Sarah August developed an opioid addiction after being prescribed painkillers in her late 20s. She began using heroin after her doctor took her off the medication. Eventually, she decided to seek treatment.

But it was hard to find the right option. “I bounced around from place to place, because there is no long-term program,” she said. Now in recovery, August works at an organization that’s trying to address that need, Dismas Home in Manchester.

It’s a nine-month residential treatment and transitional housing program for women. “The first time I got clean, I wish there was a program like this,” she said. "There's not enough of them out there.

You need long-term treatment to build your recovery foundation.” That kind of support is often unavailable, she said, so too many people are stuck cycling in and out of 28-day programs. “Most people are going to fail,” she said.

“And that's where we need to start coming up with a better system.” A decade into New Hampshire’s overdose crisis, there are some signs of progress. Overdose deaths declined last year, after surging during the pandemic.

Access to treatment, recovery support and the overdose-reversal drug naloxone has improved. But hundreds of Granite Staters are still losing their lives to drugs each year – 431 in 2023, according to the latest data from the state medical examiner. And those, like August, who are on the front lines of the crisis say many people still face barriers to getting the help they.