FREE Narcan pick up sites - VT & NH

NALOXONE SITES

Vermont Locations:

Bradford:

·        Clara Martin (Outside)

1483 Lower Plain, Bradford, VT

Burke:

·        Burke Academy (Inside)

60 Alpine Lane, East Burke, VT

Norwich:

·        Dan and Whites (Outside)

319 Main Street, Norwich, VT

Randolph:

·        Clara Martin (Outside)

11 Main Street, Randolph, VT

Springfield:

·        Springfield Food Coop (Inside and Outside in the walkway)

6 Main Street Suite 1, Springfield, VT

South Royalton:

·        South Royalton Library (no box but Narcan available inside if you ask)

23 Alexander Place, South Royalton, VT

Thetford:

·        Thetford Academy (2 boxes inside)

304 Academy Road, Thetford Center, VT

White River Junction:

·        Listen Services Dinner Hall (Inside & Outside)

42 Maple Street Suite 4, WRJ, VT

·        Listen Services thrift store (Inside)

42 Maple Street Suite 2, WRJ, VT

·        Gear Again (outside)

93 South Main Street, WRJ, VT

·        Main Street Museum (Outside)

58 Bridge Street, WRJ, VT -> go to the back of the Museum and you will find the box under the deck near the downstairs door.

·        Clara Martin (Outside)

39 Fogg Farm Road, WRJ, VT

·        VA (Inside?)

163 Veterans Drive, WRJ, VT

·        Upper Valley Haven (Multiple boxes inside the buildings)

713 Hartford Avenue, Hartford, VT

Windsor:

·        Windsor Connection (Inside)

1 Railroad Avenue, Windsor, VT

New Hampshire locations:

Claremont:

·        Groups Together (Outside)

5 Dunning Street, Claremont, NH

·        River Valley Community College (Inside)

1 College Place, Claremont, NH

Croydon:

·        Croydon Fire Department (Inside)

828 NH 10, Croydon, NH

Enfield:

·        Georges (Inside)

66 Main Street, Enfield, NH

Keene:

·        River Valley Community College

88 Winchester Street, Keene, NH

Lebanon/W. Lebanon:

·        Kilton Library (Inside)

80 South Main Street, West Lebanon, NH

·        Lebanon Library (Inside)

9 East Park Street, Lebanon, NH

·        Listen Thrift Store (Inside)

387 Miracle Mile, Lebanon, NH

·        Mascoma Village Store (Outside)

558 Dartmouth College Highway, Lebanon, NH

·        River Valley Community College (Inside)

15 Hanover Street, Lebanon, NH

·        Waypoint (Inside & Outside)

63 Hanover Street, Lebanon, NH

Newport:

·        Newport Library (Inside)

58 North Main Street, Newport, NH

·        Orion House (Inside)

139 Elm Street, Newport, NH

·        Granite Hill School (Inside)

135 Elm Street, Newport, NH

Springfield:

·        Springfield Fire Department (Inside)

2791 Main Street, Springfield, NH

·        Springfield Town Offices (Inside)

2748 Main Street, Springfield, NH

FREE Narcan Training in Newport NH on February 16, 2023

This could be a life saving training.

How a ‘Perfect Storm’ in New Hampshire Has Fueled an Opioid Crisis

By Katharine Q. Seelye

The New York Times

Jan. 21, 2018

MANCHESTER, N.H. — They sat on plastic chairs in a corner of the Manchester fire station, clutching each other in a desperate farewell.

Justin Lerra was 26 when he turned himself in last summer to the fire department’s “safe station” program, which helps get drug users into treatment. He had been using drugs for seven years. His girlfriend, Sarah, who asked that her last name not be published, was pregnant and had told him that if he didn’t stop using, she would leave him.

Emotional scenes like this play out daily at firehouses in Manchester and Nashua, a measure of how deeply the opioid scourge has ravaged New Hampshire. The state leads the nation in overdose deaths per capita from fentanyl, a powerful synthetic opioid that has virtually replaced heroin across New England. Because fentanyl is so potent, the risk of overdose is high.

In New Hampshire, which President Trump has called a “drug-infested den,” the opioid crisis is almost a statewide obsession.

A man who overdosed after injecting opioids was revived by firefighters and paramedics with two doses of Narcan in Manchester.CreditTodd Heisler/The New York Times

An astonishing 53 percent of adults said in a Granite State poll last year that drugs were the biggest problem facing the state — the first time in the poll’s history that a majority named a single issue as the most important. (Jobs and the economy lagged a distant second.)

While West Virginia leads the nation in overall drug overdose deaths per capita, New Hampshire is essentially tied with Ohio for second place.

Unlike West Virginia, New Hampshire is relatively prosperous, which makes an opioid crisis here seem all the more jarring. This state has the highest median household income in the country, ranks low in unemployment and crime, and often lands at or near the top of lists of the best states in which to live.

Researchers at Dartmouth College in Hanover, N.H., have been studying the issue to try to understand why the state’s opioid problem is so dire.

One big reason, they say, is the proximity to an abundant drug supply in neighboring Massachusetts, the center of drug distribution networks that traffic opioids throughout New England.

Another, they say, is New Hampshire’s low per capita spending on services to help drug users break free from addiction. Nationally, the state, which has no income or sales tax, ranks at the bottom in availability of treatment programs. The fire departments’ safe stations are one effort to fill that void.

The researchers also noted that the state has pockets of “economic degradation,” especially in rural areas where jobs are few, and that may contribute to the problem.

Beyond that, the researchers say, doctors here have long prescribed “significantly higher rates” of opioid pain relievers, almost twice the national average. When the government cracked down on legal painkillers, New Hampshire residents were primed to seek out illegal street drugs.

“This is a kind of perfect storm,” says Lisa A. Marsch, a professor of psychiatry and health policy at Dartmouth’s Geisel School of Medicine and the study’s principal investigator.

“We have highly available, highly potent opioids in New Hampshire,” she says. “And highly limited resources to reduce the risk.”

The researchers noted other factors, too:

• A shortage of workers in addiction and recovery. Northeast states have an average of 15.5 doctors per 100,000 residents who can prescribe Suboxone and other medication-assisted treatments; New Hampshire has seven.

• No needle exchanges, which can reduce the transmission of diseases like hepatitis C and save health care costs. New Hampshire finally legalized needle exchanges in June, long after many other states had done so, but did not fund them. Dartmouth medical students, using donations and grants, opened the first needle exchange last summer in a Claremont, N.H., soup kitchen, but it was shut down in October because it was too close to a school.

• “Live Free or Die.” The researchers said the New Hampshire ethos of “self-sufficiency and individualism” could inhibit some residents from seeking help. And for some, they said, the state’s “Live Free or Die” motto might justify risky behaviors. The state does not require drivers to wear seatbelts. It allows motorcyclists to ride without helmets. And state liquor stores are right on the major highways.

New CDC director aims to end AIDS epidemic in seven years

By Allen Cone

March 30 (UPI) -- The new director of the Centers for Disease Control and Prevention said in a speech the AIDS epidemic could be ended within seven years and pledged to bring the opioid crisis "to its knees."

Dr. Robert Redfield Jr. spoke at a staff meeting of the CDC in Atlanta on Thursday, three days after replacing Dr. Brenda Fitzgerald, who resigned in January after about six months on the job. She reportedly bought shares in tobacco, drug and food companies last year roughly one month into the job.

For 50 minutes, Redfield spoke to staff at the Atlanta headquarters and CDC operations around the country.

Redfield, 65, said he was honored to lead the best "science-based, data-driven agency in the world. I've dreamed of doing this for a long time." The CDC has nearly 12,000 employees worldwide.

"We're not an opinion organization," he said. "That's why CDC has the credibility around the world that it has."

Redfield added: "Academia does not solve problems. Academia is not a service organization."

The former AIDS researcher has spent decades treating people who have HIV.

"Ending the AIDS epidemic in America? It's possible," he said. "I think it could be done in the next three to seven years, if we put our mind to it."

Although there is no effective HIV vaccine, Redfield said existing tools for treating HIV and preventing its spread can stop the U.S. epidemic.

"I've never been an abstinence-only person -- just ask my wife," said Redfield, who is Catholic. "I believe in every measure we have scientific evidence for, including condoms."

Only about 10 percent to 20 percent are using condoms, he noted. In 2016, nearly 40,000 people in the United States were diagnosed with HIV. The CDC reported 12,497 people died with AIDS in the United States in 2015.

He pledged that CDC would play a key role in other agencies in the Department of Health and Human Services in dealing with opioid misuse and abuse, which he called "the public health crisis of our time." He said they will work on "bringing it to its knees."

Opioids killed more than 42,000 people in 2016, more than any year on record, according to the CDC. And 40 percent of all opioid overdose deaths involve a prescription opioid.

"If any of you have tried to access care for addiction in this nation, I can guarantee you it's complicated," he said. "It needs to not be complicated."

Redfield also said emergency preparedness to protect "the health of the American public from that which we don't expect" is the agency's top mission. He called a pandemic influenza "my biggest fear." And he wants the CDC to be "100 percent prepared" for new or re-emerging infectious diseases threat or bioterrorism.

"I pray it doesn't happen on our watch. But I want to make sure we're all prepared, whether it's flu -- my biggest fear -- or MERS or something else," he said, referring to the viral Middle East respiratory syndrome.

"I respect the mission we have, which is to be prepared for what we don't expect."

Marijuana legalization could help offset opioid epidemic, studies find

By Mark Lieber, CNN

(CNN)Experts have proposed using medical marijuana to help Americans struggling with opioid addiction. Now, two studies suggest that there is merit to that strategy.

The studies, published Monday in the journal JAMA Internal Medicine, compared opioid prescription patterns in states that have enacted medical cannabis laws with those that have not. One of the studies looked at opioid prescriptions covered by Medicare Part D between 2010 and 2015, while the other looked at opioid prescriptions covered by Medicaid between 2011 and 2016.

The researchers found that states that allow the use of cannabis for medical purposes had 2.21 million fewer daily doses of opioids prescribed per year under Medicare Part D, compared with those states without medical cannabis laws. Opioid prescriptions under Medicaid also dropped by 5.88% in states with medical cannabis laws compared with states without such laws, according to the studies.

"This study adds one more brick in the wall in the argument that cannabis clearly has medical applications," said David Bradford, professor of public administration and policy at the University of Georgia and a lead author of the Medicare study.

"And for pain patients in particular, our work adds to the argument that cannabis can be effective."

Medicare Part D, the optional prescription drug benefit plan for those enrolled in Medicare, covers more than 42 million Americans, including those 65 or older. Medicaid provides health coverage to more than 73 million low-income individuals in the US, according to the program's website.

"Medicare and Medicaid publishes this data, and we're free to use it, and anyone who's interested can download the data," Bradford said. "But that means that we don't know what's going on with the privately insured and the uninsured population, and for that, I'm afraid the data sets are proprietary and expensive."

'This crisis is very real'

The new research comes as the United States remains entangled in the worst opioid epidemic the world has ever seen. Opioid overdose has risen dramatically over the past 15 years and has been implicated in over 500,000 deaths since 2000 -- more than the number of Americans killed in World War II.

"As somebody who treats patients with opioid use disorders, this crisis is very real. These patients die every day, and it's quite shocking in many ways," said Dr. Kevin Hill, an addiction psychiatrist at Beth Israel Deaconess Medical Center and an assistant professor of psychiatry at Harvard Medical School, who was not involved in the new studies.

"We have had overuse of certain prescription opioids over the years, and it's certainly contributed to the opioid crisis that we're feeling," he added. "I don't think that's the only reason, but certainly, it was too easy at many points to get prescriptions for opioids."

Today, more than 90 Americans a day die from opioid overdose, resulting in more than 42,000 deaths per year, according to the US Centers for Disease Control and Prevention. Opioid overdose recently overtook vehicular accidents and shooting deaths as the most common cause of accidental death in the United States, the CDC says.

Like opioids, marijuana has been shown to be effective in treating chronic pain as well as other conditions such as seizures, multiple sclerosis and certain mental disorders, according to the National Institute on Drug Abuse. Research suggests that the cannabinoid and opioid receptor systems rely on common signaling pathways in the brain, including the dopamine reward system that is central to drug tolerance, dependence and addiction.

"All drugs of abuse operate using some shared pathways. For example, cannabinoid receptors and opioid receptors coincidentally happen to be located very close by in many places in the brain," Hill said. "So it stands to reason that a medication that affects one system might affect the other."

But unlike opioids, marijuana has little addiction potential, and virtually no deaths from marijuana overdose have been reported in the United States, according to Bradford.

"No one has ever died of cannabis, so it has many safety advantages over opiates," Bradford said. "And to the extent that we're trying to manage the opiate crisis, cannabis is a potential tool."

Comparing states with and without medical marijuana laws

In order to evaluate whether medical marijuana could function as an effective and safe alternative to opioids, the two teams of researchers looked at whether opioid prescriptions were lower in states that had active medical cannabis laws and whether those states that enacted these laws during the study period saw reductions in opioid prescriptions.

Both teams, in fact, did find that opioid prescriptions were significantly lower in states that had enacted medical cannabis laws. The team that looked at Medicaid patients also found that the four states that switched from medical use only to recreational use -- Alaska, Colorado, Oregon and Washington -- saw further reductions in opioid prescriptions, according to Hefei Wen, assistant professor of health management and policy at the University of Kentucky and a lead author on the Medicaid study.

"We saw a 9% or 10% reduction (in opioid prescriptions) in Colorado and Oregon," Wen said. "And in Alaska and Washington, the magnitude was a little bit smaller but still significant."

The first state in the United States to legalize marijuana for medicinal use was California, in 1996. Since then, 29 states and the District of Columbia have approved some form of legalized cannabis. All of these states include chronic pain -- either directly or indirectly -- in the list of approved medical conditions for marijuana use, according to Bradford.

The details of the medical cannabis laws were found to have a significant impact on opioid prescription patterns, the researchers found. States that permitted recreational use, for example, saw an additional 6.38% reduction in opioid prescriptions under Medicaid compared with those states that permitted marijuana only for medical use, according to Wen.

The method of procurement also had a significant impact on opioid prescription patterns. States that permitted medical dispensaries -- regulated shops that people can visit to purchase cannabis products -- had 3.742 million fewer opioid prescriptions filled per year under Medicare Part D, while those that allowed only home cultivation had 1.792 million fewer opioid prescriptions per year.

"We found that there was about a 14.5% reduction in any opiate use when dispensaries were turned on -- and that was statistically significant -- and about a 7% reduction in any opiate use when home cultivation only was turned on," Bradford said. "So dispensaries are much more powerful in terms of shifting people away from the use of opiates."

The impact of these laws also differed based on the class of opioid prescribed. Specifically, states with medical cannabis laws saw 20.7% fewer morphine prescriptions and 17.4% fewer hydrocodone prescriptions compared with states that did not have these laws, according to Bradford.

Fentanyl prescriptions under Medicare Part D also dropped by 8.5% in states that had enacted medical cannabis laws, though the difference was not statistically significant, Bradford said. Fentanyl is a synthetic opioid, like heroin, that can be prescribed legally by physicians. It is 50 to 100 times more potent than morphine, and even a small amount can be fatal, according to the National Institute on Drug Abuse.

"I know that many people, including the attorney general, Jeff Sessions, are skeptical of cannabis," Bradford said. "But, you know, the attorney general needs to be terrified of fentanyl."

'A call to action'

This is not the first time researchers have found a link between marijuana legalization and decreased opioid use. A 2014 study showed that states with medical cannabis laws had 24.8% fewer opioid overdose deaths between 1999 and 2010. A study in 2017 also found that the legalization of recreational marijuana in Colorado in 2012 reversed the state's upward trend in opioid-related deaths.

"There is a growing body of scientific literature suggesting that legal access to marijuana can reduce the use of opioids as well as opioid-related overdose deaths," said Melissa Moore, New York deputy state director for the Drug Policy Alliance. "In states with medical marijuana laws, we have already seen decreased admissions for opioid-related treatment and dramatically reduced rates of opioid overdoses."

Some skeptics, though, argue that marijuana legalization could actually worsen the opioid epidemic. Another 2017 study, for example, showed a positive association between illicit cannabis use and opioid use disorders in the United States. But there may be an important difference between illicit cannabis use and legalized cannabis use, according to Hill.

"As we have all of these states implementing these policies, it's imperative that we do more research," Hill said. "We need to study the effects of these policies, and we really haven't done it to the degree that we should."

The two recent studies looked only at patients enrolled in Medicaid and Medicare Part D, meaning the results may not be generalizable to the entire US population.

But both Hill and Moore agree that as more states debate the merits of legalizing marijuana in the coming months and years, more research will be needed to create consistency between cannabis science and cannabis policy.

"There is a great deal of movement in the Northeast, with New Hampshire and New Jersey being well-positioned to legalize adult use," Moore said. "I believe there are also ballot measures to legalize marijuana in Arizona, Florida, Missouri, Nebraska and South Dakota as well that voters will decide on in Fall 2018."

Hill called the new research "a call to action" and added, "we should be studying these policies. But unfortunately, the policies have far outpaced the science at this point."