Search for drug abuse prevention continues
As the use, abuse and death rates relating to drugs like heroin gain greater concern throughout New England, states are enabling more life-saving strategies.
N.H. Chief Medical Examiner, Dr. Thomas Andrew, stated drug deaths in the state of N.H. had a 300 percent increase since he entered his position in 1997.
Andrew explained this dramatic increase occurred some time between 2001 and 2009. Andrew said, “We’ve continued to see increases in drug death. We had two-hundred drug deaths in 2011, and I think, in 2013, we had about one-hundred-and-ninety-five. The [prescription] opiates are still the leading class of drugs that are responsible for the drug death — but heroin, illicit street heroin — has emerged as the trend-setter now, instead of prescription drugs.”
Andrew said this activity is seen throughout N.H. but, “The biggest issue appears to be this band-like swath that goes from Keene, in the west, across the south central part of the state, to the seacoast area. That’s where most of the activity seems to be concentrated.”
Allie Norman / Equinox Staff: Statistics and information provided in the graphic above pertain to the state of Massachusetts and can be found on the website Mass.gov.
Andrew referenced various studies from the Center for Disease Control, which have published supporting statistics.
In regard to preventing heroin overdoses, John Finneran, a Keene State College Professor of health science and substance abuse, said, “About ten people in this country die every day of opiate overdoses, and every one of them is preventable — if you get naloxone,” Finneran said.
“Naloxone is opiate antagonist. It blocks receptors that heroin would attach too. Not only will it push off an opiate molecule, it will bind and prevent other opiate molecules from attaching,” Finneran said.
The state of N.H. does not yet provide first responders with naloxone, however, Dr. Andrew explained.
“That’s being partly debated here in New Hampshire. It appears on its surface that that’s a sensible thing to do. That’s the only known immediate antidote. If an EMS crew is at a scene and everything about that evidence suggests that this is an opiate overdose, that person won’t be able to get naloxone until they get to the emergency room and that might be too late,” he said.
Finneran explained, “Some places in Massachusetts are working with parent groups; parents whose children are still actively addicted.” Finneran continued, “If the son or daughter has an opiate overdose at home, a parent can intervene with the naloxone.”
In Mass., Governor Deval Patrick declared a Public Health Emergency on March 27, 2014, in response to the growing opioid epidemic.
According a press release from Patrick, “The use of oxycodone and other narcotic painkillers, often as a route to heroin addiction, has been on the rise for the last few years in Massachusetts. At least 140 people have died from suspected heroin overdoses in communities across the Commonwealth in the last several months, levels previously unseen. From 2000 to 2012, the number of unintentional opiate overdoses increased by 90 percent.”
Kerri A. Quintal, a Mass. attorney said, “Fire, police and health care providers [in Mass.] are being provided with naloxone.” Quintal also said she has recently seen more inquiries about Section 35, a legal option within Chapter 123 of the Mass. General Laws, which, “is used for individuals who are habitual substance abusers.” Quintal explained the action is often used when there is a safety concern for the habitual abusers and others around them.
Quintal said, “This option has been around for years, and it’s been used for people who have habitual drinking issues or drugs. I think we’re going to start seeing it more now with the heroin epidemic…I just think people are getting more educated, and because of the publicity of the heroin epidemic, I think it’s becoming more and more of an issue that folks explore.”
According to the official Health and Human Services site, Section 35, “permits the courts to involuntarily commit someone whose alcohol or drug use puts themselves or others at risk. Such a commitment can lead to an inpatient substance abuse treatment for a period of up to 90 days. Under the law, the person can be committed to a licensed treatment facility or, if none is available, to a separate unit at the correctional facility.”
Quintal noted, “A family member would go into the courts and say, ‘I am petitioning this court to pick up my son. My son is a chronic habitual heroin user, and I am afraid for his life.’”
The family member petitioning would fill out a detailed affidavit with evidence that the individual which they are concerned for is a substance abuse user, according to Quintal. If the judge agrees the affidavit and family member have provided the proper evidence, Quintal explained this petition made by the family member will last for only 24 hours.
If the individual being petitioned is not found in that time, the petitioning family member must re-petition. When the individual is found, he or she is interviewed by a doctor known as a forensic specialist. According to Quintal, the doctor will help to make the determination of whether the person meets the legal requirement of a substance abuser “who is chronic, or habitually consumes substance that interferes with their functioning.”
The individual is told by the doctor the information will not be confidential to the courts, according to Quintal. Mass.
Attorney Quintal added, “If the person does not wish to speak to the doctor, the doctor can only go by evidence provided by the information of the family and the affidavit that’s presented and how the person presents physically when making a determination.”
Quintal explained further, “The whole idea of this particular section of Section Thirty-five is that it’s an emergency. An emergency should mean act now.”
As the state of N.H. has used specialty drug courts to address substance abusers, Finneran noted his research of scientific literature and said he has noticed, “It [the use of drug courts and diversion programs] certainly keeps people away from prison…We know that the more exposure a person has with treatment, the greater the likelihood of the treatment-taking is, and that it’s helpful to adopt a long term perspective in the treatment of substance use disorders.”
Dr. Andrew explained, “I think that [the presence of drug courts in N.H.] is an interesting wrinkle, because it is very a different problem than other types of crime and interpersonal violence and that sort of thing, because it’s a behavioral issue. It’s a substance abuse sort of mental health type issue.”
Despite the strategies in place in N.H., Finneran said, “We [N.H.] need more treatment resources. I should think that we would need more detox beds. We need more halfway houses. We need more outpatient services. It’s not just the person with addictive disorders. For a lot of folks now that are in the chemical dependence or the addiction field, clients just don’t suffer from a substance abuse problem. They suffer from co-occurring substance abuse and mental illness. I think the treatment resources for mental illness are not great here in this state, and I don’t think the treatment services for folks with co-occurring disorders is that great.”
Andrew expressed a societal concern on drug use. Andrew said, “It’s pathetic that we have this attitude that shows this abuse is just kind of another recreational thing to do. That’s probably the hardest thing. You can pass laws, you can even establish treatment programs, but unless there’s some sort of societal compact, sort of line-in-the -sand that says we will not tolerate substance abuse, it’s always going be with us at one level or another.”
“There is a wealth of other ways to experience alternative ways of being and ways of feeling that don’t involve the use of chemical alteration of your brain chemistry,” Andrew stated.
Pamela Bump can be contacted at pbump@keene-equinox.com