COLEBROOK, N.H.—Bruce Latham, a lanky, self-employed doctor, occupies a unique position in the depths of rural New Hampshire’s opioid drug addiction crisis.

As part of his practice in Colebrook, a town of 2,300 in Coos County, Latham responds to pain by prescribing opioid painkillers. He says he empathizes with patients’ propensity to become addicted to pain medicine because his own son is a recovering drug addict.

“I don’t judge these kids because I understand addiction and understand what dopamine does to your brain,” Latham says, describing how opioids target the brain’s reward system by releasing dopamine, a chemical that regulates feelings of pleasure.

Latham, 63, is also ruthlessly committed to stamping out the illegal use—and spread of—opiates as they decimate Coos County, which has the highest combined death rate due to drugs, alcohol, or suicide in all of New England.

On a recent April afternoon, Latham, a measured, religious man with heavy bags under his eyes, is downright gleeful as he unveils a wad of note cards, bound with a rubber band. Embellishing, the physician says these cards contain the identities of “every opioid drug dealer within 100 miles of Colebrook.”

For the past 10 years, Latham has reported to law enforcement anybody he comes into contact with or knows about who he suspects to have sold or otherwise illicitly misused drugs, including prescription painkillers.

Some of these people are his patients, he says, and others are individuals who patients notified him about.

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