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As treatment pathways and recovery organizations continue to grow throughout the Seacoast, so too has the number of locals questioning their effectiveness as high-profile overdose deaths are reported throughout various community channels.

According to local recovery leaders, that doubt isn’t just found in toxic social media commentary about the opioid crisis. It has crept into local meetings and programs. In turn, they say it’s creating a traumatizing ripple effect that undermines support systems while propagating falsehoods about a misunderstood aspect of substance use disorders (SUDs): relapse.

“It’s definitely a struggle to understand why or how someone comes to a setback or relapse,” said Lynn Fuller, the state’s family support coordinator. Fuller has two sons in long-term recovery and their addictions inspired her to create a family support group in Farmington called Circle of Hope. “We have to remind ourselves our people are not cured (just because they’ve been in treatment).”

Recurrences of substance abuse happen throughout all stages of recovery because being in recovery is a never-ending learning process for many, according to individuals like John Iudice, a licensed drug and alcohol counselor and program director of Addiction Recovery Services, which has locations in Portsmouth and Salem

“I think as a society we’re very impatient (and) rush to judgment,” said Iudice. “And it’s even modeled by a lot of our leaders, and that just promotes addiction. It promotes divisiveness, it promotes stigma (and) it promotes ostracizing people, which is just going to isolate people and increase addiction. So as a society, learning to be more patient and learning to stop and try to understand what’s going on with a person before we assume we know everything about how bad they are, that’s going to promote recovery.”

Support, the gateway to healing

Triangle Club Director Autumn Allen said support is the starting point for preventing relapses and de-stigmatizing setbacks. She believes natural support systems are the most important piece in the recovery process next to addressing underlying traumas that contribute to an individual’s substance abuse.

Stable housing, supportive workplaces, education about coping strategies, social interactions where anyone can speak openly without judgment – by giving individuals better access to these things, Allen said the community can better prevent SUDs and help people in recovery withstand the types of stressors that undermine recovery.

“Until we can help people heal, they’re going to continue to relapse,” said Allen. “As a society, I think we expect people to just know how to live (with addiction), but… it takes time and it takes a lot of energy.”

There is no one-size-fits-all, but Allen said a more welcome approach, regardless if someone is using or abstaining, would go a long way. She said it would show people in recovery, and the community as a whole, an individual who relapses isn’t a hopeless cause.

“When somebody relapses and they walk through those doors,” Allen said, tearfully gesturing to the Triangle Club’s facade in Dover, “it’s a celebration. There aren’t many places that offer second chances, especially to (substance users). And we hear it all the time – ‘If they just didn’t use, they wouldn’t have a problem.’ Well, that’s not fixing anything.

“Anytime there is a relapse, or an overdose that results in death, it’s a retraumatization for everyone who comes into these halls. There is a sense of mortality that is glaring you in the face, but for some individuals it also (makes them question), ‘Why am I doing this? Why am I trying so hard to stay sober if so-and-so couldn’t make it?’”

The pedestal

It’s common for the media and recovery organization literature to promote the successes of individuals in recovery. It can show others they too can succeed. One such example is Safe Harbor Recovery Center’s Ryan Fowler. Seacoast Media Group featured Fowler in a story last Friday as he thanked the Hampton firefighters who saved him after three overdoses. However, Fowler said there are unintended consequences of this type of publicity that can further engender the shame that prevents people from disclosing recovery setbacks.

″(It) puts an individual with SUD on a pedestal and makes it very difficult to reach out for help when they struggle,” he said, acknowledging individuals highlighted in this way are often young people in early recovery. “Early recovery is about learning humility

 

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DOVER — To help individuals with substance use disorders (SUD) connect to treatment and other recovery support services, Wentworth-Douglass Hospital in Dover is partnering with SOS Recovery Community Organization (SOS RCO) to launch an initiative that pairs people at the hospital with substance use disorders with on-call recovery coaches.

“Wentworth-Douglass Hospital strives to collaborate with community organizations who share our mission of partnering with individuals to attain their highest level of health,” said Kellie Mueller, director of Behavioral Health for Wentworth-Douglass. “We know the magnitude of substance use disorders in our community, state, and nation is large. It will take the work of an entire community to address it. It is important to focus on the growth of resources in our community, and the desire to offer more care and better care. SOS Recovery saw a need and stepped up to meet it. They have created a compassionate, safe, respectful space for individuals seeking recovery at their Recovery Center. Wentworth-Douglass Hospital is happy to partner with SOS Recovery.”

“Launching this program has been a significant undertaking; and we are grateful to everyone at Wentworth-Douglass Hospital. Without the relentless dedication of Kellie Mueller, director of Behavioral Health at Wentworth-Douglass, this would not be possible. Community partners and allies such as WDH are truly providing solutions to solve the addiction crisis, says John Burns, director at SOS RCO. “We are extremely excited to be partnering with Wentworth-Douglass to provide a bridge between the hospital and the recovery support services people with SUDs need to find and maintain recovery.”

According to Burns, upon receiving a call from the hospital via a designated SOS RCO hotline, a recovery coach will be dispatched to the hospital within 60 minutes.

“This is a non-clinical program designed to provide immediate peer-to-peer crisis response coaching to assist individuals in navigating through a crisis and barriers, as well as to assist them in developing linkage to strong SUD treatment supports, mental health supports, peer recovery-based activities and other supports,” says Burns.

While the goal is to eventually offer Recovery Support Services for the hospital seven days a week, 24 hours a day, Burns says this is the initial stage of a three-phase program. During this first phase of the program, SOS RCO recovery coach services will be available from 9 a.m. to 5 p.m. Monday through Saturday.

According to Burns, all SOS Recovery Coaches are required to complete a 30-hour Recovery Coach Academy that was developed by Connecticut Community for Addiction Recovery as well as a 16-hour Ethical Considerations for Recovery Coaches. Burns said many SOS recovery coaches are currently either credentialed, or in the process of being credentialed, as Certified Recovery Support Workers in N.H.

“Our approach is to meet individuals where they are at and provide navigation of systems that they are willing and interested in pursuing,” Burns said. “Our long-term goal is to connect individuals to Peer Recovery Support Services outside the hospital for future ongoing coaching and wellness plans.”

Burns says in addition to working with SOS RCO on this initiative, earlier this year Wentworth-Douglass Hospital also provided SOS RCO with an $110,000 grant to assist SOS RCO in its mission to provide safe space and peer-based supports for people in all stages of recovery.

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DOVER — SOS Recovery Community Organization received a $20,000 grant from CVS Health that will help it build capacity for recovery coach training and development in Strafford County.

John Burns, the director of SOSRCO, said the money will be used to develop curriculum for a comprehensive motivational interviewing and ethics curriculum along with a training of trainers. In addition, the grant will provide funding for an excellence-in-recovery coaching curriculum that will enhance recovery coaches’ skills and will provide access to staff and volunteers locally and to any of the recovery community organizations in the state at reduced rates.

The grant will also provide money to SOSRCO to provide additional professional supervisory hours from a master licensed alcohol and drug counselor for recovery coaches. Burns says this will help with the work force development shortage in the treatment and recovery industry in the state by developing a stronger pipeline of certified recovery support workers in the Strafford County community.

“We are grateful to receive these monies which will not only help build capacity for recovery coach training and development in Strafford County but will also help us to enhance training for SOSRCO coaches and staff and to improve our overall trained volunteer capacity,” Burns said in a statement. “We are greatly appreciative of the fact that CVS Health is committed to building healthy communities through grants such as this which will enrich recovery supports in Strafford County, help reduce financial barriers for volunteers seeking to become volunteer recovery coaches and assist in developing a stronger pipeline of certified recovery support workers in our community.”

Eileen Howard Boone, CVS senior VP of corporate social responsibility and philanthropy, said in a statement, “As a pharmacy innovation company, we are committed to helping people on their path to better health. We are proud to support organizations that increase access to quality health care because we know their efforts are critical to delivering better community health. We are pleased to support the work that SOS Recovery Community Organization does in the community and look forward to working with them to fulfill their program’s mission.”

SOSRCO operates two recovery community centers, one located at 4 Broadway in Dover and the other located at 63 S. Main St. in Rochester. Each center offers a variety of programs, events and services for multiple pathways to recovery including peer recovery coaches, telephone recovery support services, meetings and special programs ranging from mindful art in recovery and yoga to indoor rock climbing at Indoor Ascent in Dover and monthly bowling at Dover Bowl.

A program of Goodwin Community Health, the mission of SOSRCO is to reduce stigma and harm associated with substance misuse by providing a safe space and peer-based supports for people in all stages of recovery. For information about SOS RCO, call (603) 841-2350 or visit www.sosrco.org.

 

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DOVER — New Hampshire Senator Jeanne Sheehan came to the SOS Recovery Community Organization office on a fact-finding mission.

Shaheen, a member of the Senate’s Appropriations Committee, was seeking input from members of SOS on what is working in and what can be improved so SOS can provide better support to those recovering from their addictions. Shaheen said she was seeking the information so she can make allocation recommendations as federal budgets are crafted.

SOS, a program of Goodwin Community Health, seeks to “reduce stigma and harm associated with addictive disorders by providing safe space and peer-based supports for people in all stages of recovery,” it states on its website. While there are a few paid staffers, it’s a peer-driven organization that provides a variety of different avenues for those in recovery with many volunteers.

Some of the high hurdles those in recovery face are the stigma of addiction, lack of readily available treatment options, safe and affordable places to live and adequate funding for recovery supports, SOS Director John Burns and capacity building specialists Elizabeth Atwood and Richard Salvati told Shaheen.

“If you don’t have recovery support, treatment doesn’t hold up,” Burns said.

Often those at SOS will encounter someone who is ready for help, but places for treatment are not always immediately available. There are other times when a person is in recovery but can’t find an affordable place to live. That might force a person to live with a group of people living a lifestyle the person in recovery is trying to avoid, or it may force them to live on the streets.

Salvati told the story of a person who was trying to get into treatment and had no safe place to live. “He’s considering whether to violate his probation to go back to jail,” Salvati said.

“There are no detox beds to send them or safe places to send them,” he said.

When Shaheen asked what the most critical service SOS provides to those in recovery is, they said peer connection. Atwood said that any person who comes through the doors in SOS, no matter where they are in their recovery, is treated with respect. The peer connection allows those to feel loved and wanted, which helps them continue their journey. Salvati said people who come to SOS often say, “I can’t believe you guys are so welcoming.”

When Shaheen first walked into SOS’s meeting space on Broadway, it brought her briefly back in time. “I remember when this was a movie theater,” she said, recalling watching movies there with her husband William Shaheen early in their marriage.

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ROCHESTER — SOS Recovery Community Organization will be expanding its space in the First Church Congregational to continue serving the recovery community and meet the increasing need for peer recovery support service.

SOS Recovery Community Organization is partnering with First Church Congregational to expand the space at its Rochester center from 500 to 2,000 square feet. In addition it will also expand its hours of operation.

“In recent months we have seen an overwhelming demand for peer recovery support services and increased traffic at our Rochester SOS Center. This has prompted us to seek additional space as well as expand our hours of operation in Rochester,” said John Burns, director of SOS RCO. “Thanks to the successful partnership with the church we’ve had since opening in September of 2016, we will be able to remain in our same location while expanding our current space into a larger congruent space within the church. This will allow us to better serve the recovery community and enhance current services and programs.”

Burns said the hours of operation will also be expanding one hour a day. Beginning Feb. 18, the center will be open from 9 a. m. to 5 p.m. Monday through Friday.

“Our partnership with the Rochester community, and particularly the church, over the past 17 months has worked exceptionally well and we are grateful that they have worked so cooperatively with us to meet the needs of the recovery community and continue to meet our mission,” said Burns.

A program of Goodwin Community Health, the mission of SOS Recovery Community Organization, is to reduce stigma and harm associated with substance misuse by providing safe space and peer based supports for people in all stages of recovery.

“We had over 3,000 volunteer hours in 2017, over 1,400 visits to the Rochester center with 145 new unique visitors. In January alone we had more than 550 attendees, many who attend numerous meetings and programs each week, at recovery focused meetings, programs and events at the Rochester SOS site, said Elizabeth Atwood, Capacity Building Specialist for the center. “This expansion also allows us to continue providing critical crisis resources for the city of Rochester and the community. In 2017 we navigated emergency crisis response for over 225 individuals who came to the center requesting help with immediate substance use disorder treatment, mental or medical health supports, or housing and we’ve partnered with on-site staffing from the statewide Regional Access Point Services program through Granite Pathways.”

According to Atwood, each center offers a variety of programs, events and services for multiple pathways to recovery including peer recovery coaches, telephone recovery supports, meetings and special programs ranging from art and music in recovery to bowling and rock climbing.

“Since opening our doors in September 2016, we have seen tremendous growth in Rochester, and this additional space will help us meet the increasing need in Rochester and surrounding area as well as provide additional programming to support the recovery community,” said Atwood. “Those utilizing our center range from those who are trying to find recovery and those who may have a day or two in recovery to those with long-term recovery. All provide peer supports to each other. This additional space will help us to continue to support these individuals who are improving their lives and making enormous contributions back to the community around us.”

For more information about SOS RCO call 603-841-2350 or visit the website at www.sosrco.org.

 

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The struggle continues. The news at the end of last year that New Hampshire remains among the top three states in the country for overdose deaths was a blow to advocates who have worked so hard to tackle this crisis. But it also shows us that there is a need to embrace innovative approaches as a way out of this epidemic. These programs exist, and are being implemented throughout the country. Our state cannot be left behind.

As someone in recovery, who also has family members in recovery, I have seen firsthand the toll that the addiction epidemic is taking on our state. But I also know that the approach of arrest and incarceration is outdated and hugely counterproductive. Law enforcement may want to solve the problem, but locking up drug users who desperately need treatment will have no impact on the opioid deaths. In fact, often drug users released from jail or prison are at the highest risk of overdose death, because they have detoxed and their body is not ready to use the amount of heroin or fentanyl they used prior to incarceration. With powerful synthetic opioids like fentanyl dominating New Hampshire’s drug trade, the risk is even greater,

There is a productive role that police can play, and it comes in the shape of programs such as LEAD — Law Enforcement Assisted Diversion. The program recognizes that while we cannot stop everyone from using drugs, we can do our utmost to reduce the harm associated with drug use. Under LEAD, rather than arresting an individual for possessing drugs, law enforcement will connect the person with a LEAD case worker. The case worker will then work on a tailor-made plan to help the individual. Maybe the person needs to get into treatment, or perhaps they need recovery supports or housing. Often they could benefit from overdose prevention training or some sort of counseling. LEAD programs are a collaborative effort involving police, prosecutors, public defenders, public health experts and treatment officials. Whatever the need, the LEAD program can help.

It may sound touchy-feely, but studies have shown LEAD to be an unbridled success. A University of Washington report demonstrated that 58 percent of the individuals in the LEAD program do not get rearrested. Another evaluation showed that there was a significantly increased likelihood that individuals would obtain housing, employment and legitimate income after participating in the LEAD program. Health outcomes of participants also improve.

The program began in Seattle in 2011 but now has been replicated in a number of states, including West Virginia, North Carolina and Maine. Will New Hampshire open a LEAD program? As always, the challenge is funding. As a recent Dartmouth University report noted: ”[W]ith low spending on prevention and treatment programs, there are limited resources available statewide to effectively mitigate the risk of addiction.” What if we diverted money from programs like Granite Hammer that arrest individuals struggling with substance use disorder and spent it on programs that actually help people? Are we prepared to back the talk that we can’t arrest our way out of this up with action?

Fortunately, our federal representatives may be able to help. Sen. Maggie Hassan has signed onto letter in support of federal funding for LEAD, and Sen. Jeanne Shaheen has been the protagonist in an effort to secure this funding. In August, she used her position as the top Democrat on a powerful Senate Committee on Appropriations to secure $2.5 million in funding for a federal grant program. Shaheen has also been effusive in her support of the program in committee hearings. The Senate and House are currently negotiating a final spending bill, so we must keep our fingers crossed that Shaheen’s efforts bear fruit.

The opioid epidemic has cast light on a greater addiction epidemic that is a modern American tragedy, but we must fight back using all tools at our disposal. Innovative programs that are evidence-based and save lives are the way ahead and will hopefully be our way out of this terrible crisis.

— John Burns is director of SOS Recovery Community Organization, a collaborative of peers in recovery from substance misuse and their allies who work together to create safe spaces and peer-based recovery supports throughout Strafford County. He is also the founder of Families Hoping and Coping, a weekly support group in Dover and Portsmouth for family members and loved ones of those struggling with substance misuse.

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Over the last few weeks, a coalition of community groups and city leaders in Rochester set up an impromptu warming center as a last-ditch effort to give homeless residents a safe place to go during the recent cold snap. With this week’s warmer weather, the center’s set to close at noon Thursday. But for many, the need for stable housing isn’t going away.

Elizabeth Atwood works at SOS Recovery in Rochester, an organization that helps people dealing with addiction.

When the temperature dipped down below zero a few weeks ago and didn’t show signs of warming soon, she worried that some of their clients wouldn’t have a safe place to stay at night. There weren’t many shelters available nearby. So she started making calls.

“We had a nice couple who runs the food pantry at the church, and they ended up letting somebody sleep in the church for a night,” Atwood said. “And then the next morning it was like, alright, now we really need to do something about this.”

Within a few hours, Atwood connected with some other groups who had the same concern in mind. And soon, they were making the case to city leaders to open an overnight warming center.

“I was like, just give me the space. If you give me a space, we can do it,” Atwood said. “And like three and a half hours later we had nine people eating people eating pizza from Flatbread in Portsmouth. And it just started up like that quickly. I think the first night we had 19 people, and it’s just grown from there.”

Grown a lot. And before long, it seemed like the whole community was pitching in. The U.S. Army National Guard lent its armory to make sure there was enough space for everyone. Local restaurants donated food. Local social service groups stopped by to offer health screenings and other assistance.

Along the way, dozens of people stopped in – some for a few hours, others for a few weeks – for a warm meal, a warm shower and a safe place to sleep.

“We had a family of four that was here at the beginning, and they had some young children,” said Rochester Fire Chief and Emergency Manager Mark Close. “Then we have had, to our oldest is 81.”

He says people have come from across the region for all kinds of reasons, ranging from chronic homelessness to a broken furnace.

“We’ve had a probably day population of near 80,” Close said. “One night, I believe it was Friday or Saturday, when it was the coldest, it was 70.”

But today at noon, the shelter plans to close – at least for now. The National Guard needs its building back, and the weather’s warming up.

So that means people like D. Welch, who’s been staying there the last few weeks, will be back where they started.

“I’m going back to my tent, because I have to maintain it,” Welch says. “Every single thing I own is in that tent.”

Welch says he’s been homeless for years, but this is the first time he’s stayed in a shelter. He can usually take the cold, but 10 below was too much even for him.

“The volunteers here have been very good. The food’s been very good. No complaints,” he says. “We know it’s temporary. But where we stand now – there’s a lot of winter coming.”

That uncertainty was on the minds of a lot of people inside the Armory building Wednesday night. Wendy Bubier also wasn’t sure where she would end up – but at the very least, she felt like she made connections at the shelter that will put her on a more stable track.

“I was alone in my car by myself and isolated – I didn’t even know how to ask for help,” Bubier said. “Now, I’ve got to figure out which person to ask for what, but I have five different people I can ask. That’s the difference of coming together as people in a community.”

Close, the fire chief, said they’re trying their best – in the absence of a permanent solution – to stay in touch with people even after they leave.

“Even after today, they’ll receive notifications on who they can contact, who they can turn to, and it’s just not stopping here,” he said.

Still, the sheer number of people cycling through the warming center really brought home the severity of the region’s homelessness.

“People need help,” Close said. “And the state really needs to look at helping people. I know it’s all about money and budgeting – it’s been a challenge to help individuals to find places to go.”

That need isn’t going away, regardless of the weather.

“I’m worried and I’m interested to see where this goes,” Atwood said Wednesday night. “Even though the weather is survivable – it’s still cold, it’s still winter. We’ve still got four more months to go. And this is just the beginning of January and we’ve already seen a blizzard and extreme cold for 14 days. Who’s to say what’s going to happen the rest of the year.”

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By Kyle Stucker

ROCHESTER — Thanks to an enormous and ever-growing outpouring of support, the individuals operating Rochester’s new emergency warming shelter believe there’s enough momentum to transform their temporary salve into a regular occurrence to better aid local people in need.
Extreme, life-threatening cold inspired the conversion of part of the Rochester Community Center into the Seacoast area’s only 24-hour warming station on Thursday. Since the station opened, more than two dozen people have sought overnight shelter. In addition, countless community members and businesses have dished out hot meals and piled mountains of nonperishable food, clothing, supplies, books and more onto folding tables erected in the room typically used by Gerry’s Food Pantry.
Tri-City Co-Op’s Don McCullough and SOS Recovery Community Organization’s Elizabeth Atwood are the two social service officials credited with kickstarting the citywide collaboration that created the shelter. They say the early success is both overwhelming and validating because discussions are underway to not only extend the volunteer-run station past its Jan. 2 end date, but also to use it as the model for either a reoccurring or permanent overnight shelter in Strafford County.
“We’re going to storm the castle,” said McCullough, a retired Rochester firefighter who is the program coordinator at Tri-City Co-Op, a peer-support agency that serves Strafford County. “We’re planning to do this every cold snap, but the goal is to also make it permanent.”
Tri-City Co-Op, SOS and a number of organizations, nonprofits, ministries and businesses from throughout the region partnered with city employees to make the warming shelter a reality. The city is allowing SOS and an army of volunteers to run the shelter out of the community center at no charge. The shelter isn’t staffed by paid city employees.

By Kyle Stucker

With New Hampshire on track to finish 2017 with fewer fatal drug overdoses than in 2016, leaders within the Seacoast’s recovery community say the data gives them both relief and frustration as they continue efforts to help individuals with substance use disorders.

The Seacoast area and the Granite State as a whole made a number of strides in 2017 to combat the opioid crisis and to increase access to treatment and services. Some of those efforts played roles in a modest statewide drop in fatal overdoses from 485 in 2016 to a projected 466 in 2017, which according to the state would be the first decrease since 2012.

However, to individuals like SOS Recovery Community Organization Director John Burns, it’s not enough when there are still hundreds of people dying each year and scores more are battling with the many factors that contribute to substance misuse.

“When you look at how many deaths, I cannot think of any other crisis that would cause the death of this many people that would be treated with such limited resources,” Burns has said. “To see that the numbers aren’t showing much improvement if any shouldn’t be a surprise.”

As of Dec. 7, substance use caused 350 confirmed deaths in New Hampshire, while another 89 cases were pending toxicology results, according to the state medical examiner’s office. Of those 350 confirmed cases, 144 were related to fentanyl, 102 to a combination of fentanyl and a non-heroin opiate, 14 to a combination of heroin and fentanyl, one to heroin, and 44 to other opiates and opioids.

New Hampshire has the highest fentanyl death rate in the country and is No. 2 in terms of the overall overdose death rate per capita, behind only West Virginia. Some officials attribute the number of fentanyl-related deaths to the history of New Hampshire’s opiate pain prescriptions. They also say, based on a new study of fentanyl users, that the drug, which is cheaper than heroin, has a shorter duration, in turn causing individuals to use more frequently to maintain the effect.

The state’s latest available 2017 figures show Strafford County, the state’s fourth largest county, has the second highest per capita drug overdose death rate of 4.39 deaths for every 10,000 of population. Rockingham County, the state’s second largest county, has a rate of 2.99.

Most police and fire departments in Strafford and Rockingham counties report the number of nonfatal and fatal overdoses in their communities were fairly steady in 2017, with some small increases and decreases.

Rochester is an outlier. Based on incomplete data through part of December, Police Capt. Jason Thomas said the number of nonfatal overdoses nearly doubled in the Lilac City from 121 in 2016 to 218 in 2017. However, the number of fatal overdoses only increased from 17 in 2016 to 20

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