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.

Families across Minnesota’s Iron Range are confronting a substance that sits in plain sight on gas station counters. However, it’s not regulated like an opioid in The North Star State, even though doctors say it acts like one.

Parker Martindale, a teenage boy from Cloquet, died from what his family says was a lethal amount of synthetic kratom he believed was an ordinary energy supplement. Communities across the Iron Range are organizing in his memory, and local advocates have launched a campaign warning families about the risks to young people.

Kratom and 7-OH

Kratom is an herbal substance derived from the leaves of the Mitragyna speciosa tree, native to Southeast Asia. It’s sold as capsules, powders, teas and liquid extracts. Kratom is also used to relieve chronic pain because of its opioid-like properties, leading to a high jump in numbers among folks who take it.

Its main active compounds are mitragynine and 7-hydroxymitragynine, commonly called 7-OH. Both interact with opioid receptors in the brain, Effects vary by dose and by how the product is consumed.

Synthetic 7-OH is sold as drinks, shots, powders, tablets, capsules and gummies, according to the Minnesota Department of Health. Many people can buy it in smoke shops and gas stations. In small amounts, kratom acts as a stimulant and is marketed as an energy booster or a way to manage anxiety. But in higher doses, it has severe effects and can kill.

Doctors on the Iron Range

Dr. Robert Pueringer is a medical toxicologist and addiction specialist at Essentia. He placed concentrated kratom in the same class of medications as fentanyl.

Without FDA regulation, there’s no oversight preventing other harmful substances from being mixed in. Accordingly, doctors told the station that the lack of control has contributed to a fivefold increase in local kratom overdoses.

Minnesota Law

Kratom isn’t federally regulated and not fully regulated at the state level either. A new Minnesota law that took effect in August raised the legal purchase age from 18 to 21.

Parker’s family has started a petition to ban kratom sales locally. However, some doctors described the regulatory question as a double-edged sword.

Stephinie Mckenzie has been organizing memorial events and questioned what happens after a legal purchase enters a household. “But what really happens after a 21-year-old purchases it and brings it home, especially when it’s marketed, like a five-hour energy drink?” she asked.

Harm Reduction and Treatment for Opioid Addiction

Because 7-OH acts on opioid receptors, the treatment tools for opioid addiction apply here. 

• Naloxone aka Narcan can reverse an opioid overdose and is available without a prescription in Minnesota pharmacies. Signs of an opioid overdose include slowed or stopped breathing, blue or gray lips and fingertips and unresponsiveness. Call 911 immediately and stay with the person.

• Fentanyl test strips can identify fentanyl in a substance, though they don’t detect 7-OH or measure potency.

• For people who’ve developed dependence on concentrated kratom, stopping abruptly produces a significant withdrawal syndrome. Medically supervised withdrawal management is the safer route, and medications used for opioid use disorder are sometimes used to manage it. That decision belongs with a clinician.

Mckenzie also pointed to a gap that people in recovery on the Iron Range know well. “Not having accessible places where you can go get help, find resources, go to meetings, that adds to that number,” she noted.

Parker’s memorial event is scheduled for September 12 and will include food trucks, prizes, keynote speakers and free Narcan education. It closes with a memorial drive to dedicate a skate park bench in his honor.

NA Meetings and Treatment in Minnesota & Beyond

Peer support nevertheless remains one part of a recovery plan, alongside medical care. Accordingly, Narcotics Anonymous meetings are held across Minnesota. Many groups also meet online. 

Our browsable meeting directory lets you search NA meetings by city, day, format, and meeting type. We index meetings and explain NA concepts for a general audience. You can also dial 800-934-1582(Sponsored) to speak with an expert.

Opioid overdose prevention gets easier when the medication that reverses an overdose is free and someone shows you how to use it. That is what Grant County, Washington is offering on Saturday, August 29, at its fourth annual Community Resource Fair and International Overdose Awareness Day event.

The event runs from 8 a.m. to 1 p.m. at McCosh Park, 401 W. Fourth Ave. in Moses Lake. Grant County Health District is partnering with the Moses Lake Farmers Market, and the resource fair sits along the same pathway as market vendors near the park’s picnic shelter, which means people can walk into it without having decided in advance to attend an addiction event.

Opioid Crisis by the Numbers in Grant County

Health district officials said overdose remains a significant public health issue locally. A total of 104 overdose-related deaths were reported in the county between 2022 and 2024.

Officials described overdose as a continuing problem in the county rather than a passing one, and the resource fair is now in its fourth year.

Opioid Overdose Prevention Starts With Free Narcan

Free Narcan, the nasal spray form of naloxone, will be available at the event. Participants can also receive brief training on how to administer it.

Naloxone reverses an opioid overdose by displacing opioids from receptors in the brain and restoring breathing. It works on heroin, fentanyl, and prescription opioids including oxycodone and hydrocodone. It has no effect on someone who has not taken opioids, which is why it is safe to use when you are not certain what is happening.

Signs of an opioid overdose include unresponsiveness, slow or stopped breathing, blue or grayish lips and fingertips, and pinpoint pupils. Naloxone can wear off before the opioid does, so emergency services should be called even after someone responds.

Fentanyl makes carrying naloxone more important than it once was. It is a synthetic opioid far more potent than heroin, it now appears in counterfeit pills and in supplies sold as other drugs, and a person may take it without knowing.

Who the Event Is Actually For

Health district officials framed the event for anyone who wants to learn more about supporting someone dealing with substance use disorder, whether that person is themselves, a family member, a friend, or another member of the community.

That framing matters, because an overdose is usually witnessed by someone who is not a clinician. Whether naloxone is in the room often comes down to whether a family member, friend, or bystander happens to be carrying it.

Remembrance Built Into the Day

The event includes a way to recognize people affected by overdose. Attendees can dedicate a purple flag in honor of someone whose life was saved with Narcan, or a white flag in memory of someone who died from an overdose.

International Overdose Awareness Day has been observed for 25 years and falls annually on August 31, two days after the Grant County event. Its purpose is to reduce the stigma around drug-related deaths while raising awareness of overdose prevention and available resources.

Grant County organizers described their event as part of that broader international effort to remember people who have died, support those living with substance use, and promote prevention and recovery.

Treatment and Peer Support for Opioid Addiction

An overdose reversal buys time. What follows determines whether it becomes a turning point. Medication for opioid use disorder is the most effective treatment available, and it substantially reduces the risk of dying.

Buprenorphine and methadone are opioid agonists that stabilize withdrawal and cravings, and naltrexone blocks opioid effects for people who have already completed withdrawal. These medications are typically paired with counseling.

Peer support runs alongside treatment for many people. Narcotics Anonymous is a free, worldwide 12-step fellowship for people recovering from drug addiction, with meetings in most communities and online. There is no cost and no requirement beyond a desire to stop using.

Finding Help for Opioid Addiction in Washington

If August 29 is not soon enough, or you are nowhere near Moses Lake, these routes are open now. Narcotics.com’s meeting directory lists NA meetings across Washington by city, including virtual meetings and beginner-friendly formats.

You can also search opioid treatment programs by location to find providers offering buprenorphine, methadone, or naltrexone.

Washington residents can find free naloxone through the state Department of Health’s locator and through many pharmacies without a prescription. Call 800-934-1582(Sponsored) to learn more about treatment options near you.

The gap between deciding to stop and being able to start is where a lot of people lose their footing. Opioid addiction treatment in Denver now has one fewer step in the middle of it.

The nonprofit WellPower has opened a walk-in medication assisted treatment clinic where a person can arrive without an appointment and leave with a prescription, Denverite reported this month.

Colorado Public Radio carried the story. There is no six-week wait for an intake appointment, no requirement to enter residential care, and no daily clinic visit built into the schedule.

The Opioid Crisis Context in Colorado

WellPower opened the clinic against a local trend running opposite to the national one. In a statement, the organization said it launched the program as overdose deaths rose again in Colorado and Denver even as national trends improved, and described same-day access as the central problem it was trying to solve. WellPower framed the clinic as low-barrier care built to reach people at the moment they decide they are ready, rather than weeks later.

Understanding the Medications Involved

The clinic prescribes two formulations, both built on buprenorphine, a partial opioid agonist that occupies opioid receptors strongly enough to blunt withdrawal and reduce cravings without producing the effects of a full agonist like fentanyl or heroin.

Suboxone is the daily version, a film taken under the tongue. Sublocade is a monthly injection, which removes daily dosing from a person’s routine. Both received FDA approval in recent decades, and both have become easier to obtain as regulations loosened and generic alternatives entered the market.

Buprenorphine is one of three medications the FDA has approved for opioid use disorder, alongside methadone and naltrexone, and all three are recognized forms of opioid addiction treatment.

Which one fits depends on the person, their history, and what they can realistically get to. Methadone works well for many people for whom buprenorphine does not, and the reverse is also true, which is why access to more than one option matters.

There is one hard requirement, and it is the part people find most daunting. Because buprenorphine can displace other opioids from the receptor and trigger sudden withdrawal, a person has to already be in withdrawal before the first dose.

Clinical staff at the program told Denverite that with fentanyl the necessary window is roughly 24 hours for most people before a Suboxone titration can begin, though it varies with how much and how often a person has been using.

What Low Barrier Care Actually Means

The clinic does not require abstinence from other substances as a condition of treatment for opioid use disorder. That is a deliberate design choice, and it is what makes the program reachable for people who are not ready to stop everything at once.

Program staff described the goal as reducing use and reducing risk, with the door open to people who are not prepared to quit entirely but are willing to engage.

Staffing reflects the same logic. Peer specialists who have used drugs themselves work alongside nurses and pharmacists who help match a person to the right medication.

Peer roles have become standard in low-barrier programs because they change what the first conversation feels like, and because retention improves when the person doing intake is not perceived as an evaluator.

Fear of judgment is the barrier the program is built around. Staff told Denverite the clinic works to make people comfortable regardless of what is in their system or where they come from, which is a service design decision as much as a clinical posture.

How the Program Runs

The walk-in clinic operates Wednesdays from 1 to 4:30 p.m. at WellPower’s Recovery Center at 4455 E. 12th Ave. in Denver. No appointment is needed.

Capacity is currently around six patients a week, and the program hopes to expand both its hours and its numbers. That is a small footprint, and worth reading as a pilot rather than a citywide solution. WellPower is supported by Medicaid, grants and individual donations, and costs vary depending on a person’s insurance.

The model is what makes it notable rather than the volume. Same-day initiation without an intake queue removes the delay that a person’s decision to seek addiction treatment often cannot survive, and if the approach holds up, it is replicable by other community mental health providers.

Finding Opioid Addiction Treatment in Denver

Peer recovery groups and medication are not competing choices, and a person can use both. Narcotics Anonymous meetings run throughout the Denver metro area and across Colorado, in person and online, and attending one costs nothing.

Kratom use among American teenagers rose by roughly half in a single year, according to federal survey data, and the increase is sharpening a policy fight over whether the leaf itself drives opioid addiction.

The Food and Drug Administration has concluded the plant contains opioid compounds and warns Americans against using it. Regulators have nonetheless acted against only one concentrated kratom product, leaving the leaf unscheduled, and clinicians disagree about whether that line is drawn in the right place.

Kratom Use by the Numbers

The Substance Abuse and Mental Health Services Administration’s National Survey on Drug Use and Health estimated that 1.85 million Americans aged 12 and older used kratom in 2024, up from 1.63 million in 2023.

Among adolescents aged 12 to 17, past-year use climbed 51 percent over the same period, from about 43,000 to 65,000. Poison center data points the same direction.

A 2026 report in the Centers for Disease Control and Prevention’s Morbidity and Mortality Weekly Report found kratom-related poisonings and hospitalizations rose 1,200 percent over the past decade, an increase that largely predates the arrival of concentrated products two years ago.

Research from the University of Michigan and Texas State University in the Journal of Addiction Medicine reports the highest use at ages 21 to 34, and found kratom use was associated with cannabis use, preexisting substance use disorders, and serious psychological distress. Those are associations, not proof of cause.

Why Kratom Is Classed as an Opioid

The pharmacology is the starting point. Kratom’s principal active compound acts on the same brain receptors as heroin and prescription painkillers. In 2018 the FDA sought to place kratom in Schedule I after concluding the leaf contains opioid compounds.

Industry lobbying helped stop that effort. The agency’s website still advises Americans against using kratom, citing risks including liver toxicity, seizures, and substance use disorder. The FDA commissioner at the time said kratom “isn’t just a plant, it’s an opioid.”

Writing in Psychology Today in July, Dan Mager, a licensed clinical social worker, argued that the pattern around kratom echoes the early years of the prescription opioid epidemic, when warning signs were minimized.

In his view the receptor activity settles the question, and kratom is an opioid regardless of how it is marketed. That is a clinician’s argument rather than a regulatory finding, but it aligns with the FDA’s own stated conclusion about the leaf.

Where Regulators Have Drawn the Line

In July 2026 the Drug Enforcement Administration announced its intent to temporarily place 7-hydroxymitragynine, known as 7-OH, above a specified concentration into Schedule I, along with three synthetic derivatives. 7-OH is made by chemically treating kratom leaf to raise its opioid potency.

The Department of Health and Human Services and the FDA commended that action and stated plainly that it is not intended to regulate natural leaf kratom without enhanced 7-OH levels.

Kratom itself remains off the federal schedule, though the DEA lists it as a drug of concern. State law is a separate and increasingly uneven track. Tennessee’s full ban took effect July 1, 2026, while other states restrict concentrates only.

Where Advocates and Critics Disagree

The American Kratom Association, a consumer advocacy group, supported the DEA’s move on 7-OH. Mac Haddow, the group’s senior fellow on public policy, has argued that chemically manipulated 7-OH products are high-potency opioid products falsely marketed as kratom, and that natural leaf carries a different risk profile. The group opposes restrictions on the leaf and is urging states to preserve access to it while banning concentrates.

Mager reads the same regulatory decision differently, describing the narrower action as an acceptance of an industry framing that treats ordinary kratom as a benign wellness product.

Some federal lawmakers have pushed further than the DEA. In a March 2026 letter to the FDA commissioner, senators wrote that scheduling 7-OH was an important first step but urged the agency to consider scheduling whole kratom leaf as well, citing products marketed in forms that appeal to young people.

Advocates on the other side counter that full bans push people toward unregulated online and out-of-state sellers, raising the odds of adulterated products.

Understanding Kratom and Overdose Risk

Kratom refers to the dried leaves of the Mitragyna speciosa tree and the products made from them, sold as capsules, powders, teas, and liquid shots at gas stations, convenience stores, and online. Lower doses produce stimulant-like effects; higher doses produce opioid-like effects.

People report using kratom for pain, for emotional distress, and to manage opioid cravings or withdrawal. Kratom products have not been shown to be safe or effective for any medical condition.

Because the active compound is an opioid, repeated use can lead to cravings, tolerance, dependence, and withdrawal, and overdose risk rises when kratom is combined with other sedating substances.

Harm Reduction and Treatment

People who use kratom or concentrated 7-OH products are exposed to opioid risk whether or not the products are scheduled, and a few practical steps reduce that exposure.

Finding Help for Opioid Addiction

Peer recovery groups give people a place to talk with others who have been through opioid dependence, and NA meetings run in person and online nationwide. Narcotics.com is not affiliated with Narcotics Anonymous or NA World Services.

You can use the Narcotics.com directory to find NA meetings near you and to compare opioid treatment programs by location and level of care. Call 800-934-1582(Sponsored) to find a treatment option near you.

Opioid addiction has produced one of the largest waves of civil litigation in American history, and the settlements that followed were supposed to pay for treatment, naloxone distribution and prevention.

A lawsuit filed in June offers an unusually clear look at the machinery underneath that money, and at how much of it can get tied up before it reaches anyone.

What the Lawsuit Alleges

Giant Eagle, a grocery chain based in Cranberry Township, Pennsylvania, filed suit on June 17, 2026 in the U.S. District Court for the Western District of Pennsylvania against Aon Risk Services Central and Aon Financial Services Group.

The complaint says Giant Eagle hired Aon as its insurance broker from 2014 to 2025 and, beginning in 2018, paid additional fees for claims advocacy services under which the broker was responsible for identifying and notifying every insurer that might cover a claim.

When Ohio governmental entities began suing Giant Eagle in 2018 over its role in the opioid epidemic, the company says it asked Aon to notify its full insurance tower, including Chubb unit Westchester Fire Insurance, Navigators Insurance and Argonaut Insurance.

According to the complaint, notice went to a general claims email address rather than the address specified in the directors and officers policy, and two of the three insurers were never notified at all. The insurers subsequently denied coverage on late-notice grounds. That dispute is now in arbitration.

Giant Eagle says it has already spent more than $1 million litigating the notice defense and stands to lose the full $40 million in coverage if the insurers prevail.

The complaint also cites a 2018 SEC filing in which Aon’s parent company acknowledged that errors-and-omissions claims against it could include failures to place coverage correctly or notify carriers of claims.

The company is seeking actual and punitive damages and has demanded a jury trial. Aon did not immediately respond to a request for comment. These are allegations in a complaint, not findings by a court.

The Opioid Crisis by the Numbers

Grocery and pharmacy chains nationwide have paid billions in settlements arising from the opioid crisis. Giant Eagle alone has been named in more than 30 lawsuits alleging it failed to establish proper controls over opioid distribution, according to its complaint.

That litigation produced settlement funds now flowing to states, counties and municipalities, generally with requirements that money go toward abatement: treatment, recovery support, harm reduction and prevention. How well that requirement is honored varies considerably by jurisdiction, and oversight has been uneven.

Why This Matters for People Affected by Opioid Addiction

It would be easy to read a broker liability dispute as pure corporate housekeeping. The connection to people is real, though indirect.

When a defendant’s insurance coverage fails, the money to satisfy judgments and settlements comes from somewhere else, or the defendant’s capacity to pay shrinks.

Coverage fights add years and legal costs to resolutions. For a county waiting on abatement funds to open a treatment program or stock naloxone, timing is not an abstraction.

None of this changes what a person with opioid use disorder can access today. It does explain why the money announced in headlines often takes so long to appear as an actual service in an actual community.

Understanding Opioids and Overdose Risk

Opioids include prescription medications such as oxycodone, hydrocodone, morphine and codeine, along with heroin and synthetic opioids like fentanyl.

Fentanyl is substantially more potent than morphine and is now present throughout the illicit supply, frequently in counterfeit pills pressed to look like prescription medication.

An opioid overdose is a breathing emergency. Signs include very slow or stopped breathing, blue or gray lips and fingertips, pinpoint pupils, and unresponsiveness to shouting or a sternal rub. Naloxone reverses an opioid overdose by displacing opioids from receptors in the brain. It works within minutes, has no effect on someone who has not taken opioids, and is available over the counter.

Because opioids like fentanyl outlasts naloxone in the body, a person can slip back into overdose after an initial reversal. Call 911 in every case, even after naloxone works.

Harm Reduction and Treatment

Carrying naloxone is the single most direct thing anyone can do. Many health departments, syringe service programs and community organizations distribute it free, and it is available without a prescription at pharmacies. Fentanyl test strips let people check a supply before use, and they are legal in a growing number of states.

Medication for opioid use disorder, using buprenorphine, methadone or naltrexone, has the strongest evidence base for reducing overdose death and keeping people in treatment. It is not a lesser form of recovery, and it can be combined with peer support.

Narcotics Anonymous offers free peer support meetings for people recovering from drug addiction of any kind. NA meetings are open to anyone who wants to stop using, with no cost, no insurance requirement and no referral needed. Many people combine NA with medication treatment, therapy or a formal program.

Finding Help for Opioid Addiction

If you are looking for support right now, Narcotics.com’s NA meeting directory covers all 50 states with city-level listings, filterable by meeting type and format, including virtual and Spanish-language meetings.

Narcotics.com also lists opioid treatment programs by location for people seeking medication treatment alongside or instead of peer support. Call 800-934-1582(Sponsored) to learn more about your treatment options.

Opioid overdoses in North Carolina fell 27% through the first half of 2026, according to state Department of Health and Human Services data reported by WRAL on August 14.

Between January and June, emergency departments recorded 2,031 opioid overdoses statewide, more than 700 fewer than the same period a year earlier.

In the same month, police in Fayetteville issued a public safety notice about a local increase in suspected fentanyl overdoses. Both things are true, and the gap between them is the part worth understanding.

The Opioid Crisis by the Numbers

North Carolina recorded 4,960 emergency department visits related to opioid overdose in 2025. That represents a 21% decrease from the prior year and a 48% decrease from 2023, when the state logged a record 9,624.

Across all substances, overdose emergency department visits fell 14% between 2024 and 2025. The 2025 total of 10,627 cases remains 43% below 2023. Illicit opioids, including fentanyl, account for more than half of the state’s opioid-related emergency department visits.

WRAL’s analysis of counties around Raleigh found that rural counties posted some of the largest per-capita reductions in opioid hospitalizations. Dr. Kelly Crosbie, who directs the state’s Division of Mental Health, Developmental Disabilities, and Substance Use Services, said North Carolina is following and exceeding national trends at both state and county levels. Eight counties did not provide county-level reporting.

What a Local Spike Looks Like Against a Falling Trend

A spokesperson for the Fayetteville Police Department said the increase raised concern that particularly potent or contaminated drugs may be circulating in the area.

The timing is worth sitting with. Cumberland County, where Fayetteville sits, has reported 33 overdose cases to hospitals so far this year, down from 95 over the same window last year. The county trend is strongly downward and the city is still warning residents.

That is not a contradiction. Statewide and county-level statistics describe aggregate outcomes over months. They say nothing about the composition of any particular batch of drugs in circulation on any particular week.

A supply that is more potent or differently adulterated than usual can produce a cluster of overdoses in a small area while the broader curve continues to fall.

For a person who uses opioids, the aggregate number is not a risk assessment. Their risk is set by what is in front of them, their tolerance, and whether anyone is nearby who can respond.

Fentanyl’s Role

Illicitly manufactured fentanyl is a synthetic opioid substantially more potent than morphine and is now the dominant driver of opioid overdose deaths nationally. It is inexpensive to produce and is frequently mixed into other substances or pressed into counterfeit pills.

Because mixing is uneven, two portions from the same batch can contain very different amounts. This is why overdoses cluster: several people encounter the same unusually potent supply within a short period.

What’s Driving the Decline

No single factor explains a drop this size. Widespread naloxone distribution, expanded access to medication for opioid use disorder, and shifts in the drug supply itself have all been credited nationally. North Carolina’s own investment in mobile medication-assisted treatment and rural access has been part of that picture.

Medication for opioid use disorder means buprenorphine, methadone, or naltrexone combined with counseling and support. These medications reduce cravings and withdrawal, and for buprenorphine and methadone, substantially lower overdose death risk. They are endorsed as first-line treatment by SAMHSA, the CDC, and the American Society of Addiction Medicine.

Peer Support and NA Meetings

Medication and harm reduction address survival and stabilization. Many people also want a community of people who understand what they are dealing with.

Narcotics Anonymous is one option, built on a 12-step framework and open to people recovering from any drug. Meetings are free, and formats vary widely, including open meetings anyone can attend, closed meetings for people who want to stop using, and virtual options.

NA is one path among several. Others find what they need through SMART Recovery, therapy, medication alone, or some combination. None of these is in competition with the others, and using medication does not disqualify anyone from peer support.

Finding Help for Opioid Addiction

If you are looking for help in North Carolina, useful steps include locating NA meetings near you, finding an opioid treatment program or buprenorphine prescriber, and picking up naloxone from a pharmacy or a local harm reduction program.

Narcotics.com maintains a searchable directory of NA meetings by state and city, along with information on treatment options for opioid use disorder. Call 800-934-1582(Sponsored) to find treatment options near you.

Across 2023 and 2024, a medical examiner in one Ohio county reviewed 45 deaths involving nitazenes. In every single one, fentanyl was present too. That pattern is the clearest available picture of how these synthetic opioids are actually reaching people, which is hidden inside other drugs rather than sold under their own name.

Nitazenes are up to 40 times more potent than fentanyl and as much as 500 times stronger than heroin. They have now been seized in 48 of the 50 US states.

The findings come from a months-long investigation by Bellingcat, published June 18, 2026, and co-published with STAT and Signal Ohio. Reporters reviewed dozens of criminal court proceedings, filed federal, state, and county records requests, and obtained medical examiner reports.

What Nitazenes Are

Nitazenes were developed in the 1950s as potential painkillers and were never approved for medical use because they were judged unsafe. They resurfaced in the illicit market decades later.

They are sold predominantly online, on both the open and dark web, and are typically laced into other substances to increase potency. Someone buying what they believe is oxycodone, fentanyl, or even a stimulant like cocaine may receive something considerably stronger without knowing it.

The US Drug Enforcement Administration began tracking nitazene seizures around 2014 but saw a marked increase starting in 2019.

How Fast the Numbers Moved

Confirmed nitazene reports in the DEA’s National Forensic Laboratory Information System rose from 43 positive tests in 2019 to nearly 2,000 in 2024, the most recent year with complete figures. By March 2026, more than 8,000 nitazene reports had been logged since 2019.

Overdose deaths followed a similar curve. The Centers for Disease Control and Prevention confirmed 27 nitazene-involved deaths in 2020 and 409 in 2024. More than 1,100 fatalities have been confirmed in total through the CDC’s State Unintentional Drug Overdose Reporting System.

Experts believe the real figure is higher, possibly around 2,000 since 2019. Alex Krotulski, who directs the Center for Forensic Science Research and Education in Pennsylvania, told Bellingcat that only a limited number of forensic toxicology laboratories test for nitazenes at all. If a lab does not test for one, it will not appear in the data, and labs that do test have missed earlier cases.

That undercount matters for anyone assessing risk. The absence of nitazenes in local statistics may reflect testing capacity rather than the actual supply.

Inside the Ohio Numbers

Ohio accounts for more than a third of all positive nitazene laboratory reports nationally between 2019 and 2024, and has recorded the highest number of nitazene-related overdose deaths in the country since 2021. The state logged four such deaths in 2020, 90 in 2021, and roughly 200 more between 2022 and 2024.

Within Ohio, records obtained from the state’s Bureau of Criminal Investigation show Scioto, Butler, and Cuyahoga counties account for almost half of all nitazene detections by weight.

Medical examiner records from Cuyahoga County, which includes Cleveland, give the clearest picture of who is dying. Across 2023 and 2024, 45 people died after taking nitazenes, 31 men and 14 women, ranging in age from 29 to 72. All but one death was ruled accidental.

In every one of those 45 cases, nitazenes were detected alongside fentanyl, frequently with drugs like heroin, cocaine, methamphetamine, or benzodiazepines in the mix as well.

Why Mixtures Are the Whole Story

The consistency of that pattern is the practical takeaway. Nitazenes are not displacing fentanyl in the supply. They are being added to it.

Frank Tarentino, associate chief of operations for the DEA’s Northeast Region, said dealers mix nitazenes into other drugs to make them stronger and more addictive, and that poly-drug operations selling many substances at once have become the norm rather than the exception.

AmandaLynn Reese, chief program officer at Harm Reduction Ohio, a nonprofit supporting people who use drugs, described nitazenes as a live risk to her community and said she expects to see more of them. Her organization is pushing for wider drug checking services, better access to test strips, and more naloxone in circulation.

What Protects People

Naloxone still reverses nitazene overdoses. Because these compounds can be dramatically more potent than fentanyl, reversal may require more than one dose, so having several on hand matters.

Fentanyl test strips are widely available and worth using, but they do not detect nitazenes. A negative fentanyl strip is not a clean bill of health. Where drug checking services operate, they can identify compounds that strips cannot.

Ohio has moved on both fronts. The governor issued executive orders scheduling nine nitazenes and legalized the use of tools that test for them.

The Supply Keeps Adapting

China placed most nitazenes under national control in July 2025. Drug experts told Bellingcat that manufacturers are already marketing chemically similar compounds that fall outside those rules, a pattern that repeats what happened after China banned fentanyl-related substances in 2019 and nitazene reports climbed shortly after.

For people in recovery or using drugs now, the practical implication is that the supply changes faster than testing and regulation can follow.

NA Meetings and Peer Support

An unpredictable drug supply raises the stakes on returning to use, particularly after any break when tolerance has dropped. NA meetings offer regular peer contact with people who understand that risk firsthand, which matters most in the weeks when it is highest. Call 800-934-1582(Sponsored) to learn more about your treatment options.

Kentucky recorded 1,110 overdose deaths in 2025. That is a fourth consecutive annual decline and a drop of nearly 23% in a single year, and it is still more than a thousand people.

Both facts matter for anyone tracking opioid addiction in the state, because the programs behind the decline are the ones now being asked to hold it.

One of those programs runs through hospitals. Writing in the Kentucky Lantern on August 20, Melanie Landrum, interim chief executive and senior vice president of the Kentucky Hospital Association, described how the Kentucky Statewide Opioid Stewardship program is working and why she argues it needs to keep going.

The Opioid Crisis by the Numbers

Kentucky’s overdose deaths have fallen for four years running. The 2025 figure of 1,110 deaths reflects a decline of nearly 23% from the prior year. Across the state’s 17 Emergency Department Bridge Programs, peer support specialists have logged more than 2,000 of what the program calls peer support touches so far in 2026.

A peer support touch covers any contact between a peer support specialist and a patient with a substance use disorder, including recovery coaching, help linking or referring to treatment, referrals to services such as transportation and food, and harm reduction education, including handing naloxone directly to a patient.

What Is Driving the Change

The Kentucky Statewide Opioid Stewardship program, known as KYSOS, is a partnership between the Kentucky Hospital Association and the Cabinet for Health and Family Services through the Kentucky Opioid Response Effort.

KYSOS works with hospitals to reduce opioid overprescribing and improve safe prescribing when opioids are warranted. It operates in inpatient units, hospital-owned outpatient primary care clinics, and emergency departments.

The Emergency Department Bridge Program is the piece aimed at people already living with opioid use disorder. Patients are connected with peer support specialists while they are still in the hospital, which produces a direct handoff to addiction treatment and community resources rather than a phone number to call later.

Landrum opened her commentary with an account of a Kentucky woman who was referred to an emergency department for help managing opioid withdrawal and was afraid to walk in, not because she doubted treatment was available but because she expected judgment. A peer support specialist reached her, she received treatment, and she remains in recovery.

Landrum also argues that stewardship is not about withholding pain relief. Her framing is that hospitals should treat pain safely, prescribe responsibly, and recognize opioid use disorder early enough to act on it.

Understanding Opioids and Overdose Risk

Opioids include prescription medications such as oxycodone, hydrocodone, and morphine, along with heroin and illicitly manufactured fentanyl. Fentanyl is far more potent than heroin by weight, and because it is often mixed into other supplies, people can be exposed without knowing it.

Signs of an opioid overdose include slowed or stopped breathing, blue or gray lips and fingertips, pinpoint pupils, and unresponsiveness. Naloxone reverses an opioid overdose and does not harm someone who has not taken opioids, which is why carrying it is recommended even for people who do not use drugs themselves.

Harm Reduction and Treatment for Opioid Use Disorder

Medication for opioid use disorder, including methadone, buprenorphine, and naltrexone, is the evidence-based standard of care and is associated with reduced risk of death. A hospital that starts medication before discharge removes the gap where relapse and overdose are most likely.

Peer support works alongside that, not instead of it. A peer support specialist is someone in recovery who has been trained and certified to help others navigate treatment and early recovery. The Kentucky model puts that person in the room during the hospital visit.

Landrum’s central point is that no single program or profession solves this alone, and that the decline reflects collaboration among hospitals, clinicians, pharmacists, peer support specialists, behavioral health providers, public health leaders, law enforcement, policymakers, patients, and families.

Finding Help for Opioid Addiction in Kentucky

If you are leaving a hospital in Kentucky, ask whether the facility participates in a bridge program and whether a peer support specialist can meet with you before discharge. Ask whether medication can be started during the stay.

Narcotics Anonymous meetings offer ongoing peer support after treatment begins, and many people combine NA attendance with medication and clinical care. Search NA meetings in Kentucky by city to find in-person and virtual options, including open meetings that visitors and family members may attend. Call 800-934-1582(Sponsored) to speak witha treatment specialist today.