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Even with the total number of opioid-related overdoses dropping in Nashua and Manchester, the number of overdose deaths continues to rise, based on figures released Tuesday.

Nashua saw a 16 percent increase in opioid deaths in May, according to data from ambulance company American Medical Response (AMR). Manchester is holding steady at last year’s record-breaking death total.

Fentanyl fuels the crisis that is engulfing the Granite State, said Chris Stawasz with AMR.

“The high death rate per capita is attributed to synthetic fentanyl, which is now found in all types of illicit substances,” Stawasz explained. “People who are using illicit substances have no idea that what they are using contains synthetic fentanyl or how potent the synthetic fentanyl in the product is. Synthetic fentanyl can be lethal the first time you use it, knowingly or unknowingly.”

Where those drugs are coming from is not a mystery. While the bulk of the fentanyl and methamphetamines reaching New Hampshire originate in Mexico, plenty of illegal drugs are crossing the border from Canada, too.

Last month, federal agents arrested 31 people in the North County near the Canadian border who were allegedly engaged in large-scale drug trafficking. Agents seized 14 pounds of fentanyl and another two pounds of methamphetamine in the operation. 

Republican Gov. Chris Sununu has been pushing for another $1.4 million to beef up border security in New Hampshire, something Democrats have opposed. 

Sununu announced Monday that he would not run for president, but he is considering a run for an unprecedented fifth term as governor. Sununu told Drew Cline the opioid epidemic is something GOP presidential candidates who come to New Hampshire should focus on.

“I think there’s a big winning issue with mental health and opioids and drugs; we’ve made many strides here,” Sununu said.

Asked about the ongoing opioid epidemic in her city, Manchester Mayor Joyce Craig declined to respond. Craig has formed an exploratory committee for a possible run for governor next year. NHJournal also contacted her potential opponent in the Democratic primary, District 2 Executive Councilor Cinde Warmington, about the latest opioid statistics. She, too, declined to respond.

The opioid problem is serious across the state, as highlighted by AMR’s statistics from New Hampshire’s two major cities. Medics responded to 80 suspected opioid overdoses in May — 58 in Manchester and 22 in Nashua. There were 11 suspected opioid deaths in Nashua and Manchester in May;  seven deaths in Manchester and four in Nashua.

There have been 358 opioid overdoses in Nashua and Manchester through the end of May, with 53 suspected opioid overdose deaths. There were 32 in Manchester and 21 in Nashua.

In Nashua, suspected opioid overdoses are trending 17 percent lower than last year annually. However, suspected fatal opioid overdoses are trending 16 percent higher, according to AMR. Some 25 percent of all suspected opioid overdoses in Nashua this year have been fatalities.

In the past few months, Sen. Maggie Hassan has called for building more of former President Donald Trump’s border wall, supported a “racist” policy to block asylum seekers, and promoted more fossil fuel production — all positions that anger progressives. She is facing zero competition for the Democratic nomination.

Gov. Chris Sununu signed a budget last year that cut taxes, created Education Freedom Accounts, and blocked government agencies from using race-based CRT content. And for his trouble, he is facing five GOP primary opponents.

And that, political observers say, is the difference between New Hampshire progressives and far-right conservatives: Conservatives fight and progressives tweet.

New Hampshire progressives went after Hassan on Twitter again last week, for example, accusing the Democratic incumbent of hurting minority communities because of her stance on immigration. 

But so far, the same progressive community has failed to hold Hassan to account in real life.

Using news that racist flyers targeting immigrants were being distributed in Nashua, activist Asma Elhuni called out Hassan for her record on immigration.

“People are saying no to hate because of a racist flyer against immigrants in Nashua. We need this same pushback against @SenatorHassan. Her policies are actually more dangerous than fliers that incite violence. She is actually causing violence,” Elhuni claimed.

Progressives like state Rep. Maria Perez (D-Milford) have been trying for months to speak with Hassan about her position on Title 42 and her newfound support for building a wall at the southern border to no avail. Activist Alissandra Rodriguez-Murray said Hassan is basically running for re-election as a member of the GOP.

“Unfortunately, @Senator Hassan has chosen to run as a Republican in Dem clothing. For months constituents have begged her to hear us on this issue and she has refused, pandering instead to racists who demand ‘border control.’ We will not sacrifice our people for her reelection,” Rodriguez-Murray said on Twitter.

Even New Hampshire Quakers, famous for their pacifist beliefs, are hitting Hassan hard for her immigration platform. The American Friends Service Committee called on Hassan to rethink her stance on Title 42, which allows the United States to expel immigrants and those seeking refuge as asylum seekers.

“@Maggie_Hassan, asylum seekers and other immigrants are our family members, our neighbors, and our community members; your actions should be in service to, not in opposition to, their well-being, their rights, and their dignity,” the Friends wrote on Twitter.

Hassan opposes lifting Title 42, a move President Joe Biden wants to make saying that it would harm security at the border.

“Repealing Title 42 without a plan in place will do nothing to promote a responsible border policy that keeps our country safe and lives up to our humanitarian values. I urge my colleagues to join us in supporting this bipartisan bill, and I look forward to hearing directly from border agents during my trip to the border this weekend about what additional steps the administration must take to strengthen border security,” Hassan said in a statement.

Hassan took flak for a spring trip to the Southern border where she shot campaign videos calling for tighter security. She even said the border needs more “physical barriers,” aka “The Wall.”

“It’s very clear the administration needs to address certain gaps in the physical barriers along the border,” Hassan said.

And still — no progressive challenge.

U.S. Rep. Chris Pappas has been even more open in his rejection of progressive policies, but like Hassan, he has yet to pay a price. Pappas supports increased fossil fuel production, has broken his “no fossil fuel” campaign money pledge, and opposes Biden’s student debt bailout — a touchstone of progressive politics. And yet he doesn’t face a primary challenge or significant public criticism from the Granite State left.

The fact that Democrats like Hassan and Pappas are not facing a primary opponent — or even serious discussion of a primary challenge earlier in the cycle — has observers saying there is no progressive movement in the Granite State. Former congressman and outspoken progressive Paul Hodes doesn’t agree.

“If you take a look at many of the younger Democrats who are coming up, and you read the blogs, and you read Twitter, and you follow social media, there is a strong progressive movement that is in line with New Hampshire’s independent and quirky politics,” Hodes told NHJournal during a recent podcast. “But it’s fair to say the more moderate wing of the Democratic party has had more [electoral] success.”

Meanwhile, progressives continue to avoid criticizing their fellow Democrats in the press. Neither Elhuni nor Maggie Fogarty with the American Friends Service Committee responded to requests for comment. Rodriguez-Murray responded by saying she refuses to speak to NH Journal.

“Please remove me from your contact list,” she wrote in a message.

Rodriguez-Murray is angry over NH Journal’s coverage of her Twitter comments referring to Jewish people as termites.

Other progressives are practicing their own form of avoidance. Environmental activist group, 350 NH, for example, is skipping endorsements for federal races this election cycle rather than being forced to denounce Democratic lawmakers like Hassan and Pappas for their embrace of fossil fuels.

That is in stark contrast to activists on the right. In 2016, when conservatives were upset with Republican Sen. Kelly Ayotte over her rejection of Donald Trump (among other issues), they ran two other candidates in the general election. Independent Aaron Day took more than 17,000 votes, and Libertarian Brian Chabot got more than 12,000 votes.

Ayotte ended up losing to Hassan by just 1,017 votes.

Progressives have an uphill battle winning in New Hampshire, according to Hodes. Even if New Hampshire voters want some change from their elected officials, most Granite Staters want incremental change, not the big, structural changes progressives favor.

“I’m not sure voters are that attracted or feel comfortable with wholesale change,” Hodes said.

Sen. Maggie Hassan was supposed to be talking up infrastructure spending during President Joe Biden’s visit Tuesday. But she spent much of her day dodging protests from Granite State progressives and members of the local Latino community. They are upset by Hassan’s reversal on immigration policy and a video she released standing in front of Trump’s border wall calling for more “physical barriers.”

Protesters gathered or posted signs at various spots along Hassan’s route in Portsmouth as she traveled with the president. “Hassan + Pappas, NH Welcomes Immigrants,” one sign read. One of the organizers is Rep. Maria Perez (D-Milford), who resigned from the New Hampshire Democratic Party’s Latino Caucus last week in protest of Hassan and Rep. Chris Pappas (D-N.H.) announcing their support for Title 42. That is the emergency authorization used to turn away more than one million undocumented migrants at the border last year.

“No cages, no walls! @SenatorHassan and @ChrisPappasNH We need a real plan to increase capacity and resources to manage the needs of migrants seeking entry at the border, not a continuation of racist, misguided and inhumane policies,” Perez tweeted from the protest.

Progressives who have worked for Hassan in the past have denounced her new, more pro-enforcement policy positions on immigration.

Perez said Tuesday afternoon she has not been able to speak to Hassan about her recent call for more barriers on the border, and other right-leaning policies the senator has adopted in a tough election year.

“The response that I got from her office is that she’s too busy,” Perez said.

Hassan tried using her trip to the southern border to shoot campaign videos in which she unconvincingly promised to get tough and push for more physical barriers. Hassan repeatedly voted against funding a border wall when Donald Trump was president — the same wall she used as a prop in her video, with barbed wire hanging over her head.

Granite State immigration activists were irate. “That was the last kick in the butt for the immigrant community, and all of us as Latinos,” said Eva Castillo, executive director of the New Hampshire Alliance for Immigrants and Refugees. Some progressives called on Hassan to apologize.

Hassan has refused. She also refused to respond to requests for comment from NHJournal.

Perez said immigrant advocates want to express their views to her in person, but Hassan is avoiding them. She plans to keep up the pressure until Hassan responds in some way.

“I’m not taking a no from her office anymore. A lot of people in the community have been so disappointed. We’re just asking for time to talk to her and she’s refusing to meet with us. She’s too busy to meet with us, but she’s not too busy to go to the border,” Perez said.

Clifton West, Jr., a founder of Black Lives Matter’s Seacoast chapter, also protested the two Democrats’ actions, urging them via Twitter to “support immigrant communities and stop hijacking COVID relief funds to support a Trump policy, Title 42. New Hampshire residents stand in solidarity with migrants’ rights to seek asylum.”

The Title 42 issue puts Hassan and Pappas at odds with Biden. Both members of Congress back legislation to block the administration’s plan to end the policy. The progressive action group Rights and Democracy is demanding the two New Hampshire lawmakers “remove their co-sponsorship from bills that would indefinitely block asylum access for immigrants at the U.S. border, as President Biden finally moves to end harmful, racist Title 42.”

Perez said members of the Latino community are also being ignored by Pappas and his team as well.

“I’m a Democrat. But with everything going on these days, I’m embarrassed to call myself a Democrat,” she said.

Sen. Maggie Hassan may have thought a photoshoot in front of Trump’s border wall was smart politics. But for members of the New Hampshire Democratic Latino Caucus, it was the last straw.

“That was the last kick in the butt for the immigrant community, and all of us as Latinos,” said Eva Castillo.

Castillo is executive director of the New Hampshire Alliance for Immigrants and Refugees and, until recently, a high-profile member of the New Hampshire Democratic Latino Caucus. But on Tuesday she and several of her fellow leaders in the Latino community sent the caucus a joint letter of resignation from the caucus to state party chair Ray Buckley over the behavior of Hassan and fellow Democrat incumbent Rep. Chris Pappas.

“For many years, we have struggled, unsuccessfully, to have our voices heard; this has never been made clearer than by the recent comments and position taken by Sen. Maggie Hassan and Congressman Chris Pappas concerning immigration,” they wrote. “We take from these signals that our community does not matter, and that immigration and humanitarian steps are only welcome when white refugees are in need; when black and brown asylum seekers come needing shelter, we start to demand more ‘border security.’

“The dangerous rhetoric and its accompanying attitude is something we expect from the New Hampshire Republican Party and their fear-mongering slew of candidates, but when one of our Democratic leaders acts in the same way, we must draw a line,” they added.

The letter was signed by Castillo, caucus vice-chair Sebastian Fuentes, delegate at large Marcus Ponce de Leon, and state Rep. Maria Perez (D-Milford).

“It’s pretty pathetic they are using immigrants as tokens,” Castillo told NHJournal.

Their anger is in response to the two Democrats’ support for keeping Title 42 authority in place at the border. That authority, put in place by the Trump administration when the COVID-19 pandemic began, has been used to turn away some 2 million would-be border crossers. Liberals and progressives say they want to end it. Pappas and Hassan say they want to keep it.

And that is not all. Both Democrats are talking up border security as a priority. Despite having repeatedly voted against funding a border wall, Hassan is now touting her support for “physical barriers” in a video on Twitter.

Castillo said Hassan’s video was an example of shameless pandering, as was her call for more “barriers” at the border.

“What, are you going to put up hedges?” she asked.

On Jack Heath’s radio show Wednesday morning, Pappas repeated his support for keeping Title 42 in place. “I think the administration has to be mindful of what their plan is to make sure the border is safe.”

Castillo said Pappas and Hassan’s move to the right on immigration makes no sense. No Republican was going to vote for either candidate, she said, and their maneuvers are now alienating the progressive voters they need.

“They’re not getting any votes from Republicans,” Castillo said.

She was not the only Granite State progressive upset by their behavior.

Rep. David Meuse (D-Portsmouth) was shocked by Hassan’s “Trump Wall” video and he called on the senator to apologize.

“106 secs of posturing and ingratiation to an audience unlikely to vote for her has left Sen. Maggie Hassan with thousands of bridges to repair not only to Latinos—but to every NH ally who has supported compassionate immigration reform. Make this right @SenatorHassan,” he tweeted.

Outspoken progressive firebrand state Rep. Sherry Frost (D-Dover) joined him.

“I stand in complete solidarity with my immigrant brothers, sisters, & others. I know this isn’t a new (gross) position for @SenatorHassan but I hoped she could change. I have no idea why @ChrisPappasNH is following along.”

Hassan and Pappas’ shift to the right on the border makes little sense to Republicans, either.

“Pretending to support a wall at our southern border won’t prevent the political walls from caving in on Maggie Hassan,” NRSC chair Sen. Rick Scott (R-Fla.) told NHJournal. “As someone who voted with Joe Biden and Chuck Schumer three times to defund wall construction last year, Maggie Hassan’s 2021 actions speak louder to New Hampshirite voters than any 2022 words or border visits will. That’s why Granite Staters will send a Republican to the U.S. Senate to replace her.”

A New Hampshire GOP strategist who spoke to NH Journal on background pointed out the reaction from progressives was not merely grousing. It was planned.

“The thing that really stuck out to me wasn’t the fact that the letter went out, it was the coordination and public anger afterward. People like David Meuse, Sherry Frost, and Wendy Thomas — well-known officials in New Hampshire Democrat circles — took to Twitter and publicly excoriated Hassan and Pappas for the decision, choosing to stand with the Latino Caucus instead of their vulnerable incumbent federal delegation.

“When Hassan and Pappas need these folks’ support down the line, you can bet they won’t answer the phone,” the strategist said.

Representatives for Pappas and Hassan did not respond to a request for comment on Wednesday. So far, New Hampshire Democratic Party Chairman Raymond Buckley is silent as well.

The U.S. Department of Justice charged five men from different states last month with being part of a $12 million drug-smuggling scheme, selling prescription drugs and steroids largely manufactured outside the United States.

But those men weren’t selling dope on street corners or in the local gym. They were doing it the 21st century way:

Online.

They were dealing on two different web domains— www.ExpressPCT.com and www.ExpressPEDS.ws. The drugs they sold needed supervision under a licensed practitioner, but the sites did not require prescriptions for purchase, the indictment said.

Now seized by the federal government, the sites were accessible — not via the Dark Web or secret log on — but by a simple Google search.

“Right now, you could google Percocet or Xanax and more than likely over half of those first-page search results would be an illegal pharmacy,” said  John Hertig, professor of pharmacy practice at Butler University. According to Hertig, fake pharmaceutical websites like those two are not in the minority. Of the 35,000 online pharmacies, only 5 percent are operating legally, according to the Alliance for Safe Online Pharmacies.

Fake pharmacies are not looking to give consumers a good deal. United to Safeguard America from Illegal Trade spokesman Matt Albence said the sites are operated by drug cartels — some with ties to terrorism.

“They aren’t bound by any regulations or laws,” Albence said. “They have no care or concern for the individuals who may drastically suffer from utilizing their products.”

In 2017, 42 percent of consumers looked online for prescription medication, according to a study conducted by Hertig. Three years later, amid the pandemic, 78 percent of consumers were buying medications online.

With the boost in medical e-commerce, there is a great need for education not just for consumers, but for our health care professionals too, Hertig added. A 2021 published study revealed that over half of pharmacists could not confidently identify an illegal pharmaceutical site. The SAGE Publications study also revealed that 75 percent of pharmacists did not feel confident in directing patients to resources available for finding safe online pharmacies.

The fake pharmaceutical sites are counterfeiting everything from Viagra to Adderall, and consumers have no idea if what they are getting is safe, according to Hertig.

In 2021, the Drug Enforcement Agency seized enough fentanyl to provide a lethal dose to every American.

Targeting high schoolers and college-age kids, drug traffickers have also turned to social media platforms to sell recreational synthetic drugs. Marketed as MDMA or Xanax, those drugs end up being laced with fentanyl, Albence said.

Deaths tied to Fentanyl-laced pills have been connected to Snapchat in 17 states, according to the Partnership for Safe Medicines.

With the internet, there is no longer a need for a street drug dealer, said Kari Kammel with the Michigan State University Center for Anti-Counterfeiting and Product Protection.

“If you have someone based in China putting together counterfeit Xanax and lacing it with Fentanyl they can sell directly to consumers in small packages,” Kammel said. “Customs isn’t getting them through shipments in big sea freights. You don’t have drug-sniffing dogs looking for a small envelope package.”

Awarded a $1.75 million grant, UC San Diego professor Tim Mackey co-founded S-3 Research to combat drug traffickers on social media platforms and search engines — including Snapchat.

Drug traffickers will use keywords to attract consumers, and it is S-3 Research’s job to flag those sites and accounts. With drug traffickers constantly changing keywords, Mackey says platforms must work together.

“This is not one platform’s problem, it’s a whole ecosystem’s problem,” Mackey said. “Drug sellers are not just on one platform, they’re on multiple platforms. If you take them down on one platform, it doesn’t really impact their ability to reach customers.”

Sharing data — like certain keywords and how these keywords are changing over time — is crucial, Mackey said.

Cooperation between the private sector and law enforcement agencies is key, Albence said.

“There has to be a commitment by the social media platforms to participate and provide information to law enforcement so they can take the required action against these illegal actors.

While combating the cartels on the internet, the Southwest border must not be forgotten, Albence said.

“The cartel creates vulnerabilities,” Albence said. They will send 150 to 200 people across the border in a desolate location knowing that it will take up all the resources of the Border Patrol agents, allowing them the opportunity to smuggle their contraband.”

And now with a simple Google search, hashtag, drug cartels have direct access to consumers.

“I’ve talked to a number of families where their kids have died,” Hertig said. “They didn’t mean to do anything wrong, and they had no idea fentanyl was in the product. It was the night before an exam, and they never made it out of their room.”