New Hampshire spent the better part of a decade as one of the deadliest places in America for opioid overdoses, and now its two U.S. senators want Washington to spend big to keep the recent progress from slipping away. U.S. Sens. Jeanne Shaheen and Maggie Hassan, both New Hampshire Democrats, filed legislation this week to dramatically expand federal addiction funding, a plan that would push national spending on prevention, treatment, and recovery to roughly $65 billion over ten years. As the New Hampshire Bulletin reported, the measure, known as the Turn the Tide Act, arrives at a moment when the state is finally seeing the death toll fall, but when the federal money that helped drive that decline looks anything but secure.
The timing matters. New Hampshire recorded a 44% drop in opioid-involved deaths between 2022 and 2024, from 427 to 240, according to the New Hampshire Drug Monitoring Initiative. Public health officials are still finalizing 2025 figures, but their preliminary estimate puts the number even lower, at 187. That is a remarkable turnaround for a state that in 2017 lost 424 people to opioids, a rate of roughly 34 deaths per 100,000 residents, more than double the national average of 14.6 per 100,000 that year. The senators argue this is exactly the wrong time to ease off, and that locking in long-term investment now is what will keep the curve bending downward.
What the Turn the Tide Act Would Actually Do
The centerpiece of the bill is a major increase to the State Opioid Response Program, the federal grant pipeline that sends money to states based on how hard the opioid crisis has hit them. The legislation would raise that program’s funding by almost $4 billion, bringing it to $5.5 billion annually for five years. For New Hampshire, which received $29.9 million through the program in fiscal year 2025, a per-capita formula that rewards the hardest-hit states could translate into a substantial bump in resources.
Much of that New Hampshire money flows into The Doorway, the state’s signature recovery access program. The Doorway runs nine treatment centers across New Hampshire on a “hub-and-spoke” model, a structure that gives people a single front door to walk through and then routes them toward the specific services they need, from medication-assisted treatment to mental health therapy. It is the kind of infrastructure that takes years to build and only weeks of funding uncertainty to destabilize, which is part of why the senators are pushing for multi-year commitments rather than one-off appropriations.
Beyond the State Opioid Response Program, the bill reaches into several other corners of the crisis. It would create a new grant program aimed at children in families affected by addiction, money intended to help kids deal with the trauma that so often follows a parent’s substance use disorder. It would expand a federal program designed to build housing for people in recovery, recognizing that stable housing is one of the strongest predictors of whether someone stays in recovery. And it would require Medicare Part D plans to fully cover naloxone, the emergency medication that reverses opioid overdoses and that public health experts widely credit for saving lives during the worst years of the epidemic.
Why the Senators Say Federal Action Cannot Wait
Shaheen’s team pointed directly to instability in Washington as the reason Congress needs to act. In January, the Trump administration announced just under $2 billion in cuts to more than 2,000 programs tied to addiction and public health. The move triggered bipartisan backlash, and within 24 hours the administration reversed course and reinstated the funding. For state officials and treatment providers who plan budgets months in advance, that kind of whiplash is more than an inconvenience. It is an argument for putting funding into durable statute rather than leaving it exposed to the next round of cuts.
“We’ve made important progress to reduce overdose deaths in New Hampshire, but the fentanyl crisis continues to devastate families across our state,” Hassan said in a statement to the Bulletin. She framed the measure as a bipartisan effort to strengthen prevention and recovery, address the workforce shortages that make care hard to find, and help communities save lives.
Shaheen struck a similar note, tying the legislation to the people she has met across the state. “Substance use disorder impacts communities in every corner of our state, and I’ve heard from countless families who have been torn apart by this crisis,” she said in a statement, adding that the bill is meant to secure long-term investment in prevention and treatment. For Shaheen, the stakes are also personal in a political sense: she is hoping to get the bill across the finish line during her final year in the Senate before she retires after November’s elections.
An Uphill Climb in a Cost-Conscious Congress
None of this will be easy. Shaheen and Hassan first introduced the Turn the Tide Act in 2024, and it failed to make it out of committee. The roughly $65 billion price tag is certain to draw resistance from fiscal hawks within the GOP, who control key levers in Congress and have spent the past year scrutinizing large new spending commitments. Passing a multi-year, multi-billion-dollar program in that environment would require the senators to build a genuinely bipartisan coalition, and the bill’s emphasis on its bipartisan structure suggests they know it.
New Hampshire’s recent gains also complicate the politics in a subtle way. When deaths are falling, it becomes easier for budget writers to argue that the crisis is receding and that existing funding is sufficient. Treatment professionals push back hard on that logic. They point out that the decline is fragile, that fentanyl remains widespread, and that the workforce shortages straining the system have not gone away. The progress, in their telling, is a reason to invest, not a reason to coast. The state’s experience is a useful reminder that overdose numbers can move quickly in either direction, which is the same dynamic that has shaped New Hampshire’s broader fights over Medicaid funding and the future of its health care system.
The Broader New Hampshire Context
The Turn the Tide Act is only one front in a long-running effort to repair the damage the opioid epidemic did to New Hampshire communities. The state has also pursued accountability through the courts, securing tens of millions of dollars in settlement money from companies that helped fuel the crisis, including in the Purdue Pharma opioid settlement that directed roughly $30 million to New Hampshire. That settlement money and federal grant money are meant to work together, with one funding stream rebuilding treatment capacity while the other holds bad actors responsible. Federal investment of the scale Shaheen and Hassan are proposing would dwarf the settlement dollars and give the state a far more predictable base to plan around.
There is also the rural dimension. Much of New Hampshire’s overdose burden has fallen on smaller communities where treatment options are thin and travel times are long, the same places now counting on initiatives like the state’s rural health funding push backed by a major federal grant. A larger State Opioid Response Program allocation would, in theory, give those communities more capacity to keep Doorway hubs staffed and spokes connected, which is precisely where the per-capita, need-based formula is supposed to direct the most help.
For now, the bill is just that, a bill, and a long way from becoming law. But its reintroduction puts a marker down at a pivotal moment. New Hampshire has clawed back nearly half of its overdose deaths in two years. Whether it can hold that ground may depend in part on whether Washington decides the fight is worth $65 billion over the next decade.
For related coverage, see our reporting on New Hampshire ACA Marketplace Enrollment Falls 4.1% as Pandemic Subsidies Expire.
