Heroin use on the rise in New Hampshire

Last modified: 7/27/2013 1:48:02 AM
Drug overdoses have plagued New Hampshire for years, and until recently their leading cause was prescription medication, namely methadone and oxycodone.

It’s not anymore.

Deaths last year from heroin – 38 – outpaced those from any other drug, according to Dr. Thomas Andrew, the state’s chief medical examiner. And for the past two years, he said, heroin accounted for the most deaths from overdoses of a single drug.

There are several possible reasons for the rise, including the recession, fewer state resources for treatment and preventive education, and greater restrictions on purchasing prescribed medication. Heroin is comparatively cheap and easy to access, said Merrimack County Sheriff Scott Hilliard, making it attractive during a financial downturn.

“I don’t think we would be seeing the levels we’re seeing now without the recession, because we see the same spikes in alcohol and domestic violence,” Hilliard said. “I think the drug world follows in the same suit.”

But Andrew said he’s not convinced the economy is to blame. “Drug addiction bounces around all the time,” he said. “This year it’s heroin; next year it could be methadone again.”

Overdose deaths in general spiked to 201 in 2011, up from 194 the year before and 160 the year before that. The number fell to 164 last year – still about three times as high as it was in the late 1990s. In comparison, 108 people died last year from car-related accidents. Heroin deaths have been concentrated in the southern half of the state, in Manchester, Nashua and other areas of Hillsborough County, as well as in Grafton, Cheshire and Merrimack counties.

“It becomes a lifestyle issue,” Hilliard said. “If you don’t know somebody who is drug addicted that is trying to work through this process, then you’re a rarity.”

One issue with heroin, Andrew and Hilliard each said, is that it’s difficult for users to know exactly what they’re injecting or how potent it may be. Street heroin is on average much more concentrated today than it was a decade or two ago, and it can come mixed with undetectable substances. Authorities in Boston, for example, announced Wednesday that an adulterated batch of heroin, or a highly similar synthetic drug, had been linked to five overdose deaths in the city since July 15.

Andrew said the rise in heroin overdoses also suggests a demographic shift toward younger, more recreational users who may be less willing to seek or submit to treatment.

“With methadone and oxycodone deaths, you’re talking about an older population, people in their 40s and 60s who maybe started taking medication after an injury at work and then habituate on illicit narcotics,” he said. “That person may be more likely to seek rehab, or they may not. But the young person who has started to abuse recreationally, that’s a very, very tough population to voluntarily get into rehab.”

But the big problem, Andrew said, is a lack of resources for treatment and preventive education, and apparent public apathy about drug-related deaths.

“We have 16 to 20 homicides per year,” he said. “If that jumped to 80 per year, you think people would be upset about that? You think if asthma deaths increased by that much, people wouldn’t demand action?”

Joe Harding directs the state Bureau of Drug and Alcohol Abuse and Gov. Maggie Hassan’s Commission on Alcohol and Drug Abuse Prevention, Intervention and Treatment. Harding acknowledged that his agency is working with less now than it was a few years ago because of budget cuts, but said he and others continue to work to find ways to improve what services are available to addicts and youth in high-risk communities, mostly through greater efficiency and better coordination among departments and advocacy groups.

He said the state has also received grants to increase care for certain populations, such as military veterans and former prison convicts, and offer some prevention services and health screenings. He also said President Obama’s health care reform might increase access to addiction treatment.

Hilliard said countering heroin abuse from a law enforcement perspective depends on communication with users.

“Addicts are one of our greatest assets,” he said. “Knowing where it is and where it might be popular emphasizes for us the attention we need to be paying to it.”

First responder and former House member Jenn Coffey of Andover shares a similar belief. She’s pushing for the Senate to pass a bill similar to one she sponsored in the House that would provide immunity to people who call 911 to report a drug or alcohol emergency and the people they’re calling about, not including those who deal drugs or distribute alcohol to minors. The Good Samaritan Bill, as it’s called, has stalled in committee and will likely come up for a vote in January.

Coffey said she has witnessed through her job the recent rise in drug abuse, be it heroin or a host of other drugs, and sees immunity as a way to begin to bring users out of the shadows.

“People are afraid to call 911, and by the time we get called they’re dead, or they end up in a parking lot with a tourniquet around their arm,” she said.

Critics of the bill have charged that making arrests is critical to policing drug crime, but Coffey insists that education and treatment should be a greater priority than further overcrowding the state’s prisons.

“The numbers are going up, not down,” she said, referring to overdoses. “Why would you keep doing something that fails?”

(Jeremy Blackman can be reached at 369-3319, jblackman@cmonitor.com or on Twitter @JBlackmanCM.)

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