‘We’re just Junkies … No One Cares’ Heroin – Where to Next?

July 31, 2015


by Doug Robinson

Is the problem that nobody cares?

I stopped by the Methadone clinic in Hudson today to request a visit with their administration which I am/was going to include in next week’s edition of the HLN.  My request was simple.  “May I please speak with the administrator so that I can incorporate what this clinic is doing with the story I am writing for next week’s paper about Southern NH Regional Hospital’s new substance abuse center.  Like always I was told, “I will talk with the director, and I will call you back.”

As I was leaving, two people were sitting in chairs to my right.  The one to the left asked, “Do you want to talk to me?”  I said “sure.”

I did not ask her name nor do I know it.  She told me that the problem was “Nobody cares.  We are junkies.  Nobody has ever cared about junkies.  Back in 1990, we had lots of places we could go.  But today, that is not the way it is.  All they do is talk.  No action.”

“I have to take a cab to get here.  Why did Nashua not want us in their town?  I had to take a cab, and sometimes I even walk here.  No one cares.”

As I was talking, the “boss” came out and asked if she could talk to me personally.  “Sure” I said.  She asked me if I understood patient confidentiality, and I said, “Yes, I am familiar with HIPAA (the Health Insurance Portability and Accountability Act).”  I was then escorted out of the building.

“Just Junkies.”  Wow.  “No one cares.”

Does New Hampshire care?  Such is the subject of this third in a series of four stories about ‘Heroin in Hudson.’  Who cares?  Is the rubber meeting the road on patient care, patient involvement, community expectations, and the well-being of Hudson and all of Hudson’s residents?

Consider these statistics:

NH ranks number 1 in the United States for opioid abuse;

Emergency personnel administered 3,275 doses of Narcan in 2014;

New Hampshire had 321 overdose deaths in 2014;

The Hudson Police are experiencing an “epidemic” according to HPD Chief Jason Lavoie;

The Hudson Fire Department is experiencing a “concern” according to HFD Chief Robert Buxton; and

HFD personnel confidentially commented that “It (heroin) is out of control.”

But the words ‘epidemic’ and ‘concern’ do not truly explain the depth of the feelings and anxieties of those affected by the addictions of drugs, alcohol, and now heroin.

In researching the yearly numbers of drug overdoses in Hudson, the “epidemic and the concerns” are no larger than they were last year.  So, what is the big deal?  HPD Chief Jason Lavoie stated it best.  “People are now dying.  People throughout Hudson are dying from heroin-related drug overdoses.”

The State of N.H. was given a grant of $12 million to combat heroin, and John Wozmak was hired by Gov. Hassan to administer the program.

The Republican GOP has been bashing John Wozmak, NH’s Drug Czar, for his purported lack of communication with area police chiefs and his management skills related to rolling out a NH State program to combat the heroin concerns.  There is no continuing dialogue, more commonly known as “cross-the-aisle” between the Democrats and the Republicans regarding what can be done for the heroin concerns.  All that is being done between the two parties is the pointing of fingers, much like school children on the playground when they do not get their own way.

John Wozmak’s has offered a 22-point plan to combat the drug problem in NH.  Right, wrong, whatever, he has a plan on the table to move the heroin from the State House to the streets to hopefully begin to fix the problem.  His plan involves:

  • Reauthorize Medicaid expansion, which includes substance abuse treatment.
  • Expand substance abuse treatment to traditional Medicaid recipients.
  • Increase Narcan availability.
  • Expand drug courts.
  • Better use the Prescription Drug Monitoring Program.
  • Educate doctors about best practices for opioid prescriptions and alternative approaches to pain treatment.
  • Review state Medicaid policies for opioid prescribing.
  • Review and compare insurance company practices for substance abuse treatment.
  • Implement prevention efforts and student-assistance programs in schools.
  • Consider mandatory substance abuse treatment for overdose victims.
  • Administer the drug Naltrexone, which blocks the euphoric effects of opioids, in prison, and pilot its use for inmate transitions.
  • Provide information on treatment through New Hampshire 2-1-1.
  • Create a provider hotline for prescribers.
  • Expand treatment options: outpatient, intensive outpatient, hospitalization, residential services.
  • Establish assessment centers to determine appropriate level of care for abusers.
  • Consider strict regulation of methadone clinics.
  • Review regulations of free-standing pain clinics.
  • Expand medication take-back boxes.
  • Increase housing opportunities for people in recovery.
  • Increase transitional housing for women.
  • Centralize police data on drug enforcement.
  • Create a statewide tele-health system.
  • Establish recovery houses

“My plan focuses on prevention, treatment, recovery,” stated Wozmak.  “The issue with prevention is that my job is to increase programs and get information to school kids at an early age.  It’s to get kids to have a better sense of all they put into their bodies.  We need to educate kids about all substances.”

He continued, “We need to educate our doctors, our schools, and society and redirect their thinking regarding the education of drugs, all drugs.  We have 6,000 doctors, 6,000 other medical professionals who need education on opioids in society.”

While Wozmak commends local law enforcement and medical personnel for what they are doing, he remains committed to the creation of 13 public health regions within the state to service N.H.’s needs.  Here, patients will have the ability to go to any facility they desire and receive the help they want and need.  “A few years ago we had over 600 beds dedicated to help those with drug addictions in N.H.  “

Today, we have around 60,”commented Wozmak.  “And this situation is a direct reflection of the insurance company’s reimbursement program.  Years ago, rehabilitation programs were funded.  When the funding stopped, so did the availability of beds.  Providers wanted to be paid, and those funding dollars dried up.  Today, that is changing with Medicare and with Obamacare.  Funding is now becoming available and changes will begin to happen for those facing addiction.”

The NH Drug Czar’s position was funded by a grant from the NH Charitable Foundation.  The grant was in the amount of $12 million.  According to Gov. Maggie Hassan’s office, Wozmak’s responsibilities include, “coordinating state resources, state agency spending and budget proposals in the areas of mental health and substance abuse prevention and treatment; reducing unnecessary duplication of state efforts and resources; identifying evidence-based treatment practices and working with state agencies to ensure quality delivery of such services; identifying barriers to and gaps in New Hampshire’s system of care; recommending strategies to address those barriers and gaps; and leading grant-application efforts that may assist in the state’s efforts to address substance misuse and other behavioral health challenges.”

But the fight against heroin is not limited to the governor’s office.  NH U.S. Senator Kelly Ayotte has also joined the fight for those addicted to heroin.  In an effort to bring the heroin concerns to the national level, she has hosted two roundtables on the heroin problem at two area hospitals.  In addition, she performed a “ride-a-long” with an area ambulance to experience the trials and frustrations of both NH first responders and those afflicted by their heroin addictions.

Senator Ayotte has also brought the heroin fight to the Senate floor, in an effort to champion the causes of those addicted.  Her legislation centers on the following:

Increase opioid prevention and educational efforts;

Expand the availability of naloxone to first responders and law enforcement;

Support additional resources to identify and treat incarcerated individuals suffering from a substance use disorder;

Expand drug take-back site to promote the safe disposal of unwanted or unused prescription drugs; and

Launch a prescription opioid and heroin treatment and interventions program.

“No one cares” commented the self-proclaimed “junkie” at the methadone clinic.  “All they do is talk.  Nothing gets done.  No one cares about us.”  I was not allowed to speak with her.

Meanwhile, the political pundits banter and politicize about who has a better widget to fix the heroin epidemic. Next week, I will be writing the final story in this four-part series about heroin in Hudson.  The story will center on a place where people “do care.  You will feel important today, tomorrow, and for days to come.”

Of these proposed regional clinics, Wozmak stated, “Here they will not feel like they have an orphan’s disease.”