Tens of millions of dollars are flowing into New Hampshire from legal settlements tied to the opioid crisis — with more on the way. The Department of Justice says the state could see a total of $310 million over the next two decades.
The money comes from a series of lawsuits against drug makers, distributors and pharmacy chains. New Hampshire and other states have alleged their aggressive marketing and lax oversight of addictive painkillers sparked a decades-long public health crisis that has claimed hundreds of thousands of lives.
Officials say the money could make a real difference, at a time when overdose deaths have been rising in New Hampshire. At least 480 people died due to drug overdoses last year — the highest number in five years.
As state and local officials make decisions about where this money is best spent, they’re also confronting larger questions about how best to respond to the ongoing addiction crisis: what role law enforcement should play in addressing substance use, how to balance immediate spending with long-term investments, and whose voices matter in reaching those decisions.
Lisa Vasquez, a behavioral health strategist with the city of Nashua, said the settlements are a chance to invest in programs that save lives.
“We see the numbers in the news all the time,” she said. “But what we don't see is the families and the communities behind those numbers that are impacted.”
So far, the state’s shared few details on its spending plans
The state’s claims against the drug companies — as well as separate lawsuits filed by 23 New Hampshire towns, cities and counties — are part of a wave of nationwide litigation.
Over the past two years, New Hampshire has joined national settlements with many of those companies, including OxyContin manufacturer Purdue Pharma, major pharmacy chains such as CVS, Walgreens and Walmart, and several pharmaceutical distributors. The state also negotiated a separate settlement with Johnson & Johnson, another producer of opioid painkillers.
Not all of the money from these legal settlements will arrive at once. Some will come in installments over the next several years, and some of the settlements are spread out over 18 years.
So far, about $45 million stemming from these lawsuits has arrived in New Hampshire. All of that must be used, in some way, to address the harms of opioid addiction.
Under a state law that outlines how that money should be handled, 15% goes directly to the counties and municipalities that filed their own lawsuits; those local jurisdictions have received about $7 million to date.
The rest goes into a trust fund overseen by New Hampshire’s Opioid Abatement Advisory Commission, a panel that includes lawmakers, local officials and people who work in fields like public health, addiction treatment, law enforcement and corrections.
More than 40 organizations sought funding when the commission issued its first call for grant applications last August. In November, commissioners chose more than $6 million worth of initiatives to fund — but it’s not clear which programs are in line to receive that money, as those recommendations haven’t yet become public.
State officials say they can’t share any details until those contracts are ready to go to the Executive Council for approval, which could happen in May.
At one recent meeting, some on the commission said they were frustrated that it has taken so long to get that first tranche of money out the door. The Department of Health and Human Services, which is responsible for preparing the state contracts tied to the opioid settlement money, said drawing up the dozen or so agreements has been a huge undertaking. The agency has requested additional staff to help administer the funds.
“It's slower than I think any of us want,” said Deputy Attorney General James Boffetti, who sits on the commission. “We are looking forward to getting this money out as quickly as we can. And I think there may be ways that we could speed up that process.”
Some local governments invest in treatment programs, others in harm reduction
Some communities haven’t made any spending decisions yet, saying they’re still waiting for a clearer sense of how much they are in line to receive overall.
But already, many counties are using at least part of their settlement money to offset the cost of addiction treatment for people incarcerated at county jails, including medications like buprenorphine and methadone that reduce cravings for opioids.
Since 2020, state law has required jails to provide medication-assisted treatment for opioid addiction when medically appropriate.
Strafford County Administrator Raymond Bower said his county has been using all of its opioid abatement money — a little more than $325,000 to date, according to the state — on treatment-related programs in the local jail. He estimated Strafford County spends $500,000 to $600,000 per year on medication-assisted treatment and a separate addiction-treatment program at the jail.
“The money that we’ve gotten doesn’t come close to paying for what we do,” he said.
The Opioid Abatement Advisory Commission has said it intends to make additional funding available to reimburse counties for medication-assisted treatment.
Elsewhere, the money is going toward a range of other projects.
Manchester is putting some money toward detox services for people experiencing homelessness. Nashua has awarded funding to local agencies to expand harm-reduction services and prevent and address opioid addiction among young adults facing homelessness.
The town of Belmont bought a handheld drug-testing device for its police department. Merrimack County is funding a “county navigator” position, to help people leaving jail — many of whom struggle with substance use — connect with housing and other resources.
In Coos County, some of the funds are paying for treatment at the jail. Finance Director Carrie Klebe said the county also plans on setting aside money for renovations to create a conference room. She said corrections officials, mental health workers and other local stakeholders who regularly deal with substance use need a place to meet.
Cheshire County plans to use some of its funds for drug court programming and to host trainings on substance use for local police. It’s also giving $20,000 grants to two local recovery organizations.
One of them, the Serenity Center in Keene, says that money will allow it to expand its “Road to Recovery” transportation program, which helps people get to treatment centers, daily methadone appointments and other recovery supports. It also plans to train more people as peer recovery coaches.
“When a person goes from being hopeless in their addiction, and they get to the point when they are offering peer support to other people, that is massive,” said Executive Director Sam Lake.
As communities consider where to invest this money, officials are also weighing how to have an immediate impact — while also thinking about what they can sustainably fund over the long term.
John Burns, the director of SOS Recovery on the Seacoast, said many recovery programs currently rely on shorter-term grants. The opioid abatement funds may be an opportunity to create a more sustainable funding source.
“This money is going to be around for a pretty significant period of time,” he said.
Listening to those who ‘know what works’
As plans start to take shape, some who work in recovery and harm reduction are wondering how much of this money will be channeled through law enforcement and corrections — and stressing the importance of consulting people who have personal experience dealing with addiction.
That debate is playing out in Keene, where city officials have proposed hiring a social worker who would work out of the police department. City Manager Elizabeth Dragon told a city council committee last month that the social worker could follow up with people after drug-related calls and connect them with help.
“The police officers do not have time,” Dragon said. “They hand out a card at a scene, but they don’t have time to go back, in most cases, and make sure that person is being then referred.”
The proposal drew criticism from State Rep. Jodi Newell, a Keene Democrat who lost her fiancé to a heroin overdose years ago. People who use drugs often have negative experiences with law enforcement, she said, and may be reluctant to engage with someone who is associated with the police.
“At the end of the day, it’s an opportunity to save lives,” Newell told NHPR, referring to the opioid abatement funding. “And if we don’t involve people in the actual conversation and come up with good solutions, we’re going to have just squandered this opportunity.”
"If we don’t involve people in the actual conversation and come up with good solutions, we’re going to have just squandered this opportunity."Rep. Jodi Newell, of Keene, who lost her fiancé to a heroin overdose years ago
In some places, specially formed task forces are studying their communities’ needs and figuring out where this money could do the most good.
In Rochester, City Councilor Amy Malone heads a committee that includes city officials, people who work in public health and harm reduction, and other community members with a connection to the issue. She said they’ve prioritized hearing directly from people who have experienced addiction themselves.
“We need to ask those people that are in the encampment, that are still using substances, or recently,” she said. “They're the expert in their own lives. They know what works.”
One of the biggest needs in Rochester right now, she said, is long-term, supportive housing for people in recovery.
“We have way too many people suffering chronic homelessness based on this opioid crisis,” she said. “So that money has to go back to helping those people hit the hardest.”