Despite the narrative of a meth overdose crisis, on some level the public understands that people using fentanyl are at risk in a way that people using just meth are not, because it’s not quite okay to openly demonize the victims of a mass death situation. But if you want to openly demonize meth users, that’s okay. And yet, if we take a closer look at meth in the context of the larger unregulated drug supply, we can see that public opinion has gone a little off course.

Most meth overdose isn’t physically harmful; occasionally someone might have a seizure, but it won’t hurt them. The supply is consistent. The supply is pure. The global supply chain is decentralized.

Meth has a withdrawal process, kind of, but nothing gastrointestinal. It’s shelf-stable dry or in liquid for months, probably years. It’s rural but also urban. It’s health care amid an Adderall shortage. It’s working class. It’s gay. It’s trans. It’s pretty. It’s invisible. It’s cheap.

Like it or not, meth is the people’s drug. It’s there for the people who need to stay awake when it’s not safe to sleep, or when their jobs won’t allow them to sleep. It’s there when people can’t afford food. It’s there for the people who can’t access antidepressants. It’s there to facilitate sex work. It’s there to give people the energy to carry their stuff around. It’s there to let people feel alive—or numb, depending—even in the most miserable of circumstances where they’re supposed to feel only bad things.

And the state hates that. You go and make all these laws to ban certain people from every place they could possibly try to get a job, get a home, go to sleep, go to the bathroom, you cut every social support out from under them and chase them out of anywhere they try to rest, but no matter what you do to get them to finally just lay down and die, meth picks them up and keeps them going.

I have some bias. I used meth for three or four years, every day, and while it made a lot of things in my life harder I’m not sure how else I could have managed the things it made easier. Plus when meth causes problems for people I don’t interpret that as the meth being, like, sinister, it’s just a function of whatever else people have going on in their lives at that time. I also never would have met my husband if meth hadn’t kept him alive for the decade or so when the rest of the world was trying to kill him, so even though it’s not part of my life anymore (or his) I default to a warm opinion of anyone who is using it. 

People look down on meth like it’s the drug you do when you’ve given up on life, which bugs me because I do not see that at all. I always saw it as something people use to participate. And in pretty much any context, but especially with anyone who doesn’t have housing, it always seems like meth is what people use when it’s hard to keep going, but they want to.

Opioid users hear all day long about how the supply is dangerous because it’s adulterated. Meth users are punished because the supply is pure. Even though consistent purity and potency are traditionally good qualities for a drug supply to have, from a public-health perspective.

“[M]ethamphetamine is less physically dangerous or addictive than heroin or cocaine, yet methamphetamine is now punished more severely than any other drug,” the National Association of Criminal Defense Lawyers wrote to the United States Sentencing Commission in 2025, referring to federal meth sentencing being determined by purity rather than by weight the way it is for other drugs. “Not only do the current methamphetamine guidelines lack a legislative basis, they also lack any empirical justification … sentences now receive massive arbitrary enhancement based entirely on whether the methamphetamine received laboratory testing [to establish purity], something that is obviously beyond the control, and unrelated to the culpability, of any defendant.” 

And then there’s police violence, which benefits from the same bias driving the narrative of a meth overdose crisis—once you say someone used meth, nobody questions why they died. They were unarmed and police shot them 10 times? Well, they were on meth. It’s so potent these days.

“We started to see a pattern of kind of irrational, aggressive behavior on the part of the people that were being shot or shot at,” a special prosecutor in a New Mexico told Colorado Public Radio of rising meth use in 2020, describing the case above. “It didn’t make any sense to us.”

Okay. 

In 2024, a Black man died after 40 minutes naked in a Wyoming county jail restraint chair, with two straps across his chest in addition to the restraints on his limbs, saying he couldn’t breathe. The forensic pathologist found no evidence of restraint-related death, but instead cited “methamphetamine overdose and the cardiac effects of excited delirium.” Remember excited delirium? The racist and unscientific diagnosis has been rejected by the medical establishment as a valid cause of death, because it was just how cops covered up excessive force. But this is “excited delirium due to methamphetamine overdose.” So it’s different.

Over the past decade the US harm reduction movement has been defined by the overdose crisis, and so services and policies have been designed for people who use opioids, then retrofitted for people who use stimulants.

Which is understandable; opioids are straightforward. We have methadone and buprenorphine, we have naloxone, we have the policy goal of overdose prevention centers and eventually safer supply. We have a clearly defined mechanism of overdose death, and we have a target demographic that—broadly speaking—uses fentanyl in similar settings and for similar reasons.

Stimulants are less straightforward. They interact with a wider range of systems in the brain and body, they produce a wider range of physical and psychological effects, and meth specifically appears in extremely different contexts in different people’s lives—chemsex, sex work, shift work, street homelessness, studying. Daily daytime use, monthly nighttime bingeing. And so on. It’s more difficult to categorize meth users and pin down what common services they need. If they need housing there’s only so much that harm reduction groups can do, and if they need a harm reduction resource other than sterile syringes and fentanyl test strips, whatever it is probably hasn’t been legalized yet anyway.

We’ve organized around access barriers to methadone and buprenorphine for opioid use disorder. But for stimulant use disorder this would require a policy leap more in the direction of safer supply, and so rather than organizing around stimulant agonist medications we just observe that we don’t have any. Instead we have contingency management, the practice of telling meth users that if they do a good job peeing in a cup they will be eligible for Walmart gift cards. And, now that they have something to look forward to, they don’t have to get their dopamine rush from stimulants anymore.

The movement hasn’t known what it’s supposed to offer meth users because it approaches the problem through a fentanyl lens, thinking in terms of meth’s physical effects and risks and harms. When it shouldn’t really be looking at meth, but at the people who use it. Queer communities, Indigenous communities, sex workers, people living with HIV, people living outside, people cycling through the criminal-legal system. The harms that the movement can reduce for meth users come primarily from being overpoliced. And from really bad public relations.

Artwork by Brooke Alexandria Paine. First inset image via County of Fresno. Second inset image (cropped) via Reentry Council of the City & County of San Francisco.

The post Big Shoutout to Meth appeared first on Filter.

Fentanyl Is in Everything

Around 2013, fentanyl started percolating in the United States street opioid supply, which was heroin-based at that time. Over the next few years it steadily pushed heroin out of the East Coast, and once the COVID-19 pandemic hit it rapidly did the same on the West Coast. As crackdowns have pushed the drug supply to evolve more quickly and chaotically, fentanyl has gradually begun showing up with non-opioid drugs.

Media and law enforcement, however, tend to describe it as an additive that predatory distributors mix into whatever they’re distributing—cocaine, meth, heroin, marijuana, vapes, pills that look like pharmaceuticals.

Fentanyl sometimes ends up in meth and cocaine supplies, probably not intentionally. This varies a lot by region and isn’t as common as most local news stories would have you believe, but is important to be aware of.

A pressed pill sold as Percocet or Oxycodone might not contain fentanyl, but you should assume that it does, if you don’t have the means to check. Same goes for anything sold as Xanax. A pressed pill sold as Adderall could conceivably contain fentanyl, but that would make it a pretty significant anomaly; what you should assume that it contains is meth.

We tend to fixate on whether something does or does not contain fentanyl, but that binary distinction isn’t what determines the risk. Someone opioid-naive who buys a fentanyl pressed pill that they believe to be real Percocet will still be okay if the amount of fentanyl in the pill is small enough. Conversely, someone who smokes what they know to be fentanyl pills off foil every day will be overdosing within minutes if they get one with more fentanyl than they were expecting.

Has fentanyl been found in marijuana? It has not. Periodically there are news stories or other vaguely credible-sounding claims to this effect, but none of them ever stand up to scrutiny. The one that got arguably the most traction was a 2021 statement from Connecticut health officials, announcing “the first lab confirmed case of marijuana with fentanyl in Connecticut and possibly the first confirmed case in the United States” and citing 39 incidents “where only marijuana use was reported but naloxone was required.” Later it turned out that this boiled down to a single case of minor, accidental cross-contamination among people who also used opioids.

You can immediately write off any claims of fentanyl being smoked with marijuana, or smoked with anything else using a combustion process rather than a vaping process. Fentanyl can’t be smoked with an open flame; it gets burned and rendered inactive.

A very small number of vapes appear to have tested positive for fentanyl. For one thing, this would probably happen with literally any physical object that school boards across the country started continuously testing for fentanyl. But the important takeaway is that the more credible claims involve vapes that had clearly been modified intentionally for personal use, not vapes that had been designed that way and marketed to children. You can still pick out any news story that describes a middle- or high-school student nearly dying from using a “fentanyl-laced vape”—even the stories circulated by elected representatives—and reliably find that it has either since been debunked or does not mention any actual laboratory confirmation of fentanyl, despite whatever the headline said. Usually the source for the claim is the student or their mom.

Higher-Potency Opioids Need Extra Doses of Naloxone

Naloxone works by binding to your mu receptors—the specific protein molecules that opioids also bind to—and kicking off whatever opioids might already be there. The clinical dose of naloxone, 0.4 mg/mL, is what’s usually sufficient to reach about 50 percent of your mu receptors, or enough to reverse an overdose. That’s why 0.4 mg/mL is the dose contained in a vial of generic intramuscular naloxone.

A Narcan nasal spray contains a 4-mg dose of naloxone. Intranasal administration can’t be directly compared to intramuscular, but it’s the less efficient of the two and so Narcan is designed to deliver more than the clinical dose. A 4-mg Narcan was more than enough for most heroin overdoses, is still more than enough for most fentanyl overdoses, and is also still more than enough for most overdoses involving fentanyl analogs, nitazenes, orphines and whatever novel synthetic opioids are found in the supply next. Naloxone’s effectiveness doesn’t change based on the opioid’s potency, since it acts on the mu receptors rather than on the opioids themselves.

When cops or well-meaning bystanders share stories about someone needing five doses of Narcan to wake up, and how this just shows how much more potent the supply is these days and how naloxone doesn’t cut it anymore, this almost always comes from the same mistaken assumptions about overdose reversal.

Naloxone takes two or three minutes to kick in, which is why it’s important to administer rescue breathing while you wait. But because the two minutes that you’re supposed to wait before administering a second dose can understandably feel like an eternity, especially to anyone not experienced in these situations, the temptation is often to pump in a second dose pretty quickly. Or a third dose, or fourth, or fifth, and so on until the person wakes up. When someone wakes up after a fifth Narcan, what you’re really seeing is the first dose kick in. All the extra naloxone did nothing to help, and for people with a physical tolerance to opioids it can precipitate withdrawal and put them at increased risk of overdosing again. At a proper dose, reversing an overdose with naloxone doesn’t require waking the person up at all.

In 2021, the 8-mg Kloxxado nasal sprays hit the market and marked the beginning of the naloxone arms race. In the five years since then, the Food and Drug Administration has approved a 5-mg intramuscular autoinjector—meaning it delivers about 12.5 more naloxone than the clinical dose—a 10-mg nasal spray that launched earlier in 2026. It’s also moved beyond naloxone to a different, longer-acting opioid antagonist, nalmefene. The first nalmefene nasal spray, Opvee, has already been followed by a nalmefene auto-injector. And government contracts investing in nalmefene as a preventative measure for fentanyl nuclear war. And biased research inventing meaningless metrics that are supposed to justify any of this as necessary.

Naltrexone Is Safe and Effective

Technically, the US has three approved medications for opioid use disorder (MOUD). In reality, we have two MOUD that are shown to be safe and effective, and we have naltrexone. Methadone and buprenorphine (Suboxone) decrease overdose risk. Naltrexone’s labeling is required to carry a warning that it increases fatal overdose risk.

Naltrexone is commonly known by brand name Vivitrol, the injectable formulation touted in county jails and other correctional settings. While methadone and buprenorphine are opioid agonists, naltrexone is an opioid antagonist—like naloxone and nalmefene. It purports to work by blocking the effect of opioids, so that even if a patient tries to use opioids they won’t feel anything.

What this effectively does is reduce tolerance, which is why the FDA labeling has to warn that deaths have been documented “at the end of a dosing interval, after missing a scheduled dose, or after discontinuing treatment.” The warning about risk of fatal overdose from “[a]ttempts to overcome blockade” is similar to the warning carried by the two approved nalmefene products, Opvee and Zurnai.

Unlike methadone and buprenorphine, naltrexone requires detoxing prior to initiating the medication—going into withdrawal for at least a week, maybe two. That alone makes it a non-starter for a substantial portion of people at risk. A recurring theme with research supporting naltrexone’s efficacy is that it doesn’t count the people who tried to start the medication and weren’t able to get through the detox process, preferring to factor in only the cases where people did manage to onboard. Or it uses the framing that once detox is out of the way, “naltrexone is about as effective as buprenorphine,” which still isn’t true.

People stabilize on methadone and buprenorphine because those MOUD help manage cravings and withdrawal symptoms. But studies tracking naltrexone outcomes never show anything long-term. Conclusions that it reduces cravings come from short-term data, and any evidence of its efficacy is based on negative urine drug screens after a few weeks or at most a few months. This research is never concerned with what happens after that. The idea of naltrexone remains popular because it fits an abstinence mentality, it’s punitive and it’s an easy out for corrections departments. Not because it’s helpful.

Syringe Litter

As popular as it is to demonize syringe service programs (SSP), the arguments against them don’t see too much innovation. There’s the complaint that SSP increase “crime,” which is not true. There’s the complaint that they increase drug use, which is not true. The most substantive complaint is that they increase “syringe litter.” This is also not true.

Neighborhoods that open SSP are overwhelmingly associated with a decrease in publicly discarded syringes, for a few different reasons. They’re often more convenient than sharps-disposal bins in parks, which require people to make a separate trip just to have fewer syringes than before. They provide portable sharps containers that are small enough for people to carry around, and larger ones people can keep at home. And they employ peer workers who do daily walkabouts picking up any syringes they see on sidewalks or other public areas.

At the heart of the syringe litter myth is the suggestion that children are at risk of contracting HIV from stepping on a needle while playing at the park. This is an easy one to debunk: It has never happened. There has never been a single documented case of anyone, child or adult, contracting HIV from a publicly discarded needle. It’s just another myth.

The human immunodeficiency virus is very fragile and relies on our immune cells to survive. Once outside the body, exposed to air, it dries up and dies almost immediately. This is why the only confirmed HIV needlestick transmissions have all involved health care workers in hospital settings, and even then they’re extremely rare. For the public, transmission risk is limited to situations involving blood, semen, vaginal or rectal fluids, or breastmilk delivered directly to a mucous membrane or into the bloodstream.

The hepatitis C virus can actually live for several weeks outside the human body, but globally there have been maybe three documented cases of hep C transmission from accidental needlesticks in community settings; none in the US nor involving children. Hep C can be easily and painlessly cured with oral medication, and doesn’t begin to damage the body for years or even decades.

As often as the media runs stories about syringe litter, you might notice that the accompanying photos often show a syringe with the front and back cap still on, sterile as the day it was born, thoughtfully arranged in the middle of a ditch. I was going to make a joke about how eventually they’ll show one of those individually packaged 27-gauge 1 cc syringes still in its individual package, but this has already happened.

Secondhand Overdose From Drugs in Prison Mail

After that viral video with the San Diego County Sheriff’s Department deputy in 2021, the online harm reduction community got the rare satisfaction of rallying around a talking point—you cannot overdose from touching fentanyl—and seeing the media actually take notice. A lot of news stories will now add some kind of disclaimer when referencing passive exposure, though this remains pretty hit or miss. You can’t overdose from skin contact. You can’t overdose from breathing in fentanyl molecules floating around in the air; fentanyl has a very low vapor pressure and barely releases any molecules into the air anyway. You can’t overdose from any other kind of passive exposure. The public is now moderately more aware that there is no such thing as secondhand fentanyl overdose. However, like everything else in harm reduction, this development has not made it into the prison system.

US prisons and jails have a completely different drug supply than the free world. There is fentanyl, but the mainstays are generally synthetic cannabinoids (K2; Spice) meth, Suboxone, tobacco and strips, a catch-all term for the ubiquitous strips of paper soaked with what could be anything, but is often synthetic cannabinoids or household solvents like insecticide. In recent years, many facilities have seen synthetic cannabinoids and/or strips replace meth or other contraband similarly to the way fentanyl replaced heroin in the outside drug supply.

Countless press releases and Facebook announcements have described how corrections officers required Narcan (multiple doses!) and were hospitalized following exposure to dangerous synthetic cannabinoids and other drugs concealed in incoming mail. This does not mean the officers were harmed. It does not mean the officers were ever in harm’s way. It does not even necessarily mean the officers were exposed to any drugs. It means that officers gave themselves Narcan and took themselves to the hospital. Synthetic cannabinoids are not opioids and are not affected by Narcan, but the whole situation is so far beyond logic that we don’t have time to stop for this.

The only one of these incidents that’s ever cited actual harm was in 2024 at USP Atwater, when mailroom supervisor Marc Fischer reported feeling ill and then died at a hospital about two hours later. Initially the cause of death was undetermined, pending toxicology, which gave media outlets across the country an opening to run headlines about “possible fentanyl exposure.” The Merced County Sheriff’s Office did not respond to Filter’s February 2025 coroner records request, which is fine because a week later documents filed in US District Court for the Eastern District of California revealed that the cause of death was a heart attack. Neither the AP nor the Los Angeles Times nor any other media outlet that ran a “possible fentanyl exposure” headline ever published anything further. The Bureau of Prisons, Correctional Peace Officers Foundation and various other agencies continue to honor Fischer’s memory by not acknowledging the autopsy, and praising his sacrifice in the line of duty while handling synthetic drug-soaked mail.

There is no evidence to suggest that secondhand exposure to synthetic opioids or cannabinoids poses any kind of risk. Many corrections officers know this, since they’re the ones bringing in most contraband drugs anyway. But they continue to bravely share their stories, and Occupational Safety and Health Administration investigations conclude that mailroom staff need head-to-toe personal protective equipment and HEPA-filtered biosafety cabinets, and federal corrections officers unions use those findings to call for the expansion of digitized mail-scanning.

And that’s what all of this is really about: understaffing and the nationwide push to privatize prison mail services, and cut incarcerated people off from receiving physical letters. Along with in-person visitation, and book donations, and any other “privilege” whose physical form can be replaced with a digital service conveniently offered by a handful of for-profit contractors. More than three out of four people incarcerated in US prisons no longer have access to physical mail.

At this moment, somewhere in the US another corrections department is drafting another press release breathlessly recounting how over the weekend one or more officers were hospitalized following exposure to deadly synthetic drugs, and pleading for Congress to recognize that no one should have to risk their life just to do their job of opening other people’s mail. Media and legislators will circulate it with no scrutiny whatsoever. To date, there are no confirmed reports of any corrections officers ever having been harmed by exposure to drugs in the mail.

Meth Overdose Crisis

Opioid overdose is potentially fatal because opioid molecules can bind to the brainstem receptors that regulate breathing; the mechanism of death is respiratory depression. Meth, like synthetic cannabinoids and various other stimulants like cocaine, doesn’t have any particular mechanism of death that accompanies overdose in the same way.

Stimulant overdose, or overamps as they’re sometimes called, don’t necessarily produce stereotypical symptoms like paranoia or hyperactivity. Often they make people fall asleep. Occasionally they might cause seizures. But then they resolve, and that’s that. The harms tend to come from exposure to law enforcement, rather than the physical ordeal itself.

Meth-involved overdose deaths in the US began rising more noticeably around 2019, peaking in late 2023 before starting to gradually drop back down; the same trajectory as fentanyl-involved deaths, but less drastic. It’s clear that more people are using meth compared to a decade ago, which means more people have meth in their system at the time that they die. But it’s not quite clear that meth is what’s causing them all to die, at least not on the scale being suggested by the media.

US death investigations are a mess. Depending on the state, they might be carried out by medical examiners, elected county coroners or local law enforcement. In Nebraska, for example, cause of death is determined by prosecutors. In most California counties, the coroner is also the sheriff. Forensic pathologists are still required to sign off on the death certificate, but there are only a few hundred of them in the whole country and many jurisdictions now use forensic pathologists who aren’t board-certified. In Canada and other wealthy countries full autopsies are considered standard for suspected overdose deaths, but in the US they’re rare. Where not mandated by state law, they’re pretty much reserved for cases where law enforcement could potentially use the evidence to prosecute someone, or the family could afford a private one.

In suspected overdose cases, the death investigation often consists of toxicology and an external examination—medical history plus a long look at the body and any evidence found at the scene. None of these can reveal a heart attack, or heat stroke, or pneumonia. But they can reveal meth, and even without fentanyl that’s all that’s needed to wrap the investigation, particularly for people who die without housing. No available medical history? Well, clearly their medical history is that they used meth.

“If they had a heart death, I think [any meth] is going to get attributed as a cause of death. Because that is the bias of the system,” a toxicologist who signs off on drug death reports told Filter in 2023. “It’s like: Here’s someone that was found in a tent, we can’t contact their next of kin, we did a [urine drug screen]. They’ve got meth in their system; keep it moving. We’re not going to do an autopsy.”

Some research has suggested that meth is linked to about two out of three US deaths among people without housing. Local-level studies have found similar patterns in places like California and Oregon.

Deaths attributed to just meth, with no fentanyl present, tend to be among people who were over 45 and had a history of cardiovascular disease. To which chronic meth use may have contributed, but it wouldn’t have been the only thing. When a non drug-user dies from a heart attack in a hospital, we say they died from a heart attack—not from a sedentary lifestyle or refined carbohydrates. When a meth user dies from a heart attack and they weren’t in a hospital, their cause of death was a heart attack. But we might say it was meth, if drugs were the only thing we checked for.

Novel Synthetic Opioids, Even Deadlier Than Fentanyl

No matter how much we sensationalize fentanyl and its potency, after hearing about it for so many years the public has somewhat acclimated to the idea. So fentanyl headlines lose their power, and the only way for media outlets to combat this is with something even more potent than fentanyl.

First it was fentanyl analogs, followed by nitazenes and most recently orphines. All have the potential to be more potent than fentanyl (as well as less potent, not that this is of interest to anyone). The problem with news outlets pouncing on each novel synthetic opioid (NSO) as it hits the supply isn’t so much that they misrepresent the potency; it’s that they misrepresent the prevalence. Each NSO is presented as a harbinger, like behind the first couple of reports is a dam about to break, unleashing the substance that will replace fentanyl the way fentanyl replaced heroin. That will usher in the next wave of the overdose crisis all on its own.

Outside of North America the emergence of NSO could have a very different significance, if fentanyl hasn’t already saturated the opioid supply the way it has here. But at the moment, there’s no real reason to think that any fentanyl analogs, nitazenes or orphines are poised to overtake fentanyl in the US supply. Some of them, like carfentanil or cychlorphine, have become more recognizable names, but we’re still talking about substances linked to a very small portion of overdose deaths, and that’s including the cases where they were detected at all not just the ones where they were detected alone or determined to be the cause of death.

Most of these substances arrive mixed in with fentanyl—though some are occasionally found on their own—and aren’t really distinguishable from fentanyl, from a user perspective. Health departments will take whatever one or two talking points exist , which are probably just the location where it was detected and how many times more potent than fentanyl it’s supposed to be, and stretch them over a public bulletin that doesn’t help the public do anything differently. There’s a NSO in the supply. It’s been detected six times, in these two states; you can’t test for it and it’s not distinguishable from fentanyl. You should still use naloxone and take the precautions you were taking for fentanyl. This kind of thing is for the benefit of website traffic and re-election campaigns, not the public.

Not all recent additions to the supply are interchangeable. Xylazine and medetomidine, both non-opioid veterinary tranquilizers, have come with distinct complications and forced harm reduction groups to evolve overdose response protocols around each of them specifically. NSO have certainly reshaped how we criminalize the supply, but they haven’t really reshaped the supply itself. Even carfentanil, which has been in the US about as long as fentanyl and remains the most potent opioid we know of, has ebbed and flowed at the edge of the supply and never grown into something with a market of its own. None of them have.

No matter how potent, a substance can’t really be more deadly than fentanyl if it isn’t causing more people to die.

The post The Drug War Myths People Still Believe appeared first on Filter.

The proposal falls under the Workforce Innovation and Opportunity Act. It would direct Acting Department of Labor Secretary Keith Sonderling to send state and local governments information on “evidence-based and promising practices” to mitigate economic harms related to SUD, including how to apply for relevant federal funding. And it would broaden eligibility for National Dislocated Worker Grants to include career training in SUD, mental health care and pain management in any jurisdiction “that, as a result of widespread substance use, addiction, and overdoses, has higher-than-average demand for such activities that exceeds the availability of State and local resources to provide.”

The legislation would add a new category of eligibility that’s specific to SUD, and would apply to dislocated workers; people who have been long-term unemployed; people who work or are looking for work as treatment providers for SUD, mental health or pain; and people who are  “unemployed or significantly underemployed as a result of widespread substance use in the area.”

McCormick’s office did not respond to Filter’s inquiry.

Drugs and the people who use them have long been scapegoats for economic underinvestment.

“If we’re going to help more people recover, we need enough skilled workers to provide that care,” McCormick stated in his announcement. “This bipartisan bill gives communities more tools to train that workforce so more people can get the help they need.”

Drugs and the people who use them have long been scapegoats for economic underinvestment, and the language used in the Act and by its proponents sort of conjures an image of a small town where the “scourge of addiction” has wiped out all the jobs. Or conceivably it could refer to people who are struggling to find work because first they need to access treatment, but aren’t able to due to overwhelming demand on the few providers in their area. Or to people who are unable to work because they’re surrounded by too much drug use to escape it. But one way or another, a lot of the workforce harms the legislation is concerned with probably don’t come from drug use so much as they come from drug-testing, and the larger drug war. 

While it’s certainly true that people have lost jobs because their SUD negatively impacted their performance or their behavior in the workplace, that’s also a stereotype obscuring the larger picture of people losing their jobs due to drug use. Often urinalysis testing is the barrier to remaining at or returning to work, rather than conduct or ability. Research indicates that workplace drug-testing is not an effective means of either reducing drug use or increasing productivity. A larger barrier to employment—and to recovery—is the criminalization of drugs and the unwillingness of many employers to hire candidates with felony records.

The proposal is the latest of many cosponsored by McCormick and Fetterman, who are often touted for their bipartisanship, although Fetterman has also prompted serious conjecture about whether he intended to switch parties and recently had an apparent Freudian slip in which he told NewsNation that he was a Republican. He did not make his own announcement about the legislation, but on August 5 did appear The Weekly Show with Jon Stewart to espouse some right-of-center views on socialism and the existence of genocide in Gaza.

Image via Coon Rapids, Minnesota

The post Federal Bill Would Add SUD Category to Dislocated Worker Grant Eligibility appeared first on Filter.

The 95-percent stat itself isn’t accurate; it’s from the early 2000s, and hasn’t been true for a long time. Today it’d be around 84 percent, and that’s with the extremely conservative assumption that the only people who won’t come home are the ones serving 50 years or longer. The United States Sentencing Commission considers a de facto life sentence to be anything over 39 years and two months. Which is about the average sentence length for prisoners in Georgia right now. Lifers aren’t the outliers that they used to be.

Mandatory minimums, “three strikes” or “repeat offender” laws, truth-in-sentencing laws, sentence stacking and the formal or informal elimination of parole were all already underway by the turn of the century, and even as the size of the United States prison population has changed trajectories a few times since then the proportion of people serving life has continued to grow. (This refers to people sentenced to life with parole, life without parole, de facto life, and the death penalty.)

Since 2020 when corrections officers across the country quit in droves amid the COVID-19 pandemic, lifers—specifically the long-timers who’ve already been in prison a while—have been the ones keeping the peace at their facilities, relatively speaking. But as their role becomes more critical, corrections departments are simultaneously treating them as more expendable. Moving the older and vulnerable folks into gang-controlled units to see if that diffuses the violence; skipping over them for basic resources and programming because they don’t factor into recidivism statistics.

For example, lifers are generally ineligible for medication for opioid use disorder (MOUD), just by virtue of being lifers; if a prison has a Suboxone program at all, it’s likely considered a re-entry service and only made available to people with release dates in the next few weeks or months. Even the more traditional, non-MOUD treatment programs, which mostly consist of group meetings with limited capacity, will prioritize the people whose counselors wrote it into their re-entry plan, or who were steered toward it by the parole board.

As the only people who have to stay in the system, lifers the only ones with any real reason to make it better. Or who know how anything works.

Jobs are also considered re-entry preparation. Meaning that on wait lists—rarely do prisons have enough jobs to go around—people are in some cases bumped up or down by release date. Lifers are already ineligible for many if not most of the best-paying jobs, because they can’t go to work-release camps. Even in states that don’t pay prisoners at all, lifers who are barred from those jobs can still find themselves cut off from basic resources that went with them.

Work assignments, educational or vocational programming, pretty much any meaningful way to pass the time—these things only exist in the context of re-entry, family reunification, public safety and reducing recidivism.

The few officers who do show up, to work 16-hour shifts while they bring in contraband to offset the low pay, are rookies who will quit in a few months. The private kitchen contractors, whose job is to spend less on food than the state would have, will continue to shrink the portions of the meal-replacement powders they serve instead of food because future health care costs aren’t their problem. The private health care contractors can deny necessary surgeries and stop ordering everyone’s blood-pressure medication so they can pass the savings to their shareholders, because they’re not sticking around either. So there is an obvious need to invest in lifers. As the only people who have to stay in the system, they’re the only ones with any real reason to make it better, and the long-timers are the only ones who’ve been around long enough to know how anything works.

Though lifers build up so much expertise about the prison system they live in, they’re rarely able to compare notes with lifers in other systems, or see how the forces affecting them fit in with what’s happening in the rest of the country. The following is a discussion between three lifers who’ve each been incarcerated for around 30 years, each in a different state and different type of prison environment. It was not conducted in real time but in stages, as each contributor’s responses were relayed back and forth. As such, certain responses have been organized for readability rather than reproduced in strict chronological order.

Tony Vick, in Tennessee Department of Correction custody since 1997, serving life without parole: In Tennessee the biggest way lifers are hurt is, we can’t get into any of the good prisons. All the good prisons are short term-only prisons, 10 years or less. So we can’t get to a prison that has good [programming], and less violence, because they’re all short-time prisons. They call a prison like this one a time-building prison, and they’re the worst prisons. Might as well call it a death-waiting facility.

Jonathan Kirkpatrick, in Washington State Department of Corrections custody since 1995, serving a 60-year sentence: In this state I think custody plays a bigger role than length of time. [But] length of time is factored into your custody, so for example I reached Minimum but they have a special designation, Long-Term Minimum and this is the lowest security level I can get. So we can be classified as Minimum, but we can only go to Medium-capable facilities. So we have to have two fences between us and freedom, is what that means. Some Minimum facilities, like [work-release] camps, don’t have any fences, some have one fence, but nobody Long-Term Minimum can go to those facilities.

Jimmy Iakovos (pseudonym), in Georgia Department of Corrections custody since the early 1990s, serving life with parole: Politicians with no experience with prisons make policy calls totally contrary to all that is known to work. That pressure recently caused [a mass transfer of lifers from Medium-security Calhoun State Prison] to make room for short-timers. Consider that the lifers there had earned Medium security and were accepting of the terrible heat and insects of Deep South Georgia, because they were left alone to live as comfortable as they could make it with phones and whatnot. 

Now [Calhoun] is full of short-timers who know they are leaving in X amount of months. They are tearing the place apart because they have no reason not to.

Vick: I would dare say that the most change the younger inmates passing through, the most education and positive change they get are from the old-timers taking them under their wing and trying to help. That’s more than what the state will do for you. I say that without any hesitation. That’s why you have to invest in lifers, too. They are your constant support, constant teachers, constant moral police, constant peacemakers … lifers are the Ted Talks of the prison system.

The current ideology of what Americans think about prisons, it’s going more and more toward retaliation and less toward rehabilitation. They’re giving such long sentences, they want to just forget about you. They want you to go off to prison and they don’t have to think about you anymore. So the only reason they have to think about you is if you’re gonna come out, so they’re trying harder and harder to not let that happen. Get you sent in there once and for all, and then we don’t have to worry about you no more; we just have to build more prisons. 

Iakovos: When I first began we had Pell grants for four-year degrees available. The education director at the prison then turned me down saying, You have a fresh life sentence. You have plenty of time to get that degree. I got one year in before the Pell grant was cancelled. It’s back now, but none of the colleges are jumping at the chance to get involved. 

Kirkpatrick: That’s really similar here. In the first few months of my sentence we had Pell grants, before the feds took it. Now they’re back but there’s this real emphasis on [younger folks] with this FAFSA thing. I don’t know what it stands for, but I was starting my associate degree and got a few classes in and then the college said they needed me to fill out the FAFSA grant stuff and I got denied. It’s really common, here at least, to not get anything … this quarter the Black Prisoners’ Caucus is gonna give me a couple of classes, that’s really the main way that guys are doing it. If you’re doing any amount of time here you’re not getting classes through government grants.

Vick: If there are new computer coding programs or things like that, they don’t want anybody not getting out in there. They don’t bother putting you in a program for a good-paying job, or any self-improvement type of programming, or in any class with a certificate—what do you need that class for if you don’t need the certificate to show the parole board?

Iakovos: Lifers [in GDC] are not outright denied programs, classes, vocational training etc, but we are out at the back of the line … Our superpower is waiting lists. We naturally stick around long enough to make an issue if we have been waiting patiently. Educational aide jobs do not require long-timers, but those are the ones who have been on the waiting list the longest, so 90 percent of the time are the ones that get the job.

GDC only issues raincoats, thermal underwear and knit skull caps (AKA toboggans) to people assigned to work outside details. [Lifers are no longer assigned to those details, so that change] denied us [winter] clothes. Outside of very picky shakedowns or transfers, once I’m issued an item it’s mine until I choose to get rid of it. I had a thermal top that was 16 years old before it developed a hole in it. Because I needed it for two months a year. But without it, those two months are a misery. 

Now granted, I am able to buy my own clothes. But there are lifers older than I, who have served longer than I, who have [no money] coming in. Of course we—other lifers—look out for these men as we can, but that should not be required for survival.

Vick: [Correctional industries here] no longer hires anybody .. who doesn’t have a possibility of getting out in the next 25 years. Because of all their re-entry programs that they have now. They want people to be able to count toward their statistics. And here’s the problem, some people spend years learning those big six-color [printing press] machines that cost $1 million. You can’t learn those in a year or two. I can understand them wanting a mixture of people there. And we [lifers] even advocated for that, saying, Listen, you should at least have like 20 people who have long sentences so you can have some continuity. But …

Iakovos: The Braille transcribing program here specifically requires at least five years [served], and five remaining to serve in order to be considered … most short-timers never get in. Sometimes one will be foisted upon the group through connections to administration. Worthless for the business.

A lot of people who come in with marketable job skills are reluctant to give their skills away for free. At first. Over time they get bored and or decide to keep skills sharp and gravitate to the job near their field.

Kirkpatrick: Here you can go to correctional industries for seven years. But [these days] a regular job you can only spend two years, and have to get extensions approved by an associate superintendent or above. Reason is the same, don’t want prisoners to get comfortable. But that logic doesn’t stand … it’s the officers who get comfortable in their positions and let people do things they shouldn’t. And that’s the problem. It’s not because I live here and I’m gonna be exposed to the same thing every day, day in and day out for the rest of my life. How am I supposed to not get familiar with things? This is where I live. The officers are the ones who need to get moved around so they don’t get complacent and comfortable. My opinion at least.

Vick: Yes, that’s a good point. Because if the officers are following policy, it shouldn’t matter what the inmates are doing. It’s the officers being corrupted.

Kirkpatrick: Back when I was at Stafford Creek, where they have a lot of jobs, there was a short minute where they didn’t care who worked there. Then all of a sudden everybody doing more than 20 years got fired. Took us four or five years but then it was brought to everybody’s attention that they were supposed to have 10 percent of the population that works there be lifers, it’s supposed to reflect the population of prisoners. But they hated having lifers because their whole gig is, We’re building people for getting out. They like it when people doing a really long time come in at the end of their sentence, and then what they do is, Look, we reformed this person!

Vick: About 10 years ago they started a policy of rotating certain jobs every year, out of fear that inmate and staff would get too close. It seemed ridiculous, because you got all this skill associated with jobs you have to learn. Usually lifers or long-timers were the ones that had those jobs, because they had the most knowledge. You wait your whole life to get a job like that in prison, then all of a sudden you can’t have it no more. They diminish your skill, make you feel like it doesn’t matter if you know anything or not. You’re just a number. We’ll just move you around on a spreadsheet. We’ll just put another cow in the field.

The staff here stopped following that policy to tell you the truth. Maybe sometimes, depending on the warden or job coordinator, but they haven’t really been doing it here. I think they saw that they were supposed to take people with all this experience and [replace them] and just realized, My goodness, we can’t do that or we will never pass an audit.

Kirkpatrick: Maybe it’s different in other states, but here almost all the guys who have been around for a long time—we just want to chill. Most of the time, 90 percent of us just want to chill. And if they put us in the same place it’s going to be a real mellow institution, right? And they never do that, just let us all chill out. And I sort of understand why. In a way, the old-timers are also the most dangerous, right? They have the most experience and know-how. So I understand. But there are a lot of us that, given the opportunity to go to a lower custody level, it’d be nothing but good for [DOC] and it’d be less money spent on keeping us incarcerated.

Vick: If they put all of us [lifers] in one pod they would never even have to have an officer come in. All we want is to have peace and get along. But they know if they did that the rest of the prison would be so much more violent and chaotic, they gotta disperse us. Just using us old folks to mellow it out, keep the peace. While causing us more harm, putting us in danger, denying us programming.

Lifers are often the stability in the unit. They try to keep it clean, keep it maintained. The newcomers don’t really give a flip. They don’t regard it as any sort of home, they’re just passing through. And when I first come to prison you’d see guards here 20 years, 30 years, who retired in this industry. Now very seldom do you see guards who’ve been here more than five years, and the new ones coming in, of course, they don’t have any respect for where they are. They’re just trying to collect a paycheck and clock out, and I don’t blame them.

Iakovos: The difference is, this is a lifer’s home. We are not just visitors. Lifers are invested in prisons being comfortable, and in being left alone by the guards. 

Meanwhile, the Close security prisons that those [Calhoun] lifers were sent to have become chill, because of the overwhelming chill attitude of a bunch of lifers just trying to do the time unfucked with. We know that the police have to respond to the trouble areas. So the Close security prisons are becoming the least staffed. Completely contradictory of any planned best use of resources excusing the higher cost of higher-security prisons. Lol.

Top and first inset image (cropped) via Washington Office of the Corrections Ombuds. Second inset image via They Have No Voice. Third inset image via Tennessee Department of Correction/YouTube.

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The survey covers mental illness, substance use, treatment and recovery for respondents ages 12 and up. The 2025 NSDUH, published in late July, reflects 60,447 completed interviews in person or online; in recent years it’s typically reached around 70,000.

Based on the 2025 respondents, SAMHSA projects that 69.8 million people—around 24 percent of the population over age 12—used at least one unregulated drug at least once within the past year. This refers to marijuana, hallucinogens, cocaine, methamphetamine, heroin, and “misused” prescription opioids, stimulants or tranquilizers/sedatives.

The 2022 NSDUH was the first to include street fentanyl. But it instituted a weirdly nonintuitive format that keeps street fentanyl siloed from the main section on opioids—effectively framing it as an afterthought while keeping the focus on prescription analgesics and heroin.

Respondents aren’t asked about street fentanyl until after they’ve completed the section covering substance use disorder, so the SUD statistics intentionally exclude that data. The same is true of opioid use disorder statistics, which are designed to include “misuse” of prescription fentanyl but nothing about street fentanyl. This format has been repeated in each subsequent NSDUH, including the 2025 edition.

The data show that past-year use of street fentanyl averaged around 660,000 people between 2022 and 2024, then jumped to 768,000 people for 2025. This represents a change from about 0.2 percent of the population over age 12 to 0.3 percent. However, you wouldn’t know that without looking at supplementary materials or data from previous years. The 2025 NSDUH itself simply states that for each year from 2021 to 2025, and across all age demographics, there was no change in the number of people using street fentanyl.

“[Q]uestions about the use of illegally made fentanyl (IMF) have appeared after SUD questions in the NSDUH questionnaire since 2022. For this reason, overall SUD, drug use disorder, and opioid use disorder measures do not capture disorders arising solely from the use of IMF,” the report states. “As discussed in the Illegally Made Fentanyl Use section, however, the estimate of IMF use in the past year among people aged 12 or older was low in 2025 (0.3 percent or 768,000 people).”

The “Illegally Made Fentanyl Use section,” which totals four paragraphs out of the 157-page report, acknowledges that this is “almost certainly an underestimate of true IMF use.” But it discusses street fentanyl almost as a novel opioid emerging in the heroin supply, rather than the one that emerged a decade ago.

In several places, the commitment to the five-year trend framework effectively erases any conclusions one might have otherwise drawn about 2025. For example, take the following graphic illustrating past-year cocaine use:

You might say it shows use among the 18-25 demographic decreasing for several years, then in 2025 going back up. SAMHSA’s characterization of the data, however, is that from 2021 to 2025 cocaine use decreased among the 18-25 demographic, and other than that there was no change.

The same thing happened in the broader section on “misuse” of central nervous system stimulants.

The NSDUH is pretty much the gold-standard citation for statistics on SUD and drugs, but the survey has always been marked by awkward data taxonomies that skew the results further away from real life than they would have been already. And by ambiguous language that makes it difficult to interpret even the more straightforward parts. After respondents “who reported ever using heroin or prescription pain relievers” were asked whether they’d been prescribed medication for opioid use disorder (MOUD), for example, and shown a comprehensive and accurate list of different formulations of methadone, buprenorphine and naltrexone, the report proceeds to state that MOUD “do not include the use of medications that are prescribed to manage withdrawal symptoms.”

The survey purports to represent the national scope of drug use and mental illness, but barely acknowledges that it isn’t offered to the populations most impacted by those things. It isn’t offered to people living outside or in their cars, for example, or in jail or prison.

The 2025 NSDUH does include data on whether people received treatment while in prison, jail or juvenile detention, though it doesn’t say what kind.

Top and inset images (cropped) via Substance Abuse and Mental Health Services Administration

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As the CSA stands currently, 10-year mandatory minimums in federal fentanyl trafficking cases are triggered at 400 grams. The Act would drop this to 20 grams. For fentanyl analogs, the threshold would drop from 100 grams to 5 grams. 

Five-year mandatory minimums are currently triggered at 40 grams, which the Act would drop to 2 grams. For fentanyl analogs, the threshold would drop from 10 grams to 0.5 grams. Analog thresholds would apply regardless of whether or not the analog in question has been scheduled.

The Act was introduced July 23 by Rep. Marlin Stutzman (R-IN) as the companion bill to the Fairness in Fentanyl Sentencing Act sponsored by Sen. John Kennedy (R-LA). The latter was introduced in February 2025 and hasn’t moved out of committee. Kennedy previously attempted it in 2023 under the Biden administration. 

Stutzman and Kennedy’s public messaging around the legislation has been that 400 grams of fentanyl, the current threshold for 10-year mandatory minimum sentencing, is enough to kill 200,000 people. This was also the case for the sponsors of the Fentanyl Penalties Parity Act of 2021, which proposed the exact same threshold modifications. But the actual threshold in the CSA is not 400 grams of fentanyl. It’s “400 grams or more of a mixture or substance containing a detectable amount of” fentanyl, which is very different. Stutzman’s office did not immediately respond to Filter‘s inquiry.

If that logic bore out, a fentanyl pressed pill would be the size of three grains of table salt.

If you consider the common Drug Enforcement Administration talking point about how fentanyl is approximately 50 times more potent than heroin, you can imagine that it’d be difficult to sell or use a dose that’s 50 times smaller. Because of this, most of the “fentanyl” in a typical stamp bag or pressed pill is a mixture of non-psychoactive fillers like mannitol (sugar alcohol) or acetaminophen. The United States Sentencing Commission has acknowledged that the mixture’s total weight is used even “when a drug is mixed with an inert substance, such as a binder or filler used in the production of pills or tablets.” Changing a quantity threshold from e.g. 400 grams to 20 grams has no direct bearing on the amount of actual fentanyl involved.

Proponents of the Act and similar legislation, however, consistently characterize the mixtures as pure fentanyl.

“It only takes two milligrams of fentanyl to kill a person. That’s just about three grains of table salt,” stated cosponsor Rep. Rob Bresnahan (R-PA). “Despite this, it takes 40 grams of fentanyl, or roughly three tablespoons of butter, to trigger the federal five-year mandatory minimum sentence for trafficking. That threshold simply does not reflect the deadly reality of this drug.”

If that logic bore out, a fentanyl pressed pill would be the size of three grains of table salt.

Lowering the five-year mandatory minimum threshold for fentanyl analog mixtures from 10 grams to 0.5 grams would effectively target possession and low-level distribution—0.5 grams could mean just two stamp bags, or five pills. Anyone who uses street-supply fentanyl could find themselves subject to the penalty, if what they picked up that day happen to contain trace amounts of any analogs. It’s extremely unlikely that either the buyer or seller in that scenario would know whether the bags contained any analogs, which are usually found in combination with fentanyl and many of which are comparable in potency.

The fentanyl crisis demands action. My new bill goes after drug dealers and traffickers by:

Keeping these criminals off our streets through lowering federal sentencing thresholds.
Investing $9M to strengthen drug detection, staffing, and enforcement across the Postal… pic.twitter.com/dJVslxCi8M

— Rep. Marlin Stutzman (@RepStutzman) July 24, 2026

“This bill targets the worst offenders,” stated National District Attorneys Association Executive Director Nelson Bunn. National Alliance of State Drug Enforcement Agencies Executive Director Carlon Stapleton praised the “zero-tolerance approach toward those who manufacture or distribute” fentanyl. Indiana Drug Enforcement Association President Chris Goergen condemned those who “take advantage of fentanyl’s low cost to produce as well as its high profit margin … with little to no regard for the people it hurts the most.”

USSC data show that most of the people convicted in federal overdose cases are local sellers and that, of those who’d been at the scene of the overdose when it happened, most had tried to help the victim. But it’s not clear that the Act has any direct bearing on cases linked to overdose. The CSA currently provides that regardless of whether the mixture quantity triggers a 10- or five-year mandatory minimum, the sentencing range is 20 years to life when the case is linked to overdose; the Act does not propose to change this.

“Hundreds of thousands of Americans die every year from fentanyl poisoning,” Stutzman claimed in his announcement. “I am proud to take up the No Leniency for Fentanyl Dealers Act with Senator Kennedy so those peddling this lethal substance are punished with sentences commensurate with their actions.”

Kennedy correctly described US fentanyl-involved deaths as in the tens of thousands per year, but stated that he was proud to work with Stutzman “to ensure these ghouls get the punishment they deserve.”

The legislation would additionally authorize $9 million for drug interdiction within the United States Postal Service, and require more staffing resources—namely scientists who can be “available during all operational hours” to identify suspected fentanyl as quickly as possible.

It would also direct the USSC to review the changes and, “if appropriate,” update its drug sentencing guidelines accordingly. In late 2025 the USSC amended those guidelines to deemphasize the role of thresholds in determining someone’s sentence, in recognition of how easily those numbers are distorted in court and how meaningless they were to begin with.

“I find no greater joy than putting a fentanyl dealer behind bars,” stated cosponsor Rep. Clay Fuller (R-GA).

Image (cropped) via New Hampshire Division of State Police

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The report focuses on quantitative data for fentanyl, cocaine and methamphetamine as well as qualitative data for seven novel psychoactive substances (NPS) selected by ONDCP: acetyl fentanyl, carfentanil, ketamine, medetomidine, para-fluorofentanyl, tianeptine and xylazine. Quantitative analysis refers to the concentration of a substance relative to the size of the population using that sampling site, which isn’t necessarily possible for those that are less prevalent or more potent than fentanyl, cocaine or meth. The data represent about 18 percent of the United States population, and according to ONDCP is the country’s largest wastewater drug-monitoring project to date.

After first analyzing the seven NPS by census region, the agency decided to hone in on individual counties where at least six of the seven had been identified.

“Counties where at least six drugs were detected may signal broader polysubstance activity, making them important areas for closer monitoring,” the report states. It also labels counties as “hotspots” for fentanyl, cocaine and meth use.

Similarly, the report points out that medetomidine, para-fluorofentanyl, carfentanil and acetyl fentanyl were identified in all census regions, “signaling potential emerging and re-emerging threats.” But there’s no indication of scale for any of the NPS data, even in the report’s accompanying supplement.

For some states, the data really reflect a single county. Other states have data from up to nine counties. And within the county-level data, there’s no standardization in how many sampling sites were included, or whether multiple sites were spread out versus concentrated in one location. 

The government isn’t required to get the public’s consent to test wastewater because, legally speaking at least, property is no longer private once we’ve thrown it away; it’s the same concept behind why cops don’t need a warrant to go through trash cans on the curb.

Biobot Analytics, the first commercial wastewater-testing company, began contracting with ONDCP in January. (The National Institutes of Health has already been working with Biobot for wastewater drug-testing since 2020.) In May, the new National Drug Control Strategy called for the establishment of a “national wastewater-based monitoring system,” and referenced wastewater testing as a means of confirming AI analyses of emerging drug trends on social media.

Notably, wastewater data doesn’t distinguish between regulated and unregulated versions of a substance. This means that Adderall use, whether prescribed or not, is getting categorized as methamphetamine.

The utility of wastewater testing mostly depends on whether the data is going to public health or to law enforcement. However anonymized the samples might be initially, it’s not difficult for law enforcement to trace the information back to a specific toilet if they really want to.

“Unlike many sources, wastewater is unbiased by household income, race or gender, ensuring equal representation,” Biobot stated in a 2023 blog post about wastewater testing in the context of allocating opioid settlement funds. “With 80 percent of American households and almost all public restrooms included, wastewater analysis offers insights into where substances are used.”

Wastewater itself isn’t biased by income, but it’s harder to say that about wastewater analysis, which is entirely contingent on access to indoor plumbing.

Top and inset images (cropped) via Office of National Drug Control Policy/X.com

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The data, announced July 15, cover the 12-month period between February 2025 and February 2026. So far jurisdictions have reported 67,531 overdose deaths for that time period. The predicted number of deaths, which is considered to be more representative since death records aren’t all reported at the same time and a small portion (0.24 percent) are still pending investigation, is 68,641. That puts the national overdose rate approximately where it was in 2019.

Overdose rose sharply at the onset of the COVID-19 pandemic, after already rising almost continuously since the CDC began tracking this data in 1999. But in 2023 the trajectory abruptly reversed, and for the past two-and-a-half years the provisional data have shown the national rate continuing to drop each month. In 2024 the rate of fatal overdose decreased by more than 26 percent. But in 2025 this decrease slowed to half-speed. In the most recent report, the national rate of decrease is 12.1 percent.

Behind the national average, there’s always been a wide range in how the crisis is experienced in different parts of the country. Nebraska and South Dakota were still reporting slight increases even when the national rate first began to plummet in late 2023. 

In New Mexico, where overdose has been rising the most sharply, the predicted number of deaths is 1,037, a 27.1-percent increase from the 816 deaths predicted during the 12 months leading up to February 2025. In Colorado the increase is 14.2 percent, with 1,852 predicted deaths up from 1,622 in the 12-month period a year earlier.

South Dakota (+12.5 percent) is predicting 90 overdose deaths, up from 80 during the same 12-month period a year earlier. Other states in which overdose has continued to rise are North Dakota (+7.1 percent) with 120 predicted deaths; and Minnesota (+1.7) with 1,008 predicted deaths;  Montana (+1.2 percent) with 175 predicted deaths. In Nebraska the rate of change was 0, with 149 predicted deaths.

Outside of the Western corridor, overdose has continued to drop.

In the previous monthly report that list had included Alaska and New Hampshire for the first time. The most recent data show overdose in both states starting to drop again, with Alaska (-6.2 percent) at 324 predicted deaths and New Hampshire (-0.8 percent) at 258 predicted deaths.

Though Arizona had previously experienced a surge comparable to New Mexico’s, the past several monthly reports have showed that surge slowing to half-speed, which is not the case in New Mexico and Colorado. The latest number of predicted deaths for Arizona is 2,914, up from 2,695. 

Between the provisional death count published in April and the most recent one in July, New Mexico’s rate of change increased from about 16 percent to over 27 percent. Colorado’s increased from 10.3 percent to 14.2 percent. But Arizona’s rate of increase fell, from 21 percent to 8.2 percent in the most recent report.

Outside of the Western corridor, overdose has continued to drop. The latest data show the jurisdictions with the steepest decreases are Rhode Island (-34.3 percent) with 203 predicted deaths; Oregon (-29 percent) with 1,044 predicted deaths; and Puerto Rico (-25.8) with 435 predicted deaths.

Overdose data are subject to a ton of inconsistencies, stemming from the various ways death investigations are conducted at the county level, and so these reports are most useful when viewed in terms of the overall scope and trajectory of the crisis rather than putting too much weight on fluctuations between smaller numbers. Alongside the latest monthly report, the CDC also published county-level overdose death data covering December 2024 through December 2025.

Fentanyl pill purity has dropped sharply in recent years. But this is not the same thing as supply reduction, and is not the result of fentanyl seizures at the border. There is still no evidence that fentanyl interdiction reduces overdose, not just because the federal government doesn’t actually evaluate what if anything its fentanyl seizures accomplish but because this strategy has never been shown to meaningfully reduce drug-related harms. It’s usually shown to increase them, in the long run.

Image (cropped) via Centers for Disease Control and Prevention

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“In recent years, there has been growing interest in and active research on the therapeutic potential of psychedelic drugs, in particular for the treatment of serious mental health conditions,” the FDA stated. “In response, FDA has made significant advances in psychedelic drug development through the issuance of scientific guidance, engagement with federal partners and the public, and regulatory actions to support drug development.”

A four-hour public hearing has been set for September 14 at the FDA campus in Silver Spring, Maryland. Requests to attend, either virtually or in person, must be submitted by August 21. The public can submit comment electronically up through October 5. Confidential submissions can also be sent by mail, as long as they’re received by the same deadline.

It’s likely that the first approvals of Schedule I psychedelics would be followed by proposals for rescheduling.

The clinical guidance is the final version of draft guidance the FDA issued in June 2023.

“Drug development programs for psychedelic drugs are subject to the same regulations and same evidentiary standards for approval as other drug development programs,” the final guidance states. “However, designing clinical studies to evaluate the safety and effectiveness of these products presents a number of unique challenges.”

The agency went on to describe the potential for “intense perceptual disturbances and alterations in consciousness,” as well as “both rapid-onset and long-term benefits,” sometimes after only one dose.

“There is preliminary evidence that psychedelic therapies can rewire the brain and produce rapid improvements for people with serious mental illness or substance use disorders,” stated National Institutes of Health Director Dr. Jay Bhattacharya. “However, we still have much to learn about long-term benefits and risks, including the potential for misuse.”

A number of psychedelic substances have been heavily researched for their potential to treat conditions like SUD, post-traumatic stress disorder and major depressive disorder. These include psilocybin (the active compound in “magic mushrooms”) LSD, MDMA and ibogaine—all of which are banned under Schedule I of the Controlled Substances Act. Because the criteria for Schedule I are a “high potential for abuse” and no medical use approved by the FDA, it’s likely that the first INDA approvals would be followed by proposals to reschedule those psychedelics to a less-restrictive category, the same process by which medical marijuana was recently moved to Schedule III. The final clinical guidance states that in the event of a Schedule I psychedelic being approved for medical use, “the abuse potential assessment [from the INDA] would assist in determining an appropriate rescheduling action.”

HHS singled out ibogaine in particular.

The HHS announcement singled out ibogaine in particular. The plant-based psychedelic from Central West Africa appears to be in favor with the Trump administration, and the National Institute on Drug Abuse is currently funding research exploring it as a treatment for opioid use disorder.

On July 13, HHS also announced a new memorandum of understanding (MOU) with the VA. At publication time the VA was involved in 20 active clinical trials studying psychedelic treatments for mental health conditions.

“Under the agreement, HHS and VA will coordinate workforce training, develop evidence-based clinical protocols, support research and real-world evidence generation, and prepare the VA healthcare system to responsibly implement future FDA-approved rapid-acting psychiatric drug products as they become available,” the MOU states. 

It will be in effect through 2031. The partnership will aim to increase veteran participation in clinical trials, train the health care workers involved in such trials, create public awareness materials and facilitate data-sharing that could allow the FDA to issue INDA approvals more quickly.

The HHS announcement also referenced a “separate, complementary MOU” pertaining to mental health treatment more broadly, but this appeared to be the same one announced by the FDA. That MOU is the only one recently listed in the FDA’s Domestic MOU catalog, although there its expiration date is “Indefinite” rather than the five-year term described elsewhere. The FDA did not respond to Filter’s inquiry.

Image via Hillsboro, Oregon

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The state alleged that “most” of the 641 million prescription opioid pills Albertsons dispensed during the 16-year period investigated had unresolved “red flags,” referring to activity that the Drug Enforcement Administration’s proprietary algorithms register as suspicious.  

“The AG’s office’s investigation revealed that between 2006 and 2022 Albertsons unlawfully dispensed opioid orders without adequately investigating and documenting the resolution of such red flags,” the Office of Washington State Attorney General Nick Brown stated ahead of the trial. “Albertsons also self-distributed opioids to its own pharmacy stores for a span of time and failed to report any of the more than the tens of thousands of suspicious orders from its own pharmacies to the DEA as required by law. Instead, Albertsons shipped them all.” 

During the investigation period Albertsons owned the state’s second-largest pharmacy chain. The company acquired Safeway in 2015, and owns a number of other grocery chains like the Washington-based Haggen stores. Between those brands the company currently owns about 200 pharmacies across Washington. For approximately five years Albertsons was also the distributor to its own pharmacy stores.

Similar to much of the other opioid litigation against major pharmacy chains, Washington alleged that Albertsons repeatedly pressured pharmacists to fill as many prescriptions as possible while ignoring “red flags,” required them to fill prescriptions from “pill mill” prescribers, prevented information from being exchanged between different store locations, and generally put profits over people. 

The lawsuit alleges that Albertsons violated not only Washington’s Consumer Protection Act, but state-level nuisance statutes. Washington defines a “public nuisance” as one that affects “the rights of the entire community or neighborhood,” and an “actionable nuisance” as including “whatever is injurious to health or indecent or offensive to the senses.”

In the tradition of opioid litigation nationally, the lawsuit features a number of tropes that come at the expense of chronic pain patients and anyone living outside.

In April, Albertsons announced a $774 million settlement that spanned multiple states including California, Colorado, Illinois and Oregon. 

“This settlement framework marks a significant step toward resolving opioid-related litigation, and Albertsons Cos. believes the settlement framework is in the best interest of all parties,” the company stated in April. “This settlement is not an admission of wrongdoing or liability.”

Washington, however, continued to pursue the litigation it had filed in 2022. The state has not yet announced the amount it’s seeking in damages. In addition to Albertsons, the lawsuit names Kroger, Rite-Aid and multiple subsidiaries owned by each. Kroger settled for $47.5 million in 2024. Rite-Aid declared bankruptcy in late 2025. To date, Washington’s opioid litigation payouts total approximately $1.3 billion.

In the tradition of opioid litigation nationally, the 2022 lawsuit features a number of opioid tropes that come at the expense of chronic pain patients and anyone living outside. It warns of babies being “born addicted,” and long-term use being associated with “significant mortality.” It describes “drug-seeking patients” who fake their symptoms. 

The “nuisance” conditions Albertsons has allegedly wrought include the various health care settings, abandoned homes and public spaces that “have attracted opioid drug dealers and people seeking illicit opioids.” Unlawful prescribing is further blamed for negatively impacting parks, libraries and other public spaces.

“The scope of human suffering and economic cost of opioids on Washington reverberates far beyond overdose mortality rate,” the lawsuit states. “The State spends significant additional public resources on medical services, law enforcement, corrections, workers’ compensation, diversion programs, prosecution, probation, treatment, and child welfare because of the impacts of opioids.” 

The state seems to be spending additional resources because of the impacts of the criminalization of opioids, not the opioids themselves. Its other complaints reflect distortions, exaggerations or the nation’s affordable housing crisis.

Image courtesy of Albertsons Companies

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