Latest reporting
The Money Was Supposed to Bury Fewer People. A New Jersey Town Spent It on Cameras That Watch License Plates.
Washington Township, New Jersey spent nearly $60,000 in opioid settlement money on license-plate-reader cameras — one of at least 19 police agencies nationwide doing the same. The pattern echoes the 1998 tobacco settlement almost exactly.
The Government Calls Telehealth Prescribing Permanent. The Rule Expires in 113 Days.
HHS says telehealth prescribing for addiction medication is here to stay. The DEA's own extension expires December 31, 2026 — and the gap between the press release and the rule is where patients fall through.
Arizona's New AI Treatment Locator Can Answer 'Where.' It Still Can't Answer 'Is There a Bed.'
AHCCCS launched a Gemini-powered chatbot to help Arizonans find opioid treatment. It arrives alongside $1.215B in settlement funds and 13,198 donated naloxone doses — but the tool still can't tell anyone if a bed is actually open.
Through eight lenses
Science
Opioids bind to μ, δ, and κ receptors in the central and peripheral nervous system. Agonists (morphine, heroin, fentanyl) produce analgesia, euphoria, and respiratory depression; partial agonists (buprenorphine) and antagonists (naloxone, naltrexone) occupy receptors differently. Fentanyl's potency (~50–100× morphine) reflects receptor affinity, not a different mechanism — which is why overdose reversal still works, just often requiring higher or repeated naloxone doses.
Biology
Acute effects: respiratory depression (the killer), miosis, GI slowdown, analgesia. Chronic use downregulates endogenous opioid production, which is the neurobiology behind withdrawal — real, measurable, not "in someone's head." Long-term health impacts include endocrine suppression, constipation, cardiovascular stress, and (with injection) endocarditis and soft-tissue infections. Fentanyl's pharmacokinetics (rapid onset, short half-life in plasma but redistribution into tissue) explain its overdose profile.
Psychology
Opioid use disorder has the highest bio-genetic contribution of any SUD in twin studies (~50–60% heritability). The "warm blanket" subjective experience — which people in active use describe consistently — reflects μ-receptor activation in regions governing social pain. That's why opioids map so cleanly onto trauma, loneliness, and chronic pain.
Policy
Schedule II (except buprenorphine at III, heroin at I). DEA quota system governs legitimate supply. The 2023 X-Waiver elimination removed the barrier to buprenorphine prescribing — any provider with a Schedule III DEA number can now prescribe. [Telehealth prescribing is extended through 2026](/newsroom/dea-extends-telemedicine-buprenorphine-2026) with permanent 6-month flexibility for buprenorphine.
Trends
CDC provisional data shows ~72,000 overdose deaths in the 12 months ending October 2025, a 17% decline from the 2023 peak of ~107,000. Synthetic opioids (fentanyl + analogs) remain in 69–75% of these deaths. Emerging: nitazenes (more potent than fentanyl, naloxone-reversible but may require higher doses) and xylazine (not an opioid, but in the supply — see [SP-15](/newsroom/xylazine-what-it-is-why-it-matters)).
The Money Was Supposed to Bury Fewer People. A New Jersey Town Spent It on Cameras That Watch License Plates.
Sep 10The Government Calls Telehealth Prescribing Permanent. The Rule Expires in 113 Days.
Sep 9Arizona's New AI Treatment Locator Can Answer 'Where.' It Still Can't Answer 'Is There a Bed.'
Sep 8
Treatment
[MAT](/newsroom/mat-explained-2026) is the evidence-based standard: buprenorphine, methadone, and extended-release naltrexone all reduce mortality by ~50% vs. non-medication treatment in meta-analyses. Counseling helps but is not required to start MAT. Residential programs, IOP, peer recovery coaching, and 12-step all have roles, but without MAT the evidence for OUD treatment alone is weak.
Harm Reduction
Naloxone saves lives and is now available OTC (Narcan) in most states. Fentanyl test strips, safer-use education, Good Samaritan protections, syringe service programs, and (in some jurisdictions) overdose prevention centers. Harm reduction is not antithetical to recovery — SAMHSA's 2022 harm reduction pillar makes this explicit.
The Money Was Supposed to Bury Fewer People. A New Jersey Town Spent It on Cameras That Watch License Plates.
Sep 10The Thing That Gets People Into Treatment Was Never the Syringe. It Was the Person Handing It Over.
Sep 7Arizona's $1.2 Billion Opioid Settlement Finally Turns Into Naloxone This Month
Sep 7