Outside the Bubble: Socioeconomic Divide
Last January, a local couple entered Love Gym and stole a $12,500 diamond-encrusted Rolex watch from a student’s unlocked locker before heading to a nearby pawn shop where they sold it for $150; the watch was stolen, police later learned, to finance the couple’s opioid addiction. Dakota Winter, 23, and Amy Raynes, 22, both of Epping, NH, were arrested and convicted of the robbery. According to the Union Leader, Raynes’ plea deal requires her to complete a 60-day Substance Abuse Treatment Community for Offenders program at Valley Street Jail in Manchester before serving a one-year jail sentence.
Opioids, defined by the Centers for Disease Control and Prevention as pain-relieving drugs that produce intense euphoria, are abused by a rising number of New England residents. Opioids include heroin, oxycodone, codeine, morphine, hydrocodone and fentanyl, among many others. They are available in the form of prescription medicines like Percocet, Vicodin and OxyContin. In recent years, the New York Times, along with the rest of the news media, has covered the disturbing increase of opioid overdose deaths, reporting that in 2015, more than 33,000 people died from prescription opioids and heroin abuse. The euphoria associated with these drugs often leads patients taking the drugs for medical purposes down a dangerous path toward addiction. It's easy for these patients to take a greater quantity of opioids than what a doctor has prescribed, and opioids are relatively easy to obtain even without a prescription.
While thousands of addicts continue to suffer nationwide, the state of New Hampshire in particular has seen a recent surge in opioid addiction. According to the New Hampshire Department of Health and Human Services, opioid overdose deaths in the state increased by 250 percent from 2011 to 2015. President Donald Trump frequently touched on the opioid crisis during his campaign, and the issue has been a political hurdle for Republicans in Congress in their quest to repeal the Affordable Care Act this year. New Hampshire’s struggles with the crisis garnered national attention after Trump bragged to the Mexican President Enrique Peña Nieto in a phone call last January, saying that he’d won New Hampshire “because it is a drug-infested den.”
“To be honest, I didn’t even know it was a huge issue. Everyone plays it off like it’s the average thing, I guess.”
Despite the fact that it is a relatively small town with an affluent, well-educated community, Exeter is not immune to the problems that plague the State of New Hampshire. According to Paul Gravel, the Director of Campus Safety at Phillips Exeter Academy, Exeter’s proximity to Manchester, “the ground zero zone for drugs in the state,” means that Exeter residents can observe recent trends in the drug epidemic very clearly. “Crimes are absolutely on the rise,” he said, attributing this change to the increase in drug addiction. Supporting this view, Exeter Police Department Patrol Division Commander Captain Stephan Poulin reported around 157 incidents involving drugs and 94 drug arrests during 2016. “It is a safe assumption that there is a link [between increase in drug use and petty theft]. Offenders have broken into businesses and parked cars looking for money to buy drugs. A surging phenomenon is drug abusers are now shoplifting from major stores such as Walmart or Home Depot,” he said.
Justin Pizon, Exeter’s assistant fire chief and head of training & fire prevention, offered a perspective on the number of Narcan shots—an emergency antidote used to revive those who overdose on opioids—administered to town residents. “From January 1 to current, the Exeter Fire Department has administered Narcan 22 times,” he said. “In fairness, this is dose administrations, it is possible there was more than one administration to a single patient.”
According to Pizon, an unresponsive female patient was administered Narcan and given CPR last weekend. Both were unable to save her life. This was not her first time overdosing; one week earlier she was resuscitated after being found in a similar state. “It’s sad to see a person who’s struggling not make it,” Pizon said. Captain Poulin noted high recidivism rates among drug offenders. “Many drug abusers continue to abuse the drugs after their arrests,” he said. “The reasons are plentiful, ranging from lack of desire to quit, lack of ability or availability of rehab efforts, getting back into the same circle of drug abusing peers to continue the cycle.”
The fifteen overdoses recorded by the Police Department so far this year were the result of a variety of drugs. These ranged from heroin to pills. However, synthetic drugs like fentanyl and carfentanil have recently become the main problem. Synthetic drugs aim to mimic the sensations that come with natural opiates. “Heroin has been around thousands of years and it’s a problem, but the main reason why people in our community, our friends, our family members and our loved ones die is because of synthesized opioids,” Pizon said. “We see lives being shattered.”
Many name fentanyl, which has been used recreationally in New Hampshire since mid 2013, as the main driver behind the recent opioid epidemic in New Hampshire and more specifically, the town of Exeter. Fentanyl is also easier to obtain because, according to Jean Moser, a member of the Institutional Advancement Team at Phillips Exeter Academy and Exeter resident who runs an awareness-raising campaign against prescription drug overdose, it’s “cheaper than a six-pack of beer [...] and coming into Massachusetts then distributed to New Hampshire because we’re right on the highway.” These pills are easy to hide, being relatively odorless. “A good portion of narcotic drug use nowadays come from taking pills from elderly relatives,” Pizon said.
“It’s predominantly fentanyl, or heroin laced with fentanyl,” Moser said. “If you’re on one of these for medication, you should take it as prescribed, when you’re finished with it, you should dispose of it properly, at your local police department.” This advice, however, is not always followed.
By the end of 2016, opioid use had begun to swing in favor of carfentanil, one of the most potent and deadliest synthetic drugs. According to the New Hampshire Drug Monitoring Initiative, carfentanil has caused three known deaths in the state since late 2016, a sign that the problem in New Hampshire continues to grow more serious. In a recent report on the crisis, the Initiative calls carfentanil “10,000 times more potent than morphine and 100 times more potent than fentanyl,” adding that its appearance in New Hampshire “is cause for concern, as the relative strength of this drug could lead to an increase in overdoses and overdose-related deaths, even among opioid tolerant users.”
The lack of quality control is another aspect of fentanyl and carfentanil that makes the drugs more pernicious than any that have come before them. “Anyone who’s injecting fentanyl doesn’t know what they’re getting. It’s not from a pharmacist or someone who controls the quality,” Paul Gravel said. “It’s mixed with all kinds of derivatives to enhance the product including beta laxatives [...] it’s so strong that the first time someone uses it, it can kill them.”
“Drug addiction is a disease,” Pizon said. He thinks the epidemic should be viewed through the lense of “patient care” rather than a war on drugs. For this reason, he disapproves of police carrying Narcan in Exeter. He’d rather encourage those struggling with addiction to reach out for the help of the Fire Department. “People don't want to talk to police,” he said. “If they talk to us and share their private medical record we use it to compile a report, but we cannot share the information with anyone else.”
“Out of a thousand people we’ve administered Narcan to, if one person seeks help and fully recovers from addiction, I’d say that our job is a success,” Pizon said. “Drug addiction is a disease and some people are more predisposed,” he explained, adding that during the last two to three years, he’s been hopeful at the increasing amount of people checking themselves into in-patient rehabilitation programs. “It’s a good sign,” he said. “This was not prevalent in New Hampshire a few years ago.”
Exeter resident Sandi Coyle is a successfully recovered former opioid addict. Currently sober for 13 years, Coyle has lived in the community for the past seven, where she works in non-profit to help others struggling with substance abuse. Her story is representative of a larger movement in the community to bring both action and awareness to the issue of opioid dependency.
“I became aware of a national movement of people who were in recovery from addiction and sharing their voice as tool for sharing hope, and telling the community how we can work together to overwhelm the consequences and repercussions of people with addictions not getting enough help within a public health space and community environment,” she said. “I was personally motivated to do something about it. I set up a recovery center in Portsmouth a little over a year ago. We are a place where it’s non-clinical; it’s a peer-to-peer community center where people can walk through the door and find pathways for them to recover.”
After observing and interacting with addicts for many years, as well as experiencing addiction herself, Coyle noted the incredibly damaging stigma around opioid dependence. “It’s a public health crisis which is killing people at an alarming rate; historically we’ve had epidemics like that, and then millions of dollars were spent towards researching and putting solutions in place,” she said. “Unfortunately with this epidemic, it’s been a stigmatized issue. We’ve refused to address it for so long.” While acknowledging that the country has made a lot of progress, Coyle feels that there is much work to be done. “It’s not just the heroin crisis or the opioid crisis, but really a very human and public health-centered issue that we have to evaluate how we treat people.”
Coyle described her dissatisfaction about general public knowledge on the issue. “People know more about the negative side and less about what to do about it and how recovery works,” she said. “Part of the problem is recovery has been rather quiet and silent. A lot of people get sober and don’t talk about it.”
Coyle found it difficult to share her own story at first, and after the Portsmouth Herald published an article about her entitled “Ex-Heroin Addict Plans Recovery Center,” she worried about judgement coming from friends and local community members. “I had a son who was in fourth grade and many of my closest friends did not know that I was a former addict; I found out very quickly, though, that most people were supportive,” she said. “While pursuing my passion and trying to help others, there’s definitely some challenges to it; there have been times when I walked into a room to speak or a business meeting and I know people judge me.”
Coyle makes sure to stress the universality of the problem during these speeches or open forums. “It’s definitely everyone’s problem—all neighborhoods, all cultures and classes,” she said. “That said, what we know is that trauma is an early indicator of addiction, and I think unfortunately the possibility that an individual is exposed to traumatic experience can vary according to socioeconomic status.”
Although the epidemic afflicts many residents of the Seacoast area, the effect on the PEA community has been relatively minimal.
“As far as I know, there are no current students with an opioid addiction,” psychological counselor Christopher Thurber said. “Such an addiction is incompatible with being a successful student.” Head nurse at the Lamont Health Center Nancy Thompson reiterated this point. “Fortunately, the medical staff at Lamont has never had to deal with a situation where a student’s life is threatened because they are overdosing on substances in my eleven years working here,” she said. Thompson acknowledged that the health center has a support system in place for students struggling with drug problems of any kind, saying that can “go to the psychological counselors for advice.”
Despite the lack of past student encounters with opioids, Gravel still sees these drugs ending up on campus as a possibility. “We’re such an open campus, I’m not concerned with the student population but people we don’t know who come in,” Gravel said.
To address this concern, Gravel works hard to make sure that his officers have “all the necessary personal equipments to respond.” Additionally, he also attended a one-day conference in Manchester about new trending drugs, the ramifications and safety precautions that law enforcement and non-law enforcement responders alike have to take into consideration. Coming back from the conference, Gravel sent out a memo from the Drug Enforcement Agency that each campus safety officer had to read and acknowledge, consisting of general information on how to handle suspicious substances that we couldn’t be identified. He also noted that students should educate themselves on the issue, taking into account the general promotion of well-being on campus grounds. “Getting involved is important—we should not get our heads stuck in the sand,” he said.
While Exeter has until now been spared the worst effects of the opioid epidemic, many feel that Exonians have a responsibility to be aware of not only the national issue, but its proximity to the Exeter campus.
“All Americans are affected by the opioid epidemic,” Thurber said. “Some of us have friends or relatives who have struggled with addiction; all adults who pay into the health care system or pay taxes indirectly pay for treatment and prevention of opioid addictions; and we are all affected by decreased productivity and mental health costs of this and other drug addictions.”
In an effort to bring awareness to campus, PEA screened a documentary made by Jeanne Moser and her husband, Jim Moser, entitled Just the One Time, which chronicled the tragic death of Moser’s son, Adam. The Mosers lost their son to an opioid overdose in September of 2015. “I don’t think there’s enough awareness statewide,” Jeanne Moser said. “We brought the message to the school last year and I think we’ll have the same opportunity this year.”
For those living in the PEA community, it can be easy to disregard the epidemic as an issue that has no bearing on their lives. This includes Moser, who has lived in Exeter for 25 years, and said that she had previously seen the town and its inhabitants as “safe” from the issue of drug abuse. “We raised our children here and it was never like this,” she said. “When you hear about it in the paper, you think it’s unemployed, homeless people in the city park, and then all of a sudden you see these young people’s pictures in the paper, and when our own child died, we learned from his friends that what he referred to as a weekend ‘hobby’ was actually an addiction. My son thought it would never happen to him.”
While Moser acknowledged that New Hampshire has improved its recovery and treatment resources, like Coyle, she advocates for more awareness and action. “Now that we’ve lived through this nightmare, we find it very important to get the message out that it can happen to anyone,” she said.
Although there has yet to be an Exonian addicted to opioids, there are students who have been directly affected by the crisis. Senior Kevin Lyskawa’s brother struggled with opioid dependence for many years. “It started off with just weed, and then it got worse and pretty soon, he was battling heroin addiction,” Lyskawa said. “It was a hard battle to fight considering how serious it is but we as a family tried to help. We sent him to this rehab center to try and help cure him.” However, Lyskawa’s brother relapsed and was soon using regularly again. After this, he was sent to a detoxing center, which he described to Lyskawa as the most incredibly difficult experience he had ever had to go through. “My brother has been drug free for almost two and a half years now, and he's thankful that there were people to help him out,” Lyskawa said. “Unfortunately, my brother still faces major problems with smoking cigarettes and drinking. But as he told me, ‘Fight each battle one step at a time.’”
Lyskawa’s brother turned to opioids after losing his older sibling. “The only way he could deal with the grief was with drugs. So I urge everyone to not use drugs as a way of relieving pain because it's a chain of events,” Lyskawa said. “Most often, it's so hard to get back on the right track after one mistake becomes two, and two becomes three, and so on.”
Although students like Lyskawa and faculty like Moser have personal connections to the opioid crisis, many people on campus remain uneducated on the nationwide issue of addiction. Upper Sloane Valen, new to PEA, feels uncomfortable discussing the opioid crisis. “I know that drug addiction is a problem, but I feel like there is a stigma around talking about it,” she said. Upper day student Emmy Goyette felt “uninformed” about the issue, despite living in Rye, New Hampshire. “I know there's a crisis in New Hampshire right now, but as far as that I feel like I'm getting no solid information, especially about the places that surround me,” she said. “I feel like people are aware of the problem, but nobody talks about specifics or how the issue affects Exeter.” Lower Stephanie Harris has perceived a campus-wide feeling of brushing off the seriousness of addiction. “I’ve heard about it when I first got on campus last year in a fleeting comment, but never heard about it again,” she said. “To be honest, I didn’t even know it was a huge issue. Everyone plays it off like it’s the average thing, I guess.”
Coyle urged members of the PEA community to reach out and help those affected in the surrounding area. “We live in an affluent community with good resources, and there’s probably a feeling of shame for people who are addicted,” she said. “We can do a better job.”