November 28, 2017

Thanksgiving is a favorite holiday of mine, a time of thanks for health and happiness, for gratitude for what I have and compassion and caring for those folks who are less fortunate.  No gifts or cards, just good times with family and friends and lots of food, many favorites and so much to choose from.

It is a time for us to be grateful for all we have.  Yet, I’m always aware that many have so much less.  In the Seacoast this Thanksgiving season, the Portsmouth Herald has run many moving articles on the homeless in New Hampshire, stories of individuals who are struggling without the comforts of home and family, often in tents in the woods as homeless shelters are filled to capacity.  Estimates are that the number of individuals who are homeless has increased this year in NH.  High rents, low-paying jobs (if you have one), health problems and family problems make so many people vulnerable to the possibility of losing their home. 

I am also struck this Thanksgiving season with the awareness of the ongoing opiate epidemic. The stats for NH last year were astounding: 485 opiate overdose deaths in 2016.  Estimates are the numbers will be just slightly less for 2017, with well over 400 overdose deaths expected.  There are however many efforts on the state and local level that lend some optimism that the tide of this epidemic is beginning to turn.  

One important change is the new opiate prescribing rules instituted by the NH Board of Medicine on January 1, 2017.  That initiative includes the mandatory use of the Physician Drug Monitoring Program (PDMP) so that physicians can keep keep track of our patients’ use of opiates and other controlled medications and facilitate interventions when abuse is ascertained.

Other efforts include the increased use of MAT (Medication Assisted Treatment) for opiate use disorders. NHMS has been at the forefront of that effort in the Granite State by providing a series of free MAT eight-hour waiver courses to over 200 physicians, APRNs and PAs in the last year, thus facilitating the ability to offer such treatment so much more widely in NH.  NHMS will continue that effort with more MAT waiver trainings in 2018.

I’m also impressed by the creation of so many local groups providing peer support in our communities for intensive outpatient treatment of opiate and other addiction.  Self-help groups such as AA have been the backbone of alcohol and other addiction treatment so it is not surprising that new groups of self-help peer counseling will similarly be crucial in combating this epidemic.

In future blog posts, I’ll talk of the many efforts that lead to some optimism that the scourge of this opiate epidemic can be lessened, if not overcome.