Mind & Body · Thursday, 22 October 2026
US overdose deaths fell because fewer people overdosed, not because naloxone revived more, a study of 186 million ambulance calls finds
A study in JAMA finds emergency calls for overdoses that people survived fell along with deaths, so the drop came from fewer overdoses, which researchers link to a break in the fentanyl supply.
111,000 to 71,000
US overdose deaths a year, from the mid-2023 peak to the end of 2025
the fall came after three decades of rises
186 million
US emergency call-outs studied, from May 2020 to December 2025
about 2.5 million were for overdoses that people survived
33%
fewer call-outs to survived opioid overdoses than expected, from May 2023
naloxone given by crews fell by about 21%
The lead story — what happened
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US overdose deaths fell from about 111,000 a year at the peak in mid-2023 to under 71,000 a year by the end of 2025.
[1] -
One common explanation was naloxone, a medicine that reverses an opioid overdose within minutes, often given as a nose spray.
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A study in JAMA, a US medical journal, tested that idea on 21 October.
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Its authors, including Michael Barnett of Brown University, studied nearly 186 million ambulance and other emergency call-outs from May 2020 to December 2025.
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From May 2023, call-outs for opioid overdoses that people survived fell about 33% below the expected level.
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The number of times crews gave naloxone fell too, by about 21%.
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If naloxone were saving more people, survived overdoses would have gone up as deaths fell. Both went down, which points to fewer overdoses happening at all.
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The data cannot see a bystander who gave naloxone and never called 911, the US emergency number.
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Barnett says a break in the supply of fentanyl, a very strong illegal opioid, best explains how sudden and widespread the fall was.
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A paper in the journal Science in January said the shortage may have started in China.
[2] Opioid deaths in Canada also fell 17% in 2024.[2] -
The US overdose death rate fell 24.4% between 2023 and 2024, driven by fewer deaths involving fentanyl.
[3] -
Barnett warns that a fall caused by supply can reverse, and the decline already slowed in 2025.
[1]
Who is involved
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Michael Barnett
a health researcher at Brown University in the US and one of the study's authors; he thinks a break in the fentanyl supply explains the fall
[1] -
US emergency crews
the ambulance and other teams who answer 911 calls; their 186 million call-outs are the study's data
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The US Food and Drug Administration
the US medicines regulator; it allowed naloxone to be sold without a prescription in 2023
[4] -
Fentanyl suppliers
the people who make and sell the illegal drug; a paper in Science said a sudden shortage may have started in China
[2]
How it unfolded
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2003 fewer than 26,000 US overdose deaths a year
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Mid-2023 deaths peak at about 111,000 a year
[1] -
May 2023 call-outs to survived opioid overdoses start falling below expected
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2024 the overdose death rate falls 24.4% in one year
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End of 2025 deaths are under 71,000 a year, and the fall has slowed
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21 Oct 2026 the JAMA study finds naloxone did not drive the fall
[1]
Where this points
The next test is the 2026 death count: if it keeps falling after the slowdown in 2025, the fentanyl shortage is holding, and if it rises, suppliers have found new sources.
Signals on this beat
The bar and the word are our reading of how hard each one is pushing, and the arrow is where it is heading.
The US government scores rural health grants higher for states that scrap laws on building hospitals.
Psilocybin, the drug in magic mushrooms, lowered inflammation signals in the blood of 12 people with Parkinson's disease.
Matilda Davis, an English mother, cared full-time for her disabled son with almost no support before she died.
The rest of the day
21 more stories on this beat.
Each with its own sources. None of these is a link to the story above.
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02
Guinea-Bissau's baby vaccine trial is off
The Danish researcher leading a US-funded hepatitis B vaccine trial in Guinea-Bissau, a small West African country, said on Wednesday it will not go ahead.
[5] Frederik Schaltz-Buchholzer wrote that the team did not get the approval it needed from Guinea-Bissau's government.[5] The trial would have given 14,000 newborns the vaccine either at birth or six weeks later, to compare the two.[7] The WHO, the UN's health agency, called that unethical in February.[6] Guinea-Bissau's authorities took the team's vaccines in a search of its offices on Monday.[5] Why it matters — The US Centers for Disease Control and Prevention had promised $1.6 million, and has not said whether that money will now go to vaccinating newborns.
[5] Guinea-Bissau plans to give every baby the birth dose from 2028.[5] -
03
US rural health money tied to hospital rules
The Trump administration is scoring states higher for part of its $50 billion Rural Health Transformation Program if they scrap or loosen certificate of need laws.
[14] Those laws make a hospital prove a community needs it before it builds or expands.[14] More than 30 states have one, and six said in their applications they would revisit theirs.[14] Tennessee voted in April to undo most of its rules over four years.[14] Why it matters — Defenders of the laws say big chains will build where patients pay best, and small rural hospitals will close or sell.
[14] In Tennessee, HCA, the largest US hospital company, won approval for a hospital 20 minutes from a smaller rival.[14] -
04
Birth kits for Georgia's emergency rooms
Georgia, a US state, will spend more than $12 million of its rural health money on obstetric carts for 43 rural hospitals that no longer deliver babies.
[15] Each cart holds supplies for an emergency birth, such as tools to help a newborn breathe.[15] Only 36% of Georgia's rural hospitals still have a labour ward.[15] In Lavonia, Kara Holden drove about an hour to give birth on 11 October after her local unit closed.[15] 36 of 100
Georgia's rural hospitals with a labour ward
About a third of rural hospitals in Georgia still deliver babies. The carts go to 43 that do not. Why it matters — A maternal health worker told KFF Health News that emergency-room doctors may see a serious birth emergency only a few times a year.
[15] One obstetrician called the carts a band-aid on a haemorrhage and wants money to keep wards open instead.[15] -
05
Medicaid cuts on the ballot in California
About six in ten people in California's 22nd congressional district are on Medicaid, the US public health insurance for people on low incomes.
[22] Their congressman, Republican David Valadao, voted for the 2025 law expected to cut Medicaid spending by more than $900 billion through 2034.[22] By 1 January 2027 at the latest, 44 states must make many adults on Medicaid show they work, train or volunteer to keep it.[24] [22] Valadao faces Democrat Randy Villegas on 3 November.[22] Why it matters — A left-leaning think tank estimates 60,000 more people in the district could be uninsured by 2034.
[22] The US Congressional Budget Office expected the law's Medicaid changes to leave 7.5 million more people uninsured nationwide.[24] -
06
Local HIV groups lose their direct CDC grants
The US Centers for Disease Control and Prevention will not renew its main HIV prevention grant to community groups, according to reports that KFF, a US health research group, sets out.
[23] That grant paid $239.3 million to 96 groups from 2021, and nearly half went to the US South.[23] Money now goes through state and local health departments instead.[23] The first extra round, on 3 September, came to $91 million, 24% less than the $120 million announced.[23] Why it matters — The groups ran HIV tests, linked people to care and helped them get PrEP, a pill that prevents HIV.
[23] Tennessee has turned down CDC HIV prevention money, so its groups get nothing through the new route.[23] -
07
A new count of profound autism
Nearly 17% of autistic eight-year-olds in the US meet the criteria for profound autism, a new estimate from the US Centers for Disease Control and Prevention finds.
[8] Its estimate in 2023 was 27%.[8] Profound autism describes autistic people who will need care around the clock as adults.[8] The new count uses a tighter definition that adds everyday living skills, and the total number of autistic children has also grown.[8] Only 54% of the 7,084 children had all the data the team needed.[8] CDC estimate, 202327%CDC estimate, 202617%Share of autistic eight-year-olds counted as having profound autism. The definition changed between the two counts. Why it matters — The rate ranged from 10% in Utah to 35% in Laredo, Texas, partly because places assess children differently.
[8] A Boston doctor said 17% is still a big group of families who need intensive support.[8] -
08
UK leader backs suicide training for social workers
UK Prime Minister Andy Burnham said on Wednesday he supports making suicide prevention training compulsory for social workers in all of England's councils.
[12] He was asked about Matilda Davis, a 36-year-old mother who cared full-time for her disabled son.[12] She took her own life in October 2025, minutes after a visit from social workers who had not had that training.[12] A coroner had already ordered her council, Warwickshire, to train 600 staff.[12] Why it matters — Research from the University of Birmingham found 41% of parent-carers have thought about suicide.
[12] In the UK and Ireland, anyone in crisis can reach Samaritans for free on 116 123.[12] -
09
Psilocybin lowered inflammation in 12 patients
Twelve people with Parkinson's disease, a brain illness that slows movement, had less inflammation in their blood after two doses of psilocybin, a study in JAMA Psychiatry found on Wednesday.
[9] Psilocybin is the drug in magic mushrooms.[9] The team at the University of California, San Francisco measured five inflammation signals, and the drop lasted a month.[9] The drug acts on a serotonin receptor that many body cells carry, not only brain cells.[9] Why it matters — There was no comparison group and the patients knew they got the drug, so the authors say it must be repeated.
[9] If it holds, the authors say it could matter for depression, anxiety and illnesses of the heart and metabolism too.[9] -
10
A map of how the brain feels the body
Scientists sent tiny electric currents into the insula, a region deep inside the brain, in 87 people who already had electrodes in their brains for medical reasons.
[10] [11] Stimulating the back of the insula caused pain, heat or tingling in one part of the body.[10] The middle caused feelings inside the body, such as nausea or a full chest.[10] The front connects to thinking areas and sends signals to the rest of the insula.[11] The study appeared in Nature on Wednesday.[10] Why it matters — A co-author at Stanford University said the insula does more than read the body: it partly shapes how a feeling is felt.
[10] That pathway may help explain how thoughts change pain.[11] -
11
A low-oxygen pill helped mice move
Mice with a Parkinson's-like illness moved better after six weeks on two drugs, researchers report in PNAS, a US science journal.
[17] One drug makes the blood release less oxygen into tissues, and the other stops the body making extra red blood cells to make up for it.[17] In 2025 the same team helped such mice by having them breathe air with 11% oxygen instead of the usual 21%.[17] In mice with Leigh syndrome, a rare illness that starves cells of energy, the pair lifted the middle lifespan from 62 to 158 days.[17] Why it matters — The idea is that damaged brain cells cannot use all the oxygen they get, and the extra does harm.
[17] All the work so far is in mice, and Vamsi Mootha of Harvard Medical School, one of the scientists, warns that low oxygen can be dangerous.[17] -
12
Brain drainage blocked in Alzheimer's mice
The brain clears waste through fluid that flows along the outside of its blood vessels, a route called the glymphatic system.
[16] In mice bred to model Alzheimer's disease, a team at the Korea Brain Research Institute found those channels narrower and the flow badly reduced.[16] Cholesterol built up in those brains, and the team suggests it may block the flow.[16] An outside expert called the work a starting point for ideas, not proof.[16] Why it matters — Dementia affects around 50 million people worldwide, and Alzheimer's is its most common form.
[16] The results come from slides of dead mice, so other scientists want the flow tracked in living animals.[16] -
13
Told of her cancer by a hospital worker
Pippa Boardman from Cornwall, in south-west England, learned she had breast cancer from a phone call by a hospital worker she barely knew.
[13] He had looked at her medical records at the Royal Cornwall hospital in Truro, days before her consultant was due to give her the results.[13] Two days later, her consultant confirmed the cancer.[13] The hospital trust has apologised and says the worker could see her records for his job but should never have contacted her.[13] Why it matters — The trust says it is reviewing its rules in line with stronger NHS England guidance on staff looking at patient records.
[13] Boardman is recovering well and says she lost her privacy and dignity.[13] -
14
Hot days, fewer births in France and Italy
Each day averaging 25C or more was linked to about 360 fewer births in France and 192 fewer in Italy, two new studies find.
[18] The drop shows up nine to ten months after the heat, which points to fewer babies being conceived in hot weather.[18] Earlier studies in the US and Hungary saw some of the missing births made up later.[18] The French and Italian data show no such catch-up.[18] France360Italy192Fewer births linked to each day averaging 25C or more, counted nine to ten months later. Why it matters — Both countries already have falling birth rates, and births in France fell 22% between 2010 and 2025.
[18] The authors say the link is real but small next to money worries and changing family plans.[18] -
15
Maltreated children's brains measured smaller
Researchers at Charite hospital in Berlin scanned the brains of 299 children aged 3 to 13, including 123 who had been maltreated.
[19] They placed each child on growth charts built from the largest brain-scan database available.[19] On average the maltreated children sat lower on those charts, in both grey and white matter.[19] Lower placings went with lower intelligence scores and more behaviour problems.[19] Why it matters — A link between how severe the maltreatment was and brain size did not hold up after statistical checks.
[19] The study does not show whether the maltreatment caused the smaller brains.[19] -
16
Seven in ten Arab students had aching bodies
A survey of 4,300 university students in Egypt, Yemen, Iraq, Sudan, Jordan, Syria and Palestine found 71% had muscle or joint pain in the past year.
[21] The neck and lower back hurt most often.[21] Students who sat for longer were more likely to have pain, and those who slept six to eight hours were less likely.[21] For many, the pain stopped them doing their usual activities.[21] 7 of 10
students with muscle or joint pain in the past year
About seven in every ten of the 4,300 students surveyed. Why it matters — The authors call for active breaks and adjustable desks at universities.
[21] The survey asked students once, so it shows links, not causes.[21] -
17
Stronger teenagers, faster thinking tests
A study of 10,145 Chinese teenagers aged 13 to 18 found that stronger ones did better on two thinking tests.
[25] They answered faster on working memory, which means holding facts in mind while using them, and on switching between tasks.[25] Strength was measured by grip and a standing long jump.[25] Strength showed no clear link with stopping an automatic response.[25] The link with working memory was stronger in girls than in boys.[25] Why it matters — The data come from one moment in time, so the authors say trials are needed before anyone knows if building strength helps thinking.
[25] -
18
People who lost a leg dream of whole bodies
Researchers asked 192 people who had lost a leg and use an artificial one about their dreams.
[20] Most of those who remembered their dreams saw their body whole in them.[20] People who felt the artificial leg had become part of their own body were less likely to dream of an injured body.[20] The study appeared in Scientific Reports, a Nature journal.[20] Why it matters — The authors read this as a sign that the brain has folded the artificial leg into its picture of the body.
[20] Once that happens, the leg stops being a daily reminder of the loss.[20] -
19
Meta sued in Australia over harm to children
Meta, which owns Facebook and Instagram, faces a class action in Australia's Federal Court over claims that its apps' addictive design harmed children and teenagers.
[26] MinterEllison, the law firm bringing it, filed for eight people who say they were harmed before they turned 18.[26] A court order on Monday keeps their names and the full claim secret.[26] Meta says it will defend itself firmly.[26] Why it matters — Australia already banned social media for children under 16 in 2025.
[26] In August, Meta agreed to settle claims from nearly all US states that it designed its apps to hook children.[26] -
20
Tea linked to fewer strokes, unless scalding
Chinese people who drank tea three or more times a week had an 11.2% lower risk of diseases of the blood vessels, a study of nearly 500,000 adults followed for nine years found.
[27] The link was strongest for strokes caused by a blocked artery, at 36.6% lower.[27] Very hot tea went with a 16% higher risk instead.[27] The study appeared in the Journal of Internal Medicine.[27] All blood-vessel disease11.2%Strokes from a blocked artery36.6%How much lower the risk was in regular tea drinkers than in others. This is a link seen in the data, not proof that tea did it. Why it matters — The study only watched what people did, so other parts of their diet and lifestyle may explain the gap.
[27] A dietitian at the British Heart Foundation, a UK heart charity, said it does not prove a daily cup protects the heart.[27] -
21
Hims starts selling testosterone online
Hims, a US online clinic with 2.9 million customers, has started offering testosterone treatment to men after an at-home blood test.
[28] The test uses a small device stuck on the arm, and a lab checks 21 markers in the blood, including testosterone.[28] Men must also have a video call with a clinician, because US law treats testosterone as a controlled drug.[28] Hims says men with no symptoms will not be treated, whatever their level.[28] Why it matters — In 2022, researchers posing as patients found six of seven online clinics offered testosterone even with normal levels.
[28] A US urologist warned that testosterone treatment can cause infertility.[28] -
22
Smart rings to watch risky pregnancies
Abu Dhabi's health department has launched Project Cradle, a two-year study that gives women with high-risk pregnancies an Oura smart ring.
[29] The ring records heart rate, sleep, temperature and activity from early pregnancy until birth.[29] Researchers will test whether these signals change in the weeks before a baby comes too early.[29] Corniche Hospital and Mediclinic Airport Road will take part.[29] Why it matters — About one in ten babies worldwide is born before 37 weeks, which can leave lasting harm to breathing and development.
[29] A clear warning sign would give doctors time to treat the baby's lungs and brain before birth, or move the mother to a specialist unit.[29]
Your brain runs on the same blood as the rest of your body
The brain gets its oxygen, its cleaning and its immune signals from the blood like every other organ, so changing the blood can change how the brain works.
The twist
A medicine for the brain can work by changing the blood, because the brain gets its oxygen, its cleaning and its immune signals from the blood like every other organ.
The picture
How it works
- Blood brings the brain its oxygen and fuel
- The same blood carries immune signals and drugs
- Brain waste drains out along the blood vessels
- So a change in the blood changes how brain cells work
- And the brain keeps reading the body, through the insula
The same force, elsewhere today
Where this chain is also running, in today's other stories.
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Psilocybin in 12 Parkinson's patients
a drug known for acting in the brain also acts on the same receptor on body cells, and inflammation signals in the blood fell
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The low-oxygen pill in mice
changing how much oxygen the blood hands over changed brain oxygen and how the mice moved
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Brain drainage in Alzheimer's mice
the brain's cleaning fluid runs along its blood vessels, so narrower channels there left waste in place
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The map of the insula
the insula turns signals from the body into pain, nausea or a full chest, so the traffic runs from body to brain as well
Where you've seen this
High mountains
thinner air means the blood carries less oxygen, and climbers get headaches and muddled thinking
A heavy night of drinking
alcohol reaches the brain through the blood within minutes
Flu
immune signals in the blood make the brain order the body to rest
The catch
Most of today's evidence comes from mice or from 12 people with no comparison group, so these links show where to look, not treatments that work in people.
And the whole of it
Anyone who has felt foggy with a fever or dizzy high on a mountain has felt this traffic from the inside. The scientists in today's stories can watch only a few of its routes at a time, in mice or in a dozen patients.
What is really going on
US overdose deaths fell by about 40,000 a year mainly because fewer people overdosed, and researchers link that to a break in the supply of fentanyl, not to naloxone.
Why it works on us — A spray that brings a dying person back can be seen working, so it is easier to credit than a shortage in an illegal drug supply that nobody watches happen.
Who gains
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HCA, the largest US hospital company
— Looser building rules let it open hospitals near smaller rivals, as it did 20 minutes from Maury Regional in Tennessee.
[14] -
States that scrap certificate of need laws
— Their applications score higher for a $25 billion share of the rural health fund.
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Hospitals that kept their labour wards
— Births at Coffee Regional in Georgia rose from 551 in 2020 to nearly 1,000 in 2024 as nearby wards closed.
[15] -
Guinea-Bissau's government
— By refusing approval it kept control of a trial on its own newborns, and it now holds the team's vaccines.
[5]
Who pays
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Small rural hospitals in Tennessee
— Facing new competition, Williamson Health agreed in July to sell its hospital and clinics for $900 million.
[14] -
Pregnant women in rural Georgia
— With only 36% of rural hospitals still delivering babies, many drive an hour or more to give birth.
[15] -
Medicaid patients in California's 22nd district
— A think tank estimates 60,000 more could be uninsured by 2034 under the 2025 law and the end of extra insurance help.
[22] -
Local HIV groups in the US South
— They lose direct CDC grants, and the money now routed through health departments came in 24% below what was announced.
[23] -
Parent-carers in England
— Matilda Davis got almost no support, and 41% of parent-carers have thought about suicide.
[12]
What nobody knows yet
Open questions from across today’s stories — ours included.
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01
What really caused the fall in overdoses.
Barnett calls a break in the fentanyl supply his own read, and a paper in Science points to China, but the people at risk may also have been shrinking for years.
[1] [2] -
02
Whether the fall will last.
The decline slowed in 2025, and Barnett says traffickers can adapt by finding new chemical sources or stronger opioids.
[1] -
03
How much naloxone given by bystanders matters.
The study counts only overdoses where someone called 911, so a rescue with no call is invisible to it.
[1] -
04
What happens to the $1.6 million the CDC promised for the Guinea-Bissau trial.
The CDC did not answer whether the money will now pay to vaccinate newborns, as the WHO recommends.
[5] -
05
How many autistic children truly have profound autism.
Only 54% of the 7,084 children had complete records, and a UCLA professor says the missing data are likely not random.
[8] -
06
Whether psilocybin really lowers inflammation.
The 12 patients knew they got the drug and there was no comparison group.
[9] -
07
Whether cholesterol really blocks the brain's drainage.
The work used slides from dead mice, and Maiken Nedergaard, who helped discover the drainage system, asks why the cholesterol moved at all.
[16] -
08
Whether Georgia's birth carts will be in place and used well.
Nobody knows when the carts will arrive; the money only has to be spent by 30 September 2027.
[15] -
09
Who will track hospital owners in states that drop their building laws.
A state health policy researcher says states that repealed the laws lost sight of who owns and runs their hospitals.
[14]
From May 2023, US emergency crews were called to about a third fewer opioid overdoses that people survived than expected. Over the same years, US overdose deaths fell from about 111,000 a year to under 71,000.
Also true today
- Eighty-seven people who already had electrodes in their brains for medical reasons took part in more than ten years of tests that mapped how the brain feels the body.
- In mice with Leigh syndrome, a rare illness that starves cells of energy, a pair of low-oxygen drugs lifted the middle lifespan from 62 days to 158.
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Across the beats