New Hampshire fire chiefs seek money to hire drug counselors

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CONCORD, N.H. — A coalition of fire chiefs, responding to an increase in repeated drug overdoses by the same people, is seeking state money to hire drug counselors who can train first responders in how to better direct victims toward treatment and recovery services.

Emergency responders this year have administered nearly 3,000 doses of the opioid antidote naloxone, known by its brand name Narcan. It reflects an increase of more than 300 percent since 2012, before the height of the state's current opioid crisis, and does not count doses of Narcan given by nonemergency personnel. It's not uncommon for fire and emergency rescuers to give Narcan to the same person more than once, reflecting a cycle of addiction that first responders say they want to help stop.

"We're giving Narcan too much," Portsmouth Fire Chief Steve Achilles told lawmakers recently. "It resolves a short-term problem and doesn't address the long-term effect of the epidemic."

Achilles is joining Manchester's fire chief and the Professional Fire Fighters of New Hampshire in asking lawmakers to fund a $1.1 million initiative to place counselors in local departments. Roughly $200,000 would fund one licensed drug and alcohol counselor at the state's Bureau of Emergency Medical Services to develop a statewide training plan in how to communicate with victims about treatment options.

The remainder of the money would go toward a five-year grant program to hire counselors in the Manchester, Rochester and Nashua fire departments who can follow up directly with victims. Those three communities are seeing the greatest need for Narcan, with Manchester responders administering roughly 700 doses from October 2014 to September 2015. Responders in Nashua and Rochester gave 200 to 500 doses in the same time frame, according to state data.

Lawmakers will take up the proposal in the upcoming session.

The uptick in overdoses is partially due to an increase in the availability of fentanyl, a drug that is at least 40 times as powerful as heroin and is now responsible for the majority of overdose deaths in New Hampshire. Officials expect opioid overdose deaths to exceed 400 in 2015, more than double the number in 2013.

Fire officials say it's more important than ever that first responders know how to direct people to the help they need.

"Substance abuse has been around a long time," said Dave Lang, president of the Professional Fire Fighters of New Hampshire. "We want to go in and attack this epidemic, slow it down and eradicate it as much as we can."

This year, the state purchased 4,500 kits of Narcan to make available for free at community health centers statewide, and Gov. Maggie Hassan announced last week that Rite-Aid pharmacies in New Hampshire will begin selling Narcan over the counter.

But speaking to lawmakers recently, the fire chiefs questioned the long-term effectiveness of having friends and family members administer Narcan. They say the proposal to hire alcohol and drug counselors will be a more effective way to stop the growing number of overdoses in the long term.

"Narcan has been seen as this magic silver bullet, but it doesn't resolve the root cause," Achilles said. "By having a layperson administer Narcan and resolve a quick problem, I think we're missing the boat."


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