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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.”

N.H. Has America’s Third-Highest Jump In Suicide Rates

In the wake of the shocking suicides of celebrities like Anthony Bourdain and Kate Spade comes word that suicide rates are rising across the US.  According to new data from the CDC, suicide rates rose in every state except Nevada.  And one of the states with the highest increase in suicide deaths is New Hampshire.

According to the CDC, New Hampshire’s suicide rate jumped 48.3 percent from 1999 to 2016–the third-highest increase in the U.S.  Suicide is the second leading cause of death for young people in New Hampshire and eighth overall.

“Suicide rates in the United States have risen nearly 30% since 1999, and mental health conditions are one of several factors contributing to suicide,” the CDC report says. “Examining state-level trends in suicide and the multiple circumstances contributing to it can inform comprehensive state suicide prevention planning.”

New Hampshire does have a State Suicide Prevention Council and a State Suicide Prevention Plan. However, it also has one of America’s worst opioid-abuse rates and this may be contributing to the spike in suicide deaths.

According to the Washington Post, “the CDC has calculated that suicides from opioid overdoses nearly doubled between 1999 and 2014, and data from a 2014 national survey showed that individuals addicted to prescription opioids had a 40 percent to 60 percent higher risk of suicidal ideation. Habitual users of opioids were twice as likely to attempt suicide as people who did not use them.”

Will suicide become the “opioid addiction” of the next political cycle? President Trump, who focused on the opioid epidemic before any other national politician during the 2016 campaign, has already begun talking about suicide–particularly among veterans. But the issue is rarely mentioned in either the the New Hampshire governor’s race or the campaigns for New Hampshire’s two  congressional seats.

That may all change soon.

The Winners and Losers of the New Hampshire Legislative Session

It felt like the last day of school at the New Hampshire State House on June 22. Lawmakers were signing each other’s session books (the political version of yearbooks), shaking hands, and taking pictures together. It had been another eventful legislative session that saw many highs and lows for Gov. Chris Sununu, the first Republican in the corner office in 12 years.

The Republicans didn’t always get along during this legislative session. Remember the defeat of right-to-work legislation and the House failing to pass their own version of a budget earlier this year? Despite the varied ideological depth of the New Hampshire Republican Party, they were able to show they can work together and give Sununu some final wins at the end of the first year of the 165th General Court, including full-day kindergarten and a budget getting passed.

Now, the lawmakers head home for the summer months and it’s time to decide the winners and losers of the session:

 

WINNERS:

With his wife Valerie at his side Republican candidate for governor Chris Sununu speaks to supporters early in the morning Wednesday, Nov. 9, 2016, in Concord, N.H. Sununu said his race with Democratic challenger Colin VanOstern was too close to call. (AP Photo/Jim Cole)

Gov. Chris Sununu: As much as Democrats wanted Sununu to not do well his first term in office, several of his campaign promises and policy priorities made their way through the legislature and became law. One of his first wins in office came from the repeal of a license requirement for concealed carry firearms. It was something he said he would do on the campaign trail, and it got done within the first two months of his term.

That’s not to say that Sununu didn’t have some setbacks during the legislative session. The governor, who didn’t have prior legislative experience before taking office, saw the defeat of right-to-work under his watch and the House failed to pass a budget for the first time in recent memory. Some critics claim Sununu could have done more to get right-to-work passed, but the Republican infighting revealed a divided party that would prove difficult for GOP leadership to navigate.

With the budget, Democrats attempted to paint Sununu as not in control of his own party, but Sununu actually stood as the most to gain from the House’s failure. The House cut several of Sununu’s budget priorities in its version, but when the Senate drafted its own budget, it used Sununu’s proposal as a guide. What was ultimately passed at the end of June was a compromise of House, Senate, and Sununu’s priorities.

On the final day of the session, Sununu also saw the passage of full-day kindergarten and a key school choice bill. It might not have been a perfect process, but the governor saw several items from his policy wish-list reach his desk.

 

Marijuana: For several years, New Hampshire has been the only state in New England that still criminalized possession of small amounts of marijuana. For many lawmakers, they saw a connection between the rampant opioid crisis and marijuana being used as a potential gateway drug. Historically, the Senate has voted down various bills relating to looser pot laws, but advocates fought long and hard to see marijuana decriminalization passed. After compromising with the House on an amount, the Senate finally found a bill that it could handle.

In June, the legislature decriminalized three-quarters of an ounce of pot and Sununu signed it into law. Marijuana advocates applauded lawmakers for taking the first step, although they are continuing to work toward full legalization.

 

Libertarians: The Libertarian Party of New Hampshire had a banner election year in 2016. It obtained 4 percent of the vote in the gubernatorial election to qualify for the ballot in 2018. It also had three sitting lawmakers switch their party affiliations from Democrat or Republican to Libertarian. The last time the Libertarian Party had an official caucus in the State House was in the 1990s when it had four members.

While Libertarians haven’t been the deciding votes on any controversial bills during the session, it is clear that some members of the major parties are unhappy within their own caucuses. The Libertarian Party needs to garner 4 percent of the vote again in 2018 to remain on the ballot, but with political partisanship at an all time high, voters could see Libertarians as a more moderate choice. That’s how many Granite Staters felt when they voted for Libertarian presidential candidate Gary Johnson over Republican Donald Trump and Democrat Hillary Clinton.

 

 

Gov. Chris Sununu signs HB 262, declaring the common blackberry to be the berry of the biennium. (Image Credit: Gov. Chris Sununu’s office)

Blackberry and painted turtle: Every year, the state’s fourth graders learn how the state government works, and every year, legislation gets filed on their behalf. This year, lawmakers saw a bill from students at Simonds School in Warner naming the blackberry the official state berry of the biennium. It made its way through the House and Senate, and Sununu signed the bill in June.

Another group of students from Main Dunstable School in Nashua wanted the painted turtle to be the official state reptile for the biennium. That bill was also signed by Sununu.

It’s an annual tradition at the State House and while some lawmakers believe it’s a waste of time, some say it’s a good opportunity to get students involved and interested in the political process.

Of course, no one will forget the time in 2015 when students in Hampton Falls proposed making the red-tailed hawk the state raptor and a lawmaker suggested the creature would be a better mascot for Planned Parenthood. That became a national news story.

Luckily, no incidents like that happened this year. And Sununu enjoyed snacking on some blackberries with the fourth-grade students when he signed the bill into law.

 

LOSERS:

Democrats: The New Hampshire Democratic Party struggled to find its footing this year. For the first time since 2010, Democrats were fully the minority party in the State House — Republicans had majorities in the House, Senate, Executive Council, and the corner office. The party couldn’t decide if it wanted to work with Republicans or be the party of resistance to their agenda.

Their lack of a mission or agenda was evident in the legislature. While Democrats banded together to help defeat right-to-work and the House’s budget, there were times when some members disagreed with party leadership and voted their conscience. When it became clear that it was very likely that a budget wouldn’t be passed in the House, some Democrats advocated for at least passing something on to the Senate.

While Democrats have long pushed full-day kindergarten, they didn’t like that the final bill tied its funding to the lottery game Keno. Most Democrats voted against it, and that could be a major policy issue when they face reelection next year.

But the question still remains: will Democrats work with Republicans in the next legislative session in January or will they resist? National politics will definitely influence their decisions, and it will also be an election year. More partisanship is likely.

 

Right-to-work: The bill called for prohibiting unions from charging fees to nonmembers for the costs of representation, but even in a GOP-controlled legislature, Republicans couldn’t get the votes. A lot of different factors went into its defeat in the House, including disagreements between Sununu and House Speaker Shawn Jasper, as well as some Republicans who are part of unions or know people in unions. This was a major bill that some lobbyists and advocacy groups pushed for, including the Koch-funded Americans for Prosperity-New Hampshire. Simply, the votes were not there and lawmakers voted to not bring up the issue again until at least 2019, but expect to see another bill if the GOP retains its majority in the legislature.

 

Transgender advocates: A controversial gender identity nondiscrimination bill was tabled in the House, much to the dismay of transgender advocates. The bill would have prohibited discrimination based on gender identity, extending gender identity the same protections under state law that exist for age, sex, sexual orientation, race, or creed. The protections would have applied to discrimination in housing, employment practices, and public accommodations.

House Speaker Shawn Jasper and other members of the GOP leadership sought to kill the bill, or at least get it off the agenda for the session. Their issue with the legislation mirrors the Republican opinion at a national level — the bill would have allowed transgender people to use the restrooms of their choice.

Advocates are hoping the bill could be resurrected next year.

 

Opioid crisis: The drug epidemic still has its grips on the Granite State, which is ranked as the second hardest hit state by per capita overdose deaths in the nation. Lawmakers passed some bills to help curb the crisis, but as with any legislative process, it can take a while for treatment and recovery centers to receive the necessary funds to make a difference.

The state is also now dealing with the rise of carfentanil, a synthetic opioid that is 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. There’s still a backlog at the state’s crime lab to investigate due to the increase in the number of drug overdose deaths.

While lawmakers seek political solutions for ending the crisis, advocacy groups say more creative solutions are needed, but it appears that the end of the epidemic is still not in sight.

 

UNDECIDED:

House Speaker Shawn Jasper (Photo Credit: Speaker Shawn Jasper Facebook page)

House Speaker Shawn Jasper and House Freedom Caucus: The conservative caucus threatened to kill the state budget unless their priorities were included. None of its members were on the conference committee to have a say in final negotiations, but House Speaker Shawn Jasper reached out to members to market the budget as a conservative one. Ultimately, some House Freedom Caucus representatives voted for the budget due to its inclusion of anti-abortion language and business tax cuts. But, Jasper’s control over the speakership is still in question. With defeats of right-to-work and a House budget, some representatives are questioning his ability to lead. If the GOP retains control in the House, expect several people to challenge him in 2018 to be speaker.

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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.”

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Grandfamilies in New Hampshire and What They Have to Do With the Opioid Crisis

One of the big agenda items that passed the House on Thursday was a bill with an amendment that would appropriate $33 million in the current fiscal year to address a projected shortfall at the state Department of Health and Human Services. That was just the amendment, though. Lawmakers tacked it on to a bill that would give preference to grandparents to be the guardian of a child in certain cases, like when a parent has a substance abuse disorder.

The House overwhelmingly voted to concur with the Senate on House Bill 629. It passed on a 283-32 vote. It now heads to Gov. Chris Sununu for his likely signature.

Most of the fanfare over the passage was because of the emergency DHHS funds. Yet, thousands of Granite State grandparents are victims of the drug crisis after they have been called on to raise their grandchildren.

“I am pleased that the House today overwhelming approved HB 629. With this legislation New Hampshire is leading the way in giving grandparents a voice when it comes to the guardianship process in cases dealing with substance abuse,” said bill sponsor Rep. Mariellen MacKay, R-Nashua. “This important legislation will keep children out of the foster care system and allow them to stay with their families. HB 629 is about love, passion, family, and just doing the right thing, and I couldn’t be more proud to see this bill overwhelmingly pass the legislature.”

HB 629 places the burden of proof on the petitioner to demonstrate that grandparent guardianship is in the best interest of the child in situations that were brought on due to a parent’s substance abuse. It establishes a preference for grandparents to be appointed as guardians and makes benefit eligibility information available on the DHHS website, as well as to grandparents seeking guardianship over their grandchild.

New Hampshire social service agencies estimate that 10,000 grandparents are now full-time guardians of young children, mostly because of the drug epidemic. Nationwide, there were 2.882 million kids being cared for by their grandparents, which was up from 2.871 million in 2011, according to the Annie E. Casey Foundation.

“A lot of these grandparents are on fixed income, and they’re taking on a responsibility, and for a lot of them, it’s a hard financial responsibility,” said Keith Kuenning, director of Advocacy for Child and Family Services.

Applying for guardianship can involve many steps, and navigating state programs for food stamps and Medicare only adds to the confusion in what can be an overwhelming process for many people.

A Pew Charitable Trusts report released in November found that 21 percent of grandparents caring for grandchildren in the United States are living below the poverty line. In addition, about 39 percent are over the age of 60 and 26 percent have a disability.

Gail Snow, an administrator with the state’s Bureaus of Child Protection and Juvenile Justice Services within the Division of Children, Youth and Families, said the division removes kids from their parents in some abuse and neglect cases, which are often linked to substance abuse issues, but not always.

“We only remove children when it would not be safe for them to remain in their home,” she said. “As a division, when we remove a child…we look toward relatives to provide care, and grandparents are often the people who step up.”

The problem with the current law is that it calls for immediate protection for the child, but also requires that courts and child welfare agencies protect the sanctity of the home. That’s why Chris Wade, who is a grandparent raising his grandchild, is supportive of HB 629.

“[I]t allows us to not have to be put through the ringer to protect our grandchildren,” he told the Associated Press. “It means we can go to the judge and, if the parents want that child back after we have gone through guardianship, then it’s up to that parent to be able to prove that they are worthy of having their child back. ”

The bill also has the backing of New Futures, a nonprofit organization that focuses on the opioid crisis and its effects on children. They support it because “it provides support for children in crisis and families suffering from the opioid epidemic, encouraging healthy early childhood development.”

While this is a first step in understanding the relationship of grandparents, parents, and children who are impacted by the opioid epidemic, the New Hampshire Legislature is also looking to establish a study commission to really get the full picture.

Senate Bill 148 would establish a commission to study “grandfamilies ” in the state and would gather families, legislators, and advocacy groups to review what data exists for them, what challenges exist, and what solutions can be carried out at the policy level.

“When this happens, grandparents face specific challenges such as getting children into schools, securing the appropriate legal status as a guardian, and providing the child all they need to thrive,” said bill sponsor Sen. Martha Hennessey, D-Hanover, in February before the Senate approved the measure.

“[It] can also place a financial burden on the grandparents who are often on a fixed income,” she added, “This commission would ensure there are resources in place to help these families and to make sure the children have the care they require to thrive.”

SB 148 also passed the House earlier this month and now waits for Sununu’s signature.

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Price, Conway Visit New Hampshire to Reaffirm Trump’s Commitment to Ending Opioid Crisis

The latest stop in Tom Price’s opioid crisis listening tour brought the health and human services secretary to the New Hampshire State House on Wednesday. He wasn’t alone, though. Always near him was Kellyanne Conway, counselor to President Donald Trump. They were joined by Gov. Chris Sununu, state Health and Human Services Commissioner Jeffrey Meyers, and Democratic U.S. Rep. Annie Kuster of New Hampshire, among other treatment providers, law enforcement, first responders, and families who have been impacted by the substance abuse crisis.

The meeting in Concord only lasted about an hour and members of the press were not allowed to be in the Executive Council chambers where the listening session took place. Afterwards, Price and Conway went to Manchester Fire Department to learn about the city’s Safe Station program. Press were also kicked out at first, but were then invited back in.

At a press conference after the listening session, Price said solving the opioid crisis is a priority for the Trump administration and his visit was a chance to see how states are dealing with it at the ground level.

“The Department is all in, the President is all in,” he said. “He has such passion for this issue, because he knows the misery and the suffering that has occurred across this land, and wants to help, help solve it.”

Price points to the recent $3.1 million in funds — with more money on the way — being sent to New Hampshire as evidence of the administration’s commitment to getting more resources out into the field.

Yet, more funds are needed for the Granite State, which has the second-highest overdose deaths per capita in the country. Nearly 500 people have overdosed on drugs in 2016. New Futures, a nonprofit focused on the opioid crisis, released a report Monday that found substance misuse costs the state’s economy about $2.36 billion each year.

Sununu praised the White House for its “tremendous” effort in reaching out to the states to see what they think of certain policies and solutions to combat opioid misuse.

“This administration has provided a great philosophy in that they want to set a foundation and a platform for good policy out of Washington but they look to the states to implement it,” he said. “Unlike the previous administration where Washington was going to implement and control everything, they want the states to be the implementers.”

However, Democrats are blasting the U.S. House of Representatives’ passage of the American Health Care Act, which would make major changes to Medicaid expansion. Democrats argue that the bill would weaken funding for federal programs to battle the drug epidemic.

Just before Price and Conway’s arrival, protesters staged a “die-in,” laying on the floor in the hallways of the State House, holding up signs that said, “Trump lied, I died” and “I died for a billionaire’s caviar.”

Democrats held their own press conference while Price and Conway met with New Hampshire leaders, criticizing Sununu for holding a closed-door meeting.

“New Hampshire won’t stand for a plan where premiums skyrocket, benefits shrink, and thousands are booted off [health care] coverage,” said Senate Minority Leader Jeff Woodburn.

Price said Trump is committed “to make certain that every individual has access to the kind of coverage that they want for themselves and for their family.”

“I think it’s important to step back and say is the Medicaid program the most appropriate program for every individual in that economic setting,” he added. “Is there a better way to provide coverage? Is there a better way to provide services? Whatever the answer to that is the president is committed and we’re committed to making certain every single American has a seamless transition.”

He vowed “that nobody falls through the cracks. That no rug is pulled out from anybody and that we make certain that the coverage and the care is available to every single American.”

Sununu said he had “some severe reservations” about the House’s health care bill, but he appreciates “the progress the House made.”

“We have to move that ball forward,” he said. I do have reservations in some areas when you look at the details. But people have to understand this is simply one part of the process. The Senate is going to go through their process. It shows that Congress isn’t stalled, not stagnated. They’re not going to do nothing. I think we’ve had eight years of a lot of do nothing. They’re doing something and they’re standing up for the American people.”

Conway said the opioid epidemic should be a bipartisan issue that Democrats and Republicans solve together.

“We look at this as a non-partisan issue in need of a bipartisan solution,” she said. “And we are working with people on both sides of the aisle in Washington and within each of the states to do exactly that.”

However, there are instances of disagreement between Republicans, especially on the American Health Care Act. It also appears that New Hampshire leaders and the White House aren’t always on the same page.

Several media outlets reported that the Trump administration was contemplating a 95 percent cut for the White House Office of National Drug Control Policy (ONDCP), which houses the agency’s high-intensity drug trafficking program and drug-free communities support program. Officials dismissed the claims and reaffirmed Trump’s support for ending the opioid crisis. Sununu called the reports “very disconcerting.”

Price and Conway did not mention the national drug czar’s office during their visit. While New Hampshire is one of the hardest hit states of the drug epidemic, it appears an official from the state has not been invited to sit on the President’s Commission on Combatting Drug Addiction and the Opioid Crisis, leaving many to question how committed Trump is to fulfilling his campaign promise.

New Jersey Gov. Chris Christie is chairing the commission, and it was announced Wednesday that Democratic Gov. Roy Cooper of North Carolina, Republican Gov. Charlie Baker of Massachusetts, and former Democratic Rep. Patrick Kennedy of Rhode Island will also serve on the commission. Bertha Madras, a former deputy director of the Office of National Drug Control Policy, will also work on the commission, but no one from the Granite State.

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