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  • Rodrigo Duterte Fast Facts | CNN

    Rodrigo Duterte Fast Facts | CNN



    CNN
     — 

    Here is a look at the life of former Philippines President Rodrigo Duterte.

    Birth date: March 28, 1945

    Birth place: Maasin, Southern Leyte, Philippines

    Birth name: Rodrigo Roa Duterte

    Father: Vicente Duterte, lawyer and politician

    Mother: Soledad (Roa) Duterte, teacher

    Marriage: Elizabeth Zimmerman (annulled in 2000)

    Children: with Elizabeth Zimmerman: Paolo, Sebastian and Sara; with Honeylet Avanceña: Veronica

    Education: Lyceum of the Philippines University, B.A.,1968; San Beda College, J.D.,1972

    Religion: Roman Catholic

    Duterte was mayor of Davao City for seven terms and 22 years, although not consecutively.

    His father was the governor of unified Davao and a member of President Ferdinand Marcos’ cabinet.

    Duterte’s daughter, Sara Duterte, was the mayor of Davao City.

    Once compared himself to Adolf Hitler, saying he would kill millions of drug addicts.

    Cursed Pope Francis for traffic problems caused by the pontiff’s visit to the Philippines.

    For decades, he has allegedly been tied to “death squads” in Davao City.

    Has declared that he will urge Congress to restore the death penalty by hanging in the Philippines.

    1977-1986 – Special counsel, and then city prosecutor of Davao City.

    1986-1988 – Vice-Mayor of Davao City.

    1988-1998 – Mayor of Davao City.

    1995 – After Flor Contemplacion, a Filipino domestic worker, is hanged in Singapore for murdering her co-worker in 1991, Duterte leads protestors in burning the Singapore flag.

    1998-2001 – Becomes a congressman representing Davao City’s 1st District.

    2001-2010 – Mayor of Davao City.

    April 6, 2009 – Human Rights Watch publishes the findings of its “Davao Death Squad” investigation, scrutinizing more than two dozen killings that occurred in 2007 and 2008. Findings show no direct link to the killings and Duterte but do provide evidence of a complicit relationship between government officials and members of the DDS.

    May 24, 2015 – He vows to execute 100,000 criminals and dump their bodies into Manila Bay.

    April 2016 – Duterte comes under fire after making a controversial comment during a campaign rally about a 1989 prison riot that led to the rape and murder of a female missionary. According to a CNN Philippines translation of the video, he says, “they raped her, they lined up to her. I was angry she was raped, yes that was one thing. But she was so beautiful, I thought the mayor should have been first. What a waste.” His party issues an apology, but Duterte later disowns it.

    May 30, 2016 – The Philippine Congress officially declares Duterte the winner of the May 9th presidential election after the official count is completed.

    June 30, 2016 – Takes office as president.

    August 5, 2016 – In a speech, he claims he told US Secretary of State John Kerry that US Ambassador to the Philippines Philip Goldberg is a “gay son of a bitch.”

    September 7, 2016 – Duterte and US President Barack Obama meet briefly in Laos while attending the yearly Association of Southeast Asian Nations summit. The two were scheduled to meet prior for bilateral talks regarding the South China Sea, but Obama canceled their meeting as Duterte’s fiery rhetoric escalated.

    September 15, 2016 – A witness, Edgar Matobato, testifies before a Philippine Senate committee, claiming he is a member of Duterte’s alleged “Davao Death Squad,” and that the Philippine president gave orders to kill drug dealers, rapists and thieves. The committee was set up to probe alleged extrajudicial killings in the three months since Duterte became president.

    October 4, 2016 – The Philippines and the United States begin joint military exercises in Manila for what Duterte claims will be the final time under the decade-long landmark Enhanced Defense Cooperation Agreement.

    October 20, 2016 – Duterte announces at the PH-China Trade & Investment Forum, “In this venue I announce my separation from the US; militarily, [but] not socially, [and] economically.”

    November 29, 2016 – Nine members of Duterte’s security team are injured after their convoy is hit by an explosive device in advance of a planned visit by the president to Marawi City.

    December 12, 2016 – Admits to killing suspected criminals during his time as mayor of Davao City.

    November 9, 2017 – Ahead of APEC meetings with regional leaders, Duterte tells a group of Filipino expatriates, in the central Vietnamese city of Da Nang, that he stabbed someone to death when he was 16.

    November 13, 2017 – US President Donald Trump and Duterte “briefly” discussed human rights and the Philippines’ bloody war on drugs during their closed-door conversation, the White House announces. However, the spokesman for Duterte tells reporters that “human rights did not arise” during the meeting.

    February 8, 2018 – The International Criminal Court (ICC) says it is opening a preliminary examination of the situation in the Philippines regarding extrajudicial killings. The examination “will analyze crimes allegedly committed … in the context of the ‘war on drugs’ campaign,” specifically since July 1, 2016. Duterte’s spokesman tells reporters that the president “welcomes this preliminary examination because he is sick and tired of being accused of the commission of crimes against humanity.”

    December 5, 2018 – The ICC reports that they have a “reasonable basis to proceed with the preliminary examination” into the alleged extra-judicial killings of thousands of people since July 1, 2016.

    March 17, 2019 – The Philippines officially leaves the ICC. The action, taken after a 12-month waiting period required by ICC statute, follows an initial announcement made March 14, 2018.

    October 5, 2020 – Duterte reveals he has a chronic neuromuscular disease. In a speech in Moscow, he tells a crowd of Filipinos living in the Russian capital he had myasthenia gravis, which he describes as a “nerve malfunction,” reports CNN Philippines.

    March 12, 2020 – Duterte places Metro Manila under community quarantine from March 15 to April 14 to contain the COVID-19 spread in the metropolis.

    March 23, 2020 – The Senate, in a 12-0 vote, approves a bill declaring the existence of a national emergency and granting Duterte additional powers to address the COVID-19 crisis. The additional powers will remain in effect for at least three months or until the state of calamity in the entire country is lifted.

    November 15, 2021 – Files to run for senator in the 2022 election. Duterte is not eligible to run for president again, and his daughter, Sara Duterte-Carpio, is running for vice president. He withdraws his bid on December 14.

    June 30, 2022 – Duterte steps down as president.

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  • Former quarterback Johnny Manziel talks drug abuse, suicide attempt in new documentary | CNN

    Former quarterback Johnny Manziel talks drug abuse, suicide attempt in new documentary | CNN



    CNN
     — 

    Former National Football League quarterback Johnny Manziel reveals in a new documentary his drug usage during his playing career and a suicide attempt following his release from the Cleveland Browns in 2016.

    In Netflix’s upcoming documentary “Untold: Johnny Football,” Manziel – who became the first redshirt freshman to win the Heisman Trophy while playing at Texas A&M in 2012 – said that he began using OxyContin and cocaine every day following the 2015 season, which led to his weight dropping from 215 pounds that January to 175 pounds in September.

    Poor play and legal troubles soon followed Manziel. A Texas grand jury indicted Manziel on a misdemeanor assault charge of his former girlfriend, Colleen Crowley. Manziel denied hitting Crowley at the time and the charges were later dropped after he met the court’s terms for a dismissal agreement.

    The Browns would release Manziel in March 2016, which he said he was later diagnosed with bipolar disorder.

    Manziel said he refused to enter rehab twice and began “self-sabotaging,” going on a “$5 million bender” before attempting suicide.

    “I had planned to do everything I wanted to do at that point in my life, spend as much money as I possibly could and then my plan was to take my life,” Manziel said in the documentary. “I wanted to get as bad as humanly possible to where it made sense, and it made it seem like an excuse and an out for me.”

    Manziel said he had purchased a gun “months earlier” with the intention to use it for suicide but the gun “malfunctioned” when he pulled the trigger.

    “Still to this day, don’t know what happened. But the gun just clicked on me,” he said.

    Manziel’s relationship with his family at the time was “strained” due to his refusal to seek treatment, he said. Manziel later returned to his family’s home in Texas after leaving Los Angeles following the suicide attempt.

    “It’s been a long, long road, and I don’t know if it’s been great or if it’s been bad – that’s kind of still up for debate,” Paul Manziel, his father, said in the documentary. “But we’re blessed. And he’s still with us. And we can mend all the fences still. I think Johnny’s got a lot better days coming than what he’s had.”

    CNN has reached out to the Browns for comment.

    Manziel was drafted in the first round of the 2014 NFL Draft. Following his release from the Browns, Manziel played for multiple teams in the Canadian Football League (CFL) and in the now-defunct Alliance of American Football (AAF). Manziel last played in the Fan Controlled Football league.

    The Netflix documentary is scheduled to be released on Tuesday.

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  • As horse racing’s best trainers rake in millions, records show they’ve violated rules aimed at keeping the animals safe | CNN

    As horse racing’s best trainers rake in millions, records show they’ve violated rules aimed at keeping the animals safe | CNN



    CNN
     — 

    As horse racing’s elite saddle up for the final race of the coveted Triple Crown at New York’s Belmont Stakes, the sport’s top trainers will face off for their share of the $1.5 million purse at the lavish, star-studded event – amid growing scrutiny after a recent spate of horse deaths.

    A CNN analysis of disciplinary records found that the top earning trainers in the sport – whose thoroughbreds win them millions of dollars – have all broken rules meant to keep their horses safe. Trainers slapped with violations have continued racing, pocketing winnings while paying minimal fines.

    Records show that horse racing’s most successful trainers have violated the sport’s rules multiple times over the course of thousands of races across decades-long careers. The violations range from failed drug tests on race day to falsifying a trainer license. At least three of the trainers have horses competing at the Belmont Stakes this weekend.

    Many of the violations center on the use of drugs that could mask pain prior to a race, potentially leading racehorses – bred for speed with spindly legs – to run on preexisting injuries that increase the risk of fatal breakdowns on the tracks. Researchers have found that about 90% of fatal horse injuries involve preexisting issues, such as small fractures that weaken horses’ bones.

    While therapeutic medications are often legal for treating horses, several are banned on race day.

    “If a horse has an anti-inflammatory, it could compromise an inspection,” said Dr. Jennifer Durenberger, a veterinarian with the Horseracing Integrity and Safety Authority, the national regulatory body established in 2020. “It’s one of the reasons we do restrict medications in the pre-race period.”

    In many ways, the violations say more about the sport than the trainers themselves. Historically, drug limits and rules have varied from state to state, and punishments, which typically led to fines of a few hundred dollars, seemed more like slaps on the wrists than true deterrents. Trainers suspended from one racetrack were still able to compete on others.

    Horse racing reform advocates, and even some trainers, say that national standards for drug violations will help with compliance and improve horse safety.

    Trainers and their representatives interviewed by CNN, however, largely dismissed their disciplinary records, citing unaccredited testing labs, sensitive testing which picks up on minute traces of medication and inconsistent rules among tracks that led to mistakes often beyond their control. They also say the violations must be placed in the context of the thousands of races their horses have started.

    It was supposed to be a triumphant comeback for legendary horse trainer Bob Baffert, but his Preakness Stakes win was underscored by tragedy.

    Just hours before a horse he trained, National Treasure, won the second-leg of the Triple Crown last month, Baffert’s powerful bay-colored colt, Havnameltdown, suffered an injury to its fore fetlock, the equivalent of an ankle, during an earlier race that day. A veterinarian deemed the injury “non-operable,” leaving the three-year-old horse to be euthanized on the track. The Maryland Racing Commission is investigating the death.

    During his short life, Havnameltdown earned $708,000 in prize money for his handlers, including Baffert, who has said the horse got “hit pretty hard” by another horse coming out of the starting gate.

    The Maryland race marked Baffert’s anticipated return to a Triple Crown race – the first since his 2021 Kentucky Derby win was disqualified after his horse, Medina Spirit, failed a post-race drug test. Baffert was cited by the state horse racing commission and Churchill Downs handed him a suspension that banned him from the next two Derby races.

    The drug test revealed that Medina Spirit had betamethasone in his system. The drug is legal for horses in Kentucky, but state rules don’t allow any detectable levels on race day. Baffert disputed the test result and appealed the commission’s citation.

    During his suspension, Baffert continued to race at other tracks and claimed his cut of millions in prize money. Months after the Derby, Medina Spirit died while training at California’s Santa Anita Park; the necropsy report was inconclusive.

    Equine deaths are quite common – hundreds die on and off the track annually. The root cause of what can bring down a massive, muscular horse can range from the natural to the exploitive, including being overworked and overdrugged in the quest for winnings.

    But while some deaths are difficult to prevent, the recent spate of tragedies, especially ones like the public euthanasia of Havnameltdown, have cast a dark shadow over the multi-billion-dollar industry.

    In the span of a month, 12 horses died at Churchill Downs, Kentucky’s most prominent track, since the stable opened this season. The track has suspended racing there while the fatalities are investigated.

    Bob Baffert-trained horse Havnameltdown, behind the curtain, had to be euthanized on May 20, 2023, during the sixth race of Preakness Day in Baltimore.

    The deaths sparked public outrage and thrust the industry back into the national spotlight just a week after HISA rolled out regulations that include medication control.

    But that’s done little to assuage critics’ concerns over the treatment of horses in what was once called the sport of kings.

    “All of it sounds really impressive and it’s quite a show, but that’s all it is: A show. Meanwhile, the horses continue to die,” said Patrick Battuello, an advocate who has tracked horse deaths for the last decade. “The killing is built into the system. … In what other sport are the athletes drugged and doped without their consent?”

    Defenders of the sport argue that the number of horse racing deaths have declined in recent years, and that the industry is safer than it ever was. They point to falling annual death counts collected by The Jockey Club, an influential industry organization, which reports the number of horses who die or are euthanized after racing injuries. The group has tallied several hundred racing deaths each year, with 328 in 2022, down from 709 a decade earlier.

    But those numbers don’t include horses who die during training or between races, which critics argue leads to a severe undercounting of deaths in the sport. They also only include thoroughbred horses, not quarter horses and standardbred horses. Battuello has tallied more than 9,500 racehorses that died since 2014, largely based on death records he’s collected from state horse racing commissions – roughly 1,000 a year.

    While the exact rules vary from state to state, trainers are generally required to report horse deaths that occur at racetracks or as a result of injuries sustained during races. Most deaths are categorized as racing-related or training-related.

    In a statement, The Jockey Club argued that its numbers were “the most accurate data possible” and noted that it had different criteria for including racing-related deaths than Battuello.

    The sport’s highest-earning trainers were among those who had the most horses die at racetracks or due to racing injuries, according to a CNN analysis of state records collected by Battuello over the last decade, as well as data from the horse racing website Equibase.

    Some prominent trainers saw far more of their horses die during training than in actual races. CNN’s review found that Todd Pletcher, who’s earned more than any horse trainer in the industry over the course of his career, has trained at least 38 horses whose deaths were reported to state racing commissions since 2014.

    Trainer Todd Pletcher watches a workout at Churchill Downs Tuesday, May 2, 2023, in Louisville, Kentucky.

    More than three-fourths of those deaths were related to training, not racing, according to Battuello’s count – meaning that Pletcher largely avoided the national spotlight shone on deaths that took place during prominent races like the Preakness or Belmont.

    Similarly, four of the seven deceased horses trained by Baffert that CNN documented did not die as a direct result of injuries sustained during races, and thus likely wouldn’t be included in the official tally of deaths counted by The Jockey Club.

    CNN’s review is an undercount of deaths because it only counted deaths reportable to state commissions. The review connected horses to their most recent trainer of record as of their last race – so it’s possible that some of the horses could have moved to a different trainer before their deaths.

    Horse trainers bear the ultimate responsibility for the wellbeing of the horse and adherence to the rules on the track, an industry standard known as the “absolute insurer rule.”

    “We are completely responsible for the horses. When they arrive on the racetrack that day, we’re responsible for what’s going into that horse, whether it’s medication or feed,” said Graham Motion, a 30-year horse trainer in Maryland. “That has to be our responsibility. There’s no other way really to make it work.”

    The most successful trainers in the sport have all been cited for medical or drug violations.

    Pletcher has racked up nine drug-related violations throughout his career. On one occasion, regulators found he broke rules regarding Lasix – known as the “water drug” – which makes a horse urinate and potentially run faster. New regulations have banned the drug – though state commissions can apply for three-year exemptions – while the effect on horse safety is studied, according to HISA.

    Pletcher was suspended for 10 days last month, after a delayed drug test showed that his horse, Forte, had elevated levels of a common pain-reliever and anti-inflammatory drug during a race he won in New York back in September.

    Irad Ortiz Jr. rides Forte to victory during the Breeders' Cup Juvenile race at Keenelend Race Course, on Nov. 4, 2022, in Lexington, Kentucky.

    “Forte came into our care on March 25, 2022, and he has never been prescribed or administered meloxicam,” Pletcher, who did not respond to CNN’s multiple requests for comment, told Bloodhorse.com. “We did an internal investigation and could not find an employee who had used the drug.”

    Records show Pletcher plans to appeal the ruling.

    Baffert, too, was suspended after his horse, Medina Spirit – who placed first in a 2021 race at Churchill Downs – tested positive for an anti-inflammatory. The suspension was one of about two dozen drug-related violations during Baffert’s career; the vast majority included anti-inflammatories like betamethasone and phenylbutazone.

    One of the three highest earning trainers, Steve Asmussen, has been cited for violations of medication rules about 40 times, in many instances finding elevated levels of anti-inflammatories or thyroid medication, according to records from the Association of Racing Commissioners International, an umbrella organization of horse racing regulators. Research has shown thyroid medication in horses can cause cardiac arrythmias and new regulations ban its use in thoroughbreds, including on race day.

    Clark Brewster, an attorney for both Baffert and Asmussen, said the tally of violations from ARCI data paints an unfair picture of his clients because many of those citations involved therapeutic medications that only slightly exceeded allowable limits in the rules, which he said have repeatedly shifted. “These guys are painstakingly trying to get it right.”

    Motion, the veteran Maryland trainer, himself has been cited at least twice in his career for medication violations, once after one of his horses tested positive for methocarbamol – a muscle relaxer that is permissible to treat horses, but not allowed on race day.

    “It was a very difficult time for me. And I fought it. And I almost regret fighting it now,” said Motion, adding that he felt his team “handled the medication the proper way.”

    He said the new rules around when horses need to withdraw from such medication ahead of race day could have prevented this type of incident.

    Trainer Steve Asmussen before the 149th running of the Kentucky Oaks on May 5, 2023, at Churchill Downs in Louisville, Kentucky.

    Some therapeutic drugs, including anti-inflammatories, are a big concern for the industry on race day. Before each race, horses are examined by veterinarians to determine their fitness and identify potential ailments. But medication in the horse’s system, like anti-inflammatories, can mask some of those preexisting injuries.

    “The extent [of the preexisting injury] can change dramatically and it can go from something minor to something that is potentially serious, if not life threatening” when a horse bursts onto the track from the starting stall, said Dr. Mary Scollay, chief of science at the Horseracing Integrity and Welfare Unit which oversees the new medication control regulations under HISA.

    New HISA regulations, implemented last month, include strict rules about withdrawal times and allowable medication levels on race day.

    “We want to make sure that there is no lingering effects from that medication that could mask a potential injury that would put that horse at risk to the horse, the rider, the others that are in that race,” said Dr. Will Farmer, equine medical director at Churchill Downs Incorporated. “That’s why we have very strict regulation around use of therapeutics in regards to a race specifically.”

    For decades, a patchwork of local and state rules governed the racetracks in the United States, and trainers found in violation of the rules meant to keep their horses safe have been met with minimal repercussions.

    Pletcher – whose horses have earned more than $460 million in almost 25,000 races – paid $5,000 in fines for drug-related citations over the course of his 27-year career. Baffert and Asmussen were each fined over $30,000 during their decades-long careers, according to records from the racing commissioners association. Those fines are offset by more than $340 million and $410 million in earnings, respectively, according to Equibase.

    What’s more, suspensions only banned trainers from certain tracks, allowing them to continue racing – and pocketing earnings – in other states.

    Since the 2022 New York race where Pletcher’s horse Forte had a post-race positive drug test, the horse won four more competitions for Pletcher, earning his handlers more than $2 million.

    Forte is set to race this weekend and is one of the favorites to win the Belmont Stakes.

    Baffert, too, was able to continue racing after he was hit with the suspension following Medina Spirit’s positive drug test. During that time, Baffert entered hundreds of races on other tracks, competing for purses totaling nearly $125 million, according to Equibase data. In 2022 alone, Baffert’s horses brought in nearly $10 million in prize money.

    A general view at the start during the 145th running of the Kentucky Derby at Churchill Downs.

    The biggest change in the governance of American horse racing was tucked into a 2020 federal spending bill. That proviso ultimately created the national Horseracing Integrity and Safety Authority, or HISA – a move that, after three previous legislative attempts, found support from federal lawmakers after a particularly deadly season at a California racetrack.

    During the 2018-2019 season, a staggering 56 horses died at one of the most glamorous racetracks in the country, Santa Anita Park, once home to the famous 1940s thoroughbred Seabiscuit.

    The California Horse Racing Board could not determine a common denominator for the fatalities but found that the vast majority of horses that died had preexisting injuries. And, while no illegal substances or procedures were found, many of the horses were on anti-inflammatories and various other medications.

    “Horse racing must develop a culture of safety first,” the California board wrote in its investigative report. “A small number of participants refusing to change will harm the entire industry.”

    Initially a local scandal, the deaths in Santa Anita Park would have national implications. The fatalities led not only to a complete overhaul of racing practices in Santa Anita – improved track maintenance, restrictions on the use of medications, and softer whips on race day – but also to new national rules under the new regulator, HISA.

    As a private entity under the supervision of the Federal Trade Commission, HISA creates uniform regulations and penalties to govern racetracks throughout the country. The latest set of rules, implemented last month, include anti-doping and medication control programs. They also state that any suspension for a rule violation will carry across all tracks under HISA’s jurisdiction.

    HISA CEO Lisa Lazarus said the goal is to ensure that “there is a level playing field, that the horses are treated properly, that there is built-in safety and integrity” in the sport.

    But some pockets of the industry aren’t welcoming the changes – most notably the National Horsemen’s Benevolent and Protective Association, which has questioned the constitutionality of HISA and filed suits arguing regulatory overreach.

    In an annual NHBPA conference held in March, trainers spoke out against HISA citing an increased administrative burden and added costs of higher fees and required veterinary checks.

    “The whole thing is a façade. It’s been all smoke and mirrors,” said Bret Calhoun, a horse trainer and member of the Louisiana HBPA board, according to the Thoroughbred Daily News. “They sold this thing as the safety of the horse. It’s absolutely not about safety of horse. It’s a few people, with self-interest and they have their own personal agenda.”

    There are several lawsuits challenging HISA’s legitimacy and authority in the sport, some backed by the NHBPA, making their way through courts across the country. But while legal battles are fought in the courts, horses keep dying on the tracks.

    Last week, a horse death at Belmont Park meant that there have been fatalities around all three racetracks in the Triple Crown this season.

    “There is risk in any sport. We cannot eliminate risk. We can continue to diminish risk as best we can. We are never going to eliminate a horse getting injured,” said Motion, adding “the most important thing is the welfare of the horse. It’s not winning at all costs. It’s winning with a healthy animal.”

    To identify racehorses who died while being trained by the industry’s highest-earning trainers, CNN combined a list of dead horses compiled by activist Patrick Battuello with data from the horse racing website Equibase.

    Since 2014, Battuello has collected state horse racing commission reports on horse deaths through public records requests and published a list of racehorses who died each year on his website. Most of the horse deaths Battuello has identified are based on state records, although a handful are based on news reports or verbal confirmation he received from racetrack officials.

    CNN matched Battuello’s list of deceased horses with data downloaded from Equibase that listed each horse’s trainer as of its most recent race. For the top three trainers with the highest earnings, Pletcher, Asmussen and Baffert, CNN reviewed the original documents Battuello collected from the commissions, which he provided to reporters.

    Because the Equibase data on trainers is based on each horse’s most recent race, some horses may have moved to other trainers before they died. In a handful of cases, when state death records listed a different trainer for a horse than Equibase does, CNN used the trainer listed in the records.

    CNN’s review only included horse deaths that were required to be reported to state commissions, so it undercounts the total deaths associated with individual trainers. In addition, not all of the dead horses Battuello has documented were able to be reliably matched with Equibase’s data, so additional deaths may also be missing from the review.

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  • A mother was raising her son in a city she loved. Then San Francisco changed and stole her boy | CNN

    A mother was raising her son in a city she loved. Then San Francisco changed and stole her boy | CNN

    Watch how drugs, homelessness and crime have changed a city, and what is being done about it. CNN’s Sara Sidner asks “What Happened to San Francisco?” on “The Whole Story with Anderson Cooper,” Sunday at 8 p.m. ET.


    San Francisco
    CNN
     — 

    Tanya Tilghman moved to the Bay Area as a teenager to live with her mom. Later, she married, had two sons and made a home in San Francisco’s historically Italian North Beach district, up the hill from the tourist and financial centers.

    Even when her marriage broke down, she never thought of leaving. This was her city, her people. Liberal like her, with a mix of income levels and a general sense of community. She didn’t worry about her growing boys going out on the streets where she herself always felt safe.

    But those streets have changed, she says. She believes policies from City Hall and even groups who advocate for the homeless have exacerbated some of the problems and the community she once felt a part of has gone, she says. And her son got caught up in a scene you can almost not avoid in the city: the drug scene.

    Roman Vardanega first tried illegal drugs at the start of high school, Tilghman said, taking a prescription medication at a friend’s house.

    He quickly became hooked, his mother said, moving on to cocaine, heroin and later fentanyl, all available in the city’s seedy Tenderloin area.

    Tilghman admits she was uneducated about the prevalence of hard drugs, even naïve. But it was not something she encountered every day. Back then “I think it’s a lot worse now than when I was growing up here,” she said. “We used to come to the Tenderloin when I was a teenager because we thought it was just kind of fun, edgy and I never as a teenager felt unsafe. But I also don’t remember people coming up to me and asking me if I want to buy drugs.”

    One of her first clues that her son was getting in deep was when she was with him on a tour outside City Hall while he was in high school. It was a few blocks from the Tenderloin and some of the unhoused people on the street knew him by name, as if he spent a lot of time out there with them – which is what he was doing, scoring his drugs.

    She tried to help. Vardanega spent the 11th grade in rehab but persuaded his mom to let him return. She welcomed him home, but so did the streets.

    Roman Vardanega showed musical talent from a young age, his mother said, before his addictions consumed him.

    By then, her neighborhood had changed, with drugs seemingly freely available, even just heading home on the Bay Area Rapid Transit (BART) local transport system.

    “When I got out of the BART station, the first thing that I was asked is if I wanted to buy drugs,” Tilghman said. The ease of getting and using drugs made the city a dangerous and sometimes deadly playground for people like her son.

    Vardanega started to live on the streets full-time when the Covid pandemic hit in 2020. The city shut down, residents either left or stayed inside and at the height of the pandemic, more people died of drug overdoses than Covid-19.

    “All the tents started going up in the city,” Tilghman said. “The open-air drug market became a lot worse. And so it became easier for him to buy drugs and to use it out in the open.”

    And confusingly to Tilghman, the city just seemed to look away.

    “The city’s policies have absolutely hurt my son, has hurt us, and has caused him to, I would say go into his addiction even a lot more,” she said.

    “If you got busted with drugs, most likely you’re not going to jail, the police officers would just let you go,” she said. “That made the situation a lot worse, especially for my son because he’s really young, and still kind of in that party state of mind.”

    Tilghman’s state of mind was focused on one goal: finding her son. She knew he was an addict. She knew she loved him so much it hurt. And she knew she would not stop searching until she found him even if that meant putting herself in danger.

    She would walk the streets looking at things most people try to avoid, looking directly into the eyes of the people living on the streets. Sometimes she got back blank stares. Other times a sympathetic ear or a hopeful hint about where her son might be.

    She didn’t find him, but so many people were like him. “What makes me sad is that I see my son’s face in everybody’s faces … out on the streets,” Tilghman said.

    As Covid descended, many housed residents began disappearing and the tent cities exploded onto the sidewalks, along with the drugs, the addictions and signs of mental illness.

    Rectangles are painted on the ground to encourage homeless people to keep social distancing at a city-sanctioned homeless encampment across from City Hall in San Francisco in May 2020.

    Mayor London Breed declared a state of emergency in the city, to include a “linkage center” in the Tenderloin, promoted as a place where addicts could get services to help them.

    When it opened in January 2022, Tilghman was hopeful it could be somewhere her son would find himself, and one day she went to take a look. When she got there, she heard music blaring and tried to get a look inside.

    “I saw people doing drugs. I couldn’t believe it. I’m like, this is a place where people are supposed to get help. And they’re actually doing drugs?” Tilghman said.

    A little later, she posed as an addict and went to the center for a closer look.

    “I said to them that I wanted to get off drugs, and that I needed help,” she said. “And they laughed at me. And the guy at the door said, ‘We can help you do drugs. But if you want help getting off drugs, you’re gonna have to come back tomorrow’,” Tilghman said.

    The center had what was supposed to be an area where overdoses could be treated, but it became known as a place to take drugs, not seek other services.

    “The most upsetting thing … was that the harm reduction area was more like a party scene,” Tilghman said. “If my son were to go there wanting to access services, him being addicted to drugs, if he were to see a party scene with people dancing and singing and doing drugs, and most likely selling drugs inside, there’s just no way he would access services. Because he would get so distracted, and be so triggered that he would go and use.”

    The city’s laissez-faire philosophy had just gone too far, she felt.

    “When you could walk into a store and steal under $1,000 worth of merchandise and get away with it – that’s going way too far,” she said. “It’s going too far when you could smoke crack in front of a police officer and the police officer just looks at you and doesn’t even arrest you.”

    The struggle to try to save her son wore her down. Not once, but three times Tilghman says she got so low and so hopeless she attempted suicide.

    The situation is beginning to change, both for Tilghman personally, and perhaps her city.

    The Tenderloin Linkage Center, which was later renamed to just the Tenderloin Center, closed last December. Tilghman has found new support and a mission working with Mothers Against Drug Addiction and Deaths. A new district attorney took over after the previous one was recalled by voters who perceived him as soft on crime. Tilghman’s son Vardanega got in trouble with the law, served jail time and was sent to a court-mandated rehab program.

    Incarceration is a good thing for him in Tilghman’s mind – keeping him alive, off the streets and giving him a chance in a treatment program.

    San Francisco is still beautiful to her – with the Golden Gate Bridge, the Presidio and Fisherman’s Wharf, the Italian enclave of North Beach. But it has become scarier, and she feels some of the blame has to go to politicians whose job it is to clean up the streets.

    “I’m liberal,” Tilghman said. “My politics have stayed the same and things have gone crazy around me.”

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  • ADHD medication abuse in schools is a ‘wake-up call’ | CNN

    ADHD medication abuse in schools is a ‘wake-up call’ | CNN



    CNN
     — 

    At some middle and high schools in the United States, 1 in 4 teens report they’ve abused prescription stimulants for attention deficit hyperactivity disorder during the year prior, a new study found.

    “This is the first national study to look at the nonmedical use of prescription stimulants by students in middle and high school, and we found a tremendous, wide range of misuse,” said lead author Sean Esteban McCabe, director of the Center for the Study of Drugs, Alcohol, Smoking and Health at the University of Michigan in Ann Arbor.

    “In some schools there was little to no misuse of stimulants, while in other schools more than 25% of students had used stimulants in nonmedical ways,” said McCabe, who is also a professor of nursing at the University of Michigan School of Nursing. “This study is a major wake-up call.”

    Nonmedical uses of stimulants can include taking more than a normal dose to get high, or taking the medication with alcohol or other drugs to boost a high, prior studies have found.

    Students also overuse medications or “use a pill that someone gave them due to a sense of stress around academics — they are trying to stay up late and study or finish papers,” said pediatrician Dr. Deepa Camenga, associate director of pediatric programs at the Yale Program in Addiction Medicine in New Haven, Connecticut.

    “We know this is happening in colleges. A major takeaway of the new study is that misuse and sharing of stimulant prescription medications is happening in middle and high schools, not just college,” said Camenga, who was not involved with the study.

    Published Tuesday in the journal JAMA Network Open, the study analyzed data collected between 2005 and 2020 by Monitoring the Future, a federal survey that has measured drug and alcohol use among secondary school students nationwide each year since 1975.

    In the data set used for this study, questionnaires were given to more than 230,000 teens in eighth, 10th and 12th grades in a nationally representative sample of 3,284 secondary schools.

    Schools with the highest rates of teens using prescribed ADHD medications were about 36% more likely to have students misusing prescription stimulants during the past year, the study found. Schools with few to no students currently using such treatments had much less of an issue, but it didn’t disappear, McCabe said.

    “We know that the two biggest sources are leftover medications, perhaps from family members such as siblings, and asking peers, who may attend other schools,” he said.

    Schools in the suburbs in all regions of the United States except the Northeast had higher rates of teen misuse of ADHD medications, as did schools where typically one or more parent had a college degree, according to the study.

    Schools with more White students and those who had medium levels of student binge drinking were also more likely to see teen abuse of stimulants.

    On an individual level, students who said they had used marijuana in the past 30 days were four times as likely to abuse ADHD medications than teens who did not use weed, according to the analysis.

    In addition, adolescents who said they used ADHD medications currently or in the past were about 2.5% more likely to have misused the stimulants when compared with peers who had never used stimulants, the study found.

    “But these findings were not being driven solely by teens with ADHD misusing their medications,” McCabe said. “We still found a significant association, even when we excluded students who were never prescribed ADHD therapy.”

    Data collection for the study was through 2020. Since then, new statistics show prescriptions for stimulants surged 10% during 2021 across most age groups. At the same time, there has been a nationwide shortage of Adderall, one of the most popular ADHD drugs, leaving many patients unable to fill or refill their prescriptions.

    The stakes are high: Taking stimulant medications improperly over time can result in stimulant use disorder, which can lead to anxiety, depression, psychosis and seizures, experts say.

    If overused or combined with alcohol or other drugs, there can be sudden health consequences. Side effects can include “paranoia, dangerously high body temperatures, and an irregular heartbeat, especially if stimulants are taken in large doses or in ways other than swallowing a pill,” according to the Substance Abuse and Mental Health Services Administration.

    Research has also shown people who misuse ADHD medications are highly likely to have multiple substance use disorders.

    Abuse of stimulant drugs has grown over the past two decades, experts say, as more adolescents are diagnosed and prescribed those medications — studies have shown 1 in every 9 high school seniors report taking stimulant therapy for ADHD, McCabe said.

    For children with ADHD who use their medications appropriately, stimulants can be effective treatment. They are “protective for the health of a child,” Camenga said. “Those adolescents diagnosed and treated correctly and monitored do very well — they have a lower risk of new mental health problems or new substance use disorders.”

    The solution to the problem of stimulant misuse among middle and high school teens isn’t to limit use of the medications for the children who really need them, McCabe stressed.

    “Instead, we need to look very long and hard at school strategies that are more or less effective in curbing stimulant medication misuse,” he said. “Parents can make sure the schools their kids attend have safe storage for medication and strict dispensing policies. And ask about prevalence of misuse — that data is available for every school.”

    Families can also help by talking to their children about how to handle peers who approach them wanting a pill or two to party or pull an all-night study session, he added.

    “You’d be surprised how many kids do not know what to say,” McCabe said. “Parents can role-play with their kids to give them options on what to say so they are ready when it happens.”

    Parents and guardians should always store controlled medications in a lockbox, and should not be afraid to count pills and stay on top of early refills, he added.

    “Finally, if parents suspect any type of misuse, they should contact their child’s prescriber right away,” McCabe said. “That child should be screened and assessed immediately.”

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  • Biden administration declares fentanyl laced with xylazine ‘an emerging threat’ in the US | CNN

    Biden administration declares fentanyl laced with xylazine ‘an emerging threat’ in the US | CNN



    CNN
     — 

    The White House has declared that the powerful synthetic opioid fentanyl combined with xylazine – an animal tranquilizer that’s increasingly being used in illicit drugs – is an “emerging threat” facing the United States due to its role in the ongoing opioid crisis.

    Administration officials call the threat FAAX, for fentanyl-adulterated or -associated xylazine.

    The move, announced Wednesday, marks the first time in history that any administration has declared a substance to be an emerging threat to the country, said Dr. Rahul Gupta, director of the Office of National Drug Control Policy. The SUPPORT Act of 2018 established that the office has authority to declare such “emerging threats,” and no administration has used it until now. Last year, Congress declared methamphetamine an emerging drug threat but none have been declared by an administration previously. Under other agencies or in separate circumstances, concerns such as bioterrorism, infectious diseases or climate change may be identified as “emerging threats.”

    “This drug, which is an animal sedative, is being mixed with fentanyl and is being found in almost all 50 states now,” Gupta said Tuesday. “It’s become an important part for us to make sure that we’re declaring it an emerging threat.”

    Now that the administration has declared fentanyl combined with xylazine an emerging threat, it has 90 days to coordinate a national response. “We are working quickly to develop and implement a whole of government nationwide plan, with real deliverable action, that will save lives and will be published within 90 days of this designation,” Gupta said.

    Xylazine, also known as tranq or tranq dope, has been linked to an increasing number of overdose deaths in the United States due to its rising illicit use. Between 2020 and 2021, overdose deaths involving xylazine increased more than 1,000% in the South, 750% in the West and about 500% in the Midwest, according to an intelligence report released last year by the US Drug Enforcement Administration.

    And in some cases, people might not even know that xylazine was in the drug they used.

    Just last month, authorities at the DEA issued a public safety alert about the “widespread threat” of fentanyl mixed with xylazine, reporting that in 2022 approximately 23% of fentanyl powder and 7% of fentanyl pills seized by the DEA contained xylazine.

    Fentanyl, which has been driving the opioid crisis, is a fast-acting opioid, and people who use it illicitly say that adding xylazine can extend the duration of the high the drug provides.

    Xylazine is not an opioid. It is approved by the US Food and Drug Administration for use as a tranquilizer in veterinary medicine, typically in horses, but it is not approved for use in humans. And xylazine can do major damage to the human body, including leaving drug users with severe skin ulcers, soft-tissue wounds and necrosis – sometimes described as rotting skin – that can lead to amputation.

    “Xylazine is one of the contaminants in fentanyl, but there could be others,” Gupta said. “So, I think with the declaration of an emerging threat, we’re sending a clear message to producers and traffickers of illicit xylazine and illicit fentanyl that we’re going to respond quicker, we’re going to match the challenge of evolution of these drugs supply, and that we’re going to protect lives first and foremost.”

    Now that xylazine has been declared an emerging threat, some of President Biden’s $46 billion drug budget request to Congress can be used to respond.

    This year, the Biden administration announced that the President has called on Congress to invest $46.1 billion for agencies overseen by the Office of National Drug Control Policy to tackle the nation’s illicit drug crisis.

    If the budget request is not approved, there could be the option to reallocate money within the Office of National Drug Control Policy, but “we don’t want to be in a position where moneys that are being utilized for some other important aspect of saving lives has to be moved away for this purpose,” Gupta said Tuesday. “That is the reason we are asking Congress to act.”

    Such funds could be used to test drugs on the street for xylazine, collect data on FAAX, invest in care for people exposed to FAAX and develop potential treatments for a xylazine-related overdose.

    The medication naloxone, also known as Narcan, is an antidote for an opioid overdose, but people who have overdosed on a combination of opioids and xylazine may not immediately wake up after taking naloxone, as it may not reverse the effects of xylazine in the same way it does opioids.

    “We need to recognize, first of all, that there is a shift that is occurring from organic compounds and substances like heroin and cocaine to more synthetics,” Gupta said of the state of the nation’s illicit drug crisis.

    “Both the types of drugs have changed – from predominantly organic to predominantly synthetics – but the way drugs are bought and sold have also changed,” he said. “Now, all you need is a phone in the palm of your hand and a social media app to order and buy some of the most dangerous substances on planet Earth.”

    Xylazine is just one of the many adulterants – or substances that are typically added to others – found in the nation’s illicit drug supply.

    “All of a sudden, you can synthesize hundreds of compounds and kind of mix them together and see what does the best in the market,” Joseph Friedman, a researcher at the University of California, Los Angeles, told CNN in March. “People are synthesizing new benzodiazepines, new stimulants, new cannabinoids constantly and adding them into the drug supply. So people have no idea what they’re buying and what they’re consuming.”

    Some of these adulterants may be as simple as sugar or artificial sweeteners added for taste or additives or fillers that bulk up the drug. Sometimes, they may be contaminants left over from the manufacturing process.

    But all of these things can carry real-life health harms, says Naburan Dasgupta, an epidemiologist and senior scientist at the Gillings School of Global Public Health at the University of North Carolina, Chapel Hill.

    Like an opioid, xylazine can depress the respiratory system, so the risk of overdose multiplies when it’s combined with heroin or fentanyl.

    Also, “in the veterinary literature, we know that it causes a really bad severe form of anemia. And so when people are injecting heroin that’s contaminated with xylazine, they can end up with a near-fatal form of blood iron deficiency,” Dasgupta said in March. “We had one person here who ended up going to the hospital needing multiple blood transfusions. And it was all because of the xylazine.”

    US lawmakers are moving to classify xylazine as a controlled substance.

    In March, bipartisan legislation – the Combating Illicit Xylazine Act – was introduced in the House and Senate. It describes illicit xylazine as an “urgent threat to public health and safety” and calls for it to be a Schedule III drug under the Controlled Substances Act, a category on the five-level system for substances with moderate to low potential for physical or psychological dependence. Xylazine would be one level below opioids like fentanyl.

    “Our bipartisan bill would take important steps to combat the abuse of xylazine by giving law enforcement more authority to crack down on the illicit distribution of this drug, including by putting stiffer penalties on criminals who are spreading this drug to our communities,” Sen. Maggie Hassan, D-N.H., said in a statement in March.

    The bill would also require manufacturers to send reports on production and distribution to the DEA so the agency can ensure that the product is not being diverted to the black market.

    “This bill recognizes the dangers posed by the increasing abuse of animal tranquilizers by drug traffickers, and provides new tools to combat this deadly trend,” Sen. Chuck Grassley, R-Iowa, said in the statement.

    “It also ensures that folks like veterinarians, ranchers and cattlemen can continue to access these drugs for bona fide animal treatment.”

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  • The US sanctioned Chinese companies to fight illicit fentanyl. But the drug’s ingredients keep coming | CNN

    The US sanctioned Chinese companies to fight illicit fentanyl. But the drug’s ingredients keep coming | CNN



    CNN
     — 

    The seller, who went by the name Linda Wang, was curt when asked if she sold a chemical often used to create fentanyl.

    “That’s banned,” Wang replied, before quickly providing an alternative: “CAS79099 powder is best. U can have a try.” 

    After more than a week of back and forth, she seemed impatient. “Ok. 79099 powder in USA warehouse now…if you need. Pls order asap,” she wrote in a text message exchange.

    The interaction is part of a CNN investigation that explored whether US-sanctioned chemical companies in China are evading Washington DC’s crackdown on illicitly made fentanyl – finding at least one China-based company that had links to a sanctioned entity, and a seller eager to ship potential ingredients for the lethal drug.

    More than 100,000 Americans died from drug overdoses in 2021, and two-thirds of the fatalities involved synthetic opioids – much of it believed from illicitly made fentanyl, according to the Centers for Disease Control.

    The drug can be 50 times stronger than heroin and 100 times stronger than morphine – and pharmaceutical grade versions of it can be prescribed by doctors for severe pain. But illegally manufactured fentanyl has turbocharged the US’s opioid overdose crisis in the last decade, according to data from the CDC.

    Controlling the illegal trade of the drug has turned into a geopolitical headache for the Biden administration, as China’s vast chemicals market – which supplies the world with raw materials for everything from perfume to explosives– is also a major pipeline of the building blocks of fentanyl, known as fentanyl precursors, according to US officials. 

    Further complicating the fight against fentanyl is the sheer variety of precursors that can be used to make fentanyl and other illicit drugs. Most such precursors also have legitimate uses – including for medical research – and are perfectly legal to sell, making up part of the booming transnational trade.

    China has strict anti-drug policies domestically, but critics in the US say it is not doing enough to help monitor or regulate purchases from buyers aiming to use Chinese-made ingredients to manufacture illegal drugs overseas.

    In 2019, Beijing stepped up its crack down on the production and sale of finished fentanyl and its variants, but US-China anti-drug cooperation has since stalled amid disagreements on trade, human rights, the Covid-19 outbreak and Taiwan. Hopes that US Secretary of State Antony Blinken would bring up fentanyl during a planned visit to Beijing died in early February, when Blinken postponed his trip after a surveillance balloon from China floated over the continental US. 

    As the opioid crisis topped the domestic agenda in 2021, the US sanctioned four companies in China accused of exporting fentanyl or fentanyl precursor chemicals. Online commercial records suggest ties between one of those sanctioned companies, Hebei Atun Trading Co., Ltd., and another China-based company called Shanxi Naipu Import and Export Co., Ltd., that continues to sell fentanyl precursors legally.

    According to official public records in China, Hebei Atun Trading Co., Ltd., began liquidating in June 2021 and was formally dissolved in August that year. Shanxi Naipu Import and Export Co., Ltd. was registered in the same period, according to official records, and it shares a number of key things in common with Hebei Atun.

    For example, Hebei Atun’s still-active Facebook page once linked to a now-defunct website of Shanxi Naipu – which is where CNN found Wang’s phone number.

    The two companies’ websites are registered to the same email address, and at one time appeared to share an IP address. Today, Shanxi Naipu’s websites appear to be carbon copies of Hebei Atun’s since-deleted page – with the same navigation tabs, email address and stock photo of a pipette dropping amber-colored liquid into a cell tray. The Russian and Portuguese versions of the site list “Hebei Atun Trading Co. Ltd.” as their copyright holder.

    One post on a Shanxi Naipu website was titled, “Hebei ATUN Trading Co., Ltd. Wishes you a Happy New Year!” (sic). It has since been deleted. 

    When presented with CNN’s findings, Shanxi Naipu denied ties to Hebei Atun, saying, “we are not related at all.” In statements emailed to CNN, Shanxi Naipu said it had purchased the sanctioned company’s Facebook account, email and cell phone number in order to “attract internet traffic.”

    Shanxi Naipu also denied selling the fentanyl precursor that Wang offered by text, and stressed that everything they sell is legal, and said that they were taking steps to stop the repercussions from the apparent links to Hebei Atun.

    “To prevent further impact from Hebei Atun, we have immediately removed relevant promotional websites and platforms,” the company said in an emailed statement.”

    Logan Pauley, a China analyst who tracks criminal and drug networks, told CNN, “It’s easy on the Chinese side to start a new company to copy and paste the same text that you’re posting on social media or you’re posting on a trade website, and then just to recreate the same operation over and over again.”

    And Gary Hufbauer, trade expert at the Peterson Institute for International Economics and former US treasury official, likens it to a game of cat-and-mouse. While the US government can add an entity to its sanctions list “overnight,” said Hufbauer, there may not be the resources in the US Treasury’s Office of Foreign Assets Control, which enforces sanctions, to keep tabs on new companies that may leverage sanctioned companies’ branding or operations. 

    In a statement to CNN, a spokesperson for the US Treasury said it “had not hesitated” to go after “bad actors” – citing the four sanctioned Chinese companies – and would continue to sanction companies and individuals involved in the drug trade.

    “Treasury continues to monitor the effects of our designations,” they said. “If additional information becomes available that can assist sanctions compliance efforts, when appropriate, we provide that information to industry and/or the public.”

    Asked if Beijing was knowingly lax in its efforts to stem the flow of precursor chemicals from its country, the Chinese Foreign Ministry pointed out that most were not controlled substances, in a lengthy statement that also questioned US efforts to treat addiction and demand for opioids.

    “China has always strictly controlled precursor chemicals in accordance with international conventions and domestic laws. The US side’s so-called ‘fentanyl precursors,’ a small number of them are listed substances by the United Nations, and China has always been resolute in implementing the listed measures. But most of the rest are common chemicals that are not listed by the United Nations, China or even the United States itself,” it said in a written statement to CNN.

    “Government departments do not have the right or the possibility to regulate non-listed chemicals and common commodities,” it added.

    The ministry statement went on to highlight China’s harsh domestic penalties on drug trade and consumption. “The Chinese people deeply resent drugs. the Opium War was the beginning of China’s modern history of humiliation. The Chinese government has always cracked down on drug crime, and China is a no-go area for international drug dealers.”

     Such unregulated precursors, like the one offered by Wang, are not illegal to sell but can be used in the manufacture of illicit substances like fentanyl, methamphetamine, and cocaine.

    Several precursors used to create fentanyl have been put under international control since 2017, but a savvy chemical engineer can combine legal precursors further up the synthesis chain to make similar compounds.

    “What we have seen illicit chemists doing now is that certain components of the synthesis are now … harder for them to purchase, so what they’re doing now is they’re buying compounds that are structurally very, very similar,” Alexandra Evans, a forensic chemist with the D.C. Department of Forensic Sciences, told CNN from her lab in the US capital.

    Or they can create fentanyl analogues, substitutes that are chemically similar to fentanyl and which has made the crisis more deadly in recent years. One fentanyl analogue was found to be 10,000 times stronger than morphine, according to a 2021 US government report.

    Controlling the stream of chemicals has turned into a deadly game of whack-a-mole – where manufacturers are able to use a variety of precursors to synthesize fentanyl and its analogues faster than either can be identified, banned, or regulated. 

    Many of the building blocks to fentanyl have benign purposes and are legal to buy, but a menu Wang sent of Shanxi Naipu’s chemical products for sale appeared designed to support illegal drug manufacture, according to a synthetic chemist who analyzed the list for CNN. 

    It was “obviously a list curated to help people create illicit drugs,” Lyle Isaacs, a professor in the Department of Chemistry and Biochemistry at the University of Maryland, told CNN of the more than 25 chemical compounds on the menu. 

    At least three compounds on the list could be made into fentanyl, he said. One of the compounds, CAS 79099-07-3, also known as 1-Boc-4-piperidone, was what Wang offered to sell CNN; the other two compounds also have legitimate uses and can be found, for example, in academic laboratories researching future medicines, Isaacs said. 

    Still more compounds on the list appeared to be building blocks for meth, ecstasy, ketamine, and the cutting of cocaine, as well as over-the-counter drugs like paracetamol, a common pain medication that can also be used to cut heroin and other narcotics, he added. 

    Asked about the list, Shanxi Naipu reiterated in its statement to CNN that all products on it are legal in China, stating: “We are not professional chemists but just a trading company. Even though we don’t have an intimate knowledge of the composition and use of thousands of chemicals, we have always strictly ensured the legality of our products!”

    Attempts to contact Wang through the company for comment were not successful, and the company said in its statement that she no longer works for them.

    There are measures that responsible chemical sellers can take to avoid their products being used for illegal drugs.

    Identity checks are a hallmark of reputable sellers, said a former Drug Enforcement Administration (DEA) official. The source spoke to CNN on the condition of anonymity because they were not authorized to speak to the media. To sell non-listed chemicals, a good-faith seller would normally ask a buyer about the intended use of the compound, and whether the buyer had the backing of a company or institution, such as a research organization or university.  

    American buyers of regulated chemicals require licenses from the DEA, depending on how hazardous they are. Reputable sellers may also ask for tax identifications even for chemicals that are not controlled, like precursor materials, the source said.

    At no point in the conversation was Wang aware, nor did she ask for the identities of the CNN reporters speaking to her or what CNN planned on using it for. She even offered a “door to door” precursor delivery service via warehouses in the US or Mexico – locations that CNN has been unable to verify.

    In its statement to CNN, Shanxi Naipu denied that it had warehouses in either country.

    The small quantity of precursor needed to manufacture fentanyl ultimately makes shipments destined for illicit ends hard to catch at the border, points out Martin Raithelhuber, an illicit synthetic drugs expert at the United Nations Office on Drugs and Crime.

    “You have hundreds of thousands of tonnes (of chemicals in a shipment), and you are looking for a few kilograms, which are sufficient to produce a supply of millions of doses (of fentanyl),” he said. 

    Since China banned the production of fentanyl and related substances in 2019, Mexican criminal organizations have largely taken control of the drug’s production and sale, smuggling finished fentanyl to consumers in the US, according to a 2022 report from the Congressional Research Service.

    Mexico is now the source of “the vast majority” of meth, heroin and illicit fentanyl seized in the US, according to the US International Narcotics Control Strategy Report (INCSR) released in March 2023. “In 2022, the United States identified Mexico as the sole significant source of illicit fentanyl and fentanyl analogues significantly affecting the United States,” it reads.

    “Criminal elements, mostly in the People’s Republic of China, ship precursor chemicals to Mexico, where they are used to produce illicit fentanyl,” Dr. Rahul Gupta, director of the White House’s Office of National Drug Control Policy, told the Senate Foreign Relations Committee earlier this year. 

    “The only limit on how much fentanyl they can make is the amount of precursor chemicals they can get,” DEA Administrator Anne Milgram told CNN in early March.

    The Biden administration has taken aim at these groups and in February sanctioned a network of Sinaloa Cartel members and associated entities for their involvement in the fentanyl and methamphetamine trade. 

    Mexico’s law enforcement has also fought the trade, seizing and impounding hundreds of kilos of fentanyl precursors and pills – including a cache of over a million potential fentanyl pills in the Mexican border city of Tijuana on March 13.

    Ultimately, tackling fentanyl requires close coordination between the US, Mexico, and China. Even if countries like Mexico had the best national control measures, international cooperation is needed to understand “which flows are the ones we need to watch or [be] worried about,” Raithelhuber said.

    Former DEA official Matthew Donahue told CNN he would like to see Mexico do more, including cracking down on properties and other assets of those involved in the drug trade.

    But as the US pressures other governments to help slow the flow of illicit fentanyl, relations between the three countries have turned into a three-way blame game.

    Following the kidnapping of four Americans in a Mexican border town by cartel members in early March, US Republicans called for the US military to be allowed to fight cartels and destroy drug labs in Mexico – something Mexican President Andrés Manuel López Obrador called “an offense to the people of Mexico.” 

    “We are not a protectorate of the United States or a colony of the United States. Mexico is a free, independent, sovereign country. We don’t take orders from anyone,” López Obrador said at a news conference on March 9. 

    Washington has also called on Beijing to do more, with the latest US INCSR report describing China’s oversight functions as “poorly staffed and under-resourced to oversee its massive chemical industry.” Though it acknowledges Beijing’s harsh penalties for drug trafficking, the report laments ineffective controls on shipment labeling, customer vetting and pill-making equipment.

    The Ministry of Foreign Affairs’ statement to CNN emphasizes its “stringent” control of listed chemicals that could be used for drug-making and argues that Beijing has “improved” several “regulatory mechanisms such as end-user verification, leakage monitoring, and source backtracking, and has strengthened management of more than 200,000 chemical companies.”

    Both China and Mexico have called on the US to do some soul-searching about demand for illicit fentanyl.

    “US legislators and the authorities there are not doing their job because they are not addressing the causes (of addiction); there are no care programs for young people in the US,” López-Obrador said last week.

    “Using China as a scapegoat will not solve the drug crisis in the United States … ,” the Chinese Foreign Ministry’s statement to CNN read. “We advise the US side to reflect on itself, stop shifting blame, strengthen domestic prescription drug control, enhance publicity on the dangers of drugs, and take practical measures to reduce domestic drug demand.”

    Prescription opioids like oxycodone and hydrocodone – which have a similar chemical structure to heroin and fentanyl – were major contributors to the early opioid crisis in the US. Pharmaceutical giants, notably Purdue Pharma, downplayed the potentially addictive properties of the drugs and incentivized US doctors to prescribe the painkillers. But prescribing was curtailed as overdoses from prescription opioids climbed and now waves of heroin and illicit fentanyl took over, making the crisis far more deadly. 

    Amid the recriminations, fentanyl products continue to pour through US borders and Americans continue to die. 

    To raise awareness of the human toll, the US Drug Enforcement Administration last year created “The Faces of Fentanyl” exhibit at its headquarters in Arlington, Virginia where families can submit a photo of a loved one lost to the fentanyl crisis. So far more than 5,000 photos have been submitted.

    “We can’t be desensitized” to the number of lives lost to drug overdoses,” Donahue, the former DEA official, said. “The pain and suffering that these families are going through. That has got to mean something.” 

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  • US sues Rite Aid for missing opioid red flags | CNN Business

    US sues Rite Aid for missing opioid red flags | CNN Business



    CNN
     — 

    The Justice Department on Monday filed a lawsuit against Rite Aid for allegedly violating the Controlled Substances Act, alleging that the company “knowingly filled unlawful prescriptions for controlled substances.”

    In a statement, Attorney General Merrick Garland said the Department of Justice is “using every tool at our disposal” to hold Rite Aid accountable for contributing to the opioid epidemic.

    Associate Attorney General Vanita Gupta said “Rite Aid’s pharmacists repeatedly filled prescriptions for controlled substances with obvious red flags, and Rite Aid intentionally deleted internal notes about suspicious prescribers. These practices opened the floodgates for millions of opioid pills and other controlled substances to flow illegally out of Rite Aid’s stores.”

    In the complaint, The Justice department alleges that from May 2014 to June 2019, Rite Aid filled thousands of unlawful combinations of prescriptions known as “the trinity” which included prescriptions for “excessive quantities of opioids, such as oxycodone and fentanyl.”

    Rite Aid pharmacists were accused of ignoring obvious signs of misuse and intentionally deleting some pharmacists’ internal warnings about suspicious prescribers, such as “cash only pill mill???”

    “These practices opened the floodgates for millions of opioid pills and other controlled substances to flow illegally out of Rite Aid’s stores,” Associate Attorney General Vanita Gupta said.

    The Justice Department said the prescriptions, who were issued illegally, “lacked a legitimate medical purpose, were not for a medically accepted indication, or were not issued in the usual course of professional practice.”

    Rite Aid is one of the country’s largest pharmacy chains, with more than 2,330 stores in 17 US states. It did not immediately respond to requests for comment.

    The Justice Department accused Rite Aid of violating the federal False Claims Act by submitting false prescription claims to government health care programs such as Medicare and Medicaid.

    It joined a whistleblower lawsuit filed in 2019 by two pharmacists and a pharmacy technician from Rite Aid stores in Pennsylvania, North Carolina and West Virginia.

    The Justice Department occasionally joins whistleblower cases it considers stronger.

    It has also sued Walmart and drug distributor AmerisourceBergen Corp over their alleged roles in the nation’s opioid crisis.

    More than 500,000 people died from drug overdoses in the United States from 1999 to 2020, including more than 90,000 in 2020 alone, according to the US Centers for Disease Control and Prevention.

    Reuters contributed to this report.

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  • Fact check: Republicans at CPAC make false claims about Biden, Zelensky, the FBI and children | CNN Politics

    Fact check: Republicans at CPAC make false claims about Biden, Zelensky, the FBI and children | CNN Politics


    Washington
    CNN
     — 

    The Conservative Political Action Conference is underway in Maryland. And the members of Congress, former government officials and conservative personalities who spoke at the conference on Thursday and Friday made false claims about a variety of topics.

    Rep. Jim Jordan of Ohio uttered two false claims about President Joe Biden. Rep. Marjorie Taylor Greene of Georgia repeated a debunked claim about Ukrainian President Volodymyr Zelensky. Sen. Tommy Tuberville of Alabama used two inaccurate statistics as he lamented the state of the country. Former Trump White House official Steve Bannon repeated his regular lie about the 2020 election having been stolen from Trump, this time baselesly blaming Fox for Trump’s defeat.

    Rep. Kat Cammack of Florida incorrectly said a former Obama administration official had encouraged people to harass Supreme Court Justice Brett Kavanaugh. Rep. Ralph Norman of South Carolina inaccurately claimed Biden had laughed at a grieving mother and inaccurately insinuated that the FBI tipped off the media to its search of former President Donald Trump’s Florida residence. Two other speakers, Rep. Scott Perry of Pennsylvania and former Trump administration official Sebastian Gorka, inflated the number of deaths from fentanyl.

    And that’s not all. Here is a fact check of 13 false claims from the conference, which continues on Saturday.

    Marjorie Taylor Greene said the Republican Party has a duty to protect children. Listing supposed threats to children, she said, “Now whether it’s like Zelensky saying he wants our sons and daughters to go die in Ukraine…” Later in her speech, she said, “I will look at a camera and directly tell Zelensky: you’d better leave your hands off of our sons and daughters, because they’re not dying over there.”

    Facts First: Greene’s claim is false. Ukrainian President Volodymyr Zelensky didn’t say he wants American sons and daughters to fight or die for Ukraine. The false claim, which was debunked by CNN and others earlier in the week, is based on a viral video that clipped Zelensky’s comments out of context.

    19-second video of Zelensky goes viral. See what was edited out

    In reality, Zelensky predicted at a press conference in late February that if Ukraine loses the war against Russia because it does not receive sufficient support from elsewhere, Russia will proceed to enter North Atlantic Treaty Organization member countries in the Baltics (a region made up of Latvia, Lithuania and Estonia) that the US will be obligated to send troops to defend. Under the treaty that governs NATO, an attack on one member is considered an attack on all. Ukraine is not a NATO member, and Zelensky didn’t say Americans should fight there.

    Greene is one of the people who shared the out-of-context video on Twitter this week. You can read a full fact-check, with Zelensky’s complete quote, here.

    Right-wing commentator and former Trump White House chief strategist Steve Bannon criticized right-wing cable channel Fox at length for, he argued, being insufficiently supportive of Trump’s 2024 presidential campaign. Among other things, Bannon claimed that, on the night of the election in November 2020, “Fox News illegitimately called it for the opposition and not Donald J. Trump, of which our nation has never recovered.” Later, he said Trump is running again after “having it stolen, in broad daylight, of which they [Fox] participate in.”

    Facts First: This is nonsense. On election night in 2020, Fox accurately projected that Biden had won the state of Arizona. This projection did not change the outcome of the election; all of the votes are counted regardless of what media outlets have projected, and the counting showed that Biden won Arizona, and the election, fair and square. The 2020 election was not “stolen” from Trump.

    NATIONAL HARBOR, MARYLAND - MARCH 03: Former White House chief strategist for the Trump Administration Steve Bannon speaks during the annual Conservative Political Action Conference (CPAC) at the Gaylord National Resort Hotel And Convention Center on March 03, 2023 in National Harbor, Maryland. The annual conservative conference entered its second day of speakers including congressional members, media personalities and members of former President Donald Trump's administration. President Donald Trump will address the event on Saturday.  (Photo by Anna Moneymaker/Getty Images)

    Bannon has a harsh message for Fox News at CPAC

    Fox, like other major media outlets, did not project that Biden had won the presidency until four days later. Fox personalities went on to repeatedly promote lies that the election was stolen from Trump – even as they privately dismissed and mocked these false claims, according to court filings from a voting technology company that is suing Fox for defamation.

    Rep. Jim Jordan claimed that Biden, “on day one,” made “three key changes” to immigration policy. Jordan said one of those changes was this: “We’re not going to deport anyone who come.” He proceeded to argue that people knowing “we’re not going to get deported” was a reason they decided to migrate to the US under Biden.

    Facts First: Jordan inaccurately described the 100-day deportation pause that Biden attempted to impose immediately after he took office on January 20, 2021. The policy did not say the US wouldn’t deport “anyone who comes.” It explicitly did not apply to anyone who arrived in the country after the end of October 2020, meaning people who arrived under the Biden administration or in the last months of the Trump administration could still be deported.

    Biden did say during the 2020 Democratic primary that “no one, no one will be deported at all” in his first 100 days as president. But Jordan claimed that this was the policy Biden actually implemented on his first day in office; Biden’s actual first-day policy was considerably narrower.

    Biden’s attempted 100-day pause also did not apply to people who engaged in or were suspected of terrorism or espionage, were seen to pose a national security risk, had waived their right to remain in the US, or whom the acting director of Immigration and Customs Enforcement determined the law required to be removed.

    The pause was supposed to be in effect while the Department of Homeland Security conducted a review of immigration enforcement practices, but it was blocked by a federal judge shortly after it was announced.

    Rep. Ralph Norman strongly suggested the FBI had tipped off the media to its August search of Trump’s Mar-a-Lago home and resort in Florida for government documents in the former president’s possession – while concealing its subsequent document searches of properties connected to Biden.

    Norman said: “When I saw the raid at Mar-a-Lago – you know, the cameras, the FBI – and compare that to when they found Biden’s, all of the documents he had, where was the media, where was the FBI? They kept it quiet early on, didn’t let it out. The job of the next president is going to be getting rid of the insiders that are undermining this government, and you’ve gotta clean house.”

    Facts First: Norman’s narrative is false. The FBI did not tip off the media to its search of Mar-a-Lago; CNN reported the next day that the search “happened so quietly, so secretly, that it wasn’t caught on camera at all.” Rather, media outlets belatedly sent cameras to Mar-a-Lago because Peter Schorsch, publisher of the website Florida Politics, learned of the search from non-FBI sources and tweeted about it either after it was over or as it was just concluding, and because Trump himself made a public statement less than 20 minutes later confirming that a search had occurred. Schorsch told CNN on Thursday: “I can, unequivocally, state that the FBI was not one of my two sources which alerted me to the raid.”

    Brian Stelter, then CNN’s chief media correspondent, wrote in his article the day after the search: “By the time local TV news cameras showed up outside the club, there was almost nothing to see. Websites used file photos of the Florida resort since there were no dramatic shots of the search.”

    It’s true that the public didn’t find out until late January about the FBI’s November search of Biden’s former think tank office in Washington, which was conducted with the consent of Biden’s legal team. But the belated presence of journalists at Mar-a-Lago on the day of the Trump search in August is not evidence of a double standard.

    And it’s worth noting that media cameras were on the scene when Biden’s beach home in Delaware was searched by the FBI in February. News outlets had set up a media “pool” to make sure any search there was recorded.

    Sen. Tommy Tuberville, a former college and high school football coach, said, “Going into thousands of kids’ homes and talking to parents every year recruiting, half the kids in this country – I’m not talking about race, I’m just talking about – half the kids in this country have one or no parent. And it’s because of the attack on faith. People are losing faith because, for some reason, because the attack [on] God.”

    Facts First: Tuberville’s claim that half of American children don’t have two parents is incorrect. Official figures from the Census Bureau show that, in 2021, about 70% of US children under the age of 18 lived with two parents and about 65% lived with two married parents.

    About 22% of children lived with only a mother, about 5% with only a father, and about 3% with no parent. But the Census Bureau has explained that even children who are listed as living with only one parent may have a second parent; children are listed as living with only one parent if, for example, one parent is deployed overseas with the military or if their divorced parents share custody of them.

    It is true that the percentage of US children living in households with two parents has been declining for decades. Still, Tuberville’s statistic significantly exaggerated the current situation. His spokesperson told CNN on Thursday that the senator was speaking “anecdotally” from his personal experience meeting with families as a football coach.

    Tuberville claimed that today’s children are being “indoctrinated” in schools by “woke” ideology and critical race theory. He then said, “We don’t teach reading, writing and arithmetic anymore. You know, half the kids in this country, when they graduate – think about this: half the kids in this country, when they graduate, can’t read their diploma.”

    Facts First: This is false. While many Americans do struggle with reading, there is no basis for the claim that “half” of high school graduates can’t read a basic document like a diploma. “Mr. Tuberville does not know what he’s talking about at all,” said Patricia Edwards, a Michigan State University professor of language and literacy who is a past president of the International Literacy Association and the Literacy Research Association. Edwards said there is “no evidence” to support Tuberville’s claim. She also said that people who can’t read at all are highly unlikely to finish high school and that “sometimes politicians embellish information.”

    Tuberville could have accurately said that a significant number of American teenagers and adults have reading trouble, though there is no apparent basis for connecting these struggles with supposed “woke” indoctrination. The organization ProLiteracy pointed CNN to 2017 data that found 23% of Americans age 16 to 65 have “low” literacy skills in English. That’s not “half,” as ProLiteracy pointed out, and it includes people who didn’t graduate from high school and people who are able to read basic text but struggle with more complex literacy tasks.

    The Tuberville spokesperson said the senator was speaking informally after having been briefed on other statistics about Americans’ struggles with reading, like a report that half of adults can’t read a book written at an eighth-grade level.

    Rep. Jim Jordan claimed of Biden: “The president of the United States stood in front of Independence Hall, called half the country fascists.”

    Facts First: This is not true. Biden did not denounce even close to “half the country” in this 2022 speech at Independence Hall in Philadelphia. He made clear that he was speaking about a minority of Republicans.

    In the speech, in which he never used the word “fascists,” Biden warned that “MAGA Republicans” like Trump are “extreme,” “do not respect the Constitution” and “do not believe in the rule of law.” But he also emphasized that “not every Republican, not even the majority of Republicans, are MAGA Republicans.” In other words, he made clear that he was talking about far less than half of Americans.

    Trump earned fewer than 75 million votes in 2020 in a country of more than 258 million adults, so even a hypothetical criticism of every single Trump voter would not amount to criticism of “half the country.”

    Rep. Scott Perry claimed that “average citizens need to just at some point be willing to acknowledge and accept that every single facet of the federal government is weaponized against every single one of us.” Perry said moments later, “The government doesn’t have the right to tell you that you can’t buy a gas stove but that you must buy an electric vehicle.”

    Facts First: This is nonsense. The federal government has not told people that they can’t buy a gas stove or must buy an electric vehicle.

    The Biden administration has tried to encourage and incentivize the adoption of electric vehicles, but it has not tried to forbid the manufacture or purchase of traditional vehicles with internal combustion engines. Biden has set a goal of electric vehicles making up half of all new vehicles sold in the US by 2030.

    There was a January controversy about a Biden appointee to the United States Consumer Product Safety Commission, Richard Trumka Jr., saying that gas stoves pose a “hidden hazard,” as they emit air pollutants, and that “any option is on the table. Products that can’t be made safe can be banned.” But the commission as a whole has not shown support for a ban, and White House press secretary Karine Jean-Pierre said at a January press briefing: “The president does not support banning gas stoves. And the Consumer Product Safety Commission, which is independent, is not banning gas stoves.”

    Rep. Ralph Norman claimed that Biden had just laughed at a mother who lost two sons to fentanyl.

    “I don’t know whether y’all saw, I just saw it this morning: Biden laughing at the mother who had two sons – to die, and he’s basically laughing and saying the fentanyl came from the previous administration. Who cares where it came from? The fact is it’s here,” Norman said.

    Facts First: Norman’s claim is false. Biden did not laugh at the mother who lost her sons to fentanyl, the anti-abortion activist Rebecca Kiessling; in a somber tone, he called her “a poor mother who lost two kids to fentanyl.” Rather, he proceeded to laugh about how Republican Rep. Marjorie Taylor Greene had baselessly blamed the Biden administration for the young men’s deaths even though the tragedy happened in mid-2020, during the Trump administration. You can watch the video of Biden’s remarks here.

    Kiessling has demanded an apology from Biden. She is entitled to her criticism of Biden’s remarks and his chuckle – but the video clearly shows Norman was wrong when he claimed Biden was “laughing at the mother.”

    Rep. Kat Cammack told a story about the first hearing of the new Republican-led House select subcommittee on the supposed “weaponization” of the federal government. Cammack claimed she had asked a Democratic witness at this February hearing about his “incredibly vitriolic” Twitter feed in which, she claimed, he not only repeatedly criticized Supreme Court Justice Brett Kavanaugh but even went “so far as to encourage people to harass this Supreme Court justice.”

    Facts First: This story is false. The witness Cammack questioned in this February exchange at the subcommittee, former Obama administration deputy assistant attorney general Elliot Williams, did not encourage people to harass Kavanaugh. In fact, it’s not even true that Cammack accused him at the February hearing of having encouraged people to harass Kavanaugh. Rather, at the hearing, she merely claimed that Williams had tweeted numerous critical tweets about Kavanaugh but had been “unusually quiet” on Twitter after an alleged assassination attempt against the justice. Clearly, not tweeting about the incident is not the same thing as encouraging harassment.

    Williams, now a CNN legal analyst (he appeared at the subcommittee hearing in his personal capacity), said in a Thursday email that he had “no idea” what Cammack was looking at on his innocuous Twitter feed. He said: “I used to prosecute violent crimes, and clerked for two federal judges. Any suggestion that I’ve ever encouraged harassment of anyone – and particularly any official of the United States – is insulting and not based in reality.”

    Cammack’s spokesperson responded helpfully on Thursday to CNN’s initial queries about the story Cammack told at CPAC, explaining that she was referring to her February exchange with Williams. But the spokesperson stopped responding after CNN asked if Cammack was accurately describing this exchange with Williams and if they had any evidence of Williams actually having encouraged the harassment of Kavanaugh.

    Sen. John Kennedy of Louisiana boasted about the state of the country “when Republicans were in charge.” Among other claims about Trump’s tenure, he said that “in four years,” Republicans “delivered 3.5% unemployment” and “created 8 million new jobs.”

    Facts First: This is inaccurate in two ways. First, the economic numbers for the full “four years” of Trump’s tenure are much worse than these numbers Kennedy cited; Kennedy was actually referring to Trump’s first three years while ignoring the fourth, which was marred by the Covid-19 pandemic. Second, there weren’t “8 million new jobs” created even in Trump’s first three years.

    Kennedy could have correctly said there was a 3.5% unemployment rate after three years of the Trump administration, but not after four. The unemployment rate skyrocketed early in Trump’s fourth year, on account of the pandemic, before coming down again, and it was 6.3% when Trump left office in early 2021. (It fell to 3.4% this January under Biden, better than in any month under Trump.)

    And while the economy added about 6.7 million jobs under Trump before the pandemic-related crash of March and April 2020, that’s not the “8 million jobs” Kennedy claimed – and the economy ended up shedding millions of jobs in Trump’s fourth year. Over the full four years of Trump’s tenure, the economy netted a loss of about 2.7 million jobs.

    Lara Trump, Donald Trump’s daughter-in-law and an adviser to his 2020 campaign, claimed that the last time a CPAC crowd was gathered at this venue in Maryland, in February 2020, “We had the lowest unemployment in American history.” After making other boasts about Donald Trump’s presidency, she said, “But how quickly it all changed.” She added, “Under Joe Biden, America is crumbling.”

    Facts First: Lara Trump’s claim about February 2020 having “the lowest unemployment in American history” is false. The unemployment rate was 3.5% at the time – tied for the lowest since 1969, but not the all-time lowest on record, which was 2.5% in 1953. And while Lara Trump didn’t make an explicit claim about unemployment under Biden, it’s not true that things are worse today on this measure; again, the most recent unemployment rate, 3.4% for January 2023, is better than the rate at the time of CPAC’s 2020 conference or at any other time during Donald Trump’s presidency.

    Multiple speakers at CPAC decried the high number of fentanyl overdose deaths. But some of the speakers inflated that number while attacking Biden’s immigration policy.

    Sebastian Gorka, a former Trump administration official, claimed that “in the last 12 months in America, deaths by fentanyl poisoning totaled 110,000 Americans.” He blamed “Biden’s open border” for these deaths.

    Rep. Scott Perry claimed: “Meanwhile over on this side of the border, where there isn’t anybody, they’re running this fentanyl in; it’s killing 100,000 Americans – over 100,000 Americans – a year.”

    Facts First: It’s not true that there are more than 100,000 fentanyl deaths per year. That is the total number of deaths from all drug overdoses in the US; there were 106,699 such deaths in 2021. But the number of overdose deaths involving synthetic opioids other than methadone, primarily fentanyl, is smaller – 70,601 in 2021.

    Fentanyl-related overdoses are clearly a major problem for the country and by far the biggest single contributor to the broader overdose problem. Nonetheless, claims of “110,000” and “over 100,000” fentanyl deaths per year are significant exaggerations. And while the number of overdose deaths and fentanyl-related deaths increased under Biden in 2021, it was also troubling under Trump in 2020 – 91,799 total overdose deaths and 56,516 for synthetic opioids other than methadone.

    It’s also worth noting that fentanyl is largely smuggled in by US citizens through legal ports of entry rather than by migrants sneaking past other parts of the border. Contrary to frequent Republican claims, the border is not “open”; border officers have seized thousands of pounds of fentanyl under Biden.

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  • More than 4.5 million fentanyl pills, 3,000 pounds of methamphetamine seized in Arizona investigation, DEA says | CNN

    More than 4.5 million fentanyl pills, 3,000 pounds of methamphetamine seized in Arizona investigation, DEA says | CNN



    CNN
     — 

    Arizona authorities targeting the Sinaloa drug cartel have seized narcotics estimated to be worth more than $13 million, including more than 4.5 million fentanyl pills, 3,100 pounds of methamphetamine and large quantities of heroin, cocaine and fentanyl powder, according to the Drug Enforcement Administration.

    In a news release, the agency said the seizure was the culmination of a three-year-long investigation during which 150 people had so far been charged.

    “The fentanyl seized represents more than 30 million potentially lethal doses,” the DEA said, announcing the seizure in partnership with the Tempe Police Department and Arizona Attorney General Kris Mayes.

    Authorities displayed some of the recovered narcotics at a joint news conference Thursday, attended by CNN affiliate KNXV.

    “The sample you see here today is staggering. There are over 4.5 million fentanyl pills, over 140 pounds of fentanyl powder, over 135 kilos of cocaine, over 3,000 pounds of methamphetamine, 35 kilos of heroin, 49 firearms and over $2 million in cash,” Interim Tempe Police Chief Josie Montenegro told reporters.

    Montenegro said the substances recovered “would be poisoning members of our community, including our youth and vulnerable population,” had the seizures not been made.

    “In addition, the dangers and crimes associated with illegal drugs would be plaguing our community,” Montenegro added.

    According to authorities, “numerous” people were taken into custody in the bust. At this time, authorities do not plan on releasing the names of those involved because it is a continuing investigation, according to Montenegro.

    Phoenix DEA Special Agent in Charge Cheri Oz said investigators are “laser-focused” on the Sinaloa cartel.

    “I want to be crystal clear, the drugs in this room and the drugs that are flooding Arizona every single day are sourced primarily by one evil as the Sinaloa drug cartel,” she said at the news conference. “We are laser-focused on the Sinaloa drug cartel and we will defeat them. We will not stop.”

    Oz also praised the efforts of DEA agents and other officers over the last three years. “Their hard work and tenacity is responsible for removing these deadly drugs before they poisoned our family, our friends and our neighborhoods,” she said.

    The country is struggling with a decades-long opioid epidemic in which fentanyl has become the most commonly used drug involved in overdoses.

    Pharmaceutical fentanyl is a synthetic opioid intended to help patients manage severe pain. It is 50 to 100 times more potent than morphine, and typically prescribed in the form of skin patches or lozenges. But most recent cases of fentanyl-related harm, overdose, and death in the United States are linked to illegally made fentanyl, according to the US Centers for Disease Control and Prevention.

    Deaths involving synthetic opioids increased by 22% in 2021, according to CDC data, and in 2022, there were about 181,806 nonfatal opioid overdoses recorded in the United States.

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  • After recent student fentanyl overdoses in Texas community, court documents reveal drug supplier lived blocks away from schools | CNN

    After recent student fentanyl overdoses in Texas community, court documents reveal drug supplier lived blocks away from schools | CNN



    CNN
     — 

    Parents across the Carrollton-Farmers Branch Independent School District (CFBISD), located in a Dallas, Texas, suburb, are reeling following a string fentanyl overdoses by nine students who attend schools in the district.

    The students, who range in age from 13 to 17 and are not identified by name in court documents, overdosed between September 18, 2022 and February 1, 2023. Three of the students died, and one of the students, a 14-year-old girl, overdosed twice, according to a statement by the US Attorney’s Office, Northern District of Texas.

    Law enforcement officers traced the drugs the students overdosed on to a house within walking distance from a middle school and a high school, court documents say.

    “First with all the school shootings, now this with drugs,” Lupe Rebadan, who has two children, as well as nieces and nephews, attending schools in the district told CNN. “Our kids are not safe at school… When is this all going to stop?”

    Luis Eduardo Navarette and Magaly Mejia Cano have been charged with conspiracy to distribute fentanyl, according to the US Attorney’s Office.

    “To deal fentanyl is to knowingly imperil lives. To deal fentanyl to minors – naive middle and high school students – is to shatter futures. These defendants’ alleged actions are simply despicable,” US Attorney Leigha Simonton said in the statement.

    The complaint illuminates a network of drug dealers and users, most of them teenagers who attend R.L. Turner High School, Dan Long Middle School and Dewitt Perry Middle School, and traced the proliferation of fentanyl tainted “M30” pills to Navarette and Cano’s residence.

    International drug trafficking organizations often produce M30 pills by mixing highly addictive fentanyl with acetaminophen “and other binder type substances and pressed into various tablets/pills,” says an affidavit by a Drug Enforcement Administration task force officer included in the criminal complaint.

    Many fake pills are made to look like prescription opioids such as oxycodone (Oxycontin, Percocet), hydrocodone (Vicodin), and alprazolam (Xanax); or stimulants like amphetamines (Adderall),” according to the DEA’s “One Pill Can Kill” website.

    Criminal organizations, according to the DEA officer’s affidavit, sell M30 pills for $1 to $2 dollars per pill when the purchasers buy in bulk amounts. Those are later sold to “street level dealers” for $3 to $5 per pill, and later sold to consumers for $10 per pill.

    Law enforcement tracked multiple teenagers engaging in “hand-to-hand transactions” with Navarette and Cano outside of their house, which is approximately five blocks from R.L. Turner High School and two blocks from DeWitt Perry Middle School, the court documents reveal.

    On January 12, a Carrollton Street Crimes Unit detective observed a 16-year-old obtain M30 pills from Navarette and Cano’s residence.

    The teenager appeared to crush and snort a pill on their front porch, “possibly package” the drugs, then walk toward the high school, where he was enrolled, according to the complaint.

    The school was notified by law enforcement, and later that day a school resource officer located the teenager in a bathroom making a “snorting sound” and appearing intoxicated.

    Navarette and Cano made their initial appearances in court on Monday, Erin Dooley of the US Attorney’s Office in Northern Texas told CNN. Naverette waived his right to a detention hearing and was ordered detained pending trial, and Cano had her detention hearing on Friday, she added. Attorneys for Navarette and Cano haven’t responded to CNN’s requests for comment.

    Days after the complaint outlining the 10 overdoses became available to the public, CFBISD released a statement expressing sorrow and concern over “the loss of young lives.”

    The district explained how it has educated the community about the threat from fentanyl over the past several months.

    “We will continue to work cooperatively with local law enforcement agencies to address this issue and to maximize safety on our campuses in every way possible. We believe if we work together as a community, we can avoid these tragedies,” the district said.

    The district said Narcan, or naloxone, an emergency drug used to treat fentanyl overdoses, had been obtained for all district facilities in October and random canine searches were being conducted on secondary campuses.

    Drug awareness presentations for parents will also resume this year, according to the district.

    “The fentanyl crisis is claiming far too many young Texans,” Texas Governor Greg Abbott tweeted Wednesday. Abbott launched the #OnePillKills campaign in October 2022 to “combat the growing national fentanyl crisis plaguing Texas.”

    In the first week of school in 2022, four students died from “fentanyl poisoning, or suspected poisoning” in Hays County Independent School District (HCISD), located in a suburb of Austin. This prompted the district to create “Fighting Fentanyl,” an informational campaign warning students and faculty about the deadly drug.

    Tim Savoy, the chief communication officer at HCISD, noted that the district has spent tens of millions of dollars for preventative measures against school shootings and Covid-19, two issues that have affected schools nationwide. The fentanyl crisis on school campuses deserves the same level of concern and response, he said.

    “This is a threat. We’re losing students, too. And so we made the decision that we have to get this equal attention and resources and do what we can,” Savoy told CNN.

    Despite the district’s awareness-raising campaign, an email from the superintendent on January 9 informed parents of “three more suspected accidental fentanyl poisonings” and one death in which fentanyl may have been to blame.

    “Our students are dying from this, and we have to do what we can,” Savoy said. “This is not just something that you’re seeing elsewhere. This is really happening in our community.”

    According to the Centers for Disease Control and Prevention, median monthly overdose deaths among 10- to 19-year-olds across the United States involving illicitly manufactured fentanyl surged 182% from December 2019 to December 2021.

    Adolescents are particularly vulnerable to fentanyl exposure due to the “proliferation of counterfeit pills resembling prescription drugs containing IMFs (illicitly manufactured fentanyls), and the ease of purchasing pills through social media,” according to the CDC.

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  • The dark side of the sports betting boom | CNN Business

    The dark side of the sports betting boom | CNN Business


    New York
    CNN
     — 

    The sports gambling gold rush is coming at a high cost.

    In 2018, the Supreme Court struck down a federal ban on commercial sports betting in most of the country. Thirty-three states have made sports gambling legal in the wake of the decision. Now, on Super Bowl Sunday, a record 50.4 million US adults are expected to bet on the game.

    The booming sports betting industry, lawmakers and even the professional sports leagues themselves are making it easier, faster and more tempting for people to bet on games — and develop gambling problems, say gambling researchers and addiction specialists.

    A flood of advertising, technology that allows for one-click betting at home, and nearly unlimited betting options during games have collided. There’s been a spike in inquiries to state gambling-addiction hotlines, states say.

    In the past five years, there has been an explosion of online sports betting apps from companies like DraftKings, FanDuel and Caesars. These apps are often replacing illegal betting venues. At the same time, they also attract an influx of new gamblers who had never set foot in a casino or would have known how to place a bet with a bookie.

    During the Super Bowl, there will be an onslaught of advertisements — most starring celebrity sponsors and athletes — meant to encourage new sign-ups and grab market share. DraftKings will air a commercial featuring Kevin Hart and David Ortiz, while Rob Gronkowski will attempt a field goal kick live in a FanDuel ad. (Any customer who places a Super Bowl bet of five dollars or more on FanDuel will win a share of $10 million in “free bets” if Gronkowski makes it.)

    Hear why FanDuel CEO thinks this Super Bowl will be biggest day in company’s history

    Sports teams and leagues were once fiercely opposed to gambling on the games. Now, they’ve partnered with sportsbooks.

    These days, gamblers can also do much more than wager on the outcome of a game. There are options to bet in-game on every quarter, player, and event.

    Resources for gambling addiction programs have long been thin in the United States and have been stretched further by the current wave of sports betting. In 2020, there were 5.7 million Americans with a gambling disorder, according to a nationwide survey by the National Association of Administrators for Disordered Gambling Services.

    Focus on gambling disorders has historically been minimal in the United States, said Timothy Fong, a psychiatrist and the co-director of the UCLA Gambling Studies Program.

    This is in part because people with gambling disorders have been viewed as foolish or lacking willpower, he said. “We equate the ability to hold onto money and win money with success and equate losing with greed.”

    There is also sparse federal oversight of the gambling industry, and there are currently no federal funds designated for problem gambling treatment or research, unlike federal funding for alcohol, tobacco and drug addiction programs.

    DraftKings is one of the most popular sports betting apps.

    A patchwork of state legislation, lack of robust consumer protections in many states, and limited advertising restrictions are adding to the problems.

    “Many states naively or some other way went about legalizing sports betting without adequately estimating the costs on problem gambling resources,” said John Holden, an associate professor of management at Oklahoma State University who studies sports gambling regulation.

    “There is more that state lawmakers can do within the confines of commercial speech restrictions,” including authorizing extra funding to go after false and misleading advertising, Holden said.

    Betting on sports can be a way for some people to develop, maintain or accelerate gambling disorders.

    There are several features of sports betting that make it different from other forms of gambling and can lead to addictive behavior.

    Many sports bettors tend to perceive their wages on games are safer and more informed by their own expertise and skills than luck, researchers say. This may give them a false illusion of control.

    Additionally, live betting within games reduces the delay between risk and reward, and it’s increasing the speed and frequency of wagers, experts say.

    “I got caught up in a lot of the live betting,” said one 24-year-old man with a gambling disorder who spoke to CNN on the condition of anonymity. He started betting on sports seven years ago through a bookie, but upped his wagers once he started using apps.

    During football games, he would bet on the outcome of drives and which team would score the next touchdown. As he lost more during a game, he would try again to to win it back on the next play.

    “You see the way the game is going and you think you know,” he said. “It’s not like back in the day with a bookie betting on who wins.”

    He said he lost $100,000 on sports gambling, including money from student loans. He’s currently in recovery at Beit T’Shuvah, in Los Angeles, which provides inpatient and outpatient services for people struggling with gambling disorders.

    Casey Clark, the senior vice president at the American Gaming Association, a trade group for the gambling industry, said that the legalization of sports betting has moved the black market of sports gambling into regulated marketplaces, benefiting states.

    The gambling industry and sports betting operators work with regulators, professional sports leagues, media companies and advocates to set standards, provide gambling education for consumers and fund recovery efforts for people seeking treatment, Clark said.

    “We’ve had a really fast escalation and movement towards giving American consumers access to the legal market that they clearly want. And so we have to continue to evolve that marketplace,” he said.

    Advocates for people with gambling disorders say demand for help and treatment services has grown alongside the rapid expansion of legalized sports betting.

    Inquires to the Council on Compulsive Gambling of New Jersey’s help hotline about sports gambling have increased 60% since it became legal in the state in 2018, said Felicia Grondin, the organization’s executive director.

    Grondin feels helpless against the constant barrage of advertising encouraging betting on games.

    An advertisement for DraftKings is shown on the scoreboard during the game between the Boston Red Sox and the Detroit Tigers at Comerica Park on July 7, 2019 in Detroit, Michigan.

    “We consider it to be predatory advertising because it’s incessant and it glamorizes gambling,” she said.

    Clark from the American Gaming Association said the group has created a responsible marketing code to set industry-wide advertising standards.

    But self-enforcement by the industry cannot make up for robust oversight from regulators, said Keith Whyte, the executive director of the National Council on Problem Gambling.

    “Self-regulation tends to dumb itself down to the lowest common denominator, not the highest,” he said. “Some operators are definitely taking advantage of weak regulatory environments in some states.”

    Every state where gambling is legal has a regulatory body that oversees it.

    But few have “really done more than the minimal amount to increase funding of problem gambling treatment,” said Holden. The sports gambling industry is most similar to financial markets, he said, but financial markets are much more regulated than banks.

    Most states require that sports betting ads disclose the minimum legal age to gamble and responsible gambling messages, such as problem gambling hotlines. Those messages are brief and usually run at the very end.

    DraftKings' Super Bowl ad with Kevin Hart, David Ortiz and Emmitt Smith.

    Regulators are wary of how tightly they can curtail messages in gambling advertising without running afoul of First Amendment protections on commercial speech.

    “A lot of state regulators have big First Amendment fears,” Holden said. “No one wants to fund litigation or lose a Supreme Court case over gambling.”

    In most states, the legal age for sports betting is 21 years old. But ads during games, in stadiums, and with star athlete sponsors normalizes sports betting for kids and teenagers, critics say. The United Kingdom last year banned top athletes and celebrities from appearing in ads endorsing or promoting gambling to try to curb underage gambling. That’s unlikely to happen in the United States.

    Additionally, researchers are troubled by the incentives and promotions some sports betting apps often provide to users, such as sign-up and referral bonuses, promo codes and bonus bets. One 2017 study of people with gambling addictions found that messages with an offer of risk-free kind of bonuses had a high impact.

    The Ohio Casino Control Commission in January fined DraftKings, Caesars and BetMGM $150,000 each for advertising promotions or bonuses as “free” or “risk-free” when, in fact, users were required to lose money or risk their own money to obtain the promotion.

    “I got more incentive to gamble with these apps that give you free play and match your deposit,” said the former sports bettor in Los Angeles currently in recovery. He enlisted friends to sign up to get referral fees, and looked at these enticements as free money. “I’d have to be an idiot to pass this up.”

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  • Tracking the opioid crisis: Inside the DEA’s secret lab | CNN

    Tracking the opioid crisis: Inside the DEA’s secret lab | CNN

    Watch CNN Films’ “American Pain” at 9 p.m. ET Sunday, February 5.



    CNN
     — 

    Sitting among the warehouses of Dulles, Virginia, is one of the US Drug Enforcement Administration’s forensic labs. It’s one of eight across the country where scientists analyze illegal drugs and try to stay ahead of what’s driving deadly overdoses.

    Starting in the late 1990s with overprescribing of prescription narcotics, the opioid epidemic has continued to plague the United States for decades. What has changed is the type of drugs that have killed more than half a million people during the past 20 years.

    CNN was granted rare access to the secret lab where the DEA tests seized illicit drugs to understand what’s coming next.

    “The market is constantly changing, so we are trying to do everything we can from a science base to keep up with that,” Scott Oulton, deputy assistant administrator of the DEA’s Office of Forensic Sciences, told CNN Chief Medical Correspondent Dr. Sanjay Gupta.

    Holding a white bag of fentanyl precursor powder – one of the chemicals used to make the opioid – Oulton explained that the illicitly made painkiller continues to be a dominant presence in the drugs officials are finding.

    “This kilogram can be converted into fentanyl to make approximately 800 grams,” he said. “So it doesn’t take that much material, it’s fairly cheap, it’s inexpensive to obtain.”

    Fentanyl is the deadliest drug in the United States, and it’s often found in combination with other illicit drugs, including cocaine and heroin. But increasingly, fentanyl is showing up in illicit pills disguised as common prescription drugs like oxycodone, hydrocodone, even Adderall.

    Users buying drugs on the street that look like prescription pills may end up with a highly potent, potentially deadly drug they never intended to take.

    “Over 99% of what we see are fake. They contain fentanyl,” Oulton says of the pills that the agency is seizing.

    The 800 grams of fentanyl that Oulton held could be turned into 400,000 to 500,000 potentially lethal pills.

    As more and more of these lethal pills circulate, the opioid epidemic is reaching more of the population.

    Deena Loudon of Olney, Maryland, is among those living with its effects.

    “I truly love sharing Matthew with the world,” Loudon says as she flips through pictures of her son.

    One of her favorite memories is Matthew playing hockey – what Loudon calls his happy place.

    Matthew Loudon's mom says he turned to drugs after struggling with anxiety.

    But she also recalls his struggles with anxiety, which led him to turn to drugs. He started dabbling in them in the 10th grade. By the following year, his grades began to fall, and he couldn’t keep them high enough to stay in hockey.

    “He was using Xanax to help self-medicate himself and I think to help get rid of some of that angst so he could live somewhat of a normal life,” Loudon said.

    Matthew was always honest, almost to a fault, Loudon says. “He told me he tried everything. Like everything. Heroin, meth, crack, you name it, cocaine, whatever – until I guess he found what made him feel the best, and it was Xanax.”

    And as much as a mother can worry, Loudon says, Matthew always tried to reassure her. “I know what I’m doing,” he would tell her.

    She had heard about fentanyl showing up in pills in their area.

    “But you don’t ever think it’s going to happen to you,” Loudon said.

    She said they even had a conversation about fentanyl the day before he died. “I was sort of naive, wanting to stick my head in the sand and thinking ‘I bet he does know what he’s doing.’ ”

    On November 3, 2020, she found 21-year-old Matthew on the floor of their basement.

    Matthew’s autopsy report lists his cause of death as fentanyl and despropionyl fentanyl intoxication.

    “I don’t say he overdosed. I say he died from fentanyl poisoning. … Truthfully, like, at the end of the day, to me, he was murdered, right? Because he asked for one thing. They gave him something different. And it took his life.”

    For a parent, she said, the hardest thing is burying their child. It’s a pain she speaks out about in hopes of keeping other families safe.

    “It’s Russian roulette,” she warns them. “You never know what you’re gonna get.”

    The number of pills the DEA has seized skyrocketed in just three years, from 2.2 million in 2019 to 50.6 million in 2022.

    The sheer volume of pills has been one of the biggest challenges for the DEA’s lab, Oulton says. As the fentanyl threat continues to grow, the Virginia facility is expanding to accommodate the analysis needed.

    The lab can test for something as simple as the presence of fentanyl, but something called the purity of the pill also offers important insight. This means how much fentanyl is actually in one of these illicit pills.

    “Lately, we’ve been seeing a purity increase over the last year, where we used to say roughly four out of the 10 seizures that we were receiving would contain a lethal dose of greater than 2 milligrams. As of October last year, we started reporting that we’ve seen an uptick. Now we’re saying that six out of 10 of the seizures that we’re receiving contain over 2 milligrams,” Oulton said.

    He says they’re finding an average of 2.3 milligrams of fentanyl in each pill.

    Two milligrams may be the cutoff for what is considered lethal, but Oulton says that doesn’t necessarily mean a pill with 1.99 milligrams of fentanyl can’t be deadly.

    “One pill can kill” is his warning.

    “The message I would like to send out is, don’t take it,” he said. “Don’t take the chance. It’s not worth your life.”

    Oulton says he and his team are constantly finding new and different drugs and substances in pills – things they’ve never seen before.

    One machine in the lab is almost the equivalent of an MRI in a medical office, showing the structure and detail of a pill.

    “We will do what we call structural elucidation to determine that this is a different version of a fentanyl that’s got a new compound and molecule that’s been added to it,” Oulton said.

    They’ve seen “hundreds and hundreds of unique combinations,” he said.

    “We’ll see one that contains fentanyl, one with fentanyl and xylazine, one with fentanyl and caffeine, one with fentanyl and acetaminophen, and you don’t know what you’re getting.”

    Xylazine, a veterinary tranquilizer, poses a unique problem. It’s not an opioid, so even when it’s mixed with fentanyl, drugs designed to reverse an opioid overdose may not work.

    Narcan or naloxone, one of the more common overdose-reversing drugs, has become increasingly necessary as the prevalence and potency of illicit drugs increases. About 1.2 million doses of naloxone were dispensed by retail pharmacies in 2021, according to data published by the American Medical Association – nearly nine times more than were dispensed five years earlier.

    Oulton wants to be clear: The problem Isn’t with pills prescribed by your doctor and dispensed by a pharmacy – it’s the pills on the illicit market.

    Those, Matthew’s mother warns, are easy to get.

    “The first pills [Matthew] got was in high school. And it was just flipping out, floating around, and it was easy for him to get his hands on,” she said.

    Loudon’s message for parents now: Keep your eyes open.

    “Just be mindful of what your children are doing. You just just have to keep your eyes open. And even sometimes, when you keep your eyes open, you can miss some of the warning signs, but I think a parent knows their child best, so just keep talking.”

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  • Blinken under pressure to push China on role in lethal fentanyl trade when he visits Beijing | CNN Politics

    Blinken under pressure to push China on role in lethal fentanyl trade when he visits Beijing | CNN Politics



    CNN
     — 

    Members of Congress are urging Secretary of State Antony Blinken to pressure China to do more to curb the flow of fentanyl and synthetic opioids into the United States on his visit to the country which is expected to take place in the next few days.

    On Wednesday, a group of 14 Republican senators led by Marco Rubio of Florida wrote to Blinken ahead of his trip highlighting China’s role in the “fentanyl crisis” as one of many issues they wanted him to address.

    More than 100,000 Americans died of drug overdoses from July of 2021 to July of 2022 and two thirds of those deaths were fueled by synthetic opioids, primarily fentanyl, according to the CDC.

    An extremely powerful synthetic drug, fentanyl is 50 to 100 times more potent than morphine and 30 to 50 times more potent than heroin.

    The Chinese government cracked down on the manufacture and distribution of fentanyl in 2019, in a move that was hailed by the Trump administration. As a result, China it is no longer the primary source of fentanyl getting into the US. But it’s still the key source of precursor chemicals which are often shipped to Mexico and used by cartels to produce fentanyl which is brought over the border.

    “China is the leading producer of these precursor chemicals and is shipping and selling them to the two major Mexican cartels (Sinaloa and New Generation) producing fentanyl,” explained David Luckey, a senior international and defense researcher at RAND Corporation.

    “Virtually 98% of the precursor chemicals that are made used to make fentanyl are coming from China,” Democratic Rep. David Trone of Maryland told CNN. Getting China to engage on this crisis “has got to be Secretary Blinken’s number one mission when he gets there.”

    Experts and lawmakers say the production of precursor chemicals in China is a primary factor fueling the ongoing opioid crisis.

    “Synthetic opioid trafficking is an area where even a few meaningful steps from the PRC (People’s Republic of China) can play a significant role in combating this worsening epidemic and saving American lives,” Trone wrote in a letter to Blinken last month. He urged Blinken not to negotiate with Chinese officials on other topics until he has secured a commitment from Beijing to do more to stem the fentanyl crisis.

    Trone, whose nephew died of a fentanyl overdose, believes China should commit to adopting rules requiring drug companies to know who their customers are, put into place and enforce export regulations on the chemical sector, and cooperate with US agencies including the Drug Enforcement Administration and Office of National Drug Control Policy to crack down on the fentanyl trade.

    Blinken has directed his team at the State Department to work with interagency partners to do “everything possible” to address this deadly crisis which is the leading killer of Americans between the ages of 18 to 49, State Department spokesperson Ned Price said earlier this year.

    But it’s unclear what direct asks he will make of the Chinese government during his visit.

    “Though its past action has helped to counter illicit synthetic drugs, we continue to urge the PRC to take additional meaningful concrete action to curb the diversion of precursor chemicals and equipment used by criminals to manufacture fentanyl and other synthetic drugs,” Price said.

    Some lawmakers believe that Blinken should offer trade talks with China if it engages on efforts related to stemming the fentanyl crisis. Yet other congressional aides say that China will only respond to pressure and believe that the administration should consider steps including additional sanctions related to the dangerous substances – to force their engagement.

    Todd Robinson, the top State Department official for international narcotics and law enforcement affairs, said that the effective way to approach the challenge will be through “collaboration and cooperation.”

    “China has its own problems with narcotics. Mexico has problems has its problems with narcotics. Colombia also has a problem. And what we’ve been saying is, this is no longer an issue where you can solely use one or the other. Everybody’s got a problem.”

    But the need for Chinese engagement is clear: reducing the supply of precursor chemicals from China would have a “huge” impact on the crisis and would “mean a dramatic decrease” in US deaths resulting from drug overdoses, Robinson said.

    China is the largest producer of chemicals that are in everyday products such as cleaning supplies. Many Chinese companies have begun producing and selling the precursor chemicals in addition to the chemicals they have already been producing.

    Challenges to tackling the root of the problem persist when China and other countries often turn the tables on the US and blame Americans for the addiction problem which drives the demand.

    “It’s not as simple as saying, ‘China, stop producing and exporting these chemicals’. There are several sides to this issue. In response, China, for example, could counter with, ‘Americans, stop buying and using drugs,’” said Luckey.

    Many Americans with a direct connection to the crisis are watching Blinken’s trip closely.

    West Virginia – which had more than 1,300 deaths due to synthetic opioids from March of 2021 to March of 2022, according to the CDC – is an epicenter of the domestic crisis.

    Jordan Dennison lives in the state, grew up with parents who were drug addicts, and developed his own opioid addiction in his teens. A few years ago – after more than 10 overdoses – he finally got clean. The 30-year-old now works at an outreach program to get addicts into treatment.

    “Drugs led me to lose everything. Every relationship I ever had. I came to learn that what I was using was not heroine it was fentanyl. I was getting it off the street, I would go anywhere to get it,” he told CNN. “I never knew where it came from, but I always assumed it was coming from China.”

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  • Justice Department sues pharmaceutical company for allegedly failing to report suspicious opioid sales | CNN Politics

    Justice Department sues pharmaceutical company for allegedly failing to report suspicious opioid sales | CNN Politics


    Washington
    CNN
     — 

    The Justice Department on Thursday alleged that the AmerisourceBergen Corporation, one of the country’s largest pharmaceutical distributors, and two of its subsidiaries failed to report hundreds of thousands of suspicious prescription opioid orders to pharmacies across the country.

    The lawsuit, which spans several states, alleges that AmerisourceBergen disregarded its legal obligation to report orders of controlled substances to the Drug Enforcement Agency for nearly a decade. The company ignored “red flags” that pharmacies in West Virginia, New Jersey, Colorado and Florida were diverting opioids into illegal drug markets, the suit says.

    “The Department of Justice is committed to holding accountable those who fueled the opioid crisis by flouting the law,” Associate Attorney General Vanita Gupta said in a statement Thursday.

    “Companies distributing opioids are required to report suspicious orders to federal law enforcement. Our complaint alleges that AmerisourceBergen – which sold billions of units of prescription opioids over the past decade – repeatedly failed to comply with that requirement,” she added.

    If AmerisourceBergen is found liable at trial, the company faces billions of dollars in financial penalties, the Justice Department said.

    Lauren Esposito, a spokesperson for AmerisourceBergen, countered on Thursday in a statement that said the Justice Department’s complaint rested on “five pharmacies that were cherry picked out of the tens of thousands of pharmacies that use AmerisourceBergen as their wholesale distributor, while ignoring the absence of action from former administrators at the Drug Enforcement Administration – the DOJ’s own agency.”

    She added: “With the vast quantity of information that AmerisourceBergen shared directly with the DEA with regards to these five pharmacies, the DEA still did not feel the need to take swift action itself – in fact, AmerisourceBergen terminated relationships with four of them before DEA ever took any enforcement action while two of the five pharmacies maintain their DEA controlled substance registration to this day.”

    Yet AmerisourceBergen was allegedly aware that in two of the pharmacies, drugs it distributed were likely being sold in parking lots for cash, the Justice Department said. In another pharmacy, the company was allegedly warned that patients likely suffering from addiction were receiving opioids, including some people who later died of a drug overdose.

    The Justice Department also noted in its lawsuit that AmerisourceBergen’s reporting systems for suspicious opioid orders were deeply inadequate, and that the company intentionally changed its reporting systems to reduce the number of orders flagged as suspicious amid the opioid epidemic.

    Even when orders were flagged as suspicious, AmerisourceBergen often didn’t report those orders to the DEA, according to the complaint.

    Opioids are involved in the vast majority of drug overdose deaths, though synthetic opioids – particularly fentanyl – have played an outsized role. Synthetic opioids – excluding methadone – were involved in more than 72,000 overdose deaths in 2021, about two-thirds of all overdose deaths that year and more than triple the number from five years earlier.

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  • There aren’t enough facilities to treat all kids hooked on opioids | CNN Politics

    There aren’t enough facilities to treat all kids hooked on opioids | CNN Politics

    A version of this story appears in CNN’s What Matters newsletter. To get it in your inbox, sign up for free here.



    CNN
     — 

    After writing several previous newsletters on the stunning rise in opioid overdoses in the US, including among adolescents, I thought it was worth taking a look at what happens after an overdose, particularly for adolescents.

    I talked to Dr. Sivabalaji Kaliamurthy about what he’s encountering. A child and adolescent addiction psychiatrist who is board certified in general psychiatry, child psychiatry and addiction psychiatry, Kaliamurthy is also the director of the addiction clinic at Children’s National Hospital in Washington, DC.

    He told me that his clinic, which he set up in early 2022, has gone from getting one or two opioid use referrals per month to eight or more per month now, a year later.

    He particularly wanted to discuss some major news: The opioid overdose antidote naloxone, sold as Narcan, got approval from the US Food and Drug Administration on March 29, the day we talked, to be sold over the counter.

    Excerpts from our conversation, edited for flow, are below.

    WOLF: What is your reaction to Narcan being available over the counter?

    KALIAMURTHY: When I do an evaluation (of a patient), regardless of the substance use, you’re always talking about naloxone, brand name Narcan. …

    The message that I present parents with is always that it’s kind of like having a fire extinguisher at home. You hope you never need to use it, but you’re glad that you have it if you need to use it.

    Access is important. There are some controversies around increasing access to naloxone and fears that this may encourage more substance use. We have scientific research looking into this very specific question.

    And overall, there’s one study that came out this month that found that across 44 states where they increased access to naloxone for adolescents, it did not increase the rates of substance use in this population. And in some states, it actually decreased opioid use among adolescents. …

    The FDA approved the over-the-counter sale of naloxone, specifically the brand Narcan, because of how easily it can be administered. Naloxone also comes in other formulations, like injections, but Narcan is a nasal spray. We’re hoping that it will be out later this summer.

    The challenge remains how much is it going to cost? On average, it can cost anywhere between $50 to $100 right now. If it becomes over-the-counter, we don’t want insurances to stop covering [it].

    It will be interesting to see how the manufacturer goes about introducing it over the counter.

    WOLF: You said it’s like a fire extinguisher. Should everybody have it, or just people whose kids have demonstrated addictive behavior?

    KALIAMURTHY: Everyone should have it. Naloxone is not a treatment; it is more of an antidote. It reverses opioid overdoses, and the person who has the opioid overdose is never the one who’s going to use it somewhere in the community.

    WOLF: I’ve reported on a surge in overdoses. What are you seeing at Children’s?

    KALIAMURTHY: We are seeing an increase in the number of kids presenting to the hospital after experiencing an opioid overdose, and in general, opioid overdose deaths in the DMV (Washington, DC, Maryland, Virginia) region have significantly increased in the last two years. That aligns with a national trend we are seeing with regards to opioid overdoses.

    WOLF: Is there a profile for who these kids are? Do they share any traits?

    KALIAMURTHY: Yes. Let me talk about the kids we do see for opioid-related concerns first.

    At Children’s National, children often present after experiencing an overdose or having a medical complication because of using these M30, or the fake Percocet pills. We’ve had kids come in following conditions such as preliminary hemorrhage, where they were bleeding into their lungs, and overdose is not the only concern.

    Apart from that, we also have had kids presenting actively using these pills. They haven’t overdosed yet but they’re asking for help to stop using these pills.

    Some things that we have noticed, and this is the trend across the DMV region … the kids who are presenting to treatment, these are kids who are motivated to stop – they predominantly identify as Hispanic in ethnicity. Most of them have Medicaid for insurance.

    A lot of them, you know, they come to us – the average age is about 16, 16½ and their first use of opioids, these pills, was about a year ago. So the average first use was about 15 to 15½ years of age. They are really struggling, and they want to get better.

    KALIAMURTHY: Another common trait: cannabis use is quite common in this population. Pretty much every patient that I’ve come across started off around age 12 using cannabis products. This includes the flower and bud, vapes or edibles. Soon they transition to using the M30 pills.

    There are various different reasons, one of which is just access. A lot of other kids are using it. They’re using it in schools. They try it, they like it, and then it escalates and they stop using other substances.

    Most of these kids start off with crushing and try it nasally by snorting it and then they transition to smoking. What they do is they put these pills on a piece of aluminum foil, heat it up and inhale the fumes that come up. We haven’t had anyone come in who reported using any of these pills intravenously.

    WOLF: How is treatment for adolescents different than treating adult users who are seeking help?

    KALIAMURTHY: We have to take into consideration their developmental age and the psychological development that’s happening in adolescence, which is very different from adults.

    Oftentimes, this is the first point of entry into opioid use for these kids. Fentanyl, which is one of the most powerful opioids of abuse out there, is the first point of entry into opioid use for these children.

    Where for adults, they might have been prescribed pain medications. Or they might have started on opioids through other routes and might have used less potent products before transitioning to fentanyl.

    KALIAMURTHY: Historically, adolescents were not always the most motivated to seek treatment for substance use. What we would see was they would start off with experimenting, there would be a problem, it would take a few years and they’re adults by the time they’ve entered treatment and they’re trying different things to treat themselves before they enter treatment.

    With adolescents, now we are seeing that they can tell that they need help, and they are motivated and they are entering treatment.

    We have to take into account the presence of parents or guardians, how the school system interacts with them, what else do they do in their communities. There’s an increased association of violence and legal trouble that some of these patients end up in that we need to address while treating them. And these are some differences when it comes to treating adolescents versus adults.

    WOLF: One local community’s opioid response coordinator stressed to me that lack of availability of treatment is a real problem. Is that something that you agree with?

    KALIAMURTHY: Absolutely. That is a real problem at this point, because there is a huge discrepancy between the number of kids who need treatment and the available resources.

    The challenge is we can limit access and prevent these kids from getting the pills. But then you have a huge population of kids who are dependent on these pills, who can’t tolerate withdrawal symptoms, who have what we call opioid use disorder. That is going to perpetuate the problem if we’re not treating them. We need to do more in terms of increasing access to care for these kids.

    WOLF: Can you illustrate that capacity issue for me, through numbers or data? Or is it more anecdotal?

    KALIAMURTHY: Treatment is across different realms.

    For example, when a child is using these pills, and they have a problem with substance use, they need to go and be evaluated by a professional who has expertise in both addressing and evaluating mental health and addiction problems. And we don’t have very many people being able to do that.

    KALIAMURTHY: The first-time response is usually a counselor or social worker, sometimes physicians.

    But generally, there’s very little expertise in the pediatric health space with regards to addressing substance use-related problems. Screening is the point of entry.

    KALIAMURTHY: Then, say they need detox beds. Once they’ve entered treatment, we want to help them get through those initial days when their body is kind of adjusting to not using these pills, and we refer to that as detox.

    At Children’s National Hospital, when the kids come to the emergency room, we are not able to admit them for detoxes all the time. Sometimes we do end up admitting them.

    This depends on the availability of beds. The number of pediatric beds is very small to begin with. And beds may not always be available when somebody presents to the emergency room detox.

    And then there’s who is on call? Who’s available to treat these kids? I spoke about the lack of expertise in general, across the pediatric health space, so all that will determine whether a child is able to get access to detox services.

    That’s the detox part of treatment, which can be anywhere between two to five days.

    Detox doesn’t always mean somebody needs to be admitted. I also do outpatient detox where we are helping kids stop by providing them with medications and guiding their parents or guardians and the child on how to go through detox.

    KALIAMURTHY: Once you go through detox, depending on the extent of the problem, a child may require admission to a rehabilitation facility for anywhere between a month to six months.

    When we look at the number of facilities in the DMV region that provide this kind of rehab, I don’t think Virginia has any, DC doesn’t have any, Maryland has two. One is Sandstone Treatment Center, which is a private institution. The other is a treatment center, which is closer to Baltimore. There’s a limitation on who they can take.

    WOLF: Let me interrupt you. In a region that has millions of people, there are only two facilities that will take adolescents for one to six months’ treatment for substance use?

    KALIAMURTHY: Yes. For substance use.

    WOLF: Is that just a function of there’s more demand for those kinds of facilities among older people who are more likely to face addiction problems? Is that something the system is pivoting to address right now?

    KALIAMURTHY: It’s unclear. The system wants to help, but the challenge is historically adolescents are not always the most eager and motivated to get help.

    When we look at treatment programs, that didn’t exist in the past. They often relied on the judicial system, where some of these kids might have been mandated to treatment.

    Now we know that substance use disorders are chronic disorders and mandates don’t always work. Courts have stopped mandating treatment, because it’s like you mandate it for a month and then they come out and then what happens? There’s a lot of issues with mandating treatment.

    Now, most of the programs that were present prior to the pandemic also shut down during the pandemic because the needs also declined.

    This is not financially lucrative. That’s one reason why they’re having a huge issue with finding systems and having the county or the state take over with regards to creating the system.

    WOLF: I cut you off there. You were moving from the one-to-six-month facility to the next step in the process.

    KALIAMURTHY: So the next step is really engaging these kids in treatment. Not all kids require one to six months. Some kids might be OK with just completing detox and engaging in regular outpatient level of care. This might involve what we call intensive outpatient combined with medication.

    Which is where I would come in. A lot of what I do is provide medications for addiction treatment. These medications, the first part is for the detox to help with the child’s symptoms, but once you go through withdrawals, you can still have significant cravings to go back to using.

    The challenge, again, is the number of facilities. There are more options for intensive outpatient, but again, they are packed. The wait times to get in are longer now, and some of them are just virtual-only options, which may be good for some kids, but some kids might need more inpatient help.

    KALIAMURTHY: After this step, we have regular outpatient therapy and recovery support services, which is also lacking.

    The recovery support services are services which help kids get back on track academically. Catch up with your credit, get up on your grades and form a healthy, functioning resume. Get help finding part-time jobs. Keep these kids engaged in activities outside of school so that they are less likely to go back to the path that they were on which led to the substance use.

    WOLF: What’s your message to parents who are trying to keep an eye on their kids?

    KALIAMURTHY: Let’s look at the national-level data that we have collected up to 2021. Substance use is actually on the decline.

    Which is interesting because what is happening is that even though substance use among kids is on the decline – that’s both in middle school and high school – the substances that kids are using have become so much more potent.

    Take cannabis, which if you measure the potency by the percentage of THC content, has gone up significantly. The average THC percentage in the ’60s and ‘70s was like 2-5%. And now it’s like 20-25%. And kids are more likely to use what they call the concentrates, which is like 80% or more THC.

    When I talk to parents, the first thing I’m telling them about is the landscape of different substances that are out there, and kids are more likely to start off with cannabis or alcohol before they transition to the M30 pills.

    KALIAMURTHY: If you think about modifiable and non-modifiable risks, some risks just cannot be changed. These are things like genetics, family history and also if a child has a history of any traumatic experiences. Those are not things you can necessarily change. There are modifiable risk factors, like if a child has ADHD, they’re more likely to be at risk for developing substance use problems.

    If there are untreated mental health conditions, such as depression, anxiety, they’re more likely to have problems. We know that. The kids who identify as LGBTQ+, they also tend to have more risk factors in terms of initiating substances that transition into a problem.

    But also, we need to rethink how families address substances in the household. Kids learn by modeling they see from adults in their life and also the direct conversations we have. What are their values as a family around use of substances? These are not just legal and illegal – all substance use can have some harm. And early initiation is going to lead to more likelihood of having a problem.

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  • Top Treasury sanctions official to visit southern border as it ramps up efforts to crack down on deadly fentanyl trade | CNN Politics

    Top Treasury sanctions official to visit southern border as it ramps up efforts to crack down on deadly fentanyl trade | CNN Politics



    CNN
     — 

    Treasury’s top sanctions official Brian Nelson will travel to the southern border Tuesday as part of the department’s ongoing push to crack down on the cartels and illicit financial networks fueling the deadly fentanyl trade, Treasury officials told CNN.

    Nelson’s trip – his second in sixth months – and a spate of recent sanctions activity is the latest indicator that Treasury is ramping up efforts to tackle the illegal fentanyl trade through actions that disrupt the supply chains funneling “precursor” chemicals from China to producers in Mexico where much of the deadly drug is made.

    Nelson and Treasury officials will meet with fellow law enforcement representatives, including from the Department of Homeland Security and U.S. Customs and Border Protection, as well as private financial institutions and local officials.

    “What we are doing is trying to be as effective as we possibly can in combining Treasury’s tools with the efforts that other US government agencies and allied governments are deploying in this space,” said Nelson, the under secretary for terrorism and financial intelligence at Treasury, in an interview with CNN.

    The engagements over the 48-hour trip will provide officials an opportunity to discuss how Treasury’s tools and information can complement law enforcement and to learn about the big issues and patterns that agents are seeing on the ground. The trip is also aimed at exploring how trends and information from the extensive financial information Treasury collects can be helpful to the broader government-wide effort to quell the synthetic opioid epidemic.

    Nelson, who will also be joined by the acting director of the Financial Crimes Enforcement Network (FinCEN) Himamauli Das, will visit Laredo and San Antonio in Texas on Tuesday and Wednesday.

    In Laredo, Nelson will receive briefings on border operations from CBP officials at the city’s port of entry as well as discuss cargo processing and inspections.

    “There’s a credible value in seeing that in person,” Nelson said.

    In San Antonio, Nelson and Das will host a “FinCEN Exchange,” which is a public-private information sharing forum where Treasury can share the different patterns and connections they’re seeing with financial institutions, as well as discuss further ways the federal government can partner with the private sector to better spot red flags and identify illicit financial networks.

    The department has been involved in the counter-narcotics business for decades, using its tools and financial expertise to both starve criminal organizations of critical financing through sanctions and blocking assets, as well as providing crucial financial data to other law enforcement and federal agencies.

    “We can help disrupt financial flows and target the whole supply chain, starting with the precursor chemicals all the way down to distributors bound for US markets. And it’s not just sanctions,” Nelson said, pointing also to FinCEN’s financial mapping tools as well as Treasury’s focus on cooperating with Mexico to improve their capacity to trace and combat illicit finance.

    “These tools, combined with financial mapping that our FinCEN team does, is very, very powerful insight,” he added.

    Investigators from the Treasury, especially those at FinCEN, can access and share powerful financial data with enforcement bodies like the Drug Enforcement Agency, the Department of Homeland Security and others as they work to track and disrupt the fentanyl trade and drug suppliers.

    Nelson also said that Treasury is “absolutely” looking to build on US Secretary of State Antony Blinken’s latest engagements in China, which included discussing where the two nations could cooperate on curbing the flow of precursor chemicals from China. Blinken, who traveled to Beijing last month, said both sides agreed to “explore” establishing a working group on the precursor chemicals used to produce the deadly synthetic drug.

    There has been a government-wide push to curb synthetic opioids like fentanyl, which are the main driver of overdose deaths in the US. According to the US Centers for Disease Control and Prevention, there has been a more than seven-fold increase overall in deaths from 2015-2021, and despite a recent slowing, overdose deaths still hover near record levels and remain the third leading cause of death in adolescents aged 19 and younger.

    In April, the Biden administration announced a broad effort to target the production and distribution of fentanyl, which included criminal charges from the Department of Justice and a host of new Treasury sanctions.

    It was an announcement that built off of an executive order signed in 2021 that expanded Treasury’s authorities to target the distribution chains of fentanyl and other narcotics, which Nelson said has been critical to helping Treasury “increase the pace at which we are able to target and designate the key nodes in fentanyl distribution.”

    Since then, Treasury has continued to issue sanctions against precursor chemical supply networks, particularly in China, as well as other corrupt activity like arms trafficking and money laundering that helps support the trade.

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