MANCHESTER, N.H. -- Some New Hampshire cities saw more drug overdoses in May than they have since before the pandemic, and advocates are urging policymakers to keep their eye on the ball in fighting the opioid crisis.

Chris Stawasz, Northeast director of government affairs for American Medical Response, which provides ambulance service for Manchester and Nashua, said the rise is concerning, and while the pandemic has rightfully taken a lot of the public health focus, it's critical to maintain support for addiction treatment programs, for example, "Safe Stations," which are firehouses where people seeking recovery can go, and a trained firefighter will connect them with services.

"Some of the other pieces that go along with that are recovery-friendly workplaces," Stawasz explained. "So that people can have a job as they enter recovery, and affordable, safe housing so that people are not going back to the same situations that they were in."

He pointed to data that showed May saw 72 suspected opioid overdoses in Manchester and Nashua alone, more than any other month since June 2019, as well as increased visits to Manchester Safe Stations.

He noted the pandemic has also posed challenges for getting timely treatment and finding a job, when someone dealing with addiction is ready.

Stawasz added more than 40% of overdose patients his company encountered in Manchester had already been given a dose of Narcan, a medicine to treat overdoses in emergency situations.

He contended that means efforts to increase access to Narcan have been working.

"That's a lifesaver, in no uncertain terms," Stawasz asserted. "That's saved, I'm sure, hundreds of lives because of what people have done with that. And we would encourage that to continue."

Stawasz added Narcan is an important resource for family members and loved ones of people dealing with addiction. And he pointed out it is available at local pharmacy chains without a prescription.

States such as Minnesota continue to grapple with recent spikes in fatal overdoses tied to opioids. Now, a federal agency has taken what aid groups say is a big step in preventing such deaths.

This week, the Food and Drug Administration approved over-the-counter sales of the nasal version of naloxone, which rapidly reverses the effects of an opioid overdose. Sold under the brand name Narcan, the product has only been available through a prescription.

Minnesota recently recorded a 44% increase in opioid overdose deaths.

Maddy Reagan, overdose prevention manager for the Steve Rummler HOPE Network, pointed out in 2021, there were nearly 5,000 nonfatal overdoses.

"So what that said to me is that Naloxone is having an important impact in keeping people alive," Reagan explained.

The FDA said its action paves the way for the lifesaving medication to be sold directly in places beyond pharmacies, such as grocery stores and gas stations, as well as online.

Reagan and various medical organizations worry about the cost, potentially still keeping it out of reach for many individuals. The drug's manufacturer declined to comment on what the new price structure would look like.

Currently, Narcan doses typically cost around $130 for those without insurance. Reagan emphasized the price forces harm-reduction groups to focus on certain strategies to distribute the product to those who need it.

"We primarily distribute intramuscular Naloxone, because it's significantly less expensive," Reagan noted. "We're able to get high volumes out into the community."

Intramuscular Naloxone involves injections, and some health agencies say the nasal form is easier to use and more appealing for those worried about using needles. As for the prescription requirement, many states, including Minnesota, have already adopted laws to make it easier for an individual to obtain the medication from a pharmacist.


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More than 4,000 people in North Carolina died of overdoses in 2021, the highest number of overdose deaths in a single year on record in the state, according to recently released data.

Dr. Susan Kansagra, assistant secretary for public health with the North Carolina Department of Health and Human Services, said before the pandemic, the state's opioid overdose deaths had been leveling off, but now, she said they are on the rise, and communities have spent the past few years grappling with the loss of loved ones.

"We're seeing an increase in poly substance use as well," Kansaghra said. "Not just deaths caused from opioid overdose, but really we're seeing multiple substances have been used. "

She said the manufactured opioid called fentanyl is driving fatalities. In 2021, more than 77% of overdose deaths in the state likely involved fentanyl. The state's 988 Suicide and Crisis Lifeline offers 24/7 access to trained crisis counselors who can help people experiencing distress. Since the launch of 988 last summer, the call center has seen an 85% increase in people identifying substance use as their primary reason for calling.

Kansagra added health insurance is a major component of addressing the opioid epidemic. Lawmakers recently reached a bipartisan agreement that puts the state on a path to allow access to health care for an additional 600, 000 North Carolinians.

"One of the things we know in North Carolina is that we we are working on Medicaid expansion. And that's really important so that people have the ability to get high-quality care," Kansagra said.

She said the state has also expanded its mobile crisis care resources, where a person experiencing a behavioral-health or substance-use crisis can receive an assessment on the spot, whether at home, school, work or other location.


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Another Minnesota House committee has endorsed a bill that would allow sports betting within the state, but there are calls to add some provisions as the measure advances.

If approved, licenses would be provided to tribal nations around Minnesota to create sportsbooks at casinos, and Minnesotans age 21 and older could also place wagers through their phones, using online apps.

Bill sponsors have said revenue would go toward regulations and consumer protections, with another 40% used to address problem gambling. Susan Sheridan Tucker, executive director of the Minnesota Alliance on Problem Gambling, said that language is appreciated, but she asked lawmakers if information-sharing can be included, too.

"Operators and their licensees will be collecting quite a bit of data that can help answer many questions that researchers have concerning gambling behaviors," she said, "and can provide insights into whether more individuals are becoming addicted to gambling."

Tucker, whose organization is neutral on legalizing sports betting, stressed that no personal information, including a bettor's identity, would be shared. She said at least two other states have these provisions in their laws. The Minnesota Indian Gaming Association has said it needs more information before commenting on that recommendation.

Key supporters of the plan have said that with more than 30 other states already allowing sports betting, it's time for Minnesota to take something already being done on the black market and put it under the state's purview.

David Prestwood, government affairs manager for the online betting firm DraftKings, echoed that sentiment in his testimony.

"An estimated 1.17 million people in the state are making a combined total of more than $2.5 billion in illegal wagers annually," he said. "Nearly all of these wagers are placed online in the robust illegal market, where sophisticated illegal operators capitalize on the popularity of this form of entertainment."

As for the sharing of aggregated data, the bill's sponsor expressed a willingness to have more discussions about it. More broadly, the current version excludes horse tracks, potentially complicating final passage in the Legislature.