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It all starts with a $20 to $30 purchase. That's the average street price of heroin today, according to Framingham Police. But if that one purchase is a bad batch, too strong, or if the user injects too much, that's all it takes to cause an overdose. Although the proliferation of the overdose-reversal drug Narcan— the market name for naloxone —has saved innumerable lives, more than 1,000 people are dying a year in Massachusetts from heroin and other opioid overdoses. When you crunch the numbers, that overdose costs a whole lot more than $20. (Avery, 5/23)

Americans in different parts of the country are known to vary significantly in their consumption of particular foods — be it spicy chili, cream-cheese covered bagels or collard greens. Recent federal government data shows that the country is equally diverse in its consumption of intoxicating substances. The Substance Abuse and Mental Health Services Administration annually surveys Americans age 12 and older about whether they use opioid painkillers for non-medical reasons or consume any marijuana, alcohol or cocaine. States are ranked into quintiles based on what proportion of their population uses each substance, thereby creating a “top 10 list” for all four. (Humphreys, 5/23)

For Dr. Ross Macdonald, every person who enters New York City’s main jail with an opioid addiction represents an opportunity for treatment, and the possibility of saving a life. As the medical director of the city’s correctional health program, he ensures that offenders who come in on methadone continue to receive it. And he and his staff try to persuade as many addicted inmates as possible to get started on methadone before they leave the jail. (Vestal, 5/23)

Sen. Joe Manchin (D-W.V.) and a handful of other Democrats on Monday announced a bill that would impose a 1-cent-per-milligram excise tax on every opioid pill sold. The money raised through the tax would then be used to fund opioid addiction treatment. Republicans and Democrats alike say the legislation currently making its way through Congress is only the beginning of lawmakers’ work to address the opioid epidemic. For some Democrats, this comes with a threat of aggressively targeting drug companies in the future. Although the Manchin bill has very little chance of passage in the current Congress, the move signals that Democrats are not going to let the issue drop without pressing for more financial accountability from the drug industry for opioid abuse. (Owens, 5/23)

Missouri’s failure to set up a statewide prescription drug monitoring program during the 2016 legislative session will continue to affect other states. Each of the eight states bordering Missouri already has a program that notifies doctors when their patients have been prescribed dangerous amounts of addictive painkillers from multiple providers. Rep. Holly Rehder, R-Sikeston, says without a program of its own, Missouri is negatively affecting the efforts of others to stop drug dealers and prevent addiction. (Daily, 5/23)

Every movement needs a champion, and in the largely rural counties of western North Carolina, Richie Tannerhill is a champion of the recovery-oriented care movement for people with mental health and substance abuse issues. Recovery-oriented care is founded on the belief that people with behavioral health problems need guideposts to help them find their own routes back to a productive life -- that medication compliance and symptom control aren’t ultimate treatment goals. Advocates of this approach, which involves community-based supports to help people reintegrate into their communities, fear it could be undermined by the omnibus mental health bill sponsored in Congress by Rep. Tim Murphy, a Pennsylvania Republican and clinical child psychologist. (Sisk, 5/24)

Both of Richie Tannerhill’s parents had mental health and substance abuse disorders. His dad was sentenced to an extended prison term, and Tannerhill said he was “passed around from friend to friend, family member to family member.” By the age of 4, he’d lived in five states. His first arrest came when he was in third grade and got caught breaking into a school. He was dealing drugs at 12, and by 14 had sampled pills, mushrooms, cocaine and LSD. At 15, he landed in the behavioral health unit of a hospital in Kailua, Hawaii, and a year later, a Nebraska prison, charged with breaking into two restaurants. (Sisk, 5/24)