The city of Concord has been the capital of New Hampshire since 1808. The city consists of a few villages including Concord Heights, East Concord and Penacook as well as Riverhill, West Concord and Curtisville. Like the rest of New Hampshire and the New England region, Concord has a rich history. It has also been a victim of the current drug overdose epidemic.
Currently, the United States is in the third wave of the drug overdose epidemic. The third wave started in 2013 when the medical community realized that Americans were misusing synthetic opioids. In 2018, overdose deaths due to heroin, prescription opioids and other opioids decreased by 4%, 13.5% and 2%, respectively. However, overdose deaths due to synthetic opioids excluding methadone saw an increase of 10%.
Synthetic opioid deaths have been especially alarming because the culprit is illicit fentanyl. Prescription fentanyl is used to treat severe cancer pain because the substance is 50 to 100 times more potent than morphine. Illicit fentanyl has proven to be easily accessible, however. All street drugs are bad for the public, but illicit fentanyl is worse because a user does not know the exact ingredients of the pill. In many cases, an illicit synthetic opioid pill includes cocaine, heroin and fentanyl, which is a deadly combination.
Recently, the Centers for Disease Control and Prevention released new prescription guidelines. It was determined that doctors were overprescribing opioid medication to patients. The number of prescriptions, therefore, has decreased as have the deaths due to prescription opioids, but the overdose epidemic is still far from over. Since individuals are no longer receiving prescription opioids, the data suggests that individuals are simply substituting prescriptions with illicit means.
The Epidemic and New Hampshire
In 2018, there were 67,367 reported overdose deaths in the country. This represented a 4% decline from 2017. The only downside is that the number of deaths in 2018 was still four times more than the number of deaths in 1999. The turn of the millennium marks the beginning of the epidemic as well as the first wave. At least one opioid was involved in 70% of the overdose cases in 2018.
For New Hampshire, there were 412 overdose deaths in 2018, a number that has remained stable since 2015. In 2018, 386 deaths were attributed to synthetic opioids other than methadone, which is stable but high. In addition, 89 deaths were attributed to prescription opioids in 2016. The number dropped to 43 in 2018. The decrease in prescription overdose deaths could be tied to the fact that providers wrote 46.1 opioid prescriptions for every 100 people, which was below the national average. It was also the lowest rate since 2006 when the rate was tracked for the first time.
A new concern that has surfaced is the number of newborns who are born with Neonatal Abstinence Syndrome or Neonatal Opioid Withdrawal Syndrome. Doctors involved in hospital births began to notice that newborns are showing signs of opioid withdrawal. In 2016, the rate was seven cases per 1,000 hospital births. This is a fairly new statistic, so states differ in their reporting methods. New Hampshire data was not available for 2016.
The drug overdose epidemic has also spiked concern over the possibility of an increase in new HIV and hepatitis C cases. In the haze of a high, it is not uncommon for users to share their needles. This is one reason why cities across the United States have started needle exchange programs. Nonetheless, needle sharing has historically led to new HIV and hepatitis C diagnoses.
In 2017, there were 38,226 new HIV diagnoses in the U.S. Almost 10% of those diagnoses were due to injection drug use. The data for New Hampshire was not available. In 2017, there were 44,700 new cases of acute HCV. It is believed that at least 86% of those new cases were due to injection drug use. The data for New Hampshire was not available, but 7,700 people were living with HCV in the state from 2013 to 2016.
The Epidemic and Concord
The local leadership of Concord has recognized that residents are being impacted the epidemic. Leaders also recognized that the community is being impacted. While the Concord Fire Department was not able to set up a safe station like the one in neighboring Manchester, they did set up NH Project FIRST, which is funded through grants from entities such as the Substance Abuse and Mental Health Services Administration. Residents who require help are enrolled in treatment programs.
First responders in Concord and New Hampshire are also trained to treat overdoses on the spot by administering medication. The medication reverses the overdose and has proven to save lives.
Why Getting Help Is Important
The New Hampshire Department of Health and Human Services has published reports and gathered data regarding opioid misuse prevention, treatment and recovery. One of the reasons why this state has taken bold steps is because stakeholders recognize the risks of allowing the situation to get worse.
The Bureau of Drug and Alcohol Services has posted information that covers prevention, intervention and treatment as well as licensing for professionals.
In 2015, the Bureau found that at least 400 people in New Hampshire died from a drug overdose. This was two and a half times more deaths than in 2011. The majority of those overdoses involved opioids.
Opioids, including heroin, are defined as prescription medications used to relieve pain. All of them are highly addictive. The repercussions of substance misuse are many:
• Neglect of loved ones
• Child and elder abuse
• Newborns experiencing withdrawal
• Contraction of HIV or hepatitis C
• Major organ damage such as liver damage
• Heart problems
Today, there are decades of data that the medical community is working from to improved treatment quality, availability and accessibility. Stakeholders involved in dispersing information and guiding individuals toward the help they need know that a one-size-fits-all mentality does not work. Instead, an individual is assessed on a case-by-case basis. Substance of choice, medical history and age are all taken into consideration in addition to the length of time the substance has been misused and the size of the doses.
Drugs are chemicals, and those chemicals alter the brain and the central nervous system. All of them deliver a sense of euphoria and a dopamine rush. While cocaine is considered an upper, heroin is considered a downer. Both still cause the reward mechanism of the brain to begin craving the substance that helps it feel good. Every person can achieve a high by exercising for a half-hour. The high delivered by the chemicals in drugs, however, is far beyond what a person can naturally produce. Getting treatment means bringing the body back into balance so that it is no longer dependent on high-producing drugs.
Types of Treatment
There are many treatment options. The most common types of treatment are:
• Anonymous meetings
An outpatient treatment usually last 90 days. The patient attends scheduled sessions a couple of times a week that are used for counseling as well as therapy. Progress is measured. If everything goes according to plan, the patient successfully completes the treatment with the tools they need to continue living in a sober manner.
Outpatient treatment is beneficial for the person who can handle triggers at home, work or school. The sessions are mostly used to reinforce sober living strategies. It provides a safe space for those who need someone to talk to while working through trauma or a mental health issue.
Inpatient programs are available through publicly funded means as well as private. Green Mountain Treatment Center is an example of a private rehab facility. This addiction treatment center offers:
• A 12-step-centered curriculum
• Evidence-based clinical therapies
• Individualized treatment plans
• Holistic therapies
• Gender-separate programs and accommodations
Patients can enter a residential primary drug rehab program that features a limited number of beds so that the client-to-staff ratio is low. Green Mountain Treatment Center is serene, panoramic and secluded on purpose. A person who is struggling with substance use disorder often has to be removed from their environment and placed in a space where there are no distractions. Focusing on recovery requires a commitment and effort.
In addition, treating co-occurring mental health issues has become more common. If your program includes depression treatment, for example, it is because your assessment revealed that you may be dealing with it. A mental health issue could be the result of trauma as a child or adult. Reliving those memories may not be pleasant, but they will be necessary to help you cope with triggers that could lead to relapse.
An inpatient program makes it a point to make patients as comfortable as possible. This is why several amenities are provided at Green Mountain Treatment Center, such as:
• Yoga and meditation
• On-site gym
• Chef-prepared nutritious meals
Recovery is as much about healing the body and mind as it is about rewiring the brain back to its default state of sobriety. Physical exercise and nutrition are therefore encouraged in an inpatient program. If a patient can learn to enjoy the natural endorphins that their brain produces, it is one more tool that fights against the substance cravings that are going to be around for a while.
Inpatient programs are also beneficial because they often offer medical detox. Detox is an important step that has to be completed before rehab can start. A patient who still has their substance of choice in their bloodstream will have a harder time focusing on their sessions. Plus, they are going to go through withdrawal, which distracts away from the program.
Detox is different for everybody. Someone who just started experiencing a substance use disorder will go through withdrawal, but it will not be overwhelming, especially if the substance is mild. Meth is known to have the toughest and longest withdrawal timeline. Whatever the case may be, in a medical detox program, there is a trained staff watching over your progress around-the-clock. Professionals can forecast the intensity of a patient’s withdrawal, but they cannot guess whether or not a seizure, stroke or heart attack will occur, so they prepare with strategies and medications as needed.
Medication-assisted treatment is sometimes used to help patients who have a heroin substance use disorder because heroin is an opioid. Patients are weaned off heroin onto less addictive opioids. Then, they are weaned off those opioids, too. There is no medication that has been deemed successful for a meth substance abuse, so a patient who enters an inpatient treatment program will mainly go through cognitive behavioral therapy treatment sessions.
After a person leaves an inpatient treatment center, continuous support is recommended. Anonymous meetings can be attended throughout the United States. These meetings have been around for decades and are great for helping individuals maintain sobriety and prevent relapse.
No matter what circumstances you may be experiencing with your substance use disorder, help is available near Concord, NH. Reach out to Green Mountain Treatment Center today to learn about your options.