New Hampshire Drug Monitoring Initiative New Hampshire Information & Analysis Center

UNCLASSIFIED

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

NHIAC Product #: 2021-4638 January 2021 Report 2 March 2021 Purpose: The NH Drug Monitoring Initiative (DMI) is a holistic strategy to provide awareness and combat drug distribution and misuse. In line with this ap- proach 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 stakeholders as well as situational awareness releases as needed. Drug Environment Report—UNCLASSIFIED Table of Contents: Section Title Page #

Overview

Drug Overdose Deaths Drug Overdose Deaths Map

EMS Narcan Administration Incidents

EMS Narcan Administration Incidents Map

Opioid Related Emergency Department Visits

Treatment Admissions

Situational Awareness

Substance Use Disorder Treatment/Recovery Resource Link

Previous versions of the Drug Environment Report can be found at: https://www.dhhs.nh.gov/dcbcs/bdas/data.htm The monthly online DMI viewer can be found at: https://nhvieww.nh.gov/IAC/DMI/

 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 2019 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 UNCLASSIFIED—AUTHORIZED FOR PUBLIC RELEASE 1 UNCLASSIFIED

NH Drug Monitoring Initiative Drug Environment Report—UNCLASSIFIED

Overview: Trends for Narcan, ED Visits, Treatment Admissions, and Overdose Deaths: EMS Narcan Administration, Opioid Related ED Visits, and Treatment Admissions per 100,000 Population February 2020 - January 2021 25.00 Opioid Related ED Visits 20.00

15.00 Opioid/Opiate, 10.00 Methamphetamine, & Cocaine/Crack 5.00 Treatment Admissions EMS Narcan 0.00

Events Events per100,000 population Administration

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

Drug Overdose Deaths By Year Data Source: NH Medical Examiner's Office 40.00 36.34 36.35 34.73 35.00 33.00 30.53 * 30.00 27.80 25.03 25.00 20.00 15.25 14.51 15.00 12.34 10.00 13.45 5.00

# of Drug Deaths per Drug population of Deaths 100,000 # 0.00 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020* *2020 numbers are not finalized, and are based on analysis as of 12 February 2021

UNCLASSIFIED—AUTHORIZED FOR PUBLIC RELEASE 2 UNCLASSIFIED NH Drug Monitoring Initiative Drug Environment Report—UNCLASSIFIED

Right click on the paperclip and Drug Overdose Deaths: select “Open File” to Data Source: NH Medical Examiner’s Office view additional data.

Trends: Overdose Deaths by Year per 100,000 Population  As of 12 February there are 378 confirmed drug overdose Data Source: NH Medical Examiner's Office All Drug Deaths Fentanyl/ Heroin Related Deaths + Cocaine Related Deaths+ deaths and 31 cases pending toxicology for 2020. Meth Related Deaths 2019 Comparison  As of February 12, the projected number of total overdose 40.00 deaths for 2020 is 409. This projected number is the 35.00

lowest since before 2015 and includes confirmed 30.00 overdose deaths plus pending toxicology cases. 25.00  So far in 2020, Strafford and Hillsborough Counties have the highest suspected drug use resulting in overdose 20.00

deaths per capita, at 3.34 and 3.17 deaths per 10,000 15.00 # of # DrugDeaths per 100,000 pop population respectively. 10.00  The age group with the largest number of drug overdose 5.00 deaths is 30-39 years, which represents 32% of all 0.00 overdose deaths for 2020. 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020* *2020 numbers are not finalized, and are based on analysis as of 12 February 2021 + Cocaine, Meth, and Fentanyl/Heroin Related deaths are notexclusive, several deaths involved multiplecategories *** IMPORTANT DATA NOTES***  **Drug overdose deaths by county now accurately reflect incident county. The NHIAC continues to work with the OCME to correct any 2020 Overdose Deaths by County per 10,000 Population prior reports that reflect the location where the death occurred, not Data Source: NH Medical Examiner's Office where the drug was suspected to have been used.** 4.00

3.50 Overdose Deaths by Age 2020* 3.17 3.34 Data Source: NH Medical Examiner's Office 3.00

1% 2.50 2.47 2.40 2.47 2.13 9% 1.94 17% 2.00 1.59 1.41 0-19 1.50 18% 1.20 20-29 1.00

30-39 of # deaths per 10,000 pop 40-49 0.50 50-59 0.00 32% 60+ 23%

2020 numbers are not finalized, and are based on analysis as of 12 February 2021 *2020 numbers are not finalized, and based on analysis as of 12 February 2021

UNCLASSIFIED—AUTHORIZED FOR PUBLIC RELEASE 3 UNCLASSIFIED NH Drug Monitoring Initiative Drug Environment Report—UNCLASSIFIED Drug Overdose Deaths (Continued): Data Source: NH Medical Examiner’s Office Cocaine, Methamphetamine, and/or Fentanyl Combination Related Drug Deaths 2020 160 148 *2020 numbers are not finalized, and are based on analysis as of 140 12 February 2021 Source: NH Medical Examiner's Office 120

100

# of # Deaths 60

40 24 23 20 16 10 10 10 7 5 4 3 0

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

Fentanyl, Amphetamines, Cocaine, Acetyl Fentanyl, Fentanyl, Ethanol, Fentanyl, Fentanyl, Oxycodone Amitriptyline, Fentanyl Cocaine, Ethanol Cocaine, Tramadol Fentanyl, Heroin Methamphetamine, Fentanyl Methadone, Morphine Quetiapine, Venlafaxine Zolpidem

Cocaine, Ethanol, alpha PHP/alpha PiHP, Amphetamines, Cocaine, Cocaine, Ethanol, Dextro/levomethorphan, Ethanol, Fentanyl, Heroin, Fentanyl, Morphine, Fentanyl, Methadone Fentanyl Cyclobenzaprine, Fentanyl Ethanol, Fentanyl Methadone Fentanyl, Xylazine Methamphetamine Methadone Oxycodone

Acetyl Fentanyl, Alprazolam, Amphetamines, Cocaine, Fentanyl, Cocaine, Fentanyl, Diphenhydramine, Fentanyl, Fentanyl, Heroin, Buprenorphine, Fentanyl, Citalopram/escitalopram, Amphetamines, Fentanyl Eutylone, Fentanyl Fentanyl, Oxymorphone Methadone Morphine Methadone Methamphetamine Methadone Ethanol, Fentanyl, Trazodone

1, 1-difluoroethane, Flualprazolam, Ethanol, Fentanyl, Acetyl Fentanyl, Cocaine, Alprazolam, Amphetamines, Buprenorphine, Cocaine, Fentanyl, Xylazine Duloxetine, Fentanyl Etizolam, Fentanyl, Fentanyl, Hydrocodone Methamphetamine, Methamphetamine Fentanyl, MDMA Cocaine, Fentanyl Methamphetamine Pyrazolam Promethazine

Clonazepam, Ethanol, Fentanyl, Acetyl Fentanyl, Fentanyl, Methamphetamine, Cocaine, Ethanol, Fentanyl, Fentanyl, Methadone, Methadone, Alprazolam, Ethanol, Fentanyl Fentanyl, Flualprazolam Oxycodone Fluoxetine, Tramadol Olanzapine, Perphenazine, Methamphetamine Fluoxetine, Olanzapine Morphine Methamphetamine Risperidone, Trazodone

Xylazine, gabapentin, *Cells filled with gray Fentanyl, Acetyl Fentanyl, Fentanyl, Ethanol, Fentanyl, Fentanyl, Gabapentin, cyclobenzaprine, indicate combinations Alprazolam, Fentanyl Cocaine, Diazepam, Fentanyl Cocaine, Oxycodone Methamphetamine, Methadone Gabapentin, Morphine Hydroxyzine fentanyl, acetylfentanyl, noted twice Tramadol oxymorphone

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Overdose Deaths by Town* - 2020 + (Data Source: NH Medical Examiner's Office) *Location where the drug(s) is suspected to have been used. Pittsburg +2020 data was reported on February 12, 2021 There are more deaths that are suspected to be drug related, but the official cause of death is pending until the toxicology results are received.

Clarksville 31 CASES PENDING 17 38 Cases have an unknown location Stewartstown

Dixs Second Prepared by: Grant College Colebrook Grant Dixville NH Information & Analysis Center

16 Columbia 15

Millsfield Errol

Odell Stratford Coos Dummer Cambridge

e Stark INDEX b

h Milan

Belknap Hillsborough o

y 1 - Center Harbor 18 - Bennington n n Success e k Carroll Rockingham l i K Berlin 2 - Hales Location 19 - South Hampton Lancaster 3 - Harts Location 20 - Seabrook Coos 21 - East Kingston 22 - Kensington 4 - Hadleys Purchase Jefferson Randolph Gorham 23 - Hampton Falls Dalton ld Shelburne 5 - Beans Grant fie ite 24 - Hampton h 6 - Cutts Grant W µ 25 - North Hampton 7 - Sargents Purchase Littleton 26 - Rye 11 14 8 - Pinkhams Grant 12 27 - Portsmouth Carroll 10 13 9 - Crawfords Purchase Beans Purchase 28 - New Castle Monroe ! 10 - Chandlers Purchase Bethlehem 29 - Newington Lyman 8 11 - Low & Burbanks Grant 9 Lisbon 12 - Thompson & Meserves Purchase Strafford Sugar 5 Hill 13 - Greens Grant 30 - Rollinsford 6 7 14 - Martins Location 31 - Somersworth Bath Franconia Jackson 15 - Ervings Grant Chatham 16 - Wentworth Location Landaff 3 17 - Atkinson & Gilmanton Academy Grant Easton 4

Bartlett Haverhill Lincoln

Benton Livermore 2 Conway Number of Overdose Deaths by Town Woodstock *Location where the drug(s) is suspected Piermont Albany to have been used. Grafton Waterville Valley Warren Thornton Madison Eaton Orford Ellsworth 1 - 5 (80 towns) Wentworth Carroll Sandwich Rumney Campton Tamworth Freedom 6 - 10 (6 towns) Lyme Dorchester Holderness Effingham Groton A Plymouth s Ossipee h Moultonborough Hanover la n 1 11 - 25 (3 towns) d Hebron er Canaan at w Tuftonboro ge rid B n Meredith Lebanon Orange to p W 26 - 50 (1 towns) Alexandria m Bristol a a H Wolfeboro k e Enfield w B f r e i N Laconia o e o l Grafton d k

f i Gilford e Plainfield l 51 - 100 (1 towns) d Danbury Hill Sanbornton

N n Belknap e o Grantham t w Springfield Alton le

D d Cornish Franklin id Belmont u Wilmot Tilton r M h Croydon Andover a m Milton New London Gilmanton e Northfield e Claremont p a Newport n u Salisbury S Farmington B o Canterbury Barnstead s Sutton c Sullivan a w Loudon Newbury Webster e Unity n Strafford Goshen n r Rochester te Strafford w s Pittsfield o Warner t e s h 31 e ic l Merrimack r h a Bradford C h Lempster 30 C Acworth Concord Epsom Northwood Barrington e Hopkinton k o M Dover n r ad o b b d u g Henniker m ry n Washington e a P L n W Hillsborough w sto i en Deerfield Marlow n Bow All d Nottingham Lee Durham Alstead s o r 29 28 Stoddard Weare Dunbarton Deering Hooksett Newmarket ! Walpole Candia G lsum re 27 Gi Antrim e Raymond Epping n Newfields m la a n h d Surry Sullivan Goffstown t 18 d a 26 o r o t Rockingham S Nelson Francestown New Boston Manchester Auburn tw Exeter n 25 Fremont re y Hancock B r Gr u ee S Westmoreland b Chester a e Keene x n l Harrisville f h n l i i o el g d 24 d Hillsborough v R u o n M o w n o 22 r t 23 Bedford n a 21 a o L s

r b Mont o D g lb n H n o e d a i M m Dublin d Vernon o K Chesterfield ro Peterborough n Derry ps 20 e n t n 19 u y d e o Cheshire r a g L L d t Amherst r e h i i r P w m t r c y la e h N Swanzey a A is f t c ki t H i n o k e s i on w n Jaffrey Wilton l Troy d s d Sharon Milford a Temple Windham le Winchester G Salem r B 0 5 10 20 30

e r

o Richmond n o Hudson Fitzwilliam v

i k Rindge l Hollis l

New Ipswich e Nashua Mason l i n e Pelham Miles Scale: 1:1,150,000

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NH Drug Monitoring Initiative Drug Environment Report—UNCLASSIFIED

Right click on the paperclip and EMS Narcan Administration Incidents: select “Open File” to Data Source: NH Bureau of Emergency Medical Services (EMS) view additional data.

Trends: EMS Narcan Administration by Month per 100,000 Population  EMS Narcan administration incidents did not change from January 2016 - January 2021

December to January. 25.00  In January, Belknap County had the most EMS Narcan

administration incidents per capita with 1.30 incidents per 20.00 10,000 population. Carroll County second highest with

1.03 incidents per 10,000 population. 15.00 2016  The age group with the largest number of EMS Narcan 2017 administration incidents was 30-39, representing 31% of 10.00 2018 all EMS Narcan administrations in January. 2019

5.00 2020

*** IMPORTANT DATA NOTES*** of # Incidents Involving Narcanper 100,000 pop 2021  Narcan data in this report involves the number of incidents where Narcan was administered, NOT the number of doses of Narcan during 0.00 Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec a certain time period. Multiple doses may be administered during an incident. Source: NH Bureau of EMS  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. January EMS Narcan Administration by County per 10,000 Population January EMS Narcan Administration by Age Group 1.40 1.30 2% 1.20 7% 1.03 1.00 0.90 0.89 13% 24% 0-19 0.80 0.73 0.66 0.70 0.68 20-29 0.60 30-39 0.45 0.39 40-49 0.40

50-59 0.20 23% 60+ Unknown 0.00

31% # of Incidents Involving Narcan per 10,000 pop 10,000 per Narcan Involving Incidents of #

Source: NH Bureau of EMS Source: NH Bureau of EMS

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NH Drug Monitoring Initiative Drug Environment Report—UNCLASSIFIED EMS Narcan Administration Incidents (Continued): Data Source: NH Bureau of Emergency Medical Services (EMS) EMS Narcan Administration - Lives Saved EMS Narcan Administration - Lives Saved % 2020 2021 February 2020 - January 2021 Negative Improvement Source: NH Bureau of EMS Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Jan 100% Some Improvement RODS Outcome Lives Saved 90% 54 62 60 70 49 72 66 52 44 37 44 48 No Improvement RODS Score of 8+ 80% Lives Saved Some Improvement 70% RODS, or Revised Over Dose Score 13 14 8 14 19 17 15 17 9 11 9 12 60% is based on the combined delta of RODS Score of 1-7 documented respiratory rate (RR) 50% and Glasgow Coma Score (GCS - No Improvement 20 38 40 32 28 39 25 35 30 30 31 28 measure of alertness) before and RODS Score of 0 40% after Narcan administration. For 30% example, RR improved from 6/min Negative Improvement to 12/min (delta of 6) and GCS 8 11 5 13 22 18 12 11 13 12 15 11 Negative RODS Score 20% improved from 10 to 13 (delta of 3), the RODS score would be 9. The 10% Total 95 125 113 129 118 146 118 115 96 90 99 99 delta of the vital signs is calculated 0% per incident, so the patient may RODS , or Revised Over Dose Score is based on the combined delta of documented respiratory rate (RR) Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Jan have received more than one dose and Glasgow Coma Score (GCS - measure of alertness) before and after Narcan administration. For of Narcan to achieve the effect in example, RR improved from 6/min to 12/min (delta of 6) and GCS improved from 10-13 (delta of 3), the the RODS. Source: NH Bureau of EMS 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. EMS Narcan Administration by County per 10,000 Population 2.00

1.80 1.80

1.60

1.40 1.30 1.24 1.20 1.20 1.09 1.03 1.00 November 0.90 0.90 0.87 0.89 0.91 0.81 0.80 0.73 0.73 0.70 0.65 0.66 0.63 0.68 December 0.60 0.60 0.55 0.60 0.45 0.45 0.45 0.41 0.39 January 0.40 0.33 0.29

0.20 # of Incidents Involving Narcan per 10,000 pop 10,000 per Narcan Involving Incidents of # 0.00 Belknap Carroll Cheshire Coos Grafton Hillsborough Merrimack Rockingham Strafford Sullivan Source: NH Bureau of EMS

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EMS/Narcan Administration by T own 2/1/2020 – 1/31/2021 Data Source: New Hampshire Bureau of EMS

Pittsburg

Clarksville 17

Stewartstown

Dixs Second Prepared by: Grant College Colebrook Grant NH Information & Analysis Center Dixville

INDEX 16 Columbia Belknap Hillsborough 15 1 - Center Harbor 18 - Bennington Millsfield Errol Carroll Rockingham 2 - Hales Location 19 - South Hampton Odell Stratford 3 - Harts Location 20 - Seabrook Coos 21 - East Kingston 4 - Hadleys Purchase 22 - Kensington Dummer Cambridge 23 - Hampton Falls Coos 5 - Beans Grant d

24 - Hampton a l 6 - Cutts Grant r e Stark 7 - Sargents Purchase 25 - North Hampton b

26 - Rye u

8 - Pinkhams Grant h Milan

t 27 - Portsmouth r 9 - Crawfords Purchase o 28 - New Castle N 10 - Chandlers Purchase y n 29 - Newington n Success 11 - Low & Burbanks Grant e k l i Berlin 12 - T hompson & Meserves Purchase Strafford K Lancaster 13 - Greens Grant 30 - Rollinsford 14 - Martins Location 31 - Somersworth 15 - Ervings Grant 16 - Wentworth Location Jefferson Randolph Gorham Dalton ld Shelburne 17 - Atkinson & Gilmanton Academy Grant fie ite h W Littleton 11 14 12 Carroll 10 13 Beans Purchase Monroe ! *Incidents Where Narcan Was Administered* Bethlehem Lyman 9 8 Lisbon Sugar 5 Hill 1 - 10 6 7 Bath Franconia Jackson Chatham Landaff 3 Easton 11 - 25 4 Bartlett Haverhill Lincoln

Benton Livermore 2 Conway 26 - 50 Woodstock µ Piermont Albany Waterville Valley Warren Thornton Grafton Madison 51 - 100 Eaton Orford Ellsworth Carroll Wentworth Sandwich Rumney Campton Tamworth Freedom 101 - 200 Lyme

Dorchester Holderness Effingham Groton A Plymouth s Ossipee h Moultonborough la Hanover n 201 - 300 d 1 Hebron er Canaan at w Tuftonboro ge rid B n Meredith Lebanon Orange to p W Alexandria m Bristol a Wolfeboro a H k e Enfield w B f r e i N Laconia o e o l Grafton d k

f i Gilford e Plainfield l d Danbury Hill Sanbornton

N n Grantham e to Belknap w Springfield Alton le

r 29 28 Stoddard Weare Dunbarton Deering Hooksett Newmarket G Walpole sum Candia re 27 Gil e Antrim Raymond Epping n Newfields m la a n h d Surry Sullivan Goffstown t d a 18 Hillsborough r 26 o t o S Nelson Francestown New Boston Manchester Auburn Rockingham tw Exeter n 25 Fremont re y Hancock B Cheshire r Gr u ee S Westmoreland b Chester a e Keene x n l Harrisville f h n l i i o el g d 24

d v R u o n M o w n o 22 r t 23 Bedford n a 21 a o L s

r b Mont o D g lb n H n o e d a i Vernon M m r Dublin d o p K Chesterfield o Peterborough n Derry s n 20 e n t 19 u y d e o r a t g L L d Amherst r e w h i i r P m t r e c y la h N Swanzey a A is f t c ki t H i n o k e s i on w n Jaffrey Wilton l Troy d s d Sharon Milford a Temple Windham le Winchester G Salem 0 5 10 20 30 r B

e r

o Richmond n Hudson o Fitzwilliam v

i k Rindge l Hollis l

New Ipswich e Nashua Mason l i n e Pelham Miles Scale: 1:1,150,000

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NH Drug Monitoring Initiative Drug Environment Report—UNCLASSIFIED

Right click on the paperclip and Opioid Related Emergency Department Visits: select “Open File” to Data Source: NH Division of Public Health Services view additional data. Trends: Emergency Department Opioid Use Visits by Month per 100,000 Population January 2020 - January 2021  Opioid related ED visits decreased by 8% from December 25.00 to January. 22.66 20.45 19.64 19.71  In January, residents from Belknap County had the most 19.20 18.98 20.00 18.09 opioid related ED visits per capita with 1.78 visits per 17.21 16.77 16.04 10,000 population. Hillsborough and Strafford County 14.71 15.00 2020 residents were close to the second highest number of 14.34 opioid related ED visits per capita with 1.64 and 1.63 2021 11.33 visits per 10,000 population, respectively. 10.00  In January, the age group with the largest number of

opioid related ED visits was the 20-29 year old age group 5.00 # of ED Opioid Use Visits per 100,000 pop 100,000 per VisitsUseED of Opioid # with 27%.

*** IMPORTANT DATA NOTES*** 0.00  *Important Note*: The data being reported starting January 2020 has Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec different collection criteria than previous months/years. Due to the new Source: NH Division of Public Health Services collection criteria, the data is no longer comparable to previous data.  County represents where the opioid use patient resides.  These data include data on suspected overdoses categorized as “all drug,” “all opioid,” “heroin,” and “all stimulant.” This report uses key words and ICD-10 January Emergency Department Opioid Use Visits by County associated overdose codes that CDC has defined as tailored to nonfatal opioid per 10,000 Population overdoses. 2.00  These data are now collected using criteria the CDC established for their 1.78 Overdose Data to Action (OD2A) grant “making this report more 1.80 1.64 1.63 transparent.” 1.60 1.40 January Emergency Department Opioid 1.26 1.14 Use Visits by Age 1.20 1.00 0.99 0.93 0.82 0.80 10% 4% 0.64 0-9 15% 0.60 11% 10-19 0.40 20-29 0.20

30-39 of # ED Opioid Visits Use per10,000 pop 13% 0.00 40-49 27% 50-59 20% 60+

Source: NH Division of Public Health Services Source: NH Division of Public Health Services

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NH Drug Monitoring Initiative Drug Environment Report—UNCLASSIFIED Opioid Related Emergency Department Visits (Continued): Data Source: NH Division of Public Health Services

Emergency Department Opioid Use Visits per 100,000 Population February 2020 - January 2021 25.00 22.66 20.45 19.64 19.71 18.98 20.00 18.09 17.21 16.77 16.04 14.34 14.71 15.00 11.33

10.00

5.00

0.00

# of ED Opioid Use Visits per 100,000 pop 100,000 per Visits Use ED Opioid of # February March April May June July August September October November December January Source: NH Div. of Public Health Services

Emergency Department Opioid Use Visits by County per 10,000 Population 3.00

2.50 2.41 2.25 1.94 2.00 1.85 1.84 1.78 1.79 1.67 1.64 1.63 1.40 November 1.50 1.36 1.32 1.26 1.13 1.23 1.20 1.09 1.14 December 1.00 0.90 0.90 0.99 0.93 0.91 0.82 0.80 0.64 January 0.50 0.30

# of ED Opioid Use Visits per 10,000 pop 10,000 per Visits Use ED Opioid of # 0.00 Belknap Carroll Cheshire Coos Grafton Hillsborough Merrimack Rockingham Strafford Sullivan

Source: NH Div. of Public Health Services

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NH Drug Monitoring Initiative Drug Environment Report—UNCLASSIFIED

Right click on the paperclip and Treatment Admissions: select “Open File” to Data Source: NH Bureau of Drug & Alcohol Services view additional data.

Trends: Opioid/Opiate, Methamphetamine, & Cocaine/Crack Treatment Admissions by Month per  Opioid/opiate, Methamphetamine, & Cocaine/Crack 100,000 Population treatment admissions increased 6% from December to February 2020 - January 2021 20.00 January. 17.43 18.00 16.62 16.55  In January, residents from Hillsborough County were 16.18 15.59 16.00 14.78 admitted at the highest per capita rate for opioid/opiate 14.42 14.00 13.46 12.95 12.73 treatment, with 1.50 admissions per 10,000 population. 12.06  More males than females were admitted to treatment 12.00 10.44 programs in January for Opioid/Opiate, 10.00 Methamphetamine, & Cocaine/Crack use. 8.00  Methamphetamine treatment admissions decreased 6.00 13% from December to January. 4.00  Cocaine/Crack treatment admissions increased 80% 2.00 0.00

from December to January. pop per100,000 Treatment of Admissions# Feb Mar Apr May June July Aug Sep Oct Nov Dec Jan  Heroin/Fentanyl treatment admissions increase by 6% Source: NH Bureau of Drug & Alcohol Services from December to January.

*** IMPORTANT DATA January Opioid/Opiate, Methamphetamine, & Cocaine/Crack Treatment Admissions by County NOTES*** January Treatment Admissions by per 10,000 Population  County represents where Gender the patient resides. 1.60  These data represent 1.50 1.36 treatment admissions to 1.40 state funded facilities.

 These data have 39% 1.20 decreased due to Male numerous factors. The 1.00 0.97 Female 0.90 Affordable Care Act has Transgender been fully implemented, 61% 0.80 Opioid/Opiate 0.62 resulting in increased Methamphetamine access to affordable 0.60 0.55 0.47 health insurance and Cocaine/Crack coverage for substance Source: NH Bureau of Drug & Alcohol 0.40 0.26 0.32 0.31 use disorder treatment in 0.23 0.17 0.16 NH. New Hampshire 0.20 0.12 0.11 0.07 expanded its Medicaid program, which also provided increased opportunities of # Treatment Admissions per10,000 pop 0.03 for substance use disorder treatment in the state. Substance use disorder 0.00 treatment in the state has increased sharply in response to these policies Belknap Carroll Cheshire Coos Grafton Hillsborough Merrimack Rockingham Strafford Sullivan which has shifted clients served by State of New Hampshire contracted Source: NH Bureau of Drug & Alcohol Services treatment providers to other payment models and facilities. UNCLASSIFIED—AUTHORIZED FOR PUBLIC RELEASE 11 UNCLASSIFIED

NH Drug Monitoring Initiative Drug Environment Report—UNCLASSIFIED Treatment Admissions (Continued): Data Source: NH Bureau of Drug & Alcohol Services

Heroin/Fentanyl , Rx Opiate, Methamphetamine, & Cocaine/Crack Treatment Admissions by Month per 100,000 Population February 2020 - January 2021 14.00

12.00

10.00

Heroin/Fentanyl 8.00 Rx Opiates

6.00 Methamphetamine Cocaine/Crack 4.00

2.00 # of Treatment Admissions per 100,000 pop 100,000 per Admissions Treatment of #

0.00 Feb Mar Apr May June July Aug Sep Oct Nov Dec Jan

Source: NH Bureau of Drug & Alcohol Services

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

1.80

1.60 1.59 1.50 1.40 1.40 1.36

1.20 1.20

0.97 0.97 1.00 November 0.90 0.85 0.80 December 0.70 0.68 0.62 January 0.60 0.60 0.55 0.49 0.47 0.39 0.39 0.40 0.35 0.33 0.32 0.31 0.26 0.22 0.20 0.13

0.00 Belknap Carroll Cheshire Coos Grafton Hillsborough Merrimack Rockingham Strafford Sullivan

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NH Drug Monitoring Initiative Drug Environment Report—UNCLASSIFIED

Situational Awareness: New Hampshire Safe Stations Manchester Manchester Safe Station Began 5/4/2016 As of 12/30/2020 Q4 2020 Total Parents Find Over 5,000 Pills Number of Walk-In Requests for Safe Station: 189 7,536 Believed to be Fentanyl in Glow Number of Participants Transported to Hospitals Emergency Department: 30 1,636 Worm Bought at El Mirage Thrift Number of participants taken to Substance Misuse Treatment Facilities: 112 5,883 Store Average Number of Minutes of time AMR/Fire Companies “Not Available”: 11.0 Min 13.6 Min Phoenix (3TV/CBS 5) -- Phoenix Number of UNIQUE Participants to Manchester Safe Station: 178 4,130 parents received quite the Number of REPEAT Participants to Manchester Safe Station: 116 4,500 surprise as they were cleaning a Number of unique participants seen in both City’s Safe Station Program 566 new toy they had recently bought for their baby. The parents bought a glow worm from a thrift store in El Mirage and made the startling discovery Friday afternoon. According to Phoenix Police Sergeant Mercedes Fortune, the parents were cleaning the glow worm and opened the back to put in batteries and found a sandwich bag packed with pills. They called Phoenix police and gave the bag to officers. Police say the bag contained more than 5,000 pills believed to be fentanyl. Sgt. Fortune said due to the dangers of fentanyl, officers are unable to field test the pills but noticed they had "m-30" engraved on them. Police are using this example as a reminder for parents to inspect all open and previously owned items. Source: www.azfamily.com 02/20/2021 A full list of Substance Use Disorder Treatment Facilities and Recovery Support Services can be found here or by calling 211.

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