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Node welcomed NIDA Director, Congresswoman, Senator to discuss tackling NH’s opioid epidemic with science

On Tuesday, May 30, 2017, the Northeast Node of the National Drug Abuse Treatment Clinical Trials Network, together with the Center for Technology and Behavioral Health (CTBH) at the Geisel School of Medicine at Dartmouth, welcomed the Director of the National Institute on Drug Abuse (NIDA), Dr. Nora Volkow, and New Hampshire State Representative Ann McLane Kuster (D-NH2) to discuss New Hampshire’s Opioid Crisis.


“Tackling the New Hampshire Opioid Crisis: Harnessing the Power of Science to Break the Cycle” brought together Dr. Volkow, Congresswoman Kuster, CTBH and Northeast Node Director Lisa Marsch, and three innovative programs from the surrounding area to discuss the science behind New Hampshire’s opioid crisis and how the state might best move forward in breaking it.

Nora Volkow, MD, Director of NIDA

Dr. Nora Volkow, Director of the National Institute on Drug Abuse (NIDA) of the National Institutes of Health, addresses the crowd at the Dartmouth conference on tackling New Hampshire’s Opioid Conference, held Tuesday, May 30, 2017.

After warm welcomes from Dartmouth College President Philip Hanlon and Geisel School of Medicine Dean Duane Compton, Congresswoman Kuster, founder and co-chair of the House Bipartisan Heroin Task Force, gave her perspectives on the crisis from around the state and in Congress. “Substance use disorders are impacting communities throughout our state and affect people regardless of age, gender, race, and class,” she said. Congresswoman Kuster called for increased vigilance from Washington, particularly with the President’s proposed 2018 budget and the role Medicaid plays in treating the opioid epidemic sweeping the nation. The Congresswoman vowed to continue to hold the current administration responsible for its promise to treat the opioid epidemic.

Dr. Marsch presented findings from the New Hampshire HotSpot Study, funded by the National Drug Early Warning System and NIDA, conducted by the Northeast Node. The study included interviews with 76 opioid users, 18 first responders (police, fire, emergency medical services), and 18 emergency department personnel from six counties in the state to understand New Hampshire’s opioid use and overdose problems. In all, 10 themes were identified and categorized from the 112 interviews conducted: trajectory of opioid use, formulation of heroin/fentanyl, fentanyl-seeking behavior, trafficking and supply chain, experiences with overdoses, experiences with Narcan, harm reduction, experiences with treatment, prevention, and laws and policies. Alarmingly, the study team found that though opioid consumers may not seek fentanyl directly, if they hear that a particular batch has caused an overdose they try to get that batch. Unanimously, participants reported that the opioid crisis in New Hampshire is affecting everyone, regardless of socio-economic status, employment, age, or gender.

The keynote address by Dr. Volkow highlighted the state of the science on opioid use disorders and the problem in New Hampshire. Nationally, New Hampshire ranks second in highest drug poisoning death rates per capita, with the largest increase of all states from 2010-2015. The state also has the largest rate of overdose deaths from non-methadone synthetic opioids (fentanyl) in the country. “I love New Hampshire, I come here all the time … so when I saw [data proving the state’s problem] I was like, ‘What is going on in New Hampshire?’”

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NIDA Director Nora Volkow, MD; New Hampshire Congresswoman Ann McLane Kuster (NH-02); and Dartmouth CTBH and Northeast Node Director Lisa A. Marsch, PhD.

The audience also heard from programs which have successfully implemented treatment options for specific populations. Chief Danny Goonan, Fire Chief of Manchester, NH, and Stephanie Bergeron, Executive Director of Serenity Place in Manchester, presented on the Safe Station model of care, wherein users can walk into any fire house in Manchester and be immediately linked with treatment, typically at Serenity Place. The program has helped thousands of users get into treatment in the year since its inception. Nancy Bernardy, PhD, of the National Center for PTSD at the US Department of Veterans Affairs (VA) and Assistant Professor at the Geisel School of Medicine at Dartmouth described the VA’s pharmacist-led intervention assessing opioid patients on an individual case. Pharmacists look into a patient’s medical history and offer guidance to the prescribing physician on alternative or adjusted prescribing patterns to best fit the needs of the individual veteran. Julia Frew, MD, Medical Director of the Dartmouth-Hitchcock Perinatal Addiction Treatment Program, described the program’s fetal-maternal care for pregnant women with substance use disorder. The program offers treatment at the prenatal, perinatal, and post-natal stages of pregnancy (including well child visits for the infants). The combination of prescribed buprenorphine and group counseling allows these moms to nurture their children with limited, if any, side effects from their substance use disorder. Babies born from the program see far fewer days in hospital than others with Neonatal Abstinence Syndrome (NAS), and rarely require additional care in the Neonatal Intensive Care Unit.

During a reception following the conference, undergraduate students presented projects they had created highlighting the opioid epidemic in New Hampshire, from printable infographics to video testimonials, to a website linking resources and information on opioids.

The next day, leaders from CTBH and the Northeast Node accompanied Dr. Volkow on a tour of the Manchester community and its opioid crisis response teams, visiting Catholic Medical Center, Safe Station at the Manchester Fire Department, and Serenity Place. New Hampshire Senator Jeanne Shaheen joined in the tour and discussion at Catholic Medical Center.

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Nicole Pendenza, Director of Maternal, Children and Women’s Health, Catholic Medical Center; William Goodman, MD, Chief Medical Officer, Catholic Medical Center; Nora Volkow, PhD, Director, National Institute on Drug Abuse; New Hampshire Senator Jeanne Shaheen; Lisa A. Marsch, PhD, Director, Dartmouth Center for Technology and Behavioral Health and the Northeast Node of the National Drug Abuse Treatment Clinical Trials Network.

 

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William Goodman, MD, Chief Medical Officer at Catholic Medical Center, and Nicole Pendenza, Director of Maternal, Children and Women’s Health at Catholic Medical Center describe their maternal fetal program to NIDA Director Volkow.

 

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Director Volkow and Manchester Fire Chief Danny Goonan speak with drug court clinician Lyndsie Robinson during a tour of Serenity Place.

 

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CTBH and Northeast Node Director Marsch listens as Serenity Place Executive Director Stephanie Bergeron describes the program to NIDA Director Volkow.

Several media outlets reported on the events, and you can see their individual reports via the following links:
Associated Press, Holly Ramer, Conference explores the role of science in opioid crisis
Valley News, Nora Doyle-Burr, Researchers and politicians gathered at Dartmouth to talk opioids on Tuesday
New Hampshire Public Radio, Britta Greene, Discussion at Dartmouth Highlights Challenges in Opioid Crisis
WCAX (CBS – Ch 7), Adam Sullivan, Conference at Dartmouth College explores role of science in opioid crisis
WMUR (ABC – Ch 9), Tim Callery, Researchers call for scientific approach to dealing with drug crisis
WPTZ, (NBC – Ch 5), Helena Battipaglia, NH Rep. Annie Kuster, health professionals discuss tackling opioid crisis
Congresswoman Ann McLane Kuster, Kuster Joins Regional and National Leaders at Dartmouth College to Discuss the Opioid Crisis
NH Journal, Kyle Plantz, What Factors Led New Hampshire to Be Ground Zero for the Opioid Crisis?

Tour of Manchester:
Union Leader, Doug Alden, Addiction expert praises Safe Station program, saying, ‘You are creating new things’
Senator Jeanne Shaheen, In Visit to Catholic Medical Center, Shaheen Highlights Devastating Impact ACA Repeal & Trump Budget Would Have on NH’s Efforts to Fight Opioid Epidemic