By HOLLY RAMER, Associated Press

CONCORD, N.H. (AP) — The nation's chief doctor said Friday no place has come further in fighting the opioid epidemic than New Hampshire, a state President Donald Trump once referred to as a "drug-infested den."

U.S. Surgeon General Jerome Adams spoke Friday at a daylong conference focused on how the opioid crisis has affected children in New Hampshire, which has one of the nation's highest rates of overdose deaths. After more than doubling in five years, there were two more fatal overdoses last year — 487 in total — than in 2016.

"I've seen hope in places like New Hampshire, that represent some of the worst statistics, but also some of the best examples of hope," he said. "Five-hundred is still a lot, but I'll tell you, compared to where you were, and the trajectory you were on, no one in this country has come as far as New Hampshire has in turning around the tide of the opioid epidemic."

Sharing stories about his brother's addiction and incarceration, Adams said stigma and ignorance are the biggest obstacles to ending the crisis, but that progress is being made in places that embrace unconventional partnerships between government and the private sector. The widespread use of overdose reversal drugs is also key, said Adams, who earlier this year issued a rare public health advisory calling on more Americans to carry naloxone.

In a room full of hundreds health professionals, most raised their hands when Adams asked how many were trained in CPR. But only a handful did so when he asked how many were carrying naloxone.

"You can't get someone in recovery if they're dead," he said.

Adams recently released what he called his version of a pamphlet former Surgeon General C. Everett Koop sent to every household in 1988. Koop's seven-page brochure was about AIDS. Adams' effort is a one-page, digital document that urges readers to talk about opioid addiction, safely store and dispose of medication, understand alternative pain medications, know that addiction is a chronic disease and be prepared with naloxone