Substance use has been a serious concern in New Hampshire since the early days of the opioid epidemic, but the state has seen steep declines in recent years. Key figures:

• 431 overdose deaths in 2023, down from 487 in 2022, a 12% decrease, according to the NH Community Behavioral Health Association.
• 287 overdose deaths in 2024, a 33% decrease from 2023.
• The record high was 490 deaths in 2017.
• Fentanyl is the most commonly involved drug.
• Overdose deaths have declined for two straight years.
• New Hampshire still records over 400 lives lost annually.

New Hampshire was one of the original epicenters of the opioid epidemic, hitting a record 490 deaths in 2017. After years of effort, the state has seen two straight years of steep declines, even as fentanyl remains the dominant drug.

New Hampshire expanded Medicaid in 2014 under the Affordable Care Act, a program now known as Granite Advantage. The state’s Bureau of Drug and Alcohol Services (BDAS), under the Department of Health and Human Services, oversees substance misuse services. Of the 88 facilities listed below, 80 accept Medicaid.