Elnahal on the opioid crisis

Dr. Shereef Elnahal was confirmed as the new state Department of Health commissioner Monday in a unanimous vote by the full state Senate.

Elnahal will be the youngest commissioner ever at the DOH, at age 32. The Linden native, whose parents emigrated from Egypt and opened practices in Atlantic County, comes with an impressive resume.

A dual-degree graduate of Harvard, resident at Johns Hopkins, White House fellow and high-level U.S. Department of Veterans Affairs employee, Elnahal comes to the state with a unique perspective on some of the most pressing issues.

He spoke with ROI-NJ about his new role in Gov. Phil Murphy’s cabinet (read the full Q&A here).

Here are his thoughts on the opioid crisis:

ROI-NJ: What’s your plan to battle the opioid epidemic?

Shereef Elnahal: Imagine a person going through the journey of their first exposure to becoming addicted, getting treatment, overdosing, going through the cycle of overdose relapse and treatment relapse and dying of an overdose. Each of those, I think of as a milestone.

How do you improve the social environment and the mental and emotional well-being of people so they don’t have to resort to drugs to be happy? So that’s the first step, prevention. If you do need an opioid, what else are we giving you? If you do become addicted, how do we get you medicated-assisted treatment to avoid overdose? You’ll see within each category targeted things you can do to prevent someone from crossing that next milestone.

We are looking at it in terms of overdose deaths. We have a map here that didn’t exist until my team built it for me. We took, I think it was The Star-Ledger story of deaths county-by-county. So, we have high opioid deaths in Ocean County, Middlesex County, Essex County and Atlantic County. You can create maps like this for each of those milestones, where you see the hotspots of overprescription, where you’re seeing underutilization of medication-assisted treatment, where you have facilities that aren’t using Vivitrol and other methods of treatment. You can create heat maps likes this to not only determine what you’re doing, but where you should do it. This goes to the limitation of resources.

The governor allocated $100 million to opioids. We are also hopefully going to get, I was just at (Capitol) Hill advocating for this next funding bill, I’m hearing anywhere between $3 billion and $10 billion for the country. And, so, hopefully, we would get a piece of that.

If you have a comprehensive public health approach that’s thoughtful and isn’t just spending money on advertising necessarily that doesn’t get you anywhere, that gets you progress.

ROI: Speaking of, there were some interesting moves made by Gov. Chris Christie’s administration in its last year that some have said were too piecemeal to address the issue. How many of those are problematic and might you reverse, and how many are beneficial and will you expand?

SE: Don’t get me wrong, awareness is important. It’s an important part of the prevention and treatment missions. People who are addicted could see the right message that inspires them. I think the way it was done was probably not the best use of resources. I think this is such an important issue that is impacting people across socioeconomic and racial lines. We’re going to have to do something. The urgency around this, it’s a new administration, I don’t see many barriers to us getting started. And, again, a good chunk of that will be awareness and preventions, but it’s going to be a lot more than that.

ROI: So, will you be launching your own ad campaign?

SE: As a state government, we are going to have to do that. There is no question. And how that looks, whether we use things like social media much more than TV commercials — those details are to be worked out. There are other commissioners who have an important stake in this — human services, children and families, the attorney general. So, it’s got to be a statewide effort, it’s not just the Department of Health. I think a public health approach is the right one. The governor has prioritized this and given $100 million (in his budget proposal). So, we are really excited to make some progress and really start to get at this epidemic.