Waiting For Treatment Can Mean Life Or Death In N.H.

When Eddie Sawyer called his former partner Eileen Shea and told her he was on a waitlist to get into the Friendship House, northern New Hampshire's only residential treatment facility, she offered to take him to the hospital to try to detox off heroin while he waited for a bed. But Shea knew there was no guarantee the hospital would admit Sawyer.

“I told him when we go to the hospital, you're either gonna have to drink a bunch of booze and they'll admit you that way because they take alcoholics, or we're gonna go in there and you're gonna have to say you’re suicidal,” she says. “That was the only thing I could think of to help him because they would not let him in because he was just drug addict.”

Unlike detoxing from alcohol, when people can have life-threatening seizures and be admitted to the hospital, withdrawing from heroin and other opioids is extremely uncomfortable, but is not considered a medical emergency, explains Dr. Randy Knight, an emergency room physician at Littleton Regional Healthcare.

“When I meet a patient and their family requesting help getting off of heroin or opiates, I have to tell them a hospital is not going to be able to provide the services that they need because the patient is not unstable from a medical point of view,” says Knight. “That doesn’t mean they're not going to use again and they tell me that if you send me out there I’m going to use again, but I just can’t offer them a hospital bed in that situation.”

Knight refers these patients to rehab but he knows the waits in New Hampshire are long. That's because New Hampshire has the second lowest level of access to substance abuse treatment in the U.S., right above Texas, according to the Substance Abuse and Mental Health Services Administration (SAMHSA). At the same time, New Hampshire is among the five states with the highest percentage of drug overdose deaths.

“It's typically four to six weeks that they’re on waiting list,” says Kristy Letender, director of Friendship House. “A lot of our admissions come from Manchester and Nashua, which is the southern part of the state, because they have six month waitlists to get into their programs, so they’re coming up north.”

There's also a shortage of doctors licensed to prescribe suboxone and other narcotics used to help people detox at home.

Sean Warren has struggled with heroin for more than two years. He's from Manchester, New Hampshire's largest city, where he was told it would be nine weeks before he could get a treatment bed.

“If I stayed out for nine weeks, I guarantee I wouldn't have survived,” says Warren. “I didn't have that time.”

Warren ended up in jail and then he got a bed up north at Friendship House. But Eddie Sawyer was not so lucky. He died of an overdose while waiting to get into treatment.

Eileen Shea, who has a daughter with Sawyer, says when the police found him in his apartment, there was list of rehab facilities on the table next to his bed. It was a list Shea had given to him a month earlier. There were check marks next to the name of each one. Eddie Sawyer had called every place on the list.

“Eddie did not want to continue to do drugs, but he just could not stop and he reached out for people to help him stop and nobody took him,” she says.

Eddie Sawyer was one of 428 people in New Hampshire who died last year from a drug overdose. This year the state has doubled its funding for substance abuse treatment and has made 43,000 residents eligible for treatment under expanded Medicaid. But that money may not be available after next year if New Hampshire lawmakers fail to renew the state's Medicaid expansion program, which they are currently debating.

This story was produced in collaboration with Kaiser Health News, a national health policy news service.

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• Rachel Gotbaum, journalist and contributor to Kaiser Health News and Here & Now. She tweets @rgotbaum1.

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