01-17 The Doorway forum

Corey Gately, coordinator for LRGHealthcare's Recovery Clinic, and Dr. Paul Racicot, who oversees the program, address a packed crowd for a forum to announce the opening of The Doorway at Lakes Region General Hospital on Tuesday afternoon. Daisy Pierce, executive director for Navigating Recovery, stands at left. (Adam Drapcho/The Laconia Daily Sun)

LACONIA — If someone who is actively using substances decides to reach out for help, the window of opportunity to respond might stay open for just minutes before addiction slams it shut again. That’s why "The Doorway” at Lakes Region General Hospital, the recent opening of which was discussed at a forum held on Tuesday evening, is so important, said people who help guide patients down the path of recovery.

“The Doorway” at LRGH is part of a statewide initiative to streamline and organize the services available to people seeking to enter or continue their recovery, or for people who wish to help someone do so. LRGH is one of the nine “hubs” throughout the state, places where anyone can turn in order to reach out for help. Those “hubs” can then connect patients to “spokes” – service providers who will help counsel them through the process.

Navigating Recovery in Laconia is one of those “spokes” in this model. And while the counseling organization, as well as Horizons Counseling, have partnered with LRGHealthcare for the past couple of years, The Doorway effort will enhance past efforts to better care for patients who enter the hospital due to a substance use disorder.

LRGHeathcare’s emergency department had already partnered with the counseling agencies to have a licensed counselor or recovery coach on call, so that someone who was brought to the emergency department due to an overdose could have a conversation with a recovery professional before they walked out the door. But, said Bruce Paul, a recovery coach with Navigating Recovery, responding to such an incident could take 10, or even 30 minutes.

Thanks to The Doorway, there will soon be a licensed recovery professional present in the hospital, cutting that response time down to about a minute.

“There’s a small window of hope that that person has at that time,” Paul said. “From my own experience, I was an active opiate user for many years, those windows of hope when you want to stop using is very short. Getting those people when they’re in that frame of mind is very important… They’re at that point of vulnerability, that window, it comes and it goes, it doesn’t stick around for long.”

Wait just 10 or 15 minutes, he said, and the “glimmer of hope fades.” But, like a spark, that hope can also be fed and encouraged if attended to in time.

The first step is to meet with a counselor for an evaluation. Prior to the state’s hub-and-spoke model, it could be confusing or difficult to find out how to arrange such an appointment. The Doorway removes that confusion, and that evaluation can now occur immediately. And if the counselor recommends it, the patient can begin medically-assisted treatment in the hospital’s emergency department.

Medically-assisted treatment for opioid dependency often uses the drug Suboxone, which has ingredients that block the effects of both future opioid use and mitigate the symptoms of withdrawal.

“Withdrawal is a huge barrier to recovery,” said Daisy Pierce, executive director for Navigating Recovery. “If they are left in a waiting room for too long, that gives them an opportunity to talk themselves out of it.”

But if the patient can be encouraged to enter recovery, chances for long-term success start to rise immediately, said Dr. Paul Racicot, one of the doctors who oversees the LRGHealthcare Recovery Clinic. Research shows that once recovery patients begin medically-assisted treatment, their success rates improve from less than 10 percent to as much as 30 percent. If they can stay sober for a year, there’s a 50 percent chance that they’ll never use again, and the longer they maintain their sobriety from there, the better their prognosis for long-term success becomes.

Corey Gately, who coordinates the Recovery Clinic, told  nearly 200 people who attended the forum on Tuesday that The Doorway wouldn’t solve the state’s opioid problem, “But this is a significant step in the right direction.”

Racicot said, “We had a safety net, now we’re going to wrap our arms around people.”

How to get help:

Call 2-1-1, which is New Hampshire’s statewide, comprehensive, information and referral service.

The New Hampshire Statewide Addiction Crisis Line 1-844-711-HELP (4357).

The National Suicide Prevention Lifeline 1-800-273-TALK (8255).

Horizons Counseling Center, 603-524-8005

Lakes Region General Hospital, 603-524-3211

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