Substance Misuse Treatment Services

The treatment system in NH consists of an array of levels of care including outpatient, intensive outpatient, partial hospitalization, residential, withdrawal management, and peer and non-peer recovery support services. Many of these services are paid for by public and/or private insurance programs as well as funding from DHHS to help individuals with accessing treatment services.

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Standing Order for Dispensing of Opioid Antagonist Agents

Treatment in NH

Starting treatment is often the first step towards recovery and can leave people feeling overwhelmed and confused. It is helpful to know that resources are available to you to help make this step easier.  

211 is a resource that can provide statewide referrals and information, call 2-1-1, or visit the 211 webpages.   

SAMHSA has confidential and anonymous resources for locating treatment facilities for mental and substance use disorders in the United States and its territories.

Medication Assisted Treatment (MAT)

MAT is used to treat substance misuse disorders as well as sustain recovery and prevent overdose.  MAT is the use of medications, in combination with counseling and behavioral therapies, to provide a "whole-patient" approach of the treatment of substance misuse disorders.  

Buprenorphine, methadone, and naltrexone are used to treat opioid use disorders to short-acting opioids such as heroin, morphine, and codeine, as well as semi-synthetic opioids like oxycodone and hydrocodone. These MAT medications are safe to use for months, years, or even a lifetime. As with any medication, consult your doctor before discontinuing use.

  • Buprenorphine - suppresses and reduces cravings for opioids. Learn more about buprenorphine.
  • Methadone - reduces opioid cravings and withdrawal and blunts or blocks the effects of opioids. Learn more about methadone.
  • Naltrexone - blocks the euphoric and sedative effects of opioids and prevents feelings of euphoria. Learn more about naltrexone.

MAT medications are administered, dispensed, and prescribed in various settings such as a SAMHSA-accredited and certified opioid treatment program (OTP) or certified practitioners depending on the medication.  A current listing of OTP centers in NH can be found by selecting "New Hampshire" at the SAMHSA Opioid Treatment Program Directory.  It is important to call a facility before you visit to make sure they have the services you need.

State OTP Provider Training and Presentation - November 2022

A joint presentation of:

 

Types of Treatment
Definitions of Outpatient and Residential Services

IOP-Intensive Outpatient Program

  • IOP for substance use disorders (SUDs) offer services to clients seeking primary treatment; step-down care from inpatient, residential, and withdrawal management settings; or step-up treatment from individual or group outpatient treatment. IOP treatment includes a prearranged schedule of core services (e.g., individual counseling, group therapy, family psychoeducation, and case management [CM]) for a minimum of 9 hours per week for adults or 6 hours per week for adolescents.

PHP-Partial Hospitalization

  • PHP is a time limited, ambulatory treatment program offered during the day or evening hours and is considered an acute day hospital or a level 2.5 program per American Society of Addiction Medicine (ASAM) guidelines.
  • This level of care is used for individuals suffering from co-occurring substance use disorders that do not require an inpatient level of care, but still require intense monitoring and would not be appropriate in the outpatient level of care based on their symptoms.  
  • It is recommended per ASAM criteria (2013) that member’s needing PHP for substance abuse treatment attend a minimum of 20 hours per week of programming to ensure the most effective treatment response is received.

Low-Intensity Residential Treatment 

  • 24/7 living support and structure
  • At least 5 hours of clinical service per week
  • Counseling and in-house meetings to help support residents with essential life skills
  • Clinical, vocational, educational, or community activities for limited periods of time outside the campus

High-Intensity Residential Treatment 

  • Called Clinically Managed Medium-Intensity Residential Services for adolescents and Clinically Managed High-Intensity Residential Services for adults.
  • Provides 24-hour care with trained SUD clinicians to stabilize multidimensional imminent danger and prepare for outpatient treatment.
  • Patients in this level are able to tolerate and use full active milieu or therapeutic communities.
  • Residents are not typically able to go out into the community except for planned recovery activities that are monitored by program staff.

OTP-Opioid Treatment Program

  • Treatment for opioid use disorders using a combination of methadone or buprenorphine and counseling services, delivered by an agency certified as an opioid treatment program.

 

MAT-Medication Assisted Treatment 

  • Medication prescription and monitoring by a licensed prescriber for the purpose of treating a SUD, including clinically appropriate referral to, and coordination with, SUD treatment providers within the prescriber’s practice or externally.
  • Medications used include, but are not limited to, Suboxone, Naltrexone, and Vivitrol.

WM-Withdrawal Management 

  • Medically Monitored Intensive Inpatient Services Withdrawal Management for adults, this level of care provides 24-hour nursing care with a physician’s availability for significant problems with subacute biomedical and emotional, behavioral, or cognitive problems that are so severe that they require inpatient treatment.
  • Patients in this level of care require medication and have a recent history of withdrawal management at a less intensive level of care, marked by past and current inability to complete withdrawal management and enter into continuing addiction treatment.

Outpatient 

  • Typically require regular counseling at a clinic or facility and allow clients to return to their homes or other living arrangements during non-treatment hours.
  • MAT -Medication Assisted Treatment
  • IOP-Intensive Outpatient Programs
  • OTP-Opioid Treatment Programs
  • WM- Outpatient Withdrawal Management
  • PHP-Partial Hospitalization

ICM-Case Management / Intensive Case Management 

  • ICM is a coordinated, individualized approach that links patients with appropriate services to address their specific needs and help them achieve their stated goals. The types of settings offering SUD case management include specialty treatment programs, federally qualified health centers, rural health centers, community mental health centers, veterans’ health programs, and integrated primary care practices.
  • ICM is different from case management through factors like a smaller caseload size, team management, outreach emphasis, and an assertive approach to maintaining contact with clients. Research has demonstrated that case management, in particular, intensive case management, can improve clients' and families’ lives. 

State Funded Treatment Providers