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Tag: substance abuse

  • Moms who overcame addiction helping others through growing statewide network

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    Recovery can be a long and difficult journey. Still, it’s one Chelsey Moore and Brandi Collins say they are thankful to be on.

    “I still have a little bit of imposter syndrome. It’s like I have a life I don’t believe is mine,” Moore told WRAL.

    The mothers met at UNC Horizons, a treatment program helping mothers recover from substance use disorder.

    The duo will soon mark four years of sobriety – together.

     “This is the first time I’ve ever been alive,” Collins expressed. “I woke up sad every day for my whole life, and I never understood why. Now, I don’t wake up sad. It’s a cool feeling.”

    Both mothers told WRAL they first began using drugs as teens, and their addictions grew worse after having children at young ages.

    “For an 18-year-old, it’s a lot,” Collins said. “Going through postpartum for the first time – I was a child.”

    Nearly two decades later, Collins and Moore both have three children and work in two Chapel Hill treatment programs helping other parents like them.

    “Finding recovery showed me what I want to do with my life and help other people find recovery or what that looks like for them,” Moore shared. “You don’t have to stay stuck in that addiction. It can be hard to see that when you’re in it.”

    Collins agreed, adding that knowing where to ask for help is part of the problem for many moms who are struggling.

    “I tell people all the time, I wish I would’ve gotten help 17 years ago when it started,” Collins added.

    UNC Horizons is one of six treatment programs that currently make up the North Carolina Perinatal Substance Use Disorder Network (PSUD).

    ECU Health’s Dr. David Ryan explained that the network’s goal is to connect clinicians statewide to improve access to care and reduce the risks of potentially deadly lapses in care.

    The physician stated, “The problems with getting access to care for patients with substance use disorders who are pregnant: the stigma, unreliability of access to medications, mental health needs that go unaddressed, misinformation – all of these things are affecting patients in Asheville, Greenville, and everywhere in between.”

    ECU Health’s IMPACT Clinic is currently the only perinatal addiction clinic north of 40 and east of 95. Ryan shared that clinicians there see patients across 29 counties.

    Ryan, who serves as ECU’s division chief of addiction medicine, said he hopes to see the PSUD Network grow to include more facilities under a second-year grant by Aetna.

    “Addiction care and obstetrics care have their unique needs,” Ryan explained. “When those two things aren’t necessarily done together, there are a lot of things that happen in each of these silos that can affect the other. It can lead to worse outcomes.”

    State data points to a growing need for more treatment clinics and coordinated care.

    The latest annual report by the state’s maternal mortality review committee found 1-in-4 pregnancy-related deaths were due to overdoses.   

    The same report also found mental health was a contributing factor in maternal deaths, and the majority of pregnancy-related overdoses involved opioids.

    Statewide overdoses have dropped since the data for the report was collected pre-pandemic. However, Ryan shared that the overall decrease isn’t reflective of what’s happening specifically among the pregnant population.

    “It’s a really big issue,” Ryan stated. “When I look at what our state needs, the first thing is that substance use disorders are medical diseases that can be treated.”

    Ryan stated he hopes the network will help mothers have better access to specialized care aimed at addressing the unique challenges plaguing pregnant mothers with addiction.

    He also shared that he hopes it will spark conversations among physicians and patients about the life-saving addiction medications available, like Suboxone.

    “That ability to target that patient population at a time when not only they’re most vulnerable but also most susceptible to change, is going to make the most impact,” Ryan said.

    Moore and Collins told WRAL there is also a need for more peer support specialists with lived experience working directly with patients in treatment clinics.

    “There needs to be more awareness around what that process is going to look like for somebody who is pregnant or parenting, and has a substance use disorder,” Moore said. “The unknown is what makes it so terrifying for somebody who is pregnant and using substances to reach out for help.”

    “Peer support specialists are so important. I know the professional side of addiction: the stats and the science, but I also know how it feels not to want to live anymore,” said Collins.

    The UNC Horizons program is one of those that allows mothers to undergo treatment while still having their children. It’s an option that both women say was a game-changer in their own journeys.

    “There are other programs that are just for women or just for men, but to have a pregnant woman – or a woman who has a 1-3 month old – go and keep her family together, then you’re not just healing that person with the substance disorder, you’re keeping that family together,” Moore explained.

    Collins added, “The program I was lucky enough to go to with Chelsey saved three generations; My mom and my grandmother – it saved all our lives. I’m still engaged with my treatment program four years later.”

    After graduating from the UNC Horizons program together, Moore and Collins have since traveled to Washington, D.C., to advocate for addiction resources and funding on Capitol Hill.

    The two have also earned additional certifications and degrees to better help those following in their footsteps.

    The friends got emotional when asked about one another, each stating how “proud” they were of the other.

    “For the two people that were never going to make it, that were never going to be good moms, that were never going to have anything – I feel like I’m dreaming,” Collins said.

    The mother continued, “It’s doable. It’s possible I used to think stuff like that wouldn’t happen for me, and I would never be given those resources or those chances, and nobody would believe in me. If I can make it out of the trenches, let me help pull you out of them.”

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  • Trail of Truth: Thousands of tombstones on National Mall mark drug deaths – WTOP News

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    Nearly 4,000 hand-painted tombstones were placed on the National Mall in D.C. this weekend, stretching from 7th St. SW to 12th Street SW.

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    Drug deaths remembered at Trail of Truth

    Nearly 4,000 hand-painted tombstones were placed on the National Mall, stretching from 7th St. SW to 12th Street SW this weekend.

    The tombstones featured the names, pictures and stories of those who had lost their battle with drug addiction.

    Trail of Truth is the grassroots organization behind the display that it calls a “national cemetery for substance use related deaths.”

    The organization was started by Alexis Pleus, who lost her son to an overdose 10 years ago. The goal of Trail of Truth is to change policies regarding access to treatment, reduce stigma and distribute opioid settlement funds in ways to reduce preventable deaths.

    “The other part of that is just having community and just being together, because everyone who’s here understands exactly how that feels,” said Kathy Staples, who is with Trail of Truth.

    On Saturday there was a ceremony featuring singing, speeches and fellowship among people who all shared one thing in common, they lost someone they loved to an overdose.

    Last year, the Centers for Disease Control and Prevention reported over 70,000 people died due to drug related issues, which is down compared to the last several years. The epidemic affects young, old, rich, poor and every race and region of the country.

    As someone who has lost a brother to an overdose, the sight of thousands of tombstones with messages on them, such as a 66-year-old man’s saying, “he loved his kids and grandbabies so much” or a 24-year-old’s message that read, “wanted everyone to be happy,” can be almost overwhelming.

    Each state is grouped together, and Northern Virginia resident Trip Ward was looking in the California section.

    “Coming to see my son represented in this sea of tombstones,” said Ward. It 2019, his son Ryan Giglio died at the age of 26.

    Ward said if he could speak to him again, he would tell his son: “Still love you, still proud of you.”

    His advice for the parents of someone who is battling drug addiction: “We dealt with it for about 10 years. Just never give up. It’s a brutal path for them. And yeah, just never give up. We never did.”

    One family traveled from Long Island, New York, to honor the memory of their beloved family member.

    “I came here to represent my son, who passed a year ago, in August,” said Anna Rossi. “‘Jaden Morales’ is his name, he’s forever 25.”

    Rossi said that being here, among people that have been in her shoes brings her comfort.

    As Rossi spoke, she was holding a poster board with her late son’s picture on it, standing alongside her daughter, father and Jaden’s twin brother Jesse.

    “Honestly, this is a big cloud that I can’t get away from, and it’s hard, it’s hard to get through life without him here,” said Jesse.

    Jesse told WTOP that if he could have one more conversation with his brother, he would say, “I miss him and I love him, and I wish he was here.”

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    © 2025 WTOP. All Rights Reserved. This website is not intended for users located within the European Economic Area.

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    Jimmy Alexander

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  • Suffolk bar association partners with Nassau in lawyer aid program | Long Island Business News

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    THE BLUEPRINT:

    • Suffolk Bar Associations partners with Nassau to launch Program

    • Services include counseling, peer support and wellness workshops

    • Program offers confidential help for addiction, stress and mental

    • 24/7 helpline and telehealth counseling now available

    To support lawyers facing personal or professional challenges, the Suffolk County () and the Nassau County Bar Association () are collaborating on a Lawyer Assistance Program serving Long Island. The initiative is supported in part by a grant from The New York Bar Foundation.

    Attorneys can face disproportionately high rates of substance use and issues compared to the general population and other professionals, experts say. In response, the SCBA and NCBA are partnering to help ensure comprehensive support services are available to attorneys, judges and law students.

    Peter Tamsen, managing director of the SCBA’s Lawyer Assistance Program, said that the program had grown dormant amid the pandemic.

    The program, with the support of Judge John Leo, the SBCA’s president, and with that of recent past presidents, “became a priority and has been revitalized,” Tamsen said in a news release about the partnership.

    “The need of our members for these essential services had become obvious and the services have now been brought back with additional offerings,” Tamsen said.

    The Lawyer Assistance Program provides a range of services to lawyers, judges, law students and their immediate family members who are struggling with alcohol or drug abuse, depression, anxiety and stress as well as other addictions and mental health issues.

    These free and strictly confidential services include consultation and evaluation/assessment, counseling, peer support, a weekly recovery support group, an annual 12-step retreat, wellness workshops, intervention and motivational support, treatment referrals and assistance with law practice closings.

    Sheryl Randazzo, a past president of the SCBA, facilitates the monthly wellness workshops, and Robert Goldman, a licensed psychologist and attorney, leads the Lawyers Lounge. Elizabeth Eckhardt is currently the director of the NCBA’s Lawyer Assistance Program, and now provides free, confidential counseling to both bar associations through the HIPAA-compliant telehealth platform doxy.me.

    Eckhardt, a psychotherapist, offers outreach and education on topics including resilience, wellness, mindfulness, stress management, suicide prevention and substance use.

    “We are thankful to NCBA, Ms. Randazzo, Dr. Goldman and the individuals heading up the recovery meetings for our now robust Lawyer Assistance Program,” SCBA Executive Director Cynthia Doerler said in the news release. “We are excited to partner with them as well as add an emergency helpline to our offering. We needed 24/7 counseling services and Nassau County was able to provide that for us through Dr. Eckhardt.”


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    Adina Genn

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  • Annual Salem Walk for Overdose Awareness emphasizes need for community support

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    SALEM — A group of about 30 community members walked from the Salem Common to Riley Plaza on Thursday as a part of the annual Walk for Overdose Awareness.

    The event included speakers stressing the importance of creating a larger support network for community members struggling with substance abuse and addiction.


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    By Michael McHugh | Staff Writer

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  • Timeline of events in Fitzsimmons case

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    A timeline for the case of North Andover police officer Kelsey Fitzsimmons, 28.

    Feb. 16: Fitzsimmons gives birth to her son with fiance Justin Aylaian, a North Andover firefighter, and takes maternity leave.


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    kAmkDEC@?8mpF8] agik^DEC@?8m u:EKD:>>@?D 2AA62CD 😕 tDD6I r@F?EJ $FA6C:@C r@FCE 7@C 2CC2:8?>6?E] yF586 @C56C65 96C C6=62D6 E@ 96C A2C6?ED’ 4FDE@5J H:E9 v!$ >@?:E@C65[ ac^f 9@>6 4@?7:?6>6?E H:E9 ?@ 4@?E24E H:E9 96C 49:=5] %96 C6=62D6 :?4=F565 `_ 4@?5:E:@?D E@ 6?DFC6 E96 4@>>F?:EJ’D D276EJ[ A6?5:?8 2 9@>6 :?DA64E:@? 2?5 4C:>:?2= 324<8C@F?5 4964>@?D 😀 D6E E@ 36 C6=62D65 uC:52J]k^Am

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    By Angelina Berube | aberube@eagletribune.com

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  • Denver Health sharing patients’ stories to ease stigma of fentanyl use

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    DENVER — Denver Health is sharing the stories of patients and support specialists to ease the stigma surrounding fentanyl use and, in turn, reduce overdose deaths.

    According to data from the Denver Department of Public Health & Environment (DDPHE), as of July 10, there have been 320 confirmed overdose deaths so far this year. Of those, 213 cases involved fentanyl.

    During the same period last year (Jan. 1 through July 10, 2024), there were 275 confirmed overdose deaths in Denver.

    Denver Department of Public Health & Environment (DDPHE)

    “Really, the age range is everything from 9 years old to 90. That is not an exaggeration, we have patients at either end of the spectrum,” Sarah Christensen, medical director of outpatient substance use disorders at Denver Health, said about the patients she sees who have been impacted by fentanyl. “They’re a variety of backgrounds. No one is immune; no one is protected. Coming from a good family or having money doesn’t stop you from experiencing this.”

    Denver Health’s Center for Addiction Medicine helps people navigate recovery. Outside of the building are rows of small purple windmills, recognizing the lives lost to substance abuse.

    Denver Health's Center for Addiction Medicine windmills

    Denver7

    Christensen said the community, whether they’re impacted by substance use disorder or not, can help reduce overdose deaths through awareness and empathy. She recommends that people carry naloxone so they can intervene if they see someone experiencing an overdose.

    “I recommend to everybody to have that with you,” said Christensen. “Actually, I have it with me in my purse.”

    Naloxone, also known by the brand name NARCAN, is a medication that can reverse the effects of an opioid overdose and can be given as a nasal spray or an injection. The medication is safe and easy to use, not only by trained professionals but also by bystanders.

    Nasal spray naloxone is available at pharmacies or through various vending machines and resource centers across Denver.

    “An overdose might mean that someone has taken so much that they are no longer conscious,” Chistensen said. “What we really worry about is when they stop breathing.”

    • Denver Health created a video demonstrating how to administer naloxone. You can watch it in the video player below

    If your loved one is experiencing substance use disorder, Christensen said the best way to approach the situation is with compassion.

    “Being able to say, ‘Whatever’s happening, I love you, I’m still going to love you, and I’m here when you’re ready and I would love for you to get help,’” she said.

    In an effort to reduce the stigma surrounding fentanyl use, Denver Health is highlighting the stories of people impacted by opioids and overdoses through an exhibit titled “Stories in Black and White.”

    According to Denver Health, “patients, peer support specialists, and advisory members for the Center for Addiction Medicine’s Community Advisory Meeting shared these stories in partnership with the CDC Foundation’s Overdose Response Strategy Program.”

    Denver Health "Stories in Black and White."

    Denver7

    “We hope these stories encourage more dialogue and less stigma about how people from all walks of life can get the support they need when they are ready,” Denver Health wrote.

    The exhibit will be at Civic Center Park near Broadway and 14th Avenue on Sept. 1 between 9 a.m. and 3 p.m. It will then be showcased at the Denver Central Public Library on Sept. 4 from 10 a.m. to 6 p.m.

    You can learn more about the exhibit through this link.


    DANIELLE CALL TO ACTION.jpg

    Denver7 | Your Voice: Get in touch with Danielle Kreutter

    Denver7’s Danielle Kreutter covers stories that have an impact in all of Colorado’s communities, but specializes in reporting on affordable housing and issues surrounding the unhoused community. If you’d like to get in touch with Danielle, fill out the form below to send her an email.

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    Danielle Kreutter

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  • Boxer Julio César Chávez Jr. deported to Mexico

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    Julio César Chávez Jr., whose high-profile boxing career was marred by substance abuse and other struggles and never approached the heights of his legendary father, was in Mexican custody Tuesday after being deported from the United States.

    His expulsion had been expected since July, when Immigration and Customs Enforcement arrested him outside his Studio City home and accused him of making “fraudulent statements” on his application to become a U.S. permanent resident.

    In Mexico, Chávez, 39, faces charges of organized crime affiliation and arms trafficking, Mexican authorities say.

    He is the son of Julio César Chávez — widely regarded as Mexico’s greatest boxer — and spent his career in the shadow of his fabled father.

    Boxers Julio César Chávez, right, and his son Julio César Chávez Jr., during a news conference in Los Angeles in May.

    (Damian Dovarganes / Associated Press)

    His father both supported his troubled son and chastised his namesake, whose struggles included substance abuse, legal troubles and challenges in making weight for his bouts.

    Despite his highly publicized problems, Chávez won the World Boxing Council middleweight title in 2011 before losing the belt the following year.

    Chávez was turned over to Mexican law enforcement authorities at the Arizona border and was being held Tuesday in a federal lockup in Hermosillo, the capital of Sonora state, authorities here said.

    During her regular morning news conference, Mexican President Claudia Sheinbaum confirmed that the boxer was in Mexican custody.

    Days before his July arrest in Studio City, Chávez faced off in Anaheim for his last bout — against Jake Paul, the influencer-turned-pugilist. Chávez lost the fight.

    When he was arrested in July, U.S. authorities labeled Chávez an “affiliate” of the Sinaloa cartel, which is one of Mexico’s largest — and most lethal — drug-trafficking syndicates.

    Jake Paul, right, and Julio César Chávez Jr., left, exchange punches during their cruiserweight bout in Anaheim on June 28.

    Jake Paul, right, and Julio César Chávez Jr., left, exchange punches during their cruiserweight bout in Anaheim on June 28.

    (Anadolu / Anadolu via Getty Images)

    Chávez has faced criticism over alleged associations with cartel figures, including Ovidio Guzmán, a son of infamous drug lord Joaquín “El Chapo” Guzmán, now serving a life sentence in a U.S prison for his leadership role in the Sinaloa cartel. Ovidio Guzmán recently pleaded guilty to drug-trafficking and other charges in federal court in Chicago and is reported to be cooperating with U.S. prosecutors.

    Controversies have long overshadowed the career of Chávez.

    Chávez served 13 days in jail for a 2012 drunk-driving conviction in Los Angeles County and was arrested by Los Angeles police in January 2024 on gun charges. According to his attorney, Michael Goldstein, a court adjudicating the gun case granted Chávez a “mental health diversion,” which, in some cases, can lead to dismissal of criminal charges.

    “I’m confident that the issues in Mexico will be cleared up, and he’ll be able to continue with his mental health diversion” in California, Goldstein said.

    A lingering question in the case is why Chávez was apparently allowed to travel freely between the United States and Mexico on several occasions despite a Mexican arrest warrant issued against him in March 2023.

    On Jan. 4, 2025, according to the Department of Homeland Security, Chávez reentered the United States from Tijuana into San Diego via the San Ysidro port of entry. He was permitted in despite the pending Mexican arrest warrant and a U.S. determination just a few weeks earlier that Chávez represented “an egregious public safety threat,” the DHS stated in a July 3 news release revealing the boxer’s detention.

    Homeland Security said that the Biden administration — which was still in charge at the time of Chávez’s January entry — had determined that the boxer “was not an immigration enforcement priority.”

    While in training for the Paul match, Chávez spoke out publicly against President Trump’s ramped-up deportation agenda, which has sparked protests and denunciations across California. In an interview with the Los Angeles Times, he accused the administration of “attacking” Latinos.

    Chávez told The Times: “I wouldn’t want to be deported.”

    McDonnell reported from Mexico City and El Reda from Los Angeles. Special correspondent Cecilia Sánchez Vidal in Mexico City contributed to this report.

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    Patrick J. McDonnell, Jad El Reda

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  • Rockport school board updated on opioid prevention

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    The Rockport School Committee, along with the town’s Public Health Department, is aiming to eliminate the effects of possible substance abuse in Rockport schools.

    During the committee’s meeting on June 4, members heard from Dr. Ray Cahill, director of the Rockport Public Health Department, who updated those gathered about the “RIZE Mosaic Opioid Recovery Partnership Grant.” The grant aims to support children and families affected by the opioid crisis.


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    By Stephen Hagan | Staff Writer

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  • Sheriff expands inmate drug treatment program to The Farm

    Sheriff expands inmate drug treatment program to The Farm

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    LAWRENCE — Sheriff Kevin Coppinger plans to stand before hundreds of police chiefs this month and tell them how he’s bringing drugs into Essex County jails.

    It may sound odd as keeping illicit drugs and contraband out of jails and prisons will always be an issue, Coppinger noted.

    But Middleton Jail now has a nationally acclaimed Medication Assisted Treatment (MAT) program where addicted inmates can receive their medically prescribed doses of Suboxone, methadone and Vivitrol on a daily basis.

    In large part, such doses are used to treat the opioid addiction that has plagued the region for the past two decades. And many local crimes are drug driven.

    Last week, the MAT program expanded when a second treatment site opened at an Essex County Sheriff’s Department location — The Correctional Alternative Center, known as The Farm, off Marston Street in Lawrence.

    Adding a second MAT unit “allows us to get the medication to the inmates easier and increases public safety in the community,” Coppinger said.

    About two-thirds of Essex County inmates are diagnosed with both substance abuse and mental health disorders. The sheriff’s department was housing 819 inmates as of Friday’s count.

    At Middleton Jail, 180 inmates receive MAT. About another 35 are treated through MAT at The Farm, which includes females from the Women In Transition program, who are driven there from the Salisbury facility.

    “Abundant evidence” shows the drugs used in MAT programs “reduce opioid use and opioid use disorder-related symptoms, and they reduce the risk of infectious disease transmission as well as criminal behavior associated with drug use,” according to the National Institute on Drug Abuse.

    “These medications also increase the likelihood that a person will remain in treatment, which itself is associated with lower risk of overdose mortality, reduced risk of HIV and Hepatitis C transmission, reduced criminal justice involvement, and greater likelihood of employment,” the institute reports.

    The roots of the MAT program at Middleton came after a 2018 federal lawsuit by an inmate, Geoffrey Pesce, who had been medically treated with methadone prior to his arrest and jailing for driving without a license.

    Pesce, along with the American Civil Liberties Union of Massachusetts and a law firm, successfully sued for his access to methadone while at Middleton Jail.

    In the lawsuit, the federal court was asked to require ECSD to provide Pesce with the prescribed medication onsite or to transport him daily to a medical facility where he could get his daily dosage.

    “Pesce suffered opioid use disorder and had been in recovery for two years with help of doctor-prescribed medication,” the ACLU of Boston said. “Pesce struggled with addiction for nearly six years, experiencing unemployment, homelessness, and estrangement from his family and son. After his doctor prescribed medication-assisted treatment, he made a dramatic recovery.”

    The hope is with the continued treatment behind bars, individuals won’t want to seek drugs when they are released. Brooke Pessinis, a licensed mental health counselor affiliated with the MAT program, said the goal is “harm reduction” and readying the inmate for success when they leave lock up.

    The inmates are also given Narcan, a medication which can reverse an opioid overdose, when they leave, ECSD Assistant Superintendent Jason Faro said.

    The medication dispensed in MAT are “highly managed” and kept in a safe approved by the Drug Enforcement Administration, he said.

    “You’d probably need 100 sticks of dynamite to blow the door off of it,” Faro said of the safe.

    In October, the MAT program will be among discussion topics at the International Association of Chiefs of Police Conference being held this year in Boston.

    But off stage, anecdotally, on a local level, Faro said he has seen the benefits of the MAT program through a former inmate he occasionally runs into in the Merrimack Valley. The man has a lengthy criminal record that stretches back to when he was 17.

    After MAT treatment and release, the man has now reconnected with his family and children, obtained his commercial drivers’ license and appears to be thriving.

    Notably, Faro said his crimes were “all driven by drug use.”

    Follow staff reporter Jill Harmacinski on Twitter @EagleTribJill.

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    By Jill Harmacinski | Staff Writer

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  • Rodrigo Duterte Fast Facts | CNN

    Rodrigo Duterte Fast Facts | CNN

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    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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  • New Study Suggests Cannabis Does Not Help Opioid Use Disorder | High Times

    New Study Suggests Cannabis Does Not Help Opioid Use Disorder | High Times

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    A long-term study on opioid addiction and cannabis use found little to no evidence that using cannabis can help addicts reduce or stop their long-term intake of illicit opioids. 

    The study, published in the American Journal of Psychiatry, was led by researchers at the University of Sydney and followed over 600 heroin addicts for up to 20 years, monitoring their cannabis and heroin intake at regular intervals to try and associate a relationship, positive or negative, between the two. 

    “The Australian Treatment Outcome Study (ATOS) recruited 615 people with heroin dependence in 2001 and 2002 and reinterviewed them at 3, 12, 24, and 36 months as well as 11 and 18–20 years after baseline,” the study said. “Heroin and cannabis use were assessed at each time point using the Opiate Treatment Index. A random-intercept cross-lagged panel model analysis was conducted to identify within-person relationships between cannabis use and heroin use at subsequent follow-ups.”

    The results of the study did not find cannabis to be a statistically significant factor in reducing or ceasing a person’s opioid use, despite anecdotal evidence from addicts who claim the plant helps them use less opioids or stop using them altogether. The lead author of the study credited these misconceptions to the way previous studies were conducted, in that they only followed addicts for a short time and did not examine long-term impacts.

    “Our investigation shows that cannabis use remains common among this population, but it may not be an effective long term strategy for reducing opioid use ,” says lead author Dr. Jack Wilson, from The Matilda Centre for Research in Mental Health and Substance Use, at the University of Sydney.

    “There are claims that cannabis may help decrease opioid use or help people with opioid use disorders keep up with treatment. But it’s crucial to note those studies examine short-term impact, and focus on treatment of chronic pain and pain management, rather than levels of opioid use in other contexts.”

    The study actually found data that indicated cannabis use may lead to further opioid use, particularly around the two-three year period of the study. 

    “After accounting for a range of demographic variables, other substance use, and mental and physical health measures, an increase in cannabis use 24 months after baseline was significantly associated with an increase in heroin use at 36 months,” the study said. 

    That said, the study did not go so far as to make a claim that cannabis use may increase heroin use, it merely mentioned the data. Rather, the results section of the study indicated that there simply was not a significant enough relationship in the data to draw any conclusive conclusions, if you will. 

    “Although there was some evidence of a significant relationship between cannabis and heroin use at earlier follow-ups, this was sparse and inconsistent across time points. Overall, there was insufficient evidence to suggest a unidirectional or bidirectional relationship between the use of these substances,” the study said. 

    Dr. Wilson indicated in a press release from the University of Sydney that based on previous available research there does not appear to be a one-size-fits-all solution to opiate addiction, a sentiment which was further reinforced by the results of this long-term study. 

    “Opioid use disorders are complex and unlikely to be resolved by a single treatment,” Dr Wilson said. “The best way to support them is evidence-based holistic approaches that look at the bigger picture, and include physical, psychological, and pharmacotherapy therapies.”

    Previous studies have found somewhat contradictory results compared to this one but as aforementioned, none of those studies were conducted for anywhere near as long. For instance, a study conducted through the University of Connecticut found evidence that cannabis users required less opioids while recovering from a particular major neck surgery. However, the study lasted less than a year and did include data on any possible adverse outcomes that may have occurred after the study, context which is important due to the nature of addicts to sometimes stumble into opiate addiction after having them prescribed for pain.

    Additionally, a 2022 study published in Substance Use and Misuse found that around four out of five patients who were prescribed opioids self-reported in a survey that they were able to reduce or cease their opiate intake using medical cannabis. However, this study was based on one survey and did not follow anyone long-term. That said, there have been several other studies that found similar, positive results. In general, the issue of cannabis as a potential replacement for opioids appears to be a mixed bag until more research is conducted. 

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  • Study Shows Significant Brain Recovery Following Alcohol Abstinence | High Times

    Study Shows Significant Brain Recovery Following Alcohol Abstinence | High Times

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    A study, published in August in the journal Alcohol, focused on how long-term abstinence can undo the effects of cortical thinning in the brain among those with alcohol use disorder.

    “Several cross-sectional investigations reported widespread cortical thinning in those with alcohol use disorder (AUD). The few longitudinal studies investigating cortical thickness changes during abstinence are limited to the first month of sobriety. Consequently, cortical thickness changes during extended abstinence in those with AUD is unclear,” the researchers said.

    As they explained, cortical thickness “is genetically and phenotypically distinct from cortical volume and surface area,” and that it reflects “the number and density of cells in a cortical column…and/or neuronal cell body size, the number of spines and synapses and the extent of myelination.”

    “Cortical thickness may show a differential pattern of recovery with abstinence in alcohol use disorder (AUD) compared to volume and surface area measures in the same brain regions…The cerebral cortex is primarily composed of neuronal and glial cells [i.e., astrocytes, oligodendrocytes, and microglia…and the ratio of glial cells to neurons is approximately 0.7:1; accordingly, cortical thickness may serve as a macroscopic surrogate marker of the cytoarchitectural integrity of cells comprising the cortex,” they wrote in the the study’s introduction.

    The researchers also noted that “few studies have investigated cortical thickness changes with abstinence in [alcohol use disorder].”

    In their study, the researchers studies participants with alcohol use disorder at one week, one month and a little more than seven months of abstinence. 

    In this study, AUD participants were studied at approximately 1 week (n=68), 1 month (n=88) and 7.3 months (n=40) of abstinence. 

    “Forty-five never-smoking controls (CON) completed a baseline study, and 15 were reassessed after approximately 9.6 months. Participants completed magnetic resonance imaging studies at 1.5T and cortical thickness for 34 bilateral regions of interest (ROI) was quantitated with FreeSurfer. AUD demonstrated significant linear thickness increases in 25/34 ROI over 7.3 months of abstinence,” the researchers explained in their summary of the results,, noting that the “rate of change from 1 week to 1 month was greater than 1 month to 7.3 months in 19/34 ROIs.”

    “After 7.3 months of abstinence, AUD were statistically equivalent to CON on cortical thickness in 24/34 ROIs; the cortical thickness differences between AUD and CON in the banks superior temporal gyrus, post central, posterior cingulate, superior parietal, supramarginal and superior frontal cortices were driven by thinner cortices in AUD with proatherogenic conditions relative to CON. In actively smoking AUD, increasing pack-years was associated with decreasing thickness recovery primarily in the anterior frontal ROIs,” they continued. 

    “Widespread bilateral linear cortical thickness recovery over 7.3 months of abstinence was the central finding for this AUD cohort. Proatherogenic conditions were associated with decreased thickness recovery and thinner cortex after 7.3 months of abstinence in several ROIs; this suggests alterations in perfusion or vascular integrity may relate to structural recovery in AUD. These results support the adaptive and beneficial effects of sustained sobriety on brain structural recovery in those with AUD.”

    The findings were hailed as “groundbreaking” by PsyPost, saying that the study reveals “a remarkable potential for recovery.”

    “There is very limited information in the alcohol use disorder field regarding how human brain structure recovers over longer-term abstinence after treatment,” said Timothy C. Durazzo, a clinical neuropsychologist at the VA Palo Alto Health Care System and professor of psychiatry and behavioral sciences at Stanford University School of Medicine who was one of the authors of the study, as quoted by PsyPost. “Our study is the first to demonstrate significant recovery of cortical thickness in multiple regions in those seeking treatment for alcohol use disorder over approximately 6-7 months of abstinence after treatment.”

    Alcohol use disorder is defined as a “a medical condition characterized by an impaired ability to stop or control alcohol use despite adverse social, occupational, or health consequences,” according to the National Institute on Alcohol Abuse and Alcoholism, which said that 28.6 million adults aged 18 and older had alcohol use disorder in 2021.

    Genetics, exposure at an early age, mental health conditions and other traumas are all identified as factors that increase the risk of alcohol use disorder.

    “It encompasses the conditions that some people refer to as alcohol abuse, alcohol dependence, alcohol addiction, and the colloquial term, alcoholism. Considered a brain disorder, AUD can be mild, moderate, or severe. Lasting changes in the brain caused by alcohol misuse perpetuate AUD and make individuals vulnerable to relapse.The good news is that no matter how severe the problem may seem, evidence-based treatment with behavioral therapies, mutual-support groups, and/or medications can help people with AUD achieve and maintain recovery,” the Institute explained.

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  • James Blunt Says Carrie Fisher’s Daughter Blames Him For Her Death

    James Blunt Says Carrie Fisher’s Daughter Blames Him For Her Death

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    Blunt was with Fisher the night before she was found unresponsive during a flight from London to Los Angeles. She passed away days later, and a toxicology report later found she had cocaine, heroin, MDMA and methadone in her system.

    The report did not state a definitive cause of death, but the actor and author had been open about her struggles with substance abuse for years.

    In the book, the “You’re Beautiful” singer remembers taking a “different approach” than friends who tried to convince Fisher to quit using drugs once and for all.

    “Charlie, her best friend, confronted her more directly and told her she needed to quit drugs…” he recalls. “I took a different approach and did them with her, pretending to myself that I would guide her to redemption one day — just not today. As a result, her — daughter Billie blames me in part for her death, and no longer speaks to me.”

    Lourd previously said her mother’s mental health is what ultimately caused her death.

    “My mom battled drug addiction and mental illness her entire life,” Lourd told People in 2017. “She ultimately died of it. She was purposefully open in all of her work about the social stigmas surrounding these diseases.”

    Need help with substance use disorder or mental health issues? In the U.S., call 800-662-HELP (4357) for the SAMHSA National Helpline.

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  • Tommy Lee Said Drinking This Much Vodka Put His Liver ‘On Crutches’

    Tommy Lee Said Drinking This Much Vodka Put His Liver ‘On Crutches’

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    Tommy Lee says he was drowning himself in two gallons of liquor a day during the depths of his alcoholism.

    Pouring over his love-hate relationship with alcohol on Bill Maher’s Club Random podcast, the Mötley Crüe rocker said, “Alcohol’s such a fucking weird one.”

    “It’s easy to fall in love with, the way it makes you feel, the way it makes you relax, and then all of a sudden you’re, like, ‘Fuck! I’m drinking two gallons of vodka a day?’ You’re trying to kill yourself now.”

    “Your liver is on crutches at that point; it’s just barely functioning,” he told Maher.

    After all the abuse his body has handled, Lee was floored when his doctors told him he hadn’t been left with any long-term health issues.

    “I pinch myself on a daily basis,” he said of his glowing medical checkup.

    Tommy Lee attends the premiere of “The Dirt” in Hollywood on March 18, 2019.

    Paul Archuleta via Getty Images

    Lee was so astonished by his health update that he thought it must have been a case of mistaken identity at first.

    “I just did the full body scan, where they do head-to-toe everything, and I can’t believe ― smoking, drinking, all the fucking dumb shit, or the fun shit that I’ve done,” the “Dr. Feelgood” drummer said.

    “Dude, the doctor was, like, ‘You’re good.’ And I was, like, ‘Are you sure you have the…? Let me see. Is that my name on there, or is there some Japanese guy in here that you have his results that you’re reading from?’ Because I find that fucking impossible. This is impossible.”

    The hair metal legend talked more about his habit in an interview with Yahoo! Entertainment back in 2020, when he was marking one year of sobriety.

    “Like, I was drinking just out of boredom,” he explained. “I would just wake up and be just building, just all vodka and just a little eyedropper of cranberry or lemonade. I was drinking two gallons — not pints, not quarts, but gallons, the big-handles.”

    Need help with substance use disorder or mental health issues? In the U.S., call 800-662-HELP (4357) for the SAMHSA National Helpline.

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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

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    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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  • Fatal overdoses rise after drug seizure, study finds

    Fatal overdoses rise after drug seizure, study finds

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    Newswise — PROVIDENCE, R.I. [Brown University] — For decades, efforts by police to seize illicit drugs have been a cornerstone strategy for disrupting drug markets and removing drugs from communities. But there’s an unintended outcome when opioids are seized, a new study finds — increases in overdoses, including those that are fatal.

    The study found that police drug seizures were associated with increases in fatal overdose in the surrounding geographic area in the three weeks following enforcement, possibly by leading people with substance use disorder to take greater risks when they tried to restore their supply. The study, published in the American Journal of Public Health, raises questions about policies that might be exacerbating overdoses during a persistent epidemic that is contributing to reductions in the nation’s life expectancy.

    The findings provide evidence that efforts to disrupt drug markets can have unintended effects in generating public harm, said Bradley Ray, a senior researcher at the nonprofit research institute RTI International who led the study. 

    “It’s concerning to think routine drug enforcement can exacerbate harms, so we need to focus on mitigating these sources of overdose risk,” Ray said. 

    Brandon del Pozo, an assistant professor (research) at Brown University’s Warren Alpert Medical School and School of Public Health, co-authored the study. Del Pozo spent 19 years at the New York City Police Department and four years as chief of police of Burlington, Vermont, where he directed the city’s response to the opioid crisis. The study highlighted the “collateral consequences” of law enforcement seizures of drugs, del Pozo said.

    “To be truly effective in reducing overdose deaths, policing strategies need to be comprehensive,” he said. “That means taking into account all the outcomes of police work, not just the effect of incapacitating drug dealers, but also how seizing drugs disrupts sales in a community, and how those disrupted sales affect usage patterns, and how those usage patterns affect an individual’s health and safety. According to this study, we have evidence that seizing opioids increases exposure to overdose.”

    To conduct the study, the research team used two years of administrative data from Marion County, Indiana, to compare different types of drug seizures with subsequent changes in fatal overdoses, nonfatal overdose calls for emergency medical services and naloxone administration in the surrounding area.

    They found that within seven, 14 and 21 days, opioid-related seizures of drugs by police were significantly associated with increased overdoses within 100, 250 and 500 meters of the seizure location. Most notably, the number of fatal overdoses was two-fold higher than expected within seven days and 500 meters following an opioid-related incident in which police seized drugs.

    The researchers hypothesized that the increase in overdose events was because people who use opioids will generally seek out a new supply after losing access to their previous drug supply, and that new supply will have unknown potency. In addition, in the time period between losing the familiar supply and finding a new one, people using opioids can experience diminished tolerance to drugs. Accidentally ingesting a dose beyond one’s tolerance can be fatal.

    “One of the risks of the illicit drug market is uncertainty about what constitutes a safe dose,” Ray said. “If people who use drugs lose access to their usual supply, they are forced to find an unknown supplier, which introduces uncertainty about what is in the drugs they procure, thereby increasing overdose risk.”

    Fentanyl — a highly potent opioid often used to lace other heroin or cocaine that has come to dominate the illicit opioid market — is driving the fatality count in opioid- and stimulant-involved overdose deaths, the researchers noted. Much of the drug supply is now contaminated by fentanyl, which is lethal even in small doses.

    “The ubiquity of fentanyl in the drug supply affords people who use drugs almost no margin of error if they make a dosing mistake,” del Pozo said.

    The study findings, del Pozo said, can inform a more effective law enforcement strategy for preventing overdoses. For example, he said that it’s important to ensure that a drug seizure in a particular area is also accompanied by targeted harm reduction approaches such as outreach services, links to treatment, increased naloxone distribution and programs that test illicit drugs for the presence of fentanyl.

    “If the seizure of drugs by law enforcement is going to continue to be a part of the strategic response to the country’s overdose crisis, then it has to take into the account that at least in the short term, seizing drugs increases overdoses,” del Pozo said. “Part of the mission of drug enforcement is to save lives, and with the current approach, it’s doing the opposite.”

    Other study contributors included Steven J. Korzeniewski, Grant Victor, Philip Huynh and Bethany J. Hedden from Wayne State University; George Mohler from Boston College; and Jennifer J. Carroll from the Warren Alpert Medical School at Brown University and North Carolina State University.

    The study was funded by the U.S. Centers for Disease Control and Prevention.

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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

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    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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  • NJ Medicaid Reforms Tied to Increased Use of Opioid Addiction Treatment

    NJ Medicaid Reforms Tied to Increased Use of Opioid Addiction Treatment

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    Newswise — Reforms to New Jersey’s Medicaid program successfully spurred ongoing increases in buprenorphine prescriptions for the treatment of opioid addiction, according to a Rutgers analysis.

    Although medications such as buprenorphine effectively combat opioid addiction, less than 30 percent of potential users receive them nationwide. New Jersey sought to increase prescription numbers with three Medicaid reforms that took effect in 2019. The reforms:

    • Removed prior authorization requirements for buprenorphine prescriptions
    • Increased reimbursement rates for in-office opioid addiction treatment
    • Established regional centers of excellence for addiction treatment

    Medicaid records showed steady increases in buprenorphine prescriptions before 2019, but the rate of growth increased by 36 percent after the reforms took effect, and this increased rate of growth persisted until the end of the study period in December 2020.

    A similar trend affected caregiver behavior. The percentage of caregivers prescribing buprenorphine had been rising before the reforms took effect, but it increased faster after their implementation.

    New Jersey also experienced faster growth in buprenorphine prescriptions to Medicaid patients than did other states, the analysis reported, a strong indication that the boosts stemmed from the state’s reforms rather than some unrelated nationwide trend.

    The only disappointment came from the study’s measurement of long-term usage. The percentage of buprenorphine prescriptions that remained active for more than 180 days didn’t rise during the study period.

    “Usage remains far below the ideal where virtually everyone battling opioid addiction receives an effective medical treatment like buprenorphine,” said Peter Treitler, research project manager for the Rutgers Institute for Health, Health Care Policy and Aging Research and lead author of the analysis published in JAMA Network Open. “However, our analysis suggests these reforms may get us to that point years before we would have reached it under the previous policies.”

    Buprenorphine — a once-daily prescription pill sold in the United States as Suboxone, Zubsolv and Sublocade — works in two ways. First, it binds to the same brain cells as drugs such as opium, heroin, morphine, oxycodone and fentanyl. Once it’s in place, those other drugs struggle to dislodge it, bind to the target cells and produce addictive highs. Second, it stimulates a milder effect that reduces cravings for those other drugs and prevents withdrawal symptoms.

    Regulators once placed extra restrictions on buprenorphine prescriptions because they worried its mood-altering effects would create more addicts than it cured. These restrictions, which forced caregivers to justify each new buprenorphine prescription at length and investigated providers who prescribed the drug “too often,” led many to avoid prescribing the drug at all, said Treitler, who added Medicaid’s low reimbursement rates for office-based addiction treatment further reduced buprenorphine availability to poor patients.

    Regulators have relaxed many restrictions on buprenorphine because opioid addiction has increased. Recent research has shown buprenorphine to be both safer and more effective than previously thought. The reforms to New Jersey’s Medicaid program further reduced barriers to medication usage among its patients.

    “They looked at what obstacles were blocking the usage of a valuable drug in this particularly underserved patient population,” Treitler said. “They removed several of the biggest obstacles. And the results so far suggest they’re getting the desired results.”

    Indeed, the positive numbers seen in initiatives such as the one undertaken by New Jersey’s Medicaid program may finally be affecting the most important number of all: overdose deaths. After several decades of speedy increases, overdoses nationwide rose by just 500 in 2022.

    The trend was even better in New Jersey. Total overdose deaths fell by 232 from 2021 to 2022, and they were 93 lower in the first three months of 2023 than in the first three months of 2022.

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    Rutgers University-New Brunswick

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  • Penn Medicine to Open New Crisis Response Center as Part of a Unified Mental Health Care Hub at Hospital of the University of Pennsylvania – Cedar Avenue

    Penn Medicine to Open New Crisis Response Center as Part of a Unified Mental Health Care Hub at Hospital of the University of Pennsylvania – Cedar Avenue

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    Newswise — PHILADELPHIA—Penn Medicine is launching a new community mental health hub at the Hospital of the University of Pennsylvania — Cedar Avenue (HUP Cedar), co-locating inpatient and outpatient psychiatric care with a new crisis response center (CRC) at the facility. The multi-year plan will put crucial psychiatric and substance use care in easy reach for West and Southwest Philadelphia residents, at a time when both mental illness and drug and alcohol dependence are surging in the city.

    The project will begin with moving inpatient psychiatric and drug and alcohol detoxification units from Penn Presbyterian Medical Center to HUP Cedar in July, followed by the opening of a new crisis response center at the facility later in the summer which is expected to provide an estimated 4,000 patient visits each year. The steps will create two comprehensive, fully integrated mental health hubs at Penn Medicine facilities in Philadelphia, offering emergency mental health services and inpatient and outpatient care at both HUP Cedar and Pennsylvania Hospital, which has operated a CRC since 1999. Together, Pennsylvania Hospital and HUP Cedar will have 73 licensed inpatient psychiatric beds and 16 beds for substance use treatment. Additional space at HUP Cedar will allow for expansion of coordinated services to further care for West and Southwest Philadelphia communities over the next five years.

    “The COVID-19 pandemic accelerated the mental health crisis across the nation. As COVID recedes, we have a moral imperative to tackle this suffering in our communities,” said Kevin B. Mahoney, chief executive officer of the University of Pennsylvania Health System (UPHS). “Providing easy access to care when people are in crisis changes – and saves – lives. We are committed to the investment and innovation needed to close the gaps in access to care and reverse the toll of mental health and substance use in Philadelphia.”

    As one of the nation’s largest cities, Philadelphia’s mental health struggles are a microcosm of broader trends: A Pew Research Center survey from late 2022 reported that 41 percent of Americans — and nearly 60 percent of young adults — have experienced high levels of psychological distress at least once since the early stages of the pandemic. At the same time, more than two-thirds of Americans live in areas without sufficient psychiatrists and other mental health professionals. In Philadelphia, more than 20 percent of the city’s residents are coping with a diagnosed depressive disorder and substance use-related deaths have climbed to record levels.

    Similar to the CRC at Pennsylvania Hospital, the HUP Cedar CRC — which will replace the CRC previously operated on the site by Mercy Philadelphia Hospital until its closure in March of 2020 — will be licensed as a crisis intervention walk-in facility and will serve as a discreet psychiatric emergency room, providing triage, evaluation, treatment and social services support for acute substance use and serious psychiatric conditions such as bipolar disorder, major depression, anxiety disorders, and schizophrenia.

    The co-location of the inpatient psychiatric units with emergency care provided through the CRC will enable a seamless transition of care for patients, eliminating the wait time and additional steps required to transfer patients to inpatient units at other facilities — a common occurrence in a city where emergency psychiatric resources remain in short supply.

    “We know that a lack of quality mental health support and crisis response services has a traumatic ripple effect across families and entire communities. When patients and families are coping with a mental health crisis, the last thing they need to think about is how to navigate a complex system,” said UPHS Chief Operating Officer Michele Volpe. “By putting all our services together, we can help keep patients safer, get them into treatment faster, and better support families as they begin to navigate supporting their loved ones during their hospitalization and recovery.”

    Staff at both CRC locations will be connected via a real-time data system providing details on bed availability in order to ensure patients can be placed as quickly as possible and that each location has the right staffing resources. Penn Presbyterian will continue to provide select outpatient psychiatric care as well treatment for substance use disorders after the transition of inpatient services to HUP Cedar.

    HUP Cedar is part of the PHMC Public Health Campus on Cedar, which opened in March 2021, transitioning the building from the former Mercy Philadelphia Hospital into a campus offering emergency and inpatient care as well as primary care and community-driven social supports.

    Penn Medicine will invest $5.76M toward the opening of the CRC at HUP Cedar as part of the mental health hub project. The CRC reopening has also received funding from the Independence Blue Cross Foundation, and the City of Philadelphia Department of Behavioral Health earmarked $4.1 million in HealthChoices reinvestment funds.

    In addition to Penn Medicine’s adult mental health services on the site, Children’s Hospital of Philadelphia plans to open an inpatient pediatric behavioral health facility, the CHOP Behavioral Health & Crisis Center, on the site, as well. The 46-bed acute inpatient psychiatric facility and 24/7 walk-in crisis center will create a safe, inclusive and restorative setting for children and adolescents.

    The second phase of the new mental health hub plan will also increase care capacity at Penn Presbyterian Medical Center (PPMC), by converting the vacated psychiatric beds to medical surgical units. Those steps will help to improve patient movement across the hospital, reducing emergency department wait times and providing additional capacity for post-surgery recovery.

    The new services at HUP Cedar are part of Penn Medicine’s wraparound commitment to bringing more mental health care support to the community across each of its mission areas. Penn Integrated Care (PIC), a program, which embeds mental health professionals in primary care practices, launched in 2018. More than 230,000 patients in 24 Penn Medicine primary clinics have access to PIC services. To date, 35,000 patients have been treated directly by PIC clinicians or connected to specialty care in the community.

    Beginning this summer, the health system will add a new path for training fellows in drug and alcohol use treatment. That program, for physicians specializing in family medicine, primary care, and emergency medicine, among other disciplines, aims to ensure that providers in multiple settings are equipped to help patients take steps toward recovery and provides a much-needed addition to the existing fellowship in Addiction Psychiatry at Penn Medicine and the Corporal Michael J. Crescenz Veterans Affairs Medical Center (CMC VAMC) in Philadelphia.

    In addition, a new consultation service provides psychiatric care to patients hospitalized for complex medical needs at the Hospital of the University of Pennsylvania, Pennsylvania Hospital, and Penn Presbyterian Medical Center. Future plans include potential opening of a medical-psychiatric unit to ensure that patients with these complex needs are cared for in dedicated spaces.

    “Expanding our resources to care for mental health needs in Philadelphia is a core part of our mission,” said Hospital of the University of Pennsylvania CEO Regina Cunningham, PhD, RN. “No matter where people live in the city, we aspire to provide them with support in convenient settings, and work to erase both the stigmas and access problems that stand in the way of helping people get help.”

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    Perelman School of Medicine at the University of Pennsylvania

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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

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    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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