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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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Greater risk to UK economy following Trump’s tariffs, says Bank of England

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Greater risk to UK economy following Trump's tariffs, says Bank of England

The future of the UK economy is weaker and more uncertain due to President Trump’s tariffs and conflict in the Middle East, the Bank of England has said.

“The outlook for UK growth over the coming year is a little weaker and more uncertain,” the central bank said in its biannual health check of the UK’s financial system.

Economic and financial risks have increased since the last report was published in November, as global unpredictability continued after the announcement of country-specific tariffs on 2 April, the Bank’s Financial Stability Report said.

Money blog: €1 home goes on sale – but there are T&Cs

These risks and uncertainty, as well as geopolitical tensions, like the wars in Ukraine and the Middle East, are “particularly relevant” to UK financial stability as an open economy with a large financial sector, it said.

Pressures on government borrowing costs are “still elevated” amid significant doubts over the global economic outlook.

Had a 90-day pause on tariffs not been announced, conditions could have worsened, the report added.

More on Bank Of England

The chance of prices rising overall has also grown as tensions between Iran and Israel and the US threaten to push up energy prices.

Possible higher inflation in turn raises the prospect of more expensive borrowing from higher interest rates to bring down those price rises. This compounds the pressure on state borrowing costs.

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Trump’s tariffs: What you need to know

Mortgages

Borrowing costs for about 40% of mortgage holders are set to become costlier over the next three years as households refix to more expensive deals, affecting 3.6 million households, the Bank said.

Many homes have not refixed their mortgage since interest rates began to rise in 2021, meaning the full impact of higher rates has yet to filter through.

Those looking to get on the property ladder got a boost as the Bank said lenders could issue more loans deemed to be risky, meaning people could be able to borrow more.

Financial institutions can now have 15% of their new mortgages deemed risky every year, up from the current 9.7%.

Riskier mortgages are those with a loan value above 4.5 times the borrower’s income.

Be ‘prepared for shocks’

Despite the global and domestic economy concerns, the outlook for UK household and business resilience remained “strong”, the Bank said.

Investors, however, were warned that there could be “sharp falls in risky asset prices”, which include shares and currencies.

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If there are any vulnerabilities in non-bank lenders, it “could amplify such moves, potentially affecting the availability and cost of credit in the UK”.

“It is important that in their risk management, market participants [people involved in investing] are prepared for such shocks.”

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The steep market reaction following the tariff announcements in April “highlights that the interconnectedness of global financial markets can mean stress from one market can move quickly to others,” the report said.

Overall, though, “household and corporate borrowers remain resilient”, the Bank concluded.

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Politics

What is a wealth tax, how would it work in the UK and where else has one?

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What is a wealth tax, how would it work in the UK and where else has one?

The idea of a wealth tax has raised its head – yet again – as the government attempts to balance its books.

Downing Street refused to rule out a wealth tax after former Labour leader Lord Kinnock told Sky News he thinks the government should introduce one.

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Lord Kinnock calls for ‘wealth tax’

Sir Keir Starmer’s spokesman said: “The prime minister has repeatedly said those with the broadest shoulders should carry the largest burden.”

While there has never been a wealth tax in the UK, the notion was raised under Rishi Sunak after the COVID years – and rejected – and both Harold Wilson’s and James Callaghan’s Labour governments in the 1970s seriously considered implementing one.

Sky News looks at what a wealth tax is, how it could work in the UK, and which countries already have one.

Chancellor Rachel Reeves and Prime Minister Sir Keir Starmer at the launch of the 10-year health plan in east London. Pic: PA
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Will Chancellor Rachel Reeves and Prime Minister Sir Keir Starmer impose a wealth tax? Pic: PA

What is a wealth tax?

A wealth tax is aimed at reducing economic inequality to redistribute wealth and to raise revenue.

It is a direct levy on all, or most of, an individual’s, household’s or business’s total net wealth, rather than their income.

The tax typically includes the total market value of assets, including savings, investments, property and other forms of wealth – minus a person’s debts.

Unlike capital gains tax, which is paid when an asset is sold at a profit, a wealth tax is normally an annual charge based on the value of assets owned, even if they are not sold.

A one-off wealth tax, often used after major crises, could also be an option to raise a substantial amount of revenue in one go.

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Wealth tax would be a ‘mistake’

How could it work in the UK?

Advocates of a UK wealth tax, including Lord Kinnock, have proposed an annual 2% tax on wealth above £10m.

Wealth tax campaign group Tax Justice UK has calculated this would affect about 20,000 people – fewer than 0.04% of the population – and raise £24bn a year.

Because of how few people would pay it, Tax Justice says that would make it easy for HMRC to collect the tax.

The group proposes people self-declare asset values, backed up by a compliance team at HMRC who could have a register of assets.

Which countries have or have had a wealth tax?

In 1990, 12 OECD (Organisation for Economic Co-operation and Development) countries had a net wealth tax, but just four have one now: Colombia, Norway, Spain and Switzerland.

France and Italy levy wealth taxes on selected assets.

Colombia

Since 2023, residents in the South American country are subject to tax on their worldwide wealth, but can exclude the value of their household up to 509m pesos (£92,500).

The tax is progressive, ranging from a 0.5% rate to 1.5% for the most wealthy until next year, then 1% for the wealthiest from 2027.

Bogota in Colombia, which has a wealth tax
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Bogota in Colombia, which has a wealth tax

Norway

There is a 0.525% municipal wealth tax for individuals with net wealth exceeding 1.7m kroner (about £125,000) or 3.52m kroner (£256,000) for spouses.

Norway also has a state wealth tax of 0.475% based on assets exceeding a net capital tax basis of 1.7m kroner (£125,000) or 3.52m kroner (£256,000) for spouses, and 0.575% for net wealth in excess of 20.7m kroner (£1.5m).

Norway has both a municipal and state wealth tax. Pic: Reuters
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Norway has both a municipal and state wealth tax. Pic: Reuters

The maximum combined wealth tax rate is 1.1%.

The Norwegian Labour coalition government also increased dividend tax to 20% in 2023, and with the wealth tax, it prompted about 80 affluent business owners, with an estimated net worth of £40bn, to leave Norway.

Spain

Residents in Spain have to pay a progressive wealth tax on worldwide assets, with a €700,000 (£600,000) tax free allowance per person in most areas and homes up to €300,000 (£250,000) tax exempt.

Madrid in Spain. More than 12,000 multimillionaires have left the country since a wealth tax was increased in 2022. Pic: Reuters
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Madrid in Spain. More than 12,000 multimillionaires have left the country since a wealth tax was increased in 2022. Pic: Reuters

The progressive rate goes from 0.2% for taxable income for assets of €167,129 (£144,000) up to 3.5% for taxable income of €10.6m (£9.146m) and above.

It has been reported that more than 12,000 multimillionaires have left Spain since the government introduced the higher levy at the end of 2022.

Switzerland

All of the country’s cantons (districts) have a net wealth tax based on a person’s taxable net worth – different to total net worth.

Zurich is Switzerland's wealthiest city, and has its own wealth tax, as do other Swiss cantons. Pic: Reuters
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Zurich is Switzerland’s wealthiest city, and has its own wealth tax, as do other Swiss cantons. Pic: Reuters

It takes into account the balance of an individual’s worldwide gross assets, including bank account balances, bonds, shares, life insurances, cars, boats, properties, paintings, jewellery – minus debts.

Switzerland also works on a progressive rate, ranging from 0.3% to 0.5%, with a relatively low starting point at which people are taxed on their wealth, such as 50,000 CHF (£46,200) in several cantons.

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UK

Parents tell ‘untold stories’ of how their ‘hero’ daughters survived Southport attack

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Parents tell 'untold stories' of how their 'hero' daughters survived Southport attack

The parents of survivors of the Southport attack have revealed the “untold stories” of how their “hero” children escaped.

Axel Rudakubana, 18, murdered Elsie Dot Stancombe, seven, Bebe King, six, and Alice da Silva Aguiar, nine, in what the chairman of the public inquiry Sir Adrian Fulford called “one of the most egregious crimes in our country’s history”.

Eight children were injured along with two adults at a Taylor Swift-themed class in the Merseyside seaside town on 29 July last year, while 15 others escaped without physical injuries.

The surviving victims and their families have been granted anonymity during the inquiry, with one girl referred to as C3. Her father was the first to give evidence at Liverpool Town Hall on Wednesday.

Alice da Silva Aguiar, Elsie Dot Stancombe and Bebe King were murdered in an attack at a Taylor Swift-themed class.
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Alice da Silva Aguiar, Elsie Dot Stancombe and Bebe King were murdered in the attack

Reading a statement on behalf of him and his wife, he told how their daughter was the first girl to escape the scene by running from the Hart Space building and hiding behind a parked car before jumping through an open car door.

“Our nine-year-old daughter was stabbed three times in the back by a coward she didn’t even see,” he said.

“Although she didn’t know what was happening – she knew she had to run. She ran out of the studio door, down the stairs, and out of the building.”

Read more: Southport inquiry as it happened

He said she can be seen “looking scared, confused and pained” in CCTV footage of the incident, adding: “It was troubling for us to see what she had to go through, before either of her parents had arrived at the scene.”

“We are so thankful and proud that despite being critically injured, she was able to make the decisions she did in that terrible moment,” he said.

The girl’s father said his daughter “continues to astound” them with the way she dealt with the attack and her recovery, saying: “It has been inspiring for us to witness.”

Chair Sir Adrian Fulford sitting inside the hearing room at Liverpool Town Hall, ahead of the start of the inquiry.
Pic: PA
Pic: PA
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Inquiry chair Sir Adrian Fulford at Liverpool Town Hall. Pic: PA

He said she has difficulty sleeping, experiences flashbacks, looks over her shoulder scanning for potential danger when she leaves the house, has a fear of loud noises and has to turn off some songs when they come on the radio.

“Our daughter knows that she is loved,” he said.

“It is through this support and love that she will continue to thrive. We couldn’t be prouder of her. She is our hero.”

Stabbed 33 times

The parents of a girl referred to as C1 told how their “beautiful, articulate, fun-loving little girl” was stabbed 33 times.

After being attacked she escaped the building, but Rudakubana was seen dragging her back inside in CCTV footage played during his sentencing hearing, which drew gasps in court, before she was stabbed 20 more times.

“That is how she became known in this nightmare. The girl that was dragged back in,” her mother said.

Police at the scene of the Southport attack on 29 July 2024. Pic: PA
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Police at the scene. Pic: PA

Southport

She thanked the teachers who escaped to call police and flag down help but said: “The most painful of truths for us though, and what has been most devastating to come to terms with, is that there were no adults to help during both of her attacks.

“She was only supported by other children. The courage and strength she found leaves me crushed, but in complete awe.”

She added: “It is these untold stories of remarkable strength and bravery that are missing when we have heard other accounts of this day.”

The mother said the “hours and days that followed the attack were a living hell” and her daughter’s memories – including a concert of her “idol” Taylor Swift – have “been forfeited to make space for the trauma that she carries”.

“We tell her she was brave. How proud we are that she was able to help other girls. How her strength makes us feel strong. How important what she did that day was. She is her own hero. She may be a survivor of this attack, but she is still trying to survive this, every single day,” she said.

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‘We need to understand what went wrong’

Attack ‘changed everything’

The mother of a girl referred to as C8 said she was “like any other seven-year-old little girl”, “with an incredible energy” and “full of life”.

But in a statement read out by a legal representative, she said the attack last year “changed everything” when she got a “panicked phone call” from a friend’s mother, who couldn’t find the girls.

“That moment, the sound of fear in her voice and the panic I felt will never leave me,” she said.

“I rushed to the scene and what I saw is something no parent should ever see. My daughter had sustained serious physical injuries including a stab wound to her arm and a cut to her face and chin.”

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‘We don’t want Elsie forgotten’

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The fly-tippers turning trash into cash

She said her daughter “remembers the attack vividly” and later told her “she thought it had to be fake, because she couldn’t believe something that terrible could really be happening”.

“Where she was once eager to go off with her friends, she now needs my support if it is somewhere public or unknown,” she said.

“Simple days out now need a level of safety planning that we would never have considered before.”

‘Constant flashbacks’

The mother of a girl referred to as Q, who escaped without being physically injured, told how she arrived to collect her daughter to find “children running from the building, screaming and fearing for their lives”.

In a statement read to the inquiry by a legal representative on her behalf, she said it was “the most horrific experience of my life”.

“What I saw on that day will stick with me forever, I constantly have flashbacks and relive what happened,” she said.

She said her daughter has become “very withdrawn” since the attack and has asked her parents, “How will I ever be normal again?”

Rudakubana was jailed for a minimum of 52 years in January and is being investigated over an alleged attack on a prison officer at Belmarsh prison in May.

The public inquiry, announced by Home Secretary Yvette Cooper in January, is looking into whether the attack could or should have been prevented, given what was known about the killer.

Rudakubana, who was born in Cardiff, had contact with police, the courts, the youth justice system, social services and mental health services, and was referred to the government’s anti-extremism Prevent scheme three times before the murders.

A rapid review into his contact with Prevent found his case should have been kept open and that he should have been referred to Channel, another anti-terror scheme.

C1’s mother said: “She deserves the truth, she deserves accountability. She deserves an apology. Our girls deserve an apology.

“Backed up by the promise that changes will be made and this will not be allowed to happen again.”

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