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

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

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

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

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

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

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

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

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

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

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

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

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

The number of opioid-related overdoses first responders treated in Nashua rose sharply in March, up nearly 80 percent over the previous month, according to stats compiled by American Medical Resources (AMR). It is yet another sign the state’s opioid crisis continues in its two largest cities.

Chris Stawasz, the Northeast Regional Director of Government Affairs at AMR, said medics responded to 87 suspected opioid overdoses in March; 62 in Manchester – up 13 percent from February and 25 in Nashua – up 79 percent from February.

While the total number of opioid-related overdoses for the year in both cities is trending lower than last year’s record-setting high, 2023’s death count continues to rise. Last month, there were 10 suspected opioid deaths in Nashua and Manchester, with three in Manchester and seven in Nashua. 

Nashua is getting hit particularly hard this year, according to Stawasz. Suspected fatal opioid overdoses in Nashua are trending 29 percent higher than last year. Even more alarming: one in four suspected opioid overdoses (27 percent) in Nashua this year have been fatal.

AMR medics have responded to 224 suspected opioid overdoses in Nashua and Manchester through the end of Marc,h with 35 resulting in suspected opioid OD deaths; 21 in Manchester and 14 in Nashua.

Jay Ruais, who’s running for mayor of Manchester and has had his own struggles with addiction, points a finger at Mayor Joyce Craig’s management during the ongoing crisis.

“Our city needs to alter our approach to this crisis, the current trajectory is clearly unsustainable. We must grow our police department and fully empower them to go after drug dealers while building better systems for vulnerable individuals at critical intervening moments in our hospitals, jails, and schools.

“As Mayor, I will work to ensure we are coordinating with all those fighting to improve our community and save lives,” Ruais said.

Why are such a high percentage of overdoses becoming deaths? Stawasz believes fentanyl is the culprit.

“The significant increase in deaths is attributed to very potent synthetic fentanyl,l which is now found in all types of illicit substances,” Stawasz said. “People who are using illicit substances can 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.”

In all, there were 62 suspected opioid overdoses in Manchester during March, bringing the year-to-date first-quarter total to 173. The total number of suspected opioid overdoses in Manchester is currently trending the same as last year on an annual basis, with 12 percent of all suspected opioid overdoses responded to by first responders in Manchester this year having been fatal.

There were 25 suspected opioid overdoses in Nashua during Marc,h bringing the year-to-date first-quarter total to 51. The total annual number of suspected opioid overdoses in Nashua is currently trending 15 percent lower than last year on an annual basis, Stawasz said.

Manchester is breaking new ground in misery as the Queen City death totals from the opioid crisis keep rising. It is a crisis, Republicans say, driven by illegal fentanyl pouring over a border Democrats refuse to secure.

Manchester and Nashua experienced a record-high number of opioid-related overdose deaths last year. Manchester is on track to exceed that number in 2023 said Chris Stawasz with American Medical Response.

“There were 18 suspected opioid deaths in Nashua and Manchester in February. That is the most suspected opioid deaths in one month for Nashua and Manchester combined since tracking began in 2015.”

Nashua suffered 44 opioid-related overdoses last year, the most since 2018 when 35 people died. Manchester saw 79 people die from opioid overdoses in 2022, the highest number since 2017’s 67 deaths. More troubling, while Nashua is estimated to see a slight dip in deaths this year, Stawasz anticipates Manchester’s death toll to reach 111, the most ever.

Synthetic fentanyl, the type being smuggled over the southern border by Mexican cartels, is the most likely culprit for the increase in deaths. Fentanyl is used in counterfeit pills, and it is used to lace other illegal drugs.

“The significant increase in deaths can most likely be attributed to very potent synthetic fentanyl which is now being found in nearly all types of illicit substances,” Stawasz said. “In many cases, 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.”

Fentanyl is responsible for the majority of overdose deaths in the country, according to federal government statistics. In 2021, 90 percent of all overdose deaths were connected to the drug. And most of that is coming from Mexican cartels who are producing the synthetic drug using ingredients from China, then using their control of the southern border to smuggle it into the U.S.

“The source of fentanyl is Mexico and its drug labs,” said Todd Bensmen with the Center for Immigration Studies. “I’m not seeing any evidence that the Biden administration is interested in damming up the source.”

Gov. Chris Sununu acknowledges New Hampshire is being hit hard by the opioid crisis, but he noted it is part of a national problem.

“States across the country are seeing a rise in opioid-related deaths and New Hampshire is not immune. Every death is tragic; it is someone’s son, daughter, and family member,” Sununu said. “The bottom line is that fentanyl is now in all different types of substances, whether that be cocaine, methamphetamine, fake pills, or vape cartridges – assume it is in anything and everything.

“There is no safe experience with substances, unless they are prescribed by a provider, and taken only as directed by the person they are prescribed to.”

Getting a handle on the crisis in Manchester calls for more police support, and getting cops the tools they need to do the job, said Jay Ruais, a Republican running to replace Democratic Manchester Mayor Joyce Craig.

“We must provide greater resources for our police department to go after drug dealers and fight for bail reform at the state level to keep them off our streets,” Ruais said. “Additionally, most who suffer a fatal overdose have previously overdosed, meaning we have to build better systems for individuals when they are at their most vulnerable like in hospitals, jails, and prevention programs in schools. Solving this crisis doesn’t cost more money. It requires prioritization and better coordination with existing community partners.”

Sununu announced a new PSA campaign this year, “No Safe Experience” to educate Granite Staters, especially young people, about the danger of fentanyl and other illegal drugs. Expected to run through the fall, the campaign includes video and public service announcements, social media campaigns, an informational website, billboards, and highly visible signs, posters, and materials that will be widely disseminated across the state and made available to schools, and an active media campaign to share that there is no safe experience through personal stories and data. 

New Hampshire law enforcement is dealing with the one-two punch of fentanyl and methamphetamine, as opioid deaths continue to surge and methamphetamine fuels deadly violence. 

And the source of those drugs is 2,400 miles away at the U.S.-Mexico border.

Last month, Manchester and Nashua reported a combined 95 opioid-related overdoses, a 13 percent increase from December. Nine deaths are believed to be linked to these overdoses.

The figures from last year show a sharp rise in opioid overdoses and deaths, after an initial dip due to the 2020 COVID-19 related lockdowns.

November overdose totals in Manchester and Nashua were up 110 percent from the same time in 2020, according to American Medical Response regional director Chris Stawasz.

“I know there are a lot of competing priorities with COVID-19 and the variants that are out there, but this is, unfortunately, if not more deadly, as deadly as the COVID-19 crisis is,” Stawasz told WMUR.

Manchester had more than 500 suspected overdoses in 2021, 30 percent more than the previous, and Nashua had 250 suspected overdoses in 2021, which was 29 percent more than 2020.

Opioid fatalities are typically linked to fentanyl, the powerful synthetic drug being manufactured by Chinese syndicates and distributed by Mexican drug cartels. Those cartels continue to find ways to smuggle the drugs over the border, flooding American streets.

According to The Washington Post, The U.S. Customs and Border Patrol’s Laredo field office alone seized 588 pounds of fentanyl during the 2021 fiscal year, an eleven-fold increase over the 50 pounds it snared in 2020.

United States Attorney for New Hampshire John Farley said that while fentanyl is still the state’s main drug problem, methamphetamine is making gains among Granite Staters as well. It is now the second most common drug on the streets. Again, methamphetamine is a product from the cartels, he said.

“What we’ve seen is a real growth in the Mexican cartels manufacturing and distributing methamphetamine,” Farley said. “They are able to produce a cheap and very pure form of methamphetamine, what people call crystal meth, and they are very aggressive in distributing that highly addictive drug.”

One main method of distributing those drugs is dark web marketplaces. According to The New York Times, dark web sites are accounting for more and more of the fentanyl traffic in the country.

Farley said local and federal law enforcement are seeing come up from the border, and then getting shipped to the east coast. Many times, dealers are using the dark web to buy and sell large quantities of the drugs. 

“Almost anyone who wants to find a connection can find a connection,” Farley said.

New Hampshire Attorney General John Formella has said methamphetamine keeps popping up in investigations involving people shot by police officers. The last five complete investigations into fatal police shootings have found people with methamphetamine in their system who turned violent in confrontations with police, resulting in their deaths.

“Methamphetamine and fentanyl distribution continue to plague New Hampshire. As the Attorney General, I will continue to partner with federal and local law enforcement agencies to implement the most effective strategies to disrupt the flow of illegal drugs into New Hampshire,” Formella said in a statement. “It is only by this collaborative effort that law enforcement can marshal assets to protect not only our citizens but the  officers who work tirelessly to protect our state.”

Last year, Claremont’s Jeffry Ely, 40, was shot and killed during an armed standoff with New Hampshire State Police troopers. Ely had been suffering greater mental health problems as he increased his drug use, including methamphetamine, according to the shooting investigation. 

David Donovan, 35, was shot and killed by police in Meredith in November 2020 when he charged at police, armed with a knife and covered in blood from having just stabbed his mother’s boyfriend, according to the New Hampshire Attorney General’s report. Donovan’s methamphetamine use caused him to become violent, paranoid, and delusional in the months leading up to his fatal encounter with Meredith police.

In October of 2020, Ethan Freeman, 37, of Thornton, was shot and killed by Thornton Police Officer Matthew Yao when a naked and bleeding Freeman charged Yao during a confrontation. Freemen had a history of methamphetamine and other drug abuse, as well as a significant history of mental health issues.

In December 2020, Mark Clermont, a paranoid felon who was known to carry an assault-style rifle and wear a ballistic vest while hunting for alien spacecraft, was shot and killed by New Hampshire State Police Trooper Matthew Merrill during a gun battle Clermont had started. Clermont was known to use methamphetamines. Merrill suffered gunshot wounds during the incident. He survived.

Those drugs ending up in the hands of armed dealers and users are a real concern of law enforcement, Farley said.

“We’re seeing a lot more drug dealers who are armed,” he said. “When a methamphetamine dealer is armed, or is using, the public safety risk is substantial. The impacts that methamphetamine has on thought processes can really create a public safety risk.”