Delay in Opioid Addiction Treatment in New Hampshire Potentially Resulting in Fatal Consequences
In the small state of New Hampshire, the battle against drug overdose deaths continues to be a significant challenge. With one of the highest rates of drug overdose deaths per capita in the nation, the state is taking strategic steps to expand treatment capacity and improve access to care.
Dr. Randy Knight, an emergency room physician at Littleton Regional Healthcare, sees firsthand the impact of the opioid crisis. He recounts seeing two to three patients struggling with drug addiction every shift he works. One such patient was Eddie Sawyer, a former partner of Eileen Shea, who tragically passed away while waiting for residential treatment at the Friendship House in northern New Hampshire.
Eileen Shea will mark the first anniversary of Eddie's death on April 7. She recalls her unsuccessful attempt to get him admitted to a hospital for help with his addiction. "I was told that there were no beds available," she said. "I was even suggested to pretend he was an alcoholic or claim he was suicidal to get him admitted."
The Friendship House, with its 18 beds and transitional housing for people recovering from addiction, is just one of the few residential treatment facilities in the state. The typical wait to get into the facility is four to six weeks, which can be a critical window of time for those struggling with opioid addiction. Many addicted to heroin and other opioids such as fentanyl and OxyContin have a small window of time when they are ready for help. If they don't get help in that window, the risk of relapse and overdose is very high.
Sean Warren, who struggled with heroin addiction for more than two years, ended up in jail and then got a bed at the Friendship House after being arrested. He is now in recovery and working to help others who are struggling.
The shortage of doctors who can prescribe medications to help people detox at home is another challenge in New Hampshire. Dr. Knight mentions that hospitalization is often not an option for people seeking help to detox from opioids.
President Obama proposed a fix for this shortage on Monday, suggesting a plan to increase the number of doctors who can prescribe medications to help people detox at home.
To address the shortage of substance abuse treatment facilities, several strategic approaches are being implemented. These include enhanced insurance network adequacy and coverage requirements, federal grants to expand treatment capacity, workforce development initiatives, behavioural health coordinated crisis care systems, and the use of digital tools and enhanced data programs.
The 2025 updates to the Mental Health Parity and Addiction Equity Act require insurers to demonstrate adequate networks of mental health and addiction treatment providers, potentially increasing the availability of in-network treatment options. They also mandate expanded coverage for medication-assisted treatments (MATs), proven effective in treating opioid addiction.
Federal grants aimed at expanding substance use disorder treatment and recovery services, especially within drug courts, help divert individuals to treatment instead of incarceration. This funding supports increased treatment capacity and recovery supports in the community.
Addressing workforce shortages is critical. New York State invests millions in scholarship programs for addiction professionals to remove financial barriers and grow the addiction services workforce. Similar workforce bolstering efforts can be part of regional solutions to expand treatment availability in high-need areas.
National guidelines provide frameworks for coordinated behavioural health crisis care systems that are comprehensive, accessible, and evidence-based. These systems improve crisis response in rural and underserved areas, which often overlap with regions facing treatment facility shortages.
Programs such as CDC's Overdose Data to Action (OD2A) grant provide critical funding to improve state and county capacity for overdose prevention and linkage to care. Digital tools also enhance patient access and engagement in recovery support services, improving treatment reach and retention in the face of facility shortages.
Together, these approaches represent a multi-pronged response involving legislative, financial, workforce, and technological solutions to increase treatment availability and accessibility in high-overdose states like New Hampshire.
This article is part of a partnership between WBUR's Here & Now, NPR, and Kaiser Health News. In 2019, 428 people in New Hampshire died from drug overdoses.
[1] SAMHSA (2021). Medication-Assisted Treatment. Retrieved from https://www.samhsa.gov/medication-assisted-treatment
[2] SAMHSA (2021). Behavioral Health Crisis Care. Retrieved from https://www.samhsa.gov/crisis-response
[3] SAMHSA (2021). Substance Abuse and Mental Health Services Administration. Retrieved from https://www.samhsa.gov/grants
[4] New York State Office of Addiction Services and Supports (2021). Scholarship Programs. Retrieved from https://oasas.ny.gov/scholarship-programs/
[5] CDC (2021). Overdose Data to Action (OD2A). Retrieved from https://www.cdc.gov/od2a/index.html
- In light of the ongoing battle against drug overdose deaths in New Hampshire, a crucial step towards combating chronic diseases related to addiction is expanding the availability of medication-assisted treatments (MATs), proven effective in treating opioid addiction. [Source: SAMHSA (2021)]
- To address the shortage of substance abuse treatment facilities, a comprehensive approach involving enhanced insurance network adequacy and coverage requirements, federal grants to expand treatment capacity, workforce development initiatives, behavioral health coordinated crisis care systems, and the use of digital tools and enhanced data programs can effectively increase treatment availability and accessibility. [Sources: SAMHSA (2021), SAMHSA (2021)]
- Investing in scholarship programs for addiction professionals, similar to the efforts in New York State, can help remove financial barriers and grow the addiction services workforce, contributing to regional solutions to expand treatment availability in high-need areas like New Hampshire. [Source: New York State Office of Addiction Services and Supports (2021)]
Additionally, it is essential to remember that combating drug overdose deaths is not only about expanding treatment facilities but also encompasses elements of health and wellness, fitness and exercise, mental health, and nutrition, which play a crucial role in overall recovery and wellbeing. [not sourced]
