Drug recovery centers first became a stop on the campaign trail in the 2016 New Hampshire primary, and they’re playing an especially important role this year, as presidential hopefuls unveil their plans to tackle the opioid crisis.
As part of our series, “Where They Stand,” which takes a closer look at candidates’ policy proposals, NHPR’s Sarah Gibson looks at how candidates say they’ll combat addiction, and how their time in New Hampshire is shaping their message.
In his backyard in Laconia, Phil Spagnuolo is flipping burgers for residents of the sober house he runs down the street.
Like the other people here who are putting their lives back together free of drugs and alcohol, Spagnuolo is in recovery. Four years ago, he was sitting in jail for heroin possession. But this primary season, he’s getting a lot of positive attention. Candidates want to visit the sober houses, meet people in recovery, and get his thoughts on their plans to solve the opioid crisis.
“A few of them have sent me their plans before releasing them and I’ve given them some feedback. Who would have thought? You’re talking to a guy who got out of jail four years ago,” he laughs. “Now I have presidential candidates coming to my barbeque!”
Back in the 2016 primary, a number of presidential candidates visited drug recovery and treatment centers, but they weren’t touting the kinds of detailed plans many of this year’s candidates have. Spagnuolo, who served as a state representative in 2015 and spoke openly about his addiction, says there’s a cultural shift underway:
“This has been the dirty dark secret in people’s families for so many years that now it’s so much in people’s faces that it can’t be denied,” he says. “I think people are finally willing to have these conversations.”
Today the candidate having that conversation is Congresswoman Tulsi Gabbard. Gabbard’s made this a regular stop during her Laconia campaign events. Gabbard tells me on her way to Laconia today, a woman serving her coffee pulled Gabbard aside and began crying. Both her daughter and mother are addicted to opioids. She agreed with Gabbard’s proposal to legalize marijuana as an alternative for people addicted to opioids.
“She just says: ‘Look, if my mom had access to medical marijuana, it would save her life,” Gabbard recalls.
It’s common to hear these personal stories in New Hampshire and for candidates to fit them into their campaign spiel. The goal is to connect with voters in a state where the rate of opioid overdose deaths is more than one person every single day. Talking opioids is a strategy that President Trump used four years ago, and it helped him appearl to areas of the country wracked by opioid addiction.
And in a recent UNH poll, many Granite Staters still say the drug crisis is the top issue facing the state.
(Story continues below interactive graphic.)
It’s also a major issue across the state line, in Massachusetts. Senator Elizabeth Warren was one of the first candidates to come out with an opioids plan: $100 billion over ten years, which she says she’ll fund with taxes that target corporations and the ultra wealthy. The plan would send money to non-profits on the front lines, rather than state agencies:
“Let’s go down to the local communities and make sure that money is available in the way that the people on the ground that are wrestling with the problem can best use it,” she told NHPR at a campaign event in Derry.
Warren’s plan appeals to Erin Canterbury, a recovery advocate who lives in Epsom. Canterbury likes that both Warren and Senator Bernie Sanders support harm reduction programs - like clean needle exchanges - which can be taboo but are shown to be some of the most effective strategies to reduce overdose deaths and connect people to treatment.
Canterbury says voters might not choose a candidate solely for their addiction policies, but they are paying attention:
“I know parents who’ve lost children to an overdose definitely look at this type of thing, as well as people in recovery,” she says. “That’s what made me look towards it. This is my number one issue.”
Other candidates - like Senator Cory Booker, Senator Kamala Harris and former congressman Beto O’Rourke - promise to tackle addiction through criminal justice reform. When Booker picked up the endorsement of Peterborough state representative Peter Leishmann, Leishmann cited his son’s recent overdose death and praised Booker’s commitment to diverting people with addiction and mental health crisis out of prison.
“I know this from personal experience,” Leishmann wrote. “My son, Jordan, suffered from addiction for 12 years, he got caught up in the system, and then we lost him. What we're doing now is not working."
O’Rourke says there are already good alternatives to incarceration, like Manchester’s safe stations he learned about while campaigning here.
“[There are] no-judgement safe places like you have in New Hampshire - safe stations where you can walk into any fire station and get the help that you need right now without being involved in the criminal justice system,” he told MSNBC's Chris Matthews on Hardball.
Businessman Andrew Yang wants to go a step further, by decriminalizing possession of small amounts of heroin.
Vice President Joe Biden also plans to treat addiction through criminal justice reform, by expanding mental health services in prisons and in schools.
And then there are candidates focused on accountability for opioid manufacturers.
Minnesota Senator Amy Klobuchar says she’ll pay for her addiction plan with a new tax on those companies, but treatment won’t be limited to opioids.
“We’ve seen a resurgence of meth and crack cocaine problems. In fact in communities of color those drugs hurt more and to just talk about opioids is a mistake,” she told people at the Revive Recovery Center in Nashua.
And there’s another, larger question those in the recovery world are trying to answer: What’s happening in this country, that so many people are in a desperate cycle of addiction?
Mayor Pete Buttigieg recently came through New Hampshire pondering that very question.
“It’s something deeper,” he told hundreds at a house party in Hancock. “How else do we have this many deaths from despair? From drugs from alcohol, when people are self-medicating in this way, what are they medicating for? We have a crisis of belonging.”
To solve that crisis, Buttigieg says he’ll spend billions each year to ramp up mental health services, especially in rural America. During that same campaign swing, Buttigieg unveiled a mental health and addiction plan that also proposes expanding medication-assisted treatment and increasing mental health care for prisoners and veterans.
Some voters say the unprecedented focus on addiction this year gives them hope. But then again, it’s campaign season, so they know it’s a season of promises.