New Hampshire Drug Monitoring Initiative · The age group with the largest number of drug overdose...

Table of Contents:

Drug Environment Report—UNCLASSIFIED

Purpose: The NH Drug Monitoring Initiative (DMI) is a holistic strategy to provide awareness and combat drug distribution and abuse. In line with this approach

the DMI will obtain data from various sources (to include, but not limited to, Public Health, Law Enforcement, and EMS) and provide monthly products for stake-

holders as well as situational awareness releases as needed.

Section Title Page #

Overview

Drug Overdose Deaths

Drug Overdose Deaths Map

EMS Narcan Administration

EMS Narcan Administration Map

Opioid Related Emergency Department Visits

Treatment Admissions

Situational Awareness

Substance Abuse Treatment/Recovery Directory

1 UNCLASSIFIED—AUTHORIZED FOR PUBLIC RELEASE

UNCLASSIFIED

New Hampshire Drug Monitoring InitiativeNew Hampshire Drug Monitoring Initiative New Hampshire Information & Analysis Center

Phone: (603) 223.3859 [email protected] Fax: (603) 271.0303

NHIAC Product #: 2019-3609 December 2018 Report 29 January 2019

Population data source: http://www.nh.gov/osi/data-center/population-estimates.htm Year/month overview charts are based on annual estimates from the above website. County charts are based on a 2017 estimated population of each county.

If your agency is looking for further breakdowns than what is in this document please contact the NHIAC.

Tracked by NHIAC/HSEC SINs: 03,16 / 05,06

Previous versions of the Drug Environment Report can be found at: https://www.dhhs.nh.gov/dcbcs/bdas/data.htm

The new, online DMI viewer can be found at: https://nhvieww.nh.gov/IAC/DMI/

mailto:[email protected]://www.nh.gov/osi/data-center/population-estimates.htmhttps://www.dhhs.nh.gov/dcbcs/bdas/data.htm

UNCLASSIFIED

NH Drug Monitoring Initiative Drug Environment Report—UNCLASSIFIED

Overview: Trends for Narcan, ED Visits, Treatment Admissions, and Overdose Deaths:

UNCLASSIFIED—AUTHORIZED FOR PUBLIC RELEASE 2

13.4515.25

12.3414.51

25.03

33.0036.34 36.35

27.78

33.52

0.00

5.00

10.00

15.00

20.00

25.00

30.00

35.00

40.00

2010 2011 2012 2013 2014 2015 2016 2017 2018*

# o

f D

rug

Dea

ths

per

100

,000

po

pu

lati

on

*2018 numbers are based on analysis as of 16 January 2019 and there are 77 cases pending for 2018

Drug Overdose Deaths By YearData Source: NH Medical Examiner's Office

0.00

5.00

10.00

15.00

20.00

25.00

30.00

35.00

40.00

45.00

Even

ts p

er 1

00,0

00 p

opul

atio

n

Source: NH Division of Public Health Services, NH Bureau of Drug & Alcohol Services, and NH Bureau of EMS

EMS Narcan Administration, Opioid Related ED Visits, and Treatment Admissions per 100,000 Population

January 2018 - December 2018Opioid Related EDVisits

Opioid/Opiate,Methamphetamine, &Cocaine/CrackTreatment Admissions

EMS NarcanAdministration

Drug Overdose Deaths: Data Source: NH Medical Examiner’s Office

UNCLASSIFIED



Right click on the paperclip and select “Open File” to view additional data.

*** IMPORTANT DATA NOTES***

2018 Numbers are based on analysis as of 16 January 2019.

Analysis is based on county where the drug (s) is suspected to have

been used.

Trends: As of 16 January 2019, there are 373 total, confirmed drug

overdose deaths and 77 cases pending toxicology for 2018.

The Office of the Chief Medical Examiner has increased its projection from 437 to 450 drug overdose deaths for 2018.

For 2018 thus far, Belknap County has the highest suspected drug use resulting in overdose deaths per capita at 4.58 deaths per 10,000 population, while Cheshire County had the second highest with 3.88 deaths per 10,000 population.

The age group with the largest number of drug overdose deaths is 30-39 years, which represents 31% of all overdose deaths for 2018.

13.4515.25

12.3414.51

25.03

33.00

36.34 36.35

27.78

2.28 4.63 3.636.57

15.45

24.6526.75

28.08

24.73

1.90 1.97 1.44 2.272.71 3.68

4.72 3.723.43

33.52

0.00

5.00

10.00

15.00

20.00

25.00

30.00

35.00

40.00

2010 2011 2012 2013 2014 2015 2016 2017 2018*

# o

f D

rug

Dea

ths

per

10

0,0

00

po

p

Overdose Deaths by Year per 100,000 PopulationData Source: NH Medical Examiner's Office

All DrugDeaths

Fentanyl/Heroin RelatedDeaths +

CocaineRelatedDeaths+

*2018 numbers are based on analysis as of 16 January 2019There are 77 cases pending for 2018

+ Cocaine and Fentanyl/Heroin Related deaths are not mutually exclusive, several deaths involved both categories

4.58

1.87

3.88

1.50 1.66

3.01

2.42 2.39

2.92

0.91

0.00

0.50

1.00

1.50

2.00

2.50

3.00

3.50

4.00

4.50

5.00#

of

de

ath

s p

er

10

,00

0 p

op

* 2018 Numbers are based on analysis as of 16 January 2019 - 77 cases pending

2018* Overdose Deaths by County per 10,000 PopulationData Source: NH Medical Examiner's Office

0.80%

19%

31%25%

17%

7%

0.003

Overdose Deaths by Age 2018*Data Source: NH Medical Examiner's Office

0-19

20-29

30-39

40-49

50-59

60+

Unknown

*2018 Numbers are based on analysis as of 16 January 2019

UNCLASSIFIED

UNCLASSIFIED—AUTHORIZED FOR PUBLIC RELEASE

2013 2014 2015 2016 2017 January February March April May June July August September October November December YTD 2018

Total 192 332 439 485 488 29 36 44 33 41 18 52 33 32 22 16 8 364

County

Belknap 8 17 17 16 27 3 3 2 5 2 1 4 1 2 0 4 1 28

Carroll 4 9 22 16 12 3 0 1 1 1 0 2 1 0 0 0 0 9

Cheshire 14 17 11 20 17 0 4 6 3 2 0 6 4 3 1 1 0 30

Coos 6 9 14 10 12 0 1 0 1 1 0 1 0 0 1 0 0 5

Grafton 13 17 13 16 26 1 4 0 2 3 0 1 2 2 0 0 0 15

Hillsborough 68 106 178 199 195 8 11 22 6 11 12 23 8 10 4 3 5 123

Merrimack 17 40 39 43 43 3 2 1 5 7 2 2 4 5 3 1 1 36

Rockingham 34 64 89 90 97 11 6 6 4 9 3 10 8 6 5 5 0 73

Strafford 25 40 47 55 54 0 4 6 3 4 0 2 4 3 8 2 1 37

Sullivan 4 4 8 9 4 0 0 0 0 1 0 1 1 1 0 0 0 4

Out of State 0 3 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0

Undetermined 0 0 0 9 1 0 1 0 3 0 0 0 0 0 0 0 0 4

Gender

Male 132 219 307 336 347 19 23 31 25 32 15 38 23 20 13 9 4 252

Female 61 107 131 149 141 10 14 13 10 10 4 15 10 12 10 7 5 120

Age

0-19 3 3 8 7 2 0 0 1 0 1 0 0 1 0 0 0 0 3

20-29 40 79 110 123 118 5 10 9 7 5 3 9 7 9 4 2 1 71

30-39 32 80 116 147 127 12 12 15 6 11 9 15 13 7 7 6 4 117

40-49 52 67 99 98 114 8 5 13 14 14 4 14 6 4 5 3 3 93

50-59 51 78 91 89 98 2 6 7 6 5 3 11 5 6 7 3 1 62

60+ 15 19 14 21 29 2 4 0 2 5 0 4 1 6 0 2 0 26

Drug Overdose Deaths:Data Source: NH Medical Examiner's Office


2018 Numbers are based on analysis as of 16 January 2019

Overdose_Death_DataSheet

nh.iacFile AttachmentDrug Overdose Deaths.pdf

Drug Overdose Deaths (Continued): Data Source: NH Medical Examiner’s Office

UNCLASSIFIED



169

39

2111

5 5 4 3

0

20

40

60

80

100

120

140

160

180

Fentanyl Acetyl Fentanyl,Fentanyl

Cocaine, Fentanyl Ethanol, Fentanyl Alcohol, Fentanyl Fentanyl,Methamphetamine

Cocaine Acetyl Fentanyl,Cocaine, Fentanyl

# o

f D

eat

hs

Cocaine and/or Fentanyl Combination Related Drug Deaths 2018*

*2018 Numbers are based on analysis as of 16 January, 2019Source: NH Medical Examiner's Office

Acetyl Fentanyl, Diazepam,

Ethanol, Fentanyl

Acetyl Fentanyl, Ethanol,

Fentanyl

Alcohol, Chlorpheniramine,

Fentanyl

Alprazolam, Fentanyl,

Hydrocodone

Buprenorphine, Diphenhydramine,

Fentanyl

Cocaine,

Diphenhydramine,

Ethanol

Duloxetine, Fentanyl, Valeryl

Fentanyl

Alcohol, Cocaine, FentanylAcetyl Fentanyl, Ethanol,

Fentanyl, Ketamine, MDMA

Alcohol, Fentanyl, Heroin,

Oxycodone, Sertraline

Amitriptyline, Clonazepam,

Diazepam, Fentanyl

Bupropion, Diazepam, Ethanol,

Fentanyl

Cocaine, Duloxetine,

FentanylFentanyl, Acetyl Fentanyl

Alprazolam, FentanylAcetyl Fentanyl, Ethanol,

Fentanyl, Oxycodone

Alcohol, Fentanyl, Quetiapine,

Sertraline

Amitriptyline, Cocaine,

DiphenhydramineBupropion, Fentanyl, Olanzapine

Cocaine, Fentanyl,

HydroxyzineFentanyl, Ethanol

Cocaine, Ethanol, FentanylAcetyl Fentanyl, Fentanyl,

Heroin

Alprazolam, Amphetamines,

Clonazepam, Cocaine, Ethanol,

Fentanyl

Amphetamines, Buprenorphine,

Fentanyl, Hydroxyzine,

Methamphetamine, Trazodone

Clonazepam, Cocaine, Fentanyl,

Phenobarbital

Cocaine, Fentanyl,

Methamphetamine

Fentanyl, MDMA,

Methamphetamine

Fentanyl, MethadoneAcetyl Fentanyl, Fentanyl,

Methadone

Alprazolam, Amphetamines,

Cocaine, Fentanyl, MorphineAmphetamines, Fentanyl Clonazepam, Fentanyl Cocaine, Morphine

Fentanyl, Methamphetamine,

Methylenedioxymethamphetamine

4-ANPP, Acetyl Fentanyl,

Fentanyl,

Parafluoroisobutyrylfentanyl

Acetyl Fentanyl, Fentanyl,

Methamphetamine

Alprazolam, Buprenorphine,

Fentanyl, Lorazapam,

Oxycodone

Amphetamines, Fentanyl,

HydromorphoneCocaine, Cyclobenzaprine, Fentanyl

Diazepam, Ethanol,

FentanylFentanyl, Mitragynine

4-ANPP, Fentanyl, Valeryl

Fentanyl

Acetyl Fentanyl, Fentanyl,

MitragynineAlprazolam, Cocaine, Fentanyl Aripirazole, Fentanyl, Quetiapine Cocaine, Diazepam, Fentanyl

Diazepam, Fentanyl,

MethamphetamineFentanyl, Morphine

Acetyl Fentanyl,

Amphetamines, Clonazepam,

Fentanyl

Alcohol, Amphetamines,

FentanylAlprazolam, Fentanyl, Heroin Buprenorphine, Cocaine Cocaine, Diazepam, Oxazepam

Duloxetine, Ethanol,

Fentanyl,

Hydromorphone

Fentanyl, Oxycodone

*Cells filled with gray indicate combinations noted twice

Cocaine and/or Fentanyl Combination Related Drug Deaths that were noted once or twice*

Pittsburg

Lincoln

Alton

Errol

MilanStark

Albany

Berlin

Bartlett

LymeSandwich

Stratford

Ossipee

Weare

Conway

Odell

Hill

Bethlehem

Bath Jackson

Gilford

Concord

Carroll

Warner

Orford

Unity

Canaan

Dixville

Benton

Littleton

Success

Sutton

Warren

Derry

Franconia

Bow

Columbia

Livermore

Chatham

Enfield

Meredith

Loudon

Clarksville

Tamworth

Haverhill

Strafford

Groton

Jaffrey

Hanover

Hollis

Gilmanton

Stoddard

Plainfield

Deerfield

Campton

Keene

Dummer

Milton

WolfeboroGrafton

Thornton

Antrim

Rindge

Cornish

Jefferson

Lee

Woodstock

Alstead

Millsfield

Newport

Lancaster

Rumney

Henniker

Swanzey

Epsom

Winchester

Andover

Randolph

Dover

Madison

Acworth

Shelburne

Lebanon

Cambridge

Barrington

Moultonborough

Dublin

Tuftonboro

Wakefield

Walpole

Danbury

Hopkinton

Easton

Piermont

Rochester

Croydon

Barnstead

Eaton

Dalton

Wilmot

Newbury

Candia

Salisbury

Sanbornton

Lyman

Claremont

Freedom

Nottingham

Bedford

Hooksett

Springfield

Bradford

AmherstWilton

Alexandria

Dorchester

NashuaSalem

Canterbury

Lisbon

Washington

Gorham

Colebrook

Auburn

Deering

Chesterfield

Beans Purchase

Effingham

Troy

Wentworth

Waterville Valley

Belmont

Landaff

Hudson

Milford

Epping

Richmond

Goffstown

Marlow

Franklin

Hancock

Hillsborough

New Boston

Mason Pelham

Whitefield

Bristol

Lempster

Stewartstown

Fitzwilliam

Webster

New Durham

Londonderry

NelsonChester

Laconia

26

Farmington

Merrimack

Holderness

Monroe

Durham

Orange

Raymond

Exeter

Charles

town

Plymouth

Kilkenn

y

Temple

Northfield

Dunbarton

SurryManchester

Windham

Goshen Pittsfield

Peterborough

Grantham

Sunape

e

Northwood

New Ham

pton

New Ipswich

Greenfield

Hinsdale

Hebron

Westmoreland

Boscawen

Kingston

GilsumSullivan

Francestown

Ellsworth

Brookfield

Northu

mberla

ndPem

broke

Tilton

Sharon

BrooklineLyn

deborou

gh

FremontHarrisville

New London

Chiches

ter

Middleton

Allenstown

Second College GrantDixs Grant

Langdon

Bridgewate

r

Sugar Hill

Litchfield

Stratham

Marlborough

Brentwoo

d

24Sandown Danville

27

Roxbury

Ashland

Madbury

7

3

Atkinson

Mont Vernon

Newton

Greenland

Plaistow

Newmarket

Hampstead

11

29

1

22

Windsor

18

20

6

16

25

23

5

31

Newfields

21

30

Greenville12

17

19

4

913

8

14

15

!

28

2

!10

Coos

GraftonCarroll

Merrimack

CheshireHillsborough

Sullivan

Rockingham

Belknap

Strafford

0 10 20 305MilesScale: 1:1,150,000

Prepared by:NH Information & Analysis Center

µ

Overdose Deaths by Town* - 2018 +(Data Source: NH Medical Examiner's Office)*Location where the drug(s) is suspected to have been used.

+2018 data was reported on January 16, 2019There are many more deaths that are suspected to be drug related, but the official cause of death is pending until the toxicology results are received.77 cases pending

Belknap1 - Center HarborCarroll2 - Hales Location3 - Harts LocationCoos4 - Hadleys Purchase5 - Beans Grant6 - Cutts Grant7 - Sargents Purchase8 - Pinkhams Grant9 - Crawfords Purchase10 - Chandlers Purchase11 - Low & Burbanks Grant12 - Thompson & Meserves Purchase13 - Greens Grant14 - Martins Location15 - Ervings Grant16 - Wentworth Location17 - Atkinson & Gilmanton Academy Grant

Hillsborough18 - BenningtonRockingham19 - South Hampton20 - Seabrook21 - East Kingston22 - Kensington23 - Hampton Falls24 - Hampton25 - North Hampton26 - Rye27 - Portsmouth28 - New Castle29 - NewingtonStrafford30 - Rollinsford31 - Somersworth

INDEX

Number of Overdose Deaths by Town*Location where the drug(s) is suspected to have been used.

UNCLASSIFIED

UNCLASSIFIED - AUTHORIZED FOR PUBLIC RELEASE 5

1 - 4 (71 towns)5 - 10 (12 towns)11 - 25 (6 towns)26 - 50 (1 towns)51 - 100 (1 towns)

EMS Narcan Administration: Data Source: NH Bureau of Emergency Medical Services (EMS)


UNCLASSIFIED


Trends: EMS Narcan administration incidents decreased by 6%

from November to December. In December, Belknap County had the most EMS Narcan

administration incidents per capita with 1.97 incidents per 10,000 population, followed closely by Hillsborough County with 1.90 incidents per 10,000 population.

The age group with the largest number of EMS Narcan administration incidents was 30-39, which represents 31% of all EMS Narcan administration incidents for December.


Narcan data in this report involves the number of incidents where Narcan was administered, NOT the number of doses of Narcan during a certain time period. Multiple doses may be administered during an incident.

Narcan may be given for a decrease in alertness or respirations due to an overdose or unknown cause. Therefore, it cannot be concluded that all reported Narcan incidents actually involved drugs.

Lives Saved data has been updated from June-December.


13.85 13.78 13.63 12.9613.93

13.03

17.58

15.49

11.62 13.1114.15

13.26

0.00

5.00

10.00

15.00

20.00

25.00

Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec

# o

f In

cid

ents

Invo

lvin

g N

arca

n p

er 1

00,0

00 p

op

Source: NH Bureau of EMS

EMS Narcan Administration by Month per 100,000 PopulationJanuary 2015 - December 2018

2015

2016

2017

2018

1.97

1.25

0.39

1.20

0.44

1.90

1.22 1.16

1.51

0.00

0.50

1.00

1.50

2.00

2.50#

of

Inci

de

nts

In

vo

lvin

g N

arc

an

pe

r 1

0,0

00

po

p


December EMS Narcan Administration by County per 10,000 Population

1%

18%

31%

19%

14%

17%

December EMS Narcan Administrationby Age Group

0-19

20-29

30-39

40-49

50-59

60+


UNCLASSIFIED


2014 2015 2016 2017 January February March April May June July August September October November December 2018

Total 1,892 2,677 2,895 2,774 186 185 183 174 187 175 236 208 156 176 190 178 2,234

County

Belknap 59 113 116 215 15 19 12 10 5 8 9 7 5 12 13 12 127

Carroll 52 80 91 68 4 4 4 2 6 8 11 10 1 2 4 6 62

Cheshire 65 79 144 104 6 12 9 11 15 11 14 6 9 9 7 3 112

Coos 41 65 65 73 1 4 2 6 2 2 8 2 1 3 3 4 38

Grafton 56 57 66 84 9 13 5 3 7 5 7 9 6 4 6 4 78

Hillsborough 757 1,139 1,209 1,140 69 81 95 81 92 70 123 112 82 78 85 77 1,045

Merrimack 185 228 233 310 23 22 17 15 18 18 23 22 17 28 26 18 247

Rockingham 380 501 488 503 49 21 29 29 29 37 29 30 24 33 30 35 375

Strafford 286 380 449 242 9 7 6 14 11 15 9 9 10 7 15 19 131

Sullivan 11 35 34 35 1 2 4 3 2 1 3 1 1 0 1 0 19

Gender

Male 1,185 1,736 1,916 1,879 130 110 123 117 125 124 154 152 96 123 129 120 1,503

Female 706 938 979 887 56 75 60 57 61 51 82 56 60 53 61 58 730

Age

0-19 83 94 87 75 3 6 9 3 3 3 1 1 3 5 2 1 40

20-29 588 954 973 863 54 53 54 59 42 44 70 53 45 36 48 32 590

30-39 428 684 853 808 65 59 50 43 58 55 73 72 52 56 70 56 709

40-49 304 364 385 439 27 30 30 26 34 31 28 27 18 29 28 34 342

50-59 233 314 327 326 15 27 27 28 21 23 35 36 16 32 21 25 306

60+ 246 256 253 246 22 9 9 14 27 19 28 18 22 18 21 30 237

Age or Gender Not Given

10 11 17 20 0 1 4 1 2 0 1 1 0 0 0 0 10

EMS Narcan Administration:Data Source: NH Bureau of Emergency Medical Services (EMS)


EMS_Narcan_DataSheet

nh.iacFile AttachmentEMS Narcan Administration.pdf

EMS Narcan Administration (Continued): Data Source: NH Bureau of Emergency Medical Services (EMS)


UNCLASSIFIED


0.00%

10.00%

20.00%

30.00%

40.00%

50.00%

60.00%

70.00%

80.00%

90.00%

100.00%



EMS Narcan Administration - Lives Saved %January 2018- December 2018 Lives Saved

No Improvement

Some Improvement

Negative Improvement

RODS, or Revised Over Dose Score is based on the combined delta of documented respiratory rate (RR) and Glasgow Coma Score (GCS -measure of alertness) before and after Narcan administration. For example, RR improved from 6/min to 12/min (delta of 6) and GCS improved from 10 to 13 (delta of 3), the RODS score would be 9. The delta of the vital signs is calculated per incident, so the patient may have received more than one dose of Narcan to achieve the effect in the RODS.

1.96

0.42

1.16

0.90

0.44

1.91 1.88

1.08

0.55

2.13

0.830.91 0.90

0.67

2.08

1.75

0.98

1.18

1.97

1.25

0.39

1.20

0.44

1.90

1.221.16

1.51

0.00

0.50

1.00

1.50

2.00

2.50

Belknap Carroll Cheshire Coos Grafton Hillsborough Merrimack Rockingham Strafford Sullivan

# o

f In

cid

ents

Invo

lvin

g N

arca

n p

er 1

0,00

0 p

op


EMS Narcan Administration by County per 10,000 Population

Oct

Nov

Dec

Source: NH Bureau of EMS Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec

RODS Outcome

Total 186 185 183 174 187 175 236 208 156 176 190 178

2716

60

12 20 10 91312

51

9

16 22 18

5660 55 75 69 54

15 35 21 13

14 11 10 8

EMS Narcan Administration - Lives Saved

114 98 79 91

2018

97

646346

89

18

67

8

RODS , or Revised Over Dose Score is based on the combined delta of documented respiratory rate (RR)

and Glasgow Coma Score (GCS - measure of a lertness) before and after Narcan adminis tration. For

example, RR improved from 6/min to 12/min (delta of 6) and GCS improved from 10-13 (delta of 3), the

RODS score would be 9. The delta of the vi ta l s igns i s ca lculated per incident, so the patient may have

received more than one dose of Narcan to achieve the effect in the RODS.

9693909394102

Some Improvement RODS Score of 1-7

Negative Improvement Negative RODS Score

Lives Saved RODS Score of 8+

No Improvement RODS Score of 0

24 17

Pittsburg

Lincoln

Alton

Errol

MilanStark

Albany

Berlin

Bartlett

LymeSandwich

Stratford

Ossipee

Weare

Conway

Odell

Hill

Bethlehem

Bath Jackson

Gilford

Concord

Carroll

Warner

Orford

Unity

Canaan

Dixville

Benton

Littleton

Success

Sutton

Warren

Derry

Franconia

Bow

Columbia

Livermore

Chatham

Enfield

Meredith

Loudon

Clarksville

Tamworth

Haverhill

Strafford

Groton

Jaffrey

Hanover

Hollis

Gilmanton

Stoddard

Plainfield

Deerfield

Campton

Keene

Dummer

Milton

WolfeboroGrafton

Thornton

Antrim

Rindge

Cornish

Jefferson

Lee

Woodstock

Alstead

Millsfield

Newport

Lancaster

Rumney

Henniker

Swanzey

Epsom

Winchester

Andover

Randolph

Dover

Madison

Acworth

Shelburne

Lebanon

Cambridge

Barrington

Moultonborough

Dublin

Tuftonboro

Wakefield

Walpole

Danbury

Hopkinton

Easton

Piermont

Rochester

Croydon

Barnstead

Eaton

Dalton

Wilmot

Newbury

Candia

Salisbury

Sanbornton

Lyman

Claremont

Freedom

Nottingham

Bedford

Hooksett

Springfield

Bradford

AmherstWilton

Alexandria

Dorchester

NashuaSalem

Canterbury

Lisbon

Washington

Gorham

Colebrook

Auburn

Deering

Chesterfield

Beans Purchase

Effingham

Troy

Wentworth

Waterville Valley

Belmont

Landaff

Hudson

Milford

Epping

Richmond

Goffstown

Marlow

Franklin

Hancock

Hillsborough

New Boston

Mason Pelham

Whitefield

Bristol

Lempster

Stewartstown

Fitzwilliam

Webster

New Durham

Londonderry

NelsonChester

Laconia

26

Farmington

Merrimack

Holderness

Monroe

Durham

Orange

Raymond

Exeter

Charles

town

Plymouth

Kilkenn

y

Temple

Northfield

Dunbarton

SurryManchester

Windham

Goshen Pittsfield

Peterborough

Grantham

Sunape

e

Northwood

New Ham

pton

New Ipswich

Greenfield

Hinsdale

Hebron

Westmoreland

Boscawen

Kingston

GilsumSullivan

Francestown

Ellsworth

Brookfield

Northu

mberla

ndPem

broke

Tilton

Sharon

Brookline

Lyndeb

orough

FremontHarrisville

New London

Chiches

ter

Middleton

Allenstown

Second College GrantDixs Grant

Langdon

Bridgewate

r

Sugar Hill

Litchfield

Stratham

Marlborough

Brentwoo

d

24Sandown Danville

27

Roxbury

Ashland

Madbury

7

3

Atkinson

Mont Vernon

Newton

Greenland

Plaistow

Newmarket

Hampstead

11

29

1

22

Windsor

18

20

6

16

25

23

5

31

Newfields

21

30

Greenville

12

17

19

4

913

8

14

15

28

2

!

10

Coos

Grafton Carroll

Merrimack

Cheshire Hillsborough

Sullivan

Belknap

Strafford

Rockingham

0 10 20 305MilesScale: 1:1,150,000

Prepared by:NH Information & Analysis Center

µ

EMS/Narcan Administration by T own1/1/2018 – 12/31/2018Data Source: New Hampshire Bureau of EMS

UNCLASSIFIED

UNCLASSIFIED - AUTHORIZED FOR PUBLIC RELEASE 8

Belknap1 - Center HarborCarroll2 - Hales Location3 - Harts LocationCoos4 - Hadleys Purchase5 - Beans Grant6 - Cutts Grant7 - Sargents Purchase8 - Pinkhams Grant9 - Crawfords Purchase10 - Chandlers Purchase11 - Low & Burbanks Grant12 - T hompson & Meserves Purchase13 - Greens Grant14 - Martins Location15 - Ervings Grant16 - Wentworth Location17 - Atkinson & Gilmanton Academy Grant

Hillsborough18 - BenningtonRockingham19 - South Hampton20 - Seabrook21 - East Kingston22 - Kensington23 - Hampton Falls24 - Hampton25 - North Hampton26 - Rye27 - Portsmouth28 - New Castle29 - NewingtonStrafford30 - Rollinsford31 - Somersworth

INDEX

*Incidents Where Narcan Was Administered*

01 - 1011 - 2526 - 5051 - 100101 - 200201 - 500501 - 750

* Rochester totals for 2018are not complete as runshave not been uploaded intothe database since April.

Opioid Related Emergency Department Visits: Data Source: NH Division of Public Health Services

UNCLASSIFIED



Trends: Opioid related ED visits decreased by 12% from November

to December 2018. In December, residents from Strafford County had the

most opioid related ED visits per capita with 5.13 visits per 10,000 population.

Hillsborough County residents had the second highest number of opioid related ED visits per capita with 4.19 visits per 10,000 population.

In December, the age group with the largest number of opioid related ED visits was 30-39 year olds, with 40%.


County represents where the opioid use patient resides.

These data represent any encounter with the term “heroin, opioid, opiate, or fentanyl” listed as chief complaint text. These data also represent any encounter with an ICD-10 code that was designated for heroin and opioids.

Currently all but two of the hospitals are sending ICD-10 data.

These data include other opioid-related encounters such as poisonings, withdrawals, and detox.


2%

24%

40%

16%

10%

8%

December Emergency Department Opioid Use Visits by Age

10-19

20-29

30-39

40-49

50-59

60+

Source: NH Division of Public Health Services

41.41

32.10 32.7032.77 35.68

33.07

34.41 34.34

33.67

34.93 35.9731.51

0.00

10.00

20.00

30.00

40.00

50.00

60.00


# o

f E

D O

pio

id U

se V

isit

s p

er

10

0,0

00

po

p


Emergency Department Opioid Use Visits by Month per 100,000 PopulationOctober 2015 - December 2018

2015

2016

2017

2018

3.27

2.28

1.29 0.90 0.78

4.19

2.96

1.67

5.13

0.91

0.00

1.00

2.00

3.00

4.00

5.00

6.00#

of

ED

Op

ioid

Use

Vis

its

pe

r 1

0,0

00

po

p


December Emergency Department Opioid Use Visits by Countyper 10,000 Population

UNCLASSIFIED


2016 2017 January February March April May June July August September October November December 2018

Total 6,084 6,684 556 431 439 440 479 444 462 461 452 469 483 423 5,539

County

Belknap 94 134 14 4 6 19 27 36 38 34 36 13 34 20 281

Carroll 175 107 12 7 6 8 10 9 9 10 14 6 8 11 110

Cheshire 135 158 11 23 12 10 16 15 10 13 16 13 8 10 157

Coos 143 172 12 10 6 7 8 12 3 7 5 9 10 3 92

Grafton 205 176 9 11 10 13 15 14 11 14 12 13 22 7 151

Hillsborough 2,501 2,713 239 174 174 161 177 151 168 176 192 184 187 171 2,154

Merrimack 559 970 67 41 58 54 48 44 62 63 45 50 54 44 630

Rockingham 736 660 54 39 41 35 46 46 47 27 39 64 50 51 539

Strafford 961 896 84 77 70 74 75 79 58 71 60 71 72 65 856

Sullivan 81 197 14 14 27 20 6 2 6 1 5 7 5 4 111

Out of State 494 501 40 31 29 39 51 36 50 45 28 39 33 37 458

Gender

Male 3,452 3,798 326 229 257 241 279 269 246 267 259 281 285 244 3,183

Female 2,632 2,886 230 202 182 199 200 175 216 194 193 188 198 179 2,356

Age

0-9 5 11 2 1 0 1 0 1 0 1 0 0 4 0 10

10-19 176 170 14 6 4 12 9 6 15 12 8 6 6 6 104

20-29 2,443 2,477 214 155 139 154 169 156 152 164 152 150 174 102 1,881

30-39 1,889 2,235 183 167 158 150 158 153 172 144 158 144 172 170 1,929

40-49 774 879 75 46 79 63 64 52 51 63 58 84 54 67 756

50-59 500 562 40 29 31 38 47 46 38 47 45 57 47 44 509

60+ 297 350 28 27 28 22 32 30 34 30 31 28 26 34 350

Opioid Related Emergency Department Visits:Data Source: NH Division of Public Health Services


EmergencyVisits_DataSheet

nh.iacFile AttachmentOpioid Related ED Visits.pdf

Opioid Related Emergency Department Visits (Continued): Data Source: NH Division of Public Health Services

UNCLASSIFIED



2.14

1.251.68

2.69

1.45

4.53

3.38

2.12

5.64

1.60

5.60

1.67

1.04

2.992.45

4.61

3.65

1.65

5.72

1.14

3.27

2.28

1.290.90 0.78

4.19

2.96

1.67

5.13

0.91

0.00

1.00

2.00

3.00

4.00

5.00

6.00

7.00


# o

f ED

Op

ioid

Use

Vis

its

per

10

,00

0 p

op

Source: NH Div. of Public Health Services

Emergency Department Opioid Use Visits by County per 10,000 Population

Oct

Nov

Dec

41.66

32.29

32.89

32.9735.89

33.27 34.6234.54 33.87 35.14 36.19

31.70

0.00

5.00

10.00

15.00

20.00

25.00

30.00

35.00

40.00

45.00

Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec# o

f ED

Opi

oid

Use

Vis

its

per

100,

000

pop

Source: NH Div. of Public Health Services

Emergency Department Opioid Use Visits per 100,000 Population January 2018 - December 2018

Treatment Admissions: Data Source: NH Bureau of Drug & Alcohol Services

UNCLASSIFIED



Trends: Opioid/opiate, Methamphetamine, & Cocaine/Crack

treatment admissions decreased by 14% from November to December.

In December, residents from Strafford County were admitted most often for opioid/opiate treatment per capita with 2.29, followed by Merrimack County with 1.61 admissions per 10,000 population.

More males than females were admitted to treatment programs in December for opioid/opiate, Methamphetamine, & Cocaine/Crack use.

Methamphetamine treatment admissions increased by 29% from November to December.

Cocaine/Crack treatment admissions decreased by 23% from November to December.

Heroin/Fentanyl treatment admissions decreased by 16% from November to December.



County represents where the patient resides.

These data represent treatment admissions to state funded facilities.

These data have decreased due to numerous factors. The Affordable Care Act has been fully implemented, resulting in increased access to affordable health insurance and coverage for substance use disorder treatment in NH. New Hampshire expanded its Medicaid program, which also provided increased opportunities for substance use disorder treatment in the state. Substance use disorder treatment in the state has increased sharply in response to these policies which has shifted clients served by State of New Hampshire contracted treatment providers to other payment models and facilities.

22.4921.15

19.6618.32 21.23

22.12

19.81

22.42

18.17

23.61

20.56 17.65

0.00

5.00

10.00

15.00

20.00

25.00


# o

f T

rea

tme

nt

Ad

mis

sio

ns

pe

r 1

00

,00

0 p

op

Source: NH Bureau of Drug & Alcohol Services

Opioid/Opiate, Methamphetamine, & Cocaine/Crack Treatment Admissions by Month per 100,000 Population

January 2018 - December 2018

1.47

0.83

1.55

0.83

1.61

0.75

2.29

0.33 0.300.44

0.07 0.130.24 0.230.16 0.17

0.030.00

0.50

1.00

1.50

2.00

2.50

# o

f T

re

atm

en

t A

dm

issio

ns p

er 1

0,0

00

po

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December Opioid/Opiate, Methamphetamine, & Cocaine/Crack Treatment Admissions by County per 10,000 Population

Opioid/Opiate

Methamphetamine

Cocaine/Crack

54%46%

0.004

December Treatment Admissions by Gender

Male

Female

Transgender

Source: NH Bureau of Drug & Alcohol

UNCLASSIFIED


2017 January February March April May June July August September October November December 2018

Total 4,024 302 284 264 246 285 297 266 301 244 317 276 237 3,319

County

Belknap 156 13 15 3 10 16 10 3 7 8 12 13 4 114

Carroll 43 4 1 3 3 7 7 2 3 1 4 1 2 38

Cheshire 60 1 3 0 0 2 2 2 16 2 0 2 2 32

Coos 45 2 6 8 4 2 2 6 6 3 1 1 1 42

Grafton 122 4 9 11 9 12 15 19 9 9 18 8 6 129

Hillsborough 1,044 76 57 59 53 63 85 68 90 55 44 78 69 797

Merrimack 342 28 15 17 10 18 25 15 21 6 26 18 15 214

Rockingham 319 27 17 19 21 22 20 17 17 13 24 24 12 233

Strafford 336 29 33 30 26 34 34 24 11 20 34 30 17 322

Sullivan 25 1 2 1 0 1 2 2 1 0 1 1 2 14

Out of State 129 0 1 2 4 1 1 1 1 0 2 1 2 16

Not Provided 1,403 117 125 111 106 107 94 107 119 127 151 99 105 1,368

Gender

Male 2,419 179 167 154 131 162 183 138 165 141 183 160 128 1,891

Female 1,602 123 117 110 115 123 114 128 134 103 134 116 108 1,425

Transgender 2 0 0 0 0 0 0 0 2 0 0 0 1 3

Age

< 18 7 0 0 0 0 1 0 1 0 0 0 0 0 2

18-25 821 44 61 44 54 54 44 47 57 47 51 39 39 581

> 26 3,196 258 223 220 192 230 253 218 244 197 266 237 198 2,736

Treatment data includes opioid/opiate,

methamphetamine, & cocaine/crack admissions.

Treatment Admissions:Data Source: NH Bureau of Drug & Alcohol Services


Treatment_DataSheet

nh.iacFile AttachmentTreatment Admissions.pdf

Treatment Admissions (Continued): Data Source: NH Bureau of Drug & Alcohol Services

UNCLASSIFIED



1.47

0.83

0.00 0.00

1.55

0.83

1.61

0.75

2.29

2.13

0.21

0.78

1.71

1.14

0.79

2.21

0.49

0.210.26 0.30

0.67

1.45

0.87

0.36

0.87

0.23

0.00

0.50

1.00

1.50

2.00

2.50


# o

f T

reat

me

nt

Ad

mis

sio

ns

pe

r 1

0,0

00

po

p


Opioid/Opiate Treatment Admissions by County per 10,000 Population

Oct

Nov

Dec

0.00

2.00

4.00

6.00

8.00

10.00

12.00

14.00

16.00

18.00


# o

f Tr

eatm

ent

Ad

mis

sio

ns

per

10

0,0

00

po

p


Heroin/Fentanyl , Rx Opiate, Methamphetamine, & Cocaine/Crack Treatment Admissions by Month per 100,000 Population January 2018 - December 2018

Heroin/Fentanyl

Rx Opiates

Methamphetamine

Cocaine/Crack


UNCLASSIFIED


Situational Awareness:

New Council on Opioid Overprescribing in

N.H. to Rely on Data Analysis

A new state advisory council on opioid overprescribing will use data analysis to better understand the state's opioid crisis. Governor Chris Sununu signed an executive order creating the New Hampshire Opioid

Overprescribing and Misuse Project Advisory Council Thursday afternoon.

The council includes state health and law enforcement officials as well as a federal representative from the Centers for Medicare and Medicaid services.

CMS hopes to scale the program to other states if it is effective. The council's work will center on what Sununu called a first of its kind analysis

of opioid prescribing practices from insurance claim data.

The council's work will center on what Sununu called a first of its kind analysis of opioid prescribing practices from insurance claim data.

"This data will allow us to not just make policy on a hunch, but really look at the data, in terms of understanding both the geographic trends you might see, the trends you might see not just with individual providers but individual situations."

A private firm called Mitre will be providing the data analysis.

Source: www.nhpr.org 1/11/2019

New Hampshire Safe Stations

Prolific N.H. Opioid Prescriber Found Guilty in Kickback Scheme

A federal jury on Tuesday found a former physician assistant guilty of participating in a kickback scheme involving fentanyl.

Christopher Clough of Dover was convicted of overprescribing the painkiller to patients in exchange for receiving compensation from the drug’s manufacturer.

During 2013 and 2014, he wrote more than 750 prescriptions for a fentanyl spray approved to treat cancer-related pain. In exchange, he received more than $49,000 from the manufacturer, according to prosecutors. Medicare was billed more than $2.1 million for the prescriptions, some of which were given to patients who failed to exhibit sufficient symptoms for the powerful narcotic.

Clough was found guilty of one count of conspiracy, and seven counts

related to a kickback scheme.

Source: www.nhpr.org 12/18/2018

Manchester Safe Station Began 5/4/2016

Nashua Gateway to Recovery Began 11/17/2016

Manchester

As of 1/25/2019

Nashua

As of 1/25/2019

Q4 2018 Total Q4 2018 Total

Number of requests at MFD/NFR for Safe Station: 579 4,830 269 2,624

Number of participants transported to hospitals: 122 1,122 47 288

Number of participants taken to Substance Misuse Treatment Facilities: 456 3,692 221 2,312

Average length of time company “Not Available”: 11.7 Min 15.1 Min 9.0 Min 10.2 Min

Number of UNIQUE participants: 473 2,916 206 1,490

Number of REPEAT participants: 309 2,084 172 1,431

Number of unique participants seen in both City’s Safe Station Program 456

https://www.nhpr.org/post/new-council-opioid-overprescribing-nh-rely-data-analysis#stream/0https://www.nhpr.org/post/prolific-nh-opioid-prescriber-found-guilty-kickback-scheme


UNCLASSIFIED


Substance Abuse Treatment/Recovery Directory: State funded treatment facilities in NH (NOT a complete list) - Data Source: NH Department of Health and Human Services

BETHLEHAM

North Country Health Consortium

(NCHC)/ Friendship House

262 Cottage Street. Suite 230

Bethlehem, NH

Phone: 603-259-3700

DOVER

Southeastern NH Alcohol and

Drug Abuse Services

272 County Farm Road

Dover, NH

Crisis Center: 603-516-8181

Main: 603-516-8160

DUBLIN

Phoenix House Comprehensive

Addiction Treatment Services

3 Pierce Rd. Dublin, NH

Phone: 603-563-8501, Option 1

FRANKLIN

Farnum Center North

Ray House (Women)

14 Holy Cross Road. Franklin, NH

Phone: 603-263-6287

Families in Transition - New

Horizons

293 Wilson Street

Manchester, NH

Phone: 603-641-9441 ext. 401

Farnum Center

140 Queen City Avenue

Manchester, NH

Phone: 603-622-3020

NASHUA

Greater Nashua Council on

Alcoholism

12 & 1/2 Amherst Street

Nashua, NH

Phone: 603-943-7971 Ext. 3

Greater Nashua Council on

Alcoholism: Keystone Hall

615 Amherst Street

Nashua, NH

Phone: 603-881-4848

Greater Nashua Mental Health

Center

110 West Pearl Street

Nashua, NH

Phone: 603-889-6147

ROCHESTER

Hope on Haven Hill

PO Box 1271

Rochester, NH 03867

Phone: 603-247-2043

KEENE

Phoenix House Comprehensive

Addiction Treatment Services

106 Roxbury Street. Keene, NH

Phone: 603-358-4041, Option 1

LEBANON

Headrest

14 Church Street

Lebanon, NH

Phone: 603-448-4400

Alice Peck Day Hospital

10 Alice Peck Day Drive

Lebanon, NH

Phone: 603-448-4400

West Central Services, Inc.

9 Hanover Street, Suite 2

Lebanon, NH

Phone: 603-448-0126

MANCHESTER

Dismas Home of NH, Inc. (Women)

102 Fourth Street

Manchester, NH

Phone: 603-782-3004

A full list of Substance Abuse and

Treatment Facilities can be found

here.

A treatment locator can be found

here.
http://www.dhhs.nh.gov/dcbcs/bdas/guide.htmhttp://nhtreatment.org/

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