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Holly Cekala, back right, director of recovery at Hope for New Hampshire Recovery in Manchester, watches as purple ribbons are made to give out at an opioid abuse recovery rally earlier this year. (Shawne Wickham/Sunday News)

Citizens of the Year: The advocates who have worked for solutions to state drug crisis


In 2015, the deadly opioid epidemic reached into every corner of New Hampshire, destroying families, straining public safety agencies and overwhelming treatment resources.

In response, parents and police officers, drug counselors and medical providers, policy makers and people in recovery, all came together in a common fight. It was an “all hands on deck” approach, and there are some signs that it's working.
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The New Hampshire Union Leader and Sunday News have chosen as the 2015 Citizens of the Year those working every day to solve this crisis: the advocates.

Holly Cekala is director of recovery support services at Hope for New Hampshire Recovery in Manchester, where she sees folks making a difference every day.
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“There are a lot of truly wonderful, motivated people that just want to help, and that's what I see here,” she said.

“I see parents that come and volunteer their time even after they've lost their own children, to help other parents save theirs. I see people in recovery giving back what was so freely given to them.
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“I see advocates fighting hard at the State House and testifying at special session hearings. I see officers reaching out to help people in communities. I see city councils coming together to try to find solutions for their communities.”
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“There's so many people that are working together,” Cekala said.

'Lived experience'

Tym Rourke, director of substance use grantmaking at New Hampshire Charitable Foundation, chairs the Governor's Commission on Alcohol and Drug Abuse Prevention, Intervention and Treatment.
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He calls 2015 “a watershed year.”

What's making a difference, he said, is how advocates who have worked on substance abuse issues for decades, such as New Futures, have been joined by those who have lost loved ones to overdose: “To have the voice of lived experience, the voice of families, come out in a way we've never seen before, and bring not only their anger and their grief but their belief ... that this is solvable, and a commitment to ensure that we move from a conversation around how bad the problem is to what are we doing about that.”
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From left: Tym Rourke, Susan Markievitz, Dr. Seddon Savage, and Eric Adams. 


Rourke said he's been struck by how the drug epidemic has become part of the presidential primary campaign. “That is entirely driven by the voices of families,” he said.

Families like the parents of Molly Parks, a 24-year-old woman who died in April at the Manchester pizza shop where she worked. In her obituary, they named what killed her: a fatal heroin overdose.
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“Along Molly's journey through life, she made a lot of bad decisions including experimenting with drugs,” her parents wrote in the obituary. “She fought her addiction to heroin for at least five years and had experienced a near fatal overdose before.
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“If you have any loved ones who are fighting addiction, Molly's family asks that you do everything possible to be supportive, and guide them to rehabilitation before it is too late.”

Other parents, too, have turned their unbearable grief into efforts to save others' children.
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Susan Markievitz of Windham lost her youngest son Chad to a drug overdose on July 28, 2014; he had just turned 25. She has become a familiar face at recovery rallies and support groups, where she tells her story, reading from Chad's journal about the demons he fought for so long.
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How did she find the strength to speak so publicly about such a terrible loss? “I think it was because I wasn't the only one struggling, and I knew that,” she said.

Last year, five or six classmates of her son also died from overdoses. She has another son who has also struggled with addiction but has been clean for two years.
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What keeps her going, Markievitz said, is trying to help other parents. “I have my meltdowns, of course, and I cry with other people that are struggling and who have lost their sons or daughters.

“To be honest, it's helped me get through the loss of my son.”
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She urges other grieving parents to find a support group. “I think so many doors are starting to open now for parents that they shouldn't hide.”

New Hampshire's leading medical expert on the opioid epidemic is Dr. Seddon Savage, director of the Dartmouth Center on Addiction Recovery and Education. She's organized conferences for medical professionals about stopping the overprescribing of opioids that led to the current epidemic, and treating those who have been its victims.
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Savage said she's encouraged by the progress she's seen this past year. “There is no way to take away the pain that people have suffered as a result of this. The loss of life, the people who fell to addiction, they are going to be dealing with it the rest of their lives,” she said.
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But, she said, “People are beginning to recognize addiction as a chronic disease and I think that's very, very important. It's not unlike diabetes and heart disease, in that people have biogenetic vulnerabilities, and lifestyle choices can contribute to the manifestations of the disease.”
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And, she said, “Recovery rates are very similar if people get treatment.”

Once substance use disorder is recognized as a medical condition, Savage said, the entire health care system can become engaged in assessment and treatment, not just addiction counselors or psychiatrists.
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One of the benefits Savage has seen out of the work advocates are doing is the reduction of the stigma that has accompanied substance use for so long. She recalled the powerful testimony of an addict's mother at one conference: “When my husband was hospitalized with cancer, the phone rang off the hook and the freezer filled with casseroles. When my son went to rehab, there was just silence in the house.”
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Alarming statistics

A recent report by the Centers for Disease Control and Prevention found New Hampshire had the third-highest rate of overdose deaths in the nation per capita in 2014. With 26 deaths per 100,000 population, New Hampshire was behind only West Virginia and New Mexico.
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The state Office of the Chief Medical Examiner projects the total number of deaths from drug overdoses in 2015 will surpass 400. In 2014, there were 326 overdose deaths.

But fatalities don't tell the whole story. According to the state Bureau of Emergency Medical Services, Narcan, the overdose reversal drug, was administered in 2,819 cases in the 12-month period between December, 2014 and this November. Without that antidote, the death toll here would have been much higher.
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Evolving police response

With Narcan in their ambulances and cruisers, EMTs and police officers are now on the front lines of the epidemic.

And one Laconia officer, Eric Adams, is helping to change how police in New Hampshire deal with addicts.
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Hired as his department's first Prevention, Enforcement and Treatment coordinator, Adams gets a call whenever there's an overdose in the city. He meets with victims and their families, giving them a card with links to treatment resources -- and his own cell phone number to call when they're ready to get help.
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In the past year, Adams has met with 88 clients. Fifty-six of them have been “receptive” to working with him, he said, and 41 are now in some form of treatment, such as residential, peer support or sober living houses.
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Adams takes calls from clients at all hours. He also hears from parents, desperate to get help for their addicted children. And more and more often, he's getting calls from other police departments in New Hampshire asking for advice on setting up similar programs.
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He's met with dozens of state troopers, police chiefs and others who want to adopt “a more balanced” approach to handling drug cases, he said.

When he goes to conferences these days, Adams said, “I'm seeing more police officers there. They're in the mix; they're rubbing elbows and they're talking with people in treatment, clinicians, learning more. And to me, that's amazing.”
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It's a sea change for law enforcement, but Adams believes it goes to the heart of their mission. “Police officers have that in them,” he said. “They do want to help.”

The future

New Hampshire is moving in the right direction, he said. “I'm excited to see where it'll be next year at this time,” he said. “I can only imagine, with all the stuff that we've accomplished this year alone in making it a safer place and to try and get rid of that stigma.”
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Savage agreed.

“We can't take away the past, unfortunately, and there's been too much loss,” she said. “But I'm very hopeful for our future.”

The state's response to this epidemic will have long-term benefits in tackling other problems related to substance use disorders, she said. “Once opioids hopefully have gotten under control, we'll still have alcohol,” she said. “We're going to have medical marijuana, and more and more people using marijuana recreationally as a result, in my view. And we're going to need to address those problems; they're not going to go away.
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“We don't know what the next great epidemic is going to be, but we are going to end up as a result of this crisis with a health care system more able to treat it,” she said. “We're going to end up with more specialty beds.
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“And I think everybody's going to realize that addiction is everybody's business.”

Cekala, too, is optimistic. Hope for New Hampshire Recovery is moving into larger quarters in the spring, providing opportunities for additional support services for those in recovery.
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“Every day we have a person walk through the door, that's a life saved,” Cekala said. “Treatment providers maybe see the devastation of addiction more often. But in our field, we get to see the beauty of recovery and the brilliance it brings out in people.”
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“We see people blossom.”
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