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Drug addiction has been an ongoing crisis across the country for several years, but especially in New Hampshire, where drug abuse statistics have been on the rise since 2010. Drug abuse is prevalent across all socioeconomic groups, but many New Hampshire residents are unable to afford treatment. In order to address the issues New Hampshires residents are facing, New Hampshire must change aspects of its health care system, such as supplying more treatment centers that accept Medicaid, utilizing and encouraging harm reduction techniques, and providing treatment programs that help those struggling simultaneously with drug abuse and mental illness.
Despite what some think, its not just the availability of drugs that is causing New Hampshires crisis. Hannah Rowell-Jore, a recovery specialist at Granite Pathways says, homelessness and mental illness are the top two things that contribute to substance abuse. Compared with the general population, people addicted to drugs are roughly twice as likely to suffer from mood and anxiety disorders, with the reverse also true. (Patterson, 2018). To help treat addicts and to lower relapse statistics, New Hampshire should treat substance abuse and mental illness simultaneously. About two-thirds of people we see seeking treatment have a mental illness, says Rowell-Jore. The symptoms and issues related to one can worsen the issues of the other, (Important Statistics, 2019). Resources for those struggling with addiction and mental illness are scarce, especially for those with state-provided insurance. While several of New Hampshires treatment centers promote dual-diagnosis treatment, national average claims about 12 percent [of addicts] get the help they need for both disorders, (Important Statistics, 2019).
New Hampshires efforts to promote treatment are weak, with only two needle exchange centers in the state and low acceptance of Medicaid in treatment centers available in the state. New Hampshire finally legalized needle exchanges in June, long after many other states had done so, but did not fund them, (Seelye, 2018). Hannah Rowell-Jore says there is more that New Hampshire could be doing to promote recovery. When asked what could be done to help with this crisis she empathized on harm-reduction techniques, promoting Narcan, needle exchange centers, and providing fentanyl testing strips would all help with this crisis&Its a public health crisis and we need to take extreme measures.
Two needle exchange centers are currently up-and-running in New Hampshire, but New Hampshire faces issues finding appropriate locations and funding to open more, despite the states need for them. Dartmouth medical students, using donations and grants, opened the first needle exchange last summer in a Claremont, N.H., soup kitchen, but it was shut down in October because it was too close to a school. (Seelye, 2018). Project 439, the program that had opened the needle exchange center in Claremont, provided 1,690 clean needles and collected 329 dirty ones between July 1 and Sept. 30, (Doyle-Burr, 2017) before closing its doors in October. Since then, the project has continued to face resistance while searching for an appropriate location to house the needle exchange program. Several locations have already been deemed inappropriate, including two hospitals. Though city officials have said they want to find another location for the exchange, some in the recovery community are concerned that the stigma of drug addiction will make it difficult to find any acceptable location to provide this service, (Doyle-Burr, 2017).
Harm reduction techniques like needle exchange centers can help addicts who are not ready or unable to seek treatment. Needle exchange centers help keep the community clean of disease by taking in used needles and properly disposing of them. These centers provide clean, sterile needles and sharps containers in exchange , which helps lower risks of those with a substance abuse disorder of contracting a transmittable disease, like HIV, hepatitis A, hepatitis B, and hepatitis C. New Hampshire currently has two needle exchange centers, one in Nashua and one in Rochester. Other forms of harm reduction, like Narcan, drug-assisted treatment, and shooting galleries, -spaces in which an addict could use illegal drugs in a more controlled environment- are met with resistance from local and medical communities. It all comes back to stigma and any given communitys willingness (or lack thereof) to address the issues that its citizens are faced with, (Doyle-Burr, 2017). Some treatment programs promote abstinence only drug policies, and using medications such as methadone, suboxone, or Vivitrol to help maintain sobriety violates the recovery program policies. Hannah Rowell-Jore says drug-assisted sobriety is a valid treatment option. Methadone usually isnt used anymore, it has too many side effects. We go with suboxone or Vivitrol now. Also, marijuana is legitimately something that can be used for harm reduction, but it hasnt been legalized for medical use for opiate addiction yet, she says. New Hampshire has legalized marijuana for multiple medical conditions, but addictions is not listed in the medical conditions that qualify for legalized use.
The lack of harm reduction techniques is not New Hampshires only shortcoming in terms of treatment. Many of New Hampshires residents struggling with drug addiction are homeless or low-income. There are approximately 100,000 New Hampshire residents in need of substance abuse treatment. Only four percent of those looking for treatment receive assistance from the states publicly financed system. This leaves thousands of individuals left to find alternate ways to fund treatment, (New Hampshire Addiction Treatment, 2019). Even those who do qualify for programs like Medicaid have trouble receiving treatment. Medicaid supports four treatment centers but only one has a detox center. Private health insurance covers a lot more, says Rowell-Jore. A problem we run into is a lot of people looking for help have Medicaid, and theres a wait list for the centers that accept Medicaid. These people are homeless and a lot of them dont have phones. By the time a spot opens for them, we have no way to contact them.
New Hampshire has already started to experience the impacts that drug abuse can have on the community. Drug-related deaths have risen since 2010, from about 13 deaths per 100,000 residents to over 36 deaths per 100,000 residents. Drug abuse is associated with substantial increases in rates of violent crime, (How Does Drug Abuse Affect Society And You?, 2018). Additionally, in 2017 the states crime lab tested more than 830 meth-related arrests, compared to just 50 three years ago, (Sutherland, 2018). Drug-related crimes consist of up to 50% of prison populations, and annual costs averaged across 50 states for state prison populations is greater than $32,000 per inmate, (How Does Drug Abuse Affect Society And You?, 2018). Not only that, but drug addiction can cause increased rates of homelessness and poverty [and] substantial financial health care burden, (How Does Drug Abuse Affect Society And You?, 2018) to the community.
Drug abuse has a wide spread effect on the community. Not only do crime rates increase, but there is an influx in minors entering the foster care system due to parents drug use. Property values drop, and disease is more likely to spread due to unsanitary environments. These factors are costly to the community, tax money used to care for children, tax money used to clean communities, and over-taxed land.
While New Hampshire has started to make change, it needs to remind the community that drug addiction is an ongoing crisis that impacts the entire state. Educating the community and actively promoting treatment options would cause substantial improvement. Hannah Rowell-Jore says that publishing articles in local newspapers is not enough. Articles in the news barely touches the populations we work with. Word-of-mouth is most effective. Safe Stations, a program run by local fire departments and encourages addicts to seek help, has been a great first step in promoting treatment centers and in New Hampshire.
New Hampshire must also fine-tune its healthcare system to cater to all affected individuals. While not all harm reduction techniques will be accepted in the community focusing on how harm reduction techniques will improve the safety of those abusing drugs and help keep the community free of drug paraphernalia can entice the public to be more accepting of these techniques. By educating the community, it would help destigmatize addicts and encourage more people to seek treatment for substance abuse. Needle exchange centers can be daunting to the members of the community but are a good compromise to give New Hampshire time to address the lack of accessible treatment centers for under-insured addicts.
It doesnt stop there. Improving accessibility to treatment would be the next step New Hampshire could take to help improve the ongoing crisis. While Safe Stations is a great way to encourage treatment, it does not help addicts unable to afford private insurance or out-of-pocket treatment. How would New Hampshire make treatment more accessible? Make more treatment centers accept Medicaid, says Rowell-Jore. Promote Narcan use. And vote in representatives that care about the drug epidemic, she adds. Statistically, drug users will relapse multiple times before recovering. New Hampshire must prepare for the long road ahead by securing funding and resources to tackle the lasting effects of drug use on the community.
References
- Addiction Treatment Alternatives: The Way to Harm Reduction. (2019). Retrieved from https://www.dualdiagnosis.org/harm-reduction-guide/
- Doyle-Burr, N. (2017, November 11). Claremont Needle Exchange Program Searches for a New Home. Retrieved from https://www.vnews.com/Claremont-Officials-Seek-Legal-Exemption-to-Allow-Needle-Exchange-to-Relocate-to-Hospital-Near-School-13661092
- How Does Drug Abuse Affect Society And You? (2018, September 11). Retrieved from https://www.drugrehab.org/how-does-drug-abuse-affect-society-and-you/
- Important Statistics on Dual Diagnosis. (2019). Retrieved from https://www.dualdiagnosis.org/dual-diagnosis-treatment/important-statistics/
- NH.IAC@dos.nh.gov. (2018, June 31). [New Hampshire Drug Monitoring Initiative]. Unpublished raw data.
- Interview With Hannah Rowell-Jore [Personal interview]. (2019, February 21).
- Seelye, K. Q. (2018, January 21). How a ‘Perfect Storm’ in New Hampshire Has Fueled an Opioid Crisis. Retrieved from https://www.nytimes.com/2018/01/21/us/new-hampshire-opioids-epidemic.html
- Sutherland, P. (2018, February 6). Methamphetamines Are Back and On the Rise Across New Hampshire. Retrieved from https://www.nhpr.org/post/methamphetamines-are-back-and-rise-across-new-hampshire#stream/0
- Vivitrol Use in Drug Addiction Treatment. (2018, November 25). Retrieved from https://drugabuse.com/vivitrol/
- Wallstin, B. (2016, November 28). Drug Monitoring Program Records Significant Drop in Painkiller Prescriptions. Retrieved from https://www.nhpr.org/post/drug-monitoring-program-records-significant-drop-painkiller-prescriptions
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