Steven R. Rothman (Democrat) *
P.O. Box 714
Hackensack, NJ 07602
2008 NEW JERSEY CONGRESSIONAL
PREVENTION AND TREATMENT SURVEY
I. General Views of Alcohol and Drug Addiction Policies
to Address Stigma
The nation continues to focus on strategies
to address the need to fight alcohol and drug
use. Studies have found that the stigmatization of alcohol and
drug addiction persists, and
that the public acceptance of addiction as a disease, though seemingly
broad, is actually
quite shallow. Addiction is a widespread epidemic that affects
millions of Americans,
many of whom are in long-term recovery from the disease. Recently,
science has made
breakthroughs in understanding addiction and its effects on the
brain. As a result,
recovery from addiction has increasingly become concentrated on
treating a patient’s
specific needs. Indicate which principles you agree with (if any)
regarding your general views of alcohol
and drug addiction and policies to address the stigma surrounding
addictive illnesses by
placing a check mark next to the letter(s) which correspond with
your views.
Indicate which principles you would agree with (if any) regarding
your general views of alcohol and drug addiction and policies to
address the stigma surrounding addictive illnesses by placing a
check mark next to the letter(s) which correspond with your views.
X
a) Alcohol and drug addiction
are preventable, treatable, chronic diseases and are as consistently
diagnosable as other illnesses such as diabetes, asthma and
hypertension.
X
b) Alcohol and drug addiction treatment
are very effective and work as well as
other established medical treatments for illnesses such as
diabetes, asthma and
hypertension.
X
c) On the issue of drug use, the nation
and state should more heavily emphasize
strategies of interdiction and prosecution, which aim to control
the problem by
reducing the available supply of drugs.
X
d) The country should pursue more strategies
that favor a public health approach to
alcohol and drug addiction and target demand reduction activities,
such as
prevention and treatment.
e) Other:
II. Recovery from Substance Use Disorders
Recovery from an alcohol or drug problem is
a process of change through which an
individual achieves abstinence and improved health, wellness and
quality of life. The<
process may take months or years and may require ongoing disease
management. As is
the case with any chronic illness, addiction is not infrequently
characterized by relapses.
Millions of Americans are in recovery from addiction to alcohol
and other drugs, yet
many still find it difficult to get an education, a good job, or
health insurance due to
2 discriminatory policies and laws. These laws basically prevent
people who have paid
their debt to society from advancing themselves so they can better
contribute to their
families and their communities.
Recovery Support Services have
been critical to helping people sustain their recovery
from addiction for the long term. Recovery Community Organizations
throughout the
country have been providing services that help to support and sustain
long-term recovery
through the federal Recovery Community Support Program. These services
are generally
peer-to-peer services that focus less on illness (pathology) and
more on wellness. They
aim to help the client transition from formal treatment to the
community and maximize
the opportunities to create a lifetime of recovery and wellness
for the individual as well
as family, neighbors, and community. Peer-to-peer services include
(1) assistance in
housing, educational, and employment opportunities; (2) building
constructive family and
other personal relationships; (3) stress management assistance;
(4) alcohol- and drug-free
social and recreational activities; and (5) recovery coaching or
mentoring to help manage
the process of obtaining services from multiple systems, including
primary and mental
health care, child welfare, and criminal justice systems. The president
has eliminated
funding for recovery community organizations providing these services
from his 2009
budget.
Indicate which principles you agree with (if
any) regarding recovery from an addictive illness by placing a
check mark next to the letter(s) which correspond with your views.
X
a) Services that support
long-term recovery, such as the Recovery Community
Services Program, have proven to be successful in communities
across the
country and should be restored, funded, and extended.
b) Repeal laws that prevent people in
recovery from an alcohol and other drug
addictions from obtaining an education, welfare, licenses,
housing, and health
insurance.
X
c) Will become a member of the Congressional
Addiction Caucus, which focuses
on issues affecting addiction and recovery (applicable only
to candidates for the
House of Representatives).
d) Other
III. Preventing and Reducing Youth Alcohol and Drug Use
Although there is a gradual decline in illicit
drug use among eighth, tenth, and twelfth
graders across the country, according to the 2007 Monitoring the
Future Study, the
nations youth continue to use alcohol, marijuana, and other illicit
drugs to an alarming
degree. According to the study, 16%, 33%, and 44% of 8th graders,
10th graders, and 12th
graders, respectively, used alcohol within the prior 30 days, while
18% of the 10th
3
graders and 29% of 12th graders admitted to drunkenness within
the month. The
prevalence rates for marijuana use (the most frequently used illicit
drugs) in the prior year
now stand at 10%, 25%, and 32% for grades, 8, 10, and 12, respectively.
The study also
showed a slight increase in the reported use of ecstasy, among
the nation’s youth.
The Safe and Drug-free Schools and Communities Act (SDFSC) supports
programs
which are developed to prevent school violence and the illegal
use of drugs and alcohol
(including tobacco) by elementary and secondary school children
and is the foundation of
school-based prevention. There have been funding cuts to the act
in recent fiscal years. It
has been only minimally funded, and as a result has not been as
effective as it might have
been in preventing drug use among children.
The Administration has proposed restructuring the SDFSCA program
by significantly
decreasing the role of state grants and refocusing national activities.
For FY-2009, the
Administration has requested $282 million for the SDFSCA. Under
this proposal,
appropriations for state grants would be reduced to $100 million
(down from $295
million in FY 2008), and appropriations for national activities
would be decreased to
$182 million (down from $219 million in FY 2008).
The STOP Act establishes a national media campaign aimed at underage
drinking, funds
underage-drinking prevention programs in communities, and requires
the Department of
Health and Human Services to report annually on progress against
youth drinking. Major
provisions of the STOP Act include a $1 million annual national
media campaign on
underage drinking; $5 million in grants to help community coalitions
address underage
drinking; $5 million in grant funding to prevent alcohol abuse
at institutions of higher
education.
Indicate which principles you support (if any) concerning the
prevention and reduction of youth alcohol and drug use by placing
a check mark next to the letter(s) which correspond with your
views.
a) Increase taxes on alcoholic
beverages in order to create a price disincentive to
help reduce youth drinking.
X
b) “Zero tolerance” policies,
the practice of not tolerating undesirable behavior
such as illegal drug use, the violation of which results in
the automatic imposition
of severe penalties for first-time offenders.
X
c) Maintain funding for the SDFSC for
programs to prevent school violence and
the illegal use of drugs and alcohol (including tobacco) by
elementary and
secondary school children.
X
d) Continue administering and fully funding
the STOP Act.
e) Conduct non-compulsory student surveys
without the active consent of a parent
or guardian as allowed for by federal law to measure youth
use and develop
programs / policies.
X
f) Fund addiction prevention, early intervention
and research as an investment in
America’s future.
e) Other:
IV. Public Capacity for Alcohol and Drug Addiction Treatment
Untreated substance use disorders are a major
health problem that impacts society on
multiple levels. They cost our nation more than $484 billion per
year in health care
expenditures, lost earnings, lower work productivity, overcrowded
jails and costs
associated with crime and accidents and broken families. Yet millions
of Americans can
not access the treatment and recovery services they need.
According to the 2006 National Survey on Drug Use and Health (NSDUH),
approximately 23.6 million people over age 12 in the U.S. met the
criteria for substance
misuse or dependence in the past year, based on the Diagnostic
and Statistical Manual of
Mental Disorders, 4th edition (DSM-IV). Of these, only 2.5 million
people received
treatment in a facility specializing in substance use treatment,
leaving 21.1 million people
in need of treatment.
The lack of access to quality care has been well documented in
New Jersey. In 2006,
there were 54,825 addiction treatment admissions in New Jersey – down
13 percent or
more than 8,000 from nearly 63,000 admissions from just ten years
ago because fewer
people are able to access treatment due to limited treatment capacity.
The New Jersey
Division of Addiction Services reports more than 21,000 people
sought addiction
treatment in 2007 but could not access it as a result of limited
capacity.
Indicate which principles you support (if any) concerning expanding
public capacity for
alcohol and drug addiction treatment by placing a check mark next
to the letter(s) which
correspond with your views.
X
a) Enact treatment on demand
initiatives that aim to offer all those seeking publicly
funded substance abuse treatment immediate entry into a program.
b) Increase federal excise tax on alcoholic
beverages to expand treatment capacity.
X
c) Increase federal substance abuse block
grant funding for addiction treatment in
order to expand treatment capacity.
X
d) Dedicate drug forfeiture funds to
expand treatment capacity.
e) Other:
V. Health Care and Substance Use Disorders
Untreated chronic illnesses, which include
substance use disorders, are shown to drive up
health care costs. Substance use disorders are a chronic, treatable
medical condition that
when left untreated result in other health conditions, including
liver and heart disease,
suicide, and other illnesses. Nonetheless, providers often fail
to detect and treat the
substance use disorder, the primary illness from which other maladies
arise. This is
because diagnosis and treatment of substance use disorders often
remain separate from
primary care and are not integrated and coordinated with other
medical care. Integration
and coordination of care will save money and result in better outcomes.
Indicate which principles you support (if any) concerning substance
use and health care
by placing a check mark next to the letter(s) which correspond
with your views.
X
a) Medicaid must be flexible
enough to finance those needed services for
Substance Use Disorders.
X
b) Treatment for substance use disorders
is critical to preventing and managing
chronic and other diseases and must therefore be addressed
specifically as part of
a broader effort around care coordination and integration.
c) Substance use conditions differ from
and are unrelated to other health
conditions; treatment for such conditions should remain separate
and distinct from
other health care services.
X
d) Implement policies that promote long-term
recovery from addiction as integral
to overall health and end the criminalization of addiction.
X
e) Ensure coverage for equitable and
effective addiction prevention, treatment and
recovery care in all public and private health plans.
(f) Other:
VI. Private Health Insurance for Alcohol
and Drug Addiction Treatment
The implementation of managed care has made
access to treatment more difficult for
privately insured persons with an addiction, as well as for privately
insured families
trying to secure access to care for their family members. With
treatment limits imposed
by managed care, many privately insured persons and family members
seek access to
6
publicly funded services as an alternative. This circumstance has
increased the burden to
federal, state and local governments by as much as 20 percent.
The private sector has
successfully shifted the burden of care to the public sector, exhausting
resources that
otherwise could have been spent on expanding treatment capacity.
Indicate which principles you support (if any) concerning expanding
private health
coverage for alcohol and drug addiction treatment by placing a
check mark next to the
letter(s) which correspond with your views.
X
a) Provide parity for alcohol
and drug addiction treatment in an insurance contract.
The contract must include both inpatient and outpatient treatment
at the same
level as for other medical services and provide that utilization
management in
health insurance contracts for addiction and mental health
services is no more
restrictive than utilization management for other health services.
X
b) As part of the federal substance abuse
block grant, require states to establish an
addiction treatment services ombudsman to assist consumers
of addiction
treatment services in navigating private health plans’ appeals
processes.
X
c) Require health insurance providers
to utilize a neutral assessment instrument
such as American Society of Addiction Medicine – Patient
Placement Criteria
(ASAM – PPC) or Addiction Severity Index (ASI) for addiction
treatment
determinations.
X
d) Provide that federal parity laws do
not preempt stronger state parity laws.
e) Other:
VII. Criminal Justice and Treating
the Addicted Offender
The link between substance use and criminal
activity is well documented. Approximately
80% of prisoners have extensive substance use histories. Many violated
drug or alcohol
laws were under the influence of drugs and/or alcohol at the time
they committed their
crimes, stole property to buy drugs, have a history of substance
use disorders, or share
some combination of these characteristics. The Bureau of Justice
Statistics survey
reported that 52% of female prisoners and 44% of male prisoners
met the criteria for
alcohol or drug dependence upon incarceration. Despite high levels
of substance use
disorders, relatively few prisoners receive drug treatment while
incarcerated.
Each year, approximately 650,000 prisoners are released from jail.
An estimated twothirds
of them are rearrested within three years. In contrast, within
three years of Drug
Court completion, only 15% of New Jersey’s Drug Court graduates
were rearrested.
The Second Chance Act prisoner reentry legislation is designed
to reduce recidivism by
coordinating reentry services and criminal justice policies at
the federal, state, and local
levels. The law, which Congress authorized but did not fund, will
help connect people
released from prison and jail to mentoring, mental health and substance
abuse treatment,
expand job training and placement services, and facilitate transitional
housing and case
management services. It authorizes a $55 million grant program
to state and local
governments to develop reentry initiatives and a $15 million mentoring
program for
community and faith-based organizations. Funding, however, has
not been provided to
enable community- and faith-based organizations to access these
grants and provide the
necessary services.
Indicate which principles you support (if any) concerning the criminal
justice system and
the treatment of the addicted offender by placing a check mark
next to the letter(s) which
correspond with your views.
X
a) Support mandatory minimum
sentences for drug offenses.
X
b) Increase federal funding for Drug
Courts to reach an estimated 1.47 million
nonviolent offenders in the American criminal justice system
who are in need of
this proven antidote to substance abuse and associated crime.
X
c) Given the success of drug courts in
the states, the federal government should
study how to modify its sentencing to incorporate elements
of the drug court
model and to assess the effectiveness of community-based alternatives
to
imprisonment for nonviolent federal drug felons.
d) Support legislation that puts an emphasis
on substance use treatment alternatives
instead of incarceration.
e) Allow first- and second-time, non-violent,
simple drug possession offenders the
opportunity to receive substance abuse treatment instead of
incarceration.
X
f) Establish treatment of criminal offenders
as a key part of the entire criminal
justice system that encompasses incarceration, probation and
parole.
X
g) Fund the Second Chance Act to ensure
that prisoners receive the substance use
treatment they need, as well as other services.
(h) Other:
VIII. Other
On an attached page, in a total of seventy-five (75) words or less,
please explain if you are elected any other legislative priorities
you will have pertaining to the prevention and treatment of, and
recovery from, alcohol and drug addiction.
National Council on Alcoholism and Drug Dependence - New Jersey
