Melanie T. | Oppose SB557

SB 557 – Harm Reduction Concerns from a Registered Nurse Dear Committee Members, I am writing as a Registered Nurse to express concern about SB 557 and its potential impact on harm reduction efforts in New Hampshire. New Hampshire has recently experienced a meaningful decline in overdose deaths, widely attributed to pragmatic public health strategies such as expanded treatment access, naloxone availability, and harm reduction approaches. Policies that remove lower risk substitutes can unintentionally reverse this progress. In clinical practice, when safer or stabilizing options are eliminated, individuals often turn instead to unregulated black market opioids, where fentanyl and xylazine dominate and overdose risk is significantly higher. This substitution risk is not theoretical—it is something nurses see firsthand. Some patients report that 7 hydroxymitragynine–containing kratom products help them manage pain, remain functional, and avoid a return to illicit opioids. For individuals with chronic pain or prior opioid exposure, continued access can mean maintaining employment and housing rather than relapse or crisis. While 7 hydroxymitragynine is not risk free, it differs pharmacologically from full agonist opioids and does not appear to carry the same overdose risk profile that drives today’s fatalities. Rather than prohibition, I urge the House to consider a science based regulatory approach that: • Preserves adult access as a harm reduction option • Implements quality control, labeling, and dosing transparency • Restricts youth access and misleading marketing Prohibition has historically shifted risk toward more dangerous substances. Regulation grounded in harm reduction principles offers a safer and more effective path forward for New Hampshire residents. Thank you for your consideration and for your continued work to protect public health.