WASHINGTON — To fulfill his audacious pledge to end America’s opioid crisis, President Trump is turning to Chris Christie.
The New Jersey governor, who is leading Trump’s commission to tackle the problem nationwide, has seen the worst of the crisis in his state. Nearly 1,500 people died from overdoses in New Jersey in 2015, as the state saw one of the biggest spikes in deaths of any state in the nation.
Christie has been lauded for his heartfelt response to addiction issues and his commitment to treating drug abuse as a public health problem. The crisis was a plank of his failed bid for Republican presidential nomination, and he devoted his last State of the State speech in January to the issue.
“Our friends are dying,” Christie said in that address. “Our neighbors are dying. Our coworkers are dying. Our children are dying, every day, in numbers we can no longer afford to ignore.”
His agenda, however, has not been without controversy, with some critics arguing he has used blunt-instrument policies to address nuanced problems.
The commission is Trump’s first major move on opioids since he became president. He has otherwise left key administration posts that would work on the crisis unfilled, and his proposed budget would slash funding for the agencies that oversee those efforts.
Advocates welcomed the appointment of Christie, who has cited the overdose death of an old friend in explaining his outlook on the issue.
“He has been at the forefront, he has signed legislation, he has put it at the center of the agenda,” said Andrew Kessler, a consultant who focuses on addiction. “He’s been one of the best.”
Here’s what you should know about Christie’s record on opioids.
Cracking down on prescription painkillers
Some of Christie’s most ambitious and controversial policies have sought to limit access to prescription painkillers.
Last month, he signed a bill that limits painkiller prescriptions for acute pain — like pain experienced after surgery or dental work — to just five days at first, as opposed to the usual 30. It is perhaps the most restrictive law in the country, though some other states have winnowed the length of those initial prescriptions to seven days.
Christie portrayed it as an aggressive step to stem the black market for opioids. Lengthy prescriptions, the governor said, are “dangerous, ill-advised, and absolutely unnecessary. We know addiction to opioids can occur within days.”
But the bill faced some backlash from doctors, who said it interfered with their ability to care for their patients.
“This is a legal medication,” said Mishael Azam, a top official at the leading New Jersey doctors association. “The people who need it and use it legitimately — it is not fair to cut them off.”
The governor has also explored having New Jersey’s prescription-monitoring program coordinate with New York’s, again in an attempt to stop opioids from being diverted from their prescribed use. Christie also signed a bill in 2015 to expand the state’s program that allows people to drop off their unused medications.
Expanding insurance coverage and treatment options
First and foremost, Christie expanded Medicaid under the Affordable Care Act. That extended health coverage to half a million low-income New Jerseyans. Christie, one of several Republican governors who bucked his party and accepted the law’s expansion, has directly connected that decision to the opioid crisis.
“Through our efforts over the last three years, we have eliminated many of the barriers for the poor to receive treatment as well,” he said in his State of the State speech earlier this year. “When I expanded Medicaid eligibility … it created a sea change in the availability of drug treatment for the poor in New Jersey.”
Christie also approved new rules for private health insurance in New Jersey, requiring plans to provide up to six months of inpatient and outpatient addiction treatment and prohibiting requirements for prior authorization.
New Jersey has had some trouble making treatment available, however. A 2013 report found that the state had about 6,000 beds available for inpatient treatment, while more than 70,000 people were expected to seek either inpatient or outpatient treatment that year.
More recently, Christie signed legislation to expand access to overdose medications to emergency responders and non-professionals, and his office has also set up a hotline for people seeking treatment.
Overhauling the criminal justice approach to addiction
Christie, a former prosecutor, said in 2014 that the so-called war on drugs had failed. Much of his work has also focused on the criminal justice side of the opioid crisis.
As governor, he has pushed for the expanded use of drug courts, which direct nonviolent offenders to addiction treatment instead of prison. He has also sought to encourage businesses to hire people in recovery, while, at the same time, upping the criminal penalties for the production of illicit versions of powerful opioids like fentanyl.
Most controversial, however, was his opposition to a bill to provide some criminal immunity for people who have overdosed and for witnesses to an overdose who call for medical help. The bill’s supporters said it would encourage people to seek aid when an overdose occurred, by removing their fear of prosecution.
Christie, however, vetoed the initial version of the bill in late 2012. He argued that it did not account for the need to deter more widespread drug abuse and asked for an 18-month study of the concept.
The governor and the state Legislature reached a compromise the next year, after some minor adjustments were made, and Christie signed a bill granting such limited immunity.