scorecardresearch Skip to main content

N.H. at a crossroads in fighting substance use disorders

In the next one to two years, some of the state’s funding for substance use disorder services will end, sparking “significant concerns” about how the state will help prevent opioid overdoses.

A depleted Narcan nasal spray on the ground in April in Manchester, N.H.Andrew Burke-Stevenson/Andrew Burke-Stevenson for The Boston Globe

In 2023, New Hampshire had around $171 million in state and federal funding to spend on substance use disorder services, according to a recent study commissioned by the New Hampshire Charitable Foundation.

The study looked at the financial health of New Hampshire’s delivery system for substance use disorder. The goal is to keep behavioral health services available for everyone.

In the next one to two years, some of that funding will end. And there are “significant concerns” around the short and long-term financial sustainability of services, the study found.

In the early 2000s, New Hampshire had one of the highest rates of overdose deaths in the country. People started paying attention and taking action — investing money and doing policy work to make prevention, treatment, and recovery services more available.


From 2018 to 2021, the rate of overdose deaths went down by more than 11 percent, according to data from the Centers for Disease Control and Prevention. Overdose deaths have again been on the rise in recent years. In fact, in 2022 overdose death rose 11 percent, nearing a decade high, according to the state’s Chief Medical Examiner’s office.

But overdose deaths have been rising faster in other states, so New Hampshire will lose some supplemental funding as it’s no longer one of the states with the highest per capita overdose death rates.

The study found that in 2023, New Hampshire is at a crossroads. There’s more money available for services, but some resources supporting core services are either getting reduced or ending in the next one to two years. And those providing prevention, harm reduction, treatment, and recovery services still report being on the financial brink.

But the study found that regulatory and fiscal policy changes can improve the situation. “We need to make sure that our treatment and recovery providers have strong and consistent resources to be able to do what they do now,” said Jake Berry, vice president of policy for New Futures, a Concord-based nonprofit that does health policy advocacy in New Hampshire.


He said that while the state will lose some federal funding, money is coming in the form of opioid abatement funds. In 2023, the state received $44 million in opioid settlement money from a series of lawsuits against drug makers, distributors, and pharmacy chains.

Berry said while there’s been a lot of attention on opioids in recent years, the system also needs to be flexible.

“We know that meth is rising and has been for a number of years, and the treatment for meth is very different than opioids.”

This story first appeared in Globe NH | Morning Report, our free newsletter focused on the news you need to know about New Hampshire, including great coverage from the Boston Globe and links to interesting articles from other places. If you’d like to receive it via e-mail Monday through Friday, you can sign up here.

Amanda Gokee can be reached at Follow her @amanda_gokee.