New Hampshire leads the nation in overdose deaths per capita from fentanyl, a powerful synthetic opioid that has virtually replaced heroin across New England. Because fentanyl is so potent, the risk of overdose is high. In New Hampshire, which President Trump has called a “drug-infested den,” the opioid crisis is almost a statewide obsession, the New York Times reports. An astonishing 53 percent of adults said in a Granite State poll last year that drugs were the biggest problem facing the state, the first time in the poll’s history that a majority named a single issue as the most important. While West Virginia leads the nation in overall drug overdose deaths per capita, New Hampshire is essentially tied with Ohio for second place.
Unlike West Virginia, New Hampshire is relatively prosperous, which makes an opioid crisis seem all the more jarring. The state has the nation’s highest median household income, ranks low in unemployment and crime, and often lands at or near the top of lists of the best states in which to live. Researchers at Dartmouth College say one reason the state’s opioid problem is so dire is the proximity to an abundant drug supply in Massachusetts, the center of drug distribution networks that traffic opioids throughout New England. Another is New Hampshire’s low per capita spending on services to help drug users break free from addiction. The state has pockets of “economic degradation,” especially in rural areas where jobs are few. New Hampshire doctors have long prescribed “significantly higher rates” of opioid pain relievers, almost twice the national average. “This is a kind of perfect storm,” says Lisa Marsch, a professor of psychiatry and health policy at Dartmouth’s Geisel School of Medicine.