Shereef Elnahal was nominated in January 2018 to serve in the Cabinet of New Jersey GovernorPhil Murphy. He was approved by the New Jersey Senate on March 8, 2018 and sworn in April 2, 2018. He is the first Muslim-American to serve in the cabinet. He will resign July 1, 2019 to become president/CEO of University Hospital in Newark. In order address the opioid epidemic, Elnahal's efforts included expansion of syringe access and harm reduction, new funding to connect substance use disorder providers to electronic health records and a statewide health information exchange, and reducing regulatory barriers to medication-assisted treatment for addiction treatment. On June 24, 2019, Dr. Elnahal authorized NJ's paramedics to administer buprenorphine in the field after naloxone administration at the time of overdose. Although buprenorphine use for withdrawal management is technically off-label, the rationale is to manage a patient's withdrawal symptoms and cravings immediately after revival, in order to encourage more to accept transport to the emergency room for further care. NJ is the first state in the nation to take this step, and received national attention for doing so. Soon after his election, Governor Murphy restored state funding to family planning agencies in New Jersey, which were line-item vetoed by Governor Chris Christie, Murphy's predecessor, for seven straight annual budgets. Under Commissioner Elnahal, the Department then disbursed these funds in grants that resulted in 10,000 more women served, 80,000 additional STD tests administered, and many additional clinic hours and staff. Elnahal has also collaborated with NJ First Lady Tammy Murphy on maternal and infant health initiatives, including her Nurture NJ. Dr. Elnahal also expanded provider participation in the NJ Health Information Network, a statewide health information exchange. Over 60 hospitals, three federally qualified health centers, and 6,000 physicians joined this network since the Murphy administration began, tying important sources of hospital funding like charity care to requirements to join the program. During Elnahal's tenure, the Department of Health significantly expanded New Jersey's medical marijuana program, more than doubling the number of dispensaries and number of patients served, and expanding the number of physicians in the program.