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Will the National, Local Political Shift Impact Efforts to Address N.H.'s Drug Epidemic?

Paige Sutherland/NHPR
Out of the 302 drug related deaths so far this year, more than two-thirds have been linked to fentanyl, which is a potent, synthetic opioid pain medication.

The opioid crisis was a big issue in New Hampshire in 2016 – both on the campaign trail and in the State House. Nearly 433 people died of a drug overdose last year; this year, that number is expected to surpass 500. But what will the shift in political control both nationally and at the state level mean for policy approaches to tackling this issue?

NHPR’s Paige Sutherland, who’s been covering the opioid crisis for us both on and off the campaign trail, joined All Things Considered host Peter Biello to help break down some of these lingering questions.

So to start off nationally - in January Donald Trump will be in the Oval Office. What are people in the recovery community here in New Hampshire saying about what that might mean for substance abuse policy?

There are a lot of questions. Every time Donald Trump came here and, he did come to New Hampshire often, he would say the opioid crisis was a big issue and a top priority if elected but when it came to the details there really weren't any. Then you have Hillary Clinton on the other hand whenever she came she talked about it in much detail, you can go on her website, she had this huge plan - $10 billion attached to it for prevention, treatment, etc. When he came, the biggest thing he said was he wanted to build a wall on the Southern Border to stop the flow of drugs from coming in but prevention, treatment – what that would mean, the details were very slim.

One of Trump’s biggest talking points this election has been repealing the Affordable Care Act. What role has this program played in substance misuse policy in New Hampshire?

Talking to people when it comes to substance abuse in New Hampshire their biggest fear is that Trump will repeal Obamacare. In the state alone 7,000-10,000 people accessed treatment for addiction through this program so if they get rid of it what does it mean? Can they still get coverage? Will they be able to access these services? He’s also been criticized because he wants to repeal it but with what? So it kind of leaves these people hanging.

More on the local level the new governor Chris Sununu has said he doesn’t per say want to make the program permanent but doesn’t seem to be as gong hoe on repealing it like some of his other Republican counterparts

As of now the program continues until 2018 but recently the plan’s request to attach work requirements to enrollment was denied by the federal government and that was a huge detail that got Republicans to sign onto the program last session. So whether the legislature will agree to continue it past 2018 is really up in the air.

Staying on the local level – this is the first time since 2003 and 2004 that Republicans will control both the governor’s office and the legislature. Will this have an effect on funding or policy changes around addiction and recovery?

Yes – it’s going to be a budget year so people in substance abuse are going to be very vocal this session on getting more resources directed their way but many of the Republicans who got elected ran on a platform of fiscal restraint so that might throw a wrench into the mix on getting more money towards these efforts.

But Sununu has said as governor addressing the opioid crisis will be a top priority for him – not quite sure the exact details but he’s said he wants to fully fund the Alcohol Fund. This fund allocates five percent of the state’s liquor sales to substance abuse efforts but the fund has only been fully funded once and that was in 2001. To fully fund it would take about $19 million and would be huge for the substance abuse community.

Last session several bills were passed to tackle this epidemic – are there any concerns that given new leadership some of these efforts may be pulled back?

Yes – talking to leaders in the substance abuse community besides the fate of Medicaid Expansion, there’s a possibly there might be efforts to nix last session’s bill that removed insurance barriers, as that got a lot of pushback from insurance companies. The "Good Samaritan Law" is also at stake as Sununu has said he wants to get rid of it. Sununu says it has offered loopholes for drug dealers to avoid prosecution. But those in the substance abuse community say it’s a good law and has saved lives as people are more inclined to call 911 when someone has overdosed if they don’t fear possesion charges.

The state’s drug czar position is also up in the air. This position has been heavily criticized by Republicans in the past and since it is appointed by the governor, Sununu can choose to replace James Vara, who currently holds this job, or could even get rid of the position all together.

There were some big changes on Tuesday to drug laws across the country as well as our bordering states. Marijuana will now be legal in Massachusetts and Maine. Given that outcome - are there any concerns here in New Hampshire?

Yes – the biggest worry is that it will be near to impossible to patrol the border, meaning a lot of people potentially will be making the short drive to these states, buying marijuana and bringing it back. I think the substance abuse community worries about how that will affect youth or lead to more opioid abuse as marijuana some say is a gateway drug.

However – it’s likely New Hampshire might change its marijuana laws. Sununu is for decriminalizing half an ounce and that’s something the State House has signed off on before, so could be likely.

Overall though when it comes to addressing the opioid crisis, it seems advocates are hoping the bipartisan attitude from last session will continue but that policymakers don’t get complacent as they say much more work needs to be done.

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