PARAMUS, N.J. -- If you think most heroin users started by choice, you're in for a surprise, speakers at an anti-opioid Town Hall meeting at Bergen Community College in Paramus on Wednesday agreed.
If you think casual teenage drinking makes no difference in the long run, do some research -- beginning with material from the live-streamed "Knock Out Opioid Abuse" event, which drew more than 300 professionals and lay people from all walks of life.
Several myths were shattered at the gathering.
For instance: If you think most users are uneducated younger people who don't know any better, guess again.
"We see people with double degrees nowadays prostituting themselves on the streets," Bergen County Prosecutor Gurbir S. Grewal told the attendees.
"They didn't start by saying they wanted to go to Paterson to get beat up by drug dealers," he said. "It started with the pills."
"We have to erase the stigma that people are weak because they go on an opioid or they try to use a drug," said Tracy Parris-Benjamin of Horizon Blue Cross Blue Shield of NJ, which co-sponsored the event with the Partnership for a Drug-Free New Jersey.
Dr. Michael Kelly, chairman of the Department of Orthopaedic Surgery and Sports Medicine at Hackensack University Medical Center, recalled coaching girls softball in Franklin Lakes.
A player from that team recently died of an overdose at 22, he said.
Opioids simply are too quickly prescribed and too available, Kelly said.
A recent study of post-surgical patients found that 98.6% received opioids, he said. Their stashes -- what until recently had been legal 90-day doses -- could be shared with family or friends or be stolen, Kelly said.
"That's 90 pills that could be sitting somewhere for the next two years," Kelly told the gathering of health care professionals, law enforcement officers, elected officials and others, the fourth of 17 anti-opioid seminars held statewide.
HUMC intends to become a leader in "multi-modal pain management," which involves either little or no opioids or steroids, he said.
"Personalized management" of non-opioid, non-narcotic medications -- including acetaminophen, gabapentin and even ketamine -- can be extremely successful in treating pain without leading to addiction, Kelly said.
Timeworn warnings about the dangers of underage drinking and drug-taking missed a critical element, said Samantha Harries, director of the Center for Alcohol & Drug Resources: Meaningful statistics.
These have shown that "the earlier that alcohol or drugs are introduced to the brain, the more likelihood there is of addiction," she said.
For one thing, Harries said, "the brain doesn't stop developing until 26 or 27 [years old]."
For another, early substance use of whatever kind "decreases the perception of harm or risk."
"It used to be using alcohol when you were young was a rite of passage," Harries said. "But we now know the younger someone starts using the more likely it is to become a problem for them later on."
In fact, she said, the risk of someone over 12 years old who uses alcohol becoming hooked on heroin doubles -- and increases 15-fold if they're frequently using marijuana.
"Building self-esteem is not enough," Harries said. "There is no magic bullet that will stop it."
Education must begin in kindergarten, she said, where adults can teach young children about healthy decisions, identifying their feelings and, most of all, expressing them.
Grewal, the county prosecutor, has been an active proponent of the holistic approach.
A former federal prosecutor, he has united various disciplines to address the epidemic through programs that take law enforcement "out of our lane."
• A pilot program that allows users to walk into police stations one day per week to get the help they need. Right now, police in Lyndhurst, Paramus and Mahwah are operating the program;
• Pairing every surviving overdose victim with a "recovery specialist" who's been down the same road, provided by Paramus-based Children's Aid and Family Services;
• Following Bergen buyers to Paterson and elsewhere -- with the blessing of Grewal's Passaic County colleagues in blue -- then taking them into custody when they return and offering them treatment options, through "Operation Helping Hand."
After a recent "Helping Hand" roundup, 15 of 42 people arrested and brought to Grewal's office in Paramus agreed to accept intervention -- not in lieu of charges but to help them get their lives together.
Recovery specialists "stayed with" those who refused, eventually convincing 15 more to accept treatment.
Making it possible was Bergen Regional Medical Center's offer of however many of its 84 detox beds were needed, the prosecutor said.
"Some of [the users] relapsed, but that will happen," Grewal said. "We're going to stay with them."
Grewal has also gone into 50 ninth-grade classes and spoken to nearly 10,000 students about the perils of starting prescription pain medication at a young age -- including alerting them to their right to "informed consent," so that they can refuse such drugs no matter their age.
At the same time, law enforcement officers countywide have are making Narcan saves constantly. Grewal said there are also the countless saves by those users' family members and friends who have the anti-opioid medication on hand.
With Narcan saves in Bergen up -- to 102 from 84 at this time last year -- overdose deaths are down, Grewal said: There were 22 OD deaths in the county this year going into Wednesday's gathering at BCC, compared with 46 at this time in 2016.
Overdose deaths nationwide -- at a rate of nearly 100 per day -- are outpacing homicides throughout the U.S., the prosecutor said.
In Bergen County, he said, "there isn't a day that goes by without a Narcan save, a drug overdose or an arrest."
The holistic approach to the crisis allows law enforcement to "focus more on the distribution side of it," the prosecutor said.
Bergen County Executive Jim lauded Grewal for "his innovation and his openness with law enforcement to deal with this crisis. It's through the innovation, and through the dialog, that new ideas will spring."
And while the county-operated BRMC has made beds available, "what we need is help from the state level," the county executive said.
"I can't print money and I can't do magic," Tedesco said, "but I could use the help of many of you" to lobby state legislators for funding, he told the crowd. "Bergen County is really, willing and able -- if we can get more funding."
At the same time, Tedesco urged everyone in attendance to do what they can to help others in need.
"One person can make a difference," the county executive said.