Recent threats to government-funded healthcare programs could jeopardize a years-long reduction in New Hampshire overdose deaths.
While the number of opioid-related fatalities in the state showed consistent decline through May of 2025, recovery advocates note that funding cuts and changing requirements have the potential to reverse those positive strides.
Overdose fatalities across New Hampshire have fallen steadily since 2022, according to a report released by the New Hampshire Department of Health and Human Services (DHHS). A growing prevalence of overdose-reversal medications, like NARCAN, and recent legislative changes at the state level have contributed to the downward trend.
Deaths peaked at 486 in 2022, then fell in 2023 and continued to fall to 287 in 2024 — a 40% drop over the two-year period. The numbers continued their decline into 2025. Only 77 deaths were recorded through mid-May of this year, as compared to 122 deaths by mid-May last year.
“It’s really important to note that this isn’t just a one-year decline,” said Jake Berry, the vice president of policy at New Futures, a nonprofit health policy organization. “We’ve been seeing not just steady decline, but rapid decline over the last three or four years.”
Those who have worked hard to see these trends finally move in the right direction don’t want to lose any ground.
“Nothing is slowing down for us, that’s for sure,” said Michelle Lennon, the president and CEO of New Hampshire’s four Archways recovery centers. “What is very frightening is the pullback of resources. There’s a lot of concern that we’re just going to see the numbers get worse.”
Inside the effort
The encouraging drop comes thanks to a continued joint approach between the state and nonprofit partners.
“Going back to the beginning of the opioid crisis, New Hampshire was kind of caught flat-footed. We didn’t have systems in place, and we didn’t have the resources that we needed at the time,” Berry explained. “New Hampshire has been working really hard over the last 10 years to establish a treatment and recovery system to really help get services to people who need them where they’re at, and I think that so much of that is coming to fruition.”
One of those changes was the 2024 decriminalization of fentanyl and xylazine test strips, which allowed nonprofits to provide open guidance on avoiding laced substances.
State agencies also worked to increase the availability of naloxone (NARCAN) and nalmefene (Opvee), both of which save lives by temporarily reversing the effects of an opioid overdose. The public can pick up the medications at any of the nine Doorways locations throughout New Hampshire, and both are typically available with or without prescriptions at local pharmacies.
New Hampshire began using federal funding from State Opioid Response grants to purchase NARCAN in 2018. Five years later, it became the first state in the country to launch widespread placement of Naloxboxes. Last January, the state’s DHHS authorized pharmacies to begin dispensing nalmefene.
Fatalities have fallen with additional access to both medications, but they cannot reverse the effects of non-opioid overdoses, including cocaine.
In the first half of 2024, deaths involving cocaine accounted for 11% of all overdose fatalities. So far in 2025, that number has jumped to 18%. The percentage of deaths related to opioids fell from 79% to 68%.
According to Lauren McGinley, the executive director of the New Hampshire Harm Reduction Coalition, medication makes up just one part of a successful response to drug abuse.
“The reasons that people use drugs, or the reasons that people are experiencing fatal or nonfatal overdoses, are composed of a whole lot of different factors,” McGinley explained. “I do think that these numbers are reflective of increased availability of Naloxone coupled with really great emerging practices and policies and changes that our state has made in the way that we are supporting the whole person.”
Even with positive changes, overdose hotspots remain active throughout the state. Manchester and Nashua, New Hampshire’s two largest cities, tallied the most drug-related deaths through May of 2025, with nine apiece. Concord, Pembroke, Allenstown and Northfield all recorded between one and five.
The state saw a blip between April and May when the total drug overdoses and abuse incidents logged by emergency responders increased by 24.1%. Still, the total number of drug overdose and abuse incidents has fallen by about 15% each year since 2022, according to the most recent report from the New Hampshire Drug Monitoring Initiative (DMI).
Hillsborough County continued to account for the most drug-overdose incidents and deaths. Between January and May, Manchester recorded 144 suspected opioid overdoses and 17 suspected opioid overdose-related deaths. Nashua totaled 69 suspected opioid overdoses and 14 suspected opioid overdose-related deaths in the same time frame. Those numbers may be under-reported, since neither city submitted full EMS records.
Within Merrimack County, Concord, Franklin and the growing town of Hooksett recorded the highest number of both EMS drug overdose/abuse incidents and NARCAN administrations between June 2024 and May 2025. Over the past two years, rates of both have fallen by about 37%.
Increased emphasis on treatment and recovery has further supported the decline in overdose and drug abuse incidents, experts say.
Can it last?
The state of New Hampshire currently funds 20 recovery community centers, including an Archways location in Concord. These peer-run and peer-led agencies provide a variety of services to individuals recovering from substance misuse, from coaching and telephone support to mutual aid groups and family support programs.
“We have had more organizations focusing on prevention and recovery,” said Kate Frey, vice president of advocacy at New Futures. “When somebody overdoses, if they are brought to the hospital or to the doorway, they are connected with resources to help them if they choose to stick with treatment and take the next steps into recovery.”
Total treatment admissions in the state fell by roughly 7% from April to May of 2025, but they have remained fairly constant over time. Across the past year, the number of admissions per 100,000 people rose and fell from month to month, but overall stayed fairly constant.
Those ages 30-39 and 40-49 continued to seek treatment most frequently, with males tending to do so at slightly higher rates than females.
Lawmakers have recently proposed diverting some of the state’s recovery-center funding to close budget gaps. Interference with New Hampshire’s treatment systems could negatively impact the trends outlined in DMI’s report.
Those in the treatment space also fear the impact of federal changes to government-funded healthcare programs, such as Medicare and Medicaid. Work requirements and higher premiums could impact access to both providers and those seeking recovery.
“Most of our treatment providers, especially those who are providing treatment to people who are on Medicaid, who are at the greatest need, are our nonprofit healthcare providers,” Berry said. “Some of these changes to Medicaid that we’re seeing make them extremely vulnerable.”