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Opioid user numbers in NH are staggering

New Hampshire Sunday News

October 17. 2015 6:50PM
Laconia Police Officer Eric Adams, left, speaks with Leanna Kirk, a case manager with the Merrimack County Mental Health Court, at the New Hampshire Alcohol & Other Drug Service Providers Association "Modeling the Future" conference in Concord. Also in the conversation are Rick Cogswell from White Horse Addiction Center in Center Ossipee and Kieran Cunningham, a North Conway psychotherapist. (Shawne K. Wickham/Union Leader)

More than 13 million doses of Schedule II painkillers — the kind implicated in the opioid epidemic plaguing the state — were dispensed at New Hampshire pharmacies in just one three-month period this year.

The first data to come from the state's Prescription Drug Monitoring Program reveals that 108,398 patients filled 16,285,259 prescriptions for Schedule II medications in April, May and June.

And 80 percent of those prescriptions were for pain relievers, such as fentanyl, morphine and oxycodone.

Michelle Ricco Jonas, the PDMP manager, presented the data at the New Hampshire Alcohol & Other Drug Service Providers Association's annual conference in Concord last week.

Under New Hampshire's law, physicians, nurses, dentists, physician assistants, veterinarians and pharmacists are all required to register with the PDMP. But it's not mandatory here that they consult the database before prescribing a drug, as it is in some states, Ricco Jonas said.

She explained pharmacies have seven days to upload data about Schedule II, III and IV prescriptions they fill to the PDMP. And licensing boards can use the data to make sure their licensees are in compliance, she said.

Last week's providers conference, “Modeling the Future,” comes at a time when New Hampshire officials are considering emergency rules dictating how physicians prescribe opioids, which can lead to addiction and illegal drug use.

“It's not an easy job out there today,” Sandi Coyle, president of the board for the NH Providers Association, told her members.

“This is not just a heroin epidemic. This is an addiction epidemic,” she said.

Chief Leonard Campanello from the Gloucester Police Department gave a candid keynote talk about his department's innovative approach to drug addicts: getting them the help they need instead of arresting them. (Shawne K. Wickham/Union Leader)

Law talk

The group heard from an unlikely ally in the fight against addiction: law enforcement.

Keynote speaker Leonard Campanello, the police chief in Gloucester, Mass., gave a candid, impassioned talk about his department's innovative efforts to combat the drug problem in that city of 28,000.

After 26 years in law enforcement, Campanello has the tough demeanor of a veteran cop, but he speaks with the compassion of a caregiver.

When he talks with recovery groups, he said, the first thing he does is apologize: “If anybody was mistreated, or your family member was treated with less dignity, less respect and less compassion than you deserve, I'm sorry, on behalf of the law enforcement community.”

Laconia Police Officer Eric Adams gives a presentation at the New Hampshire Alcohol & Other Drug Service Providers Association's conference in Concord last week. (Shawne K. Wickham/Union Leader)

After four overdose deaths in his city in the first three months of this year, Campanello took to social media last March. “Personally as a dad, professionally as the police chief, it tends to make you angry,” he said.

He proposed three options for Gloucester residents. For those not affected by the drug epidemic, he urged, “Educate yourself that addiction in and of itself is not a crime; it's a disease.”

To drug dealers “seeking to profit off the misery of others,” he said, “we didn't want you on our streets.”

But for addicts, he offered help: “If you presented to the police department as an addicted person and you surrendered the remainder of your drugs ... and you asked for help, we refused to arrest you.”

“Instead, we will facilitate treatment for you.”

And in the four-and-a-half months since the program got under way, the Gloucester Initiative has helped 238 people get into treatment, the chief said.

The providers rose to their feet, applauding.

“More importantly, no one has been charged with a criminal offense, which further compounds their issues later on when they try to get a job, when they try to get an education, when they try to reintegrate into society with no opportunities because they have a criminal record,” Campanello went on.

In the first three months of the initiative, Gloucester saw a 23 percent drop in drug-related crimes such as theft, shoplifting and burglaries, compared with the same period last year, he said. “That's unheard-of for a program, so we know it works.”

It's also saving the city money. It costs about $220 to arrest someone and bring him to court, he said. “It has cost us an average of $55 per person to facilitate that same person into treatment.”

He estimates the city has spent $13,000 to help those 238 individuals. And none of it came from taxpayers.

Instead, he funds the program with assets seized from convicted drug dealers. “We could think of no better use ... to use at least a portion of those asset forfeitures for additional recovery, since it was literally coming out of the pockets of drug dealers ... who were profiting off the death and misery of other people,” he said.

Since the program began, the Gloucester Police Department has:

• recruited 50 “angel” volunteers from the community to support addicts who come to police for help;

• lined up 50 treatment centers in 19 states that will accept addicts who come to police for help; and

• offered to pay for Narcan, the overdose reversal drug, for anyone who needs it.

Campanello said he discovered that those with insurance could get Narcan for $3 a dose, but without insurance, it would cost you $140. “Which we found to be right up our alley,” he said, “because we felt it was criminal ... to be charging someone who we knew mostly couldn't afford $140 for what could potentially be a drug that saved their life.”

His department worked with retail pharmacy chains, which agreed to buy Narcan in bulk. That has lowered the price to $20 a dose.

And so far, no one has asked the police department to pay for it. “Everyone can afford $20,” he said.

The Gloucester initiative is being replicated in 30 other police departments to date, with 85 others lined up to come on board, the chief said.

Police were late in recognizing that addiction is a disease, not a crime, he said. But now, he promised, “The cavalry is here.”

The same sort of seismic shift is also beginning in New Hampshire.

Another presenter at last week's conference was Eric Adams, the Prevention, Enforcement and Treatment (PET) coordinator for Laconia police. A former undercover narcotics detective, he now helps those struggling with drug addiction in his city.

Adams meets with every overdose victim, gives them his cell phone number and asks them to call, any hour of the day or night, when they're ready for help.

What he's learned from experts like the providers in the room, he said, is that the 24-hour period after someone overdoses is “the most critical point, where that person is susceptible to getting help and treatment.”

A year into the program, 44 people have made that call and been referred for treatment. And while some have had a “reoccurrence” of their addiction — Adams doesn't call it a relapse — more than half are in active recovery.

This new approach is helping not only addicts, Adams said, but their loved ones, who are often the ones who find overdose victims.

“That is so traumatic,” he said. “I have rolled up on those scenes where the person is doing CPR on their own kid.”

Adams has conducted “sensitivity training” for his fellow Laconia officers, an effort that has earned him nicknames such as “Huggy Bear” and “Cuddles.”

And he has met with other police departments, including Wolfeboro and Concord. The program, he said, “can work for pretty much any agency, large or small.”

It's not about thinking outside the box, Campanello told the group. “We're going back inside our box to where we're supposed to be. We're supposed to be helping people.”

Now Campanello is calling on drug manufacturers to do their part, again using social media to gain public support for his efforts.

Among his “demands:” a “transparent and ethical approach to marketing their drugs,” and providing nasal Narcan with every opiate prescription.

But the “biggest ask,” he said, is this: “Take liability for every single person who suffers from addiction that can be proven to go back to a legally prescribed medication that they made.”

If they won't, Campanello said, he's willing to work with families to file class-action lawsuits against drug manufacturers.

“We want to say, ‘Yeah, you're the Exxon Valdez of this. You made a huge spill. You wrecked a lot of people's lives,” the chief said.

“Clean it up. We'll forgive you. Clean it up.”

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