Meeting in Plymouth, group urges Medicaid expansiion needed for substance abuse treatment

PLYMOUTH —  On the day before the Legislature's Committee of Conference convenes to hash out the differences between House and Senate budgets, some N.H. citizens urged the lawmakers to support Medicaid expansion. Health care providers, business professionals and advocates gathered in the atrium of Speare Memorial Hospital to give lawmakers yet another reason to support accepting the federal funds to expand Medicaid: Nearly 8,000 New Hampshire residents in need of substance abuse treatment will be eligible for treatment under Medicaid expansion.
"This represents the single biggest opportunity in half a century to increase access to substance abuse treatment for thousands of Americans and thousands of New Hampshire residents with a diagnosable substance use disorder," said Tym Rourke, chair of the Governor's Commission on Alcohol and Drug Abuse Prevention, Intervention and Treatment.
In New Hampshire, the current system has the capacity to treat between 4 and 6 percent of those with a substance use disorder, and that for many individuals the greatest barrier to treatment is cost, he said.
President and CEO of Speare Memorial Hospital Michelle McEwen described the type of people the hospital sees every day. "They seek treatment in our ER from the effects of overdoses and dangerously high levels of alcohol. They peer in our door in need of medical attention as they go through withdrawal. Some are also in our ER trying to gain access to drugs — drugs that they've become dependent on, usually citing some other problem to be able to get that prescription."
If those people had access to ongoing care, they wouldn't have needed to come to the hospital, McEwen said. "We see a cycle of repeated hospital care," she said. "And hospital care is the most expensive care there is."
Ed Rajsteter, president of Friends of the Grafton County Drug Court, linked Medicaid expansion to the Grafton County Drug Court. He said with Medicaid expansion, the drug court would be able to increase capacity by 20 percent. The Friends of the Grafton County Drug Court is a non-profit organization that is devoted to supporting and assisting the Grafton County Drug Court, which is an alternative sentencing program in which offenders participate in substance abuse treatment, supervision, and drug testing in lieu of prison time.
"We have all heard the bailiff in a courtroom say 'All rise.' We all rise when lives are saved; we all rise when families are reunited; and we all rise when substance use is abated," Rajsteter said.
"Amanda", a Manchester native who is currently in a residential treatment program, said her substance use began at 14. Like many, Amanda's drug use began with prescribed medication and evolved to Oxycontin and heroin.
"There were more than a dozen times I was ready to put forth the effort and change but could not do so because I did not have the right tools or enough money to get the proper treatment," she said.
Amanda sought and received treatment while she was pregnant under Medicaid, but was no longer eligible for coverage once the baby was a few months old.
When she turned 26, Amanda could no longer remain on her parent's insurance plan. She was homeless, addicted to heroin and on a two-month waiting list for detox treatment. After an arrest for heroin possession and spending several months in jail, Amanda was released into a residential treatment facility.
"Every other (young) woman I met in jail was struggling with drug addiction," Amanda said.
Now she worries about what will happen next for her. "I'm worried that once I leave I won't have access to follow-up treatment. And without follow-up treatment, I increase my chances of relapse," she said.
"There is a solution," she said, "And people who suffer from the disease of addiction should be able to access it."
Rourke ended the event with a message to the Committee of Conference: "We strongly encourage the Committee of Conference to take advantage of a profound opportunity to economically, smartly, efficiently provide services for one of the last diseases known to man that we don't provide treatment for. For us, it's a simple solution."