New Hampshire's 2016 agenda includes combating drug epidemic

Keene, New Hampshire (CNN)This is not how Pam Livengood envisioned her life.

In 2012, shortly after Livengood turned 50, she and her husband, John, obtained legal guardianship of her 2-year-old grandson, Francis Martin VI. They adore the inquisitive boy, but hadn't planned to raise him.
The reason they are raising him is a familiar one for many New Hampshire families: drugs. Francis' mother and father could no longer care for the boy because of addiction to "whatever is around or available at that time," in the words of Livengood.
    "It wasn't our plan to be in our 50s and raise a child," Livengood said with a slight laugh. "But you do what you've got to do, right?"
    Many New Hampshire voters, like Livengood, are personally affected by an explosion of prescription pill and heroin addiction. It's an issue presidential hopefuls won't be able to ignore when they visit this first-in-the-nation primary state.
    Professionals and advocates in the field of drug abuse hope candidates coming to New Hampshire will be forced to take a stand on this issue -- just as they have to talk about corn-based fuel in Iowa or nuclear waste in Nevada. They hope the ensuing conversation will lead to more understanding -- and less stigmatizing -- of addiction.
    Pam Livengood brought it up at a roundtable with Democratic candidate Hillary Clinton in April, even though the event's focus was on small businesses and manufacturing.

    Hillary Clinton to address addiction

    Clinton will be back in New Hampshire on Friday for another small-business roundtable at a brewery in Hampton. Aides are anticipating that there, too, Clinton will comment on the state's drug epidemic.
    Other candidates and potential candidates have already been confronted about the scourge, or to be in the process of drafting plans to combat the problem, such as Democrat Martin O'Malley and Republicans Rand Paul and Chris Christie.
    "We have reached a new and unfortunate level in the epidemic where it is touching too many people too directly," said Tym Rourke, chairman of New Hampshire Gov. Maggie Hassan's commission on alcohol and drug abuse prevention, treatment and recovery. "The reality of the crisis is that it's becoming less and less possible for you to walk into a room with more than 10 people and find someone not affected by the drug epidemic."
    Rourke said the problem "has gotten to such a crisis level that elected officials or candidates no longer have the luxury of thinking about addiction in the abstract."
    Kim Fallon, spokeswoman for the New Hampshire Chief Medical Examiners Office, said 325 people died from drug overdoses in the state in 2014. Of those deaths, 90% were from opioids or opiates.
    There have been 76 confirmed drug deaths so far this year, but that number is likely to climb as toxicology results come in on other probable drug deaths, Fallon said.
    Such statistics are part of the reason that Livengood and others at the roundtable wanted to talk to Clinton about the issue.
    In response to their questions, Clinton described the problem as "a hidden epidemic" that is "striking in small towns and rural areas as much as any big city." She also pledged to make drugs and mental health, which she said were connected, a "big part" of her campaign.
    "We need a concerted policy -- national, state, local, public and private -- and we need to try to help young people like the mother and her grandson," Clinton said.
    Livengood, part of the April roundtable because she works at a New Hampshire manufacturer, is a big Clinton supporter. She backed the then-New York senator in 2008 and said she was so excited to meet her in Keene that her "hands were clammy." She still plans to support her in 2016, but she said that Clinton's answer did not totally satisfy her.

    Seeking specific solutions

    "I would have liked a little bit more specifics," she said as Francis ran around a nearby playground. "It flowed so quickly that we just kind of went around it and over it."
    Clinton campaign spokesman Ian Sams said in a statement to CNN that Clinton was committed to the issue. For Clinton, he said, stamping out the problem "begins with adequately funding mental health and substance abuse treatment programs -- not cutting them, as Republicans in some states are proposing -- and making sure insurance companies take care of mental health in the same way they approach physical health."
    Since the Keene event, Clinton has brought up drug policy a number of times. At a house party in Iowa this week, she mentioned that drugs are "tearing families apart" and added that it was time to "end the stigma against talking about it."
    O'Malley, the former governor of Maryland, also addressed the issue while in New Hampshire last week, said the drug epidemic is a nationwide issue -- not just a local one -- that "requires collaboration at the local level and requires leaders at the state and national level to remove the stigma."
    "All of us know people who have lost sons or daughters, or maybe we have lost family members of our own to overdose deaths," said the likely 2016 Democratic candidate, who as mayor of Baltimore and governor of Maryland saw an uptick in overdose deaths.

    Republicans weigh in

    Some Republicans have also tackled the issue.
    Christie, the New Jersey governor and expected 2016 presidential candidate, argued earlier this month that the war on drugs was "completely a failure."
    Christie held a roundtable at a drug treatment center in Manchester, New Hampshire, where he said addiction is a "treatable problem and we need to be talking about it and treating it like an illness, and not like some moral failure."
    Paul, the Kentucky senator and a declared presidential candidate, also has addressed treatment issues, particularly the incarceration of nonviolent drug offenders.
    But drug policy experts think the issue could be tricky for some GOP candidates, chiefly because of Obamacare.
    The Affordable Care Act requires all insurance sold through the program, along with Medicaid, to cover substance abuse disorders. Christie and Paul would be among the Republicans likely to face intense pressure from the party's conservative core to come out strongly against Obamacare in the 2016 primary season.
    Dick Turner, regional director of Phoenix House, a drug treatment facility in New Hampshire, said that when he hears the "rhetoric" that Republicans are going to "revoke Obamacare," all he can think of is the men and women who come to his center for treatment.
    "For substance abuse treatment, repealing Obamacare is a very, very big deal," he said. "We have plenty of people coming to treatment and we have waiting lists."
    Phoenix House has locations in three New Hampshire towns, including Keene. It offers patients access to methadone and buprenorphine, two opioids that are used to help combat addiction to other, more harmful, drugs like heroin. According to Turner, people are usually in treatment for two weeks, but waiting lists can run as long as 25 to 30 people at one location.
    "With some of the addicted, they need to have their drug. It is not a choice any more, it has become a demand, a requirement, a physiological need," he said. "So when you are put on a waiting list, you just go right back."

    Treatment top concern

    When asked what she wants to hear politicians say about drug abuse, Livengood quickly and bluntly said: "Treatment, and where to get it."
    Livengood noted that her own daughter, who asked not to be named in this article, is receiving such treatment right now.
    "She is trying," Livengood said. "She is doing one of the walk-in centers where you pick up your daily dose and she is looking for employment. They all are looking for employment."
    Livengood assumed custody of her grandson after New Hampshire's Division of Children, Youth and Families had been called to the house so many times that the government agency bluntly told the family to find a stable home for Francis or it would be forced to put him in a foster care.
    So Livengood and her husband stepped in. After raising three kids of her own, she came to terms with the fact she wouldn't be riding her motorcycle as much and got back into the routine of changing diapers, entertaining a child and filling her garage with toys a young boy would love.
    The grandmother-turned-mother has quietly accepted that her daughter may never be able to fully overcome her addiction, but she still hopes that she might.
    Livengood also hopes that Clinton will keep talking about drug policy, and come back to Keene to check in on the issue.
    "I am afraid she is going to hear the same thing everywhere," Livengood said. "It is not just New York or Los Angeles or Reno, Nevada, that have these issues. It is your backyard."
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