Taking on the Opioid Crisis

The States of New Hampshire and Vermont both admit they are in the midst of an opioid epidemic, with overdose deaths in New Hampshire predicted to top 400 by the end of 2015 and Vermont communities scrambling to curb the related crime devastating numerous communities.

Both states have taken significant steps to begin to bring this epidemic under control, though there is likely more that still needs to be done.

Vermont is implementing a comprehensive strategy that includes increased access to treatment, especially medication assisted treatment. Their plan also includes distributing Naloxone, a medication which can temporarily reverse the effects of an overdose allowing time for emergency medical care to intervene.

In response to the opioid crisis in New Hampshire, the state has created the campaign Anyone.Anytime.NH to educate the public and professionals about addiction. This campaign is designed to help anyone affected by this crisis, including people experiencing addiction, parents, family and friends of those experiencing addiction and health care, safety, and other system staff working with people who may be experiencing addiction.

New Hampshire authorities are also working to make Narcan (aka Naloxone) more available. Regional public health networks, PHC included, are hosting community events that offer training in the use of Narcan and provide free Narcan kits to individuals who are concerned about someone’s opioid use.  Some pharmacies, using standing orders from a physician, are able to provide Narcan to anyone who wants it. First Responders in New Hampshire are looking for more and better training on how to direct victims to treatment and recovery services.

In New Hampshire, the NH Heroin Task Force spent the last few months of 2015 developing a series of proposals intended to address the crisis. Some of the proposals relate to increasing criminal penalties for dealing, improving the Prescription Medication Monitoring Program, removing insurance barriers to accessing treatment, and many more. Many of these proposals must still be considered by the legislature in the form of bills and consideration will begin early in 2016.

For anyone concerned about heroin and other opioids in the communities or families, there are resources available – albeit not enough – and people should be encouraged to reach out for information and help.  In New Hampshire, start at Anyone.Anytime. In Vermont, start at the HealthVermont website.

A Brief History of the Public Health Council Priorities

PCH_Logo1_blue_03The Public Health Council of the Upper Valley is dedicated to facilitating leadership on regional public health priorities, fostering collaboration to improve effective action, and making sure we know how much has changed.  The community health improvement planning process, started in late 2014, has been the PHC’s approach to getting started. We recognize that needs will change, knowledge about effective strategies will evolve, and our capacities for coordination and collaboration will grow. For these reasons, we understand that this “improvement planning process” will be an ongoing part of our work and that this document represents our best thinking at this point in time.

In the later part of 2013, members of the PHC’s Executive Team reviewed relevant needs assessment data from the previous ten year period. The goal was to identify the top health-related issues of concern, particularly those issues that had shown little improvement over time. The thinking was that our purpose, as a collaborative leadership body, was to find new ways to tackle these problems collectively. Some of the conclusions from this review include recognition that despite the fact that the Upper Valley Region mirrors or exceeds the strong health status of the states of NH and VT, there are significant variations in health and well-being between individual communities and residents. These disparities appear to be primarily related to income. Lower income residents, including many skilled workers, have significant challenges with housing, access to health care, and transportation.  Housing costs often push them to the edges of our region, making access to jobs, job training, and health care a challenge driven by access to transportation. Another factor is that distance from health care increases the time required to get to and from appointments; time that many working people cannot afford.

In 2014, PHC members worked together to review the health-related needs of our communities and establish a set of priorities for collaborative action. The Upper Valley Agenda for Public Health (link to document) lays out the priorities and the measures we will use to measure our progress. The priorities established include:

Healthy Community

  • Improve oral health
  • Decrease substance misuse
  • Promote healthy weight
  • Decrease heart disease
  • Increase cancer prevention
  • Increase preventative care and access to care

Safe Community

  • Reduce preventable injuries
  • Improve community conditions for elders
  • Decrease incidents of sexual assault and relationship violence
  • Reduce violent crime
  • Ensure preparedness for public health emergencies

Supportive Community

  • Reduce adverse childhood experiences
  • Increase supports for aging in community
  • Ensure access to behavioral health and substance abuse services
  • Increase caring response to people with behavioral health and substance abuse concerns

Vital Community

  • Increase number of people in living-wage, full time jobs
  • Increase access to affordable and safe housing
  • Increase transportation options connecting people to jobs, shopping, and services
  • Increase social capital

Members of the PHC acknowledge that our list of priorities is ambitious and we are not able to work on all of the priorities immediately or simultaneously.  Our approach has been to start where there is current momentum, resources, and willing partners. The other priorities remain in the developmental phase as we look for opportunities to bring them to the forefront; these opportunities might include new interest in the topic, new stakeholder activity that provides a foundation to build from, or new funding opportunities.