A record number of people died of a drug overdose in the US last year, according to government estimates.
The death toll of 93,000 is a big increase from the 72,000 estimate in the previous year, and it means there were more than 250 deaths each day, roughly 11 every hour.
Only two states – New Hampshire and South Dakota – did not see an increase in drug overdose deaths.
Kentucky saw a 54% increase to more than 2,100 and Vermont was up 58% – from 118 to 186, with large increases also seen in South Carolina, West Virginia, and California.
There is no evidence that more Americans started using drugs last year but the deaths were more likely to be among those who were already struggling with their addiction, according to Shannon Monnat, an associate professor of sociology at Syracuse University.
Prof Monnat, who researches geographic patterns in overdoses, said some addicts also told her that, when benefits were extended and evictions were paused as part of government pandemic measures, they had more money to feed their addiction.
Lockdowns and other pandemic-related restrictions left addicts isolated and made it more difficult for them to get treatment.
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Needle exchange programmes, opioid substitution therapy, safe injection sites, support groups, and therapy sessions were all curtailed by social distancing and stay-at-home orders.
Image: Jordan McGlashen, left, and his brother, Collin
Jordan McGlashen died after overdosing on heroin and fentanyl in his Michigan apartment in May last year, a day before his 39th birthday.
The musician had seen his father die of cancer a few months earlier and had also lost his job in the early days of the pandemic.
His brother Collin said: “He was alone, and suffering emotionally and felt like he had to use again.”
“Someone can be doing really well for so long and then, in a flash, deteriorate.
“It was really difficult for me to think about the way in which Jordan died.”
Decades ago, overdoses were driven by prescription painkillers but they were overtaken by heroin, with around 7,200 deaths in 1970.
By 1988, crack cocaine was the drug of choice and there were about 9,000 overdose deaths.
Then fentanyl took over and it is thought to have been involved in more than 60% of overdose deaths last year, with opioids overall blamed for 74.7%.
Fentanyl, which is 80-100 times stronger than morphine, was made to treat pain from illnesses such as cancer but it is now mixed with other drugs and sold illicitly.
It is too soon for national figures covering 2021 but state data so far indicates that fentanyl is continuing to push up the number of drug overdose deaths.
Rhode Island reported 34 in January and 37 in February – the most for those months in at least five years.
Prof Monnat said: “What’s really driving the surge in overdoses is this increasingly poisoned drug supply.
“Nearly all of this increase is fentanyl contamination in some way. Heroin is contaminated. Cocaine is contaminated. Methamphetamine is contaminated.”
President Joe Biden and House Speaker Kevin McCarthy have reached an “agreement in principle” on raising the US debt ceiling, according to sources in Washington.
The tentative deal would bring to an end the months-long stalemate between the Republican controlled Congress and Democrat run White House.
Currently, the debt ceiling stands at $31.4trn (£25.4trn) with the new limit yet to be announced.
Mr Biden and Mr McCarthy held a 90-minute phone call on Saturday evening to discuss the deal, as the 5 June deadline looms.
Following the conversation, the speaker tweeted: “I just got off the phone with the president a bit ago.
“After he wasted time and refused to negotiate for months, we’ve come to an agreement in principle that is worthy of the American people.”
During a very brief press conference on Capitol Hill Mr McCarthy said they “still have more work to do tonight to finish the writing of it”, adding that he expects to finish writing the bill on Sunday, then hold a vote on Wednesday.
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The deal would avert an economically destabilising default, so long as they succeed in passing it through the narrowly divided Congress before the Treasury Department runs short of money to cover all its obligations.
Republicans have pushed for steep cuts to spending and other conditions, including new work requirements on some benefit programmes for low-income Americans and for funds to be stripped from the Internal Revenue Service, the US tax agency.
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They said they want to slow the growth of the US debt, which is now roughly equal to the annual output of the country’s economy.
Exact details of the deal were not immediately available, but negotiators have agreed to cap non-defence discretionary spending at 2023 levels for two years, in exchange for a debt ceiling increase over a similar period, according to Reuters news agency.
The impasse frightened the financial markets, weighing on stocks and forcing the US to pay record-high interest rates in some bond sales.
A default would take a far heavier toll, economists say, likely pushing America into recession, rocking the world economy and cause unemployment to spike.
A Dallas school district has apologised after distributing a Winnie The Pooh-themed book about school shootings.
The book is titled Stay Safe: Run, Hide, Fight and its cover says: “If there is danger, let Winnie the Pooh and his crew show you what to do.”
Inside, it includes passages such as: “If danger is near, do not fear. Hide like Pooh does until the police appear. Doors should be locked and the passage blocked. Turn off the light to stay out of sight.”
Dallas Independent School District said in a statement it works “hard every day to prevent school shootings” by dealing with online threats and improving security measures.
“Recently a booklet was sent home so parents could discuss with their children how to stay safe in such cases,” the statement read.
“Unfortunately, we did not provide parents [with] any guide or context. We apologise for the confusion and are thankful to parents who reached out to assist us in being better partners.”
The school district did not say how many pupils received the book.
California’s governor, Gavin Newsom, was among those who criticised the book, posting on Twitter: “Winnie the Pooh is now teaching Texas kids about active shooters because the elected officials do not have the courage to keep our kids safe and pass common sense gun safety laws.”
‘It’s not exactly cute’
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Cindy Campos, whose five-year-old son was sent home with the book, said she cried when she read it.
“It’s hard because you’re reading them a bedtime story and basically now you have to explain in this cute way what the book is about, when it’s not exactly cute,” she said.
Ms Campos said it seemed especially “tone deaf” to send it home around the time Texas was marking the anniversary of last year’s mass shooting at a school in Uvalde, when a gunman killed 19 children and two teachers.
The book was published by Praetorian Consulting, a Houston-based firm that provides safety, security, and crisis management training and services.
The company says on its website that it uses age-appropriate material to teach the concepts of “run, hide, fight” – the approach US authorities say civilians should take in active shooter situations.
An 11-year-old boy who was shot by a police officer has returned home from hospital after almost a week of treatment.
Aderrien Murry spent five days in hospital with a collapsed lung, lacerated liver, and fractured ribs after the officer shot him in the chest early on Saturday, lawyer Carlos Moore said.
Aderrien was well enough to leave hospital on Wednesday, and is continuing his recovery at home in Indianola, about 95 miles northwest of Jackson, Mississippi.
Mr Moore said the family is “demanding justice”.
“An 11-year-old black boy in the city of Indianola came within an inch of losing his life – he had done nothing wrong and everything right.”
Mr Moore said that Aderrien’s mother Nakala had asked him to call police at about 4am on Saturday after a previous partner had showed up at home.
Ms Murry felt threatened, Mr Moore said, and the child had “called the police to come to his mother’s rescue, he called his grandmother to come to his mother’s rescue, the police came there and escalated the situation”.
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Two police officers arrived and one kicked the front door before Ms Murry opened it, telling them that the man had gone but her three children were inside.
Child does not understand why a police officer shot him
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Mr Moore said that Sergeant Greg Capers, who is black, yelled out that anyone inside should come out with their hands up.
When Aderrien walked into the living room with nothing in his hands, Capers shot him in the chest, Mr Moore said.
Indianola City Attorney Kimberly Merchant confirmed to Indianola’s Enterprise-Tocsin newspaper that Capers was the officer who shot the little boy and Mr Moore said on Thursday that Capers had been suspended with pay while the incident is investigated.
Ms Murry said her son is “blessed” to be alive but he does not understand why a police officer shot him.