Best place to have a job when you are a criminal – LAW ENFORCEMENT ?

DEA task force member arrested by state police in drug probe

http://www.wwl.com/DEA-task-force-member-arrested-by-state-police-in-/22512462

Louisiana State Police have arrested a second investigator assigned to a U.S. Drug Enforcement Administration task force.
 
Maj. Doug Cain, a State Police spokesman, says they are scrutinizing cases made by the task force officers where drugs and cash seized in raids disappeared or were never recorded as evidence.
 
Cain says 49-year-old Karl Newman, a longtime deputy with the Tangipahoa Parish Sheriff’s Office, was booked Thursday on counts of conspiracy to distribute cocaine and abuse of office.
 
Cain says Newman is being held without bail in the St. Tammany Parish Jail.
 
Cane says the arrest comes a month after troopers booked Johnny Domingue, another Tangipahoa Parish Sheriff’s Office deputy who had been assigned to the DEA task force.

A mental health epidemic ?

CABELL COUNTY, W.Va. (WSAZ) — A WSAZ investigation into the heroin epidemic in Cabell County quickly went viral. Now, we are following up with the young man shown overdosing and the paramedics who saved him in that shocking body camera video.

In WSAZ Investigates: A Dose of Reality, 26-year-old Joey overdoses on heroin in his Barboursville home. His mom calls 911, and Cabell County EMS Supervisor Chad Ward arrives on scene first.

Chad’s body camera is rolling as he finds Joey lying on his bed, turning blue and only breathing twice a minute. He is just minutes from death. More paramedics arrive and they give Joey Narcan, a drug that reverses an overdose.

In just a matter of minutes, Joey is awake and walking. The dramatic scene is shown through the eyes of Chad — a scene he and his paramedics see every single day.

“I want these people to know, you were on death’s door,” said Chad. “I know it doesn’t seem like it now, but truly you were. Another five or 10 minutes could have made a big difference.”

After the story first aired, it went viral. The web article was viewed more than 300,000 times in just a couple of days. The story was also featured on national websites, was the number one story in the news section of Reddit, and was shared thousands of times on social media across the country.

“I never believed it was going to get that big,” Chad said. “When you get a story and it gets out that big, maybe it helped one person to quit doing heroin — decide, ‘This is not for me. I don’t want to risk it.’ Or maybe it helped one person to say, ‘I’m never going to try heroin. I see what it can do.’ Either way, if we helped one person, it was a great story. It was worth it.”

One person the story did help is Joey. After the story aired, Joey posted a message to his friends and family on Facebook explaining that he planned on seeking help and going to rehab.

“I can’t continue to live this way anymore,” said Joey’s post. “I want better things to happen in my life and if I continue on the path I am in, I will be dead. Time to improve my life.”

After our story aired, he posted again, saying he didn’t give us permission to use the video for attention, but to bring awareness to the drug epidemic. He wants to help other people who are struggling.

Joey’s sister also spoke to WSAZ, saying the story was a wake-up call for her brother.

“I hope and pray this opens people’s eyes,” said Emmi, Joey’s sister. “Thank you, Kaitlynn LeBeau, for doing this documentary. Hopefully it’s saving lives.”

Chad said he is glad to see the video is eye-opening for Joey and his family.

“It is a wonderful feeling to that that OK, we did this story and now this young man might get some help, might get past this addiction,” Chad said. That just feels good — there’s no other way to put it.”

Chad, Joey and Emmi all say they hope this story continues to make a nationwide impact — showing the reality of the heroin problem and that there are real people behind the overdose statistics.

“I hope people keep seeing it; I hope it changes people,” Chad said. “Anything we can do that is going to eventually help is what we need to be doing.”


ORIGINAL STORY 2/11/16
CABELL COUNTY, W.Va. (WSAZ) — A 911 call comes in to Cabell County EMS. The caller is a worried mother. She just found her son unconscious in their Barboursville home. He’s turning blue and barely breathing. A used needle lays on the floor next to his bed. He is minutes from death.

The first to arrive at the home is EMS supervisor Chad Ward. His body camera is recording the disturbing but familiar scene.

“A lot of times you’ll hear people refer to Huntington as Little Detroit,” said Chad. “I never believed we’d be treating 2 and 3 heroin overdoses a day. Never.”

It’s a cold Sunday night. Chad arrives and is greeted at the door by Mary.

“He might be dead,” said Mary. “I have no idea what he took.”

Chad is calm. He’s responded to a heroin overdose dozens of times before. He enters a back bedroom and sees Joey unresponsive on the bed.

“Alright, honey, let me work with him,” Chad reassures Mary.

The body camera scans the room — Chad is looking for the needle Joey used to shoot up. He finds it on the floor and tells Mary not to touch it.

“Just leave it there; just leave it there,” Chad tells her.

He moves Joey on to the floor and begins giving him oxygen. Joey’s heartbeat is strong, but he’s only breathing twice a minute. Chad is working against the clock.

This is a normal day for Chad and his paramedics.

“I don’t know what brings anybody to it,” Chad tells WSAZ. “Anxiety, depression, just looking for something to do. It’s hard to say. But it is truly everywhere.”

In 2015, there were 944 drug overdoses in Cabell County. That’s up more than 300% from 2014.

944 reported overdoses in 2015
272 reported overdoses in 2014
256 reported overdoses in 2013
146 reported overdoses in 2012

Out of the total number of overdoses, 70 proved fatal — the deadliest year the county has seen for drug overdoses. Chad fears 2016 will be just as grim.

“I think it’s going to get worse before it gets better,” said Chad. “And honestly, I don’t know what will make it better.”

He also worries that the staggering numbers pack little punch now-a-days. He understands why, though. He has responded to 7 overdoses in one day. Some of his paramedics have responded to as many as 14 in one day of work.

“Every day that we go on an overdose, I just think oh my goodness, here we go again, here we go again, here we go again,” said Brenda Johnson, a Cabell County paramedic.

Brenda has been a paramedic for Cabell County for 14 years. When she started her career, she had no idea how many of her patients she would be treating for an overdose.

“Once they start using it then it’s hard to let go of it,” said Brenda.

But it’s not just addicts, she said. It can be a gamble for first-time users — especially if the heroin is laced.

“It may be a situation where they’re going to try it one time, you know just that one time, but they don’t realize that one time could be the last time they try it,” said Brenda.

Some of the additional drugs that heroin can be laced with are incredibly dangerous and even lethal.

“It will literally just kill them in a matter of minutes,” said Chad. “Some of these drugs are mixed with light fluid and phosphorus and things you would never dream about putting in your body.”

About four minutes have gone by when more paramedics arrive to help Chad. They immediately begin prepping Joey for Narcan — a drug that reverses an overdose.

“Everybody’s heard about Narcan and what an amazing drug it is and literally it will take somebody from the edge of death to back alert and oriented just like we’re talking now,” said Chad.

But although Narcan saves lives, and could save Joey’s, Chad and many of his paramedics say it’s creating more concern than comfort for them. Brenda says Narcan is giving drug users a false sense of security.

“That scares me because I’m afraid the people who are using or abusing these drugs are going to get into the mindset of, ‘Well, somebody’s going to have Narcan. It’s going to be close by so I’m okay. Even if I overdose, somebody’s going to save me,'” said Brenda. “You know, some we can save, some we can’t.”

The paramedics give Joey Narcan. Less than a minute and a half later, Joey takes a deep breath. He’s awake and the paramedics begin asking him what drugs he took.

“Heroin — did you shoot heroin?” Chad asks.

“A tiny bit, yeah,” Joey responds after some hesitation. The paramedics have to reassure Joey that they are not the cops and are there to help — something they have to do often on overdose calls, Chad said.

“Now, Joey, listen to me man,” Chad says as Joey stands up. “About ten more minutes, you’d be dead. I’m not kidding you, I’m not lying to you, I’m not trying to scare you. Somebody hadn’t been here about 10 more minutes, you’d be laying there dead as a doornail right now.”

Joey has a second chance at life, but the paramedics know for as many people as they save, there will be another overdose.

They just saved someone’s child, but Chad says one of the most heart-breaking experiences is interacting with children who have found their parents unresponsive.

“It’s harder to deal probably with the children and try to make them understand and comfort them than it is to deal with the patient themselves,” said Chad. “You’re trying to comfort them. You’re trying to tell them and they’re, ‘What’s going on? Is mommy dead?’ And you know, depending on the situation, you have to try to explain to these children at their level what’s going on. You know, that they’ve taken something bad it looks like and we’re going to try to help em out and make ’em well again.”

The same calls stick with Brenda.

“That to me is very disheartening, that’s very disheartening,” said Brenda. “To think that you would have small children in your house that are depending on you to keep them safe and then this person is engaging in that kind of activity. But here, again, it’s an addiction.”

Chad has responded to homes where an entire family has overdosed: Mother, father and son.

“I walked in and thought, how does one family, the entire family, get involved in this?” said Chad. “What’s going on in their lives that they think this is good for everybody?”

Many of the calls they go on are for patients they have treated for an overdose before. After saving their lives with Narcan, they just begin using again.

“It’s kind of sad when you roll up on a scene and look at somebody and you know immediately who they are because of the fact that you’ve picked them up before for a drug overdose,” said Brenda.

As more people become addicted, Brenda and Chad say there is yet to be a real solution to the problem.

“I don’t see it slowing down any time soon,” said Chad. “I only see it getting worse.”

“The only solution is to educate as many people as we can about this epidemic and get the people who are using drugs treatment,” said Brenda.

The family featured in this story did not want to be interviewed, but gave WSAZ permission to show the video.

more people are going through withdrawal – and turning to heroin

Labeling the sharp rise in prescription drug abuse an ‘epidemic’ has made the problem WORSE, expert warns

http://www.dailymail.co.uk/health/article-3465991/I-ve-never-seen-patients-heroin-Labeling-sharp-rise-prescription-overdoses-epidemic-problem-WORSE-experts-warns.html#ixzz41LNV7aMi

  • The Centers for Disease Control has labeled opioid abuse ‘an epidemic’
  • But, a top pain expert warns that label is leading to increased heroin use
  • Doctors are now taking patients off painkillers abruptly, he says
  • And so, more people are going through withdrawal – and turning to heroin 

Health experts in the US have labeled prescription painkiller abuse an ‘epidemic’.

The Centers for Disease Control and Prevention (CDC) were moved to do so after noting a sharp rise in opioid overdoses.

But that move, some say, is in fact making the situation worse.

One top pain management expert has argued the ‘epidemic’ label is aggravating the issue, and is causing patients to turn to heroin instead.  

Dr Vitaly Gordin, division chief of chronic pain management at Penn State Hershey Medical Center, said he has never seen so many inpatients on heroin, as in the last six to 12 months.

‘Because of this declared epidemic, many primary care physicians, specialists and surgeons are taking these patients off the narcotics,’ he said.

‘But if they don’t have an exit strategy and get referred for alternate treatment, addictions counseling or rehabilitation, they can become desperate as they go through withdrawal.’

The CDC has labeled abused of prescription painkillers in the US as 'an epidemic' - but a top pain expert warned that the label is making it worse. That's because doctors are now taking people off of the narcotics

The CDC has labeled abused of prescription painkillers in the US as ‘an epidemic’ – but a top pain expert warned that the label is making it worse. That’s because doctors are now taking people off of the narcotics

Prescription painkillers – such as oxycodone and tramadol – are opiate analgesics, just like heroin.

Those painkillers are frequently prescribed for pain control.

Many people who are prescribed the pills to relieve short-term acute pain – such as the pain that occurs following surgery – are not at risk of addiction.

Dr Gordin said: ‘The vast majority of them will very easily get off these medications as their condition improves and pain is decreasing.’

Similarly, painkillers are also often prescribed to patients suffering from chronic conditions.

I have never seen as many inpatients on heroin as I have in the past six to 12 months
Dr Vitaly Gordin, of Penn State Hershey Medical Center

Those patients require high doses of narcotics for long periods of time.

Dr Gordin said: ‘There are a lot of very legitimate patients who are receiving these medicines in a chronic setting who are not abusing them.’

However, the risk sets in when someone is taken off the medication after using a high dose for a long period of time.

For some of these patients, if they aren’t able to renew a prescription for narcotics, they may turn to heroin while going through withdrawal.

Heroin is relatively inexpensive and easier to access illegally than prescription medications.

But unlike prescription painkillers – which are regulated by the Food and Drug Administration – heroin has no regulation.

And so, it is hard to verify what is in the heroin a person buys from a dealer.

Dr Gordin said: ‘Several years ago there was a string of deaths of addicts who bought heroin laced with a potent painkiller called fentanyl.

When people who have been taking painkillers long-term are abruptly taken off the drugs, they start to go through withdrawal - and may end up turning to heroin (pictured) instead

When people who have been taking painkillers long-term are abruptly taken off the drugs, they start to go through withdrawal – and may end up turning to heroin (pictured) instead

‘Because it’s all underground, illegal business, you don’t know what exactly you’re getting.’

Nearly 20,000 deaths occur each year from prescription opioid abuse.

Most of those deaths happen when the narcotics are taken with another substance – such as benzodiazepine or alcohol.

 There are a lot of very legitimate patients who are receiving these medicines in a chronic setting who are not abusing them
Dr Vitaly Gordin

Such combinations can be lethal, according to Dr Gordin.

The doctor noted that patients with a history of drug abuse, untreated psychiatric conditions or a history of pre-adolescent abuse are more likely to develop addictions.

Dr Gordin said: ‘In my 17 years working here, I have never seen as many inpatients on heroin as I have in the past six to 12 months.

‘Those who have abused heroin are getting into car accidents or involved in violent crimes because of being on the drug or trying to obtain it.

‘I think it’s directly related.’

The doctor suggested that society start removing the stigma of addiction – and stop thinking of it as a character flaw.

Dr Gordin said: ‘We need to understand it is a disease with psycho-social components, and we need to have resources available to both prescribing physicians and patients who need drug rehabilitation

Alcohol sales to benefit mental health?

stupidcanyoube

http://www.jconline.com/story/news/college/2016/02/26/alcohol-sales-benefit-mental-health/80991716/

Purdue’s Counseling and Psychological Services (CAPS) needs more funding to meet the need of a rising rate of students seeking mental health care.

The undergraduate student government thinks selling alcohol at sporting events could help.

In 2015, CAPS saw a 15 percent increase from the previous year in the number of students who sought an appointment, Purdue Student Government President Mike Young said in a presentation to the Board of Trustees Friday.  About 100 students will be on a wait list in a given week.

The center has 17 full-time employees, which Young said is eight fewer staff members than the International Association of Counseling Services recommends.

Young proposed the university hire additional CAPS clinicians and up resources to meet those recommendations and reduce the wait time for appointments. He suggested to partially fund the $682,200 plan with alcohol sales from sporting events.

“A lot of these ideas, like the more off-the-wall things, kind of sound unfeasible or ridiculous at first,” he said, “but then you start to look at it and this could be a double-win for students, in my opinion.”

Purdue started allowing season ticket and VIP card holders to purchase beer and wine at the Ross-Ade Stadium’s South End Zone Patio in 2014, but fans currently can’t purchase or drink alcoholic beverages outside the gated area or private suites. The general public also can’t buy drinks at other sporting events.

Young said he got the idea from the University of Maryland’s student government, who successfully campaigned in 2015 for the school to sell alcohol at games and use the funds for student support services like mental health counseling. The school projected the sales would hit $500,000 annually.

Purdue President Mitch Daniels said additional mental health resources are probably needed and he’ll take a look at the proposal.

“We’re going to take it very seriously,” he said.

 Other items discussed at the meeting

  • Purdue Graduate Student Government President Andrew Zeller proposed a 3.5 percent increase to all general fund teaching assistant lines for Fiscal Year 2017, the same increase implemented last year.
  • Board approved plans to move forward with a $6.25 million Controlled Environment Phenotyping Facility.
  • University Senate Chairman Kirk Alter presented a resolution for collaborative decision-making with Purdue leaders while the University Senate and regional campus Faculty Senates are in session.
  • PSG President Mike Young also requested a permanent funding solution for Student Legal Services.

 

CDC GUIDELINES… do practitioners consider all of these mandatory.. like a law ?

http://www.cdc.gov/vaccines/hcp/acip-recs/index.html

Here is a link and the list of all the CDC’s vaccination recommendations. I wonder how many practitioners consider these “guidelines” mandatory to follow…  If a pt refuses/declines to get a flu shot…  should the practitioner be held responsible for not following these guidelines ?

Believe it or not the CDC … does not keep stats on flu deaths.. they just estimate them   http://www.cdc.gov/flu/about/disease/us_flu-related_deaths.htm

That estimate ranges from 3,000 to 49,000 per year. So have practitioners, prescribers and pharmacists been negligent for failing to make sure that each and every pt gets a flu shot EVERY YEAR… that means that there is up to 49 K UNNECESSARY DEATHS..  That is as many claimed deaths from drug overdoses.. which includes drug overdoses from OTC’s. Should practitioners, prescribers, pharmacists be held liable for some of these deaths ?

For those of you with chronic pain  and your practitioner or pharmacist tell you that the new CDC “GUIDELINES” on opiate dosing is the NEW LAW OF THE LAND… You might want to consider challenging them as to if they are absolutely following the OLD CDC guidelines on vaccinations.. and if not… are they discriminating against those who have a valid medical necessity for being prescribed opiates ?… the same pts that are covered under The Americans with Disability Act and a violation under that act is a civil rights discrimination ?

Those who wish to live by the rule book… could find out that they may end up dying by the rule book.  Either all the rules are in concrete or none of the rules are in concrete… Liking/enforcing some rules.. and ignoring/not enforcing other rules.. does not CUT IT !

I wonder how many other guidelines that the CDC has formulated and published and they are not universally being adhered to and no one is being held responsible for consequences/deaths for not following them ?

Vaccine-Specific ACIP Recommendations

To prescribe opiates to treat chronic pain is really old school medicine

DEA investigates three central Indiana pain clinics

http://fox59.com/2016/02/26/dea-investigates-three-central-indiana-pain-clinics/

If I was a news reporter… I would always seek out an addiction counselor ( with no medical background)  for medical advice on treating chronic pain.

INDIANAPOLIS, Ind (Feb. 26, 2016)–Three central Indiana pain clinics were searched by federal and local agencies Friday morning.

Sources tell FOX59 the Pain Management Centers of Indiana are being investigated for the alleged overprescribing of pain medications possibly linked to overdose deaths.

The investigation is spearheaded by the Drug Enforcement Administration along with local agencies in Marion, Miami and Monroe counties. The prosecutors from all three counties are  assisting  along with The Indiana Attorney General.

Records and files were removed in evidence boxes from the clinics. They operate in locations in Peru, In, Bloomington, In and the south side of Indianapolis.

The main physician’s home was also searched in addition to the three practices.

According to the Miami County Prosecutor’s office, the investigation was sparked in part by individual complaints.

“It is the duty of DEA, the Attorney General and the prosecuting attorneys to investigate such complaints. Whether or not they are substantiated by the evidence being gathered and reviewed may not be determined for several weeks,” said Bruce Embry, prosecuting attorney for Miami County.

Addiction counselor Scott Watson says these investigations are key in holding physicians accountable.

“To prescribe opiates to treat chronic pain is really old school medicine. There are better ways to treat chronic pain than to simply push more medicine at those patients​,” said Watson.

FOX59 is withholding the doctor’s name because criminal charges have yet to be filed.

A Leopard can’t change its spots

Law Enforcement and Pain Patients

http://www.painnewsnetwork.org/stories/2016/2/25/law-enforcement-and-pain-patients

http://www.naddi.org/aws/NADDI/pt/sp/home_page

http://www.pharmacytimes.com/search?get1=search&keywordType=relevancy&keywordTerm=burke&x=0&y=0

The first link is to a article written by John Burke.. recently retired from a 48 yr career in law enforcement.. he would have started just before Congress passed The Controlled Substance Act in 1970 that eventually morphed into our “beloved” DEA of today.

The second link is to the organization that John Burke help founded/lead …. National Association of Drug Diversion Investigators

and currently President of  International Health Facility Diversion Association.

The third link is to PHARMACY TIMES that John Burke wrote a monthly article for years in the magazine.

I had Barb read the article he penned on painnewsnetwork and she came back believing that it was a nice article.. then I reminder her that this was the same person that I had written a letter to PHARMACY TIMES about Burke’s monthly opiophobic rant after one month he basically accused many “grandma types” getting opiates so that they could sell them to supplement their income… My letter to PHARMACY TIMES said it was time to pull Burke’s opiophobic rants… of course, PHARMACY TIMES never bothered to respond to my letter and continued to published Burke’s opiophobic rants…  You can go to the third link to see some of these rants published monthly in PHARMACY TIMES.

If you come to the same conclusion that I did.. Burke writes to the anticipated readership.. I have seen this from him at least once before in a article penned by him that was directed to the  chronic pain community.

IMO… Burke’s head/heart belongs to law enforcement and typifies a “wolf in sheep’s clothing “

 

 

 

History repeats itself … stupid people pass stupid laws

dumbpeople

Stopping Drug Dealers

cell

The Indiana General Assembly is focused on ways to reduce the illegal drug epidemic in Indiana. Part of our strategy includes tougher penalties for the dealers who fuel drug abuse in our communities.

House Bill 1235 would establish mandatory minimum sentences for the worst drug dealers. Under this bill, the sentence for the highest felony level of dealing meth or heroin with a prior dealing conviction could not be suspended below 10 years.

Additionally, Senate Bill 290 would allow courts to convict people in possession of large amounts of drugs as dealers, not just users.

These bills would work together to stop drug dealers in our state.

If these Indiana legislators would come out of the mid-20th mindset that they are apparently stuck end and WAKE-UP that as long as we have people suffering from the mental health disease of addictive personality disorder that are UN-diagnosed, under treated or untreated and have elected to self medicate the demons in their head and/or monkeys on their back with some substance… sometimes alcohol, sometimes opiate based substances or whatever their substance of choice is… there will be someone who tries to make a buck to sell those people whatever substance they want or can afford to abuse. To quiet those monkeys and/or demons.. and after a few years when they have developed a large tolerance … they no longer get much of a high.. they just end up trying to fight off the suffering of going into withdrawal. If we chose to treat those with mental health issues… the dealers on the streets would not have any customers…no customers.. no profits… sells substances that can be abused… I guess that concept is just too complicated for Indiana’s legislators and most other states’ legislators and bureaucrats.  Cause they all seem to have the same delusion of stopping substance abuse.. except Tobacco , Alcohol and Gambling.. because they impose a “sin tax” on those products… Addictions are ok as long as the bureaucrats get their “take” of the action ???

Not worth two cents

twocents

Tell everyone denying you pain management/relief

WITHOUT MY NECESSARY MEDICATION… MY QUALITY OF LIFE IS NOT WORTH TWO CENTS

Number of people diagnosed with addictive personality increasing faster than counselors to treat

Shortage Of Addiction Counselors Further Strained By Opioid Epidemic

http://www.npr.org/sections/health-shots/2016/02/24/467143265/shortage-of-addiction-counselors-further-strained-by-opioid-epidemic?sc=17&f=1001&utm_source=iosnewsapp&utm_medium=Email&utm_campaign=app

Burnout and low pay can make it tough to retain counselors in the field of addiction services. "You take on your clients' pain," explains one former counselor.

Gary Waters/Ikon Images/Corbis

As the drug-related death toll rises in the United States, communities are trying to open more treatment beds. But an ongoing labor shortage among drug treatment staff is slowing those efforts.

Each year, roughly one of every four substance-abuse clinicians nationally chooses to leave the job, according to recent research. And that’s not just turnover — leaving one job for another in the same field. As an Institute of Medicine report documented in 2006, there’s been a shortage of addiction workers for decades. And the demand is only increasing; the Affordable Care Act and other federal laws have given millions more people insurance to help them pay for those services. If only there were enough counselors to treat them.

Amelie Gooding runs Phoenix House in Keene, N.H., and says she’s been short a full-time counselor for a year and a half.

“Everybody thinks, ‘Oh, there aren’t enough beds!’ ” Gooding says. “But there’s not enough treatment staff to open more beds.”

Because she’s understaffed, Gooding has to leave three of her 18 residential beds empty, and she cut her outpatient groups down to 50 percent capacity.

So where have all the counselors gone?

“For me, it got to be too heavy,” says former counselor Melissa Chickering, who used to work for Gooding at the Phoenix House and still lives in the area.

Clinical directors would give their right arm to hire someone with Chickering’s long resume, Gooding says. She has a master’s degree in social work and 10 years of experience. Instead, the valued counselor now spends her days teaching courses in psychology and health sciences at local New Hampshire colleges.

The problem with addiction treatment, Chickering says, is you take on your clients’ pain. Plus, she says, she found the lack of funding and coordination from the state criminal.

She remembers a particularly bad time when she was running an addiction program for teenagers.

“I had open beds,” she says. “But a girl came in and was on the waiting list — she just didn’t have the right funding.” Because of the rules, Chickering had to reserve empty beds for clients who had a different kind of health insurance than the girl in front of her had.

“So she died while she was sitting on the waiting list,” Chickering remembers. “And I went home that night, and I was like, ‘I had an open bed!’ How do you sit with that and be OK the next day?”

The problem isn’t just burnout, other addiction counselors say, though the job entails many late nights and loads of paperwork. The biggest problem, they say, is the low pay — addiction counselors earn an average of about $40,000 a year, according to the Bureau of Labor Statistics.

Anne Herron leads workforce development for the federal Substance Abuse and Mental Health Administration — the agency that oversees services for the treatment of substance abuse. Federal officials are well-aware of the counseling shortage and are working on it, Herron says. Her agency is reaching out to high schools and colleges, developing training curricula.

Those initiatives are a start, she says, adding, “We would like to see more.”

Becky Vaughn, an executive with the National Council for Behavioral Health, an industry group for state associations of addiction services, says she would like the federal government to reimburse tuition for people who are taking courses in addiction treatment.

In the meantime, the directors of a few clinics in New Hampshire say that the expanded coverage for addiction services that has come with Obamacare is already boosting counselor salaries. Staff will come, these employers say, if the clinics have the money to pay them.