Diamorphine

Portland, Maine, faces a visible increase in homelessness post-COVID-19, with encampments growing across the city. The state's homeless count rose to 4,258 in 2023, up from 1,297 in 2020, including those in transitional housing. Portland shelters about 850 nightly, with many living in tents. The city has formed an Encampment Crisis Response Team to offer housing solutions before clearing encampments. Stories from individuals like j Rancourt, Nikki Cassetta, Edward Stewart, Amber Lesperance, Allan Hill, James Spanos, and Mona Miller highlight personal struggles with homelessness, addiction, and the search for stability and support.

A Philadelphia woman, Tracey McCann, shares her harrowing experience with xylazine, a veterinary tranquilizer mixed into street drugs, causing severe health issues like sepsis, blood clots, and flesh-rotting sores. After becoming addicted post a car crash, she underwent a painful withdrawal and is now sober, highlighting the growing xylazine crisis in the US.

In 2021, overdose deaths hit a record high, with fentanyl deaths increasing by 24% from the previous year. Fentanyl, a synthetic opioid, has become the dominant drug threat, with death rates nearly quadrupling over five years. Cocaine and methamphetamine overdose deaths also rose sharply. Heroin and oxycodone overdose deaths decreased. The CDC estimates 108,820 overdose deaths in 2021, with synthetic opioids like fentanyl responsible for most.

The FDA approved Narcan, an overdose-reversal drug, for over-the-counter sale to improve access and reduce opioid overdose deaths. Narcan, a nasal spray, can counteract overdoses from opioids like fentanyl and heroin. This move aims to make the drug more accessible in various locations, though concerns about pricing and proper use remain.

The FDA approved Narcan, a nasal spray to reverse opioid overdoses, for over-the-counter use, aiming to combat the opioid epidemic. With 101,750 fatal overdoses reported in a year, this move allows easier access to the drug, expected in stores soon. Opioid deaths, fueled by fentanyl and prescription misuse, could surpass 1.2 million by 2029 without intervention.

Oregon faces a severe fentanyl crisis among teens, with drug-related deaths increasing faster than any other state. Despite available tools, state officials failed to act, leading to a lack of prevention and treatment services. Efforts like Senate Bill 238 aim to educate on fentanyl dangers, but youth addiction treatment resources are critically insufficient.

An FDA advisory committee recommended over-the-counter sales of Narcan, a nasal spray for opioid overdose reversal, aiming to increase accessibility. The FDA's decision is expected by March 29. This move could reduce stigma and save lives amidst the U.S. overdose epidemic, with over 107,000 deaths last year, primarily from fentanyl and other street drugs.

The CNN documentary "American Pain" explores the opioid crisis's roots in the US pharmaceutical industry, focusing on the George brothers' rise and fall as prescription drug kingpins in South Florida. It highlights the absurdity and tragedy of the crisis, the transition from pills to heroin and fentanyl, and the lack of accountability for pharmaceutical companies, despite legal actions against clinic owners and the pivotal role of local journalism in exposing the issue.

Purdue Pharma's 2010 OxyContin reformulation aimed to deter abuse but inadvertently increased hepatitis C infections by shifting users to injecting heroin. States with high non-medical OxyContin use saw hepatitis C rates spike 225%. The study highlights unintended consequences of opioid crisis policies, urging broader metrics for drug epidemic responses.

Lipid-soluble, low molecular weight, positively charged molecules can cross the BBB; others require transport systems. Five mechanisms facilitate solute movement: passive diffusion, solute carriers, carrier-mediated efflux, receptor-mediated transcytosis, and leukocyte diapedesis. Over 90% of drugs can't cross the BBB, prompting research into invasive and non-invasive delivery strategies, including drug modification, transport system use, efflux transporter inhibition, Trojan horse approach, chimeric peptides, monoclonal antibody fusion proteins, pro-drug bioconversion, nanoparticle technologies, gene therapy, intracerebral gene therapy, and intranasal drug delivery.