Rice Law Office Blog

New Hampshire is currently considering legislation that would expand the “drug court” system, which proponents say are more effective in reducing crime and fighting addiction. The drug courts offer an alternative to incarceration for high-risk drug offenders by providing a program with treatment, accountability, and supervision.

Tina Nadeau, chief justice of the New Hampshire superior courts, has come out as a strong and vocal advocate for the drug court system. Judge Nadeau has pointed towards evidence that drug courts reduce crime and save money by providing an alternative to expensive incarceration. The issue is particularly pressing given the current opioid epidemic facing the state.

New Hampshire currently has six drug courts, but is looking to increase this number to eleven. In 2007, Texas enacted a drug court system that led to reductions in parole violations and crime rates while saving the state billions in prison costs. Judge Nadeau cited the example, and said “if Texas can do it, we can do it.”

New Hampshire needs to confront its drug abuse problem head on, and this means honestly addressing the problem in ways that will lead to positive results. Rather than jailing drug abusers, we need to help them find treatment—it’s cheaper and more effective. Judge Nadeau’s bold stance in support of drug courts is one we should all support.

New Hampshire is currently in the midst of an opioid epidemic, and the problem can be traced in part to high rates of prescription for opioid painkillers. New Hampshire ranks third in the country in terms of prescription rate for high-dose and long-acting opioid pain relievers according to the Center for Disease Control and Prevention (CDC).

There has been a great deal of effort expended on reducing unnecessary opioid prescriptions across the country and more particularly in NH. This June, Senator Kelly Ayotte co-sponsored a law that would create a “Pain Management Best Practices Inter-Agency Task Force”. At the state level, New Hampshire established a prescription drug monitoring program in 2012 that is still in the implementation process.

Patients can be their best first defense against prescription drug addiction by being informed, asking doctors if there is an alternative to narcotic pain medication and understanding whether the dosing is optional or required. Patients often think they have to take the meds as prescribed, but if they asked, they would find many narcotic prescriptions are only by choice and need not be taken as often or for as long as the bottle says.

New medical studies are showing that the body may actually become acclimated to narcotic medications, leading to increased sensitivity in pain receptors and a greater reliance on medication for pain management. Many studies show that alternate pain management treatments are as effective as opioids without the risk of addiction. Each case is unique, but patients should be proactive in understanding the treatment they are receiving. 

It’s important to listen to your doctor, but if you’re being prescribed high-dose opioids for pain relief you need to be informed and engaged in determining if this is the best course of treatment. Ask about dosage, risks, and alternatives to be sure you are receiving the best care.

At the end of 2015, the 12^th Annual Survey of Prescription Drug Management in Workers’ Comp, which tracks pharmacy costs for workers’ compensation, was released. The study showed that drug costs increased more than 6 percent compared to 2014.

This increase in drug costs is thought to be due to the increased price of medication but also due to the dramatic increase in the amount of prescriptions being written, particularly for opioids. In 2012, total spending on opioids in the US was just over $8 billion, and workers’ compensation paid for about 17 percent of that total.

That figure has grown dramatically and New Hampshire has one of the highest per capita rates of opioid prescription in the country. Not surprisingly, NH has one of the highest rates of addiction in the country. Last year more than 300 people died from drug related causes in New Hampshire, with the vast majority of those deaths stemming from opioid abuse.

The opioid epidemic in New Hampshire is very much in the spotlight, and this post will be the first in a series examining prescription drug addiction, strategies for managing prescriptions, and new legal approaches to combatting addiction.

Photo courtesy of Flickr user Chris Potter under a Creative Commons Attribution 2.0 Generic License.

Since August 2014, New Hampshire has had a law in place that requires most health care facilities and licensed providers to create a written drug testing policy that also addresses the issue of diversion of controlled substances. While the legislation does not spell out the specifics for the internal policy, it does require that it apply to all employees who “provide direct or hands-on care to clients.”

Last spring USA Today reported that there were more than 100,000 medical professionals abusing prescription drugs, and that this abuse posed a threat to patient care and health. One of the core findings was that, in many cases, it was extremely easy for these healthcare professionals to access prescription, and that they were particularly adepts at hiding their addiction. Understandably, the report sparked a national debate on how best to combat this problem.

The law also requires testing when there is reasonable cause to believe an employee is impaired, but generally leaves room for facilities to select their own policy so long as it is “appropriate to its size, the nature of services provided and its particular setting.”

The ultimate implementation of these policies will vary a great deal across the state, but all healthcare providers need to be aware of the new requirements. Developing a policy which protects patients means establishing procedures to monitor controlled substances in the medical facility, provide confidential employee assistance programs, as well as maintain consistent reporting and discipline standards will be critical for all health care providers in New Hampshire.

Photo courtesy of FtWashGuy under a creative commons license.