Fentanyl Crisis in New Hampshire
From big pharmaceutical corporations to the streets- the time for blame is over. More than 400 people every year die of a drug overdose in New Hampshire. The overdose decline is slow and arduous despite statewide efforts.
This opioid epidemic was labeled by the Council on Foreign Relations as one of the nation’s “worst-ever drug crises” and “beyond the risks it poses to public health, it is becoming a drag on the economy and a threat to national security.” Heroine negatively affects the nervous system, digestive system, respiratory system and cardiovascular system and many possible complications lead to death.
The human brain has receptors perfectly fitted to react with opioids. Brain cells affected by opioids could become damaged and stop producing serotonin, the “happy chemical.” According to the American Addiction Center, “Those cells may be unable to produce chemical signals of pleasure in the absence of heroin, and they may call out for a heroin correction. That’s the seed of addiction, and it can be planted with just one hit of heroin.”
Life without opioids, like heroin and fentanyl, becomes difficult once addiction paths are set in the brain. Withdrawal symptoms usually occur 12 to 30 hours after the last dose. The FDA reports the following symptoms as complications of opioid withdrawal syndrome: Anxiety, pain in joints and muscles, elevated heart rate, increased respiratory rate and insomnia.
Opioid withdrawal is known to be very painful and many would rather dose again than detox cold-turkey. Medical Assisted Treatment, MAT, is one way addicts can slowly taper off opioids in a safe and controlled manner with their physician. With proper care and lifelong treatment, people can overcome opioid addiction and live a fulfilling life.
In 2016, the Center for Behavioral Health Statistics and Quality released data showing the demographics of opioid addicts. Opioid addiction affected anyone from age 12 to 65 and older. Male and females are affected almost equally. Young, white males ages 26–35 are the biggest category of users however, opioid addiction can happen to anyone.
Everyone knows everyone here. New Hampshire is stitched together from rural towns, sprawling green landscapes, charming cities with broken infrastructure and 29 Market Baskets to date. That ‘drug addict’ is now an old co-worker, a friend, a sister or son. Everyone knows someone affected by the opioid crisis here, regardless of age. As a New Hampshire citizen, born and raised, I feel I have the authority to say- We are not a drug-infested den. We are New Hampshire and we want our state back.
As reported by National Capital Poison Center, the first wave of opioids in the United States, hit in 1991 when opioid-related deaths spiked in correlation to a sharp increase in opioid prescriptions. Pharmaceutical companies pushed opioids for non-cancer related pains and reassuring medical professionals that the risk for prescription opioid addiction was low.
According to the American Addiction Center people with an addiction to prescription opioids, like oxycodone, Vicodin, codeine or morphine, are 40 times more likely to abuse heroin.
National Capital Poison Center records 86 percent of patients using opioids by 1999, were using them for non-cancer related pains. In communities where opioid prescribing was highest, opioid abuse settled there first in the form of diversion (where prescribed opioid users switch to illegal means of obtaining opioids).
In 2010, early efforts to cut back on over-prescribing of opioids began and a mass diversion from prescription to illegal opioids occurred because regular addicts were now unable to get their opioids from medical personnel. Research from the National Capital Poison Center says that “heroin-related overdose increased by 286 percent from 2002 to 2013, and approximately 80 percent of heroin users admitted to misusing prescription opioids before turning to heroin.”
In 2013, more synthetic drugs became available and lead to a major increase of opioid-related deaths. Synthetic drugs, most common in NH is fentanyl, were directly linked to the spike of deaths. Fentanyl is “cheaper and up to fifty times more potent than heroin” and more lethal according to the Council on Foreign Relations. Some Law enforcement agents refer to the drug as “manufactured death” because it is so incredibly easy to overdose.
Toxicology reports from the NH Attorney General found, in 2018, fentanyl-only related deaths totaled 192 and fentanyl and other drugs (excluding heroin) totaled 171. These numbers would indicate that there were 363 Fentanyl- related deaths in 2018. New Hampshire Heroin-related deaths in 2018 totaled 4. New Hampshire doesn’t have a heroin problem. Fentanyl is the newest killer on the streets.
As stated by the Council on Foreign Relations, the opioid crisis has been “a drag on the economy.” the Since 1999, the young American workforce has dropped 20 to 25 percent and research explains this to be directly related to the opioid crisis affecting that group the most.
An Ohio boiler company came forward and admitted that nearly 25 percent of their job applicants fail their drug tests. This manpower shortage causes a loss of roughly $800,000 a year in orders that go to foreign competitors instead. The American Addiction Center had a study showing “Drug abuse and addiction cost American society more than $740 billion annually in lost workplace productivity, healthcare expenses, and crime-related costs.”
The growing rate of economic inequality, a new study has found to be a serious cause of opioid related deaths in communities like New Hampshire. Higher drug-related deaths were found around urban areas like New Hampshire’s small cities of Manchester, Nashua and Laconia. Rural areas where citizens have to rely on poorly paid service jobs had higher drug-related deaths. The higher the economic anxiety in these rural areas, like Northern New Hampshire which has seen a shrinking logging industry, the drug deaths are proportional.
Many drug addicts lack insurance and have a hard time getting into treatment facilities in New Hampshire. New Hampshire hospitals have shown signs of understaffing in key areas like mental health.
Hospitals aid drug users during acute treatment of complications from opioid use such as overdose or infections. Treatment after the initial Emergency Room visit may be up to the patient to continue looking for addiction treatment at outpatient services.
Ryan Thomas, R.N. said “We can you give them numbers and locations of rehabilitation centers and support centers. We also give them information on addiction to try to help out as best as we can… But we can only [treat] in the acute phase, they have to continue getting help afterwards.” At Parkland Medical Center in Derry, New Hampshire nurses are expected to check personal belongings of friends and family visiting someone in the hospital. People frequently bring in street drugs and other paraphernalia, “it’s just you’re using while you’re in the hospital and that puts everybody at risk.”
Anecdotally, I have heard stories from medical staff further north in New Hampshire and their understaffing and opioid problems have become dire. Some recovery facilities, like this one in Franklin, were at risk of closing due to a “lack of demand”. According to Dartmouth School of Medicine, New Hampshire has one of the lowest per capita spending on drug treatment and many have simply given up on finding treatment due to so many obstacles.
To hear more, listen to the podcast episode where I interviewed Thomas about his experiences in a Southern NH hospital and what he sees day to day.
In February 2017, Rochester woman Sarah Brooks took a lethal dose of fentanyl provided to her by drug dealer Joshua Naples. Nikole Coe was arrested and charged with Brooks death for allegedly setting up the transaction, and was facing life in prison.
On April 3, 2018, Coe was found unresponsive and it was later concluded that she died of a fentanyl overdose. Kerri Guay, originally arrested on unrelated charges, was found to have provided Coe with the lethal dose that killed her. Guay could spend 10 to 20 years in prison for this charge. Guay was able to sneak in drugs because she was pregnant at the time and able to bypass the x-ray exam because of possible negative effects to a fetus.
Coe’s family showed up in court in January 2019, to ask the judge to show leniency for Guay. “Throwing somebody away for 10 or 20 years does not solve the problem,” said her father, Robert Coe. “I’m sorry, but it’s the stupidest idea they came up with. These people should be in treatment getting help.
The NH LASER docket is a treatment opportunity for addicts going to prison on drug-related charges of some kind. The docket allows these individuals a lighter sentence and addiction treatment from the state. Unfortunately only a small percentage of defendants are allowed to join LASER docket. Some admission requirements require no record of violent crime and no record of past treatments. These requirements limit the amount of people accepted into the program each year.
A study back in 2007, showed that former prisoners were 3.5 times more likely to die from an overdose than the average citizens over a period of about 2 years. The first 2 weeks after release, the former inmate is 12.7 times more likely to OD than other citizens. This research was conducted in Washington State before street Fentanyl exploded.
As of March 21, 2019 New Hampshire has been granted an additional $12 million towards fighting the opioid crisis in the state. This grant will go towards a new 24/7 drug-treatment coalition called the Doorways Program. This is an incredible resource for information regarding treatment centers, prevention, recovery and general questions and help.
The New Hampshire ‘Good Samaritan Law’, passed in 2015, allows people to call 911 without being charged for possession of a controlled drug at the scene. Meaning, if you or someone near you is suffering from an overdose or other drug-related complications, calling an ambulance does not put you or them at risk of being arrested for possession. As research provided by New Futures states, make sure people continue to expand medicare so that the 52,000 or so individuals under care of Medicare in NH can remain insured.
New Hampshire has several clean syringe programs which help to keep possibly infectious needles out of parks and public spaces. These programs ensure that needles are properly disposed of to cut down on risk of infections like HIV.
According to the National Paralegal College, NPC, pharmaceutical companies lack meaningful self-regulation. The regulations concerning marketing and other distribution practices are “silent” or absent. What is not explicitly prohibited is permitted.
Nationally, New Hampshire ranks at the bottom for availability at treatment programs and centers. Research conducted at Dartmouth Medical Center shows that northeast states have an average of 15.5 doctors per 100,000 residents who can prescribe medication-assisted treatments for addiction, New Hampshire has seven. This treatment helps recovering addicts live a fulfilling life while managing to wean off of opioids. There is a need to expand these Medical Assisted Treatment Programs in the state.
NH lacks a robust number of needle-exchange programs.NH, despite one of the highest opioid struggles in the nation, has one of the lowest per capita spending reports for drug treatment. Continuing the spread of naxolone, common name ‘narcan’, and educate people on the use of it. Learn how to properly administer naloxone or narcan nasal spray. It is the simplest thing you could learn to give a life another chance.
Fentanyl Crisis in New Hampshire
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