CONCORD, N.H. -- New England is in the grips of an opioid drug epidemic, and a medical examiner who's been on the job for two decades says it's hard to separate accidental overdoses from cases of suicide.

Dr. Thomas Andrew has spent much of his medical career calling attention to the issue. He said in the 20 years he has been New Hampshire's Chief Medical Examiner, he has seen overdose deaths increase by 1,000 percent. With so many people dying of opioid overdoses, he said it's hard to determine how many actually intended to take their own lives.

"Last year, [there were] over 500 people - in a state that used to see 40 drug deaths a year,” Andrew said. "How many of those drug deaths are truly accidental, and how many represent intentionally self-destructive acts? It's beyond my ability to tease out. "

As Dr. Andrew put it, he works "at the end of the pipeline" in the epidemic. Opioid overdoses were up 25 percent in New Hampshire in 2016. And unless someone leaves a suicide note or other evidence is found, he said the vast majority of opioid-related deaths are classified as accidental.

Andrew added that New Hampshire ranks close to the bottom among states for access to addiction treatment. He said he thinks it is a factor not only in overdoses, but in addicts' decisions to end their lives.

“Once productive people who find themselves out of control, unable to get the help that they need for various and sundry reasons; and that leads to suicides by other means - whether it's, you know, hanging or gunshot, or what have you,” he said.

Andrew said lawmakers both in New England and at the federal level are starting to pay attention. But for too long, he said opioid addiction was viewed as a problem that happened to "other people."

"If we had that kind of 1,000 percent increase in homicides or traffic deaths, or asthma deaths, or breast cancer, people would be out there marching in the streets,” he said. "Well, they finally are now, regarding these deaths."


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More than 1,000 family members of firefighters who died in the line of duty, including some from Texas, will gather in Emmitsburg, Maryland, starting this Friday, to honor their loved ones.

The occasion is the National Fallen Firefighters Memorial Weekend and 13 of the firefighters being honored are from Texas.

Victor Stagnaro, CEO of the National Firefighters Foundation, said their names will be added to a memorial wall.

"Every firefighter that's died in the line of duty since 1981 has their name inscribed on a bronze plaque that's mounted on a marble wall," Stagnaro explained. "The monument itself at the center is a marble sphere, I would say, and there's a flame that never goes out."

Fire chiefs from around the country will present the families with a rose, a badge and an American flag flown at the U.S. Capitol and the memorial site. Anyone who would like to honor the firefighters can participate in "Light the Night for Fallen Firefighters," this Wednesday through Sunday night, by lighting their homes, businesses and other landmarks with red lights, or by signing a virtual remembrance banner on the foundation's website.

The Foundation was formed in 1992 to not only honor those firefighters who pass away but provide support for their relatives. Through a "Fire Hero Family Network," survivors are matched with others who have similar experiences and circumstances. Stagnaro pointed out assistance is available for however long it's needed.

"We continue to support those families -- through scholarships, through wellness conferences, we have kid's camps -- all other types of activities to help support those families throughout the year," Stagnaro outlined.

He added relatives of people honored in previous years will be in attendance this weekend to offer support to those who are just beginning their journey. This year's tribute is for 226 fallen firefighters nationwide.


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Rates of suicide among young people have increased by about 36% in roughly the last two decades and the surge has caught the attention of federal policymakers.

The Biden administration has a new National Strategy for Suicide Prevention and a Federal Action Plan, highlighting the need for a coordinated approach to prevention and equity in treatment and research. It follows the Bipartisan Policy Center's launch of a youth mental health task force in January.

Val Demings, co-chair of the Youth Mental Health and Substance Use Task Force and a former member of Congress from Florida, said in Sioux Falls last week rural communities face unique mental health challenges.

"For example, having access to care, the affordability of care, removing the stigma," Demings outlined. "You may be in a substandard educational setting. You may also have substance abuse, addiction in the household. And so we have got to, as a nation, deal with the social ills that cause decay in certain communities in the first place."

A big focus of the task force is a link between suicide and increased use of technology and social media. The U.S. Surgeon General said young teens who spend more than three hours a day on social media are at double the risk of mental health struggles, including depression and anxiety.

Technology can also be used to help deliver health care services in rural places. In 2021, the Helmsley Charitable Trust launched a virtual crisis care program in South Dakota, equipping law enforcement with iPads, so they can connect people with mental health professionals by video.

Walter Panzirer, trustee of the trust, has seen positive results.

"We had a 75% reduction of transports to the mental health facilities," Panzirer pointed out. "They were able to get care at home, locally; 25% of the calls were for youth."

People living in rural places are almost twice as likely to complete suicide than those living in large cities, according to the Centers for Disease Control and Prevention. The agency said South Dakota had the fifth-highest suicide rate in the country in 2021 at over 200 deaths.

If you or someone you know is in crisis, contact the Suicide and Crisis Lifeline at 988.

New continuing education classes can help New York psychologists better work with disabled patients.

The courses center on understanding disabilities - providing universal access for patients with disabilities, ethics, and cultural competence.

Sharon McLennon-Wier, Ph.D. - executive director of the Center for Independence of the Disabled New York - said in developing the curriculum, there were certain takeaways people should have.

"The first step really is for people to understand that a disability is a disability, and there are going to be barriers to the environment with it," said McLennon-Wier. "And we need to work together to ensure that each and every person has access to treatment."

Other takeaways are ensuring clinicians are aware of their expectations, noting they're not trained to work with every single client.

It's taken two years to get these courses up and running, and McLennon-Wier said she is eager to see how these will shape up.

The first course begins on May 29 and anyone interested can register online at www.cidny.org/ce.

There's also a hope psychologists will learn about confronting their stigmas toward disabilities.

McLennon-Wier said she feels this begins by looking through the lens of ableism. She said people should consider how they implement universal access for disabled patients.

"Does your biases prevent you from utilizing the knowledge of treatment that you have?" said McLennon-Wier. "Does it work with what's needed by that person who has a disability because first is the treatment practice, but also you have to understand the implications of disabilities."

Other considerations should be given to issues like the segregation disability creates. She said she thinks certain determinants of health like race and gender also impact a person's mental health.

Future classes could deal with different psychological treatments with an infusion of multicultural disability competence.