Addiction Recovery Options Increase, but Advocates Say N.H. Needs More

Jul 9, 2015

For years, advocates for people with addiction problems have been working to create a viable recovery system for New Hampshire. New organizations in Keene, Manchester and Portsmouth are working to help people stay away from addictive drugs. But the state still has a long way to go. 

Tym Rourke is the chairman of the Governor’s Commission on Alcohol and Drug Abuse Prevention, Treatment, and Recovery. He’ll be part of a forum tonight in Concord and he'll discuss how the state can get more people into recovery. 

Let’s start with the difference between treatment and recovery. There is some overlap, but there are key differences. What are those?

The way I like to phrase it is that treatment is really a clinical intervention. This is a healthcare, medical model where someone who is diagnosed with a substance use disorder receives specialized care from a licensed drug and alcohol counselor, perhaps a psychiatrist, a mental health counselor, or social worker. Recovery is really about how people live with a chronic illness. Once that treatment ends, for those who need that kind of clinical intervention…addiction is a chronic illness. There is no cure for it. People don’t recover in treatment. They find recovery in treatment, but they really recover in community. So recovery is programs and it’s about how we build social supports and ongoing peer-based services that allow people in recovery to connect with a positive, healthy community that can sustain their sobriety over the rest of their life.

And now New Hampshire has a few new recovery centers. Earlier this year, New Hampshire had none. Tell us about these.

We’ve seen two physical recovery centers currently open, one in Keene called the Serenity Center, one in Manchester, the Manchester Recovery Community Center, which opened last month. You have a vibrant organization called Safe Harbor in Portsmouth that is actively working with community leaders around the establishment an opening of a physical center there. And you have other forms of support, sober housing, other kinds of recovery programs that are beginning to emerge across the state. It’s a very recent and exciting development.

Our neighbor to the west, Vermont, has 11. Is three enough for New Hampshire?

No, and I think Vermont is a model for us, as are most other states, because it’s important to recognize that we’re one of the last states in the country to really have this level of care available for folks who struggle with this. So I think there’s a vision in New Hampshire that the governor’s commission shares—that we look to the state’s public health network system. There are 13 public health regions in the state of New Hampshire and I think the conversation is, ultimately, “How do we get to at least one in every region of the state?” That probably isn’t even enough. And remembering that recovery centers are physical spaces that provide some levels of recovery supports, but there are other things, like sober housing and job training, things like that. Some may emerge out of a recovery center, some may come from halfway houses, sober houses for men and women. There are very few of those in the state. So we’re hoping that we’re beginning a journey of growing a tremendous amount of recovery capacity all over the state. These three that are emerging and some other groups that are beginning to do some work are beginning to do good work, but they will quickly find themselves overwhelmed by demand, so I think we know that we have to work hard to scale these types of opportunities and resources as best we can.

Let’s talk about funding. These three derive most of their funding from private philanthropy. Any money from the state?

Not currently. And you’re correct. My other hat is, I work for the New Hampshire charitable Foundation, and we do significant funding in the arena of substance abuse. The Manchester Recovery Center is operated by Hope. We’re currently the sole funder. Most of the others are working with donor giving, private philanthropy. As a state we have not invested in recovery supports up to this point and that has been very much a topic of conversation and of priority for the commission as we’ve been working with legislators and the governor around the state budget.

Last year we had a record-breaking year in the number of overdose deaths. Are we headed for that again this year?

I think in the absence of intervention, we are. The police chief in Manchester came out yesterday talking about the seizure rates of heroin, a tremendous increase over last year. I think there are some steps we’ve taken to try to mitigate overdose deaths. The legislature passed and the governor signed into law a bill that makes Narcan widely available to patients and families. This is a rescue drug that can save someone from an overdose. It is not treatment. It does not support long-term recovery. It just helps someone in the middle of an overdose get out of it. It doesn’t work every time. But we’ve made that more available. A good Samaritan law was passed that prevents those who might call first responders if there is someone in the middle of an overdose from potential criminal prosecution, so we can encourage people to reach out for help if there’s an emergency. But ultimately, in the absence of the availability of treatment and recovery supports, for an individual with an opiate addiction, to get immediate access to a clinician who can get them into treatment—in the absence of that, I don’t think we’re going to get ahead of this anytime soon, and that’s unfortunate because there’s a lot of good work going on, but that’s the missing piece that we’ve been trying to address through the budget process, but now with the budget on hold, I think we’re in the same kind of holding pattern we’ve been in this entire year where there’s some kind of patchwork attempts to get ahead of it. Law enforcement is doing the best they can, the treatment and recovery community is doing the best they can, but what we really need is added resources, so as people get identified, they can get into treatment much faster, so they don’t get turned away at the door.

In the budget, Governor Maggie Hassan asked for a certain amount, the legislature returned with a lesser amount. Do you feel that lawmakers in New Hampshire understand the scope of this problem?

I think many of them do and there were certainly fair champions, particularly in our process in the Senate. There was very much bipartisan agreement about the need to do something. I’m not sure that our legislators are recognizing the level of crisis that it is and the response that it requires. The part that we’ve talked about as a commission is that while we’re appreciative of the resources we may receive pending the final decisions on the budget, it’s important for people to recognize what they will provide and what they will not. You know, we are terribly concerned about the ongoing debate on the Health Protection Program. Its reauthorization is critical to getting services available to folks, including recovery supports, because there are components that are covered by that.

That’s the Medicaid expansion.

Correct, our state’s version is called the health Protection Program. It’s going to sunset at the end of December next year. It requires reauthorization. The governor included reauthorization in her budget, the legislature did not, and it’s one of the issues that is tied to the veto and the ongoing conversations around that. For our commission, the reauthorization of the Health Protection Program is vital to the rest of our fiscal strategy. There are about 40,000-plus people on the Health Protection Program right now. Of those, between September of 2014 and March of 2015, 1,800 of them got substance abuse treatment, and they would not have been able to otherwise. So we have a population of folks, many of whom are in a lot of high-risk substance abuse disorders, who now have access to a means to pay for services, but in the absence of a guarantee that that is going to continue to be made available, that makes it difficult to treat them effectively, it makes it difficult for the healthcare community or the recovery community to go ahead and take risks to expand capacity, because there’s no guarantee that that financing is available. So without the Health Protection Program, I think it will be difficult for us to finance and invest in those kind of community-based services we know are incredibly important to make treatment successful in the long run.