Pubdate: Wed, 21 Mar 2018
Source: Boston Globe (MA)
Copyright: 2018 Globe Newspaper Company
Author: Steve Annear


When President Trump took the stage in New Hampshire on Monday and
delivered a fiery speech about how the White House plans to tackle the
nationwide opioid problem, he leaned heavily on the idea that the
Massachusetts city of Lawrence was largely to blame for the scourge of
addiction in the Granite State.

Citing a 2017 study by researchers at Dartmouth College's Geisel
School of Medicine, the president said the "sanctuary city" of
Lawrence, a community that restricts its cooperation with federal
immigration officials, is one of "the primary sources of fentanyl in
six New Hampshire counties."

Trump used that factoid during his speech in Manchester - in a state
he once referred to as a "drug-infested den" - as an opportunity to
call for the death penalty for drug traffickers. He also reiterated
his stance on keeping so-called sanctuary cities like Lawrence and
Boston from receiving federal funding, a move he claimed is "crucial
to stopping the drug addiction crisis."

But according to researchers who conducted the Dartmouth study, the
high overdose rates in New Hampshire are due to a combination of
several factors other than where the lethal drugs come from, as
highlighted by Trump. (Also worth mentioning: Mexico provides the US
with more than 90 percent of its heroin, according to the Washington

Below are some other key aspects that the report, titled
"Understanding Opioid Overdoses in New Hampshire," says contribute to
the opioid issues:

According to a summary of the study, the Granite State has
"consistently" and "historically" been in the top 10 in the country
when it comes to high overall drug use, with the rates at which
opioids are prescribed surpassing the national average.

Lisa Marsch, director of Dartmouth's Center for Technology and
Behavioral Health, which helped lead the study, said "recent history
of prescribing includes not only long-acting, extended-release opioid
prescriptions at higher rates than the national average, but
higherdose opioid prescriptions flooded the market ,thereby
contributing to demand."

At the time the study was published, researchers said New Hampshire
had limited resources to "effectively mitigate" the risk of addiction.
Some people who contributed to the study admitted that they gave up
trying to find help because there were either too many roadblocks or
help was inaccessible, going as far as saying that it was "impossible"
to get into a treatment program.

"When it comes to treatment, New Hampshire has the lowest per-capita
spending for drug treatment in New England and the second-lowest in
the nation," according to highlights from the report. "Low rates of
Suboxone . . . prescribers per capita, an absence of needle-exchange
programs, significant barriers to accessing Narcan, and, according to
some respondents, the state's rural setting, all contribute to the
escalating problem."

While respondents commonly cited Lawrence as one of the sources of
opioids - one person was quoted as saying "Lawrence seems like it's
one of the capitals for distributing heroin" - many other communities
were mentioned by opioid consumers, including Lowell, Haverhill,
Boston, and parts of New York and Connecticut, the report said.

First responders who participated in the study went further, adding
Springfield, Holyoke, Methuen, and Springfield, Vt., when asked about
trafficking and the supply chain.

New Hampshire's "unique rural setting" was mentioned in the report as
a possible reason for the opioid problem.

"This could give way to increased boredom among residents and
contribute to seeking mood-altering states," researchers said.
"Self-sufficiency and individualism are core values of rural New
Hampshire that may reduce help-seeking behaviors among those
experiencing problematic opioid use."
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MAP posted-by: Matt