New Hampshire is a beautiful state with so much to offer its residents – great food, nature, coastline, and friendly people. However, much like other states across the United States, New Hampshire isn’t exempt from drug abuse. In a national overview of drug use by state, New Hampshire ranks at number 18. The state isn’t in the top 10 problematic areas, but it’s not in the bottom half either. Clearly, there’s room for improvement.

In 2020, the Annual Report from the New Hampshire Office of Chief Medical Examiner reported 413 confirmed drug deaths in total. This number was almost on par with 2019 when New Hampshire reported 415 overdose drug deaths. So, after getting (almost) through a pandemic and all the difficulties that come with that – what will the state’s drug use levels be like in 2021? Keep reading for a reflection of drug trends in New Hampshire in 2020 and what it means for 2021.


New Hampshire’s deadliest drug problem is fentanyl – a concentrated form of opioids. In 2020, 318 overdose deaths involved fentanyl by itself or in combination with another drug. Of all the drug overdose deaths in the state, fentanyl, heroin, and other opioids accounted for 86% of all drug deaths.

Chief Medical Examiner Dr. Jennie Duval said that the numbers speak to “just how lethal fentanyl is.” Fentanyl can be one thousand times more potent than morphine, so it’s an extremely high-risk drug for overdose and fatalities.

New Hampshire has reported 59 overdose deaths involving fentanyl, heroin, or opioids from January to May 14, 2021. If this trend continues for the rest of 2021, fentanyl-related deaths in New Hampshire should be significantly lower than the rates in 2020.


After fentanyl-related overdose deaths, opioids come in second place for the most overdose deaths. The abuse of opioid prescription drugs has been a problem across the United States since the 1990s. Unfortunately, not only are opioid prescription drugs really addictive, but they also often lead to a progression of other drugs.

According to the National Institute on Drug Abuse, 80% of heroin users reported initially starting with the abuse of opioid prescription pills. After getting addicted to prescription pills, people may find it hard to get more pills. As a result, they turn to heroin or fentanyl, which is much more affordable and accessible, but also more dangerous.


In 2020 there were 56 overdose deaths involving cocaine in New Hampshire. This was a significant drop from 2019’s 79 cocaine deaths. However, only seven deaths were solely from cocaine, while the other 44 were a combination of cocaine and fentanyl. These numbers seem to suggest that New Hampshire doesn’t have an overwhelming cocaine problem. Instead, fentanyl is impacting all drug users. It’s very possible that people think they’re purchasing pure cocaine when they are getting a concoction that includes fentanyl.

Help is Available

It’s unclear if 2021 will bring a spike in overdose deaths from New Hampshire’s 2020 numbers. On the one hand, the pandemic was especially challenging for those struggling with drug abuse. However, many people may be walking into 2021 feeling like they have a new chance in the world.

You can get the help you need at Live Free Recovery Services. We offer drug and alcohol treatment throughout New Hampshire. Live Free SSL believes in helping people address all of their problems, not just addiction. Contact us today to find out how we can help you.