‘If this isn’t a state of emergency, I don’t know what is’

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U.S. Senator Kelly Ayotte, R-NH, during a recent ride along with MPD to witness the heroin epidemic firsthand. She witnessed one person who had taken what seemed to be a fatal overdose, and watched as AMR and MFD did CPR and brought the person back.
U.S. Senator Kelly Ayotte, R-NH, during a recent ride along with MPD to witness the heroin epidemic firsthand. She witnessed one person who had taken what seemed to be a fatal overdose, and watched as AMR and MFD did CPR and brought the person back.

MANCHESTER, NH – “We’ve had 20 overdose deaths in two months. If this isn’t a state of emergency, I don’t know what is,” said Mayor Ted Gatsas on Thursday.

The question of what constitutes an official “state of emergency” and how that might stem the rising tide of human loss from drug overdoses is the question at hand, and the answer to that is at the heart of Gov. Maggie Hassan’s response to the mayor’s call Wednesday for executive action from her.

On Wednesday, Hassan responded to a letter (see below) sent by Gatsas requesting that she declare a public health emergency, which would focus all available state resources on Manchester’s epidemic.

According to Gatsas, in the first two months of 2016, 1 in 6 calls for opioid overdoses have resulted in death, nearly double last year’s numbers for the same time period. Out of 119 calls for service, 77 patients were treated with Narcan, with 20 deaths attributed to opioid overdose, pending official toxicology reports.

“When this conversation started we were talking about heroin. Now, it’s fentanyl. People have no clue what they are taking,” Gatsas said.

In the letter, Gatsas described  a synthetic version of fentanyl called “China White,” and a resurgence in the use of “bath salts,” which broadly describes a synthetic chemically-treated substance packaged and sold under various product names.

In August of 2014 Hassan declared a 21-day state of emergency after widespread medical emergencies in Manchester and other communities due to the “use or misuse” various derivatives of bath salts or “herbal incense.”

That executive action, supported by Attorney General Joseph Foster, directed merchants around the state to remove such substances from their shelves.

Gatsas said beyond declining to call for a state of emergency in her response Wednesday, he took particular exception to the governor’s characterization of his request as a “renewed interest” in the matter.

City's first-responders are spread thin with the rising calls for service.
The city’s first-responders are spread thin with the rising calls for service.

“At the rate I see first responders go by this office you’d think the city was burning down,” Gatsas said.

“It costs about $845 every time one of those trucks move, and there’s no question it’s depleting our resources, wear and tear on vehicles, gasoline, and there’s always the chance of an incident or accident. But none of that comes before the importance of saving lives,” Gatsas said.

A spokesman for the governor said in response Thursday that the issue of reversing the trend in overdose deaths is “top priority” for Hassan.

“The governor is working on this issue every single day. It’s her top priority. It’s something she loses sleep over, and she will do everything she has the legal authority to do to combat this crisis and save lives,” said William Hinkle, Hassan’s communications director.

Hinkle said Gatsas acknowledged in Wednesday’s request that he understood the limited scope of a “state of emergency” as explained by Hassan last summer.

“Mayor Gatsas said a state of emergency was needed to provide ‘heightened awareness.’ We’re past the point of awareness.  Awareness of this crisis is at an all-time high. There’s no silver bullet. What we need is action, and the most important thing we can do is pass these current bills that would free-up significant funds to take important steps on a number of different issues,” Hinkle said.

Hinkle said the onus now is on the legislature to vote on a number of bills the governor is pushing, that if passed would bring action allowing expenditure of the $60 million in revenue surplus identified in the state budget for this fiscal year.

Included in the bills are measures for expansion of state and local law enforcement partnerships; hiring of a new attorney at the Department of Justice to focus on opioid crimes; initiating a statewide drug court; boosting treatment and prevention measures; and taking aim at prescribing practices by physicians, Hinkle said.

They are:

  • Senate Bill 533, with an amendment sponsored by Senator Jeff Woodburn, would have provided  $5 million in funding for the Governor’s Commission on Alcohol and Drug Abuse Prevention, Treatment and Recovery and roughly $150,000 for an additional attorney at DOJ focused on opioid-related crimes and issues.  However it was voted Inexpedient to Legislate out of Senate Health and Human Services a couple of days ago, as some on the committee disagreed with an amendment brought by the chair that reduced the $5 million request to $500,000,  and articulated a grant program to release those funds that would have significantly slowed the release of those minimal dollars when there is an existing opportunity active right now that those resources could be plugged into to support recovery services. The original version of the bill will be voted on by the full Senate on March 9.
  • Senate Bill 464 would provide roughly $3.2 million to establish a statewide drug court program. It passed the Senate in a bipartisan voice vote and is currently in the House Ways and Means Committee.
  • Senate Bill 485 would provide nearly $1.9 million to expand a state grant program to partner with local law enforcement in hard-hit communities, such as the state’s partnership with Operation Granite Hammer in Manchester. It also passed the Senate in a bipartisan voice vote. Senate Bill 485 is currently in the House Finance Committee.
  • Senate Bill 522 would provide $130,000 for upgrades to the state’s Prescription Drug Monitoring Program to ensure that more prescribers can use it in a timely fashion. The Senate passed it in a bipartisan voice vote, and it is currently in the House Finance Committee.

“There’s not a room the governor walks into where there’s not someone who is affected personally by this crisis. The stories are out there,” Hinkle said. “Awareness isn’t the problem. It’s a matter of continuing to push for legislative action – and  the things we’re talking about to stem and reverse the tide of this crisis aren’t always comfortable. They require big changes, and also for lawmakers to move at a pace faster than they’re accustomed to.”

Tym Rourke, who is chairman of the The Governor’s Commission on Alcohol and Other Drug Abuse Prevention, Treatment, and Recovery, says part of the rapid response system from Concord will require a financial commitment to solving this problem.

“All over the state families, providers, the recovery community and their allies are doing their best to respond to the crisis. While the legislature has moved on important policies that are part of the solution, we won’t get far without additional financing. Many of the bills before the legislature right now will require financial investment, including the reauthorization of the state’s Health Protection Program, SB533 and others,” said Rourke.

“What is being called for is more resources, and quickly, to expand access to prevention, treatment and recovery services. Tools to make that happen are in front of the legislature right now. This state has had a plan to address substance use since 2013. It’s time to finally pay to implement it, and demonstrate what a response to an emergency ought to look like,” he said.

Holly Cekala, Director of Support Services for Hope for New Hampshire Recovery, said to her way of thinking, a “state of emergency” conjures something more immediate than waiting for lawmakers to decide whether to vote up or down on spending.

“When I hear ‘state of emergency,’ I think you’re maybe sending in the National Guard to set up some emergency field hospitals, and bringing in a couple of doctors and nurses to start pumping people through these field hospitals  so they can at least detox, reducing the waiting lists and relieving already overtaxed staff,” Cekala said.

If such a thing happened today, she could fill 200-300 beds within 24 hours, from Manchester alone, and hundreds more statewide. The need is that dire.

“In January alone we had 2,400 visits to our community recovery center in Manchester from all over the state, and just out of sheer need and motivation to get help, they’re coming to us to say please, get me off this stuff,” Cekala said.

She likened it to a flood, or disease that had claimed 400 lives, situations for which the governor would have the power to bring in reinforcements to sandbag, or quarantine and treat those afflicted.

Cekala says the catch for many who want treatment is that, without private insurance, their options are limited due to restrictions on Medicare services, not to mention a shortage of medical detox facilities.

And even with private insurance, it’s a shell game.

“Of the three people who have come through Amber’s Place since it opened three days ago, one of them just got picked up by an out-of-state treatment provider, because that individual had private insurance,” says Cekala, of the transitional emergency shelter that shares space at the HOPE center.

That person suffering from alcohol addiction, who was under age 25, came to the center out of desperation, with his mother. They didn’t know where else to turn, Cekala said.

“You know the problem is bigger than opiates, even though that’s what we hear most about. It’s addiction across the board. And so, the only way it was possible to get this person help from their insurance was if that person went from one hospital bed to another, so we had to work with Catholic Medical Center‘s outreach team, who came to the center and did their best to triage this person, who was very ill.”

The stipulation for the patient’s hospital-to-hospital care was discovered as HOPE staff assisted the family in wading through the insurance fine print.

“It doesn’t seem right, to have to add another $2,500 bill to the tab just to get him picked up at hospital and into treatment. So yeah, if I had the power, I’d set up a few field hospitals,” Cekala said.

⇒Related: HOPE for NH joins forces with national non-profit to expand services

She knows of agencies outside of New Hampshire who would gladly come in-state and set up medical detox and treatment centers, if there were some way to do that, an arrangement she does not have the power to broker.

“Or just make some money available to send people out of state for treatment, where it is available.  Until we find a way to treat these people, the overdoses will keep happening,” Cekala said.

Melissa Crews, who chairs the Hope for NH board of directors, echos Cekala’s point. She says action is what those in the trenches have been waiting for from Concord, although it shouldn’t require a “state of emergency” to release available money that has yet to be allocated.

“The only real action that we have seen is for the governor to put out $500,000 for Narcan kits that people can get for $50 themselves. I believe what these parents would really like is to have the money immediately put out to treatment and recovery providers to expand the services that are actually accessible, so that their children’s lives can be saved,” Crews said.

“While Narcan is very important, when we asked for $300,000 to start a pilot program to put our recovery coaches in emergency departments to initiate recovery after an overdose, there was no response from Concord. This proven model will be a collaboration between HOPE,  the police department, all the hospitals and the treatment providers in the city of Manchester,” Crews said.

The pilot program will go forward without state funding, Crews said, as their organization will continue to find a way to save lives.

“We will never save everyone; that will never happen. But intervening in emergency rooms, followed by a temporary stay at Amber’s Place, followed by an assessment by a treatment provider, and detox and treatment, and then back to a supportive recovery community paired with a little affordable recovery housing — that is the path forward, and the best allocation of funds,” said Crews.

She also believes that the discussion over legislation as a path to action is misplaced.

“There is no excuse the the state’s lack of response. To blame the legislature is wrong. I have had a front-row seat for two years, and been told there is money available, but never have I been given directions as to how to access it,” Crews said.  “I have been gravely disappointed — or let’s say educated — in my first two years of learning how these things work. All the while watching those close to me — very close to me — die.”

A community meeting set for March 4 is another kind of action step that residents can take if they want to focus on immediate solutions, Cekala said.

“We want to highlight things the community can do to help in this effort. We’re not talking about costly things. We’re talking about creative solutions, and they’re very out-of-the-box solutions, because they’re not coming from the bureaucrats; they’re coming from those suffering,” Cekala said.

“There are still people getting into recovery every day, whether we have an epidemic or not. People are still finding a way. We just have too many people in need and too few pathways available to recovery,” Cekala said.

“The banter I’m hearing right now between state and local government sounds like somebody wants somebody else to cough up some money. Is it within Maggie’s power to set up some field hospitals and call in the National Guard to get people detoxed? I’m not privileged to that stuff,” Cekala said.

‘If you ask me, the state of emergency is that our providers are so overtaxed and have been so underfunded for so many years, no wonder we’re in this mess.  What was the expectation, after so many years? Cekala said. “It’s not just one governor, it’s a few governors, who’ve allowed us to get to where we are.”


⇒Related: March 4 listening session on addiction and recovery: Time for action and healing.


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Below is contact information for your Hillsborough County Manchester delegation:

Representatives:
District 08
   Ward 1
Jeffrey P. Goley : 1683 River Road , Manchester,  NH ,    03104-1645
Joseph R. Lachance : 105 Brae Burn Drive , Manchester,  NH ,    03104-1705
District 09
   Ward 2
Linda A. DiSilvestro : 145 Fox Hollow Way , Manchester,  NH ,    03104-6406
William J. O’Neil : 309 Ash Street , Manchester,  NH ,    03104-3203
District 10
   Ward 3
Jean L. Jeudy : 134 Calef Road , Manchester,  NH ,    03103-6324
Patrick T. Long : 112 Hollis Street , Manchester,  NH ,    03101-1234
District 11
   Ward 4
Elizabeth Edwards : 524 Wilson Street, #5 , Manchester,  NH ,    03103-4871
Robert M. Walsh : 114 Weston Street , Manchester,  NH ,    03104-5263
District 12
   Ward 5
Amanda Bouldin : 412 Central Street FL 2 , Manchester,  NH ,    03103-4105
Ted V. Rokas : 393 Wilson Street , Manchester,  NH ,    03103-4913
District 13
   Ward 6
Larry G. Gagne : 126 Lakeside Drive , Manchester,  NH ,    03104-5801
William J. Infantine : 89 Winward Lane , Manchester,  NH ,    03104-4743
District 14
   Ward 7
Mary C. Freitas : 279 Candia Road , Manchester,  NH ,    03109-4215
Mary Heath : 76 Island Pond Road , Manchester,  NH ,    03109-4806
District 15
   Ward 8
Thomas Katsiantonis : 45 Glen Bloom Drive , Manchester,  NH ,    03109-5062
Mark McLean : 43 Forest Hill Way , Manchester,  NH ,    03109-5145
District 16
   Ward 9
Barbara E. Shaw : 45 Randall Street , Manchester,  NH ,    03103-6434
Victoria L. Sullivan : 1056 S. Beech Street , Manchester,  NH ,    03103-6715
District 17
   Ward 10
Tammy A. Simmons : 142 Parker Street , Manchester,  NH ,    03102-4407
Timothy J. Smith : 494 South Main Street #1 , Manchester,  NH ,    03102-5144
District 18
   Ward 11
Patricia Cornell : 787 Montgomery Street , Manchester,  NH ,    03102-3027
Armand D Forest : 692 Montgomery Street , Manchester,  NH ,    03102-3028
District 19
   Ward 12
Robert A. Backus : 1318 Goffstown Road , Manchester,  NH ,    03102-2326
Dick Marston : 25 English Village Rd #304 , Manchester,  NH ,    03102-2415
District 42
   Ward 1
Kendall A. Snow : 150 Birchwood Road , Manchester,  NH ,    03104-3913
Daniel J. Sullivan : 172 Arah Street , Manchester,  NH ,    03104-2119
   Ward 2
Kendall A. Snow : 150 Birchwood Road , Manchester,  NH ,    03104-3913
Daniel J. Sullivan : 172 Arah Street , Manchester,  NH ,    03104-2119
   Ward 3
Kendall A. Snow : 150 Birchwood Road , Manchester,  NH ,    03104-3913
Daniel J. Sullivan : 172 Arah Street , Manchester,  NH ,    03104-2119
District 43
   Ward 4
Benjamin C. Baroody : 1175 Bridge Street , Manchester,  NH ,    03104-5703
Christopher J. Herbert : 85 Watts Street , Manchester,  NH ,    03104-4512
Kathleen F. Souza : 628 Belmont Street , Manchester,  NH ,    03104-5167
   Ward 5
Benjamin C. Baroody : 1175 Bridge Street , Manchester,  NH ,    03104-5703
Christopher J. Herbert : 85 Watts Street , Manchester,  NH ,    03104-4512
Kathleen F. Souza : 628 Belmont Street , Manchester,  NH ,    03104-5167
   Ward 6
Benjamin C. Baroody : 1175 Bridge Street , Manchester,  NH ,    03104-5703
Christopher J. Herbert : 85 Watts Street , Manchester,  NH ,    03104-4512
Kathleen F. Souza : 628 Belmont Street , Manchester,  NH ,    03104-5167
   Ward 7
Benjamin C. Baroody : 1175 Bridge Street , Manchester,  NH ,    03104-5703
Christopher J. Herbert : 85 Watts Street , Manchester,  NH ,    03104-4512
Kathleen F. Souza : 628 Belmont Street , Manchester,  NH ,    03104-5167
District 44
   Ward 8
Andre A. Martel : 81 Maurice Street , Manchester,  NH ,    03103-3825
Mark L. Proulx : 76 Janet Court , Manchester,  NH ,    03103-2209
   Ward 9
Andre A. Martel : 81 Maurice Street , Manchester,  NH ,    03103-3825
Mark L. Proulx : 76 Janet Court , Manchester,  NH ,    03103-2209
District 45
   Ward 10
Jane E. Beaulieu : 609 South Main Street , Manchester,  NH ,    03102-5134
Carlos E Gonzalez : PO Box 154 , Manchester,  NH ,    03105-0154
   Ward 11
Jane E. Beaulieu : 609 South Main Street , Manchester,  NH ,    03102-5134
Carlos E Gonzalez : PO Box 154 , Manchester,  NH ,    03105-0154
   Ward 12
Jane E. Beaulieu : 609 South Main Street , Manchester,  NH ,    03102-5134

Click here to find contact information for your legislator.


March 2, 2016 letter from Mayor Gatsas to Gov. Hassan:

 

 

About Carol Robidoux 6698 Articles
Longtime NH journalist and publisher of ManchesterInkLink.com. Loves R&B, German beer, and the Queen City!