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.

Heroin and Opioids in the Northeast

Police agencies in the Mid-Atlantic and New England areas of the country report some of the highest availability of heroin in the country, USA Today publishes. In 2014, the largest percentage of local and state agencies in the northeastern US reported heroin as the biggest drug threat in the region and controlled prescription drugs as the second biggest threat, according to the National Drug Threat Assessment. Heroin abuse seems to be rising as an alternative to more expensive controlled prescription opioid narcotic drugs that are becoming harder to get.

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.

Legislative and Law Enforcement Efforts to Combat Local Opioid Abuse

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.

Massachusetts

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.

Rhode Island

Serving around 50,000 Rhode Islanders, the Rhode Island Department of Behavioral Healthcare, Developmental Disabilities, and Hospitals (BHDDH) is the state source for public substance abuse and mental health services within the state. There are seven community health centers around the state that provide mental health services through the Community Support Program. There are also 16 Mobile Support Programs for residents who will benefit from integrated and research-based mental health treatment programs.

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.

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.

Connecticut

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.