KEENE, N.H. — When Hillary Rodham Clinton and Jeb Bush made their inaugural visits to New Hampshire this year as presidential candidates, the first question they were asked wasn’t about their last names, the economy — or even about an e-mail server.
It was about the state’s opioid epidemic.
One by one, as the candidates march through New Hampshire, they are forced to confront the state’s drug crisis through sorrowful, first-hand testimonies of addiction. A recent poll showed the drug crisis ranked second as the biggest issue facing the state — ahead of health care, education, and an unresolved state budget.
Drug addiction, including heroin and other opioids, has emerged as a central issue on the campaign trail — especially in New Hampshire, where 321 people died of opioid overdoses in 2014 and state officials estimate 1,000 will die this year for the same reason. Candidates have struggled with answers — and few have provided policy proposals — as voters recall harrowing personal stories or those from loved ones hurt or killed by addiction.
“The heroin epidemic is the sleeper issue of the 2016 campaign in a way I have never seen an issue emerge in the New Hampshire primary,” said New England College professor Wayne Lesperance. “What has really struck me is that these heroin questions usually begin with a personal story, and then the candidate usually tells a story back. This issue ends up being about as personal as we see [in] these people running for president.”
While former Hewlett-Packard chief executive Carly Fiorina was running for the US Senate in California five years ago, her 35-year-old stepdaughter died from a drug overdose. She avoided the topic until recently. Today, Fiorina regularly brings up her family’s tragedy with voters during her frequent and long visits to New Hampshire.
“We lost a daughter to addiction, so this is personal to me. I get it,” Fiorina said in response to a question about the drug crisis at a Salem, N.H., house party in May.
Also that month, Governor Chris Christie of New Jersey had roundtable meetings in Manchester and Franklin to discuss addiction. In his home state, Christie said he’s tried to focus on recovery more than law enforcement. But he also talks about how a good friend from law school was found “in a hotel room with an empty bottle of Percocet and a bottle of vodka. And he was gone.”
Governor John Kasich of Ohio said the issue became personal for him when a group of mothers visited his office.
“They all came with pictures of their sons, all of whom had been athletes, all of whom were dead. These ladies said, ‘Will you help us?’ I said, ‘Are you kidding?’ ” Kasich said at a recent New Hampshire town hall meeting. “So we took action immediately.”
On Wednesday, when the issue came up at a Bush town hall meeting in Merrimack, the former Florida governor got personal about his daughter’s struggle with drug addiction. In 2002, Noelle Bush, then 25, was sentenced to 10 days in jail for violating her drug treatment after crack cocaine was found in her shoe.
“I have some personal experience with this as a dad, and it is the most heartbreaking thing in the world to have to go through,” he said, according to CNN.
To be sure, the hallmark of New Hampshire politics — its town hall meetings — are typically filled with questions for candidates on immigration, the economy, and foreign policy concerns. These are the kinds of inquiries for which candidates prepare and practice their answers.
But when it comes to the question about drug addiction, candidates have proven they can provide empathy — but not yet solutions. It’s rare for candidates to offer detailed policy proposals at this point in the campaign, more than five months before the New Hampshire primary. However, not a single candidate has offered a comprehensive federal plan for dealing with the drug addiction crisis.
When Clinton made her most recent trip to the state earlier this month, she held a 90-minute campaign event that focused solely on drug addiction. She asked questions of people closest to the problem — public health specialists, law enforcement officials, and recovery counselors. Aides said Clinton will release a plan to address the issue in the next few weeks.
During her roundtable, she talked about the son of good friends in New York who died after he took pills that he thought would help him stay up to study for law school finals. Also during her trip, Clinton met two grandmothers in New Hampshire who are taking care of their grandchildren because their daughters were addicted to drugs.
“The problem is the worst that I have seen in 20 years,” said Maddon, who is undecided who he will support for president. “For Clinton to hold an event on this and ask the right questions shows leadership to me.”
A few hours after Clinton held her event on addiction, Gary Carpenter of Peterborough got a front-row seat at a town hall meeting for Kasich. He came to the event for a purpose: He wanted to hear Kasich talk about what he would do about heroin and addiction.
Kasich said he started a program to increase dialogue about drug addiction in Ohio, as well as increased law enforcement efforts and drug rehabilitation in prisons.
Then Kasich recalled a recent campaign stop in Manchester, where he ran into some youths at a business. He said he did not ask for their vote. Instead, he told them, “you have a responsibility to keep your friends from getting into drugs.”
“A reporter said that I acted like I was their dad,” Kasich told the crowd. “And I am going to act like dad because we have to spread the word.”
James Pindell can be reached at firstname.lastname@example.org. Follow him on Twitter @jamespindell, or subscribe to his daily e-mail update on the 2016 campaign at bostonglobe.com/groundgame.