TRENTON, N.J. - Gov. Chris Christie has drawn accolades from supporters and detractors alike for his work addressing the opiate problem in New Jersey and elsewhere. But advocates and addicts say he is helping those already in trouble with the law and failing those who are looking to get clean before they slip up and find themselves in jail.
One of the brightest moments of Christie's campaign for the Republican presidential nomination was his emotional telling of a law school friend's struggle with drug addiction, relayed to a town hall audience in New Hampshire and later watched by millions on Facebook.
He is credited for getting people to pay attention to drug addiction, expanding drug court programs and signing measures including expanding the use of the overdose-prevention drug naloxone and a prescription monitoring program.
But that praise is coupled with complaints of sometimes monthslong waiting lists to get into drug treatment, as well as a delayed effort to raise Medicaid rates that is stretching an already strained system to help addicts in need of public assistance.
"The administration often says it has added money to treatment in drug court, but that's once you're entangled in the criminal justice system," said Roseanne Scotti, the New Jersey director for the Drug Policy Alliance. "A lot of people wouldn't be entangled in the criminal justice system if they had treatment. You shouldn't have to get arrested to get treatment."
Christie says putting more people in the pipeline for treatment encourages the private sector to offer more services, and he doesn't want to see New Jersey "broadly offering state-sponsored treatment."
About 40 percent of the 79,000 people in need of substance abuse treatment in New Jersey in 2014 didn't get it, according to state estimates. That percentage has increased slightly since Christie came into office, while the number of people who have entered state-financed treatment programs has decreased.
Debra Wentz, president of the New Jersey Association of Mental Health and Addiction Agencies, a nonprofit advocacy group for mental health and drug treatment providers, said Christie has done an "incredible job" of raising visibility on treating drug addiction as an illness, and done good work on expanding treatment for nonviolent offenders and prison re-entry. But those helping the state's poor and uninsured have been waiting several years for the state to raise Medicaid reimbursement rates as they face increasing costs and struggle to attract and retain skilled workers, Wentz said.
"I think for years they've talked about and done other things much to the credit of both the providers and the state to try to work with limited funds, but you can only squeeze so much water out of a stone," she said. "I think many, many facilities around the state have waiting lists that are long in terms of service or those they can't take who they refer elsewhere."
Christie says he wants to incentivize the private sector and plans to make sure insurance companies and state regulations are providing the proper level of services.
"If I don't have luck in being able to incentivize the private sector to do more then I'm going to have to confront a decision about whether or not to have the government do it," Christie said in an interview last month. "That's something that I'll confront when I need to make that decision, but I don't think I'm there yet."
Valerie Mielke, assistant commissioner for the state Division of Mental Health and Addiction Services, said finalizing the rates is taking longer than expected. She hopes they will be ready in time for the next fiscal year, starting in July.
"We are taking the time to do it because it's really important that these rates are right," Mielke said, pointing to details that needed to be tweaked after an actuarial firm completed work on rate changes. "As we delve into the rates and the assumptions, we really believed that we needed to make some modifications so that it would be of greater benefit to our system and individuals that we serve."
Mielke also cited a new, centralized help system for the addicted that maintains a database of openings at treatment facilities. When there aren't facilities available, she said, counselors keep in touch with addicts daily to let them know they're still looking for a bed and to see if there's anything else they can do to support them.
Through November, more than 28,000 people had called into the hotline, and about a quarter of the eligible callers received treatment through the state, according to state data. The average wait for people calling the number to get into detox is 9 days.
Ed Brazell, who started volunteering to help addicts get into treatment this year as his son goes through recovery, said he has helped 60 addicts in the state and many more outside of New Jersey. He said he gets 15 calls every day from people looking for treatment. He said the hotline has improved since launching, but the level of service can be inconsistent.
"Really, the only way the system works is if they're proactive. They have to make those phone calls every day and wait for someone to talk with them. It's a chore," he said. "I end up losing them, they end up going back out. I would say maybe 50 percent who don't get in the first time, they just pretty much give up. They either end up in jail or pass away from an overdose."
By John Cornfield - AP/Dec. 27, 2015
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