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San Francisco surpassed its deadliest year last month, with fatalities counted in the first 11 months of 2023 eclipsing the previous peak of 726 deaths in all of 2020. This new preliminary data through the end of December, released Wednesday by the medical examiner’s office, provides a more complete picture of how the overdose epidemic continues to grip the lives of San Franciscans despite efforts by top city and state leaders to curb the crisis. (Angst, 1/17)

The South Dakota House passed a bill Wednesday that would make xylazine, an animal sedative that is being mixed with fentanyl and then used by some people, a controlled substance. The measure, which passed unanimously in the Republican-held House and now goes to the Senate, would establish penalties of up to two years in prison and fines of up to $4,000 for possession and use of xylazine. There are exceptions for veterinary use, however. (1/17)

Teresa Gladstone, of Concord, lost her grandson Oliver to an overdose in 2020. In the years since, she's turned to advocacy and helped to organize local overdose awareness vigils. Ahead of this year's presidential primary, Gladstone — who describes herself as a center-leaning independent — has been curious to hear how candidates plan to address addiction. (Cuno-Booth, 1/17)

Colts owner Jim Irsay was found unresponsive and struggling to breathe last month at his home in Carmel, Ind., due to what police logged as a suspected overdose, according to police reports obtained by The Athletic on Wednesday. The incident occurred on Dec. 8, when emergency responders were dispatched to Irsay’s home at approximately 4:30 a.m. ET. ... One police officer wrote in his report that Irsay was “cool to the touch and had agonal breathing,” so he used naloxone (more commonly known as Narcan) on Irsay. A different officer wrote in his report that Irsay “responded slightly” to the naloxone before eventually being transported via ambulance to a local hospital. (Boyd, 1/17)

Nearly 50,000 veterans received free emergency suicide prevention care in 2023, the first year of the program, the Department of Veterans Affairs will announce on Wednesday. In January 2023, the Department of Veterans Affairs instituted a new policy allowing eligible veterans and certain former service members in acute suicidal crisis to go to any VA or non-VA health care facility to receive emergency care at no cost. The policy covers emergency room care, inpatient or crisis residential care for up to 30 days, and outpatient care for up to 90 days. (Watson and Cook, 1/17)

Military families may get easier access to mental health outpatient care and counseling under two new provisions in the recently signed defense policy law. The fiscal year 2024 National Defense Authorization Act allows Defense Department health officials to waive out-of-pocket costs for the first three outpatient mental health visits each year for active duty families using Tricare. It also expands non-medical counseling services for military families through the Military and Family Life Counseling Program. (Jowers, 1/17)

One solution that is gaining support is to create more pathways into the field of mental health care. The requirements of traditional licensure make it quite hard to become a therapist — harder, many advocates and scientists contend, than the evidence suggests is necessary. This is not to say that traditional training and licensure are irrelevant. Licensure exists in part to preserve quality control and prevent charlatans from peddling bogus treatments. John C. Norcross, a professor of psychology at University of Scranton, compiled a history of  disproven treatments and co-created a course on the topic titled “Psychoquackery: Discredited Treatments in Mental Health and the Addictions.” “All I have to do is go Google [quack psychology] and I say, ‘Oh my god, this is why we have licensure,’” Norcross said. (Rubenstein, 1/18)