Life or death choices in recovery community

LACONIA — Michael Tensel sat behind his desk in his upstairs office on Main Street just after dark Tuesday and pointed toward an old file cabinet.

Before a recent office cleanup, one drawer had numerous files from people who died of drug overdoses.

The licensed drug and alcohol counselor remembered one woman in particular.

“I had a young lady who was on medication-assisted therapy,” he said. “She was young and naive and trying to manage and not go back to opioids. She had gone from using pills to using heroin and fentanyl.”

There had been times when she was saved by the overdose-reversing medication, Narcan.

“I had her scheduled for an appointment,” Tensel said. “Someone in her family had to cancel the appointment and leave a voicemail saying she wasn’t going to make it in because she had passed away.

“And she had two very young children, less than two years old. So that hurts because these babies are not going to see or know their mom at all. This is part of the phenomenon of grandparents bringing up children.”

The state Medical Examiner’s office estimates that the final death toll from overdoses in New Hampshire in 2019 will be 411 when toxicology testing on outstanding cases is complete.

Of course, the true death toll from substance abuse would be quite a bit higher when one considers traffic accidents and chronic medical complications associated with drug and alcohol use.

As tough as it is to confront the deadly consequences of substance misuse disorder, Tensel and others in the recovery community realize there is a limit to what a provider can do to encourage patients to act in their own self interest.

“If I’m too stern with them, they just won’t come back,” he said. “I don’t have the power to make them.

“Even those who are on probation or parole and will get in trouble with the court, and the judge and the parole officers, when it is outpatient counseling, they know they can stay away from me for a while.

“What I have to do is be careful to not lose them completely by saying, ‘Young lady, what’s the matter with you? Don’t you know you’re going to die?’

“If I act like the upset, worried parent, that could be enough of a trigger to make things go bad.”