Opioid addiction remains the main cause of overdose deaths in Berrien County, Michigan. But the county’s numbers have moved substantially in the right direction. Health officials recorded 46 opioid-related overdose deaths in 2022. New data shows the figure is half that.

That decline matches statewide stats. The Wolverine State has an abundance of treatment programs from inpatient care to local Narcotics Anonymous chapters. Hannah Darr is the county’s health promotion and prevention supervisor and credited these programs for the drop in opioid-related overdose deaths across Michigan.

The Opioid Crisis in Michigan

Berrien County marked National Overdose Awareness Month in August. They had 23 fatalities, down from 46. This is a 50% cut for a county with only 153,000 people. But officials note they still have a long way to go.

Darr identified two factors behind the decline: increased access to treatment and increased access to Narcan.

That pairing reflects what public health researchers have generally found nationally as well. Naloxone distribution reduces deaths at the moment of overdose. Medication for opioid use disorder reduces the number of overdose events in the first place. Neither one alone produces the trend Berrien County is reporting.

Naloxone in Action

Andrea Loveless is a prevention specialist with the Berrien County Health Department. She says Narcan works on opioid and kratom overdoses. It doesn’t reverse overdoses involving stimulants such as methamphetamine or cocaine.

So if someone is unresponsive and you do not know what they took, administer naloxone and call 911 in that order. Getting it wrong costs nothing. Not acting can cost a life.

Kratom Draws County Attention

Beyond opioids, county officials flagged kratom as a substance under watch.

Loveless described kratom as a problem drug sold in gas stations and smoke shops with no age restriction on purchase in Michigan. Kratom’s active compounds act on opioid receptors and produce opioid-like effects at higher doses.

The Settlement Funds

Berrien County will receive $1.8 million from opioid settlements through 2040. Most of that will go to community and youth programs focused on prevention and awareness.

That’s the majority of the county’s total allocation. Officials say they need to extend care beyond overdose reversal.

Harm Reduction and Treatment

Berrien County held free drive-through Narcan training events throughout the year. Their Health Department maintains an online scheduling system for training throughout the year.

Counseling supplements harm reduction tools like naloxone and medications. Peer support like NA also opens the door to fellowship and camaraderie that carries many folks through their recovery.

NA Still a Top Option

Narcotics Anonymous hosts groups across southwest Michigan in Benton Harbor and Saint Joseph. Meeting formats include virtual options. They’re free and require no insurance, referral or ID.

NA also has chapters across the country. Our browsable directory features meetings by state and city with details on day, time, format, and meeting type. 

You can also dial 800-934-1582(Sponsored) , which is free, confidential and available 24 hours a day and connects callers to local resources.

Estonia spent more than a decade with the highest overdose death rate in Europe, then broke the back of its fentanyl market in 2017. What replaced it was worse. Nitazene overdose deaths now account for half of the country’s drug-related deaths, and the same class of synthetic opioids is spreading through the United States.

The American numbers are smaller and moving in one direction. Confirmed nitazene-involved overdose deaths in the US rose from 27 in 2020 to 409 in 2024.

Nitzaones Strike Estonia

Heroin mostly disappeared from Estonia in the early 2000s. But by 2004 illicitly manufactured fentanyl had replaced it. Police seized nearly 10 kilograms of fentanyl in 2017, up from 314 grams the year before. The disruption of the main trafficking networks ended the fentanyl era abruptly by the close of that year.

The gap didn’t stay empty for long. In April 2019, Estonia became the first European country to identify isotonitazene and a new class of highly potent synthetic opioids. Drug-related deaths rose from 39 in 2022 to more than 100 in 2023. Over 2021 through 2024, 332 people died from overdoses in Estonia, 262 of them men.

Nitazenes now turn up in powders, counterfeit tablets, liquids and illegal drugs.They’ve displaced fentanyl and heroin across Estonia through Western European countries like Germany.

Nitazenes Behave Differently

Nitazenes produce a stronger, faster, sharper and shorter-lived effect than fentanyl. The clinically important part for drug users is that nitazene overdoses are harder to reverse.

Some nitazenes are now deadlier than fentanyl. They were originally intended as pain meds decades ago and never approved for medical use. The class now includes more than 20 distinct substances.

The US Picture

The DEA began tracking nitazene-related seizures around 2014 and saw a marked increase starting in 2019. Federal authorities have since scheduled dozens of nitazenes as illegal substances.

More than 1,100 US fatalities have been confirmed. Toxicologists think the real figure is higher because only a small number of labs test for nitazenes. Cases go uncounted.

The DEA’s New Orleans division issued a warning on August 25 to St. Tammany and Tangipahoa Parishes about a spike in nitazene-involved overdose deaths. They noticed that nitazenes arrived primarily through foreign chemical suppliers and mixed into fentanyl powder and heroin or pressed into counterfeit prescription pills.

That last detail concerns the exposure risk for most folks on Main Street. Someone buying what they believe is a prescription pill or a familiar bag has no way to know nitazene is in it.

Understanding the Terms

Opioids include prescription medications and synthetic compounds like fentanyl and nitazenes. Overdose happens when brain receptors overload and you slow or stop breathing.

Naloxone, sold as Narcan, reverses opioid overdose by displacing opioids from those receptors. It works on nitazenes but more than one dose may be needed as it wears off. That’s why calling 911 matters even after someone responds.

Practical steps in the US context:

• Naloxone is free through many local health departments and syringe service programs.
• More than one dose may be needed with synthetic opioids and call 911.
• Fentanyl test strips don’t detect nitazenes. Some programs now distribute nitazene-specific test strips through local harm reduction services.
• Don’t use drugs alone. Never-use-alone phone lines exist for exactly this.

Medications for opioid use disorder remain one top choice. These prescriptions reduce cravings and lower the risk of fatal overdose. Team it up with peer support rather than as an alternative.

NA Fights Any Opioid Addiction

Peer support like Narcotics Anonymous meetings give people facing drug addiction a place to start tonight, in person or online, in most US cities. 

Start checking it out. Our browsable directory maintains a searchable NA meeting directory by state and city with filters for meeting type, format and language.

Also feel free to call 800-934-1582(Sponsored) 24/7 for confidential guidance alongside a live expert.

The fentanyl supply moving through five Midwestern states is changing shape, and the shift matters for anyone tracking overdose risk. Federal seizure data released August 10 shows fentanyl pill seizures falling while fentanyl powder seizures climbing sharply in the same territory.

The DEA’s Omaha Field Division seized more than 67,000 fentanyl pills across Iowa, Minnesota, Nebraska, North Dakota and South Dakota during the first seven months of 2026. The agency characterized that pill figure as down from previous years. Over the same stretch, fentanyl powder seizures rose nearly 87% compared with the same period in 2025.

The Shifting Numbers

Taken together, pill and powder seizures in the five-state division account for more than four million potentially lethal doses, according to the DEA.

The agency reported both figures without offering an explanation for the divergence, and seizure totals reflect enforcement activity as well as supply. Together, they’re an indirect measure of what’s circulating. Still, a substantial move toward powder in a region where pressed counterfeit pills have dominated represents a meaningful change in the local drug supply.

Powder and Pills Carry Different Risks

Fentanyl is a synthetic opioid primarily used clinically for severe pain. Illicitly manufactured fentanyl is far deadlier than other street drugs, so small variations in a dose have outsized effects on breathing.

Both forms of illicitly manufactured fentanyl remain dangerous. Furthermore, neither is safer than the other in any practical sense.

The risks are distributed differently, though. Counterfeit pills’ danger lies in its misrepresentation. A pill pressed to resemble a prescription medication may contain fentanyl, and the person buying it believes they’re taking something else entirely.

Powder introduces a different problem. It is commonly mixed into or sold as other substances, and dosing within a single batch can be uneven. Harm reduction organizations have long emphasized that people who use drugs can’t assess potency by sight. That’s why they recommend test strips and starting with a smaller amount.

The Supply Reaches Buyers

The DEA paired its seizure figures with a warning about drug sales on social media as students returned to school. Sellers advertise through posts and disappearing stories, often using code words and emoji, then moving conversations to encrypted apps such as WhatsApp, Signal, and Telegram. Payments run through consumer apps including Venmo, Zelle, and Cash App, with delivery by package.

“Social media is just another avenue that drug dealers are using to push counterfeit pills and other poisons to a new generation,” reported Dustin Gillespie, Special Agent in Charge of the DEA Omaha Field Division.

The DEA also released a video series for parents and caregivers called “Hidden on Your Kid’s Phone.”

Treatment Options Abound

Naloxone, often sold under brand names like Narcan, reverses an opioid overdose by displacing opioids from receptors in the brain. It’s available over the counter at pharmacies nationwide and free through many health departments, syringe service programs and community distribution sites. Due to fentanyl’s potency, more than one dose is sometimes needed, and remember to always call emergency services.

Medications for opioid use disorder are the most strongly evidence-supported treatment available. Methadone, dispensed through licensed opioid treatment programs, and buprenorphine, available through outpatient providers and by telehealth, reduce overdose death substantially. Naltrexone is an additional option after a period without opioids.

These medications are treatment, not a lesser substitute for it. Folks taking buprenorphine or methadone as prescribed are in recovery.

NA for Peer Support

Peer support works alongside medication rather than in competition with it. Narcotics Anonymous meetings run throughout the Midwest and the rest of the country. In person and online options are available, including formats built for people attending for the first time.

Some people find a 12-step program central to their recovery. Others build recovery through medication, therapy, SMART Recovery or a combination. All are legitimate paths, and many folks use several at once.

Getting started is easy. Our browsable directory lists NA meetings for all 50 states, searchable by city and meeting type.

For help finding treatment, our helpline is free, confidential, and available 24 hours a day at 800-934-1582(Sponsored) . For anyone in crises, call or text 988.

Forty-eight individuals succumbed to drug-related overdoses across Mid-Michigan in early 2026. A first-quarter report from the medical examiner’s office at University of Michigan Health Sparrow offers additional details. 

To be clear, the overall count has dropped, and that’s a credit to Michigan’s wide range of clinical and relief programs, including local Narcotics Anonymous chapters. But the report describes a change in what people are using, and that change has direct consequences for how overdoses are reversed.

Chief Investigator Michelle Fox observed the shift toward stimulants stands out. “We’re seeing a lot more amphetamines, cocaine, more stimulants in this quarter,” she explained, describing the shift as different from prior periods.

The Mid-Michigan Numbers for Early 2026

Ingham County recorded 20 deaths, the highest of any county in the region during the quarter. Eaton County recorded four, two of which officials classified as suicides with prescription medications. Clinton County recorded three. The numbers may seem small, but each death leaves behind grieving loved ones and shattered communities.

In Ionia County, authorities warned about a synthetic chemical designed to mimic THC, which officials link to four deaths.

The people who died ranged in age from 10 to 75. The report listed one case in the county as an indeterminate manner of death for a 10-year-old, but suspected methadone toxicity.

Fentanyl and Stimulant Mixes are Harder to Reverse

The clinical significance of the trend sits in this detail. Opioids including fentanyl are being mixed with stimulants such as cocaine or methamphetamine, and those combinations aren’t always reversible by naloxone alone.

Fentanyl is up to 100x deadlier than morphine. It appears in the illegal street trade of counterfeit pills and often mixed into powders without the buyer’s knowledge. Even a tiny dose causes respiratory depression.

That’s where naloxone comes in. It works by displacing opioids from receptors in the brain and restores breathing in an opioid overdose. It doesn’t affect stimulant toxicity, which can produce agitation, hyperthermia, seizures, and cardiac events. When both fentanyl and stimulants are present, reversing the opioid doesn’t resolve the stimulant effects, and the person still needs emergency medical care.

Driving the Change

Deborah Smith is clinical director at Wellness, InX, an addiction treatment center in Lansing. She pointed out the trend didn’t surprise her. In her assessment, the shift toward stimulants tracks with economic conditions, with stimulant use rising in stronger economies and opioid use in weaker ones. 

Smith also pointed to the role of community involvement. She described a need for people willing to hold others accountable while continuing to support them. Folks with a substance use disorder can connect with local resources because any amount of an illicit substance can be fatal.

Treatment and Peer Support Options

Naloxone, sold under brand names including Narcan, is an opioid antagonist available over the counter as a nasal spray. It’s safe to give if you’re unsure whether an overdose involves opioids because it does no harm when no opioids are present.

For opioid misuse, medication is the treatment with the strongest evidence base. Methadone, buprenorphine, and naltrexone are FDA-approved and typically accompany counseling. 

Stimulant abuse currently doesn’t have any approved medications. Treatment centers on behavioral approaches, including contingency management and cognitive behavioral therapy.

Peer support works alongside these, not against them. Narcotics Anonymous meetings are free and open to all. Some people find NA sufficient on its own. Others combine it with medication, therapy, or a treatment program. All are legitimate paths.

NA for Narcotic Addiction in Michigan & Beyond

Our browsable directory features NA meetings across Michigan and the rest of the country by city, with filters for meeting type, format, and language, including virtual meetings. Our website also covers detox, inpatient, and outpatient options.

Feel free to also reach out to our helpline at 800-934-1582(Sponsored) for free and confidential guidance from an expert.

Germany now sees the kind of shift in its drug supply that reshaped opioid addiction in the United States a decade ago. The American experience is the reason the German numbers are worth reading closely here.

Federal figures in 2026 reported 2,150 drug-related deaths across Germany in 2025. Deaths among people under 30 reached 528, roughly 53% higher than in 2021. Among those under 20, deaths rose to 106, close to double the 54 recorded in 2021. About one in four German drug deaths last year involved someone under 30.

Driving the Shift in the Opioid Crisis

The overall German total has hovered near or above 2,100 for several years. Federal figures recorded 2,227 deaths in 2023 and 2,137 in 2024, so the 2025 figure of 2,150 isn’t a new national high. What changed in Germany’s case is the age distribution.

Federal Drug Commissioner Hendrik Streeck publicly noted that the persistence of these numbers is itself the alarming part. He worries that the country risks becoming accustomed to them.

German officials attribute much of the rise to newer and more dangerous substances, particularly synthetic opioids. As the Taliban’s ban on poppy cultivation in Afghanistan constricted the traditional heroin supply, laboratory-made opioids moved to fill the gap.

Nitazenes are the group drawing the most concern. These synthetic opioids can resist naloxone and have appeared in counterfeit pills sold as familiar medications, meaning people can take them without knowing. European drug surveillance has documented nitazene-linked death clusters in several countries, including Germany.

Understanding Synthetic Opioids

Opioids act on receptors in the brain and brainstem that regulate pain and breathing. At sufficient doses they suppress breathing, which is how an overdose kills. Synthetic opioids including fentanyl and the nitazene group are made entirely in laboratories, and potency varies enormously between batches and between compounds.

That variability comprises the core danger. A dose a person has tolerated before can be lethal when the underlying compound changes. Nothing about the appearance of a pill or powder reveals its contents.

The US Is Not Past This

Illicit fentanyl reshaped the American supply over the past decade and pushed overdose deaths to record levels. What German officials now brace for, many American communities have already lived through.

The more recent American trend has run the other way. Federal data show overdose deaths falling substantially, following wider naloxone distribution, broader use of medications for opioid use disorder, and drug-checking efforts. That decline is real and also fragile. 

The same synthetic compounds worrying German officials continue to circulate here, and authorities have detected nitazenes in the U.S. supply. A supply can turn in the space of a year or two, which is the actual lesson in the German figures.

Help for Opioid Addiction with NA

Peer support and medication don’t compete. Many people use both. NA meetings offer free, no-commitment peer support, and medications for opioid use disorder have the strongest evidence for reducing overdose deaths.

Our directory lists NA meetings nationwide, searchable by state, city, day, format, and meeting type, including virtual and Spanish-language meetings. 

For free and confidential help finding opioid treatment programs at any hour, dial our helpline at 800-934-1582(Sponsored) .

Border interdiction numbers don’t measure how safe the drug supply is, and a report from Texas illustrates the gap as smuggling continues. For anyone living or supporting those with opioid addiction, the practical takeaway from falling border statistics is smaller than the headline suggests.

People along the Southern border region in Texas remain vigilant despite a drop in border crossing statistics. Even though The Longhorn State features many inpatient programs and local organizations like Narcotics Anonymous, drugs still move through rural areas and South Texas ranchland.

The Numbers’ Actual Measurements

US Customs and Border Protection reports that illegal border crossings have declined significantly. As of January, they had fallen 84% from 2025.

That figure counts crossings, not drug seizures and not drug volume that enter the U.S. Being precise counts because a decline in one doesn’t establish a decline in the other. Indeed, overdoses among vulnerable Texan groups, such as in prisons, have skyrocketed.

Rio Grande City Police Chief Jose Solis described a slowdown in the drugs he sees locally, dating back to 2019 and 2020. The larger loads have decreased compared with when he started in 2007. Vehicle pursuits, once far more common, have quieted down.

Mike Vickers, a Brooks County rancher, relayed that suspected drug carriers continue to move throughout the region. He described a camera detection that showed suspected drug dealers carrying backpacks. Further detections between Herbertville and Zapata feature others carrying backpacks along pipeline routes.

Those incidents aren’t daily, he clarified, but happen a few times each month.

Thus, drugs still enter the U.S. via two means. Large vehicle loads occur, but have declined, according to local law enforcement. Small volumes still cross on foot through ranchland according to the people who live there.

Analysis and Limitations

The source doesn’t report drug seizure totals, overdose figures for the region, or any data on what substances are involved. No claim can be made from it about fentanyl availability in any particular city, and none is made here.

This matters because interdiction is upstream of the problem people actually encounter. Supply reaching a given neighborhood, the potency of its contents, and any adulterants it contains are determined much closer to the point of sale than the border.

Opioids and Overdose Risk

Keep in mind the bigger picture. Opioids consist of prescription medications and illegal street drugs. Fentanyl is a synthetic opioid potent enough that very small amounts can suppress breathing and now turns up in substances people didn’t intend to buy.

An opioid overdose can stop a victim from breathing. Look for unresponsiveness, gurgling or choking sounds and discolored lips and fingertips. It’s a medical emergency, and the first step is to call 911.

Naloxone reverses opioid overdose. It works within minutes, and is safe to give even if you’re not certain opioids are involved because it causes no harm to someone who has not taken opioids. It doesn’t reverse non-opioid sedatives, so still call 911.

Harm Reduction and Treatment

Nothing about a shift in border enforcement changes what reduces individual risk, and the tools are the same ones as last year.

Naloxone belongs within reach of anyone who uses opioids and anyone close to them. Harm reduction organizations throughout Texas and pharmacies distribute it free or at low cost without a prescription.

Fentanyl test strips allow folks to check substances before taking them. They aren’t a guarantee but provide information not previously available.

Medication for opioid use disorder has proven to reduce overdose deaths. Meds work alongside peer support groups rather than instead of them.

NA Effective in Fighting Opioid Addiction

For anyone in South Texas or elsewhere looking for a next step, several cost nothing.

NA meetings are free and ask that you only show up and partake. Meetings run daily across the entire nation, in person and online, and Spanish-language meetings are widely available in border communities.

You can get started by browsing our directory. We feature NA chapters in all 50 states, searchable by community and city.

You can also dial 800-934-1582(Sponsored) for free and confidential guidance with our specialists. Also, remember that the 988 Suicide and Crisis Lifeline is reachable by call or text.

Two state alerts and local overdose deaths point the same direction in Northeast Ohio. Even though The Buckeye State features a wide range of programs to deal with substance misuse, including local Narcotics Anonymous chapters on the local level, a new wave of substances like xylazine threaten to increase the human toll. 

This time, there’s a catch. The substances driving opioid overdose deaths are increasingly not the ones people think they are buying.

Matthew Vanyo, director of the Westshore Enforcement Bureau Drug Task Force, reported that 18 overdose deaths in Cuyahoga County have been directly linked to xylazine, often mixed with other drugs, from 2025 through the present.

“If you are buying illegal drugs on the street, just know you never know what’s going to be in that drug,” Vanyo relayed. “You have no clue.”

The Ohio Alerts

The Ohio Narcotics Intelligence Center recently issued two public safety alerts.

The first covers orphine analogs, a group of potent synthetic opioids. Like other opioids, they suppress breathing, and their potency raises the risk of a fatal overdose.

The second covers xylazine and medetomidine, two veterinary sedatives that now turn up mixed into the illicit drug supply. Neither has approval for human use.

Vanyo described how people receive combinations of contaminated drugs they never chose.

“The user thinks they’re only getting drug A, but they’re getting xylazine and medetomidine and fentanyl, and that’s aiding or the cause of a fatal overdose,” Vanyo pointed out.

The Substances Involved

Fentanyl is a synthetic opioid many times deadlier than morphine. It’s now common in the illicit supply across drug classes, including in counterfeit pills.

Xylazine and medetomidine are sedatives, not opioids. They slow heart rate and breathing through a different mechanism, which is what makes them dangerous alongside opioids like fentanyl. Two depressants acting at once compound the effect on breathing.

Xylazine also causes wounds that worsen quickly without care.

“The one unfortunate byproduct of xylazine abuse is open wounds that, if not taken care of, will eat down the skin,” Vanyo pointed out.

Anyone who develops a wound after using drugs should have it seen by a clinician early. These wounds respond to treatment, and delaying care turns them serious.

Naloxone Still Matters in an Opioid Overdose

Officials noted that naloxone, sold under the brand name Narcan, may not fully reverse an overdose involving these combinations, because naloxone works only on opioids. Many local Ohio neighborhoods have made Narcan readily available.

Authorities recommend giving naloxone faster and calling 911. Naloxone reverses the opioid portion of the overdose, which usually stops someone’s breathing. When a non-opioid sedative is also involved, additional doses or emergency medical care may be needed, and the person might stay sedated after the opioid effect is reversed.

Basically, give naloxone, call 911, stay with the person, and stand ready to give another dose. Someone who’s breathing again but still unresponsive still needs medical attention.

Enforcement’s Limits

Vanyo directly stated that arrests alone won’t lower the death count. Rather, connecting people to care remains essential to the task force’s job.

“For those who want to go into recovery,” Vanyo reaffirmed, “we help them get onto that pathway of care for themselves.”

The task force plans to host Operation Bridge on August 26 from 2 to 6 p.m. at the Lakewood Women’s Pavilion on Lake Avenue in Lakewood, Ohio. Nearly 40 organizations will be on hand with resources, including treatment providers, recovery services and the Homeless Coalition.

Vanyo concluded that the reach of the problem extends past the people using drugs. “It affects communities abroad, the county and the entire state.”

NA: Help for Opioid Addiction

Treatment for opioid addiction includes medications such as buprenorphine, methadone and naltrexone, which reduce cravings and withdrawal and help reduce overdose death rates. These work alongside counseling and peer support rather than in competition with it.

Speaking of peer support, Narcotics Anonymous meetings are among the most effective steps to take to get help. Meetings offer free peer support and run throughout every neighborhood in Ohio and the rest of the country, including evening and virtual options. 

Feel free to use our online directory to find NA meetings by city and meeting type. You can also call 800-934-1582(Sponsored) to speak with an expert and discuss treatment options.

Most people given opioids for short-term pain stop taking them well before the pain is gone. That’s the reassuring finding from a large new federally supported study. The harder finding is what stays behind in the medicine cabinet, and why leftover pills should be properly trashed. However, many prescriptions stay in the cabinet, which leads to risks of opioid addiction and overdose.

Researchers reported that roughly two in three patients had unused opioid tablets after an acute pain episode. The study was backed by the Food and Drug Administration and is intended to inform FDA guidance on prescribing for specific conditions.

Opioids and Overdose Risk

Let’s take a step back and look at the bigger picture. Opioids include prescription medications such as oxycodone, hydrocodone, morphine and codeine alongside heroin and fentanyl. With sustained use the body adapts, so more is needed for the same effect and stopping produces withdrawal.

Most overdose deaths in the United States now involve illicitly manufactured fentanyl rather than prescribed medication. So, leftover pills matter less as a direct overdose source than as a first exposure on a path toward opioid addiction. An opioid overdose produces unresponsiveness, very slow or stopped breathing, and blue or gray lips and fingertips.

The Study Tracked Opioid Pills

The prospective cohort study followed 1,708 opioid-naive patients between September 2020 and March 2023. They came from Cedars-Sinai Medical Center, Mayo Clinic, Monument Health, the University of Alabama at Birmingham and Yale-New Haven Health. Dental practices in several Southeastern states also participated. Molly Moore Jeffery of Mayo Clinic led the study. The analysis ran from April 2023 to February 2026.

Patients were enrolled from emergency departments, primary and urgent care clinics, dental practices, and after cesarean delivery or knee replacement who opted for opioids following surgery rather than without. All were adults who had never used opioids, apart from adolescents aged 15 to 17 having impacted molars removed at one site. Participants completed digital surveys for up to 180 days tracking pain, medication use, and side effects.

Opioid Use Ended Before Pain Did

Among the 1,502 patients who reported a pain level at least once, pain took a median of 20 days to resolve, regardless of which treatment they received. Median opioid use lasted 7 days.

That gap is the study’s central observation. Most participants stopped taking opioids while still in some pain, which suggests they used their meds for the worst stretch of the episode rather than until full recovery. This find correlated with other research that shows opioids don’t ease long-term pain.

Recovery time varied sharply by condition. Surgical pain took a median of 74 days to resolve and low back pain 69 days, while kidney stone pain resolved in a median of 8 days.

The authors concluded that many patients are well served by current guidance recommending a short initial opioid prescription. Some patients needed opioids longer and that treatment should be tailored to individual needs.

Leftover Pills and Opioid Addiction Risk

About 67% of participants reported having leftover opioids. The study documented that surplus but did not track what happened to it.

That distinction matters. Unused opioids sitting in homes create routes to diversion, accidental ingestion by children, and unsupervised use later by the patient or someone else. The FDA has previously noted that studies of post-surgical prescribing commonly find a majority of dispensed tablets go unused.

The practical response is unglamorous. One simple way to decrease the risk of addiction is to ask for the smallest quantity that covers the worst days, store it securely, and dispose of the rest.

Those Who Kept Using Longest

Roughly 10% of participants continued using opioids for at least 90 days. Persistence was highest among those who reported frequent pain in the six months before enrolling.

Prolonged use isn’t the same as opioid addiction, and the study diagnosed no one. It measured how long people took medication, not who developed a disorder. Extended use is, however, a recognized signal that warrants clinical attention rather than an automatic refill.

The findings are descriptive and can’t establish cause and effect. Treatment data came from patient self-report rather than confirmation against pharmacy or health records. Enrollment was complicated by the COVID-19 pandemic and by technical problems linking patient accounts to health records. The study also didn’t compare opioids against nonopioid treatment head to head.

Harm Reduction and Treatment Options

Naloxone reverses an opioid overdose and works within minutes. Fentanyl test strips can detect fentanyl in a supply, though not how much is present.

Medication for opioid use disorder, including methadone, buprenorphine, and naltrexone, reduces overdose death. 

Peer support is a complementary path. Narcotics Anonymous meetings are free and require no insurance, referral, or diagnosis, and many people use medication and peer support together.

NA Fights Opioid Addiction

To dispose of leftover medication, the Drug Enforcement Administration maintains a year-round collection site locator, and many pharmacies accept returns.

If you want support, feel free to browse our directory to find NA meetings by state and city, including online and Spanish-language options. For those seeking treatment, call 800-934-1582(Sponsored) and ask our experts specifically about medications and whether it continues after any inpatient stay.

For years, the working assumption in overdose prevention was that injecting carried the highest risk and that moving away from it lowered that risk. A new analysis of people affected by heroin addiction in Baltimore complicates the picture. It found no evidence that any one route of use was riskier than another. In this case, higher overdose odds correlated with using several routes during the same period.

The study matters because the way folks in the United States use opioids has changed sharply since 2020. Even though states like Maryland feature a wide range of addiction treatment programs, from inpatient care in modern facilities to local Narcotics Anonymous chapters, the shifting drug scene continues to take its toll on residents and their families.

The Opioid Crisis in Baltimore

Drug overdoses have caused more than one million deaths in the United States since 1999, according to the Centers for Disease Control and Prevention. Despite efforts and funding to lower overdose numbers, the rates remain near historic highs.

The mix has shifted underneath those totals. Multiple studies documented a move away from injecting and toward smoking and nasal inhalation starting during the COVID-19 pandemic. By 2022, CDC data showed smoking-related overdose deaths had passed injection-related overdose deaths.

The Baltimore Study’s Findings

Researchers used the ALIVE cohort, a community-recruited study of adults in Baltimore who have a history of injecting drugs. Participants attend visits twice a year and report their drug use over the previous six months.

The heroin analysis covered 1,121 participants across 4,396 study visits. Of those visits, nearly 890% were from adults aged 40 to 79, 33% by women, and 77% by Black participants. Past-six-month overdose was reported at 11.6% of visits.

Injection alone was the most common pattern at 34% of visits, followed by injection with nasal inhalation at 29% and nasal inhalation alone at 28%. All three routes together accounted for 4%.

Using all three routes associated with higher overdose odds than injecting alone, with an adjusted odds ratio of 2.37. Compared with nasal inhalation, the adjusted odds ratio was 2.87. Using both injection and nasal inhalation associated with higher odds than just nasal inhalation, at 1.78. The authors reported similar patterns for cocaine.

The Design Matters Regardless of Location

Earlier research on this question was largely cross-sectional. This means it compared different people at a single point in time. That approach cannot separate the effect of a route from everything else that differs between people, including which drugs they use, how often, and at what potency.

This analysis instead looked at within-person change. It asked whether the same participant had different overdose odds during periods when they used drugs differently. This was the first study to examine the relationship this way in a longitudinal, community-recruited sample.

The finding doesn’t offer a direct proof of cause. It’s also based on one cohort in one city whose participants all have a history of injecting, even as the overdose rates in Maryland have fallen from its peak. It shouldn’t be read as guidance for any individual.

Fentanyl’s Role in the Shift

The authors situate their work against a changing drug supply. Fentanyl became more common in non-injection formulations before and during the pandemic. Xylazine emerged as a contaminant. Harm reduction services, routine health care and treatment access were all disrupted.

Fentanyl’s presence means the contents and strength of a given supply are frequently unknown to the person using it. That unpredictability partly explains why the authors treat unfamiliar or shifting use practices as worth studying.

Opioids and How to Handle Overdose

Opioid classifications include heroin, fentanyl and prescription meds. They act on receptors in the brain and spinal cord that regulate pain, and at high enough doses they slow or stop breathing, which is what makes an overdose fatal.

Naloxone, sold under brand names including Narcan, reverses an opioid overdose by displacing opioids from those receptors. It is available over the counter and works within minutes.

Harm reduction programs supplying sterile equipment for drug administration may help people who use drugs reduce overdose risk. That is their recommendation based on these findings, and approaches to equipment distribution vary by state and locality.

Beyond equipment, medication for opioid use disorder remains the most established treatment for heroin addiction. Buprenorphine and methadone reduce withdrawal and cravings by acting on the same receptors, and naltrexone blocks opioid effects after withdrawal is complete. These medications are typically paired with counseling.

Peer support runs alongside treatment rather than replacing it. Narcotics Anonymous meetings give people in recovery from heroin addiction and other opioid use disorders regular contact with others working through the same thing, and meetings are free to attend.

NA a First Defense Against Heroin Addiction

If you or someone close to you is dealing with heroin addiction or another opioid use disorder, several steps are available now.

• Get naloxone and keep it accessible. Pharmacies stock it over the counter, and many local harm reduction programs distribute it at no cost.
• Ask about fentanyl test strips, where they’re legal and available.
• Contact an opioid treatment program or a buprenorphine prescriber to discuss medication options.

Our online directory lists NA meetings by state and city, with filters for meeting type and virtual options. You can find something nearby without waiting for an appointment. Feel free to browse our listings or call 800-934-1582(Sponsored) to speak with an expert.

The leader of an international drug trafficking organization operating through Southern California was sentenced on July 9 to 240 months, or 20 years, in federal prison. 

For people living with narcotic addiction and the families around them, it’s a reason to celebrate. To be sure, The Golden State offers a wide breadth of programs ranging from inpatient care to grassroots Narcotics Anonymous programs to combat substance misuse. However, cases like this one shape the illicit supply without changing the day-to-day work of finding treatment and staying safe.

The Court’s Findings

United States District Judge John A. Kronstadt sentenced Guramrit Sidhu in the Central District of California. Sidhu pled guilty on March 26 to one count of engaging in a continuing criminal enterprise. That charge, brought under the federal statute known as the kingpin statute, applies to those who organize or supervise a large-scale drug operation rather than simply participate in one.

Under his plea agreement, Sidhu led an organization that trafficked drugs out of the United States between September 2020 and February 2023. Over six weeks from mid-September to October 2022, he orchestrated eight separate drug loads totaling approximately 1,150 pounds of methamphetamine and 765 pounds of cocaine. Law enforcement seized all of it. Prosecutors estimated the wholesale value at roughly $15 million to $17 million.

After purchasing bulk quantities in the United States, Sidhu arranged transport by long-haul semi-truck across interstate highways. Couriers used phone numbers and currency serial numbers as identifying tokens during handoffs.

Sidhu came into federal custody in October 2024 after the Justice Department’s Office of International Affairs secured his extradition. He’s the eighth defendant in this case to plead guilty thus far. Others received federal prison terms ranging from 27-108 months.

The investigation involved the FBI, the Los Angeles Police Department, the Los Angeles Interagency Metropolitan Police Apprehension Crime Task Force, federal authorities, and international law enforcement partners.

Stimulants in the Current Supply

Methamphetamine and cocaine are stimulants. They increase alertness, heart rate, and blood pressure, and they carry their own overdose risk, which can present as chest pain, agitation, seizures, hyperthermia, or stroke rather than the slowed breathing seen with opioids.

Stimulant use disorder doesn’t currently have an FDA-approved medication comparable to methadone or buprenorphine for opioid use disorder. Treatment relies on behavioral approaches, contingency management and peer support. That’s one reason support groups matter so much for people recovering from stimulant use.

A separate and important point: the loads described in this case were methamphetamine and cocaine. Court documents don’t describe fentanyl in these seizures, and nothing here should be read as saying otherwise. Nationally, however, fentanyl contamination of the stimulant supply remains a documented risk, which is why the harm reduction guidance below applies to stimulants and not just opioids.

Enforcement in Action

Large seizures remove products from the market and can disrupt distribution networks. But they don’t reduce the number of people who wake up tomorrow with cravings, withdrawal, or a use disorder they want help with. Supply disruption can also push the illicit market toward substitutes of unknown or mixed composition.

Even though the number of fentanyl cases in LA County has declined in recent years, residents need to stay vigilant lest an addiction or overdose strike. If you or someone you care about is using stimulants or opioids, the next step is the same today as it was last week.

NA Fights Narcotic Addiction

Recovery paths vary and none of them require choosing just one. Options include:

• Medically supervised detox and inpatient or outpatient treatment
• Medication for opioid use disorder, including methadone, buprenorphine, and naltrexone, where clinically appropriate
• NA meetings, including open, closed, virtual and Spanish-language formats
• 988 Suicide and Crisis Lifeline for anyone in crisis

NA remains a free, confidential and easy-to-join way to fight addiction. Local chapters dot the landscape nationwide. To find one, simply browse our directory or call 800-934-1582(Sponsored) to speak with an expert about treatment options for narcotic addiction.