First Edition: March 30, 2023

KHN: $50 Billion In Opioid Settlement Cash Is On The Way. We’re Tracking How It’s Spent. 
More than $50 billion in settlement funds is being delivered to thousands of state and local governments from companies accused of flooding their communities with opioid painkillers that have left millions addicted or dead. That’s an enormous amount of money — double NASA’s budget and five times the revenue of an NBA season. But how that massive windfall is being deployed and how future dollars will be spent seem to be shrouded in mystery. Reporting requirements are scant, and documents filed so far are often so vague as to be useless. (Pattani, 3/30)

KHN: Localize This: Public Reporting Of Opioid Settlement Cash
State and local governments will, over the next nearly two decades, receive billions of dollars from companies accused of sparking the opioid epidemic. KHN recently published an investigation showing these jurisdictions have promised little to no public reporting on how that money is spent. The investigation is based on a detailed analysis of hundreds of written plans, statutes, executive orders, and public statements, first conducted by Christine Minhee of OpioidSettlementTracker.com and bolstered by KHN’s reporting. The information has been compiled into an interactive map and a detailed spreadsheet that we hope can help others investigate opioid settlement stories in their communities. (Pattani, 3/30)

KHN: States Try To Obscure Execution Details As Drugmakers Hinder Lethal Injection 
In 2011, Jeffrey Motts was executed in South Carolina. More than a decade later, the state hasn’t carried out another execution because officials have struggled to obtain the drugs needed for lethal injection. Now, to resume executions, lawmakers are debating a bill that would further shroud the state’s lethal injection protocols from public scrutiny by shielding the identities of the drug suppliers. (Rayasam, 3/30)

The Washington Post: Drug Overdose Antidote Narcan Goes Over-The-Counter
Narcan, the lifesaving nasal spray that reverses opioid overdoses, has been approved for purchase without a prescription, the Food and Drug Administration announced on Wednesday. The long-awaited decision could dramatically broaden the availability of Narcan, a spray version of naloxone, which requires no special training to administer, and has already been credited with saving thousands of lives from opioid overdoses. The approval came on the same day Homeland Security Secretary Alejandro Mayorkas testified to a Senate panel that the record number of Americans dying of fentanyl overdoses is the “single greatest challenge we face as a country.” (Ovalle, 3/29)

Bay Area News Group: FDA Approves Narcan, But Many Barriers Remain As California Considers New Laws
“The cost barrier is still very real,” said Rachel Sussman, who practices primary care and addiction medicine at O’Connor Hospital in San Jose. “How many families are going to be able to afford this is a real problem. But I think the fact that it is now possible (to get it over-the-counter) does start to shift the conversation about who should have naloxone available, who can have it, and how easy it is to get.” (Nickerson, 3/29)

The Boston Globe: Advocates Cheer OTC Approval For Narcan, But Questions Remain About Price And Insurance
Traci C. Green, professor and director of the Opioid Policy Research Collaborative at Brandies University, was thrilled by the news. “It’s about time,” said Green. “This is the best news you could possibly hear. It wasn’t all that long ago, naloxone wasn’t even covered [by insurance]. It took a lot of advocacy to shift that.” Green envisions naloxone being sold at restaurants, highway rest stops, even vending machines. (Freyer and Mohammed, 3/29)

The New York Times: 10 Questions About Narcan
Think of Narcan or any naloxone nasal spray as a fire extinguisher, said Corey Davis, director of the Harm Reduction Legal Project at the Network for Public Health Law. “Hopefully you’ll never need it,” he said. “But at some point maybe the kitchen’s going to catch on fire and you won’t have time to run to the fire extinguisher store.” Here is some guidance for using Narcan correctly. (Hoffman, 3/29)

The Washington Post: Fentanyl Is ‘Single Greatest Challenge’ U.S. Faces, DHS Secretary Says 
The record number of Americans dying of fentanyl overdoses is now the “single greatest challenge we face as a country,” Department of Homeland Security Secretary Alejandro Mayorkas told a Senate panel Wednesday. The statement appeared to be the first time Mayorkas or any other Cabinet-level member of the Biden administration has described the deadly synthetic opioid in those terms. Appearing before a Senate Appropriations subcommittee, Mayorkas cited the deaths of more than 70,000 Americans in 2021 tied to fentanyl overdoses. (Miroff, 3/29)

CNN: Guns Lead As Most Common Cause Of Death For Children And Teens In The US
Guns are the leading cause of death for US children and teens, since surpassing car accidents in 2020. Firearms accounted for nearly 19% of childhood deaths (ages 1-18) in 2021, according to the Centers for Disease Control and Prevention Wonder database. Nearly 3,600 children died in gun-related incidents that year. That’s about five children lost for every 100,000 children in the United States. In no other comparable country are firearms within the top four causes of mortality among children, according to a KFF analysis. (Choi, 3/29)

NPR: 74 People Have Been Killed Or Injured By Guns At American Schools This Year
On Monday, three children and three staff members were fatally shot at the Covenant School in Nashville, which one expert describes as part of an "astronomical increase" in violence on school campuses in recent years. There is no universal definition of a school shooting, explains Jillian Peterson, an associate professor of criminology and the president of the Violence Project, a non-profit research center. (López Restrepo, 3/29)

The New York Times: Shooting Prompts a Shrug in Washington, as G.O.P. Rejects Pleas to Act
The mass shooting at a Christian elementary school in Nashville this week has generated a broad shrugging of the shoulders in Washington, from President Biden to Republicans in Congress, who seemed to agree on little other than that there was nothing left for them to do to counter the continuing toll of gun violence across the country. But while President Biden’s stark admission on Tuesday that he could do no more on his own to tackle the issue was a statement of fact that aimed to put the burden on Congress to send him legislation, like the ban on assault weapons he has repeatedly championed, Republicans’ expressions of helplessness reflected an unwillingness, rather than an inability, to act. (Karni, 3/29)

The Washington Post: In Congress, Little Urgency To Address Gun Violence With Legislation 
After a shooter killed three children and three adults at a private Christian school in Nashville, lawmakers on Capitol Hill once again indicated there was little support for addressing gun violence through legislation. ... “I’m a realist,” said Sen. Richard J. Durbin (D-Ill.), the chair of the Judiciary Committee, about the possibility of moving gun legislation through his committee without enough Republican support to overcome the 60-vote filibuster. “I know what’s going to happen on the floor.” (Sotomayor and Goodwin, 3/29)

ABC News: Opposing Lawmakers Get Into Verbal Altercation At Capitol Over Guns And Gun Violence
A Democratic lawmaker who was screaming about Republicans' approach to gun violence just off the House floor on Wednesday soon got into a tense altercation with one of his conservative colleagues. An animated Rep. Jamaal Bowman, D-N.Y., a former principal, came off the floor and began telling reporters to continue to press GOP members on their views on the issue of guns and shootings. (Ibssa, 3/30)

The New York Times: After Mass Shootings, Republicans Expand Access To Guns 
After a mass shooting at an elementary school in Texas last year prompted calls for new gun restrictions, Republican-led states around the country moved in the other direction. One of them was Tennessee, where the governor insisted that tighter firearms laws would never deter wrongdoers. “We can’t control what they do,” Gov. Bill Lee said. Tennessee lawmakers have instead moved to make firearms even more accessible, proposing bills this year to arm more teachers and allow college students to carry weapons on campus, among other measures. (Baker, Kovaleski and Thrush, 3/29)

The Hill: North Carolina Legislature Overrides Veto And Repeals Permit Requirement For Handgun Purchase
North Carolina’s state legislature has voted to override Gov. Roy Cooper’s (D) veto and repeal the state’s requirement for a resident to obtain a permit from a local sheriff before legally purchasing a handgun. Senate Bill 41 passed in the state’s House of Representatives in a 71 to 46 vote on Wednesday. The state Senate previously voted 30 to 19 on Tuesday in approval of the measure. ... The enacted bill would also allow guns on some school properties where religious services are held. In a statement, North Carolina Attorney General Josh Stein (D) said that the state legislature’s moves to override the requirement is a mistake and will eventually put citizens at risk. (Oshin, 3/29)

AP: Idaho Law Could Criminalize Helping Minors Get Abortions 
Idaho lawmakers are considering making it illegal for an adult to help a minor procure an abortion without parental consent. The measure would create a new crime of “abortion trafficking,” barring adults from obtaining abortion pills for a minor and “recruiting, harboring, or transporting the pregnant minor.” To sidestep violating a constitutional right to travel between states, the state law would make illegal only the portion of a trip to an out-of-state abortion provider that takes place in Idaho. People convicted of breaking the law would face two to five years in prison. (Mulvihill and Hanna, 3/29)

AP: North Dakota Aims At School Curriculum To Deter Abortions 
North Dakota schools would be required to show students high-quality video of how a human fetus develops in each week of pregnancy under a bill Senate lawmakers approved during a vote Wednesday. The 37-9 vote comes on the heels of the North Dakota Supreme Court’s ruling this month that a state abortion ban will remain blocked while a lawsuit over its constitutionality proceeds. (Ahmed, 3/29)

AP: GOP Lawmakers Override Veto Of Transgender Bill In Kentucky
Republican lawmakers in Kentucky on Wednesday swept aside the Democratic governor’s veto of a bill regulating some of the most personal aspects of life for transgender young people — from banning access to gender-affirming health care to restricting the bathrooms they can use. The votes to override Gov. Andy Beshear’s veto were lopsided in both legislative chambers — where the GOP wields supermajorities — and came on the next-to-last day of this year’s legislative session. The Senate voted 29-8 to override Beshear’s veto. A short time later, the House completed the override on a vote of 76-23. (Schreiner, 3/30)

AP: West Virginia Governor Signs Ban On Gender-Affirming Care 
West Virginia Republican Gov. Jim Justice on Wednesday signed a bill banning gender-affirming care for minors, joining at least 10 other states that have enacted laws restricting or outlawing medically supported treatments for transgender youth. The bill outlaws those under 18 from being prescribed hormone therapy and fully reversible puberty blockers. It also bans minors from receiving gender-affirming surgery, something physicians say doesn’t even happen in West Virginia. (Willingham, 3/30)

AP: Montana Bill To Deny Care For Transgender Minors Passes
A Montana bill to deny gender-affirming medical care to young transgender residents passed a final vote in the state Senate on Wednesday, which sends the measure to Republican Gov. Greg Gianforte for his consideration. Lambda Legal, the American Civil Liberties Union and the ACLU of Montana have said they will take legal action if the bill becomes law. (Hanson, 3/29)

AP: SC Senators Advance Ban On Gender-Affirming Care For Minors 
About five dozen advocates for transgender youth rallied outside the South Carolina State House as Republican senators joined their conservative counterparts nationwide in advancing a ban on gender-affirming medical care for minors. A South Carolina bill to ban gender-transition surgeries, hormone therapy and puberty blockers for people under the age of 18 passed a Senate subcommittee on Wednesday. (Pollard, 3/30)

Dallas Morning News: Texas Senate OKs Ban On Treatment For Transgender Youth, Exempts Current Patients
The Texas Senate on Wednesday gave initial approval to a bill that would ban certain medical treatments for transgender youth, but only after exempting anyone already receiving such care. (McGaughy, 3/29)

Roll Call: Senate Votes To Overturn COVID-19 National Emergency Order
The Senate voted Wednesday to terminate a COVID-19 pandemic ​national emergency order implemented by former President Donald Trump in 2020 that was due to be terminated in May anyway. The 68-23 vote on the measure came after the House voted 229-197 in February, with 11 Democrats joining 218 Republicans in support. (McIntire and Lesniewski, 3/29)

The New York Times: AstraZeneca’s Covid Vaccine May Have Posed A Higher Heart Risk For Young Women, Study Shows
Young women who received at least one dose of the Covid vaccine made by AstraZeneca might have been more likely to die of a heart problem in the 12 weeks after their vaccination, according to an analysis of immunization and death records in Britain released on Monday. Those findings carry a big caveat: Britain withdrew AstraZeneca’s vaccine use for young people under 30 in April 2021, citing the risk of rare but dangerous blood clots. By that time, the young women who were immunized would have been mainly health care workers or those who were medically vulnerable, because people at high risk of Covid from their age, health or employment were vaccinated first. So the results of the study may not apply to the general population. (Mandavilli, 3/29)

CIDRAP: Study Bolsters Evidence Of Heightened Heart Attack Risk After Flu 
People who are sick with flu are six times more likely to experience a heart attack the week after they test positive compared to the year before or the year after, researchers from the Netherlands will report at the European Congress of Clinical Microbiology and Infectious Diseases (ECCMID) meeting in Copenhagen between Apr 15 and Apr 18. (Schnirring, 3/29)

NPR: A New Flu Is Spilling Over From Cows In The U.S. How Worried Should We Be?
In 2011, a farmer in Oklahoma had a bunch of sick pigs. The animals had what looked like the flu."Just like a person with respiratory disease, the pigs had labored breathing, maybe a runny nose, cough and potentially a fever," says virologist Benjamin Hause. (Doucleff, 3/29)

Reuters: Chile Detects First Case Of Bird Flu In A Human
Chile detected the first case of bird flu in a human, the country's health ministry reported on Wednesday. he case was detected in a 53-year-old man who presented severe influenza symptoms, according to a statement issued by the ministry, but they noted the patient was in stable condition. (3/29)

Modern Healthcare: Prior Authorization Revamped By Cigna, UnitedHealth Group
UnitedHealthcare will eliminate nearly 20% of existing prior authorizations beginning in the third quarter for its commercial, Medicare Advantage and Medicaid members, the insurer announced Wednesday. Next year, UnitedHealth will implement a "gold card" program through which qualifying providers will simply notify the insurer about pending care rather than request prior authorization. This will eliminate the need for prior authorization in most cases, according to the company. (Tepper, 3/29)

Stat: Medical Device Makers Must Now Prove Cybersecurity To FDA
Hidden in this year’s federal spending bill, among major changes to Medicare payments to doctors and post-pandemic Medicaid, lies a little-noticed change with big implications: a mandate to protect medical devices connected to the internet from hacks or ransomware attacks. The law, which goes into effect Wednesday, explicitly states that companies cannot sell their connected medical devices without first showing the Food and Drug Administration a solid cybersecurity plan. It also gives the FDA $5 million to see a higher security standard through. Historically, the agency has lacked the resources to keep up with rapidly-evolving security threats, or the authority to force device makers to comply with its draft guidelines. (Lawrence, 3/29)

The Washington Post: Damar Hamlin Visits Capitol Hill To Support Bill Promoting Access To AEDs
Buffalo Bills safety Damar Hamlin, whose life was saved by swift-acting medical personnel and a portable defibrillator when he suffered sudden cardiac arrest during an NFL game in January, came to Capitol Hill on Wednesday to raise awareness for legislation that would improve students’ access to the type of care that saved him. Hamlin, with his 8-year-old brother and 10- and 11-year-old cousins by his side, spoke briefly at a press event advocating for the Access to AEDs Act, which was introduced on Wednesday in the House of Representatives and calls for schools to receive grants for the implementation of AED and CPR programs. (Boren, 3/29)

Stateline: As 988 Crisis Line Sees More Use, States Debate How To Pay For It
Almost everyone agrees that putting money behind the national suicide and crisis hotline is a good thing. But not everyone thinks a new phone tax is the best way to pay for it. Since the crisis line’s easy-to-remember 988 number launched last July, its use has increased significantly. The lifeline had 404,194 calls, chats and texts in February alone, an increase of 161,678 contacts over February 2022. (Straub, 3/29)

Stat: Monkey Shortage Imperils Early-Stage Drug Development Timelines
A growing shortage of monkeys used for early-stage pharmaceutical research is causing concern that many companies will soon face costly delays starting clinical trials — leading to a slowdown in drug development. In recent weeks, the U.S Fish & Wildlife Service began denying company requests to import long-tailed macaques from Cambodia in the wake of a federal investigation into a smuggling ring. Meanwhile, the cost of these monkeys, when they can be obtained, has jumped to more than $25,000 each, compared with $10,000 or less three years ago. (Silverman and Garde, 3/29)

Reuters: Novo Nordisk Says Stopping Obesity Drug May Cause Full Weight Regain In 5 Years 
Patients discontinuing the use of weight-loss drugs such as Wegovy risk regaining their original body weight in about five years, a Novo Nordisk official said on Wednesday. Based on individual profile, patients could gain back about half of the original body weight in two to three years if they stop the treatment, the Danish drugmaker's head of global drug discovery, Karin Conde-Knape, told a health conference organized by CNBC. (3/30)

NBC News: Migraines And Cluster Headaches Are Linked To The Body's Internal Clock, Science Shows
Cluster headaches are a rare type of headache that cause bursts of intense pain around the eye. Each burst lasts about 15 minutes, but an attack can last between one and three hours. The condition is more common in males than in females. The opposite is true for migraines, a severe headache condition that is three times more prevalent in females than in males. (Sullivan, 3/29)

The Washington Post: Living With Cats Or Dogs May Lower Children’s Risk Of Food Allergies 
Newborns who live in a home with cats or dogs appear to be less likely to develop food allergies, according to the findings of a large study. The benefit holds even if the exposure is during fetal development, when a pregnant mother lives with pets. The effect in the study was modest but statistically significant: Exposure to dogs or cats during fetal development or the first few months of life lowered the odds of a later food allergy by about 14 percent. The benefit was strongest when the dogs were kept indoors and when the exposure was during both fetal development and infancy. (Hurley, 3/29)

The Washington Post: How To Know Whether You Have Allergies Or A Virus
Spring is in full bloom, setting off an orchestra of coughing, sneezing and wheezing. The symptoms are all too familiar for chronic allergy sufferers. But amid a persistent coronavirus pandemic and the tail end of influenza season, how do you know whether that congestion is simply allergies or something more? And what should you do about it? The Washington Post spoke to allergists and immunologists for answers. Here’s what they said. (Bever and Chiu, 3/29)

The Press Association: Honey Bees Could Help Track Microorganisms In Cities, Scientists Say
Bees play an important role in the ecosystem as pollinators but scientists believe they may be helpful in other ways - such as providing insight into the health of people living in cities. Scientists have been investigating urban honey bees to see if they can provide clues on the types of microorganisms that exist in cities - collectively known as the microbiome. (Marshall, 3/30)

The Hill: American IQs Rose 30 Points In The Last Century. Now, They May Be Falling.
A new study of human intelligence posits a narrative that may surprise the general public: American IQs rose dramatically over the past century, and now they seem to be falling. Cognitive abilities declined between 2006 and 2018 across three of four broad domains of intelligence, the study found. Researchers tracked falling scores in logic, vocabulary, visual and mathematical problem-solving and analogies, the latter category familiar to anyone who took the old SAT.  (De Vise, 3/29)

AP: Remembrances, Calls For Reform At Irvo Otieno's Funeral 
Family, friends and other mourners gathered Wednesday at a Virginia church to remember Irvo Otieno at a funeral service, celebrating his life and calling for mental health care and policing reforms after the 28-year-old Black man’s death earlier this month while in custody at a state psychiatric hospital. “He had an illness. He should have been doctored to, not treated with brutality,” said civil rights leader the Rev. Al Sharpton, who delivered the eulogy. (Rankin, 3/29)

AP: Vatican: Pope Has Good Night In Hospital Despite Infection 
Pope Francis spent a good first night in the hospital after being admitted for a respiratory infection, a Vatican official said Thursday. Further medical updates were expected later in the day. Francis was taken to Rome’s Gemelli hospital for tests on Wednesday afternoon after experiencing difficulty breathing in recent days. The 86-year-old pope, who had part of one lung removed as a young man, does not have COVID-19 but will remain in the hospital for several days of treatment, the Vatican said. His audiences were canceled through Friday. (Winfield, 3/30)

ABC News: Sperm Donor In The Netherlands Fathers More Than 500 Children, Foundation Says
A 41-year-old man allegedly fathered more than 500 children in the Netherlands, according to the Donorkind Foundation, an organization that helps children born via sperm donations who are looking for their origins. Donorkind, which is based in Den Haag, Netherlands, confirmed in a statement that a generous "serial donor" would have given his sperm nationally and internationally. (El Hammar Castano, 3/29)