News from the Node

In partnership with the National Drug Early Warning System (NDEWS), the Northeast Node of the National Drug Abuse Treatment Clinical Trials Network (CTN) has been awarded funds to complete the second phase of the Fentanyl Hot Spot Study conducted in New Hampshire earlier this summer.

Since 2014, the state of New Hampshire has seen a disproportionately high rate of opioid overdose compared to other states, especially involving the use of fentanyl. From 2013 to 2014 alone, the Centers for Disease Control reported a 73.5% increase in opioid overdoses in the state; estimations of that number have only increased in the years since. During the rapid first phase, the Northeast Node of the CTN and NDEWS teams met with multiple stakeholders throughout the state, including treatment providers, medical responders, law enforcement, and state authorities and policymakers, to learn more about their perspectives on the fentanyl crisis in New Hampshire.
State authorities expressed serious concern regarding the state’s apparent trend towards higher rates of alcohol and drug use compared to the rest of the country in national surveys, and that the current drug of choice is fentanyl.
Furthermore, questions were raised about how much anecdotal or speculative information is driving policy; it was clear from stakeholders that policy decisions need to be based on solid data about the opioid overdose crisis in the state.
It was apparent in the interviews with stakeholders in New Hampshire that there is much unknown about the fentanyl overdose crisis in the state. Many expressed that user-level data was imperative to answer pointed questions to more accurately inform policy, such as the trajectory of fentanyl use, supply chain, fentanyl-seeking behavior versus accidental ingestion, value of harm reduction models (testing kits on the street), treatment preferences, etc.

In this second phase of the Hot Spot Study, researchers at the Northeast Node will conduct a rapid epidemiological investigation of the fentanyl users’ and first responders’ perspective, so that real-time data can inform policy in tackling the fentanyl overdose crisis.
We will conduct systematic interviews of active fentanyl users and individuals new to treatment for opioid use disorders. Sampling will be heavily concentrated in the Hillsborough and Strafford Counties given they have been targeted as “hot spots,” with additional sampling in Rockingham, Grafton, Cheshire and Sullivan Counties. Interviews will focus on questions that arose during Phase 1, including trajectory of fentanyl use, supply chain, fentanyl-seeking behavior versus accidental ingestion, value of harm reduction models (testing kits on the street), prevention strategies, and treatment preferences.
We will also conduct systematic interviews with first responders and Emergency Department personnel. We will conduct brief 60-minute individual interviews with first responders (police, fire, and Emergency Medical Service teams) and Emergency Department personnel in counties where fentanyl-user interviews will be conducted. Interviews with these stakeholders will concentrate on trends in fentanyl-related overdoses, including user characteristics and patterns, assessment/investigative protocols, and referral practices.

The Northeast Node of the CTN is very pleased to participate in this study, and looks forward to presenting its findings to the stakeholders who have dedicated their time and energy into fighting this epidemic in New Hampshire.