With the news that the White House has organized a new commission to examine opioid addiction, industry watchers wonder what practical effect the group might ultimately have. New Jersey Governor Chris Christie is leading the effort, and he has a long track record of driving treatment-focused solutions in his state. However, others on the commission might not be so quick to follow.
U.S. Attorney General Jeff Sessions is also part of the team. Many have suggested Sessions might seek to resurrect the “war on drugs.” And according to Politico, President Trump likewise spoke of a focus on law enforcement at the commission’s launch meeting. Florida Attorney General Pam Bondi is a commission member as well, and she has previous experience working on treatment-based solutions in Florida.
“I hope they also include somebody on the commission who knows how to deliver care,” says Doug Tieman, president and CEO of Caron Treatment Centers, a BHE editorial advisor.
Christie’s track record
Statistically New Jersey is about average in the United States in terms of drug overdose death rates, according to the Centers for Disease Control and Prevention, but in January, Christie dedicated most of his state-of-the-state address to the addiction crisis. From his support of drug courts and recovery coaching programs dating back to 2012, to increased use of naloxone and state prescription drug monitoring program in recent years, Christie has driven effective solutions with legislation as well as funding. There was a combined state and federal investment to address addiction of $127 million in fiscal 2017 in New Jersey.
As one example, a key New Jersey strategy launched in July 2015 set up a 24/7 consumer hotline that has become a central referral source for treatment centers. The hotline has fielded nearly 100,000 incoming calls from consumers looking for treatment thus far.
Its 40 employees are trained and overseen by a clinical professional, says Manuel Guantez, PsyD, LCADC, Rutgers’ University Behavioral Health Care vice president of outpatient and addiction services. Rutgers is under contract to operate the hotline.
“A live person will answer the call within 30 seconds,” Guantez says. “But we’re usually answering the call within 12 to 18 seconds.”
A treatment capacity management system allows the hotline staff to access information on available programs from detox to residential to outpatient in real time and connect immediately with intake professionals for a warm handoff. Guantez says the call center stays on the line with the consumer until the contact is confirmed.
Consumers are screened with a brief assessment to help determine their care options.
“We do that in a number of ways,” he says. “We use ASAM criteria. We look at the ZIP code for ambulatory settings, for example, to get them somewhere near their home or within their preference based on prior history.”
If a preferred placement is not available, the call center will record the consumer’s information and call him or her every day until the placement is achieved, offering care coordination in the meantime. The database is updated in real time, which helps treatment centers fill available beds quickly. Guantez notes that the staff is trained to call 911 in the event the caller is in need of immediate emergency attention.
Positives for providers
There are 150 licensed providers with 300 sites in the treatment capacity database receiving the warm handoffs from the hotline.
“The providers appreciate it,” Guantez says. “Some providers can’t meet all the needs of the consumer. They might need a higher level of care or have a co-occurring disorder they didn’t disclose. We will re-engage that consumer and try to help them and appropriately work with the provider. It’s been a real collaborative effort.”
Overall, Guantez says New Jersey has been very progressive in addressing the challenges of addiction, beyond just the hotline.
“Clearly Governor Christie has really brought substance use disorder to the forefront of people’s minds and has worked to reduce the stigma,” he says.
The New Jersey hotline is available at (844) 276-2777.