John Milne

The danger signs have been posted, but New Hampshire's politicians keep ignoring them.

The drug overdoses are sometimes just notations on a death certificate.

Instead the politicians brag that state was proclaimed safest in the nation last week by CQ Press. Gov. John H. Lynch immediately associated himself with the low crime rate.

"New Hampshire has long been one of the safest states in the nation, and our low crime rate is part of what makes this (state) such a great place to live and work," said the governor. "We should take time to thank the hard-working men and women of New Hampshire law enforcement, who help keep us all safe."

How, then, can Lynch explain the statistics also released last week by one of the hardest-working law enforcers, Dr. Thomas Andrew? The state's chief medical examiner points out that in 2007, 168 New Hampshire citizens died of drug overdoses, and 129 residents were killed in traffic accidents.

Compare this with the 2006 statistics: 142 drug overdose deaths, 128 traffic deaths. While the traffic death toll was relatively stable, the drug overdose death rate rose 18 percent, an increase probably too big to be a statistical fluke. More and more human beings are dying.

Part of the answer involves data. The CQ Press statisticians count only reported crimes of murder, rape, aggravated assault, burglary, robbery and motor vehicle theft and compare those to national averages. A drug overdose — a middle-aged woman, say, who takes methadone at the same time she drinks too much alcohol — would not be counted among the CQ Press statistics.

As a matter of fact, the federal Centers for Disease Control statistics say New Hampshire is tied for fourth in the nation in the number of methadone-related deaths — just over half of all drug overdoses.

The rest of the answer is that neither the state nor the country understands this prescription-drug-abuse epidemic, said Dr. Leonard J. Paulozzi, a senior epidemiologist for the federal Centers for Disease Control and Prevention.

In testimony before the Senate crime and drugs subcommittee March 12, Paulozzi said, "Judged by any measure — person-years of life lost, health-care costs, self-reports of drug abuse — the prescription drug problem is a crisis that is steadily worsening." He describes this death rate as substantially higher than that of the heroin epidemic in the 1970s or even the cocaine-related fatalities from the "Miami Vice" years of the early 1990s.

"Street drugs were not behind the increase," Paulozzi insisted. The dramatic rise in drug overdoses "from 1999 to 2004 was driven largely by opioid analgesics, with a smaller contribution from cocaine, and essentially no contribution from heroin." These are opium-based painkillers such as OxyContin, Vicodin and methadone.

This is no longer a problem of young people from minority neighborhoods. The victims of prescription drug abuse are more likely to be white men, Paulozzi said: "People in their 40s are more likely than those in their 20s or 30s to die of an overdose." Rural overdoses are higher than city overdoses. New England is one section of the Republic where overdose rates are higher than normal.

The overdoses don't come from the liquid methadone that drug treatment clinics use to treat heroin addicts. They come from the use of methadone pills as a cheap prescription painkiller. Often timed-release capsules are crushed and snorted, or the methadone is mixed with other drugs, or alcohol.

"It's been challenging to prosecute these cases because there are often multiple drugs in a person's system," Senior Assistant Attorney General Jane Young told The Associated Press. Methadone pills are sometimes given away instead of sold. "From this office, we have not seen the trafficking of it, although we know it's there," Young added.

Prescription drug abuse presents a clear and present danger, and if the state were an alcoholic, he'd be in denial. The state budgets far more money for highway safety and enforcement that it spends on drug abuse prevention and control. Andrew has numbers to demonstrate the greater problem.

The Legislature twists itself in political knots over whether to decriminalize marijuana even though the governor has promised to veto the bill.

Instead the Legislature could authorize an electronic prescription monitoring program — the information is already on file in most large drug stores — and permit authorities to check for patterns of abuse, such as one patient getting prescriptions from multiple doctors. Doctors and emergency rooms could, if they had electronic medical records, be on the lookout for possible abusers. Privacy advocates have blocked progress, but there should be a way to compromise.

Before progress can take place, the state has to acknowledge that New Hampshire has a prescription drug problem.

John Milne is a veteran New Hampshire political reporter and analyst. Reach him at jmilne@mcttelecom.com.