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Michael Vera walked into a bedroom of a residential drug treatment program in Los Angeles in March to find its occupant slumped over on his bed and struggling to breathe, a homemade straw on the floor beside him and tinfoil with what appeared to be drug residue under his body.

This story also ran on Los Angeles Times. It can be republished for free.

The 35-year-old overdose victim had been out of custody less than 48 hours, in the midst of a frequently fatal danger zone: Individuals newly released from prison are 40 times as likely to die of opioid overdoses as members of the general population, researchers say.

But he was one of the lucky ones, because Vera was among tens of thousands of California inmates to receive training in overdose prevention and resuscitation when he was released from state prison in 2020. He was given two doses of Narcan to take with him, part of California prisons attempt to arm every departing inmate with overdose-reversal medication.

Vera and his roommate quickly summoned staff members. Paramedics administered two jolts of Narcan, a brand-name version of the drug naloxone. That stabilized the patient enough to get him to a hospital, where he soon recovered. Email Sign-Up

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More than 80% of inmates released in California between April 2020 and June 2022 departed with antidote kits and the training that goes with them, according to a January study by corrections officials. Acceptance has continued to grow, with 95% of departing inmates accepting Narcan in July 2022, the most recent month with data.

Now corrections officials are trying to determine whether the kits actually save lives by examining overdose rates among formerly incarcerated people. They are still gathering data and have no timeline for results, though their report calls the evaluation effort “a critical priority.” Officials are also looking at whether the program can help address health inequity issues, since overdose death rates are higher in lower-income areas, where parolees often live, and occur disproportionately among racial minorities and people with disabilities.

At the same time, California Gov. Gavin Newsom, a Democrat, is looking to cut the cost and boost the supply of opioid antidotes by having the state produce them itself. Currently, federal grants and legal settlements with opioid vendors fund most of the Narcan for departing inmates, but officials said the state did have to buy 1,180 kits for $62.40 each. In 2020, California began offering kits containing two doses of Narcan and information on how to use it to every departing prison inmate. Education and Narcan is key. Its not a perfect solution, but its a damn good one, said Mark Malone, director of administration at Fred Brown Recovery Services. (Alessandra Bergamin / KFF Health News) Narcan, a common form of the antidote naloxone, is kept in the kitchen first-aid kit at Fred Brown Recovery Services. At the instruction of a 911 operator, staff rushed to retrieve Narcan from the box amid a potentially fatal overdose. (Alessandra Bergamin / KFF Health News)

This is an extremely serious problem, said Lynn Wenger of the nonprofit research institute RTI International. As people leave jail and prison, their tolerance for opioids is very low and the stress of release is high.

Wenger is the lead author of a 2019 study of a naloxone distribution program at the San Francisco County Jail, where over a four-year period nearly one-third of inmates who were equipped with the drug upon release reported reversing an overdose.

California officials estimate that some two-thirds of inmates in the state have a substance abuse problem, fed by smuggled contraband. That statistic tracks with national estimates. A new program to administer anti-craving medications like methadone to incarcerated drug users has brought inmate overdose deaths down substantially over the past several years.

But parolee overdoses remain a huge problem.

The California report, quoting various studies, says people just released from incarceration are 40 times as likely to die of opioid overdoses as members of the general population, though estimates vary. Massachusetts put the death toll at 120 times as high, while a study using Washington state prison data put the risk at 12.7 times as high in the first two weeks. Research in Georgia, Maryland, Michigan, New Mexico, North Carolina, and Cook County (Chicago) all found significant connections.

Globally, overdoses are the top cause of death among people recently released from custody.

Its just so scary whats going on here, and were seeing it, said Mark Malone, director of administration at Fred Brown Recovery Services, a 40-year-old nonprofit in the Los Angeles neighborhood of San Pedro. Thats where Vera was getting addiction treatment when he helped save the overdose victim. With quick thinking, roommates Michael Vera and Agustin Pargas intervened amid a potentially fatal overdose. “It made me feel good to be able to save somebody, Vera said. He has a second chance now.” (Alessandra Bergamin / KFF Health News)

Research shows that formerly incarcerated drug users are especially vulnerable because their tolerance for opioids fades while they are behind bars and their social networks and medical care are disrupted, often including any substance abuse treatment they were receiving in prison. And if they use drugs once released, they often do so in solitude, where they are less likely to be found quickly if they overdose.

California offers departing inmates a kit containing two doses of Narcan, along with instructions on how to recognize and prevent overdoses, perform CPR, and administer the antidote.

Demian Johnson, who spent 35 years in prison for a second-degree murder he committed when he was 18 before being paroled in 2018, now helps formerly incarcerated people and others with substance abuse problems at Five Keys Schools and Programs, a San Francisco Bay Area nonprofit. He says two of his friends died soon after they were released from years of incarceration.

“It’s not hard for me to figure out why so many are succumbing to these really, really potent drugs, said Johnson, noting that what inmates obtain in prison is likely to be much less pure than what they would find outside.

One of Johnsons buddies died alone of fentanyl within a year of leaving prison.

He had nobody to save him, to bring him back or to issue him some Narcan, Johnson said. When Michael Vera was released from prison in 2020, he was shown a training video and given two doses of Narcan to take with him. (Alessandra Bergamin/KFF Health News) (Alessandra Bergamin / KFF Health News) At Fred Brown Recovery Services, a residential drug treatment program in San Pedro, California, Narcan is available in emergency boxes throughout the house. Because of increased overdoses in the last year, the treatment program has increased training and availability of Narcan. (Alessandra Bergamin / KFF Health News)

Wenger says the California program is likely having benefits beyond helping those recently paroled: They can use the Narcan to save others, too.

They are often released to neighborhoods where they are likely to encounter someone who is experiencing an opioid overdose & will have the tools to reverse an overdose, she said in an email.

That was the case with Vera, who said he was particularly glad to be able to help someone because he lost a 21-year-old niece and 24-year-old nephew to overdoses around the time he was released.

Vera said the paramedics told him they were just in time. “If we wouldn’t have found him, they don’t know what his outcome would have been but it would have been bad,” Vera said. He has a second chance now.”

This aticle was produced by KFF Health News, which publishes California Healthline, an editorially independent service of the California Health Care Foundation. Related Topics California Pharmaceuticals California Legislature Georgia Illinois Legislation Maryland Massachusetts Michigan New Mexico North Carolina Prescription Drugs Prison Health Care Contact Us Submit a Story Tip

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UK

Fireball at Southend Airport after small plane crashes

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Fireball at Southend Airport after small plane crashes

A small plane has crashed at Southend Airport in Essex.

Essex Police said it was at the scene of a “serious incident”.

Images posted online showed huge flames and a large cloud of black smoke, with one witness saying they saw a “fireball”.

A police statement said: “We were alerted shortly before 4pm to reports of a collision involving one 12-metre plane.

“We are working with all emergency services at the scene now and that work will be ongoing for several hours.

“We would please ask the public to avoid this area where possible while this work continues.”

Fireball after plane crash at Southend Airport. Pic: Ben G
Image:
A huge fireball near the airport. Pic: Ben G

It has been reported that the plane involved in the incident is a Beech B200 Super King Air.

According to flight-tracking service Flightradar, it took off at 3.48pm and was bound for Lelystad, a city in the Netherlands.

One man, who was at Southend Airport with his family around the time of the incident, said the aircraft “crashed headfirst into the ground”.

John Johnson said: “About three or four seconds after taking off, it started to bank heavily to its left, and then within a few seconds of that happening, it more or less inverted and crashed.

“There was a big fireball. Obviously, everybody was in shock in terms of witnessing it. All the kids saw it and the families saw it.”

Mr Johnson added that he phoned 999 to report the crash.

Southend Airport said the incident involved “a general aviation aircraft”.

Four flights scheduled to take off from Southend this afternoon were cancelled, according to its website.

Flightradar data shows two planes that had been due to land at Southend were diverted to nearby airports London Gatwick and London Stansted.

Smoke rising near Southend airport. Pic: UKNIP
Image:
Plumes of black smoke. Pic: UKNIP

Essex County Fire and Rescue Service said four crews, along with off-road vehicles, have attended the scene.

Four ambulances and four hazardous area response team vehicles are also at the airport, as well as an air ambulance, the East of England Ambulance Service said.

Its statement described the incident as “still developing”.

Fire engines at the scene at Southend Airport
Image:
Fire engines at the airport

David Burton-Sampson, the MP for Southend West and Leigh, posted on social media: “I am aware of an incident at Southend Airport. Please keep away and allow the emergency services to do their work.

“My thoughts are with everyone involved.”

Local councillor Matt Dent said on X: “At present all I know is that a small plane has crashed at the airport. My thoughts are with all those involved, and with the emergency services currently responding to the incident.”

This breaking news story is being updated and more details will be published shortly.

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World

Meredith Kercher’s killer faces new trial over sexual assault allegations

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Meredith Kercher's killer faces new trial over sexual assault allegations

The man convicted of the murder of British student Meredith Kercher has been charged with sexual assault against an ex-girlfriend.

Rudy Guede, 38, was the only person who was definitively convicted of the murder of 21-year-old Ms Kercher in Perugia, Italy, back in 2007.

He will be standing trial again in November after an ex-girlfriend filed a police report in the summer of 2023 accusing Guede of mistreatment, personal injury and sexual violence.

Guede, from the Ivory Coast, was released from prison for the murder of Leeds University student Ms Kercher in 2021, after having served about 13 years of a 16-year sentence.

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Since last year – when this investigation was still ongoing – Guede has been under a “special surveillance” regime, Sky News understands, meaning he was banned from having any contact with the woman behind the sexual assault allegations, including via social media, and had to inform police any time he left his city of residence, Viterbo, as ruled by a Rome court.

Guede has been serving a restraining order and fitted with an electronic ankle tag.

The Kercher murder case, in the university city of Perugia, was the subject of international attention.

Ms Kercher, a 21-year-old British exchange student, was found murdered in the flat she shared with her American roommate, Amanda Knox.

The Briton’s throat had been cut and she had been stabbed 47 times.

(L-R) Raffaele Sollecito, Meredith Kercher and Amanda Knox. Pic: AP
Image:
(L-R) Raffaele Sollecito, Meredith Kercher and Amanda Knox. File pic: AP

Ms Knox and her then-boyfriend, Raffaele Sollecito, were placed under suspicion.

Both were initially convicted of murder, but Italy’s highest court overturned their convictions, acquitting them in 2015.

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Politics

RWAs build mirrors where they need building blocks

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RWAs build mirrors where they need building blocks

RWAs build mirrors where they need building blocks

Most RWAs remain isolated and underutilized instead of composable, DeFi-ready building blocks. It’s time to change that.

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