the same time, those saved by naloxone has increased since the spring of 2014, when police and rescuers started administering the spray form of the drug:

• In Monmouth County, naloxone was used 193 times as of Nov. 4, up from 98 times last year.

• In Ocean County, there were 150 uses of naloxone as of July 8 of this year, up from the 126 uses in 2014.

Does the overdose death toll combined with the groing number of people revived from overdoses with naloxone who otherwise may have died mean the epidemic is growing?

”I don’t think it’s getting worse, I think we’re just finding out about the depth and the magnitude of the problem,” said Ocean County Prosecutor Joseph Coronato, who has lobbied for treatment beds for overdose survivors.

 

‘The monster that is always there…’

While naloxone saved the lives of a good number of those people – some would have been brought to an emergency room and been given naloxone there or even sooner by paramedics – the quick saves did nothing to deal with their addictions.

A 32-year-old Ocean County woman, who spoke only on the condition of anonymity, remembers Monday, Oct. 6, 2014, as the day she almost died of a heroin overdose. Paramedics saved her with Narcan.

But after being released from an emergency room three hours later, all she got was a standard discharge form. It told her to consult the Yellow Pages for addiction help.

Already in an intensive outpatient treatment program, she found support by tearfully pleading to her drug counselor. A week later, she injected heroin into her arm, but didn’t overdose. It was the feeling of disgust – the burden she placed on family members – that finally drove her to get clean and ward off “the monster that is always there,” she said.

Steep climb

But even with rehabilitation services being offered, getting naloxone patients into detoxification clinics or rehabilitation facilities has so far proven difficult.

Of 150 naloxone patients that Barnabas staff tried to convince to undergo treatment, two went into detoxification, Greene said. And they left within a day or two.

But those staff members were not from the ranks of those addicted to heroin, she said.

“They were just reversed from death – they’re going to see the light. If you’re not in the field of addiction, that is the belief,” Greene said of the common perception of recovery. “The recovery specialist understands this disease is so complex and the readiness is not there just because they were brought back from death. The engagement is down and dirty and real. Engage on the addiction and the hopelessness of that situation and the family problems.”

Success elsewhere

In Rhode Island, a program called AnchorED, started using 16 certified “recovery coaches” to guide naloxone recipients into treatment in eight of the state’s 11 hospitals in June 2014. Of the 230 people the program saw in its first year, 191 have entered some kind of treatment or recovery support, said Thomas Joyce, spokesman for the program.

“They’re using that human touch, that compassionate, empathetic approach at a time of crisis,” said Thomas Joyce, a spokesman for the program.

The onetime weekend program has expanded its hours and now services nine hospitals. And AnchorED is now sending coaches to homeless shelters and other places where the population is at a high risk of overdosing.

“Why can’t we catch them before they hit?” Joyce asked.

The AnchorED program is funded by a federal block grant, he said.

Spiraling upward

And the economic cost of heroin addiction is climbing because of the sheer increase in the number of users.

One study pegged the cost at $22 billion – in 1996. Factor in inflation, and that number balloons to $33 billion today, the cost of running the New Jersey government in 2015. About half of that came from productivity losses, and a quarter each from criminal activity and medical care.

Based on national surveys of drug abuse of those 12 and over in the United States, there were about 450,000 heroin users in 1996. That number climbed to 740,000 in 2013, according to a national survey.

Factor in the number of people using heroin and the inflation-adjusted figure of $33 billion, the cost could rise to $54 billion or more, the Asbury Park Press found. That’s the 2015 budget for the state of Michigan and a few billion more than what Apple last made in annual profits

Ongoing redemption

Brogan’s determination to beat addiction came while inside a jail. Being held on a theft charge, he witnessed an inmate in court who had been clean for two years helping other addicts in the lockup. It was Christmastime and a judge released the inmate as a reward for her efforts.

That inspiration coupled with reality helped him break the addiction cycle.

“I was broken,” he said. His drug habit was traumatizing his three young daughters and other family members. That had to come to an end, he said.

Narcan saved Brogan in a Burger King bathroom in 2010. It saved him three other times as well.

But it wasn’t until he was at the Trenton Salvation Army – a rehabilitation facility that he was admitted to after being released – that he said he found the hope he needed through a 12-step program, principles principles of abstinence and peer support used by Alcoholics Anonymous and other groups.

It is that hope that Brogan said he will bring to Narcan survivors.

“They’ve got to be loved out of it,” Brogan said.

Christie recognizes recovery coach from Toms River