TCNJ

30 The College of New Jersey Magazine THE NIGHT Jesse Dariano '18 spent in the storage shed was the last straw. It was March 12, 2005, his 21st birthday. He'd been using an escalating mix of opioids and other drugs since he was 14 — alcohol, marijuana, cocaine, Adderall, Vicodin, ecstasy, Percocet, OxyContin, heroin — and three months earlier, the depth of his addiction had gotten him kicked out of his parents' home. He spent his birthday with friends in Philadelphia, enjoying a long night of paid-for drinks and drugs at one nightclub after another. When they returned to New Jersey, Dariano expected to fall asleep on a friend's couch, but his friend had also been kicked out. addiction — the country treats addiction as a public health issue rather than a criminal issue — has upended conventional thought on treatment worldwide. The Portugal model, and its outcome, has informed Gibson's own perspective on addiction and treatment. In 2001, she says, Portugal had the highest rate of opioid abuse in Europe. That year, Portugal decriminalized the use of all drugs, even heroin and cocaine, and set out to tackle its addiction crisis using more carrot than stick. The new law made the purchase or possession of small quantities an administrative offense, akin to a traffic ticket. Portuguese citizens caught using drugs would be evaluated by a local Commission for the Dissuasion of Drug Addiction — regional panels consisting of health, legal, and social work professionals — and encouraged to seek treatment, though treatment would not be mandatory. If heroin users continued to use, the government would provide clean needles to prevent the spread of AIDS. The driving ethos behind the policy favored treatment over punishment, and the results have been dramatic reductions in overdoses, HIV infections, and drug-related crime, and an increase in the number of people being treated for addiction. Dariano tried his first opioid at the 1998 Creation Festival, a three-day musical gathering that he calls "the Christian Woodstock." He was there with a youth group from his church. A friend who had some teeth pulled offered him a Percocet, a prescription painkiller. "What does it do?" Dariano asked. "It makes you feel good," his friend said. "OK," Dariano says now, recalling the exchange, "that's all I needed." Collectively, Gibson and her five colleagues in the counselor education program spend a month each July in Lisbon, Portugal's capital, teaching two courses, three credits each. The trip represents the hands-on portion of Gibson's course, Addiction: Individuals, Families, and Society, for which graduate students earn credits toward their certification as alcohol and drug counselors. The students tour SICAD, the government agency that UNDER THE PORTUGAL MODEL, GIBSON SAYS, DARIANO COULD HAVE BEGUN TREATMENT IMMEDIATELY. AND HIS DISCHARGE DATE WOULD HAVE BEEN DETERMINED NOT BY AN INSURANCE COMPANY, BUT BY HIS MEDICAL NEEDS. So the two of them sought shelter in the small wooden shed behind his friend's house. A layer of snow covered the grass outside, and a late-winter chill embraced the shed in an icy grip. Dariano was not wearing a winter coat, just a thin sweatshirt. He had never shivered so violently. Even in his stupor, the shame of the experience resonated. He promised himself that if he made it through the night, he would find his way home. The following day found Dariano at his parents' door. They said he could return home as long as he got help. He wasn't convinced he had a problem — it was just a stretch of bad luck, he told himself, that had rendered him homeless — but he yearned to sleep in his own bed again. So he agreed. No doubt the deadly scourge of opioid abuse across New Jersey and around the globe has yielded countless stories like Dariano's. According to the Centers for Disease Control and Prevention, of the 63,600 drug overdose deaths in the United States in 2016, opioids were involved in more than 42,000, the highest yearly total ever recorded. That was more deaths than caused by guns, more than by traffic accidents, and more than by suicide. Statistically speaking, by the time you finish reading this story, another American will die from an opioid overdose. Perhaps no one at TCNJ has tracked the opioid epidemic as closely as Sandy Gibson, a professor in the graduate-level counselor education program. Gibson has worked in the field of drug addiction and treatment for 25 years. Each summer she takes a dozen students to Portugal, where a radical approach to drug

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