It was a recent Friday night just after 7 p.m. and the Manchester police department was responding to its 13th overdose call of the week at a local restaurant.
Metivier, the general manager, said the young man was able to recover enough to leave before the police or the ambulance could arrive. She said she'd never seen anything like it but knew how widespread drug addiction has become.
"It's all we've been hearing," she said.
Here in New Hampshire's biggest city, the police department says it has witnessed some of the worst effects of the state's drug epidemic, with 75 overdose deaths so far this year. The state's Office of the Chief Medical Examiner expects more than 400 deaths in 2015 across the state, double the number from 2013.
According to the state's bureau of Emergency Medical Services the life saving anti-overdose drug Naloxone (commonly known as Narcan) has been administered by the county in more than 2,000 incidents in 2015.
Growing addiction to opiates and opioids like heroin and fentanyl is not unique to New Hampshire, but every four years its residents have an unusual megaphone as the first-in-the-nation primary rolls around. This year they are putting the issue of addiction front and center -- whether questioning candidates about their policies at a town hall or sharing their own personal stories.
"This ranks among the most intense in terms of how much voters' feelings about a personal issue have moved upwards, have shot upwards, to the presidential level," Dante Scala, a political science professor at the University of New Hampshire told CNN.
According to an October survey from the University of New Hampshire and WMUR, a quarter of Granite Staters think drug abuse is the most important problem facing the state, the first time in eight years that a plurality think an issue is more important than jobs and the economy. The epidemic reaches across all demographics and nearly half of those surveyed say they know someone who has abused heroin.
A 2014 report from the U.S. Department of Health and Human Services found that New Hampshire ranks second to last among states when it comes to access to substance abuse treatment for those who need it.
One of the first candidates to focus on the addiction crisis in New Hampshire was Republican Chris Christie
, who has attended seven separate campaign stops focused on the issue. He has called for an end to the stigma surrounding addiction and said the war on drugs has been a "failure."
At a recent roundtable event at HOPE for New Hampshire Recovery in Manchester, Christie listened to Holly Cekala, director of recovery support services, speak about her own recovery.
"Every single day of my life I try to give back because I'm alive and I'm grateful. There's 23 million of me out there that are like that too. And we all vote," Cekala said.
"That's just the ones in recovery, how about the 50 million family members? We're talking about a constituency of consequence that could make or break any candidate," Cekala told CNN. "This is the first year I've seen presidential candidates come down to the front line and say, what's going on here? How can I help?"
Cekala says she has seen some politicians struggle with the language around addiction and that it infuriates her when she hears them label people by their condition, calling them "addicts", rather than saying: "These are people with substance abuse disorders, these are people with mental health issues."
"Candidates should understand, if we're the largest voting constituency and you don't know how to talk to us, you've lost us even if your policy is good," Cekala said.
Christie has firsthand experience with the language surrounding addiction and says it should be treated as a disease and not a "moral failing." A video shot by the Huffington Post at a town hall in New Hampshire shows an emotional Christie talking about his mother's death from cancer after a lifelong addiction to smoking, and a friend's death after he became addicted to painkillers following a back surgery. It has been viewed more than 8 million times on Facebook.
Christie's campaign says the New Jersey governor has long focused on addiction
in his home state, but he recognized how the issue would resonate with voters and activists in the important primary state. A number of high profile endorsements have cited Christie's stance on the issue in recent weeks.
Fellow Republicans Jeb Bush
, Carly Fiorina
, John Kasich
and Democrat Hillary Clinton
have all spoken about the significance of hearing about addiction straight from New Hampshire voters and have participated in roundtables and events focused on the issue.
Jeb Bush has spoken
about his daughter's struggle with addiction as well as ways he addressed the issue as Governor of Florida. Bush suggests expanding drug courts that help non-violent drug offenders find treatment and tightening border security to stop the flow of illegal drugs.
Businesswoman Carly Fiorina lost her step-daughter to alcohol and drug addiction and emphasizes prevention as well as treatment. She says that some laws aimed at stopping substance abuse can actually isolate those that need to find a way toward recovery.
Ohio Gov. John Kasich has spent considerable time addressing drug addiction in his state and tells New Hampshire audiences about his efforts to shut down pill mills, regulate how many drugs can be prescribed to patients -- many addictions start after patients are prescribed painkillers -- and educate kids about the dangers of substance abuse.
Former Secretary of State Hillary Clinton, like many of the candidates, emphasizes treatment over incarceration for non-violent
drug offenders. Clinton says she was surprised by how widespread the issue was when she started visiting New Hampshire and she has pushed for supporting local treatment programs.
State legislators are also taking on substance abuse. The latest state budget increased funding for tackling the problem, and a task force is deciding where to focus additional efforts.
Options include enhanced prescription drug monitoring, making Narcan more available, and increased funding for statewide drug courts and police departments.
"The drug crisis in New Hampshire didn't start yesterday. It's been a long time coming and there's no one single initiative that will solve the problem," said State Senate Majority Leader Jeb Bradley. "Its already front and center in people's minds."