A Deeper Reflection on Governor Christie’s Drug Policies

On January 10, 2017, Governor Chris Christie uttered his seventh and final state of the state address at the statehouse in Trenton. In the early years of his administration when the Governor was popular and strutted across the national stage, seats at these speeches were extremely difficult to come by. On January 6th, Christie’s staff was still sending out email invitations in order to fill up the room (I declined)

The Governor’s approval ratings hover in the teens, and politics clearly mirrors life in this simple fact: people don’t show up to unpopular peoples’ parties (unless the food is really good).

Mr. Christie is a historically unpopular politician who is serving out his last year in office. NJ is facing a cascade of economic problems: slower job recovery than the rest of the region, declining home sales, high property taxes, crumbling infrastructure, companies moving out of state, and one of the worst cases in the country of underfunded pension obligations. Despite statements to the contrary, the Governor has been unable (or unwilling) to address those aforementioned issues (he has also overseen a record number of state credit downgrades), and they will be passed on to the next person who takes over in January of 2018.

These difficult economic issues and his resounding unpopularity may have influenced the focus of this year’s state of the state address. The Governor fell back upon a topic that he has forcefully and eloquently talked about for years: drug addiction. He spent over 2/3 of his speech discussing policies and programs around addiction and recovery (this was not historic – the Governor of Vermont devoted his entire State of the State to addiction in 2014). This is a subject that has bi-partisan support and one that can still get him positive media coverage. The day after his speech, a member of his staff sent out a self-congratulating email with links to glowing coverage from the area papers as well as the Governor’s appearance on “Fox and Friends” that morning.

To the average citizen with a cursory understanding of addiction and recovery, it appeared that Mr. Christie is a visionary with several incredible and well-meaning policy proposals. Advocates, those deeply ensconced in substance misuse policy, and other politicians know the real story, and we’ve been sharing it with various media outlets over the last three weeks.

Some of my friends and colleagues have asked me why I have been so critical of the Governor when he is finally focusing more attention on this issue. Two analogies: (1) You work very hard at a job. You put in long hours. It’s clear that you are vital to the organization. Other people of less skill and work get raises. After seven years, you finally get a 3% raise. While you are happy for the money, you think, “Why did it take so long and why so little?” (2) You do a majority of the housework in your home (more than your spouse/kid/parent/sibling). After three years, your spouse/sibling takes out the garbage and cleans the kitchen sink. Once. How much praise do you give them?

During his speech, Governor Christie announced or asked for the following:

  • That he wants a bill from the legislature that mandates insurance coverage of inpatient treatment for six months. Senator Joe Vitale introduced a bill that would cover three months last September. Six months is unlikely to pass and even if it does, would be subject to a massive pushback on the state and national level by insurance companies. The Governor did not address whether or not this would apply to people on Medicaid or those without private insurance. If it did apply, it is something that the state could not currently afford.
  • He announced a one-stop number for people to call about treatment – 1-844-REACH-NJ. This is redundant. On July 1, 2015, the state created and funded the NJ Addiction Hotline. That number is 1-844-276-2777. Either Governor Christie is creating a redundant program or is changing the number in order to get some press for a program that has been around for 18 months.
  • He ordered the creation of a curriculum on opioids and other prescription drugs for school children of all ages. The NJ Heroin and Opiate Task Force suggested this in its report back in 2014, and the NJ legislature has tried to pass legislation regarding this for the last few sessions.
  • He talked about Narcan saves, but he did not say that he would ensure that first responders received the additional funding required in order to have Narcan. Gov. Christie was slow to support Narcan, and its presence, use and expansion in this state is largely due to the front line work of advocates like Patty DiRenzo and Paul Ressler, both of whom last their sons to this epidemic.
  • Christie said he would instruct his Attorney General to limit initial opiate prescriptions to 5 days. Seven day limits have passed in NY and Massachusetts in the last couple of years. This is a sound policy and a major departure from the Governor’s lack of motivation of regulating doctors (he refused to mandate the Prescription Drug Monitoring Program, require medical providers to be trained on addiction, or require doctors to warn parents of those under 18 about the dangers of opiate painkillers when prescribing them).
  • The Governor did not discuss needle exchange programs, the NJ Recovery High School in Union, the importance of medication assisted therapies (and much needed regulation that would require them to be accompanied by urine screens and counseling), or the various programs that police are trying to utilize to address what happens after an overdosed person is revived.
  • A few days later, Governor Christie announced the creation of yet another Task Force to study the problem. He largely ignored the report of the first Task Force (which I chaired in 2012). The co-chairs of the second Task Force were at the statehouse for his speech. Advocates, policy advisors and politicians have made the issues very clear. There are many other states that have implemented good programs and strong regulations. It is hard to fathom why we need a third Task Force.
  • Perhaps most significantly, he has not commented at all on President Trump’s plan to repeal the Affordable Care Act and gut the Medicaid expansion. Thousands of New Jersey citizens were able to get access to treatment with that expansion, and many in the future will be cut off. Despite his big talk about wanting to address this issue in a bi-partisan way, the Governor has shown himself loathe to criticize the President. That isn’t leadership. Breaking with Trump and stating the very obvious fact that Medicaid expansion helped treat thousands of people (and saved a lot more money in the criminal justice system and health care) would be leadership.

Within the first year of taking office, Governor Christie supported expanding drug courts as an alternative to incarceration (which is costly and largely ineffective in addressing addiction). I was excited to hear him talk, and I believed that a Republican Governor who had been a US Attorney had a much more real shot at meaningful criminal justice reform and overhauling the treatment industry than a Democrat (who would be accused of being soft on crime, wasting tax dollars, and suffering from a bleeding heart). Despite talking about expanding drug courts, he didn’t significantly increase their funding. This is a pattern he has oft-repeated over the last 7 years. Mr. Christie is quick to talk about new laws, effective programs, tougher regulations and increased funding, but when it comes time to sign the dotted line, he hems, haws, delays and under-delivers. But by that time he has already basked in the sunlight of media attention and public adoration, and the citizens of NJ are either too busy or too apathetic to notice that he has accomplished very little.