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The Legislature will reconvene this month for a special session intended to address New Hampshire's substance abuse crisis. The Executive Council voted 4-1 Wednesday in favor of Democratic Gov. Maggie Hassan's call for a special session despite some Republican lawmakers' objections that the state shouldn't rush the legislative process. Among the efforts she has outlined are increasing penalties for dealing the prescription drug fentanyl, requiring state medical boards to revamp their rules for prescribing opioids and strengthening the state's prescription drug monitoring program. (11/4)

New Hampshire’s medical board adopted emergency rules for opioid prescribers Wednesday, but rejected many of the changes sought by Gov. Maggie Hassan. The rules take effect Friday and require doctors and nurses to use an “evidence-based screening tool” to assess patients’ risk of abuse, and to provide information on how to dispose of unused medication. (Wallstin, 11/4)

Testimony like that has motivated law enforcement across the country to start offering Vivitrol in jails and drug courts in recent years. Alkermes, the pharmaceutical company that manufactures Vivitrol, has donated doses of the drug to about 30 programs since the U.S. Food and Drug Administration (FDA) approved Vivitrol to treat alcohol addiction in 2006 (the drug was approved to treat opiate addiction in 2010). Many more programs have found funding elsewhere. Dr. Elina Chernyak helped get some free doses for the Rock Springs area earlier this year — enough to give 25 offenders like Largent a shot on their way out of jail, and a shot a month later. She said medically, Vivitrol is considered a “complete antagonist.” The drug binds with the brain’s opioid receptors and shuts them down, she said, which means that while the Vivitrol is active, opiate drugs and alcohol won’t make the patient feel high. Other opiate addiction medications can actually give addicts a buzz. (Bryan, 11/4)

In a small but growing number of places, people who land in hospitals after being revived by the drug are being guided toward long-term treatment. That's largely because decision makers have heard so many stories about people being brought back from the brink — sometimes repeatedly — and then turned loose to use again. The drug, pronounced nuh-LOX-ohn but often known by the brand name Narcan, is administered via shot or nasal spray and can almost immediately revive a victim of an overdose on heroin and its painkiller relatives, known as opioids. It's widely distributed to anyone likely to encounter an overdose victim, including police, paramedics and users' families. (11/4)

The United States' opiate drug problem isn't limited to illegal narcotics. The sale of dangerously addictive painkillers prescribed by physicians has quadrupled in the past decade, and one company in particular is pushing pain to the legal edge of aggressive medical marketing. (Gusovsky, 11/4)