Heroin Abuse: A growing

epidemic with no cure in

sight

By
Liz Markhlevskaya
lmark@fosters.com

Posted Feb. 22, 2015 at 3:15 AM

ROCHESTER As more local residents struggle with heroin use and addiction,
causing heroin overdoses to triple in some communities, local officials say better
access to treatment is necessary to help alleviate the growing health problem.
Police Capt. Gary Boudreau said law enforcement alone cannot solve the growing
numbers of heroin-related offenses.
We can't arrest our way out of a health care issue, said Boudreau.
In a recent interview, Rochester Police Chief Michael Allen encouraged residents to
seek treatment for heroin addiction while at the same time acknowledging that the
area does not have enough treatment options to meet potential demand.
The Rochester Police reported that in 2014 they responded to 78 confirmed heroin
overdoses, of which seven were fatal, he said. In Dover, police reported at least 32
heroin overdoses in 2014, of which four resulted in death. Those numbers represent
a dramatic increase over 2013, when Rochester police reported about eight heroin
overdoses and Dover police reported nine.
Meanwhile, officials at local treatment centers say they are challenged to meet this
growing epidemic and are hoping changes in law will enable them to help more
patients.
A dangerous addiction
Carrie Conway, Strafford County's criminal justice programming coordinator, said the
high proportion of heroin and opiate users in the Strafford County Drug Court
program is something we haven't seen, ever.
She said when she began working for the county 13 years ago, cocaine appeared to
be the most frequent drug of choice. Then, over the years, prescription pills became
more popular among abusers. Now the vast majority of Drug Court participants are
struggling with addiction to heroin and other opiates.

It's cheap and easy to get, said Conway.

She said that today's heroin users often begin by abusing prescription medication.
Some users, she said, get addicted to opiates after having them prescribed at a
doctor's office for pain, such as an injury or a surgical procedure. After their
prescriptions run out, some turn to heroin to feed the opiate addiction.
It's definitely scarier (because) there is such a high possibility of overdose, Alex
Casale, director of the Drug Court program, said of heroin use.
Heidi Moran, clinical administrator at Southeast NH Services in Dover, said the
number of heroin users seeking help at the Dover treatment center has probably
tripled over the past 18 months. She said she sees clients from all walks of life and
all economic groups. Many of her clients have used heroin cut with other drugs,
including fentanyl, which makes the drug even more lethal.
When you're buying street drugs, you don't know what it's mixed with, you don't
know what you're getting, Moran said.
Moran noted that some users hear about a particularly lethal strain of heroin, such as
that laced with fentanyl, and think they are missing out on a better high. She said
that even when an addict reads or hears about a person dying from a heroin
overdose, they often think, It can't happen to me, she said.
According to Moran, most of the clients seeking help with heroin addiction began by
snorting the drug then graduated to injecting it. She said the treatment center often
treats clients with abscesses or blood infections caused by these injections.
Those clients, she said, have to be treated at a hospital before beginning substance
abuse treatment. In some cases, even clients who started treatment had to be
revived with Narcan two or three times in one week after overdosing, she said.
Rochester police said they respond to heroin overdoses on a regular basis. At times,
they find their victim unconscious with a needle still in his or her arm. Allen said that
every time his department responds to a heroin overdose, the officers look for
probable cause for an arrest, such as drug paraphernalia found on scene.
Allen said that these arrests can lead to positive change. On some occasions, the
person who is charged can be eligible for the Strafford County Drug Treatment Court,
an intensive drug treatment program that many would otherwise not be able to
afford. If participants are able to complete the program and graduate, they can avoid
spending time behind bars.
The Drug Court Program
On Tuesday, Strafford County Drug Treatment Court celebrated the Rite of Passage
for four residents who have overcome their addictions. This intensive outpatient

treatment program is available to some who have been charged with a crime they
committed due to drug use. These crimes may include burglary, robbery and theft,
which are often committed to feed a drug habit, police say.
To participate in the Drug Court program, a person must plead guilty to the offense
and be sentenced to jail or prison. That sentence is waived if the person successfully
completes the program.
The program has about a 49-percent success rate treating heroin addiction, said
Program Director Alex Casale. But he said that the journey to recovery is not easy
and many participants relapse several times before reaching sobriety. For some
struggling with heroin addiction, it takes up to three years to graduate, he said.
County Attorney Thomas Velardi said the Drug Court program is very intensive. It
involves random drug testing, frequent counseling, and checking in with a judge
once a week. But for those who have made it, he said, the effort is worth it.
The people who decided to make that change and stick with it have done amazing
hard work and have changed their lives, said Velardi.
One of the graduates at Tuesday's ceremony was James Dumais, 35, who has been
clean for about 24 months after abusing using heroin and other drugs for many
years.
Dumais said his substance abuse began in high school, starting with alcohol and then
marijuana. By his junior year, Dumais said he was part of what he called the rave
scene and had begun experimenting with ecstasy and angel dust. He also used
cocaine, which he said was more readily available than it is today.
By the age of 29, Dumais began using heroin and had overdosed on it twice before
starting the Drug Court program.
Dumais, who served in the Air Force from 2005 to 2009, said he was told to leave
the military for using cocaine and methamphetamine while working as a security
officer. He was placed in the Drug Court program after being charged with burglary
and attempted burglary, he said.
Dumais said he has completed the program once before but had failed to stay clean.
This time, he believes he can remain on the right track.
I have more hope now then I have had before, he said.
Velardi said the most common reason why participants fail is that they are not ready
to make significant changes in their lives. These changes include overcoming
everyday habits and not socializing with same friends.
Imagine if you got up today and you had to change where you live and who you
associate with, said Velardi.

Casale said seeing someone make positive changes and graduate the program is an
amazing experience.
The best days of the year are graduation days, said Casale. Within the course of
the year, to see a person completely change their lives, that's amazing.
Residential treatment OPTIONS
There are treatment options available outside of Drug Court, but perhaps not enough
to help everyone who wants it.
In Strafford County, for example, the Addiction Recovery Center (ARC) at Southeast
NH Services is the only residential substance abuse treatment center. The ARC
program, said Heidi Moran, the clinical administrator for Southeast NH Services, has
only 10 beds available and there is always a waiting list.
She said that to stay on the waiting list clients have to call the center three times a
day to stay in touch and show that they are motivated to get treatment.
Participants admitted to the program are monitored for withdrawal symptoms and
are kept busy from 6:30 a.m. to 11 p.m. with activities such as group therapy
sessions, lectures, individual counseling and guest speaker presentations, Moran
said.
After the 28-day ARC program, participants enter the Turning Point Transitional
Housing Center, which Moran describes as a 90-day halfway house with 15 beds.
Moran said that the situation could get worse before it gets better. Beginning in
March, residential substance abuse centers will be eligible for Medicaid
reimbursement but a federal law enacted in 1965 as part of the Social Security Act
could force centers to reduce beds in order to get that reimbursement.
That's because a provision of the law, known as the Institutions of Mental Disease
(IMD) exclusion, states that mental health facilities (including those treating
substance abuse) are not eligible for Medicaid reimbursement if they have more than
16 beds.
The law's intent when it was enacted in 1965 as part of the Social Security Act was
to prevent the warehousing of mental health patients, but Southeast NH Services
expects to have to eliminate nine beds because of it.
The intent of the provision was to encourage community-based treatment for
patients with mental illnesses, said Linda Saunders Paquette, executive director of
New Futures, a nonprofit organization that advocates for substance abuse prevention
and education. But it puts New Hampshire at risk of losing about 50 beds in
substance abuse center beds statewide unless they refuse to accept newly eligible
Medicaid patients.

Moran said, This is a horrible, horrible thing (for Southeast NH Services). Every bed
is needed desperately, she said.
The IMD exclusion has gotten the attention of some legislators, including Sen.
Jeanne Shaheen, Congresswoman Ann Kuster and Sen. Kelly Ayotte, who have
encouraged a review of the provision.
Medication assisted treatment
Several centers in the area offer outpatient substance abuse treatment programs
using medications such as methadone or suboxone. One such facility is ROAD to a
Better Life, which provides drug and alcohol treatment throughout the state.
Tom Barnes, ROAD's director of community relations, said the Somersworth center
currently has about 600 clients, of which about 500 are recovering from opiate
addiction through the help of suboxone. He said there is a limit to how many
suboxone patients the center can treat.
By law, doctors may not have more than 100 suboxone patients. Because the
Somersworth facility has five doctors it cannot have more than the 500 patients it is
currently treating. And that means that those seeking help for heroin addiction have
to wait several weeks before they can get an appointment, said ROADS Clinical
Director Monika Ostroff.
Barnes said that although the 100-patient-per-doctor limit was intended to prevent
suboxone from being diverted, he would like to see the law changed to allow more
people to get help. He said because of the limit, the few privileged receive the
medication while others don't have access to it unless they illegally buy suboxone on
the street.
Medication such as suboxone can be effective in treating heroin addiction because it
helps subdue cravings, letting the patient focus on improving his or her life, said
Barnes.
Overcoming addiction, said Ostroff, is about changing your whole entire life.
Barnes said that although some view suboxone use as trading one addiction for
another, he believes otherwise.
It's trading a miserable life for a tolerable life, he said.
Patients using suboxone often stay on the drug for six months or less, according to
Barnes. At other times, particularly when the patient is suffering from a mental
illness such as bipolar disorder or depression, patients stay on the drug for longer.
Barnes estimated that more than 50 percent of ROADS' patients are able to
successfully remain clean from opiate drugs such as heroin. He said the center's

success rate vastly improved when it added group therapy about five years ago.
Now, the group therapy sessions are overflowing, said Ostroff.
ROADS accepts private insurance, as well as Medicare and Medicaid patients. Ostroff
noted that Medicaid currently does not currently cover outpatient treatment. That will
change in March, but only for newly eligible Medicaid patients.

Familyandfriendsofheroinoverdose
victimgatherinKingstonSaturday
20yearoldCourtneyGriffindiedfromaheroinoverdosein
September
12:32AMESTNov09,2014WMUR9

Kingston,N.H.ThefamilyandfriendsofaNewtonwomanwhodiedfromadrugoverdose
gatheredinKingstonSaturdaytorememberherandtalkaboutaddiction.20yearoldCourtney
GriffinoverdosedonheroinanddiedonSept.29.
Herfather,DougGriffin,hostedthememorialtohonorhisdaughterslife,andspeakopenly
aboutheroinaddiction.Hehopeshiscandorwillhelpotheraddicts.
Itwouldmeanthatshedidn'tdiefornothing.Wearetryingtomakesurethatinherpassing
therewillbesomevalue,thatwecangetoutandhelpsaveanotherkid,DougGriffinsaid.
FriendsandfamilymetatKingstonPlainsat2onSaturdayafternoon.Theysharedstoriesand
smilesaboutCourtney.
Shewassuchawonderfulkid.Abright,smartkid.Thiswasakidwho,inourmind,wouldn'tdo
drugs.Akidwhowouldn'tdiefromdrugs,andthenshewasgone,DougGriffinsaid.
TheGriffinfamilyalsoofferedsupportforthosebattlingdrugaddictions.Courtneyssister
ShannonGriffinsayssheandherfamilydidalltheycouldtosaveCourtney,butitwasn't
enough.
It'sterriblethatwehadtoloseher.Itsreallyawful,butlet'sbringawareness.Letsgetitouton
thetablesowecanlessenonefamily'sburden,oneaddict'sburden,oneatatime.Ifwecan
touchonelife,itssomething.It'sastart,ShannonGriffinsaid.

CourtneysmotherPamGriffinsaidherdaughterfoughtherdrugaddictionforafewyears.
Thesekidsarestruggling.Whentheyareaskingforhelpandtheparentsaretakingthemtoget
helpandtheyhavebeendeclined,thisisamatteroflifeordeath.Nowwearewithoutour
daughter,PamGriffinsaid.
TheGriffinfamilyalsoinvitedformeraddictsandfamilymembersofaddictstospeak.Charles
Rosalosttwoofhissonstodrugoverdoses,andnowdevoteshistimetoeducatingyoung
peopleaboutthedangersofdrugs.
Ithelpsme.ImblessedthatIhavethecourageandstrengthfromboystobeabletodothis,
Rosasaid.
SandiCoylealsospokeatSaturdaysgathering.Shesbeendrugfreefornineyears.Coyleis
nowworkingtocreateadrugrecoverycenterontheSeacoast.
Toreachpeopleandgivepeopleanintroductiontorecoverybeforeit'stoolate,Coylesaid.
CourtneyGriffinisalsosurvivedbyhertwobrothers,JoshuaandJeremyGriffin.