Methadone spurs rise in OD deaths
What may be a surprise is this statistic: Even more people in the state — 168 — died from drug overdoses. And that was up from 2006, when 142 people overdosed on drugs and died, according to state officials.
Law enforcement officials, some of whom tie the jump in deaths to the increased availability of methadone, are taking notice. They wish the public was, too.
“It’s not talked about,” said Merrimack County Sheriff Scott Hilliard. “I have a huge concern for the level of addiction.”
Attorney General Kelly Ayotte shares that concern and has tried for three years to sell legislators on a prescription monitoring system she believes will prevent patients from “doctor shopping” in search of multiple prescriptions for the same drugs.
“I think this is a really important issue for our state,” Ayotte said. “This is very important public health and public safety issue.”
If the numbers alone don’t get your attention, Hilliard hopes this will:
“When the addiction level rises, the crime level rises,” he said. “Addicts are going to break into houses. They are going to steal from family members. And they are going to commit armed robberies. I talk about it in terms of a quality-of-life issue.”
Dr. Thomas Andrew, the state’s chief medical examiner, began tracking the state’s drug-overdose deaths a few years ago. He was away on vacation and unavailable for comment, but his office shared his counts.
Ten years ago, the number of drug deaths in New Hampshire was under 60. By 2003, it had climbed to just over 100. In 2005, the number was 153, according to Andrew’s count. Each year, methadone was responsible for a large number of those deaths.
Methadone is available two ways, through methadone clinics, like the one on Loudon Road, and by prescription. The clinics get a lot of negative publicity, but the police said it’s the supply available by prescription, not at the clinics, that’s being abused.
An addict who gets methadone at a clinic for heroin withdrawal typically gets only one methadone dose per visit. The supply and the amount dispensed are closely monitored, the police said, making it almost impossible to abuse or sell.
That’s not so for methadone prescribed by doctors for chronic pain. In those cases, patients are given many days’ supply when they fill a prescription, making it easy for them to abuse or sell their tablets on the street.
Laconia knows that firsthand, said Police Chief Michael Moyer. In that city last year, eight people died of methadone overdoses, prompting Moyer, the county sheriff and county attorney to team up and tackle the problem in a number of ways, including prosecution and education.
“The reason we saw the increase,” Moyer said, “is because doctors are prescribing (methadone) for chronic pain. It’s readily available now.”
There’s another problem with methadone, Hilliard and Moyer said. It creates a delayed, rather than instant, high. If someone takes one dose, fails to get high, and takes more doses, the amount in their system compounds and can become lethal.
“Before they know it, they don’t wake up,” Moyer said. The eight people who died in Laconia in 2007 ranged in age from 18 to 49, according to the police.
New Hampshire is still learning how best to respond to the increase in drug overdoses.
Laconia and Belknap County have been among the most aggressive. The eighth overdose in Laconia 2007 came around the time Moyer became police chief. One of his first moves as chief was to talk with Belknap County Sheriff Craig Wiggin and County Attorney Jim Carroll about tackling the problem. Late last year, they began a campaign that combined law enforcement and education.
They created a large poster titled “Eight is Enough” that gave the ages and first names of the eight who had died. They also included pictures of the five overdose victims whose families agreed to share a photo. The poster put this challenge to the community: “Why do we stand by and let our family and friends die?”
In addition, the police and county attorney’s office decided to begin prosecuting people who supplied the drugs in fatal overdose cases.
A conviction can be punished by a maximum sentence of life in prison.
They can be hard cases to prove, but Belknap County has had some success. Earlier this year, Carroll reached a plea deal that sent 55-year-old Edward Costello to prison for 15 to 40 years for supplying methadone to a 20-year-old Lakeport man who died of an overdose. Costello’s wife, Diana, 44, and his daughter, Lisa, 18, also pleaded guilty to related charges and are serving shorter sentences.
In May, Carroll indicted two others, Bernard Huard, 49, of Gilford and Anthony Shaner, 53, of Laconia with drug sales where death resulted.
Each is accused contributing to separate overdoses. Rockingham County’s deputy county attorney, Tom Reid, has also prosecuted similar drug sales. Merrimack County has not brought any cases.
Carroll said the case are difficult to prosecute because there isn’t always much evidence at the scene, and witnesses may not cooperate with the police if they, too, are connected to the drug scene. For those reasons, Moyer has instructed his officers to treat all drug overdose deaths like a crime scene so they’ll be more likely to gather any evidence available.
Carroll said the challenge of the cases can’t be a deterrent.
“When the number of deaths resulting from a drug overdose reaches the level it was in a community this size, I think you have to reflect on the level of availability (of the drugs),” Carroll said. “I’ve tried to be aggressive.”
Moyer said the poster and aggressive law enforcement response have gotten the right kind of attention. The city hasn’t had a drug overdose death since last year, and Moyer said the word on the street is that drug dealers know they can go to prison if their drugs lead to a death. He’s also heard from other law enforcement communities all over the country who want help implementing a similar approach in their own areas.
Here’s another selling point: Moyer said the effort has cost almost nothing but the salaries of a couple of police officers he’s asked to work on the drug overdose problem.
Ayotte said she remains committed to tackling the drug overdose problem, too, and will again advocate for a prescription drug monitoring program that will track a person’s prescriptions. She said 32 other states have such a program; New Hampshire is the only New England state that doesn’t.
The monitoring program would make it harder, maybe even impossible, for someone to visit doctor after doctor in search of prescriptions for the same ailment. Ayotte said well-meaning doctors do not have the ability to determine whether a patient has received a prescription elsewhere.
The same is true of pharmacies, she said.
Critics have cited privacy concerns, but Ayotte said she knows of no case where a person’s privacy has been compromised.
Ayotte has also talked with state Safety Commissioner John Barthelmes about joining efforts to tackle the problem. She’d like to include state health experts, too.
“I’d like to have a much more coordinated approach from the state,” she said.