Four dozen of New Hampshire’s top law officers, health officials and addiction experts came together to share their first-hand frustrations and observations about the fallout from the current drug epidemic responsible for unprecedented accidental deaths, spiking crime rates and a revolving door of addiction here, and across the country.

U.S. Sen. Kelly Ayotte, R-NH, organized the two-hour listening session on April 23, a group which included: NH Attorney General Joseph Foster; police chiefs from more than a dozen cities and towns, including Manchester Chief David Mara and Nashua Chief John Seusing; Chief Medical Examiner Dr. Thomas Andrew; Dr. Cheryl Wilkie, of Easter Seals/Farnum Center; and others.

The only thing missing from the gathering was the kind of politicized posturing one might expect from a meeting of the minds involving state officials and federal officials.

Instead, the panelists spoke with a genuine sense of urgency about the alarming prevalence of heroin and opiate use, which has rapidly become an epic public health problem here.

Jails are jammed, with no in-house rehabilitation; state-funded beds  at treatment centers have wait lists at least two months out. Crime victims have no assurance that their communities are safe from drug-driven criminals. Families are desperate for answers.

The result is a revolving door of addicts who can’t get the treatment they need to recover, which leads to relapse and recidivism. Unintended consequences include over-burdened police drug units and a staggering spike in death rates, 96 percent of them deemed “accidental.”

The following is a recap  of the highlights from each of the seven resulting video clips, filmed at Manchester NH Police headquarters:

You can watch all seven parts of the Heroin/Opioid Roundtable below. Just click play.

 Part 1

Manchester Police Chief David Mara talks about the progression of heroin addiction for the typical user –  often escalating from oxycodone use. But with a street cost of $30 for a 30 milligram pill,  multiplied by a several pill-a-day habit, addicts turn to crime to support their addiction.

Mara said over the past four years, Manchester’s drug unit has confiscated  an increasing amount of heroin:

2010 – 45.25 grams

2011 – 186.8 grams

2012 – 406.2 grams

2013 – 664.6 grams

In the first quarter of 2014: 600 grams of heroin were confiscated so far, on track to quadruple what was confiscated in 2013.

Part 2 

New Hampshire Chief Medical Examiner Dr. Thomas Andrew said annual drug deaths have increased from about 50 to nearly 200 in the past decade.

Of the 193 drug-related deaths in 2013, all but two were ruled accidental, pointing out an unintended consequence of drug addiction.

“If we saw a 400 percent increase in asthma or traffic deaths or homicides, that would get a lot of attention,” Andrew said.  But we’ve seen a 400 percent increase in drug deaths, and the deaths are just the tip of the iceberg.”

Purity and price are the driving factors pushing heroin to the top of the chart of most-deadly drug.

Part 3 

NH Attorney General Joseph Foster said heroin and prescription drugs are a problem in every jurisdiction across the state.

“It has no boundaries. When I meet with Attorneys General from around the country, I hear the same thing,” Foster said.

He relayed getting a prescription for 30 pain killers after minor knee surgery.

“I probably only needed six or seven of them, but it led me to think about what would have happened if I were prone to addiction?” Foster said.  “I don’t believe we can arrest or prosecute our way out of this.”

He has asked the NH legislature to add another drug prosecutor to his team, and will press for more treatment options.

He said he’s also working to put more Narcan, an opiate blocker, into the hands of police and medical personnel.

Dr. Cheryl Wilkie, Senior Vice President of Substance Abuse Services for the Farnum Center in Manchester, said  New Hampshire is heading “in the right direction.” Wilkie would like to see jails and prisons include treatment for addicts, once incarcerated.

“They are a captive audience, and we’re already paying $30,000 for them to be there,” Wilkie said.

Part 4

Kensington Police Chief Michael Sielicki said police see no short- or long-term solution.

“There’s nothing we can do but arrest them and hope they sober up and stop breaking into houses,” Sielicki said.

He is calling for a top-down approach to solving this problem.

“There has to be a more comprehensive approach. There has to be leadership from the top to focus all our efforts in fighting this,” Sielicki said.

Enfield NH Police Chief Richard Crate  said it’s time to call on the medical community to stop over-prescribing oxy medications.

“Even officers in our ranks have been affected by this, and we’re going to see more of it – and these numbers are going to continue to increase. When you talk about 20 year olds fighting heroin addiction, they will be fighting it for the rest of their lives, and will probably be  in treatment centers for the rest of their lives. This doesn’t go away.”

Medical Examiner, Dr. Thomas Andrew, said for every death from drugs in New Hampshire there are 26 people seeking treatment; over 100 habitual users; and 675 who are at some point in the pipeline to addiction.

“The death piece is the tip of the iceberg. The bang for the buck is in treatment, not on my side,” Andrew said.

Andrew also talked about the call to boycott Zohydro, a controversial new time-release opiate that has recently received FDA approval, and which some experts say will only increase the problem of opiate addiction.

Part 5

Nashua NH Police Chief John Seusing said “the majority of crimes investigated” by police across New Hampshire are either directly or indirectly related to this drug.

Over the past four years the number of heroin-related arrests in Nashua have increased six fold, and the number of overdoses are on track to triple this year over 2013 overdose statistics.

Seusing said his primary focus is to get drug dealers off the street. But it’s equally important to focus on treatment, otherwise addicts and dealers end up right back on the street.

Based on the need in Nashua, Seusing is preparing to request an increase in funding from the Board of Aldermen to hire more police officers.

“My drug unit has told me there is too much work on the street for them to handle,” Seusing said.

Part 6

Portsmouth NH Police Chief Stephen Dubois said based on what he’s heard from his peers, things worked better when there were more federal funding sources available to fight the crack problem of the 1980s and early 1990s.

Sen. Kelly Ayotte, R-NH, said there are things that can be done from a federal level to help state and local law enforcement.

“I know there are always challenging budget times – but I think this is a priority for people. What I’m hearing from my colleagues, is that this isn’t a  Republican or Democrat issue; this is just basic for everyone, in terms of public safety and quality of life,” Ayotte said.

Hampton NH Police Chief Jamie Sullivan said he’d like to hear more about holding drug companies accountable.

“What can we do to address the extreme profit motive these pharmaceuticals have to put these pills out there?” Sullivan asked. He said he’d like to engage drug companies in providing more education and treatment.

Enfield NH Police Chief Richard Crate said federal programs like Operation Streetsweeper may have been effective for the crack epidemic, but in small towns, treatment options are what’s needed most.

“I have housewives and moms burglarizing other homes for pills … I don’t need more officers, I need more help with treatment centers available to rural communities, so when we arrest them we have a place to send them so it stops,” Crate said.

Dr. Cheryl Wilkie said the heroin epidemic is different from other drug problems.

“I don’t think we’re going to see this changing back to cocaine or any other drug. The way heroin hits the system, the addiction is so powerful, and coming off of it is so different from coming off cocaine. With heroin, you are so sick you will do whatever it takes to get the drug, which is why we’re seeing housewives, and all the different people , who will do anything. It’s the only thing that stops them from being sick.  That addiction doesn’t just disappear. This is going to be the drug of choice, and once they try this they will not spend another dime on alcohol or cocaine or anything else,” Wilkie said.

Part 7

Derry NH Police Chief Ed Garone said he was frustrated, and sensed frustration of others in the room.

“Law enforcement has to do something about the symbiotic relationship between supply and demand, and law enforcement has the ability to affect one side of it – and that’s the supply side, and we do that by arresting,” Garone said.

“Once arrested, they have to be incarcerated and when they are incarcerated they need treatment. It’s the perfect opportunity to provide treatment. I’ve been told you can spend however long in prison as an addict, and when you come out, you’re still an addict and that is a problem,” he said.

Garone also said there are too many victims.

“This is an ugly octopus, this goes way out into the community,” and fighting it is a “three-pronged stool – education, treatment and enforcement.”

“We can’t arrest our way out of it, but we have to stop saying it costs too much to incarcerate.  We can’t wait to educate 7th or 8th graders so by time they’re 17 or 18 or 19 they are not breaking into homes; we have to do something now,” Garone said.

Manchester Public Health Director Tim Soucy  said he was heartened to hear so many law enforcement officials talk about treatment.

Getting to kids earlier will help. But for now, quality of life issues persist.

“Not a day goes by where my office doesn’t get called to go pick up used needles in the city.  We’re  finding them everywhere –  street corners, people’s driveways, alleys, woods – and I’m concerned with the long-range implication of this continued needle use that we’ll  see more Hep C and HIV,” Soucy said.

These drugs are coming primarily from South America and Afghanistan. Dr. Thomas Andrew made the point that someone needs to cultivate better collaboration across state borders to stop the drugs from coming in.

“The corridors from which these [drugs] are distributed are 91 and 95. If we look at a Zip Code analysis, there’s a wide swath between Keene and the Seacoast; the Lakes Region and North Country; and the border and south. Is it a federal responsibility to enhance interdiction efforts and distribution? We’re not even hassling the end users, at the distribution level, and I think this is  federal responsibility,” Andrew said.