In May 2026, New Hampshire finally got paid. The state's share of the national Purdue Pharma settlement came to $29.5 million, part of a $7.4 billion deal that also bars the Sackler family from ever selling opioids in this country again.

Governor Kelly Ayotte put out a statement:

"The opioid crisis has devastated families in our state, and I thank the Attorney General's Office in New Hampshire and AGs across the country who have worked tirelessly to hold Purdue Pharma accountable for their role in poisoning our communities."

It's a good statement. Here's the problem with it.

Nineteen years ago, Kelly Ayotte was the Attorney General of New Hampshire. Other attorneys general went after Purdue Pharma. She didn't.

2007: the states sued, and New Hampshire sat it out

In May 2007, Purdue and three of its executives pleaded guilty in federal court to misleading doctors and patients about OxyContin — the claim that the pill gave 12 hours of pain relief and was therefore safer and less addictive than the competition. The company paid $600 million.

The states brought their own case. Twenty-six of them, plus Washington, D.C., reached a consent judgment with Purdue that year — a court order barring the company from making misleading claims about addiction and abuse in its OxyContin marketing.

New Hampshire was not one of them. As the Concord Monitor's editorial board later put it, New Hampshire was, "under then-Attorney General Kelly Ayotte, the only New England state not to participate in the suit."

Nobody has ever really explained why. Writing about it years afterward, the Monitor said the reason "could not be determined on deadline."

The other New England states took the money and spent it fighting addiction. New Hampshire got nothing. Purdue paid the participating states $19.5 million, and MeidasTouch estimated New Hampshire left between $720,000 and $950,000 on the table.

Under a later attorney general, New Hampshire eventually did sue Purdue — in 2017, a full decade after the rest of New England, and after the state had spent years being one of the hardest-hit places in America. New Hampshire then fought the Sacklers' bankruptcy deal as too soft. That fight is the one that produced the check Ayotte just praised. She wasn't part of it. She was on the other side of the decision that started it.

Then she went to Washington and took the industry's money

Ayotte won a U.S. Senate seat in 2010. The drug companies noticed.

From 2009 to 2015, she took $138,650 from members of the Pain Care Forum and their allies — more than any other New Hampshire politician, and nearly $100,000 more than Senator Jeanne Shaheen, the next closest. Out of $664,399 that pharmaceutical companies and their lobbying groups poured into New Hampshire politics, more than a fifth of it went to one person.

So what is the Pain Care Forum? It's not a household name, and that was the point. The Associated Press and the Center for Public Integrity spent 2016 pulling it apart. What they found:

• It's a coalition of drugmakers, trade groups, and industry-funded nonprofits with no office and no website.
• It was co-founded — and its monthly meetings run — by Purdue Pharma's own Washington lobbyist.
• Between 2006 and 2015, its participants spent more than $740 million on lobbying and more than $140 million on political campaigns.
• Groups pushing for limits on painkillers spent about $4 million over the same period. The industry outspent them roughly 200 to 1.

That's the money Ayotte led New Hampshire in collecting. From the network run by the company she declined to sue.

The speech and the checks

On January 27, 2016, Ayotte testified before the Senate Judiciary Committee about the crisis back home. Her statement for the record is genuinely moving:

"In New Hampshire, the number of drug overdose deaths is staggering: In 2014, there were over 320 drug overdose deaths."

She went on to say those statistics were "more than just numbers" — they were family members and friends, in every community in the state. Then she laid out what she wanted done about it: tougher fentanyl trafficking penalties, more Narcan for first responders, drug take-back programs, and passage of the Comprehensive Addiction and Recovery Act.

Every one of those remedies points at the street supply or at treatment capacity. None of them points at the companies that built the market.

Now look at the calendar around that speech. MeidasTouch reported that a PAC supporting Ayotte accepted $1,041.67 from Mortimer Sackler on January 26 — the day before she testified. A week after, on February 2, it took $2,083.33 from Jonathan Sackler. In September 2016 she collected another $4,483.32 from opioid manufacturers and distributors, the same month she accepted an award for her leadership fighting the opioid crisis. Across her Senate career, the tally from opioid makers, distributors, their owners and employees came to at least $83,000.

She gave the speech. She cashed the checks. She never went after the source.

Today she's squeezing the thing that actually pays for treatment

Ayotte is Governor now, and she likes to talk about this issue. In March 2025 she put out a release touting New Hampshire as "a model for the nation" on overdose deaths.

But ask who actually pays for addiction treatment in New Hampshire, and the answer isn't Operation Granite Shield. It's Medicaid. The New Hampshire Fiscal Policy Institute is blunt about it: Medicaid is "the single-largest payer for SUD treatment" both nationally and here, covering roughly half of all substance use disorder spending in the state — about $57.8 million in 2024 alone.

And Medicaid is exactly what Ayotte has been cutting.

• Her budget added Medicaid premiums of $90 a month for a household of three, plus a renewed push for work requirements.
• Her budget plan raised pharmacy copays from $1–$2 to $4 for the lowest-income recipients.
• Trump's "Big Beautiful Bill" is projected to cost 43,729 Granite Staters their health insurance, 19,029 of them cut from Medicaid. Ayotte said there were "aspects of it, of course, that I disagree with" — and then her administration set about implementing it rather than fighting it.

NHFPI lays out where that leads. It cites research estimating that 156,000 people nationwide could lose access to medication-assisted treatment because of the new federal law — and that this alone would mean roughly 1,000 more opioid deaths every year. KFF projects federal Medicaid spending in New Hampshire will fall by $2.3 billion, about 15 percent, over the next decade.

If you are a Granite Stater in recovery, a $4 copay and a paperwork requirement are not abstractions. They are the difference between picking up your prescription and not.

The pattern

Put it in order and it's the same choice, three times.

In 2007, she could have joined the other states and made Purdue pay. She didn't.

In the Senate, she could have gone after the industry that manufactured the epidemic. Instead she took more of its money than any other politician in the state, and pointed her legislation at traffickers.

As Governor, she could protect the Medicaid coverage that pays for half of New Hampshire's addiction treatment. Instead she's adding premiums and copays to it.

The $29.5 million is real, and it will help. But it arrived in spite of the decision Ayotte made when she was the one holding the pen — and it arrives just as she's cutting the program that keeps people in treatment after the settlement money runs out.

Thanking the lawyers is easy. Being one of them was the job she had.

Source

Reporting from the Concord Monitor on New Hampshire's $29.5 million Purdue Pharma settlement, and the Monitor's 2016 coverage of OxyContin and pharmaceutical money in New Hampshire politics. Photo: Purdue Pharma headquarters, AP Photo / Douglas Healey.