Pubdate: Sun, 11 Jan 2015
Source: Eagle-Tribune, The (MA)
Copyright: 2015 The Eagle-Tribune
Author: James Niedzinski


As one Newton mother found out, a big part of battling addiction is
finding help.

Deaths tied to heroin and opiate use are on the rise in New Hampshire,
but treatment options are limited.

In 2014, at least 213 New Hampshire deaths were drug-related,
according to Kim Fallon, the chief medical investigator for the Office
of the Chief Medical Examiner.

A number of cases are still pending, she said, so that number could

Of those 213 deaths, 53 were from the pain medication fentanyl, 33
were from heroin, 20 involved both heroin and fentanyl, 102 had
fentanyl as a contributing drug and 82 had heroin as a contributing
factor, Fallon said.

In Rockingham County alone, 45 deaths were blamed on

But even when an addict wants help, it can be tough to

Some say New Hampshire lacks short-term drug detox programs,
residential drug treatment, and recovery programs that help prevent
people from falling back into addiction. Recovery programs offer
people coping skills, relapse prevention and support meetings.

"It's not easy," Newton police Chief Larry Streeter said, "especially
in New Hampshire."

Kimberly Couto, a 40-year-old Newton resident, knows that

"It's a nightmare to get any help," she said.

Couto's daughter, now 20, nearly overdosed on heroin in April

Since then, Couto said, she has been struggling to find the right care
for her daughter.

"Basically, from that day on, she's been in numerous mental health
facilities that have done basically nothing for her," Couto said.

She even pleaded to have her daughter arrested so she might find help
in jail.

The biggest problem, Couto said, was finding a detox

She tried to get her daughter into a number of hospitals and
facilities in New Hampshire, but was denied primarily because of a
lack of space.

"I don't have the time to wait for a bed to become available," she

When Couto did find a detox program for her daughter, more problems

Her insurance, obtained through a Massachusetts company, was not
accepted by treatment facilities in New Hampshire.

"There's nothing in my area to help," she said.

Couto's daughter has been in three detox programs. She recently
started a long-term treatment program in Saugus, which lasts from six
months to one year.

Couto's struggle to find treatment help is not unique.

Options are limited

The New Hampshire Center for Excellence, a resource center that aims
to prevent and treat substance abuse, conducted a study of state drug
treatment facilities last year.

The center, headquartered in the New Hampshire Community Health
Institute in Bow, was launched by the Bureau of Drug and Alcohol
Services, a division of the N.H. Department of Health Human Services.

It's funded through the U.S. Substance Abuse and Mental Health
Services Administration, the N.H. Governor's Commission on Alcohol and
Other Drug Prevention, Intervention and Treatment, and the New
Hampshire Charitable Foundation.

Staff members work to provide technical assistance and data to support
coalitions, service providers and others working in addiction services.

The center found the demand for residential treatment programs is not
being met, there is a low number of licensed counselors and the
recovery support network is underdeveloped.

In addition, treatment can be expensive and there is not enough
insurance reimbursement, according to the report.

Some progress has been made.

In August, the state expanded Medicaid through the New Hampshire
Health Protection Program. Among other things, the program allows
low-income residents to get substance abuse treatment.

One qualification is income, a one family household must have an
annual income of $16,105 or less.

"For many, peace of mind means getting coverage for preventive care
such as regular checkups," Nicholas Toumpas, Commissioner of the N.H.
DHHS said in a prepared statement. "It also means they will now be
covered for emergency care due to accidents, for mental health
counseling and for substance use treatment."

For people who do not qualify for Medicaid, there are some other
options, according to Jaime Powers, a clinical administrator at the
N.H. Bureau of Drug and Alcohol Services, a division of the N.H.
Department of Health and Human Services.

If someone earns up to four times the federal poverty level, they may
qualify for state-funded programs, she said.

The 2014 federal poverty level is an annual income of $11,670; anyone
earning $46,680 could qualify for a state funded program.

Demand far exceeds programs

There are 15 state-funded addiction treatment providers, Powers said,
each offering two or three levels of addiction care.

"For all levels of care at this time, the demand fair outweighs the
capacity for state-funded services," she said.

In the coming months, Powers said, she is expecting the state will
receive federal money to help develop more programs or facilities for
substance abuse treatment.

It's unclear where the money will come from, Powers said, and exactly
how much.

"It's a constantly moving target," she said.

Now, she said, state officials are in the process of listening to what
specific programs, facilities, or training people need.

"We really want to hear from providers, what they need," she

Additionally, with more people eligible for coverage under the
Affordable Care Act, the hope is that more health-care providers will
offer treatment because there will be more reimbursement from
insurance companies, Powers said.

There are about 100,000 people statewide that are dependent on drugs
or alcohol, according to a November 2014 report by PolEcon Research
and New Futures, a nonprofit group which aims to reduce substance
abuse in the state.

Only about 6 percent - or 6,000 people - received treatment in 2012,
according to the report.

Even if there were more treatment options, not every addict is ready
for help.

People need to commit themselves to a program that's right for them,
according to Streeter, the Newton chief.

"It's not going to work for a person unless they're ready for it," he

Rehabilitation efforts can backfire when friends or family members of
addicts try to intervene too often, he said.

Newton police intervene and try to get residents into drug treatment

They tried to get Courtney Griffin, a 20-year-old Newton resident, the
help she needed.

Courtney died on Sept. 29.

Treatment may mean going out of state

Sending people out of state for drug treatment is common.

"Generally speaking, a lot of people leave the state to go to
treatment," said Eric Spofford, the founder and chief executive
officer of The Granite House, a sober house for men in Derry.

The Granite House offers different levels of treatment, such as
counseling, developing financial and work skills, and working with
recovering addicts so they can live independently.

The majority of people trying to kick heroin addiction, Spofford said,
are left with nothing.

Treatment has bottle-necked because of a lack of funding, he said, and
when people are released from treatment, the support safety net they
need often isn't there.

Recovering addicts need to have resources in place to remain sober
after getting out of a treatment program, he said.

"The whole network that supports their addicted life is right there,"
he said.

Because options in the Granite State are limited, addicts and their
families often look south of the border for help.

It's just one way New Hampshire and Massachusetts differ, Streeter
said, the Bay State just tends to offer more social services.
"There's certainly a lot more social service intervention in
Massachusetts," he said.

Hampstead Hospital offers treatment, but can only accommodate a couple
dozen people

"The more intensive levels of care, there's a very limited bed
availability," said Patti Shea, director of clinical operations at the
hospital. "Here or somewhere else."

Hampstead Hospital has 15 beds in its detox program, which usually
takes about five to 10 days, Shea said.

The hospital also had 10 beds in its residential treatment program,
which lasts from one week to one month and involves intensive,
constant care.

Those programs can come with long wait lists.

"Honestly, substance abuse facilities at this point are a four-to
six-week wait out for treatment," Shea said. "And that's being
generous; there's just not enough resources for those people."

State officials look for solutions

At the state level, officials are working to expand the capacity of
different types of treatment centers, Powers said.

On Friday, Gov. Maggie Hassan named John Wozmak of Walpole as Senior
Director for Substance Misuse and Behavioral Health for the Governor's
Office, a newly created position. He will work state agencies and
others to coordinate substance abuse and behavioral health policies.

Last week, DHHS and the Center for Excellence launched a new website - - which helps people find substance abuse centers.

Creating a resource for treatment centers was one of the
recommendations from The New Hampshire Center for Excellence.

In addition, under ACA, more insurance companies are required to cover
mental health and substance abuse needs, said Linda Paquette,
executive director of New Futures, a nonprofit organization which aims
to reduce drug and alcohol abuse.

This year, five insurance companies are offering coverage in New
Hampshire, she said, when previously there was only one.

"Treatment can be very expensive," she said. "We think that
contributes to a lower rate of folks getting treatment in New Hampshire."

Meanwhile, Couto, the Newton mom, hopes her daughter will learn some
skills for a sober life.

"She's in there working on how to better herself," Couto said. "And
how to function in society without being high."
- ---
MAP posted-by: Jo-D