New Hampshire's Opioid Deaths Hit a 10-Year Low—Here's What Actually Worked

New Hampshire achieved its lowest opioid overdose numbers in a decade during 2025, with deaths dropping 33% from 431 in 2023 to approximately 287 in 2024. The state's coordinated approach combining aggressive law enforcement with expanded recovery services appears to be working, offering a potential roadmap for other states battling similar crises.

What Made New Hampshire's Strategy Different?

Unlike approaches that focus solely on treatment or enforcement, New Hampshire tackled both supply and demand simultaneously. Manchester recorded 371 suspected opioid overdoses in 2025, representing a 30% reduction from 2024 and a 54% decrease over the past two years. Nashua saw 155 overdoses, a 16% decline from the previous year—both cities hit their lowest annual totals since tracking began in 2015.

"The continued decline in opioid overdoses reflects a well-coordinated, rapid public-safety response, widespread naloxone use, and immediate connections to proven recovery care," said Chris Stawasz, Regional Director at American Medical Response.

How Did Law Enforcement Target Drug Trafficking?

A cornerstone of the strategy was Operation Granite Shield, a grant-funded initiative that gave local and county police departments resources to identify and apprehend drug traffickers. The program funded 10 law enforcement partners and 30 agencies statewide in fiscal year 2025.

The results were substantial. One coordinated effort involving 88 law enforcement agencies resulted in:

• Arrests: 151 people taken into custody on drug-related charges
• Drug Seizures: More than 551 grams of heroin and fentanyl seized, worth approximately 18,000 doses with a street value exceeding $22,000
• Weapons Confiscated: 24 weapons removed from circulation
• Cash Seized: $37,000 in drug proceeds confiscated

What Recovery Services Did New Hampshire Expand?

While cracking down on supply, the state simultaneously expanded access to medication-assisted treatment, recovery support services, and harm reduction programs. The Governor's Commission on Addiction, Treatment, and Prevention provided $74.3 million over the past decade to support these initiatives.

New Hampshire also invested settlement funds from pharmaceutical companies strategically, spending approximately half of the $95.8 million received through opioid settlement agreements on case management for incarcerated individuals, additional recovery centers, and social workers embedded in correctional departments and police stations.

"With our coordinated approach to fighting the drug crisis, New Hampshire is a model for fighting addiction and saving lives," said Governor Kelly Ayotte. "We're going to continue to strengthen drug trafficking and prevention efforts while making sure people in recovery get the compassionate care they need."

This represents a dramatic turnaround for a state that once ranked among the nation's hardest hit by the opioid epidemic. In 2017, New Hampshire experienced 490 drug-related deaths, with opioids accounting for 424 of those fatalities, placing the state in the top five most affected per capita nationwide.

Despite the progress, challenges remain. Fentanyl continues to be the most commonly involved substance in overdoses, and adults aged 30-39 still account for nearly 32% of all overdose deaths. Males comprise approximately 70% of overdose deaths, reflecting national patterns.

The state plans to build on 2025's progress by continuing Operation Granite Shield and maintaining $10 million in funding for uncompensated care provided through Community Mental Health Centers, demonstrating that sustained investment in both enforcement and treatment can produce measurable results.