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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 NH.IAC@dos.nh.gov 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:NH.IAC@dos.nh.govhttp://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
NH Drug Monitoring Initiative Drug Environment Report—UNCLASSIFIED
3 UNCLASSIFIED—AUTHORIZED FOR PUBLIC RELEASE
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
NH Drug Monitoring Initiative Drug Environment Report—UNCLASSIFIED
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
NH Drug Monitoring Initiative Drug Environment Report—UNCLASSIFIED
4 UNCLASSIFIED—AUTHORIZED FOR PUBLIC RELEASE
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)
NH Drug Monitoring Initiative Drug Environment Report—UNCLASSIFIED
UNCLASSIFIED
6 UNCLASSIFIED—AUTHORIZED FOR PUBLIC RELEASE
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.
*** IMPORTANT DATA NOTES***
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.
Right click on the paperclip and select “Open File” to view additional data.
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
Source: NH Bureau of EMS
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+
Source: NH Bureau of EMS
UNCLASSIFIED
UNCLASSIFIED—AUTHORIZED FOR PUBLIC RELEASE
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)
NH Drug Monitoring Initiative Drug Environment Report—UNCLASSIFIED
EMS_Narcan_DataSheet
nh.iacFile AttachmentEMS Narcan Administration.pdf
EMS Narcan Administration (Continued): Data Source: NH Bureau of Emergency Medical Services (EMS)
NH Drug Monitoring Initiative Drug Environment Report—UNCLASSIFIED
UNCLASSIFIED
7 UNCLASSIFIED—AUTHORIZED FOR PUBLIC RELEASE
0.00%
10.00%
20.00%
30.00%
40.00%
50.00%
60.00%
70.00%
80.00%
90.00%
100.00%
Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec
Source: NH Bureau of EMS
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
Source: NH Bureau of EMS
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
NH Drug Monitoring Initiative Drug Environment Report—UNCLASSIFIED
9 UNCLASSIFIED—AUTHORIZED FOR PUBLIC RELEASE
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%.
*** IMPORTANT DATA NOTES***
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.
Right click on the paperclip and select “Open File” to view additional data.
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
Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec
# o
f E
D O
pio
id U
se V
isit
s p
er
10
0,0
00
po
p
Source: NH Division of Public Health Services
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
Source: NH Division of Public Health Services
December Emergency Department Opioid Use Visits by Countyper 10,000 Population
UNCLASSIFIED
UNCLASSIFIED—AUTHORIZED FOR PUBLIC RELEASE
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
NH Drug Monitoring Initiative Drug Environment Report—UNCLASSIFIED
EmergencyVisits_DataSheet
nh.iacFile AttachmentOpioid Related ED Visits.pdf
Opioid Related Emergency Department Visits (Continued): Data Source: NH Division of Public Health Services
UNCLASSIFIED
NH Drug Monitoring Initiative Drug Environment Report—UNCLASSIFIED
10 UNCLASSIFIED—AUTHORIZED FOR PUBLIC RELEASE
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
Belknap Carroll Cheshire Coos Grafton Hillsborough Merrimack Rockingham Strafford Sullivan
# 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
NH Drug Monitoring Initiative Drug Environment Report—UNCLASSIFIED
11 UNCLASSIFIED—AUTHORIZED FOR PUBLIC RELEASE
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.
Right click on the paperclip and select “Open File” to view additional data.
*** IMPORTANT DATA NOTES***
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
Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec
# 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
p
Source: NH Bureau of Drug & Alcohol Services
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
UNCLASSIFIED—AUTHORIZED FOR PUBLIC RELEASE
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
NH Drug Monitoring Initiative Drug Environment Report—UNCLASSIFIED
Treatment_DataSheet
nh.iacFile AttachmentTreatment Admissions.pdf
Treatment Admissions (Continued): Data Source: NH Bureau of Drug & Alcohol Services
UNCLASSIFIED
NH Drug Monitoring Initiative Drug Environment Report—UNCLASSIFIED
12 UNCLASSIFIED—AUTHORIZED FOR PUBLIC RELEASE
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
Belknap Carroll Cheshire Coos Grafton Hillsborough Merrimack Rockingham Strafford Sullivan
# o
f T
reat
me
nt
Ad
mis
sio
ns
pe
r 1
0,0
00
po
p
Source: NH Bureau of Drug & Alcohol Services
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
Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec
# o
f Tr
eatm
ent
Ad
mis
sio
ns
per
10
0,0
00
po
p
Source: NH Bureau of Drug & Alcohol Services
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
NH Drug Monitoring Initiative Drug Environment Report—UNCLASSIFIED
UNCLASSIFIED
13 UNCLASSIFIED—AUTHORIZED FOR PUBLIC RELEASE
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
NH Drug Monitoring Initiative Drug Environment Report—UNCLASSIFIED
UNCLASSIFIED
14 UNCLASSIFIED—AUTHORIZED FOR PUBLIC RELEASE
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/Recommended