The Hippo


May 31, 2020








A turning point?
Early signs suggest N.H. may be turning the tide in the addiction epidemic

By Ryan Lessard

 Though there is still work to be done, the state’s addiction treatment infrastructure is stronger now than it has been in decades, and projections show that overdose deaths for 2017 may be down from last year. 

New drug courts, which divert addicts from prison sentences to intensive treatment and case management, got up and running, and the state has been helping to fund them. Nashua and Manchester have successful Safe Station programs, where people seek treatment by presenting at local fire stations. And similar Regional Access Points have been set up in other parts of the state.
“All of that kind of capacity to solve that up-front problem is new this year,” said Tym Rourke, chairman of the governor’s commission on substance misuse.
There have been growing pains, to be sure. Hope for N.H. Recovery faced allegations of dysfunction and verbal abuse at some its facilities this summer. And just last week, Serenity Place, Manchester’s tip-of-the-spear outpatient treatment center (connected to Safe Station and Hillsborough County North Drug Court), was placed under receivership due to a $600,000 deficit.
But people are getting treatment. And there may be a sign that it’s making a difference in the death toll. 
Numbers from the state Medical Examiner’s office, up to Dec. 7, count 350 overdose deaths so far this year and a projected total of 466 deaths. If that projection is accurate, it will mean the first time in six years the number didn’t increase. The death toll from drug overdoses in 2016 was 485. In 2015, it was 439 — so it’s still a high number.
“Taking the long view, it’s not a lot to celebrate, because one death is too many,” Rourke said. “But … this is a public health crisis, and with any disease outbreak, what you want to look for is that sort of other side of the mountaintop and when that begins.”
It’s also possible that even if the numbers are down for 2017, they could climb again in 2018. We won’t know until the end of next year if this is the beginning of a positive trend. 
But Rourke said it’s encouraging that this year saw a potential decline in mortality even while the state was being inundated with unprecedented quantities of fentanyl and other highly potent drugs.
“One of the reasons why I think it’s so important to see that as a point of cautious optimism, is that … 2017 brought carfentanil to the state, and much more fentanyl,” Rourke said.
Carfentanil is 100 times more potent than fentanyl, which is itself 50 times more powerful than heroin. Carfentanil was originally formulated as an elephant tranquilizer. It was first documented in the state earlier this spring and there have been at least 12 deaths from the uber powerful drug, according to Kim Fallon at the ME’s office.
As of January, Manchester’s drug court was up and running at Hillsborough County Superior Court North. After several attempts to get one started in Manchester had failed, a 2016 bill establishing a statewide drug court system and funding mechanism made the difference. 
Participants agree to random drug testing, case management and regular check-ins at Serenity Place. If they miss any of their required tests or meetings, or if they use drugs, the drug court applies sanctions to shorten the leash with things like GPS devices or curfews or maybe brief jail stays for certain offenses.
The Queen City is the epicenter of the drug crisis by population count, so having a working drug court there is likely to make a big difference. Another drug court opened in Concord, for Merrimack County, in October.
Alex Casale, the statewide drug offender program coordinator, said there are now treatment providers set up in Coos and Carroll counties and he hopes they will begin drug courts there by February. After that, Sullivan County will be the only county without a drug court.
As of this month, New Hampshire has 290 individuals participating in drug courts statewide, Casale said.
Rourke said some important progress is being made in northernmost Coos County, with ongoing work to renovate and build new facilities at Friendship House in Bethlehem, the only residential treatment program in the North Country.
“The North Country is woefully under-resourced when it comes to addiction treatment services,” Rourke said. “The regions of the state that have the highest density of overdoses is the Manchester region and the North Country.”
Earlier this month, Hope on Haven Hill, a nonprofit treatment center for mothers of young children and pregnant women opened in Rochester.
Meanwhile, the state budget increased funding to the alcohol fund from 1.7 percent of gross liquor profits to 3.4 percent. While this effectively doubles the formula, it also keeps it fairly level to the previous fiscal year amount, which was buoyed by an injection of $2.5 million in emergency funding.
Still, the change in the formula is a significant step, Rourke said.
“That’s really the first time that there’s been that significant an increase in that fund formula, and it marks only the second time in the last 20 years I think that the legislature made those appropriations by following the formula,” Rourke said.
Recently, the state awarded a $500,000 grant to Harbor Homes to set up a subsidized housing program for people leaving treatment programs. The idea is to cover a person’s rent for a while so they can get on their feet.
“Treatment and recovery only work if you have a roof over your head and a job,” Rourke said.
Efforts to make sure community members have access to the anti-overdose drug naloxone have also ramped up. To date, the Department of Health and Human Services has distributed or shipped more than 13,140 naloxone kits throughout the state, according to a presentation DHHS made to the Executive Council earlier this month. It currently has about 2,000 in the warehouse. 

®2020 Hippo Press. site by wedu