Experts say N.J. ill-equipped to stem epidemic of young suburban addicts [The Philadelphia Inquirer]

Oct. 09--An epidemic of addiction to heroin and prescription painkillers among suburban teens and young adults in New Jersey will get far worse if treatment does not improve and become more readily available, experts say.

Members of a task force Gov. Christie established to suggest changes have been told by affected families and health-care professionals that the state has too few residential treatment programs, poor follow-up care, and inadequate insurance coverage.

"It's urgent, it's an epidemic, and it is right in front of us," said John L. Hulick, executive director of New Jersey'sCouncil on Alcoholism and Drug Abuse.

New Jersey's limitations are forcing a different kind of traffic among addicts from the state -- to Florida, where facilities don't have long waiting lists.

Hulick is heading the 15-member task force, created to study abuse of prescription opiates such as OxyContin, antianxiety medications such as Xanax, and heroin use among those 25 and younger.

The task force has held four hearings, the last one Tuesday at Cooper University Hospital in Camden, just a block from Broadway, a drug corridor that draws constant business from the suburbs.

Though the panel, established in March, has yet to issue recommendations, members heard from experts that part of the problem is that programs quickly fill with court-ordered addicts, sometimes leaving less than 20 percent of the resources for noncriminal users.

Also, they heard that insurance companies arbitrarily deny treatment. Experts say insurance companies must be included in discussions to improve treatment in cost-effective ways.

Susan Pisano, a spokeswoman for America's Health Insurance Plans, an industry trade association, said cost does not always drive decisions. Approvals are also based on successful treatments, she said.

"It's what works," Pisano said. "There is a crying need for evidence of models that are working."

The American Society of Addiction Medicine News recently published an analysis on the impact of managed care on addiction, concluding that the appropriate level of treatment is essential to avoid relapse.

Alan Stevens, chief executive officer of Behavioral Health, a treatment facility in Palm Beach, Fla., said proper assessment was critical.

Stevens, a Temple University graduate who lived in New Jersey before moving to Florida, said 75 percent of the 400 beds at Behavioral Health's four facilities were filled with clients from other states, mostly from the Northeast, including New Jersey. The clients go to Florida to bypass waiting lists in New Jersey.

Counselors work with families and insurance companies to cover costs, Stevens said.

Behavioral Health separates housing from medical and therapy costs: Families pay for housing, deductibles, and co-pays, and insurance pays for treatment.

Thomas D. Allen Jr. is executive director of Summit Behavioral Health, which has an outpatient program near Princeton. He is using Florida's model to open a facility near Asbury Park that will have a mixture of outpatient and residential care. It's difficult, he said, to establish new facilities because of New Jersey's tough zoning laws.

Christie, who spent five years on the board of a treatment facility in North Jersey, is a former prosecutor. In July, he approved mandatory treatment for nonviolent offenders after urging the Legislature to move quickly as a way to save lives.

Experts note that treatment is cheaper than jail, and that health-care costs can increase dramatically for acute cases who repeatedly land in emergency rooms or require treatment for chronic medical problems caused by extended drug use.

The problem is nationwide, with drug deaths exceeding 37,000 a year -- more than traffic fatalities, which had been the top killer for accidental deaths, experts say. They attribute the surge to proliferating abuse of prescription drugs.