inside sources print logo
Get up to date New Hampshire news in your inbox

In Manchester and Nashua, Fentanyl Death Toll Keeps Rising

Nashua and Manchester continue chasing a grim record as opioid-related overdose deaths continue to rise in the two cities. 

According to data released Thursday by ambulance company American Medical Response, there were 77 suspected opioid overdoses in Nashua and Manchester during September 2022 bringing the combined total for this year to 701.

And they warn there is no end in sight.

“Preliminary data show Nashua has experienced 33 suspected opioid-related deaths through September. That is 3 more deaths than during all of 2021,” said Chris Stawasz, Northeast Regional Director of Government Affairs for AMR. “Nashua remains on pace to have the highest number of suspected deaths from opioids in one year since the opioid epidemic began in 2015. Manchester is also still on pace to have the highest number of suspected opioid-related deaths in a one-year period since 2017.”

This year’s number of opioid-related overdose deaths is already close to last year’s totals. Manchester had more than 500 suspected overdoses in 2021, 30 percent more than the previous year, and Nashua had 250 suspected overdoses in 2021, which was 29 percent more than in 2020.

Stawasz said opioids like Fentanyl are not the only thing first responders are worried about. The growing prevalence of methamphetamines on New Hampshire streets is concerning, he said.

“Methamphetamine, which is not currently tracked and is not included in this report, continues to be seen mixed with opioids. Meth is a particularly dangerous drug for both users and first responders as it can cause extreme excited delirium and alarmingly unpredictable behavior in users,” Stawasz said.

Meth use has been linked to violent incidents in recent years, with several fatal police shootings involving people who were heavy meth users coming into conflict with police.

Both methamphetamine and fentanyl are coming over the Mexican border and making their way into New Hampshire, according to law enforcement. Mexican drug cartels are getting the necessary chemicals to make the deadly drugs from Chinese triads. The partnership extends to billions of dollars being laundered by the triads for the cartels, with the knowledge of China’s government.

The drugs continue to stream over the border, which has seen record numbers of people illegally crossing. The Border Patrol reports it apprehended 2 million people this year, the largest number of illegal crossings in history. That blows past last year’s figure of 1.7 million people coming over the border illegally, which was a record number at the time.

Democratic Sen. Maggie Hassan received testimony on the need to secure the border from national law enforcement officials during a hearing earlier this year. Jon DeLena, Deputy Special Agent in Charge of the New England Field Division for the DEA, testified regarding the danger posed by the cartels.

“The model of the drug cartels right now is simple. Relentless expansion and addiction. They simply don’t care if Americans die. They only want to reach more Americans in unprecedented ways. This is a moment in time, our moment where we have to do everything we can to reverse this deadly trend,” DeLena said.

 

EDITOR’S NOTE: This article has been updated to more accurately reflect the testimony offered by Mr. DeLena.

Report: Chinese Government Exploiting Southern Border to Feed Fentanyl Epidemic

An explosive report published in ProPublica links the official policy of China’s government to the fentanyl epidemic killing Americans, including a record number of Granite Staters. And Granite State GOP opponents of President Joe Biden’s border policy are pointing to it as more proof it is time to make a change in Washington.

ProPublica released a story last weekend by reporters Sebastian Rotella and Kirsten Berg about a Chinese American gangster named Xizhi Li who came to dominate the money laundering market for Mexican drug cartels. The ruthless cartels are making billions sending fentanyl and other drugs to users in the United States and beyond through the porous Southern border.

“At no time in the history of organized crime is there an example where a revenue stream has been taken over like this, and without a shot being fired,” retired DEA agent Thomas Cindric, a veteran of the elite Special Operations Division, told ProPublica. “This has enriched the Mexican cartels beyond their wildest dreams.”

Since 2006, China has exported more than $3.8 trillion through money laundering schemes according to the report. China now leads the world as the primary financial underwriter for the cartels.

According to ProPublica, the Chinese government certainly knows that its citizens around the globe are involved in money laundering for the cartels and it approves.

With a major world power now suspected of using America’s unsecured southern border to attack the United States, Republicans like retired Gen. Don Bolduc are laying the blame at the feed of Biden and his Democratic allies, including his opponent Sen. Maggie Hassan.

“It’s no secret the drug crisis is plaguing New Hampshire communities and families, exacerbated by the open-border policies supported by Sen. Hassan,” Bolduc’s spokesperson Kate Constantini told NHJournal. “Drugs are pouring in and killing Granite Staters while Sen. Hassan is hiding in her safe and cushy D.C. office. Parents across the country now have to worry about telling their own children they can’t eat Halloween candy because Democrats like Sen. Hassan continue to stay soft on crime and drugs.

“We’ll gladly compare our vision for a secure border and strong communities over Sen. Hassan’s pathetic record any day.”

The issue is more problematic for Hassan because she sits on the powerful Homeland Security Committee which has direct oversight of border security policy.

Former senior FBI official Frank Montoya, Jr. told ProPublica China supports the money laundering business which props up the cartels as part of a policy to further weaken the United States.

“We suspected a Chinese ideological and strategic motivation behind the drug and money activity,” Montoya told ProPublica.

He offered this rationale to ProPublica for the Communist government’s policy.

“To fan the flames of hate and division. The Chinese have seen the advantages of the drug trade. If fentanyl helps them and hurts this country, why not?”

The Hassan campaign did not respond to a request for comment. But in the first U.S. Senate debate of the general election Tuesday, Hassan insisted she supports “a secure, orderly and humane border,” and that she supports additional “physical barriers,” aka “a wall.”

But as a senator, Hassan repeatedly voted against funding the border wall former President Donald Trump tried to build while he was in office. And she opposes deporting illegal immigrants who successfully make their way into the nation, also known as “interior enforcement.” 

Karoline Leavitt, in an apparent neck-and-neck race with incumbent Democrat Rep. Chris Pappas, also blames her opponent for the border problem.

“With each passing day, Chinese fentanyl continues to be smuggled across our wide-open southern border. Our families and communities are being poisoned by this dangerous drug, and we cannot afford another weak leader in D.C. who will act as if this problem isn’t occurring,” Leavitt said. “We need a representative who will work with law enforcement to secure our communities and stop this dangerous drug from pouring into our state.”

Pappas also did not respond to a request for comment.

Both Pappas and Hassan heard testimony earlier this year from national security officials who testified that Chinese triads are supplying Mexican cartels with the chemicals needed to make fentanyl. Those drugs are making their way into New Hampshire with deadly consequences.

New Hampshire’s two largest cities, Manchester and Nashua, are on target for record opioid overdose deaths this year, thanks to the fentanyl flooding the streets. According to American Medical Response, a large ambulance company that services New Hampshire, opioid deaths continue to rise.

Data for August, the most recent set available, show Nashua has seen 32 suspected opioid-related deaths, topping last year’s 30 opioid deaths.

“Nashua remains on pace to have the highest number of suspected deaths from opioids in one year since the opioid epidemic began in 2015,” AMR states in its monthly report.

Manchester is on pace to have the highest number of suspected opioid-related deaths in a year since 2017, with more than 71 opioid deaths projected for the year. As of the end of August, the Queen City has 45 suspected opioid overdose deaths on record.

As Pols Debate Border Security, NH Opioid Deaths Climb

The rate of overdose deaths from the opioid epidemic continues to climb in Manchester and Nashua, with both cities approaching record deaths this year. And Republicans are pointing a finger at President Joe Biden’s border crisis.

According to Chris Stawasz with American Medical Response, first responders were called to 86 suspected opioid overdoses in Nashua and Manchester during July 2022, bringing this year’s total to 539. That is 99 more incidents than the same period last year, a 23 percent increase.

Nashua is on track to have the highest number of opioid deaths in a year since the start of the pandemic. Manchester is looking to break the record it set in 2017.

“Preliminary data shows Nashua has experienced 29 suspected opioid-related deaths through July. There were 30 suspected opioid-related deaths in Nashua during all of 2021. Nashua remains on pace to have the highest number of suspected deaths from opioids in one year since the opioid epidemic began in 2015. Manchester is still on pace to have the highest number of suspected opioid-related deaths in a one-year period since 2017,” Stawasz said.

There were 10 likely opioid-related deaths in July, eight in Manchester, and two in Nashua. Their causes are still pending verification from the Office of the New Hampshire Chief Medical Examiner. 

Republicans note the surge in unlawful border crossings since Biden took office and the flood of fentanyl across the southern border.

So far this year, United States Customs and Border Patrol has seized about 133,000 pounds of methamphetamine at the border, compared to more than 8,000 pounds of fentanyl, and 50,000 pounds of cocaine.

National Republican Congressional Committee spokesperson Samantha Bullock says voters should hold elected Democrats like Reps. Annie Kuster and Chris Pappas to account.

“Chris Pappas and Annie Kuster have buried their heads in the sand to avoid addressing Democrats’ southern border crisis that’s allowing deadly drugs to destroy New Hampshire communities.”

A spokesperson for the House Republican Conference reiterated that point to the Washington Examiner.

“Joe Biden’s open-border policies have plunged our southern border into absolute chaos. It is a fact that Biden’s fentanyl crisis is directly a result of his border crisis, as the illegal drugs pour in over the wide open southern border,” the spokesperson said.

In New Hampshire’s two largest cities, Stawasz says first responders are dealing with people overdosing after they use drugs that they did not believe were opioids.

“AMR medics continue to see and listen to reports from suspected opioid OD patients who believed they were not specifically using opioids and were surprised that they overdosed on an opioid,” Stawasz said.

Stawasz told Democratic Sen. Jeanne Shaheen during a July roundtable that dealers are putting potentially deadly doses of fentanyl into other drugs and selling them to unsuspecting users.

“I personally have experienced several occasions on a call when someone we’ve woken up from an opioid overdose will insist, ‘I was not using an opioid, I’m not an opioid user. I smoke marijuana. But I bought it from a different person.’ I think that’s contributing to an increased number of deaths,” Stawasz said.

July also saw an increase in the number of patients treated who reported or were suspected of consuming methamphetamine. Methamphetamine use numbers are not currently tracked and are not included in this report. Meth is a particularly dangerous drug for both users and first responders as it can cause extremely excited delirium and alarmingly unpredictable behavior in users.

Methamphetamine is seen by federal law enforcement as a growing problem in New Hampshire. It is coming into the United States in the same way as fentanyl, largely from Mexican cartels who smuggle the drugs over the border. 

 

The Number of NH Opioid Overdose Deaths Keeps Climbing

The opioid addiction crisis in New Hampshire continues to worsen as Nashua and Manchester recorded another month of increased overdoses and deaths. 

According to Chris Stawasz, Northeast Regional Director of Government Affairs with Global Medical Response, Nashua is expected to have a record number of deaths this year.

“Nashua is still on pace to have the highest number of suspected deaths from opioids since the opioid epidemic began in 2015,” Stawasz said.

Through the end of June, Nashua and Manchester have seen a 20 percent increase in opioid overdoses from the same time last year. In the two cities alone, there have been 453 overdoses in the first half of 2022 and 45 suspected overdose deaths. The two cities typically have among the highest rates of overdoses and overdose deaths in the state.

Nashua currently has 27 suspected opioid overdose deaths this year. In 2021, the city recorded 30 such deaths. If the addiction crisis continues at that pace, Nashua will likely have a record 55 deaths this year, according to projections. In Manchester, the projection expects 59 opioid deaths, the highest total since 2018.

State and federal law enforcement is working to stop the flow of drugs into the state. Michael Garrity, the director of communications for the New Hampshire Department of Justice, said the state Drug Task Force goes after dealers at all levels.

“The NH DOJ continues to work with its local, state, and federal law enforcement partners to investigate and prosecute individuals and groups who seek to traffic in opioids and perpetuate this epidemic within New Hampshire communities,” Garrity said. “Additionally, the Attorney General’s Drug Task Force works within local New Hampshire communities to target drug dealers, including opioid dealers, at all levels.”

Last week, the U.S. Justice Department announced a new New England Prescription Opioid (NEPO) Strike Force to combat the illegal use of prescriptions by doctors, pharmacists, and others in the medical field to distribute opioids. The strike force combines efforts in New Hampshire, Vermont, and Maine and will operate out of Concord.

But law enforcement in New Hampshire can’t control the southern border, where most of the fentanyl that reaches the Granite State originates.

Jon DeLena, Deputy Special Agent in Charge of the New England Field Division for the DEA, told Democrats U.S. Sen. Maggie Hassan,  U.S. Reps. Chris Pappas and Annie Kuster during a Homeland Security Committee presentation that Mexico is the key to the drug epidemic.

“It’s the goal of DEA always to try to map these networks and to take these investigations literally from Mexico to Main Street What we’re doing now in all 11 offices throughout Mexico is trying to target the highest-level violators within the Sinaloa Cartel and CJNG (Cártel de Jalisco Nueva Generación) who ultimately are impacting the East Coast of the United States more than anybody, and right here in New Hampshire as well,” DeLena said.

U.S. Customs and Border Protection have been making record seizures of drugs at the border, with a 1,066 percent increase in the amount of fentanyl seized in the last fiscal year in south Texas.

The means 87,652 pounds of narcotics, including 588 pounds of fentanyl, with a total street value of worth $786 million, were seized at eight ports from Brownsville to Del Rio, Texas, according to CBP. The street value of the drugs is worth $786 million.

Those seizures obviously have not stopped the drugs from getting into the United States and making their way to New Hampshire. Even though drug seizures are up, the border itself is less secure. According to CPB, illegal border crossing is up significantly.

“The number of unique individuals encountered nationwide in May 2022 was 177,793, a 15 percent increase in the number of unique enforcement encounters over the prior month,” according to the latest CPB report.

Fake Pharma Websites Bring Fentanyl Right to Your Laptop

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.”

What Factors Led New Hampshire to Be Ground Zero for the Opioid Crisis?

It’s a well-known figure that New Hampshire has the second-highest per capita drug overdose deaths in the United States, right behind West Virginia. The state also has the highest rate of fentanyl-related overdose deaths per capita, leading researchers, health care providers, first responders, and lawmakers to wonder what about the Granite State makes it one of the most ravaged by the drug epidemic.

That was the subject of a forum at Dartmouth College last month, which included Dr. Nora Volkow, director of the National Institute on Drug Abuse (NIDA) at the National Institutes of Health; Lisa Marsch, director of the Dartmouth Center for Technology and Behavioral Health (CTBH); and U.S. Rep. Annie Kuster, D-N.H.

“Not only did we want to bring together a broad group of stakeholders about the crisis in our communities, but we also wanted to have a discussion about the response to the crisis,” Marsch told NH Journal. “Why New Hampshire? What’s going on in New Hampshire that’s distinct and giving rise to it?”

To find out why the rate of opioid overdoses increased by nearly 1,600 percent from 2010 to 2015, the New Hampshire Fentanyl “HotSpot” Study was funded by the NIDA. The rapid epidemiological study focuses on the increase of overdoses from fentanyl, a drug that is 50 to 100 times more potent than heroin and often is mixed with heroin. In Phase I of the study, researchers spoke with medical responders, law enforcement officers, state authorities, and policymakers.

The study was conducted by the CTBH, in collaboration with the National Drug Early Warning System, and funded by the NIDA.

Marsch said they quickly realized that they needed to speak with opioid users to better understand the trajectory of fentanyl use, the tracking of the drug, and fentanyl-seeking behavior in order to effectively inform policy and community response.

Phase II was then commissioned to do just that. March’s team interviewed 76 opioid users, 18 first responders, and 18 emergency department clinical staff from six counties in New Hampshire during October 2016 to March 2017. The results of the study are not publicly available yet, but Marsch presented key findings at the forum.

The report found that the recent increase in the availability of fentanyl is because it is less expensive and quicker to take effect than heroin. However, the high doesn’t last as long and requires users to use more often, increasing the risk of overdose.

About 90 percent of the drug users interviewed for the study indicated they actively sought out drugs that would cause overdoses.

“We want whatever is strongest and the cheapest. It’s sick,” one respondent said. “I now me using, when I hear of an overdose, I want it because I don’t want to buy bad stuff. I want the good stuff that’s going to almost kill me.”

Marsch said the study allowed researchers to analyze “a whole array of factors that set up the perfect storm” for New Hampshire to be one of the hardest hit states by the opioid crisis. She said the Granite State consistently rates in the top 10 states with the highest drug use rates and opioid prescribing by doctors exceeds national averages.

 

New Hampshire is also in close proximity to a supply chain for the fentanyl drug in Massachusetts.

According to the U.S. Drug Enforcement Administration’s 2014 National Drug Threat Assessment Summary, most heroin supplies in the New England region are brought in from New York along the vast interstate highway system, naming I-95 and I-93 as the major routes for New Hampshire’s heroin traffickin. The report also named Lawrence, Mass. as a main distribution center for northern New England states.

The New Hampshire “HotSpot” Study pointed to these other factors contributing to the heroin and fentanyl crisis in the Granite State:

  • Treatment admission rates per capita are lower than both the national average and all other New England states
  • N.H. has the lowest per capita spending on treatment in all of New England and it’s the 2nd lowest in the nation
  • The state has the lowest rate of Suboxone, a medication used to treat opioid addiction, providers per capita in all of New England
  • Public health funding per resident is lower than the national average and surrounding states
  • N.H. is the only state in the Northeast with no needle exchange program (The legislature recently passed a bill legalizing the programs and Gov. Chris Sununu said he would sign it.)
  • The state’s rural setting keeps people in tightly knit social networks and has limited access of “things to do.”

“The economic factors, the rural nature, the politics, lack of resources, and the close proximity to the source of these drugs has created a really bad scenario for the state,” Marsch said.

In order to curb the alarming trend of opioid overdose deaths in the Granite State, the researchers suggested the state increase public health resources for substance use prevention and treatment, expand prevention programs in elementary and middle schools, assist physicians with understanding opioid prescribing, and collaborate with Massachusetts on addressing the manufacturing and trafficking of fentanyl and other opioids.

At the forum, Kuster, who co-chairs the House Bipartisan Task Force to Combat the Heroin Epidemic, said she was confident that Granite Staters’ “certain blend of tenacity and creativity” will help find solutions to this epidemic. Officials point to the Safe Station program, which allows anyone who is struggling with drug addiction to go to fire stations in the state to connect with recovery resources, as a New Hampshire solution to the drug epidemic.

Yet, Kuster was worried that it would be difficult to get more funding and resources under President Donald Trump’s leadership.

“We cannot get this job done without Medicaid expansion. I’m concerned about cuts for mental health and behavioral health services,” she said. “If they’re [Republicans] going to walk the walk, as they have talked about opioid addiction, they’ve got to fund the programs that will bring the services to our communities.”

Follow Kyle on Twitter.

Sign up for NH Journal’s must-read morning political newsletter.

Synthetic Opioid Carfentanil Enters NH. What Is It and Where Does It Come From?

New Hampshire became the latest state to have three residents die of overdoses from one of the most deadly opioid drugs in the world, adding to the growing list of communities nationwide trying to handle the crisis. Gov. Chris Sununu and public health officials announced last week that for the first time in the Granite State, the synthetic opioid carfentanil was found in the bloodstream of three people who died from overdoses in March.

Two of the deaths were in Manchester, and the third was in Meredith. The substance is so potent that it’s not intended for human consumption. It’s 100 times more potent than fentanyl and is commonly used to tranquilize elephants.

“Unfortunately, today is the first day that we’ve been able to confirm this,” Sununu said at a Tuesday press conference. “And worse yet, I think we all understand that it is likely not the last day that we talk about this issue.”

New Hampshire is the first New England state to have confirmed deaths from carfentanil and its effects are being felt by many key players in the opioid crisis, including public health officials, first responders, and treatment and recovery providers.

While these are the first confirmed cases in New Hampshire, the rise in carfentanil overdoses has been happening throughout the United States over the last few months. At least 96 heroin users overdosed in one devastating week in August in just one Ohio county, with several of the overdoses linked to carfentanil. In September, the Drug Enforcement Administration issued a nationwide warning about the powerful opioid.

Tom Pifer, forensic lab director for the N.H. State Police, said the drug was developed in the mid-1970s by a pharmaceutical company, but was never made public due to its high potency.

It takes just two milligrams of carfentanil to knock out a 2,000-pound African elephant. When veterinarians or zookeepers do that, they wear gloves and face masks to prevent exposure to the drug because a dose the size of a grain of salt could kill a person. A dose may even be lethal when absorbed through the skin or potentially through inhalation. That’s why the state asked law enforcement and first responders to stop field testing drugs. The problem is that users might not know they are even taking the drug since dealers have been cutting heroin with fentanyl or carfentanil to give it a boost and stretch their supply further.

“You cannot tell the difference between heroin and fentanyl and certainly not fentanyl and carfentanil,” Pifer told New Hampshire Public Radio. “You are literally rolling the dice with any sort of dosage unit you’re purchasing on the street.”

It’s not only incredibly powerful, but it’s also incredibly resistant to naloxone — also known as Narcan, the opioid antidote that can save someone’s life from a heroin overdose. A typical overdose requires one or two shots to work, but when a dosage is laced with carfentanil, it could require six or more shots to be effective — if it works at all.

Even though there is an abundant supply of Narcan in states battling the opioid crisis, an increase in carfentanil overdoses could deplete the antidote supply fairly quickly and drain money from states who need to purchase more. With drug overdose deaths rising, state crime labs could also see a backlog of cases to investigate. In New Hampshire, there are thousands of cases dating back from 2015 that have yet to be investigated.

A criticism in New Hampshire of government officials is that funding from the state and federal government to tackle the crisis has been slow to come out.

Congress signed the 21st Century Act in December, which would provide more funding to states for the opioid crisis. In April, U.S. Sen. Jeanne Shaheen, D-N.H., said $485 million in grants would soon be administered to states. It’s not clear exactly when that would happen.

New Hampshire is ranked as the second hardest hit state in the opioid crisis based on per capita deaths. Yet, it’s only supposed to receive $3 million out of the $485 million promised to states since the formula is based on total mortality. Shaheen is urging Trump’s administration to revise the funding formula for next year.

The other Democratic senator from New Hampshire, Maggie Hassan, and Shaheen wrote in a letter last week to U.S. Health and Human Services Secretary Tom Price that the formula should be re-tooled. Officials have indicated that they will review the formula and the two senators were optimistic after their meeting with New Jersey Gov. Chris Christie, who is heading President Donald Trump’s national opioid commission.

In March, Trump created The President’s Commission on Combating Drug Addiction and the Opioid Crisis with Christie at its helm to start fulfilling his campaign promise to end the opioid crisis.

Trump promised the people of New Hampshire that he would build a wall between the U.S.-Mexico border to curb the opioid crisis and stop the flow of drugs into the area.

“New Hampshire has a tremendous drug epidemic,” he said in October. “I am going to create borders. No drugs are coming in. We’re going to build a wall. You know what I’m talking about. You have confidence in me. Believe me, I will solve the problem. They will stop coming to New Hampshire. They will stop coming to our country.”

While heroin supplies mostly come from Mexico, synthetic opioids, like fentanyl and carfentanil, are believed to originate in China. Even though it’s illegal there, secret labs in the country manufacture the drug before shipping it to the United States. People can order it online, and it’s shipped through the U.S. Postal Service before it makes its way into the local heroin supply.

It’s still not immediately clear how the drug made it into New Hampshire. It’s likely that either someone bought it online, or it was purchased in another state and then followed the traditional route of heroin and fentanyl into the Granite State, which is from major distribution centers like Philadelphia and New York and then through Massachusetts.

Follow Kyle on Twitter.

Sign up for NH Journal’s must-read morning political newsletter.

 

The Facts Behind Sununu, Lawrence Mayor’s Fight Over Opioid Crisis

It’s not often where there is a war of words between a governor and a mayor of neighboring state. Yet, that’s what happened last week between New Hampshire Gov. Chris Sununu and Mayor Daniel Rivera of Lawrence, Mass., when discussing who’s to blame for the Northeast’s growing opioid crisis.

“It’s coming from Lawrence,” Sununu said Wednesday at the Greater Manchester Chamber of Commerce breakfast. “Eighty-five percent of the fentanyl in this state is coming straight out of Lawrence, Massachusetts.”

He also pointed to Lawrence again in an interview later that day with Boston Herald Radio, saying the city’s status as a “sanctuary city” is causing problems for New Hampshire.

Sununu said he had a meeting with other New England governors when they met in Washington D.C. for the National Governors Association annual winter meetings.

“I sat down with [Massachusetts Gov.] Charlie Baker and all the governors from the New England regions and said we’re going to cross borders, you better get ready,” Sununu said. “I’m working with the DEA [Drug Enforcement Administration] in Bedford, working with the DEA in Boston, our state police, their state police.”

Sununu then vowed that “we’re going in.”

“We’re going to get tough on these guys, and I want to scare every dealer that wants to come across that border,” he said. “We’re not giving dealers nine months on parole and probation anymore. We’re putting them away for the five, 10 and 15 years that they deserve.”

Sununu’s “tough on drugs” rhetoric makes sense — albeit an interesting political move to pick a battle with a town in another state. He’s the first Republican governor in 12 years and the opioid crisis is still rampant in New Hampshire. He campaigned on the epidemic being the number one priority the state faces and depending on what he does to curb the crisis in his two-year term, could be a factor in his 2018 reelection campaign.

Despite several media reports about the subsequent back-and-forth between Sununu and Rivera, there is some legitimacy in Sununu’s claim about Lawrence being a hot bed of activity for heroin and fentanyl.

Most of the heroin coming to New England originates in Colombia and travels through Mexico, according to a 2013 report from The New York Times. Despite an increase in the number of seizures along the southern U.S. border, enough is still getting through to major distribution centers, including Philadelphia and New York, which then makes its way into northern New England, “often through Lowell, Lawerence, and Holyoke, Mass.”

According to the U.S. Drug Enforcement Administration’s 2014 National Drug Threat Assessment Summary, most heroin supplies in the New England region are brought in from New York along the vast interstate highway system, naming I-95 and I-93 as the major routes for New Hampshire’s heroin trafficking routes. The report also named Lawrence as a main distribution center for northern New England states.

“Massachusetts also serves as a staging area or interim transportation point for heroin being transported north,” the report states. “Lawrence and Lowell, north of Boston, are distribution centers for northern New England and Canada. Maine, New Hampshire, and Vermont are supplied with heroin chiefly by drug groups in northeastern Massachusetts, particularly in Lawrence and Lowell.”

Western Massachusetts is one of the staging areas for distribution in Vermont, Maine, and New Hampshire because drug dealers from those states who want the product have to drive to Massachusetts to get it because drug penalties in Vermont, Maine, and New Hampshire are stricter in the three northern New England states.

Because Lawrence sits on the I-93 highway, police have said many drug deals occur at fast-food restaurants off the highway exits.

It is so widely known that Lawrence is a main distributor for the opioid crisis, that even Massachusetts Attorney General Maura Healey said it to the Times in 2016.

“Massachusetts is the epicenter for the heroin/fentanyl trade,” she said. “From Lawrence, it’s being trafficked and sold all over the New England states.”

For example, undercover detectives followed a car on a heroin buying mission from Manchester to Lawrence and back on Sept. 15, 2015, which resulted in one arrest.

Still, despite these reports and former statements that show Lawrence is a main distributor of heroin and fentanyl for New England, Rivera took offense that Sununu called out his city.

“Just like the President is finding out that health care is complicated, I think that the governor is going to find out that this is a complicated issue,” Rivera said in a hastily scheduled press conference on Thursday. “I’m not sure that he meant to threaten the sovereignty of the Commonwealth of Massachusetts, but he did.”

One of the major problems Rivera had was with Sununu’s claim that 85 percent of the fentanyl entering New Hampshire came from Lawrence.

“I would ask you guys to ask him where he got that number from,” he charged reporters. “I don’t know if it’s a true number. I think the problem is if you think like ‘oh you snuff out what’s happening in Lawrence, it will all go away.’ I know he’s only been on the job 60 days, but the reality is it’s like water, it will find another place to go.”

Rivera and Sununu eventually spoke on Thursday afternoon, and Sununu released a statement after the call.

“The Mayor and his local law enforcement personnel have been doing a good job on this issue, but we must recognize this is a cross-border problem that requires cross-border solutions,” Sununu said. “It has no geographic boundaries and it remains incumbent upon all of us to come together and work collaboratively across our borders along with federal, state and local law enforcement.”

Sununu’s office has not offered any evidence of his “85-percent” claim, but regardless, Lawrence’s role in the opioid crisis cannot be disputed.

Baker, the Massachusetts governor, weighed in on the controversy, and said, “I do view this as a problem that affects us all and I think singling out a single community or a single state is not accurate.”

New Hampshire Senate Democratic Leader Jeff Woodburn offered his two cents.

“Instead of antagonizing key regional partners in our collective fight to combat the devastating effects of the opioid crisis, Governor Sununu should be fighting for our state’s successful Medicaid expansion program which has helped over 100,000 Granite Staters gain access to mental health and substance abuse treatment,” he said in a statement. “New Hampshire needs steady and serious leadership from the Governor’s office that focuses on a holistic approach to solving this public health crisis, not reckless, cavalier comments.”

Follow Kyle on Twitter.