Each state in the Northeast has different public substance abuse and mental health programs open to residents. People looking for care may be required to contact a county health department, an office devoted to substance abuse, a community mental health center, or a different agency altogether. Those looking for private options may have an easier time finding centers, as they can simply hop online and look for providers with immediate openings.
The northeastern region of the United States, as named by the U.S. Census Bureau, encompasses two regional divisions, the Mid-Atlantic and New England divisions, and nine states (Maine, New York, Rhode Island, Connecticut, Vermont, Massachusetts, New Jersey, New Hampshire, and Pennsylvania) in the northeastern corner of the country, bordering Canada to the north and the Atlantic Ocean to the east.
The northeast US includes some of the oldest parts of the nation. Made up of some of the original 13 colonies, the northeastern region of the United States is often considered the birthplace of America.
Drug abuse is rampant throughout this region, as the northeastern US sees some of the highest levels of heroin abuse, drug seizures, and overdose in the country, Public Intelligence reports. Drugs may be being brought down from Canada, shipped into ports, flown in on aircrafts, and trafficked over land on the extensive interstate and intrastate highway systems.
Substance abuse often co-occurs with mental illness and poor mental health. The American Psychological Association (APA) reports that in 2012, Vermont had some of the highest rates of adults per capita suffering from serious mental illness, while conversely New Jersey had some of the lowest rates. Fortunately, the northeastern region of the US has some of the highest numbers of licensed psychologists per every 1,000 residents in the country.
Mental health and substance abuse concerns may be addressed through specialty treatment programs, and these programs may be either public or private in nature. Public programs may be run by the state and open to residents who otherwise may not be able to fund treatment, while private programs may accept insurance plans and are often licensed through the state to provide a high level of comprehensive care. Both private and public programs may offer a range of programs and services, from outpatient care to medical detox to residential treatment services. Individual state agencies and local substance abuse and mental health providers may provide specific details on the types of programs offered. The Substance Abuse and Mental Health Services Administration (SAMHSA) also provides several resources on their website, as well as a Behavioral Heath Treatment Services Locator that can help individuals find local treatment options.
The heroin market in the Northeast may be partially controlled by Mexican cartels. It is dominated by white powder heroin, potentially coming from Asia or South America. Major cities in the northeastern US, including Baltimore, Washington, DC, Philadelphia, and New York City, are some of the most prominent white powder heroin markets in the United States, the National Heroin Threat Assessment reported in April 2015.
In Massachusetts, the governor declared opioid abuse and dependency one of the greatest public health concerns in the state in 2014, as deaths from opioid drug overdoses had jumped up 90 percent since 2002, USA Today reports. Vermont is considered the state with the highest rate of drug abuse in the entire country, as Business Insider publishes that for the years 2010-2011, more than 15 percent of its residents reported past-month illicit drug use, and drug addiction rates in the state are among the highest in America. In 2014, the governor of Vermont focused his entire “State of the State” address on the heroin problem in the state, as heroin public treatment admissions spiked 64 percent from 2013 to 2014, with 2,258 people receiving public treatment and more than 400 on the waiting list for heroin detox, CBS News reports.
Per capita, Rhode Island has some of the highest drug use in America. In 2014, there were 239 drug overdose deaths, 90 percent of which involved opioids, the Rhode Island Overdose Prevention and Intervention Task Force reports.
In the New England High Intensity Drug Trafficking Area (HIDTA), the DEA reported that heroin and opioid abuse and dependency accounted for almost three-quarters of all treatment admissions to public substance abuse treatment programs in 2009. As opioid abuse goes up, so may crime rates. The DEA reported that of the state-reported drug arrests in Maine, prescription opioids made up 40 percent in 2009.
Many states have plans and strategies in place to reduce problematic opioid abuse, such as prescription drug monitoring programs (PDMPs) that regulate the prescription of controlled substances like opioids. In June 2014, in one of the biggest collaborative efforts to reduce overdoses and increase treatment in New England states for opioid abuse and dependency, governors from Rhode Island, Vermont, Massachusetts, Connecticut, and New Hampshire met to discuss opening up treatment options for Medicaid patients and allowing residents to seek necessary treatment in neighboring states. They also discussed ways to reduce some of the methods contributing to prescription opioid abuse, such as doctor shopping, the Boston Globe published. As prescription opioids are more tightly controlled and regulated, however, heroin abuse may increase.
Legislative, government, and law enforcement agencies are indeed attempting to reduce heroin issues in the northeastern part of the United States. In August 2015, the White House and the Office of National Drug Control Policy (ONDCP) announced they were allocating funds to a program called the Heroin Response Strategy. This program targets this issue in these (some of the hardest hit states in the country) areas by improving efforts to reduce heroin distribution, trafficking, and abuse.
In Maine, there were 208 overdose deaths in 2014, an increase of 18 percent over the previous year.
Most overdose fatalities involved pharmaceutical drugs; however, between 2011 and 2014, there was a 340 percent increase in illicit drug overdoses, according to the Maine Office of Substance Abuse and Mental Health Services.
Naloxone is a medication that acts as an opioid antagonist, blocking opioid receptors in the brain and reversing the effects of an overdose from heroin and other opioids. In 2010, Quincy, Massachusetts, patrol officers became the first in the country to be required to carry the drug. Through 2014, the DEA reports that they had used naloxone more than 200 times. First responders and pharmacies can now distribute naloxone in Massachusetts, and all state troopers carry the drug in Vermont. In both Buffalo, New York, and Ocean County, New Jersey, police departments are training and licensing officers to carry and use the overdose reversal tool.
For information on private institutions, individuals should contact facilities directly, as services vary greatly from program to program. Public and state-specific programs, broken down by each state in the northeastern region, are as follows:
In the state of Maine, the Office of Substance Abuse and Mental Health Services (SAMHS) handles both public drug and alcohol abuse as well as mental illness treatment programs. State-run hospitals or facilities for adult mental health services are Dorothea Dix Psychiatric Center and Riverview Psychiatric Center.
Maine residents can call or access the 2-1-1 Maine website for information on local behavioral health resources. In a crisis, when individuals need immediate help, Maine residents can call the statewide crisis hotline. Other information, including additional numbers and treatment options, can be found on the Maine SAMHS website or by accessing the Maine Substance Abuse Treatment Services Directory. Maine SAMSH partners with community organizations, like Healthy Maine Partnerships, to facilitate substance abuse prevention and educational programs at a local level and also provides a list of peer support services beneficial to recovery.
For resources specific to children’s behavior health and support, Maine’s Office of Child and Family Services hosts a list of qualified providers contracted with the state.
In Pennsylvania, most mental health and substance abuse services are provided through local county offices, and many offices contract out to local providers in the area.
The Mental Health and Mental Retardation Act of 1966 mandates that county offices provide partial hospitalization, emergency care, short-term inpatient care, specialized rehabilitation training, residential arrangements, outpatient care, and vocational rehabilitation services, according to the Pennsylvania Department of Human Health Services. Individuals can find a list of county offices on the Pennsylvania Association of County Administrators of Mental Health and Developmental Services website.
The state of Pennsylvania also hosts a Human Services Provider Directory to help individuals locate specific substance abuse or mental health services. The Pennsylvania Department of Drug and Alcohol Programs keeps an updated list of local providers, as well as tools to help residents understand and use their insurance benefits, and sponsors drug take-back programs where individuals can drop off unwanted prescription medications to prevent diversion or abuse. The nonprofit and community-based organization Drug-Free Pennsylvania (DFPA) raises substance abuse awareness, provides prevention resources, and strives to improve health and positive habits within the Commonwealth.
The Bureau of Behavioral Health in New Hampshire splits the state into 10 regions, each with a private contracted local Community Mental Health Center that provides publicly funded mental health services to eligible residents. Each center has specialty programs for children, families, and older adults as well as traditional treatment programs with services that include case management, evaluation and assessments, 24-hour emergency services, individual and group therapy, community-based rehabilitation services, psychiatric services, referrals for additional counseling, and community disaster mental health support.
One out of every five New Hampshire residents will battle mental illness within their lifetime. The NH Behavioral Health Association is a partnership between all 10 of the community health centers in the state to improve the mental health of New Hampshire residents. Many private, not-for-profit agencies contract with the NH Department of Health and Human Services to provide peer support services to enhance and support recovery of NH adults over the age of 18 who suffer from mental illness.
The Bureau of Drug and Alcohol (BDAS) Services Treatment Services promotes community and nonprofit substance abuse treatment programs that provide services on a sliding fee scale that is determined by a person’s ability to pay and more information about programs offered can be found here. The New Hampshire Treatment Locator lists where to find specific drug or alcohol treatment services within the state. In many cases individuals are referred to treatment through outpatient services or from crisis management services. Licensed mental health clinicians and Substance Use Professionals may belong to the New Hampshire Alcohol & Drug Abuse Counselors Association (NHADACA), which is a nonprofit organization designed to enhance the level of mental health and substance abuse care within the state.
The Massachusetts Bureau of Substance Abuse Services (BSAS) provides prevention resources through a partnership with MassTAPP (Massachusetts Technical Assistance Partnership for Prevention) and many residential, outpatient, and transitional services, including specialty programs for women, children, families, homeless, and DUI offenders. BSAS provides access to and overseas substance abuse treatment within the Commonwealth of Massachusetts.
Residential substance abuse programs offered by BSAS are divided into two categories: under 30 days and over 30 days. Under-30-day programs provide acute treatment services (ATS) or detox for individuals who are at risk of alcohol or drug withdrawal and require 24-hour medical care and supervision; transitional support services (TSS) that a person is referred into from a publicly funded ATS program or homeless shelter; and the Tewksbury Stabilization Program for adult homeless men who are chemically dependent on drugs or alcohol and referred from an ATS program, homeless shelter, or other mental health or medical facility. There are three main models for residential treatment services over 30 days offered by BSAS: social model programs, recovery homes, and therapeutic communities. To qualify for any of these three programs, Massachusetts residents must be at least 18 years old and in the early recovery stages from alcohol or drug abuse, with priority given to minorities, homeless people, individuals with disabilities, people referred from the criminal justice system, those at risk for HIV/AIDS, injection drug users, and pregnant women. Specialty residential programs exist for women, families, and at-risk youth between the ages of 14 and 18.
Ambulatory services are outpatient and community-based programs where individuals attend sessions and appointments for treatment and counseling.
Individuals must be medically stabilized, and services include intensive outpatient treatment, or day treatment, outpatient counseling, acupuncture services for withdrawal symptom management, opioid treatment, and compulsive gambling services.
Recovery and aftercare support services are designed to match families and individuals with community-based programs that strive to enhance recovery by providing sober or transitional living arrangements, vocational or educational skills training, employment opportunities, and self-help resources. The state of Massachusetts has four Recovery High Schools in Boston, Beverly, Springfield, and Brockton to help youths in recovery from alcohol or drug abuse. BSAS also supports peer recovery support centers in South Boston, Brockton, Worcester, Lawrence, Roxbury, Marlborough, and Greenfield. For more information, individuals can call the Massachusetts Substance Abuse Information and Education Helpline or check the website.
The New York State Office of Mental Health (OMH) regulates, oversees, and certifies several thousand programs around the state that are locally operated by nonprofit or government organizations. These programs provide emergency, outpatient, inpatient, residential, family care, and community support services as well as operate psychiatric centers within the state.
To find an alcohol or drug treatment provider that is certified by the New York State Office of Alcoholism and Substance Abuse Services (OASAS), New York residents can use the OASAS Provider Directory search. For immediate help or crisis services, individuals can call the New York State HOPEline. Treatment services for drug or alcohol abuse and dependency in New York are offered by a network of NY OASAS providers that make up one of the most diverse and largest addiction treatment systems in the United States.
The city of New York provides mental health services through the New York City Department of Health and Mental Hygiene. Mental health services within NYC are provided by the LifeNet Network of Care, and individuals can call the 24-hour hotline for crisis services or access the service directory on information regarding local treatment services. To help combat the health risks surrounding heroin and injection drug use, which are often compounded by the sharing of dirty needles, the New York City Bureau of Alcohol & Drug Use, Prevention, Care & Treatment operates Harm Reduction Syringe Access Programs that allow IV drug users to trade out old needles and obtain new ones. The program has locations in Queens, Staten Island, Manhattan, Brooklyn, and the Bronx.
The Division of Mental Health and Addiction Services (DMHAS) is the Single State Authority (SSA) on substance abuse and the state mental health authority (SMHA) for the regulation, planning, and monitoring for New Jersey’s substance abuse and mental health prevention, intervention, treatment, and recovery services. The New Jersey DMHAS operates Ann Klein, a specialized maximum security psychiatric facility, and three regional adult psychiatric hospitals: Trenton, Ancora, and Greystone Park.
Community-based behavioral health services are provided by government agencies and private nonprofit organizations in a fee-for-service or third-party contract arrangement for New Jersey adults with mental health and/or substance abuse treatment needs. Services may include early intervention, substance abuse prevention, emergency screening, outpatient and intensive outpatient treatment, partial hospitalization, short-term and long-term residential substance abuse and mental health treatment services, case management, supportive housing, and recovery and support services.
To find a local treatment provider, individuals should check the New Jersey Substance Abuse Treatment Provider Directory to search by county for a local licensed provider. Behavioral health professionals provide referral and information through the NJMentalHealthCares for New Jersey residents as well.
Rhode Islanders should contact their local community health center to be assessed and to determine what level of care or program is most appropriate. Services include emergency or crisis services, case management, psychiatric services, education, counseling, patient services, psychiatric rehab, and community residences, with a provider list found here.
For substance abuse treatment in Rhode Island, individuals should contact a Rhode Island substance abuse provider who is licensed to provide treatment within the state and follows protocols set up by the American Society of Addiction Medicine (ASAM). Upon contact, a professional assessment can be done to determine the level of care required. The levels assessed by BHDDH are as follows: acute intoxication, withdrawal, biomedical conditions, behavioral or emotional conditions, treatment resistance and acceptance, potential to use continuously, and the recovery environment. Services are tailored to the individual, depending on the level of illness measured by the phone screening, and may include detox, outpatient treatment, intensive or partial hospitalization, residential treatment, and aftercare or continuing support services.
Treatment for mental health and addiction is handled by the Department of Mental Health and Addiction Services (DMHAS), which breaks Connecticut into five service regions. Residents can find local treatment providers by choosing their region and town on the website to find local listings. DMHAS also provides service listings for both state and non-state funded programs.
Individuals may receive inpatient care at one of four state-run inpatient treatment facilities for severe mental illness or addiction problems: Connecticut Mental Health Center, Connecticut Valley Hospital, Capital Region Mental Health Center, and Greater Bridgeport Community Mental Health Center. Crisis intervention and therapeutic services are provided locally by local mental health authorities that are operated or funded by the DMHAS as well as nonprofit agencies that may be found through the Embrace Hope Expect Change service directory. Behavioral health services within the state are also supported through a partnership with the CT Behavioral Health Partnership, which offers resources and information on statewide mental health and addiction services.
In Vermont, the Agency of Human Services is within the Department of Mental Health and strives to create healthy communities by improving mental health and substance abuse services and access to treatment for residents. To find a local treatment provider, residents can check the list of mental health agencies that shows what types of services particular providers offer, provider contact information, and the areas they serve.
Services are either run and operated by the state, or through a contract with a designated agency, nonprofit, or private organization. Vermont Cares is a collection of 16 community-based and nonprofit agencies providing integrated and comprehensive care to Vermonters affected by substance abuse or mental health concerns. Substance abuse counselors must be licensed and certified as licensed alcohol and drug counselors (LADC) through the Department of Vermont Health Access, or DVHA.
The Center for Health and Learning also operates a website full of resources for families and individuals who may struggle with mental health issues or substance abuse. In Vermont, the alcohol and drug abuse programs (ADAP) page lists public, private, and nonprofit treatment providers that are approved by the state to offer a variety of services. These services range from prevention to intensive addiction treatment. A list of approved substance abuse treatment providers can be found here.