Fact check: West Virginia, not New Hampshire, ranks first in fatal drug overdoses

Former President Donald Trump claimed during a New Hampshire rally that the state has an unexplained drug problem. But his claim hinges on outdated data.

"I don't understand New Hampshire for whatever reason, you have a worse drug problem per capita than any other state," Trump said during a Nov. 11 rally in Claremont. "Nobody's explained that."

Trump didn’t define what he meant by "worse drug problem," but he also praised the fire and police departments for "saving people from overdoses."

Trump’s campaign did not answer PolitiFact’s question on whether he was referring to overdose deaths, an often used metric, or something else.

But Trump’s assessment isn’t supported by federal fatal overdose data.

The U.S. Centers for Disease Control and Prevention gathers data from states showing how many people die annually from drug overdoses. The most recent final data is for 2021.

That year, West Virginia had the highest per capita drug overdose death rate, with 90.9 deaths per 100,000 population. New Hampshire’s per capita death rate was 32.3, placing it at No. 23 among all states. CDC’s provisional 2022 data shows that New Hampshire ranked similarly and West Virginia remained first.

But even with New Hampshire ranking in the middle of the nation, there is cause for concern: drug overdose deaths have been rising. There were 487 drug overdose deaths in 2022, an 11% increase from 2021.

New Hampshire officials found that the majority of the 2022 deaths were linked to overdoses from fentanyl (a potent synthetic opioid), or fentanyl with other drugs. 

The CDC national data says that in 2021 most drug overdose deaths involved opioids; and New Hampshire placed in the middle again for deaths involving only opioids.

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New Hampshire’s per capita ranking has been worse in the past. From 2014 to 2016, the state’s per capita death rate was in the top two or top three among all states.

"New Hampshire was one of the first states seriously affected by fentanyl," said Peter Reuter, a University of Maryland public policy analyst and professor. Yet its death rates have remained constant while the rates of other states, such as Ohio and West Virginia, have soared, he said.

In the same New Hampshire speech, Trump said drug dealers should be given the death penalty. But experts say that the death penalty would not wipe out addiction.

The death penalty will not result in many executions; the courts have been very resistant to such penalties, Reuter said. "If Mr. Trump means much harsher penalties, we ran that experiment in the 1980s and 1990s," Reuter said. "It did not noticeably reduce the national drug problem."

Trump said that New Hampshire has "a worse drug problem per capita than any other state." 

Trump didn’t provide evidence for his statement. CDC data on fatal drug overdoses shows that West Virginia is the state with the highest per capita death rate. New Hampshire ranks toward the middle of the 50 states.

New Hampshire years ago ranked second or third in terms of per capita fatal overdoses. But Trump’s recent statement overreaches.

We rate his claim False. 

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