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In NH, the opioid crisis hasn’t faded. But its role in the primary campaign has.

Photos of people lost to drug addiction at an overdose-awareness vigil in front of New Hampshire's Statehouse in 2022.
Paul Cuno-Booth
This 2022 vigil at the New Hampshire State House honored people who lost their lives to overdoses.

Teresa Gladstone, of Concord, lost her grandson Oliver to an overdose in 2020. In the years since, she's turned to advocacy and helped to organize local overdose awareness vigils.

Ahead of this year's presidential primary, Gladstone — who describes herself as a center-leaning independent — has been curious to hear how candidates plan to address addiction.

She thinks law enforcement and border security have a role to play. But she’d like to see candidates talk more about other solutions: increasing access to treatment, expanding harm reduction measures, breaking down stigma and addressing youth mental health.

“It's like a pot boiling over, with the anxiety and that sort of thing,” she said, describing the ease with which vulnerable young people can turn to substances. “And so they're more susceptible to drugs.”

Teri Gladstone, one of the organizers, speaks during a vigil in front of the New Hampshire State House Wednesday for International Overdose Awareness Day.
Paul Cuno-Booth
Teri Gladstone spoke at an overdose-awareness vigil in front of the New Hampshire State House in 2022.

But such nuance is largely missing from this year’s campaign trail. Most of the action is on the Republican side, and to the extent that those candidates have addressed the issue in public speeches and campaign stops in New Hampshire, they’ve mostly invoked fentanyl while calling for hardline policies at the southern border, harsher sentencing laws or a more aggressive U.S. stance toward China.

That’s a departure from 2016, when many candidates — including some Republicans — made a point of talking about substance use during their campaign stops. Some relayed their own personal stories about family members dealing with addiction.

In the eight years since, more than 3,000 Granite Staters have died due to drug overdoses. To Gladstone and some others touched by the crisis, the political rhetoric in this year’s Republican primary feels empty.

“I think they're just throwing stuff out there to try to appease people at this point,” Gladstone said. “And that's not what we need. We need somebody that really is taking it seriously and has sat down and thought about a plan.”

What the GOP candidates are saying

Federal immigration officials say the vast majority of drugs coming across the southern border are smuggled through legal ports of entry, mostly by U.S. citizens or other legal residents – not by migrants illegally crossing the border between entry points.

Nonetheless, top Republican presidential candidates continue to link the drug crisis to immigration. In recent months, former President Donald Trump has claimed that “drugs, criminals, gang members and terrorists are pouring into our country” because the border “has been erased.” He’s also called for drug dealers to get the death penalty.

Florida Gov. Ron DeSantis has proposed sending the military into Mexico to take out the cartels, and pledged to shoot suspected drug smugglers “stone-cold dead right at that southern border.”

Some candidates also frame fentanyl as part of a growing confrontation between the U.S. and China, which is a major source of the precursor chemicals that criminal groups in Mexico use to manufacture the drug.

In her speeches to New Hampshire voters, Nikki Haley, who was Trump’s ambassador to the U.N., has threatened to cut off normal trade relations if China doesn’t “stop killing Americans.” Businessman Vivek Ramaswamy – before dropping out after his fourth-place finish in Iowa – accused China of waging an “opium war” on the United States.

In some ways, the rhetoric this year echoes the talking points top Republicans leaned on in 2016. At the time, New Hampshire was among the states hardest hit by opioids, and overdoses were rising to record levels.

At his 2016 campaign rallies, Trump drew a direct line between building a wall at the southern border and solving the opioid crisis. He later attributed his 2016 primary win to New Hampshire being a “drug-infested den.” Another top candidate, Texas Sen. Ted Cruz, also focused primarily on border enforcement as his response to rising drug overdoses.

But some other candidates put forward more comprehensive plans that also included treatment, prevention or reforms to the criminal justice system. And several Republican hopefuls – including Cruz – spoke candidly about family members who had struggled with substance use themselves.

This time around, there’s been little talk about treatment or recovery.

The one candidate who had emphasized those principles as part of his drug policy agenda – former New Jersey Gov. Chris Christie – is no longer in the race. While Christie also talked often about stopping fentanyl at the border, he made a point of saying that alone won’t solve the problem.

Last month, before he dropped out of the race, Christie visited Hope on Haven Hill – a treatment center in Rochester serving pregnant women and mothers – where he laid out a series of plans to expand access to substance use treatment.

“We don't solve this crisis unless we focus on substance use disorder and what gets us there – and what helps to get people out of it, and into recovery,” he said.

Former New Jersey Gov. Chris Christie speaks about substance use at Hope on Haven Hill, a treatment center in Rochester, in December.
Paul Cuno-Booth
Former New Jersey Gov. Chris Christie speaks about substance use at Hope on Haven Hill, a treatment center in Rochester, in December.

Jessica Parker, who until recently worked at that recovery center, said Christie struck a very different tone from other candidates.

“It is good to hear people speaking about it, and speaking about solutions," she said, "versus speaking about criminalizing and stigmatizing people."

Kerry Norton, Hope on Haven Hill’s executive director, said even though candidates don’t seem to be talking about addiction as much as in past election years, the urgency hasn’t gone away. Drug overdoses are a leading cause of death during and after pregnancy, she said, and yet women still face barriers getting treatment. That’s especially true if they’re pregnant or have children.

“It's obviously still a high focus for me, and for our state,” she said.

‘It needs to be in the headlines more than it is’

It’s also a focus for Jim and Anne Marie Zanfagna. Their daughter, Jacqueline, died of an overdose in 2014. She would have turned 35 last month.

“We decided to not bury our heads in the sand,” Jim said. “In the first sentence of the obituary we put in the newspaper, we did say ‘died of a heroin overdose’ – so that people would know.”

“And we were not ashamed,” Anne Marie added.

In the years since, the Plaistow couple has advocated for funding to address addiction and sought to raise awareness. They founded a nonprofit, Angels of Addictions, through which Anne Marie paints portraits of loved ones lost to drugs.

Several national news outlets interviewed them in 2015 and the following years. Jim said they get fewer of those calls these days.

“It needs to be in the headlines more than it is,” he said.

The Zanfagnas are registered Democrats, but they have been following the GOP primary. Jim said they spoke briefly to Christie and Haley at campaign events in New Hampshire, and felt both candidates took the issue seriously.

Jim said more money should be spent on educating young people about substance use, and making treatment easier to access. The Zanfagnas sometimes get calls from people trying to figure out how to get into treatment.

He’d like to see journalists ask more questions about substance use during debates.

“We really haven't heard enough concrete solutions from politicians,” he said.

To Anne Marie, it also makes sense to aggressively pressure China to curb the supply of fentanyl, as Haley’s been calling for, and pursue with stricter enforcement at the border.

“Drug addiction is killing our country and our children – and my child,” she said. “And that’s something we’ll never get over.”

Another local advocate, Doug Griffin, said the priority needs to be prevention.

“The whole issue starts with mental health and prevention,” he said. “And we could stop this problem if we were to address it at an early age.”

Griffin, who lives in Newton, lost his 20-year-old daughter, Courtney, to an overdose in 2014. He’s since become an advocate and has worked with the national nonprofit Addiction Policy Forum. President Joe Biden invited him to the State of the Union last year and mentioned Courtney in his speech.

A registered independent who says he usually votes Republican, Griffin said politicians are focusing a lot on the supply of drugs — not enough on why people use drugs in the first place.

“It's not about the wall, you know,” he said. “It's about what's going on in the schools. That's where it starts.”

Paul Cuno-Booth covers health and equity for NHPR. He previously worked as a reporter and editor for The Keene Sentinel, where he wrote about police accountability, local government and a range of other topics. He can be reached at
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