Mayor's Opioid Task Force
The City of Nashua Mayor's Opioid Task Force (MOTF) is diverse group of committed individuals led by Mayor Jim Donchess of Nashua, who have a passion and vision to create change and make an impact on the current opioid problem in Nashua and beyond. We expect to achieve success in our efforts by working collaboratively using an approach that incorporates a shared vision, a common agenda, a shared system of measurement, mutually reinforcing activities, and continuous communication. The backbone of support for the MOTF is the City of Nashua, through the Office of the Mayor and the Division of Public Health and Community Services (DPHCS). This model, referred to as a “collective impact” model, uses a community-wide approach to tackle the difficult health issue of opioid addiction that plagues our communities.
MOTF envisions the development of sustainable solutions through a continuum of care model to reduce barriers to access to treatment and recovery for substance misuse; and improve prevention activities and access to behavioral health services to stop overdose and save lives. The goal of MOTF is to provide strategic leadership and guidance through systems thinking to develop a continuum of care model, which incorporates prevention, treatment, and recovery efforts using a collective, adaptive approach to effectively reduce opioid misuse, overdose, and death.
• DEA 360
Strategic 2020 Goals
During the 2019 strategic planning process, MOTF members identified the below four goals to address in 2020 within the Greater Nashua Public Health Region (GNPHR).
Goal 1: Reduce illicit stimulant (methamphetamine) use among all age groups.
Goal 2: Reduce illicit depressant (opioids, heroin) use among all age groups.
Goal 3: Reduce marijuana use among middle and high school aged youth.
Goal 4: Reduce alcohol use among women of child-bearing age.
The theme of the 2019 MOTF legislative breakfast was "Creating a
Healthy Community through Prevention - Getting the Conversation Started".
The goal was to begin the conversation with the Greater Nashua Delegation on the
importance of prevention efforts to decrease the impacts of substance use in
The theme of the 2020 MOTF legislative breakfast was "Creating a healthy Community through Prevention - Continuing the Conversation". The goal of this breakfast was to build off of concepts built in the 2019 breakfast and continue the conversation about root causes.
"Working collaboratively is the key in building resiliency in our citizens, in regards to both mental health and physical well being."
- 2019 MOTF Legislative Breakfast Attendee
Hub and Care Spoke Model
The hub and spoke care model was designed to arrange service delivery assets into a network. This network consists of an anchor establishment, known as the hub, which is a resource to offer a full set of services. The hub is then complemented by secondary establishments, known as spokes, that offer a more limited set of services. The goal of this model is for patients needing more intensive services to be routed to the hub for treatment. The hub and spoke model is defined, an array of benefits are provided, and it's applications are discussed, allowing healthcare providers essential insights for the establishment and operation.
In New Hampshire (NH) the Hub and Spoke Model is named the NH Doorway. The NH Doorway is a new program that is changing how NH helps people with an opioid use disorder (OUD) or other substance use disorders (SUD). There are nine Doorway locations, providing single points of entry for people seeking help for substance use, whether they need treatment, support, or resources for prevention and awareness. The regional Doorways ensure that help is always less than an hour away. In addition, 24/7 access to services is also available by dialing 211.
"We need to create a system
that feeds into all of the existing services and be able to track that more
efficiently. We need to be able to identify our shelter and housing capacity and
increase it as needed to keep clients off of the streets, parks and behind the
library in states of homelessness."
- MOTF Member on the Nashua Hub
DPHCS staff members, working collaboratively with MOTF members, developed a community-based research study to assess the extent and define the degree of substance use disorder in the Greater Nashua region. MOTF members were involved in the survey and interview design, survey distribution, and the outreach proponent of data collection.
During the data collection phase, over 200 community members participated in an online survey and fifty additional participants participated in in-depth, in-person interviews with a member of the research team. The research team is transcribing the fifty in-person interviews and is currently coding those qualitative interview responses into semi-quantitative data. The specific objectives of this research are:
1) Estimate the prevalence of SUD in Nashua and the Greater Nashua Public Health Region
2) Understand the
personal history, beliefs, and practices of individuals that are actively
using and individuals in recovery
3) Determine whether personal history, beliefs and practices differ between individuals that are actively using and individuals in recovery
4) Understand how substances are being obtained, what substances
are being used, and by what methods substances are being used
This research is intended to improve prevention and intervention strategies implemented in the community, identify potential improvements in the continuum of care, and identify barriers to accessing care in order to better serve Nashua and the GNPHR. Check out the results here!
Strategic Planning 2020-2023
The 2020-2023 Strategic Plan for Prevention is an opportunity for the Greater Nashua Community to come together to assess how far we’ve come and look towards the future. The beauty of this strategic plan is that it is made by the Greater Nashua Community for the Greater Nashua Community, understanding our shortcomings and strengths and assets simultaneously. Every step of the strategic planning process required and received input from our community partners and community members.
Using the prevention framework, community members were able to identify issues in the community, conduct root cause analysis for identified issues, and create logic models to address the underlying causes that were identified through the process. Social determinants of health and Adverse Childhood Experiences (ACEs) were identified as root causes to many of the discussed substance misuse issues in the community. It is the belief of the Nashua DPHCS Strategic Planning Team that addressing social determinants of health and ACEs is essential to improving and maintaining the health of the community.
Adverse Childhood Experiences
Childhood experiences, both positive and negative, have a tremendous impact on future violence victimization, and perpetuation, and lifelong health and opportunity. As such, early experiences are an important public health issue. Adverse Childhood Experiences (ACEs) is now understood to be one of the leading causes of everything from heart disease and cancer to substance use and depression, extremely stressful experiences in childhood can alter brain development and have lifelong effects on health and behavior. The Nashua DPHCS is working with community partners to educate the community on the prevention and mitigation of ACEs.
2019 Greater Nashua Public Health Annual Meeting
The 2019 Greater Nashua Public Health Annual Meeting (GNPHAM) was held on October 2, 2019 from 8am-4pm in Nashua, NH. This event was a great success with 111 attendees from the GNPHR and the State of NH. The 2019 GNPHAM was intended to inform the community about ACEs and Adverse Environments. The event was titled “Working Together at the Roots: Becoming a Trauma Informed Community”. It consisted of a full-day interactive workshop focused on learning about ACEs and the science of brain development, finding out how ACEs and trauma impact our community, and strategizing ways in which we can work collectively to transform how we respond to community needs and challenges.
"I will be looking for more community collaborations and partnerships to help connect clients to more resources and education."
- 2019 Annual Meeting Attendee
The Nashua DPHCS is collaborating with regional partners to host free screenings of the documentary Resilience: The Biology of Stress & The Science of Hope. Resilience is a one-hour documentary that dives into the science of ACEs and the birth of a new movement to treat and prevent toxic stress. This film highlights physicians, educators, social workers, and communities that talk about the effects of divorce, abuse, and neglect. Resilience uses cutting edge science to help the next generation break the cycles of adversity and disease.
Nashua DPHCS has already hosted three Resilience screenings to the Greater Nashua community since September 2019, reaching approximately 70 + # of people at division screening. Each screening is followed by a thirty minute panel discussion, then the conversation is opened up to the audience.
"We need to be a trauma informed community. Everyone needs to know about this."
- Resilience screening attendee
Suicide occurs across all economic,
age, social, racial boundaries. Suicide prevention is a significant public
health concern and a top priority for the Division of Public Health and
Community Services. Although suicide prevention efforts largely focus
on identifying and providing treatment for people with mental health
conditions, there are many additional opportunities for prevention. We hope that shifting the culture
and starting the conversation about suicide encourages people to talk more
openly, increase awareness and, ultimately, curb the trend. We want to educate,
decrease stigma, and implement change within the community.
In 2017, 14 out of every 100,000 Americans died by suicide, 10 out of every 100,000 New Hampshire residents died by suicide, and 20 out of every 100,000 Hillsborough County residents died by suicide (graph below).
Sharing data among community partners is a key strategic initiative to ensure the health and well-being of Greater Nashua residents.
Members of MOTF are encouraged to share data with DPHCS to be included in the region's 2020 Community Health Assessment and the implementation of the 2018-2021 Community Health Improvement Plan.
Share data on your substance use prevention and continuum of care initiatives here.