The Spiritual Dımension

This medical examiner sounded an early warning about the opioid crisis. Now in a new role, hes doing something about it

- Dr. Thomas Andrew

FOR TWO DECADES, I WORKED AS what I call an accountant of America’s opioid crisis. From 1997 to 2017, I was the chief medical examiner for the state of New Hampshire. I oversaw autopsies. My department’s job was to determine and officially certify the cause of death.

New Hampshire is a small state. In 1997, the population was almost 1.2 million. (It’s a little more than 1.3 million now.) When I started as chief medical examiner, the department saw roughly 30 to 40 drug-related deaths per year. Then, suddenly, in the early 2000s, after pharmaceutical companies began heavily marketing opioid pain medicines, the number of drug deaths shot up to 200 per year. They kept climbing. By 2015, they were at 439 per year. Last year, 487 people in New Hampshire died from drug-related causes. That’s more than one drug-related death per day. A one thousand percent increase in two decades. One thousand percent!

I learned to recognize the telltale signs of opioid abuse. Needle marks. Bruising in areas associated with injection. Inflamed or damaged sinuses from snorting drugs. Signs of respiratory failure—most overdose victims die from lack of oxygen to the brain.

I did my job with professionalism and medical objectivity. But the work took its toll. I’m a Christian, strongly influenced by my upbringing and youth spent as a Boy Scout. I believe in serving others. Examining the bodies of overdose victims, I often felt helpless. I could determine how people died. I couldn’t stop the deaths from happening.

I told myself when I took over my department that I would stay in the job no more than 20 years. In my view, public servants shouldn’t consider their jobs lifetime appointments. Organizations need new leadership to change and grow. I knew I would retire in 2017.