Opioid crisis putting strain on NH fire dept.

From October through May, the Keene Fire Department responded to at least 51 suspected opioid overdoses, administering 110 doses of naloxone to those patients

By Paul Cuno-Booth
The Keene Sentinel

KEENE, N.H. — From October through the end of May, the Keene Police Department paid for 150.75 hours of overtime related to drug investigations.

The Keene Fire Department responded to at least 51 suspected opioid overdoses, administering 110 doses of the overdose-reversal drug Narcan to those patients.

From October through May, the Keene Fire Department responded to at least 51 suspected opioid overdoses.
From October through May, the Keene Fire Department responded to at least 51 suspected opioid overdoses. (Photo/City of Keene)

And the city’s Human Services Department helped pay for the funerals of 11 residents who died due to substance misuse and whose families could not afford to bury them.

Nationally, the opioid crisis has claimed tens of thousands of lives and, according to a 2017 report from the president’s Council of Economic Advisers, drained the economy of hundreds of billions of dollars. Meanwhile, a wave of litigation against pharmaceutical companies has highlighted another cost: the financial impact of the drug crisis on municipalities like Keene.

In April, Keene joined the hundreds of state, county and municipal governments suing the makers and distributors of certain opioid painkillers. They allege that the companies caused the opioid crisis by aggressively pushing medications they knew to be addictive.

In its lawsuit, Keene claims that it “spends hundreds of thousands of taxpayer dollars each year” on law enforcement, emergency medical response, public assistance and other services.

The city has not yet come up with a more precise estimate, City Manager Elizabeth A. Dragon said Thursday.

But she said police, fire and human services — also known as welfare — are probably burdened with the highest opioid-related costs, given their responsibilities.

Tallying those costs is tricky. And with the opioid crisis affecting everything from property crime to workforce issues to child welfare, it’s difficult to tease out exactly what the epidemic has cost.

“I don’t think we’ve done a lot of work yet in terms of trying to determine what those (costs) are and to what extent, but really you could make a case for almost any department,” Dragon said.

Further complicating matters, the city doesn’t bear all the costs of its drug-related services.

The state grant program known as Granite Shield reimbursed the city for 401.25 overtime hours related to drug investigations from October through March, on top of the 150 or so overtime hours the city paid for out of pocket.

The fire department receives Narcan at no cost from Cheshire Medical Center, according to Fire Chief Mark Howard. The Human Services Department aid is technically a loan, which recipients are supposed to pay back when and if they are able.

Investigations and emergency response

This spring, The Sentinel filed a public-records request for documents outlining city costs related to the opioid crisis. Those documents included police overtime records, tallies of fire-department overdose responses and a report of public assistance provided to city residents with substance-misuse issues.

The records offer an initial — but incomplete — look at the municipal costs of the crisis.

From October through May — the period covered by The Sentinel’s records request — Keene police conducted 86 felony-level drug investigations, according to internal quarterly reports. The drugs seized included opioids like heroin and fentanyl, as well as non-opioid substances like crack cocaine.

For the purposes of grant applications, Keene police calculates the cost of overtime drug investigations at $63 per hour, according to Capt. Steven Stewart.

For the 150.75 hours of overtime the state didn’t reimburse, that works out to a little under $9,500.

Detectives also spend some of their regular working hours on drug investigations. Stewart said it’s hard to say how much time overall goes to drug work, as it depends on what other crimes the department is investigating.

Howard, the fire chief, said overdose calls can be labor-intensive, but make up a small fraction of the department’s medical calls. Last year, Keene Fire Department personnel responded to 3,315 medical calls, 78 of which were overdoses, according to numbers compiled by the department.

The department has not had to change its staffing due to the opioid crisis, Howard said.

Some costs to first responders, such as their “stress level,” can’t be quantified, Dragon said.

“With the crisis came more deaths,” she said, “and obviously you have to think of not only the well-being of your patients but of your employees as well.”

In an interview last month, Liz Sayre, the city’s human services manager, said she sees the effects of the opioid crisis regularly.

The crisis “has had a definite impact on people’s ability to get a job, maintain a job, because of the addiction,” she said. “ … There’s more single people homeless than have been in the past. More families are becoming homeless because of a substance abuse crisis.”

New Hampshire law requires every municipality to provide short-term assistance to people in need, who are then supposed to repay the city when they can.

From Oct. 1 through May 17, according to a department report, the city provided $99,459 in benefits in 81 cases of clients who self-identified as having a substance-misuse problem, whether connected to opioids or a different substance.

That includes $7,520 related to unemployment, $20,870 related to mental-health or medical expenses and $30,500 related to homelessness.

The funeral expenses were $11,076.

Copyright 2018 The Keene Sentinel

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