If someone were to ask you what states are hardest hit by the drug epidemic, you’d probably choose some of the poorer Southern states, or maybe places like New Mexico, Texas, California, and Arizona that are near the Mexican border. You’d be surprised to hear, then, that one of the regions with the highest number of overdose deaths is New England.
New Hampshire has the largest number of overdose deaths from fentanyl, per capita, in the nation. In overall drug overdose deaths, it’s tied for second. In a speech in August of 2017, President Trump referred to the state as “a drug-infested den.” According to statistics compiled by the New Hampshire Department of Health and Human Services, there were an estimated 470 drug overdose deaths in New Hampshire in 2016. The population of the state is an estimated 1.35 million.
One explanation for this tiny, relatively prosperous state having such a big drug problem is its proximity to Massachusetts, which is the center of a system of drug trafficking networks. Another problem in that New Hampshire spends very little money on services to treat addiction. Doctors there have also prescribed significantly higher than average amounts of opioid pain relievers – almost twice the national average – and when the federal government cracked down on opioids, users were forced to turn to the streets.
In contrast, Vermont has made great strides in reducing overdose deaths. While the other New England states have rates well above the national average, Vermont’s is fairly close to that average. Part of the reason for this is that Vermont has been focusing on medication assisted treatment, employing a model called hub and spoke. The center of the program, or hub, are addiction specialists who provide MAT, and the spokes are primary care providers who give continuing care. Vermont has six hubs in 10 locations and dozens of spokes across the state. The system owes much to the Affordable Care Act, under which Vermont was able to use a special Medicaid waiver to help pay for the hub and spoke system.
Vermont also has new rules relating to the prescription of opioids. One, doctors must talk to patients about non-opioid alternatives. Two, providers must have a discussion of the risks with the patient and have them sign an informed consent form. Three, there is a limit to how many opioids a doctor can prescribe if it’s the patient’s first time using them.
Experts hope that this approach will catch on and allow more people to both avoid addiction and receive proper treatment if they do develop a substance use disorder. California is developing a similar model using a $90 million federal grant from the Substance Abuse and Mental Health Services Administration
If you or a loved one need help with quitting drugs or alcohol, consider Asana Recovery. We offer medical detox, along with both residential and outpatient programs, and you’ll be supervised by a highly trained staff of medical professionals, counselors, and therapists. Call us any time at (949) 438-4504 to get started.
