Camden County Rolls Out Treatment, Interventions Backed by Opioid Settlement Funds

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The county launches the program with $1.2 million in settlement funds, and anticipates receiving some $2 million annually to continue it throughout the next 20 years.

By Matt Skoufalos | March 1, 2023

Camden County Public Health Officer Dr. Paschal Nwako addresses the media about a plan to leverage opioid settlement money into treatment programs and outreach services. Credit: Matt Skoufalos.

In March 2022, the state of New Jersey entered into a $641-million settlement agreement with opioid manufacturer Johnson & Johnson and the three largest pharmaceutical distributors in America — McKesson, Cardinal Health, and AmerisourceBergen — over their involvement in the national opioid epidemic.

As a result of that settlement, which will be split 50-50 between the state and county and municipal governments, Camden County anticipates additional revenues of some $2 million annually over the next 15 years.

On Wednesday, county officials described their plans to leverage those funds into programming and supports that will help combat the damage sustained by local communities during the opioid crisis.

“Compared to the scope of the problem, we could use a lot more, but it’s certainly going to go a long way,” Camden County Commissioner-Director Lou Cappelli said.

Camden County, which suffered some 300 overdose deaths last year, 70 percent of which were related to fentanyl, Cappelli said, will parlay some of the settlement funds into medication-assisted treatments (MAT) to help wean people with substance abuse disorders (SUDs) off opioids.

The county will fund a pilot program based around a mobile outreach van to administer the opioid replacement drug buprenorphine. Take-home kits with the overdose-reversal drug naloxone (also known as narcan) will be offered to SUD patients seen in emergency departments.

The settlement funds also will be used to deliver narcotics overdose prevention and education (NOPE) in area high schools and middle schools as well as advertising about the dangers of opioid use.

The settlement dollars will support addictions-related mental health initiatives, including follow-up case management services for people discharged after a crisis event. They will also pay for suspended or expelled schoolchildren to receive “free, expedient access” to licensed clinical health professionals to help them return to school.

Other of the funds will be dedicated to deliver socialization, recreation, and support group services for boarding home residents, as well as municipal court mental health navigators attached to Project SAVE, which works to divert criminal defendants into SUD treatment.

“We know that substance use and mental health disorders are very complicated,” said Cooper University Health System Emergency Room physician Matt Salzman, who specializes in toxicology and addiction.

Camden County Commissioner-Director Lou Cappelli speaks about the county’s share of the statewide opioid settlement. Credit: Matt Skoufalos.

“At Cooper, we’ve worked hard to create an integrated multidisciplinary program to meet people where they are, and get them the help they need,” Dr. Salzman said, “and the program is a model for others throughout the country.”

Camden County Public Health Officer Dr. Paschal Nwako described the county’s approach as that of “trailblazers” on the issues of mental health and addiction issues related to the opioid crisis — but it has had to be, having suffered 354 suspected drug-related deaths in 2022, behind only Essex County for the most in New Jersey.

“[These programs] will not erase the pain or anguish that so many people have suffered; however, we will make possible inroads that will have lasting effects,” Dr. Nwako said.

“We are working with all of our partners, so by using these funds for these programs, we hope we can mitigate the pain to the community,” he said. “As we work together, we can succeed in our efforts.”

In addition to the programs outlined in Wednesday’s announcement, Cappelli and Nwako also described preliminary plans that the county is undertaking to establish a 24-hour urgent care facility for behavioral health incidents, especially those involving juveniles.

“Nobody else has done this in New Jersey,” Dr. Nwako said. “We’re still working on the modalities to house it.”

According to the New Jersey Hospital Association, less than one-third of all 71 acute-care hospitals in New Jersey have a designated psychiatric unit, “and only a marginal number of those with units are equipped to provide specialty services for children and adolescents (Children Crisis Intervention Services):

“Policies that help fund, support, and staff acute-care hospitals so that they are better able to care for those with mental or behavioral health disorders are ever more crucial. While those experiencing a psychiatric emergency will likely require additional – and ongoing – care outside of a hospital, acute-care hospitals may be the first point of contact that many have with the healthcare system. Increasing access to care in an outpatient or community -based setting must be a priority for New Jersey’s mental health system of care. But absent a holistic and systemic approach to this challenge, equipping hospitals so that they can adequately provide specialized psychiatric care should be a top priority.”

—NJHA Center for Health Analytics, Research and Transformation (CHART) Bulletin, June 2022

Without additional support, children dealing with these issues are going unseen by professionals, or are waiting hours in hospital emergency rooms to be seen. Some are students with undiagnosed mental health concerns, and others who have voiced homicidal or suicidal thoughts must be evaluated before they can be cleared to return to school.

“We spoke to superintendents, and see that this is a big problem we’re seeing in schools,” Dr. Nwako said. “This is clogging the emergency room with kids … and that takes away their time to be in school.”

For other populations, including those experiencing homelessness, some of the funds will help connect them with treatment services that will give them resources they need to regroup and get stabilized.

“A lot of people don’t understand the homeless population, so we go out there and we engage with them,” said Delia Burgos, a Certified Peer Recovery Specialist Supervisor with the Maryville Addiction Treatment Center of Turnersville.

“We take people to treatment and get them the resources they need,” Burgos said. “I go out there every day and train the team to love and show support to anyone out there.”

Normalizing both the ability to discuss and receive treatment for mental and behavioral health concerns, including substance use disorders, is “an issue of national security and economic prosperity,” said Dr. Rahul Gupta, Director of the Office of National Drug Control Policy (ONDCP), in a visit to Camden County last week.

“We want to make sure we’re getting people the help they need so we can get them back in the workforce, or whatever else they want to do.”

The funds that will launch the programs county leaders outlined Wednesday are the first of a series of opioid settlements of which the state of New Jersey has sought its share.

An additional $500 million may follow, as settlements with pharmacy chains CVS, Walgreens, and Walmart, and drug makers Teva Pharmaceuticals and Allergan, are in the works.

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