Pubdate: Tue, 22 Dec 2015
Source: Baltimore Sun (MD)
Copyright: 2015 The Baltimore Sun Company
Contact:  http://www.baltimoresun.com/
Details: http://www.mapinc.org/media/37
Author: Seema Mehta, Tribune Newspapers

N.H. HEROIN CRISIS PUTS ISSUE INTO PRESIDENTIAL CAMPAIGNS

Anguished Voters Tell of Drug Use in Their Families

MANCHESTER, N.H. - Zach Brewster had a long history of addiction and 
was dealing drugs after flunking out of college.

One night he injected a cocktail of cocaine and heroin and stopped 
breathing. He was taken by ambulance to the emergency room of the 
suburban hospital that employed his parents, where they were told 
their son might not survive the night.

When he pulled through, his parents thought the scare might make him 
serious about recovery.

Three days later, he was back to using heroin.

Over the last decade, families like the Brewsters have become the 
face of opioid and heroin addiction that is gripping the Northeast. 
Until recently, the epidemic received little attention.

But a sharp increase in heroin overdoses over the last 18 months - a 
trend mirroring an uptick in Maryland - and New Hampshire's 
first-in-the-nation presidential primary are placing the issue 
squarely in front of the country as candidates barnstorm the state.

At town halls, in diners and at house parties, candidates of both 
parties are hearing tales from anguished voters about drug addiction 
in their families. And the White House hopefuls are repeatedly 
grilled about their approach to fighting drug abuse.

"If they didn't get it before they started campaigning, they 
certainly get it now," said Tim Soucy, director of Manchester's 
Public Health Department. "We've always had heroin and opioid 
addiction issues, but it has really exploded. It's so cheap and so 
readily available."

The presidential candidates today have placed a far greater emphasis 
on rehabilitation than punishment. This is a departure from nearly a 
half-century's approach, starting with President Nixon's "war on 
drugs" and through the 1990s, when the number of people imprisoned 
for nonviolent drug offenses skyrocketed.

A task force created by Gov. Larry Hogan to address Maryland's heroin 
overdose problem has called for a similar approach, including 
expanded access to treatment, tighter monitoring of prescription 
drugs and greater focus on groups like inmates and ex-offenders. 
Among the group's 33 "holistic" recommendations are a proposal to 
create a registry to track prescriptions of opioids - highly 
addictive drugs that have led some users to heroin - and "day 
reporting centers" to provide treatment and other services to 
prisoners upon release.

State governments began turning to rehabilitation during the first 
decade of the new millennium, but the federal government only 
recently began shifting its focus.

Brewster has seen both approaches. He has been arrested nearly a 
dozen times and has spent time in treatment centers that cost tens of 
thousands of dollars a month. None of it worked, until one day in 
2013 when he woke up in a hotel room surrounded by people doing drugs 
and he felt as though a "concussion grenade" had gone off in his 
head. He acted on an overwhelming urge to call his mother and told 
her he was serious about getting straight.

"We were just assuming every phone call we got after a hiatus of not 
hearing from Zach would be the last," said his father, Bill Brewster, 
a physician at Harvard Pilgrim Health Care, where he works as 
associate medical director for New Hampshire. Zach's mother, Jo-Ann, 
is an emergency room nurse at the hospital.

The state attorney general told a legislative task force this month 
that New Hampshire was on pace this year to see a record of more than 
400 overdose deaths related to heroin and opioids - double the number 
two years ago.

A major cause is people being prescribed painkillers, developing an 
addiction and then switching to heroin because a crackdown made it 
more difficult to obtain prescription opioids and because of the 
cheap and abundant supply of the illegal narcotic. A 30-milligram 
oxycodone pain pill can cost $90 to $100 on the street, money that 
can buy 10 or more doses of heroin, Soucy said.

Heroin addiction is a nationwide problem. The rate of heroin use 
doubled from 2002 to 2013, and the number of overdose deaths nearly 
quadrupled, according to the Centers for Disease Control and Prevention.

The number of Marylanders who died of heroin overdoses has more than 
doubled since 2010. In 2014, heroin claimed 578 lives in the state, 
compared with 464 the previous year, and the upward trend has 
continued this year.

Geographically, the problem is the greatest in the Midwest and the 
Northeast, and New Hampshire is one of the epicenters.

Manchester is the state's largest city, with about 110,000 residents. 
This year, paramedics have responded to nearly 700 overdose calls, 
with 85 deaths. Mayor Ted Gatsas raises the crisis with every 
candidate he meets.

"It's the first thing we have a conversation about," Gatsas said. "If 
there was any one item that was killing people at the rate that this 
is doing, people would be outraged."

He added, "If this has not touched you yet, it will very soon."

Indeed, many of the Republican presidential candidates have personal 
connections with addiction.

Former Florida Gov. Jeb Bush has spoken about his daughter, Noelle, 
who battled prescription drug abuse and was jailed for possessing 
crack cocaine. Sen. Ted Cruz's sister and former Hewlett-Packard 
chief Carly Fiorina's daughter both overdosed and died. The 
candidates' candor reflects a growing movement to increase awareness 
by being open about the cause of such deaths. It's seen in the too 
frequent obituaries of young people in the New Hampshire Union 
Leader; write-ups now include information provided by families about 
their loved ones' struggles with addiction and death by overdose, 
rather than euphemisms about "dying suddenly."

At a town hall in Belmont, N.H., this year, New Jersey Gov. Chris 
Christie described staging an intervention for a close, successful 
friend from law school who developed an addiction to pain pills after 
a back injury. The man was in and out of rehab for a decade before 
being found dead in a motel room with an empty bottle of Percocet and 
an empty quart of vodka.

"When I sat there as the governor of New Jersey at his funeral and 
looked across the pew at his three daughters sobbing because their 
dad is gone, there but for the grace of God go I. It can happen to 
anyone," Christie said. "And so we need to start treating people in 
this country, not jailing them. We need to give them the tools they 
need to recover because every life is precious."

Democratic presidential candidate Hillary Clinton hosted a drug forum 
in Keene, N.H., where she laid out a $10 billion proposal that would 
send states federal money to boost treatment programs and urge law 
enforcement to focus on rehabilitation rather than incarceration.

Zach Brewster, who has stayed away from drugs for more than a year, 
now runs the learning center at Teen Challenge, the 26-bed men's 
group home where he lived for 15 months in downtown Manchester during 
his rehabilitation. (Despite its name, the group home treats adult addicts.)

Brewster, now 29, said he believes he has a "moral obligation" to 
share his experiences with others.

"Help is going to come from success stories, people who aren't afraid 
to talk about what they've come from."
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