Optimism on NH’s opioid front line

by Shawne Wickham — It was a rare moment of optimism, amid all the bad news about the opioid epidemic, as leaders on the front line of the crisis gathered at Manchester Health Department Wednesday to talk about what’s going well.

Dr. Joseph Pepe, president and CEO of CMC Healthcare System, said it will take a collaborative approach to address the issues that led to the epidemic. “This truly is a health crisis, and it belongs to all of us, and it’s going to take all of us to solve it,” he said.

Pepe mentioned some of Catholic Medical Center’s efforts, including using alternative methods of pain management; an intensive treatment program for pregnant women and their babies; and giving “deactivation” kits to patients who have been prescribed painkillers after surgery.

“We have a long way to go but we are making a dent in this,” he said.

Lisa Guertin, president of Anthem Blue Cross and Blue Shield of New Hampshire, said the insurer is covering alternative approaches to pain management, “doing everything we can to take unnecessary opioids out of the system.”

Anthem is bringing an innovative program that covers home-based treatment to New Hampshire, Guertin said. And the state’s largest insurer has been working with New Hampshire Medical Society and New Hampshire Hospital Association to train primary care doctors in providing medication-assisted treatment for patients with substance use disorders, she said.

Cheryl Wilkie, chief operating officer of the Farnum Center, praised the collaboration she’s seen among insurers and providers, and even among providers themselves.

“Everyone’s working together to figure out how do we help all the programs in the state become the best, humane, dignified treatment we can offer,” she said. “That’s what we all want.”

Rik Cornell, vice president of community relations for the Mental Health Center of Greater Manchester, recalled when he first got into the field in the 1970s, such cooperation among agencies was nonexistent.

But now, he said, “Organizations that have never talked to each other, never even cared to hear about each other, are working together, coming together to see what they can do to make this work.”

The stakes couldn’t be higher, Cornell said.

“I have seen families destroyed, children destroyed, villages, towns and neighborhoods destroyed, schools destroyed,” he said. “Our community is not healthy right now.”

Peter Janelle, executive director of the Network4Health, said his organization includes 43 partners who meet regularly to address challenges. And despite low reimbursement rates for their services, he said, “Providers are not giving up. They’re working as hard as they can to do the best they can.”

Consultant Scott Spradling from the Spradling Group hosted the meeting, praising the insurers, treatment providers, police and advocates in the room as “thought leaders and doers.”

Cornell said one thing that is making a difference is the availability of mobile crisis teams that can respond to individuals in crisis in their homes and communities. And that’s having an impact on the number of those folks who end up in emergency departments, he said.

In the last fiscal year, he said, 351 fewer people sought help in the ER than the previous year. That’s good news, he said.

“Some good things are happening,” Cornell said. “People’s lives are being saved.”

Still, he sounded a somber note, stressing the critical importance of reaching out to children to talk about drugs, suicide, anxiety and depression. Otherwise, there’s a risk of creating a whole new generation of addicts, he said.

“If we can’t get at that, then what we’re dealing with now, all these people who have died,” he warned, “Another 10 years from now, this is going to seem like a heyday.”

Beyond the Stigma, sponsored by the New Hampshire Solutions Journalism Lab at the Nackey S. Loeb School of Communications, is funded by the New Hampshire Charitable Foundation, Dartmouth-Hitchcock Medical Center, NAMI New Hampshire, and private individuals. Contact reporter Shawne K. Wickham at swickham@unionleader.com.