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Letter: DHMC Is Part of the Problem

To the Editor:

The Valley News is to be commended for the recent article and editorial that focused on the opioid abuse epidemic in the Upper Valley and across the U.S. (“Addiction Doctor Defends Unconventional Approach,” June 23).

Especially useful for the public is the identification of those in a position to answer questions.

Dr. Ben Nordstrom, director of addiction services at Dartmouth-Hitchcock Medical Center, believes it unfair for me to raise the issue of how important a part DHMC plays in the problem or its role in solving it, “because the prescribing of these drugs (opioids) has increased astronomically across the country.” He fails to note that opportunities for successful treatment, for example buprenorphine/Suboxone (for almost 10 years considered the gold standard for successful treatment), have also “increased astronomically” virtually everywhere except for the Upper Valley in particular, and New Hampshire and Vermont in general. (Appropriate patients in the rest of the Northeast can usually get started on buprenorphine within 24 hours after presentation at a licensed doctor or clinic; also true in most places in the US.) As the region’s largest provider of mental health services, and given the medical acceptance of drug addiction as a psychiatric illness since the 1950s, DHMC’s failure to treat this problem aggressively is critical to understanding why we are in this mess.

My questions for Nordstrom are:

∎ How many buprenorphine patients is DHMC currently treating in Lebanon and statewide?

∎ How long is the waiting list (number of patients and number of months) for receiving treatment?

∎ In the Upper Valley, what fraction of motivated addicts who would benefit from this treatment are able to get it?

∎ What percent of opioid medication prescribed by DHMC and the VA hospital end up diverted to illicit use?

∎ Is there evidence that diversion of buprenorphine prescribed to patients is even remotely as frequent or harmful as the diversion of opioid medications from these two institutions?

∎ What are the plans for, and obstacles to, increasing access to this life-saving and community-strengthening medication?

∎ When can the public expect opioid addicts to get as expert and accessible care as virtually every other group of Upper Valley patients?

Michael E. Schorsch, M.D.

Mental Health Alliance

Lebanon

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