Chronic Pain and Addiction Treatment in New Hampshire

How is chronic pain treated when someone also has a substance use disorder?

When someone has chronic pain and a substance use disorder, pain and addiction clinicians usually treat both from one shared plan, so medication, therapy and follow-up support each other. In New Hampshire, that can mean an addiction program working with your current pain prescriber, or one clinic that offers both kinds of care.

Physical dependence on long-term opioids is an expected body response and is not the same as a use disorder. A use disorder involves cravings, loss of control and continued use despite harm. Clinicians work out which one applies before changing a treatment plan, and many people on long-term opioids do not have a use disorder.

Options in a shared plan can include buprenorphine, which treats opioid use disorder and also eases pain, or methadone from a certified opioid treatment program. Non-opioid pain medicines, physical therapy and cognitive behavioral therapy may sit alongside them, with clinicians weighing your condition and other prescriptions.

Cutting long-term opioid or benzodiazepine doses sharply on your own is risky. Sudden changes can bring withdrawal and more pain, and lower tolerance raises danger if someone later returns to an old dose, so any taper belongs in a plan agreed with the prescriber.

Your clinicians make the final choice of options. They weigh your pain condition, your other medicines and your history. Programs offering medication for opioid use disorder appear on the New Hampshire Suboxone clinics and methadone clinics pages.

Is it safe to stop or reduce pain medication on my own?

Stopping or sharply cutting long-term opioid or benzodiazepine prescriptions on your own is not considered safe. Plan any taper with the prescriber. Sudden changes can bring withdrawal and a rise in pain. Tolerance can also drop, which raises the risk if someone returns to use at a former dose.

Benzodiazepine withdrawal can be medically serious. Taking benzodiazepines with opioids also raises breathing risks. A plan made with your prescriber sets the pace and the support, and covers what happens if pain flares. Programs listing benzodiazepine care are gathered on the New Hampshire benzo rehab page.

What New Hampshire rules might a patient come across?

Naloxone is easier to get in New Hampshire under HB 271, a 2015 law. It lets pharmacists dispense naloxone under standing orders. It also lets physicians prescribe it to a family member or friend who is in a position to help. A separate Good Samaritan law, in place since 2015, offers some legal protection to people who call for help during a drug emergency. Ask about its limits.

Prescribers can look up a patient’s controlled-substance history in the state’s prescription monitoring program. Rules on opioid prescribing for chronic pain can change, so ask your prescriber which rules apply to you now. Under state law, NH Medicaid must pay for telehealth, including audio-only visits, at no less than the in-person rate. When medication for opioid use disorder is given by telehealth, the regional Doorway is notified with your written consent. Remote options are listed under telehealth rehab in New Hampshire.

How do I pay for pain and addiction treatment in New Hampshire?

Pain and addiction treatment in New Hampshire is usually paid for through NH Medicaid, private insurance, or state-funded care arranged through the Bureau of Drug and Alcohol Services. NH Medicaid is run by the Department of Health and Human Services and was expanded in 2014. Care is delivered through three plans: AmeriHealth Caritas New Hampshire, NH Healthy Families and WellSense Health Plan. Ask your plan how it covers medication for opioid use disorder and each level of care. See programs accepting Medicaid.

Private insurance plans in New Hampshire fall under federal parity rules. Those rules mean substance use and mental health benefits should be no more restrictive than medical benefits. The Bureau of Drug and Alcohol Services is the state’s single state authority for substance use care, and state-funded care runs through it. Programs that list public funding appear on the state-funded rehab page.

What should I ask a New Hampshire program before starting?

Ask a New Hampshire program three things before you start. Does it treat pain and substance use together? Can it continue or start medication for opioid use disorder? Will it coordinate with your pain prescriber? Then ask about levels of care, whether it accepts your insurer, its accreditation, the languages spoken and the groups it serves. Programs that also treat mental health conditions are on the dual diagnosis page. Weekly care options are on the outpatient page.

Where the listings sit

Every program listing pain and addiction services in New Hampshire sits within 25 miles of a river, a median of 3.3 miles away, most often the Nissitissit or Mascoma. Manchester-Boston Regional Airport is the nearest airport for most of these programs, and the median distance to the nearest airport is 8 miles. Elevations run from 20 to 660 feet. About six in ten programs sit within 25 miles of a named summit such as Wiley Hill or the Wapack Range.

Free places to start

To reach The Doorway, New Hampshire’s network of nine hospital-based access sites, call 211. The national treatment referral line can also suggest options, and 988 answers in a crisis. To compare more programs, see opioid rehab in New Hampshire, the national pain and addiction page, or all New Hampshire listings.