heroin cocaine addictive opioids

New neuroscience research is sharpening what addiction specialists already understood about opioid addiction and drug dependence more broadly. Not all opioids carry the same addiction risk. Heroin and cocaine remain more addictive than other opioids in terms of their grip on the brain’s memory and reward circuitry, even though opioids overall remain the deadliest class of drugs due to overdose risk. 

For people living with opioid addiction or supporting loved ones who’re battling addiction, the findings help explain why relapse can happen even after long periods of sobriety and how treatment must address the brain, not just willpower.

Opioid Crisis Continues

Addiction psychiatrist Dr. Mark Golda and his team ranked illegal drugs specifically by addiction liability. They found that heroin placed highest among all of them, including other opioids, with cocaine and methamphetamine close behind. 

Separately, when researchers looked at overall harm, including toxicity, mental impairment, and harm to others, alcohol ranked as the most harmful legal drug, while heroin and cocaine ranked highest among illegal drugs for harm to individuals. Opioids as a class remain the drugs most likely to cause immediate death through overdose, even when specific opioids like heroin don’t top every ranking category.

Persistent Cravings and Relapse

It all comes down to molecular biology to explain why cravings persist for months or years after someone quits drugs. A transcription factor called ΔFosB accumulates in the brain with repeated drug exposure and can persist for weeks, unlike most gene regulators that clear within hours. 

This buildup isn’t unique to any single drug. In fact, a shared molecular signature across many addictive substances, including opioids, reshape the brain’s memory and reward circuitry in ways that make certain environmental cues, a place, a person, a smell, capable of triggering intense cravings long after physical withdrawal has ended.

Researchers point out that cravings aren’t just about willpower or personal weakness. Substance use disorder is increasingly understood as a chronic brain disease driven by pathological changes in neural circuitry, not moral failings. Even survivors of opioid overdose remain at elevated risk of dying in the year that follows should they relapse, a sobering reminder that overdose alone doesn’t always motivate a change in drug use.

Options for Opioids and Overdose Risk

Heroin’s particularly high addiction liability compared to other opioids doesn’t make prescription opioids safe by comparison. To be clear, all opioids carry real dependence and overdose risk. 

Naloxone, often sold as Narcan, can reverse an opioid overdose in progress. Naloxone remains among the most important tools available for preventing opioid deaths regardless of which opioid is involved.

Since relapse ties in with durable brain changes rather than a lack of willpower, harm reduction and medication-assisted treatment both play a critical role in recovery from opioid addiction. Prescriptions like buprenorphine and methadone help stabilize brain chemistry disrupted by chronic opioid use, giving people a more manageable path toward recovery.

Peer support also plays an important role for many people recovering from opioid and other drug addictions. Narcotics Anonymous meetings offer a place to connect with others who understand the day-to-day reality of staying in recovery.

NA Still a Top Option to Fight Opioid Addiction

If you or someone you love struggles with opioid addiction, help is available regardless of how long the addiction has lasted or how many times a previous attempt at quitting has not worked out.

Some folks find their first NA meeting overwhelming, but they quickly realize that they’re among colleagues who understand their experiences and don’t judge. Meetings are free, confidential and form fellowship that lasts a lifetime.

Get started. You can call 800-934-1582(Sponsored) to speak with an expert or browse our directory for chapters located anywhere in the U.S.

urine tests xylazine fentanyl

Nearly 17% of people testing positive for fentanyl also test positive for xylazine, a veterinary sedative with no approved use in humans, according to a national study of urine drug tests. The number is climbing, especially in parts of the country where xylazine barely showed up just two years ago.

The Opioid Crisis in Wastewater

Researchers analyzed 42,307 urine drug tests collected from patients in primary care, behavioral health, and substance use treatment settings between March 2023 and September 2025. All tested positive for fentanyl. Of those, 7,156 samples, or 16.91%, also tested positive for xylazine.

The trend lines tell the real story. In the Eastern United States, where xylazine has circulated for years, positivity climbed from 11.11% to 19.63% over the study period. The numbers peaked at 42.31% of samples in a single month. 

In the West, where xylazine essentially had no presence at the start of the study, positivity rose from 0% to 13.46%. It’s a sign that the drug has actively spread into markets that hadn’t seen it before.

Testing also found that people whose samples tested positive for heroin were more than twice as likely to also test positive for xylazine. Higher fentanyl concentrations also strongly linked to higher odds of xylazine detection. In other words, xylazine doesn’t show up at random. It travels with the heaviest exposure to other substances.

Driving the Trend

Interestingly, while more people test positive for xylazine, the actual concentration found in positive samples has dropped. In eastern states like New York, median xylazine levels fell sharply after an early 2023 peak. Researchers think manufacturers and distributors may be adjusting how much xylazine they mix into fentanyl, whether in response to reports of severe skin wounds and prolonged sedation, or because new state laws and restrictions on veterinary xylazine supplies make it harder to source in bulk.

That’s a mixed signal for people who use drugs. More positive tests means more people are being exposed to xylazine somewhere in their supply, even if any individual dose tends to be smaller than it once was.

Fentanyl’s Role

Fentanyl remains the driver of the opioid crisis, and this study only counted samples where fentanyl was already present. Now, xylazine rides along inside a fentanyl supply that’s already dangerous. Since xylazine isn’t an opioid, naloxone doesn’t reverse its sedative effects, so more people testing positive for both drugs together matters for how overdoses get treated on the ground.

Researchers also flagged medetomidine, a chemically similar veterinary sedative. Medtomidine is starting to show up as a possible replacement for xylazine in some markets, but wasn’t part of this study’s testing panel. That means the true scope of veterinary sedatives mixed into the fentanyl supply right now may be larger than these numbers capture.

Harm Reduction and Treatment Works

People who use drugs have a practical takeaway. A fentanyl test strip might confirm fentanyl but says nothing about what else it contains. Xylazine-specific test strips exist and are increasingly available through harm reduction programs, though access still varies by state and city.

Naloxone remains essential and should be carried by anyone using opioids or spending time with someone who does. Since xylazine keeps a person sedated even after naloxone reverses the opioid component of an overdose, calling emergency services after administering naloxone matters more than ever when xylazine exposure is a possibility.

Medication for opioid use disorder (MOUD), including methadone and buprenorphine, remains a first-line treatment option regardless of what adulterants are present in someone’s supply. 

Narcotics Anonymous meetings also offer ongoing peer support for people building a recovery plan around opioid use, whether or not they are using MOUD alongside it.

NA Still a Top Option

NA meetings remain a critical first step to recovery, from either fentanyl or any other substance. Meetings are free, confidential, and build fellowship that lasts a lifetime, through the good times and bad.

Getting started is easy. Just dial 800-934-1582(Sponsored) to speak with an expert about local opioid addiction treatment options. Or browse our directory to find chapters anywhere across the United States.

Federal drug agents say Interstate 25 remains a primary route for cartel-linked fentanyl trafficking through Wyoming, even as the state posts a significant drop in fentanyl overdose deaths compared with last year.

Fentanyl Seizures Already Exceed Last Year’s Total

Speaking in Cheyenne, U.S. Attorney Darin Smith and Drug Enforcement Administration officials said Wyoming has already seized nearly 6,000 fentanyl pills so far this year, surpassing the roughly 5,500 pills confiscated during all of 2025.

DEA Rocky Mountain Field Division Special Agent in Charge David Olesky said I-25, which connects Cheyenne, Casper, and Sheridan, remains a key transportation route for cartel-led trafficking organizations moving fentanyl, methamphetamine, cocaine and heroin through the state.

Federal officials said nearly all illicit fentanyl entering the country is manufactured by Mexico’s Sinaloa and Jalisco cartels using precursor chemicals shipped from China, then trafficked north through established smuggling corridors that reach states like Wyoming. Much of what circulates locally moves through distribution hubs in Denver and Salt Lake City before reaching Wyoming communities.

Overdose Deaths Are Down, but Risk Remains

Even with more fentanyl moving through the state, Wyoming recorded 54 opioid-involved fentanyl overdose deaths last year, down from 84 the year before, a decline of about 35 percent.

DEA laboratory testing now shows roughly three in every ten counterfeit pills seized nationwide contain a potentially lethal dose of fentanyl, down from about seven in ten in previous years.

Olesky cautioned that the improving trend does not mean people can let their guard down. “My number one advice to all is: don’t take a pill that doesn’t come directly from a licensed pharmacy and based on a prescription from your doctor,” he said.

Smith said Operation Take Back America has strengthened cooperation between local, state, and federal agencies to identify and prosecute drug traffickers operating in Wyoming, and that prosecutors intend to use every available resource to hold traffickers accountable, whether they are using the state’s highways, the mail, or stash houses to move narcotics.

Understanding Fentanyl and Naloxone

Fentanyl is a synthetic opioid up to 50 times stronger than heroin, and even a small miscalculation in dosage can cause a fatal overdose. Counterfeit pills made to look like prescription opioids or other drugs frequently contain fentanyl without the buyer’s knowledge, which is why federal officials continue to warn against taking any pill that did not come directly from a pharmacy with a valid prescription.

Naloxone, sold under brand names including Narcan, can reverse an opioid overdose within minutes when administered promptly and is available without a prescription in most states.

Fentanyl test strips, which can detect the presence of fentanyl in a substance before use, are another harm reduction tool that public health officials increasingly recommend alongside naloxone access.

Harm Reduction and Treatment for Opioid Addiction

Laramie County Sheriff Brian Kozak said his deputies have made 186 drug-related arrests so far this year and credited partnerships with the DEA and Wyoming Division of Criminal Investigation with helping connect people struggling with addiction to treatment programs when they are willing to seek help.

Whether someone is using fentanyl, heroin, or another opioid, medication-assisted treatment combined with peer support through Narcotics Anonymous meetings can significantly improve the odds of sustained recovery.

Finding Help for Opioid Addiction in Wyoming

Anyone in Wyoming struggling with opioid use can search Narcotics.com’s directory to find NA meetings to receive recovery support.

Naloxone distribution programs and fentanyl test strips are increasingly available through local harm reduction organizations across the state. Call 800-934-1582(Sponsored) for opioid addiction treatment options and referrals.

opioid crisis

Physician prescribing practices, not just pharmaceutical marketing, played a critical role in fueling the nation’s opioid crisis, according to new research from the University of Notre Dame that adds important context to the ongoing opioid addiction epidemic.

The Opioid Crisis by the Numbers

Economists William Evans and Ethan Lieber, both from Notre Dame’s Department of Economics, analyzed National Ambulatory Medical Care Survey data from 1980 through 2015 and found that opioid prescribing for chronic pain shifted dramatically after 1995.

Before that year, about 7 percent of patient visits for conditions likely to cause chronic pain resulted in an opioid prescription. By 2015, that figure had climbed to 25 percent.

The researchers’ modeling suggests opioid-related deaths in 2015 would have been roughly 43 percent lower had 1995 prescribing levels held steady.

The study, published in the Journal of Human Resources, also found that counties with higher rates of Social Security Disability Insurance enrollment, a marker of higher chronic pain burden in a population, experienced disproportionately severe drug poisoning crises.

What’s Driving the Change

The shift traces back to 1995, when medical experts released a statement encouraging wider use of opioids to treat chronic pain. Physicians responded by prescribing far more aggressively over the following two decades.

Much of the public conversation and opioid litigation in recent years has focused on pharmaceutical marketing, and the researchers say their findings show that prescribing decisions by physicians themselves were also a major factor, separate from advertising campaigns.

According to the CDC, roughly 860,000 people in the United States have died from an opioid overdose since 1999, including nearly 318,000 deaths linked specifically to prescription opioids.

In 2024, opioids were involved in 73.4 percent of drug overdose deaths, and illegally manufactured fentanyl accounted for 65.1 percent of those opioid deaths, reflecting how the crisis has shifted from prescription pills toward illicit fentanyl over time.

Understanding Opioids and Overdose Risk

Opioids include prescription medications like oxycodone and hydrocodone as well as illicit drugs like heroin and fentanyl. All opioids carry overdose risk, which increases sharply when they are combined with other substances or when tolerance drops after a period of abstinence, such as after detox or incarceration.

Naloxone, sold under brand names like Narcan, can reverse an opioid overdose in progress and is available without a prescription in most states.

Harm Reduction and Treatment for Opioid Addiction

Regardless of how someone became dependent on opioids, whether through a legitimate prescription that grew into dependence or through illicit use, medication-assisted treatment with methadone, buprenorphine, or naltrexone remains the most evidence-based path to recovery.

Naloxone access and fentanyl test strips can reduce overdose deaths in the meantime, and NA meetings offer peer support for people at any stage of recovery from opioid or other drug addiction.

Finding Help for Opioid Addiction

Anyone whose opioid use started with a legitimate prescription and grew into something harder to control is not alone, and this pattern is common enough that researchers can trace it in national prescribing data.

Narcotics.com’s meeting directory can help people find NA meetings for peer support, and treatment referral options are available for anyone ready to explore opioid use disorder treatment, including medication-assisted treatment.

louisiana inmates overdose

Four inmates at the West Baton Rouge Parish Jail in Louisiana received Narcan after a suspected overdose inside the facility’s booking area, according to the West Baton Rouge Sheriff’s Office. Authorities expect all four to recover. 

To be sure, Louisiana has many programs and harm reduction services to assist anyone who experiences an overdose. However, the incident in Baton Rouge represents the growing problem that corrections officials across the country struggle to contain. Synthetic drugs and other narcotics are finding their way past security and into the hands of people already in custody.

Tragedy at the Jail

According to Major Kevin Devall, the sheriff’s office’s Chief of Criminal Operations, the overdoses happened after a work-release inmate allegedly brought a substance known as Mojo into the jail. Mojo is a synthetic cannabinoid, sometimes described as similar to K2 or Spice, that users can spray onto paper and later smoked or ingested. This method of consumption makes Mojo difficult to detect through standard screening.

Devall relayed that they found the inmate intoxicated at a job site and returned him to the jail, where he went through a search and a body scanner. That’s when authorities discovered the inmate smuggled the drug in on paper. After the overdoses, prison officials took two affected inmates to the hospital by Acadian Ambulance, and two more via the West Baton Rouge Fire Department. The sheriff’s office says they’re reviewing and updating its screening procedures to prevent similar incidents.

A Problem Facing Jails Nationwide

Devall told local reporters that the challenge of keeping synthetic drugs out of correctional facilities is not unique to West Baton Rouge Parish. Jails and prisons around the country have reported similar incidents involving drugs soaked into paper, mail, or other everyday items that can slip past conventional contraband screening. 

Synthetic cannabinoids in particular are difficult to detect because their chemical makeup changes frequently, and standard drug tests are not always designed to catch every variant.

Looking at Synthetic Cannabinoids and Overdose Risk

Synthetic cannabinoids like Mojo, K2, and Spice are lab-made chemicals sprayed onto plant material or paper to mimic the effects of marijuana, but they’re not chemically related to THC. Cannabinoids can produce far more unpredictable and dangerous effects, including seizures, rapid heart rate, psychosis, and loss of consciousness. Since manufacturers create these drugs without any quality control, potency varies wildly from one batch to the next. This raises overdose risk even for people who believe they know what they are taking.

Narcan, also known as naloxone, is most effective at reversing opioid overdoses. In prisons, first responders and jail medical staff frequently administer naloxone any time a suspected overdose scenario presents itself, particularly if they don’t know the substance involved or the person’s history of use. Using Narcan as the first option reflects standard precautionary emergency response rather than a confirmed opioid presence.

Harm Reduction and Treatment Behind Bars

Correctional facilities face a unique set of harm reduction challenges. Those incarcerated often lack access to substance use treatment, naloxone education or peer recovery support compared to people outside. 

In Louisiana, advocates for people with substance use disorders continue to push for expanded access to overdose prevention education and medication assisted treatment. People in jail are often at their most vulnerable and fall prey to temptations and triggers. 

Narcotics Anonymous meetings inside jails and prisons remind inmates that their loved ones and the public still care. Proponents argue that incarceration is often a missed opportunity to connect people with care rather than just a consequence.

NA for Those in Incarceration

Whether you or someone you love faces incarceration, has recently released, or simply wants support, NA meetings and structured treatment programs exist. Enroll in one to help build a life without narcotic addiction. 

Start today. Call 800-934-1582(Sponsored) to find NA meetings or opioid and drug addiction treatment programs anywhere in the country. Receive information on treatment programs that address both drug dependence and the circumstances, like incarceration, that often complicate recovery. You can also browse our directory to see listings organized by location.

prenatal opioid exposure school

A new study finds that prenatal opioid exposure has far less influence on a child’s school performance than previously believed, once researchers accounted for factors like school quality, family income, and a mother’s education level. 

For families affected by opioid use, this study is one of the more encouraging findings to come out of neonatal abstinence syndrome (NAS) research in recent years.

The Study’s Findings

Every 25 minutes in the United States, a baby is diagnosed with NAS, a condition where infants exposed to opioids in the womb develop withdrawal symptoms after birth. Researchers at Penn State College of Medicine compared standardized test scores for 3,494 students in grades three through eight, 23% of whom had a history of NAS and 77% of whom didn’t, using an integrated data system from South Carolina that links health, education, and socioeconomic records over time.

After controlling for age, sex, and socioeconomic factors, the two groups performed similarly on English and language arts tests. In math, students with a history of NAS showed a small but statistically significant drop compared to the control group. Overall, both groups scored below the state average at every grade level.

“Historically, we’ve been quick to blame prenatal opioid exposure for poor academic achievement, but it appears that socio-environmental factors play a much larger role,” reported Dr. Tammy Corr, a corresponding author and associate professor of pediatrics at Penn State. Corr optimistically added, “There’s every reason to believe that these children can do well and thrive when given the right resources.”

Driving the Trend

More than 30% of the children in the study were born to a mother with less than a high school degree, and 85% were either uninsured or covered by Medicaid at birth. The researchers found these markers of socioeconomic status more strongly linked to academic performance than NAS history itself. Attending a lower-rated school, limited access to early childhood education, and participation in the WIC nutrition program all played a larger role in outcomes than opioid exposure alone.

In the study, children of non-Hispanic Black mothers scored a grade level lower than their non-Hispanic white counterparts. Test scores rose as maternal education levels increased. Researchers say the South Carolina data, while state-specific, reflects socioeconomic and environmental patterns similar to those seen in NAS studies elsewhere in the country.

Neonatal Abstinence Syndrome

NAS occurs when a baby exposed to opioids before birth experiences withdrawal after delivery, usually because of drugs the mother took during pregnancy. Earlier research had linked prenatal opioid exposure to increased risk of developmental, cognitive, and behavioral difficulties in early childhood, but this study tracks outcomes into the school years while accounting for the broader circumstances these children grow up in.

Researchers plan to build on the findings with interviews of parents and guardians of school-aged children with a history of NAS. They want to understand the day-to-day experiences that help or hinder academic success.

Harm Reduction & Treatment During Pregnancy

For pregnant people using opioids, medically supervised care, including medication-assisted treatment, remains the safest path for both parent and baby, by reducing the risks associated with unsupervised withdrawal. This study doesn’t change that guidance. 

Instead, it reinforces that a child’s long-term outcomes depend heavily on the support systems available after birth. Stable housing, early childhood education, nutrition assistance and the mother’s own access to continued care and recovery resources all play critical roles for a healthy future.

Starting with NA

If you’re pregnant or parenting and affected by opioid use, treatment programs exist that address both recovery and family stability.

The easiest step–and a free one–is to sign up with Narcotics Anonymous. NA meetings offer peer support at every stage of recovery, and case management services can help connect families to WIC, early childhood education, and other resources shown to matter for a child’s long-term success.

Getting started is simple. Call 800-934-1582(Sponsored) and speak with an expert or browse our directory to find NA chapters anywhere in the USA.

overdose death prosecutions

Pennsylvania is a national leader in prosecuting people who supply the drugs involved in a fatal overdose, and a new investigation shows the practice has led to hundreds of prison sentences even as families who have lost loved ones to opioid addiction remain deeply divided over whether it helps.

The Charge, Explained

The charge is known as drug delivery resulting in death, a felony punishable by up to 40 years in prison. It applies whenever someone illegally provides drugs, whether by selling or simply giving them, that cause a fatal overdose.

The statute does not distinguish between large-scale dealers, street-level sellers, or a fellow person who uses drugs and shared them with a friend.

Its modern use traces to a 2011 change in Pennsylvania law that removed a requirement to prove malice in these cases. Data from the Pennsylvania Commission on Sentencing, which historically captures data on about 95% to 98% of all cases from common pleas courts, shows the law was rarely used at first.

From 2007 through 2011, not a single person was convicted and sentenced on the charge. As Pennsylvania’s opioid crisis deepened, with more than 5,000 overdose deaths recorded in some years, prosecutors increasingly turned to the charge, and convictions reached a recent annual high of around 100 in 2019.

Why the Numbers by County Vary Widely

Prosecution rates differ significantly from county to county, and compared with the overall number of overdose deaths statewide, charges and convictions remain relatively uncommon.

Whether a case results in prosecution often depends on how local law enforcement approaches drug deaths and what resources are available to investigate them, rather than any single statewide standard.

Families Who Support the Charge

Some families who have lost a loved one to a fatal overdose have become advocates for using and even expanding these prosecutions. Cyndi Compton, whose 24-year-old son Isaiah died of an overdose in Tioga County in 2020, spent years pushing for accountability after learning the two-year statute of limitations had run out before a charge could be filed in his case.

Her advocacy helped fuel legislative proposals that would extend the statute of limitations from two years to five, or eliminate it altogether for these prosecutions. State Rep. Dane Watro, who backs extending the timeline, has said the current limit “has hampered the prosecution of various serious cases.”

Families Who Oppose It

Other families who have experienced the same loss have reached the opposite conclusion. Susan Ousterman, a national drug policy advocate whose son died of an overdose, said she briefly considered pursuing charges against the person who supplied the drugs before deciding against it.

“I knew that the person that gave him the drugs was no different than him,” she said. Ousterman and others have written to Pennsylvania’s governor raising concerns about criminalization as a response to the opioid crisis.

“Prosecuting drug-induced homicide cases does not deter supply, it pushes the drug market further underground, making substances even more unpredictable and deadly,” they wrote.

Advocacy groups including the Public Defender Association of Pennsylvania have also opposed expanding the law, arguing that these prosecutions frequently target family members, friends, or partners who may themselves have a narcotics addiction rather than large-scale traffickers.

State Rep. Emily Kinkead has raised similar concerns, telling reporters that unless lawmakers narrow the law’s scope to specifically target dealers and traffickers, extending the statute of limitations further would be “irresponsible and dangerous.”

What This Means for Families Affected by Opioid Addiction

Multiple proposals extending or eliminating the statute of limitations for these prosecutions remain pending in the Pennsylvania legislature.

Whatever the legal outcome, families dealing with a loved one’s opioid addiction or the aftermath of an overdose death face a genuinely contested question with strong arguments on both sides, and no single national consensus on which approach reduces future deaths.

Harm Reduction and Treatment Resources

Regardless of how the legal debate resolves, harm reduction tools remain a proven way to prevent overdose deaths in the first place. Naloxone can reverse an opioid overdose when used quickly, and fentanyl test strips can help people identify unexpectedly potent supply.

NA meetings offer peer support for people working toward recovery from opioid or other drug addiction, and medication-assisted treatment using methadone or buprenorphine is an evidence-based option for opioid use disorder. Find NA meetings near you or call 800-934-1582(Sponsored) for information on opioid addiction treatment options in your area.

clark county fatal overdoses

Most fatal drug overdoses in Clark County, Nevada, happen behind closed doors, not on the street, according to new data from the Southern Nevada Health District. Even though Nevada features a wide range of inpatient care centers and local Narcotics Anonymous chapters for community members, the data shows that people still fall through the cracks. Now, the finding can reshape how public health officials think about opioid addiction and overdose prevention in the Las Vegas area.

The Opioid Crisis Around Las Vegas

“Inside residences, by far, that’s where most of the drug overdoses occur,” Brandon Delise, a senior epidemiologist with the Southern Nevada Health District, relayed. Delise observed a common misconception that most overdoses happen outdoors or in public spaces, but the data points the other way.

The findings come from a project the health district launched to understand why The Silver State has been slower than the rest of the country to bring down fatal overdoses. According to the health district’s advisory board, the United States has seen a 15.9% reduction in fatal drug overdoses, compared to just a 2.2% reduction in Nevada over the same period.

Clark County overdose deaths climbed sharply after 2020, when the county recorded 560 deaths. That number rose to 802 in 2024 before falling to 714 in 2025, the first decline in the current data. Delise reported some progress, but fatalities remain well above 2020 levels.

Driving the Trend

Delise identified fentanyl and methamphetamine as the two substances most responsible for Clark County’s overdose deaths. Deaths involving illicit fentanyl and other synthetic opioids rose from 193 in 2020 to 454 in 2024, before dropping to 421 in 2025. Methamphetamine-related deaths followed a similar arc, climbing from 250 in 2020 to 455 in 2024 and fell to 381 in 2025.

To understand these patterns better, the health district deployed a team in May 2026 to interview people at risk of overdosing and service providers directly. They wanted to understand drug use patterns, demographics and whether folks at risk knew about or had access to harm reduction supplies.

Delise also pointed to a lag effect that may help explain why Nevada trails the national trend. Shifts in the opioid supply that show up nationally often don’t reach Nevada until years later. The health district has observed this pattern repeatedly as new synthetic narcotics appear and the drug supply changes over time.

Harm Reduction & Treatment Options

The health district has leaned heavily on naloxone distribution as part of its response. Delise pointed out that Southern Nevada distributed more than 200,000 free doses of naloxone in 2025 alone. He credited the scale-up for bringing down the area’s overdose death rate.

Naloxone reverses the effects of an opioid overdose within minutes, but doesn’t treat the underlying opioid addiction that leads to repeated overdose risk. 

Medication-assisted treatment (MAT) options remain the most evidence-based approach for people with opioid use disorder. Clinicians often pair MAT with counseling and peer support such as NA meetings.

Because most fatal overdoses in Clark County happen inside homes, the health district’s data suggests that having naloxone on hand at home, and making sure family members or roommates know how to use it, may matter as much as public-facing distribution programs.

NA for Opioid Addictions in Las Vegas & Beyond

Despite federal funding cuts affecting other jurisdictions, the Southern Nevada Health District’s funding for overdose prevention has remained intact. This means cost shouldn’t be a barrier for Clark County residents seeking naloxone or information about treatment.

Anyone in Clark County concerned about their own opioid addiction or a loved one’s fentanyl use can attend their first NA meeting in Las Vegas and the surrounding area, as well as opioid treatment programs  that offer MAT and free harm reduction supplies.

No matter where you’re located, these options exist. Get started by calling 800-934-1582(Sponsored) for opioid addiction treatment options if you or someone you know needs help. Our browsable directory also features NA groups all across the United States, searchable by location.

chicago drug trafficking charges

Federal officials in Chicago say a 60-day, 11-agency operation resulted in drug trafficking and other charges against 179 people, the arrest of 305 fugitives, and the recovery of 24 children who had been kidnapped or reported lost. Named Operation New Dawn, the effort is being cited by prosecutors as evidence of what coordinated enforcement can accomplish against narcotics trafficking and other violent crime in a single metro area.

The sting comes at a time when the number of opioid overdose deaths trend downward. Illinois has taken a lead in the crusade by offering an abundance of residential treatment programs and local Narcotics Anonymous chapters at the community level. Nevertheless, many officials continue to urge vigilance and caution as street drugs continue to take its toll.

The Opioid Crisis in the Windy City

U.S. Attorney Andrew Boutros said his office has increased narcotics prosecutions by 24% so far this year compared with 2024, alongside a 154% increase in firearm charges. The dozens of new cases filed during the operation ranged from murder and kidnapping to firearm and drug trafficking offenses, reflecting how closely narcotics distribution networks tend to overlap with other violent crimes.

The good news is that the number of opioid-related deaths in Illinois has declined alongside the national average. Officials credit harm reduction programs, including making naloxone available at libraries and other public venues. Each dose can save a life, but health officials warn that as new illegal drugs hit the street, the trend may reverse at any moment.

The Increase in Narcotics Cases

Boutros described the joint effort, which combined agencies including the DEA, ATF, FBI, U.S. Marshals Service, and ICE, as an experiment in coordinated enforcement that hadn’t previously been tried at this scale in Chicago. Officials displayed seized guns, drugs, and cash at a news conference. They framed the rise in narcotics prosecutions as a direct result of pooling resources across agencies rather than a single agency working alone.

Drug trafficking charges typically target the distribution side of the supply chain inside and outside the country. Programs target people moving or selling large quantities of narcotics, rather than individuals struggling with substance use themselves. 

Enforcement operations like this one can disrupt supply in the short term, but public health researchers generally note that treatment access and harm reduction measures work alongside enforcement to reduce overdose deaths, rather than replacing the need for it.

Harm Reduction and Treatment Still Matter

For individuals and families affected by the drug trade in Chicago, whether as someone who uses drugs or as a loved one of someone who does, the sting may have saved the life of someone close. However, enforcement actions don’t address the underlying need for treatment. 

Naloxone access, fentanyl test strips, and medication-assisted treatment remain available regardless of law enforcement activity in a given area. NA meetings continue to offer peer support to anyone ready to seek it.

NA Often the First Step

Many folks take Narcotics Anonymous as their first step to recovery. Meeting peers in local community spaces, confidential support, and free resources make NA an indispensable force for lifelong recovery.

Anyone affected by narcotics use anywhere in the country, whether directly or through a family member can find an NA chapter in their neighborhood. Simply browse our directory for chapters organized by location or call 800-934-1582(Sponsored) to speak to an expert for additional treatment options.

fentanyl tolerance overdose risk

New research helps explain two things people in recovery from opioid use disorder have reported for years. Quitting fentanyl feels different, and relapse and overdose risk after time away from the drug is far more dangerous than people expect. 

A UCLA-led study finds that people who use illicit fentanyl daily in Los Angeles can build a tolerance to amounts that’s lethal for someone without that tolerance. That tolerance isn’t permanent, but explains why relapse after a period of abstinence is so often fatal. It also shows why folks who use fentanyl daily often have trouble starting medication for opioid use disorders, or MAT.

The Research Findings

The study was led by Drug Checking Los Angeles, a community-based public health program. It’s one of many centers out in The Golden State, which offers an impressive range of programs from inpatient care to local Narcotics Anonymous chapters.

Researchers analyzed the purity of more than 500 fentanyl samples tested between September 2023 and January 2026, then surveyed 47 people who reported using fentanyl daily or near-daily about their consumption patterns. The findings describe this specific group of frequent users, not fentanyl users as a whole.

Using morphine milligram equivalents (MME), a standard unit that lets researchers compare opioids of different strengths, the team calculated that this group of daily users consumed an average of about 8,887 MME per day. For context, the CDC considers 2 milligrams of fentanyl potentially lethal for someone with no opioid tolerance. Daily users in the study consumed roughly 60x that amount each day. Due to the tolerance built up through sustained daily use, they didn’t overdose at that level. That tolerance, built gradually, is the entire reason they could survive doses that would kill someone without it.

Raising Overdose Risk After Relapse

This is the main point for anyone in or near recovery: tolerance built through daily fentanyl use isn’t lethal for the person who built it, but it’s also not permanent. Tolerance begins dropping within days of stopping, whether that break comes from detox, incarceration, hospitalization, or completing a treatment program. If someone relapses and returns to the amount they used before stopping, that same amount can now be fatal because their body lost the tolerance that once made it survivable. 

This is one of the best-documented and most dangerous patterns in opioid overdose deaths. The study’s data on just how extreme fentanyl tolerance can become shows why the drop after even a short break risks your life.

Complicating Treatment

The same tolerance pattern has direct implications for anyone trying to start MAT. Buprenorphine is an effective medications for treating opioid addiction but can trigger precipitated withdrawal, a sudden and severe withdrawal reaction, if it’s started too early or at too low a dose for someone with this level of built-up tolerance. Clinicians have increasingly moved toward faster, higher-dose buprenorphine induction protocols specifically because standard low-dose approaches didn’t account for tolerance levels like the ones documented in daily users in this study.

Chelsea Shover, the study’s senior author and an associate professor at UCLA, relayed even a less pure fentanyl supply in other regions would still produce dramatic tolerance levels among daily users. “It’s no longer ‘how do we treat someone who smokes a gram of fentanyl per day,’ it’s ‘how do we treat someone using thousands of MMEs of oral morphine in fentanyl per day,'” Shover noted.

Harm Reduction After Any Break From Use

Anyone who has stopped using fentanyl, for any reason and for any length of time, faces heightened overdose risk if they return to it. Naloxone can save a life by displacing opioids from receptors in the brain. But for someone whose tolerance has dropped, even a single dose is no longer strong enough. Using a smaller amount of drugs than before, avoiding using alone, and having naloxone on hand are basic protections during this specific window of risk.

Methadone remains available as an alternative for people who need a different approach than buprenorphine, particularly those for whom induction has been difficult. Both medications work, and neither is a lesser path than the other.

NA Meetings & Peer Support During Recovery

Starting treatment after daily fentanyl use and staying in recovery afterward is rarely accomplished alone. NA meetings can provide steady peer support both during a demanding induction period and in the vulnerable weeks after any break from use, when relapse overdose risk is highest. Meeting with others who understand this specific risk can make the difference between a slip and a fatal overdose.

If you or someone you love uses fentanyl daily, or is returning to use after any period of abstinence, seek out others who understand what you’re going through before the problem escalates. Remember that NA meetings are free and confidential, and the fellowship there offers peer support during withdrawal, induction, and the early weeks after any break from use.

Simply call 800-934-1582(Sponsored) to get started or browse our directory for chapters located anywhere in the USA.