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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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Politics

Can Streeting stop the doctors strikes?

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Can Streeting stop the doctors strikes?

👉Listen to Politics at Sam and Anne’s on your podcast app👈 

After yesterday’s royal welcome from the King, French President Emmanuel Macron will get down to business today, meeting Prime Minister Sir Keir Starmer for lunch, after PMQs.

But, as Sky News’ Sam Coates and Politico’s Anne McElvoy discuss on this episode, away from the pomp, Sir Keir’s in-tray doesn’t look any less challenging.

It includes a headache for Health Secretary Wes Streeting as resident doctors, formerly known as junior doctors, announce a new strike – and there is as a punchy warning from the OBR on making financial promises to the public.

Also today, the welfare bill returns to the House of Commons, with reports of another rebellion brewing.

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World

Why do so many from around the world try to cross the English Channel?

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Why do so many from around the world try to cross the English Channel?

While the politicians talk, so many people come from around the world to try to get across the Channel on small boats. But why?

Why make such a perilous crossing to try to get to a country that seems to be getting increasingly hostile to asylum seekers?

As the British and French leaders meet, with small boats at the forefront of their agenda, we came to northern France to get some answers.

It is not a new question, but it is peppered with fresh relevance.

Over the course of a morning spent around a migrant camp in Dunkirk, we meet migrants from Gaza, Iraq, Eritrea, South Sudan, Sri Lanka and beyond.

Some are fearful, waving us away; some are happy to talk. Very few are comfortable to be filmed.

All but one man – who says he’s come to the wrong place and actually wants to claim asylum in Paris – are intent on reaching Britain.

They see the calm seas, feel the light winds – perfect conditions for small boat crossings.

John has come here from South Sudan. He tells me he’s now 18 years old. He left his war-torn home nation just before his 16th birthday. He feels that reaching Britain is his destiny.

“England is my dream country,” he says. “It has been my dream since I was at school. It’s the country that colonised us and when I get there, I will feel like I am home.

“In England, they can give me an opportunity to succeed or to do whatever I need to do in my life. I feel like I am an English child, who was born in Africa.”

John, a migrant from South Sudan, speaks to Sky News Adam Parsons
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‘England is my dream country,’ John tells Adam Parsons

He says he would like to make a career in England, either as a journalist or in human resources, and, like many others we meet, is at pains to insist he will work hard.

The boat crossing is waved away as little more than an inconvenience – a trifle compared with the previous hardships of his journey towards Britain.

We meet a group of men who have all travelled from Gaza, intent on starting new lives in Britain and then bringing their families over to join them.

One man, who left Gaza two years ago, tells me that his son has since been shot in the leg “but there is no hospital for him to go to”.

Next to him, a man called Abdullah says he entered Europe through Greece and stayed there for months on end, but was told the Greek authorities would never allow him to bring over his family.

Britain, he thinks, will be more accommodating. “Gaza is being destroyed – we need help,” he says.

Abdullah, a migrant from Gaza, speaking to Sky's Adam Parsons
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Abdullah says ‘Gaza is being destroyed – we need help’

A man from Eritrea tells us he is escaping a failing country and has friends in Britain – he plans to become a bicycle courier in either London or Manchester.

He can’t stay in France, he says, because he doesn’t speak French. The English language is presented as a huge draw for many of the people we talk to, just as it had been during similar conversations over the course of many years.

I ask many of these people why they don’t want to stay in France, or another safe European country.

Some repeat that they cannot speak the language and feel ostracised. Another says that he tried, and failed, to get a residency permit in both France and Belgium.

But this is also, clearly, a flawed survey. Last year, five times as many people sought asylum in France as in Britain.

And French critics have long insisted that Britain, a country without a European-style ID card system, makes itself attractive to migrants who can “disappear”.

Read more:
Channel crossings rise 50% in first six months of 2025
French police forced to watch on as migrants attempt crossing

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Migrant Channel crossings hit new record

A young man from Iraq, with absolutely perfect English, comes for a chat. He oozes confidence and a certain amount of mischief.

It has taken him only seven days to get from Iraq to Dunkirk; when I ask how he has made the trip so quickly, he shrugs. “Money talks”.

He looks around him. “Let me tell you – all of these people you see around you will be getting to Britain and the first job they get will be in the black market, so they won’t be paying any tax.

“Back in the day in Britain, they used to welcome immigrants very well, but these days I don’t think they want to, because there’s too many of them coming by boat. Every day it’s about seven or 800 people. That’s too many people.”

“But,” I ask, “if those people are a problem – then what makes you different? Aren’t you a problem too?”

He shakes his head emphatically. “I know that I’m a very good guy. And I won’t be a problem. I’ll only stay in Britain for a few years and then I’ll leave again.”

A young man from Iraq walks away from Sky's Adam Parsons

A man from Sri Lanka says he “will feel safe” when he gets to Britain; a tall, smiling man from Ethiopia echoes the sentiment: “We are not safe in our home country so we have come all this way,” he says. “We want to work, to be part of Britain.”

Emmanuel is another from South Sudan – thoughtful and eloquent. He left his country five years ago – “at the start of COVID” – and has not seen his children in all that time. His aim is to start a new life in Britain, and then to bring his family to join him.

He is a trained electrical engineer, but says he could also work as a lorry driver. He is adamant that Britain has a responsibility to the people of its former colony.

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“The British came to my country – colonising, killing, raping,” he said. “And we didn’t complain. We let it happen.

“I am not the problem. I won’t fight anyone; I want to work. And if I break the laws – if any immigrant breaks the laws – then fine, deport them.

“I know it won’t be easy – some people won’t like me, some people will. But England is my dream.”

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Science

Axiom 4 Mission Crew Settles Down at ISS, Begins Conducting Research

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Axiom 4 Mission Crew Settles Down at ISS, Begins Conducting Research

Axiom 4 mission’s crewmates began conducting biomedical research aboard the International Space Station on Tuesday. Expedition 73 and Ax-4 crews found electrical muscle stimulation and cellular immunity. The Cargo transfers and exercise gear maintenance take a day for orbital residents.

Takuya Onishi, Situation Commander from JAXA( Japan Aerospace Exploration Agency), has begun the shift in continuation of his space biology studies. His blood and saliva samples are being collected for storage and processing. Further, he spun the specimens in a centrifuge and placed the blood samples in the freezer. After that, he stowed the samples in the incubator.

JAXA’s Takuya Onishi Leads Cellular Immunity Study with Blood and Saliva Analysis

According to a report from NASA, the samples will be analysed to determine the effect of microgravity on cellular immunity, observe stress-related immune reactions, and learn about how to treat symptoms of immunity. The flight engineers Johnny Kim, Anne McClain, and Nichole Ayers spent their day on orbital lab maintenance and further support activities of the crew. Kim focused mainly on orbital plumbing as he replaced and drained the Tranquillity module.

Ayers checked cables and power components in the Destiny laboratory module and deactivated and placed the microscope. McClain took the cognition test on the laptop and kept on supporting the Ax-4 crew at a time of a busy schedule.

Ax-4 Crew Explores Muscle Stimulation and Space Suit Fabric Efficiency in Microgravity

Veteran astronaut Peggy Whitson and her Ax-4 crewmates Shubhanshu Shukla, Tibor Kapu and UznaÅ„ski-WiÅ›niewski conducted numerous space investigations throughout the lab. The private scientists in their second full week on the station found out that the electrical muscle simulation escalates the space-related and muscle atrophy in space. Ax-4’s other experiments looked at suit fabrics promote thermal comfort with exercising the weightlessness, crew health and agriculture in space.

Sergey Ryzhikov and Alexey Zubritskiy worked together on the Zvezda service module, repairing and organising components on a treadmill, one of the two inside the space station, which included the COLBERT treadmill. Kirill Peskov started his day by going through the biological samples from the crewmates. At the end of his shift, he transfers water from Progress 92 cargo craft and unloads the stuffs of hardware and crew supplies.

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