“addicted.” Credit: rick

May 23, 2017; New Hampshire Union Leader

By many counts, the Northeast has been ground zero for the nation’s opioid crisis in recent years, putting nonprofit organizations on the front lines of the battle against addiction. In New Hampshire, one of the agencies leading a new initiative called Safe Stations says it’s facing a large deficit, and in Boston, advocates for safe injection sites continue to face pushback

Heroin use more than doubled among young adults over the past decade, according to the U.S. Centers for Disease Control and Prevention, and 45 percent of heroin users were also addicted to prescription opioid painkillers. Since 2010, heroin overdose death rates have more than quadrupled.

As the crisis has progressed, states and local communities have approached the problem in different ways. A federal bill passed last year was widely criticized for inadequately funding new efforts to treat addiction, and although President Trump pledged to solve the opioid crisis on the campaign trail his approaches have faced criticism from many advocates on both sides of the aisle.

Politico reported on the recent proposal by the administration to gut the Office of National Drug Control Policy: “The office’s staff of 70 would essentially be cut in half and help support a temporary White House opioids commission established by executive order and led by New Jersey Gov. Chris Christie. Public health advocates have warned that Trump’s new commission is duplicative, given that the surgeon general’s office in November released a months-long study on how to combat addiction.” The presidential commission is scheduled to expire 30 days after submitting its final report, planned to take place on October 1, 2017 unless the commission seeks a delay.

In New Hampshire, a groundbreaking initiative puts firehouses to use as “safe stations” where addicts can be quickly connected to nearby resources, 24 hours a day, without the fear of reprisal. The program connected more than 1,300 people to treatment options during its first year and didn’t rely on new funding.

As Kimberly Houghton reported for the Union Leader, one of the nonprofits involved in the new initiative highlighted the financial toll the program is taking at a recent city council meeting:

The executive director of Harbor Homes, a non-profit organization assisting with Nashua’s new Safe Station initiative, told aldermen this week that his organization is running a deficit of up to $400,000, with nearly $100,000 of the shortfall due to its efforts with the Safe Stations program.

Although Nashua Mayor Jim Donchess was originally asking aldermen to transfer $20,000 to Harbor Homes for its help battling the heroin epidemic in the Gate City, he is now seeking $50,000 to help offset some of the costs the agency has incurred…

According to Police Chief Andrew Lavoie, there were 332 overdoses reported in 2016 in Nashua, and 44 drug fatalities. While overdoses are down about 34 percent from last year, fatalities are up slightly, he said.

Meanwhile, a different New Hampshire nonprofit came under fire from former employees, prompting an NHPR investigation:

Over the past two years, the nonprofit organization HOPE for New Hampshire Recovery has expanded from a single modest space in Manchester to seven drug recovery centers statewide, making it the largest such organization in New Hampshire.

But Hope for New Hampshire’s growth hasn’t gone smoothly.

Several employees quit claiming they were mistreated. There are allegations that staffers used and at times sold drugs at work. One center has closed.

Former employees spoke with NHPR about what they call serious problems for a key player in the state’s fight against opioid addiction.

HOPE for New Hampshire Recovery fired back with a statement questioning the timing of the allegations and the story:

It is regrettable that at a time when New Hampshire is in the middle of a health crisis of historic proportions that HOPE for New Hampshire Recovery must take time away from getting people well to address several inaccurate statements published in a recent story regarding our organization… No organization has helped more New Hampshire residents find hope and achieve recovery. We look forward to responding to the complaints filed against a staff member that were referenced in the story. We believe that these allegations will withstand neither scrutiny nor the facts. We are also troubled about the timing of these complaints, the timing of this story, and the motivations of the sources (both cited as well as those not identified) given that it would appear to be a concerted effort to denigrate HOPE in an effort to deny funding for the work that we do.

Meanwhile, in Boston, a call for the establishment of safe injection sites for opioid addicts remains controversial. As the Boston Herald reported:

Wary city councilors are looking to get in front of building momentum to create so-called “safe injection sites” for opioid addicts, where users can inject drugs under the watchful eyes of medical pros and prevent overdoses.

But the controversial idea—which is being pushed by state lawmaker and advocacy groups—is being greeted by skepticism, including from Mayor Martin J. Walsh. Walsh said that while he was not outright opposed to the sites, better efforts were needed.

“The solution to drug addiction by having a safe place to shoot drugs is not the response,” the mayor said. “The response is funding (recovery) programs… come up with creative solutions on how we can come up with ways of getting people into recovery.”

[…]

The Massachusetts Medical Association has urged the state to open one or two pilot facilities and state Sen. William N. Brownsberger filed legislation that would legalize the facilities…

Safe injection sites, which would require federal approval, would not supply opioids but instead would let users bring their own supply. They exist in countries like Canada and Denmark, but not in the U.S.

When NPQ reported on the proposal way back in 2015, we noted the success of the programs outside the United States: “This is not a new idea; nine other countries have places where people can even use illegal drugs under the guidance of a nurse or other medical professional. Those spots are known as supervised injection facilities, or SIFs. A relatively large body of research about such facilities indicates that SIFs reduce overdoses and facilitate the use of treatment options.”

However, the pace of the process is concerning at a time when innovative approaches are necessary to combat the crisis, as in the case of “safe stations” in New Hampshire, which started at the city level in Manchester.

With uncertainty over federal funding and the Trump administration’s approach to the epidemic, it’s unfortunate that the nonprofits on the ground will continue to face challenges.—Anna Berry