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One of Donald Trump’s first political successes was his embrace of the opioid addiction issue in New Hampshire during the 2016 campaign. Long overlooked, the scourge of addiction was hitting working-class Americans hard, with the Granite State suffering more than 300 drug overdose deaths in 2015.

In 2018, the data analysts at WalletHub ranked New Hampshire as having the third-highest drug use rate in the U.S.

But a decade after Trump came down the golden escalator and helped raise the profile of the opioid issue, New Hampshire’s fortunes have reversed. The latest WalletHub report, released Wednesday, ranks New Hampshire 11th best overall in terms of its drug problem. The report looks at factors like recovery availability, law enforcement efforts, and rates of addiction. Hawaii, Utah, and Nebraska were in the top three for states doing well, while New Mexico, West Virginia, and Nevada have the most dire drug addiction problems according to the report. 

“I think we’re doing significantly better,” said Chris Stawasz, regional director with ambulance company American Medical Response.

Only one New England state, Connecticut, has a lower rate of drug abuse than New Hampshire. Massachusetts and Maine rank 26th and 27th, respectively; Rhode Island comes in at 28th, and Vermont is last in the region at number 32.

Stawasz, who has been collecting and publishing overdose data from the cities of Manchester and Nashua for years, said data from this year is already showing a major improvement.

“Nashua and Manchester are at half of where we were a year ago, and statewide it’s down as well,” Stawasz said. 

Part of the credit goes to state government, where Gov. Chris Sununu led a bipartisan effort to make treatment more readily available to Granite Staters. Mental health and confronting addiction have been among a handful of issues where, despite some differences in approach, support for solutions has been strong on both sides of the aisle.

As a result, New Hampshire ranks 48th among states with adults whose drug-treatment needs are unmet, WalletHub reports.

In Manchester, which has been ground zero for the Granite State’s battle with addiction, Mayor Jay Ruais — who has struggled with his own addiction issues — says the battle has been hard fought. But, he told NHJournal, the results are undeniable as the number of fentanyl overdoses and deaths continues to decline.

“Trend lines have been extraordinarily clear,” Ruais said. 

Stawasz will release numbers for the first quarter of 2025 within the next few days, but he said Manchester and Nashua have seen at least a 50 percent reduction from the first quarter of 2024. The projections for the total 2025 number of overdoses and deaths could be their lowest in at least a decade. 

Getting from the worst of the opioid crisis to the recovery being seen today takes a combination of different people and agencies working on different aspects of the problem, Stawasz said.

“I can’t point to one specific item. There’s a lot of effort going into the recovery, prevention, and law enforcement.”

Focusing police agencies on busting fentanyl dealers and stopping the traffic of drugs coming up from Massachusetts has been a big part of the recent success, Stawasz said. Ruais said police are a major component of Manchester’s success in combating the epidemic, along with the city’s Rapid Overdose Assessment and Response (ROAR) Team, assembled to deal with different aspects of addiction.

“This is an entirely collaborative effort,” Ruais said. 

Now, the ROAR team can redouble efforts and hopefully get ahead before there is a next wave, Ruais said. The city can start looking more at prevention, targeting efforts to schools and youth in the city to keep them away from drugs. 

“We can further reduce these numbers so that a person never gets into an addiction,” he said. 

Hours before her termination hearing in front of Manchester’s Board of Aldermen, Housing Stability Director Adrienne Beloin took a deal to resign her post and end her public spat with elected officials.

Beloin walks away with a $57,000 payment, according to sources, after she spent weeks trashing board members in public when they began questioning her management of the city’s Beech Street shelter. Aldermen complained about Beloin’s condescending answers to their questions and her refusal to follow the board’s guidance.

When asked for comment, Mayor Jay Ruais’ office released a statement: “The personnel matter has been resolved, and the mayor has received Ms. Beloin’s resignation effective tomorrow, April 12, 2024. The mayor will not be commenting on personnel matters.”

Beloin refused to accept the board’s policy and said it lacked the necessary experience to set the agenda for her department.

“I know it’s very hard for you to understand what the work is that we’re doing, because this is not your field of work,” she told Aldermen at a public meeting last week.

Beloin doubled and tripled down, going to the media and blasting the board for pushing her out and claiming it lacked the expertise to instruct her regarding homeless policy.

At one point, she claimed the board giving her an office in the Beech Street shelter was retaliation.

Beloin’s lack of a permanent office in city hall was something she wanted corrected, but apparently balked when given an office in the shelter she oversaw.

While Beloin tried to turn the controversy into a personal issue between herself and individual board members, a source close to the negotiations told NHJournal the real problem came down to policy.

It was Beloin’s refusal to be accountable to elected leaders and to follow their policy directive that ultimately ended her tenure.

“This isn’t personal; it’s policy. She refused to do what the board wanted. What else were they supposed to do?” the source said.

Another city insider told NHJournal Beloin was protected by former Mayor Joyce Craig, who kept her away from aldermen who questioned how she did her job.

According to a report by the Union Leader, Beloin’s settlement included $27,064.36 in wages, $25,000 for compensatory damages, and $5,000 for attorney fees.

Manchester’s homelessness crisis, and Craig’s mishandling of that crisis, is seen as a primary reason for Ruais’ win in the mayoral race last year. The Republican ran on a promise of fixing the problem.

Beloin is now the city’s second Housing Stability Director to leave since the position was created a few years ago. The first director, Schonna Green, suddenly quit in 2022 after about a year and a half on the job, citing personal reasons.

Manchester’s homelessness crisis peaked in the winter of 2023 when a homeless woman gave birth to a child at an outdoor camp, and two people died in their tents. Homeless camps dominate parts of Manchester’s downtown, and those camps account for at least half of the city’s opioid overdose calls.

Voters take to the polls on Tuesday after another violent week in Manchester.

Three people were stabbed Saturday by a man wielding a box cutter at the Capital Auto Auction on Londonderry Turnpike. Byron Bloomfield, 25, is charged with three counts of first-degree assault for the attack.

But, there is a good chance Bloomfield will be back on the streets in time to vote. The Queen City keeps seeing people charged with serious crimes get easy bail.

On Tuesday, Manchester Police arrested Anastase Kabura, 24, on a charge of being a felon in possession of a deadly weapon while investigating a disturbance on Precourt Street. Kabura had been arrested days before on a disorderly conduct charge and was quickly released.

The revolving door at the courthouse is leaving Manchester’s streets unsafe, said Jay Ruais, the GOP candidate for mayor.

“Time and time again, we see violent criminals released on bail and rearrested. We must fix the broken bail system to keep our streets and neighborhoods safe … The safety and well-being of Manchester residents and visitors is at risk every time a violent criminal is released back out onto our streets,” Ruais said. 

In recent months, two men charged in an Elm Street shooting got released on relatively low cash bail. In another incident, 10 people were arrested for being part of a street fight in the area of Auburn and Cedar Streets, where two men were stabbed. Most of the suspects were quickly released on bail.

Ruais is running as a change agent against current Mayor Joyce Craig’s hand-picked successor, Democrat Kevin Cavanaugh. Ruais wants to see the bail system plaguing New Hampshire fixed, he wants to concretely deal with the city’s growing homeless problem, and he wants to get a handle on the opioid crisis.

Critics of the city’s current leadership argue Cavanaugh is essentially running as Craig 2.0, offering more of the same policies the incumbent mayor has already tried. “I want to build on the progress we’ve made in the past few years,” Cavanaugh said in an ad.

Many Manchester residents don’t see the past few years as a time of progress.

Manchester’s homeless population continues to grow, seeing a major increase over the past several years. According to the New Hampshire Coalition to End Homelessness, the Manchester region was home to more than 1,700 homeless people in 2021, the most recent data available.

The homeless population is tied to the city’s opioid addiction crisis, with half the opioid overdoses taking place among that group. 

“We have a city filled with promise, but the drug problem and homeless crisis are contributing to the serious public safety concerns we have and are keeping us from reaching our full potential,” Ruais said.

Manchester is on track for more than 720 opioid overdoses this year, according to American Medical Response data, the biggest number of overdoses since 2016.

Crime statistics show Manchester is the top spot for violent crime in New Hampshire, far outpacing other cities and towns. Data from the Manchester Police Department show the city is experiencing a drop in property crime this year, though violent crime reports are holding steady compared to prior years.

“The status quo that we are seeing here in the city cannot continue,” Ruais told WMUR. “We cannot tolerate the disorder and dysfunction we’re seeing on our streets, and we also can’t tolerate the human suffering we’re seeing.”

Even if Eric Spofford is charged as part of the vandalism conspiracy targeting New Hampshire Public Radio reporter Lauren Chooljian, he still has the right to sue the broadcaster for defamation, according to Rockingham Superior Court Judge Daniel St. Hilaire. 

This week’s ruling was a setback for NHPR, which sought to head off Spofford’s attempt to revive the defamation lawsuit. Spofford maintains NHPR and Chooljian were reckless in reporting allegations of sexual misconduct and sexual assault against him.

The public broadcaster argued Spofford’s connection to Eric Labarge and the alleged criminal conspiracy showed his bad faith in the lawsuit. They wanted the court to end his quest to see Chooljian’s work product.

Spofford’s associate, Labarge, 46, was charged this month for allegedly conspiring to vandalize the homes of Chooljian, NHPR journalist Dan Barrick, and their families. Larbarge allegedly coordinated the vandalism with co-defendants Tucker Cockerline, 32, of Salem; Michael Waselchuck, 35, of Seabrook; and Keenan Saniatan, 36, of Nashua.

Labarge, himself the owner of several recovery centers, is described by prosecutors as Spofford’s “close personal associate.”

St. Hilaire denied NHPR’s request to prevent Spofford from accessing Chooljian’s notes and interview transcripts for her story. For St. Hilaire, it was about the presumption of innocence.

“Even if charges were brought against Spofford directly, the Court is not convinced that would warrant reconsideration of the balance of interest in this case given the presumption of innocence at the core of our criminal justice system,” St. Hilaire wrote.

Spofford is not accused of taking part in the vandalism conspiracy himself. According to St. Hilaire, the available documents from the federal case don’t show he was even aware of the vandalism conspiracy.

St. Hilaire dismissed Spofford’s lawsuit this year, finding he had not provided the evidence in his 300-plus page complaint to back his claims. However, Spofford is being allowed to refile the complaint. For that, Spofford said he needs to see Chooljian’s notes and interview transcripts to find the evidence St. Hilaire found lacking the first time.

With the defamation case still open for now, NHPR has been broadcasting a new series by Chooljian, “The 13th Step.” The program focuses on her story of reporting on Spofford, the vandalism, and the lawsuit. It also looks at cases of sexual predators in recovery settings in other states.

Spofford has denied all wrongdoing alleged in Chooljian’s reporting. His lawsuit claimed Chooljian based her reporting on a biased source who was looking to hurt his reputation, ignored sources who contradicted the abuse narrative, and reported as fact things that never happened. 

According to Spofford’s lawsuit, Chooljian was looking for a #metoo scalp to bolster her resume, and she and the liberal-leaning NHPR targeted him because of his conservative views.

Spofford came to prominence as a recovery success story. He was an addict who got clean and started Granite Recover Centers to help others. His business grew as New Hampshire grappled with its opioid addiction crisis, and he became a leading voice on recovery initiatives. Spofford even counseled Gov. Chris Sununu on dealing with the opioid crisis.

Spofford sold Granite Recovery Centers for an undisclosed sum, thought to be in the millions, to a Texas-based company in 2021.

With three men charged for vandalizing the homes of NHPR journalists in Massachusetts, the alleged link to former Granite Recovery Center CEO Eric Spofford is being hidden by authorities.

But NH Journal readers already know the identity of at least one close Spofford associate investigated as a potential suspect, Hollis resident and recovery center owner Eric Labarge.

Federal prosecutors aren’t yet naming the fourth man tied to the vandalism, though prosecutors claim someone in Spofford’s circle coordinated with the three vandals.

Last week, Tucker Cockerline, 32, of Salem, N.H., Michael Waselchuck, 35, of Seabrook, N.H., and Keenan Saniatan, 36, of Nashua, N.H., were each charged in the United States District Court in Boston with conspiring to commit stalking through interstate travel for allegedly vandalizing the New Hampshire and Massachusetts homes of NHPR reporter Lauren Chooljian and her family, according to prosecutors.

Chooljian, NHPR News Director Dan Barrick, and others had their homes vandalized last year, about a month after Chooljian’s explosive story accusing Spofford of sexual harassment and sexual assault against women who were either clients or employees at Spofford’s Granite Recovery Centers.

Prosecutors linked Chooljian’s story to the motive for the vandalism. While the statement on the charges leaves out the names of the NHPR victims and Spofford, the identities are clear from the context and facts made public.

“According to the charging document, after a year-long investigation, an NHPR journalist (Victim 1) published an article in March 2022 detailing allegations of sexual and other misconduct by a former New Hampshire businessperson, identified in the charging document as Subject 1,” prosecutors state. “Another NHPR journalist (Victim 2) also contributed to the article, which appeared on NHPR’s website during and after March 2022. After that, it is alleged that Cockerline, Waselchuck, and Saniatan conspired with each other and with at least one other individual – allegedly identified as a close personal associate of Subject 1 — to retaliate against NHPR and Victims 1 and 2 by vandalizing the victims’ homes with bricks and large rocks, as well as spray-painting lewd and threatening language on the homes’ exteriors.”

Though the identity of the person close to Spofford who conspired with the three suspects is not being revealed, NHJournal first reported in March that Spofford associate, Labarge, is linked to at least one of the New Hampshire incidents. 

Labarge, 44, is himself a recovering addict and the owner of the Starting Point Recovery centers.

Labarge has not been charged by any law enforcement agency in the vandalism cases. He has a criminal history that includes violence against women and attempted murder. He is also currently awaiting trial on charges of assaulting a man in Manchester. That assault took place days after the last vandalism attack in May of last year, and the alleged victim was a man who had been a resident at a Starting Point center, according to court records. 

Spofford’s attorney, Michael Strauss, declined to comment on the arrests of the three suspects and their possible connection to Spofford last week. Previously, Spofford has acknowledged his relationship with Labarge.

“I worked closely with Eric Labarge to help him overcome his addiction in the early days of his sobriety,” Spofford said. “I’ve had the opportunity to watch him grow through the ups and downs of recovery for almost 10 years. He’s done great things for the recovery community, and I believe he will continue to for years to come.”

Labarge was set for trial in the Manchester assault case last month, but that was delayed due to his attorney Charles Keefe’s vacation plans. Court documents indicated last month Labarge and Keefe would use the extra time to negotiate a possible resolution to the case.

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

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

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

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

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

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

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

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

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

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

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

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

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

Global Medical Response released its November numbers for opioid overdoses and deaths on Monday. It reported a 30 percent increase in opioid-related overdose deaths in Nashua and Manchester so far this year, and a total of 112 opioid-related overdose deaths according to GMR’s Christopher Stawasz.

Those overdoses and deaths are directly related to the flow of fentanyl across the border from Mexico and making its way to the Granite State.

But just hours after the GMR report, White House Press Secretary Karine Jean-Pierre insisted criticism of the Biden administration’s border policy is exaggerated.

“It would be wrong to think that the border is open. It is not open,” said Jean-Pierre said. 

Border security advocates and elected officials don’t agree.

Illegal border crossings have skyrocketed in recent years, jumping from 405,000 in fiscal year 2020 to 1.6 million in 2021. In fiscal year 2022, which ended in October, the figure spiked again to more than 2.2 million. 

And with that record flood of migration comes drug trafficking and other crimes, said Jessica Vaughan, director of policy studies for the conservative Center for Immigration Studies.

“The tragic spike in deaths from fentanyl and other dangerous illicit drugs is a direct result of the Biden administration’s failure to control the border and to enforce immigration laws in the interior, which makes the deadly drug trafficking business way too easy and profitable for the cartels and all their operatives and subsidiaries,” Vaughan said. “Because the Border Patrol is so tied up with processing and with care and feeding of the thousands of illegal migrants taking advantage of the catch and release policies, there are no agents on the line to prevent the drug traffickers from getting their product over the unguarded areas.”

Chinese organized crime syndicates, working with Mexican cartels, ship precursor drugs to Mexico where fentanyl and methamphetamines are manufactured. Those deadly drugs are then smuggled over the southern border and then flow freely throughout the United States.

According to the Drug Enforcement Agency, Chinese syndicates are mostly responsible for illicit drugs obtained through online markets and sent through the mail to the United States, while the Mexican cartels are manufacturing hub for drugs that get smuggled into the U.S. India is emerging as a new source for fentanyl that gets smuggled into China and then sold into America according to an unclassified DEA report.

New Hampshire Gov. Chris Sununu scoffs at the Biden administration’s claims they have got the situation under control.

“Yes, the governor believes the nationwide surge in drug deaths is a direct result of fentanyl coming across the southern border,” said his spokesperson Ben Vihstadt. “The unfettered movement of these drugs has created more of a ‘cartel driven’ market than ever before. It’s not just over-prescribing or user demand. The cartels are now putting fentanyl in a variety of other substances to drive their market of addiction.”

Even the Biden administration believes the problem is likely to get worse with the court-ordered end of the Title 42 border policies put in place by President Donald Trump during the COVID-19 pandemic. A DHS memo obtained by CNN warned the end of Title 42 will “likely increase migration flows immediately into the U.S.,” and they predict 14,000 unauthorized migrants crossing into the country each day.

On Monday, Jean-Pierre appeared to suggest the Biden administration opposed ending Title 42 and blamed the policy shift on the courts. “What I am telling you is that it was a court order that was — that we are following. And we’re going to follow the law when it comes to what the court has decided to do.”

But President Biden announced on April 1 he planned to end the policy on May 23. The courts prevented the administration from doing so until now.

U.S. Supreme Court Justice John Roberts has issued a temporary halt to ending the policy.

During their reelection bids last month, both Sen. Maggie Hassan and Rep. Chris Pappas said they opposed the Biden plan to end Title 42 and wanted the administration to continue turning away would-be migrants. Sununu agrees.

“The governor believes the Biden administration must do everything in its power to extend Title 42 and secure the border and is pleased the Supreme Court just this evening halted Title 42 from expiring,” Vihstadt said.

Vaughan said the fentanyl crisis will get worse until the Biden team gets serious about securing the border.

“There is little to inhibit the flow of this illegal poison into communities – the product and the people who distribute it are able to do so with impunity,” Vaughan said. “But if we could regain control of the border and deport the criminals who are trafficking the drugs here, authorities could begin to clean up the streets.”

People with anxiety and depression are disproportionately prescribed painkillers. That’s what new research from the Dartmouth-Hitchcock Medical Center suggests, adding a complex layer to the opioid epidemic ravaging the United States and encouraging calls from New Hampshire’s congressional delegation to not move forward with the repeal of the Affordable Care Act.

The findings, which appear in the July issue of the Journal of the American Board of Family Medicine, show that nearly 19 percent of the 38.6 million American adults with mental health disorders use prescription opioids compared to only 5 percent of those without a disorder. Adults with depression and anxiety receive 51 percent of the 115 million opioid prescriptions distributed each year in the U.S., the study found.

“Because of the vulnerable nature of patients with mental illness, such as their susceptibility for opioid dependency and abuse, this finding warrants urgent attention to determine if the risks associated with such prescribing are balanced with therapeutic benefits,” said Brian Sites, an anesthesiologist at Dartmouth-Hitchcock and one of the co-authors of the study.

Image Credit: Dartmouth-Hitchcock

Opioid prescribing in the U.S. quadrupled between 1999 and 2015, and during that time more than 183,000 people died from overdoses related to prescription opioids, according to the Centers for Disease Control and Prevention.

Sites also notes that because pain is subjective, “the presence of mental illness may influence the complex dynamic between patient, provider, and health system that results in the decision to write an opioid prescription.”

The study does not give a specific reason why people with mental disorders are more frequently prescribed opiates. The study encourages more research on this population to understand opiate addiction.

Those patients may have some form of physical pain, but their mental condition may cause them to feel that pain more acutely or be less able to cope with it, leading to increased requests for something to dull the pain. As a result, doctors trying to be empathetic to their patients’ complaints may tend to overprescribe opioid painkillers, Stiles said.

Research also shows that patients are more likely to take opioids when there aren’t specialists nearby. A study published earlier this year found that the number of seniors in rural America who take at least three prescribed psychotropic drugs ― including opioids and antidepressants ― tripled over a nine-year period. The study found that many of these prescriptions were given without a proper diagnosis.

Being able to identify a subset of the population that could be more likely to use opioids could help providers and policymakers address opioid use. It “suggests that there may be additional patient- and provider-related factors specific to those with mental illness that increase the likelihood of receiving prescription opioids,” the authors wrote.

U.S. Rep. Annie Kuster, D-N.H., was present for a press conference about the study on Monday. She said repealing Obamacare could be disastrous for New Hampshire’s opioid epidemic.

“This is critically important in New Hampshire, as we have gone from second in the nation in deaths from the opioid crisis and heroin to first for fentanyl,” she said. “That’s not what we want to be known as first in the nation for.”

The U.S. Congress is currently in a heated healthcare battle. The Senate is working on legislation to repeal the healthcare law, but a vote on the bill has been delayed due to opposition from Republicans. New Hampshire Democratic Sens. Jeanne Shaheen and Maggie Hassan have both stated their opposition to the healthcare overhaul and have sent many press releases condemning “Trumpcare.”

“This new study is yet another reminder that, to combat the devastating opioid crisis, we must make mental health treatment affordable and accessible,” Shaheen said in a statement.

Hassan said she opposes proposed cuts to Medicaid that would affect coverage of mental health and substance abuse services.

“As we work to combat the horrific substance misuse crisis that is devastating our communities and taking a major toll on our economy in New Hampshire, this study highlights how dangerous Trumpcare, which includes massive cuts to Medicaid, would be for our state,” Hassan said in a statement. “We need a comprehensive, holistic approach to combating this epidemic that addresses the underlying causes of addiction, including mental health issues.”

To address the overprescription problem within the mental health community, Sites has suggested physicians need more access to alternative medicine besides opioids, including acupuncture, massage therapy, physical therapy, and non-opioid pharmaceuticals.

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