Brian Mann

Every time Shani Damron, 34, buys methamphetamines or heroin on the streets of Huntington, W.Va., she knows the risk is extreme.

"That fentanyl is no joke," Damron said, referring to the deadly synthetic opioid that now contaminates much of the illegal drug supply in the United States. "Every time we stick a needle in our arm, we're taking a 50-50 chance. We could die."

There's also a high risk of disease from contaminated needles shared by drug users. Damron's community has seen a major HIV/AIDS outbreak.

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When Aaron Hinton walked through the housing project in Brownsville on a recent summer afternoon, he voiced love and pride for this tightknit, but troubled working-class neighborhood in New York City where he grew up.

He pointed to a community garden, the lush plots of vegetables and flowers tended by volunteers, and to the library where he has led after-school programs for kids.

But he also expressed deep rage and sorrow over the scars left by the nation's 50-year-long War on Drugs. "What good is it doing for us?" Hinton asked.

After more than a year of high-stakes negotiations with billions of dollars on the line, a bankruptcy plan for Purdue Pharma, the maker of OxyContin, cleared a major hurdle late Wednesday.

Federal Judge Robert Drain in White Plains, N.Y., moved the controversial deal forward despite objections from dozens of state attorneys general, setting the stage for a final vote by the company's creditors expected this summer.

The drugmaker filed for Chapter 11 protection in 2019 facing an avalanche of lawsuits tied to its aggressive opioid sales practices.

During years when the prescription opioid epidemic was spiraling out of control, corporate executives at the drug wholesaler McKesson sent at least two memos ordering employees to "refrain from using the word 'suspicious'" to describe escalating opioid orders from pharmacy chains.

The documents were disclosed this week as part of a landmark federal opioid trial now underway in West Virginia, one of the states hit hardest by opioid deaths.

Copyright 2021 NPR. To see more, visit https://www.npr.org.

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Updated May 3, 2021 at 9:51 PM ET

A senior Drug Enforcement Administration official told NPR efforts to target drug cartels operating inside Mexico have unraveled because of a breakdown in cooperation between law enforcement agencies and militaries in the two countries.

For months, members of the Sackler family that owns Purdue Pharma, the maker of Oxycontin, have portrayed their bid for immunity from future opioid lawsuits as a kind of fait accompli, a take-it-or-leave-it fix to a legal morass.

The Biden administration says new federal guidelines released Tuesday will allow far more medical practitioners to prescribe buprenorphine, a drug proven to reduce opioid relapses and overdose deaths.

The change lowers regulatory hurdles that critics believe sharply limit use of the life-saving medication at a time when drug deaths are surging.

"We have made this much easier for physicians but also for other medical practitioners," said Dr. Rachel Levine, assistant secretary of health, speaking with NPR.

Researchers gathered for a conference on addiction this week received a grim update on the growing spread of street drugs laced with deadly synthetic opioids including fentanyl.

The trend contributed to a stark rise in overdoses that left more than 90,000 Americans dead during the 12-month period ending in September 2020, according to the latest data.

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