New Hampshire achieved its lowest opioid overdose numbers in a decade during 2025, marking what state officials are calling a turning point in the battle against the drug crisis that has plagued the Granite State for nearly ten years. According to data released by American Medical Response and the Office of the Chief Medical Examiner, the state's coordinated approach combining aggressive law enforcement with expanded recovery services appears to be working. Manchester recorded 371 suspected opioid overdoses in 2025, representing a 30 percent reduction from 2024 and a 54 percent decrease over the past two years.
Nashua saw 155 overdoses, a 16 percent decline from the previous year. Both cities hit their lowest annual totals since AMR began tracking overdose data in 2015. "With our coordinated approach to fighting the drug crisis, New Hampshire is a model for fighting addiction and saving lives," Governor Kelly Ayotte said in a statement. "We're going to continue to strengthen drug trafficking and prevention efforts while making sure people in recovery get the compassionate care they need."
The improvements represent 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.
Statewide overdose death data tells an equally encouraging story.
In 2024, approximately 287 people died from drug overdoses, according to a New Hampshire Fiscal Policy Institute study—a 33 percent decrease from the 431 deaths recorded in 2023. Preliminary data from the first half of 2025 showed an estimated 77 drug-related deaths, down from 122 during the same period in 2024. Opioid-specific deaths declined 35 percent from 2023 to 2024, outpacing the national rate of decline over the same period, according to the Office of the Chief Medical Examiner.
Chris Stawasz, Regional Director at AMR, attributed the declining numbers to systematic coordination. "The continued decline in opioid overdoses reflects a well-coordinated, rapid public-safety response, widespread naloxone use, and immediate connections to proven recovery care," Stawasz said.
A cornerstone of New Hampshire's strategy has been Operation Granite Shield, a grant-funded law enforcement initiative that provides local and county police departments resources to identify, investigate, and apprehend individuals involved in drug trafficking. The program's companion Northern Shield initiative focuses on cross-border coordination, particularly with Massachusetts communities like Lawrence.
In the fiscal year of 2025, the program funded 10 law enforcement partners and 30 agencies statewide. Multi-jurisdiction operations under Granite Shield have resulted in hundreds of arrests and significant drug seizures. One coordinated effort involving 88 law enforcement agencies resulted in 151 arrests and the seizure of more than 551 grams of heroin and fentanyl – worth approximately 18,000 doses with a street value exceeding $22,000 - along with 24 weapons and $37,000 in cash.
Granite Shield operations continue to produce results. During a one-month period ending in May 2025, Nashua Police arrested 14 people on drug-related charges. Similar operations throughout the year have consistently disrupted trafficking networks feeding New Hampshire's drug market.
Law enforcement efforts represent only half of New Hampshire's equation. The state has simultaneously expanded access to medication-assisted treatment, recovery support services, and harm reduction programs. The Governor's Commission on Addiction, Treatment, and Prevention has provided $74.3 million over the past decade to support these initiatives. New Hampshire has also invested settlement funds from pharmaceutical companies in case management for incarcerated individuals, additional recovery centers, and social workers embedded in correctional departments and police stations. Through 2025, the state had spent approximately half of the $95.8 million received through opioid settlement agreements.
Manchester Mayor Jay Ruais, who identifies as a person in long-term recovery himself, emphasized the human dimension behind the statistics. "Every life lost is a tragedy, and we are blessed to have so many committed partners like AMR, the Manchester Health Department, the Manchester Fire Department, the Manchester Police Department and more leading the way to combat addiction," Ruais said. "We are deeply grateful to all the heroes working tirelessly every day to help those struggling to find recovery."
Despite the progress, public health officials caution that New Hampshire's drug crisis is far from over. Fentanyl remains the most commonly involved substance in overdoses, and the state continues to rank among those with higher-than-average overdose death rates nationally. The age group most affected by drug overdose deaths remains adults aged 30-39, accounting for nearly 32 percent of all fatalities in recent data.
Males comprise approximately 70 percent of overdose deaths, reflecting national patterns. Additionally, uncertainty around federal funding threatens some support programs. The recent turmoil over SAMHSA grants, which were briefly canceled then reinstated, illustrated the vulnerability of federally-funded mental health and addiction services that many New Hampshire organizations rely upon.
State officials have pledged to build on 2025's progress by continuing Operation Granite Shield and Northern Shield, while maintaining $10 million in funding for uncompensated care provided through Community Mental Health Centers. Governor Ayotte emphasized the ongoing nature of the fight.
"Together, we will keep working to get this deadly poison out of our communities and help Granite Staters seeking treatment for substance use disorders," she said.
For New Hampshire, the 2025 statistics represent validation that a coordinated approach addressing both supply and demand can produce measurable results. Whether the state can sustain and build upon these gains will depend on continued funding, coordination between agencies, and political will to maintain comprehensive strategies that treat addiction as both a public safety and public health crisis.
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