CONCORD, N.H. — Alastair P. Huntley’s addiction began as many do: with an opioid prescription to manage pain after undergoing surgery for a knee injury. He was 23 years old, an ROTC student in college, when he unwittingly embarked on what he now describes as a five-year detour from his life.
That detour, he said, didn’t include a warning from his doctor about how addictive the painkillers were.
It reached its peak when, faced with suicidal thoughts, Huntley said he decided to check himself into a local emergency department and begin the long road to recovery.
Looking back on the harrowing experience, Huntley, who is now 35, said he never encountered the option of harm reduction, which includes life-saving drugs like naloxone that can reverse an overdose, and needle exchanges to prevent the spread of disease.
Harm reduction is a big part of Huntley’s work now as an Emergency Medical Technician, and he’s studying to become a doctor. With the help of a state grant, he’s working to tell the stories of those in addiction, while training people to use naloxone.
New Hampshire saw a surge in overdose deaths last year nearing the decade-high, after the death rate declined for two years before the pandemic. In 2022, there were 486 deaths, an 11 percent increase over the prior year.
Huntley grew up in southern New Hampshire before studying at Norwich University as an ROTC student. During a training exercise, he hurt his knee and shoulder and needed surgery.
“I think it’s a pretty common story where you see an individual have an injury, go through some sort of surgical procedure. They’re then prescribed some sort of opiate-based pain medication, and there’s a dependency that can evolve from that,” he said.
Huntley said he was feeling low because of the injury’s impact on his career trajectory in the Army. He said poor mental health is a contributing factor to developing substance use disorder.
His experience with addiction left him further isolated, knowing the Army had strict rules against substances even as he was in the grips of the addiction. “It’s just a really dark, tumultuous time in my life, and that’s why I’m so invested in harm reduction,” he said.
Huntley said he reached a turning point when he considered taking his life, but instead checked himself into an emergency department for suicidal ideation and started seeking treatment.
“It took four years to piece myself back together, to have the courage to go back to Norwich, complete my degree, and move on with life,” he said.
The experience encouraged him to become a doctor, and it’s inspired his efforts to train others in harm reduction and use storytelling to raise awareness about addiction.
He’s working with visual artist Samuel Rafa Garcia to create a short film that tells the fictional story of a woman struggling with substance use disorder and poverty, while trying to create a better life for herself and her child. Huntley said it’s based on someone he met while dealing with his own addiction.
He plans to complete the film’s production by 2024 and present it at locations in the Upper Valley alongside a panel discussion featuring people in recovery who can share lived experiences. He’s working with the HIV/HCV Resource center in Lebanon and with the TLC Family Resource Center, which has locations in Claremont and Newport, and plans to open a new location in Lebanon.
“The public health benefit is training everyone that’s there on how to administer Narcan, how to recognize signs of an overdose, and making sure they leave there with doses of Narcan to carry with them,” he said.
His broader goal is for naloxone, the generic name for Narcan, to become as commonplace as the automated external defibrillators used to revive people from cardiac arrest.
Huntley also works for the HIV/HCV Resource Center as a mobile phlebotomist, conducting testing and collecting blood samples all across the Upper Valley.
“One of the reasons I like the project is that I think it will help reduce stigma,” said Laura Byrne, the center’s executive director. While harm reduction has become more accepted, Byrne said, there’s still a lot of stigma against people who use drugs or have Hepatitis C or HIV.
That’s part of the reason she began working with Huntley in the first place. Byrne said they started offering mobile blood testing because their clients refused to get tested at medical centers and hospitals where they experienced stigma.
In addition to reducing stigma, she said Huntley’s project will help start an important community conversation.
“Storytelling is such a great way to relay information,” she said. “It’s not like the community versus the drug users — everybody is experiencing this story and then talking. It’s going to get people talking.”
Byrne said the center, which began as a peer support group for people with HIV, has evolved to include services and case management. As public health measures have been successful in curbing the HIV epidemic, the center has turned its efforts to overdose prevention.
“It’s the biggest need right now,” she said. “There’s so many people that are dying from overdoses that could be preventable if people were not using alone or if they had access to naloxone.”
The center’s focus on harm reduction is possible in part because New Hampshire laws have changed to make it legal, Byrne said. Now, she said, people can call in an overdose without fear of getting arrested for possessing drugs. It was only a few years ago that a needle exchange became possible — a key part of harm reduction to prevent the spread of diseases transmitted through reusing needles, like HIV and hepatitis C.
As laws have shifted, so has public perception.
“Now if I go to a town meeting, I can talk about harm reduction,” Byrne said. “I can talk about giving people syringes, without having people on the select board get upset. That’s really changed in the past decade.”
Dan Wargo has been in recovery for 11 years and is now the TLC Recovery Program manager. His goal is to ensure others in recovery have a strong community network, a key component that has helped him maintain his own recovery. He believes that social isolation during COVID is partly to blame for the increase in overdose deaths the state has seen.
Translating the issue at hand to those who don’t have firsthand experience remains challenging.
“I think the community at large doesn’t really understand the depths of the problem we face with substance misuse, how bad it gets sometimes,” Wargo said.
He said the storyline Huntley is presenting in his project is realistic and raises awareness about this problem in a way that will allow people to start talking about solutions.
“There’s so many opportunities for intervention in that story, just like there’s so many opportunities for intervention out here in the community on a regular basis that just aren’t happening because I just don’t think there’s enough awareness,” he said.