2001 Anthrax Attacks Fast Facts | CNN



CNN
 — 

Here’s a look at the 2001 anthrax attacks, also referred to as Amerithrax.

There are four types of anthrax infection: cutaneous (through the skin), inhalation (through the lungs; the most deadly), gastrointestinal (through digestion) and injection anthrax. Injection anthrax is common in heroin-injecting users in northern Europe. This has never been reported in the United States.

Anthrax can be contracted by handling products from infected animals or by breathing in anthrax spores and by eating undercooked meat from infected animals.

It has been blamed for several plagues over the ages that killed both humans and livestock. It emerged in World War I as a biological weapon.

The Centers for Disease Control and Prevention categorizes anthrax as a Category A agent: one that poses the greatest possible threat for a negative impact on public health; one that may spread across a large area or need public awareness and requires planning to protect the public’s health.

Read more: America’s long and frightening history of attacks by mail

Five people died and 17 people were sickened during anthrax attacks in the fall of 2001; outbreak is often referred to as Amerithrax.

Anthrax was sent via anonymous letters to news agencies in Florida and New York and a congressional office building in Washington, DC.

Of the five victims who died of inhalation anthrax, two were postal workers. The other three victims were an elderly woman from rural Connecticut, a Manhattan hospital worker from the Bronx and an employee at a Florida tabloid magazine who may have contracted anthrax through cross-contamination.

The letters were sent to NBC anchor Tom Brokaw, Sen. Majority Leader Tom Daschle, Sen. Patrick Leahy, and the New York Post offices. The letters were postmarked Trenton, New Jersey.

No arrests were made in the attacks.

The FBI has interviewed more than 10,000 people and issued more than 6,000 subpoenas in the case.

4.8 million masks and 88 million gloves were purchased by the Postal Service for its employees, and 300 postal facilities were tested for anthrax.

Over 32,000 people took antibiotics after possible exposure to anthrax.

Stevens, Bob – photo editor at American Media Inc, died of inhalation anthrax, October 5, 2001

Morris, Thomas Jr. – DC postal worker, died of inhalation anthrax, October 21, 2001

Curseen, Joseph Jr. – DC area postal worker, died of inhalation anthrax, October 22, 2001

Nguyen, Kathy – employee at Manhattan hospital, died of inhalation anthrax, October 31, 2001

Lundgren, Ottilie – Connecticut woman, died of inhalation anthrax, November 22, 2001

October 5, 2001 – Sun photo editor Stevens dies of inhalation anthrax.

October 12, 2001 – NBC News announces that an employee has contracted anthrax.

October 15, 2001 – A letter postmarked Trenton, New Jersey, opened by an employee of Senate Majority Leader Daschle contains white powdery substance later found to be “weapons grade” strain of anthrax spores. More than two dozen people in Daschle’s office test positive for anthrax after the envelope is discovered.

October 19, 2001 – An unopened letter tainted with anthrax is found in the offices of the New York Post. One Post employee is confirmed to have a cutaneous infection and a second shows symptoms of the same infection.

October 21, 2001 – DC postal worker Morris Jr. dies of inhalation anthrax.

October 22, 2001 – DC postal worker Curseen dies of inhalation anthrax.

October 31, 2001 – Nguyen, a stockroom worker for the Manhattan Eye, Ear and Throat Hospital, dies of inhalation anthrax.

November 9, 2001 The FBI releases a behavioral profile of the suspect, who is probably a male loner and might work in a laboratory.

November 16, 2001 – A letter sent to Senator Leahy is found to contain anthrax. The letter is among those at the Capitol that has been quarantined. The letter contains at least 23,000 anthrax spores and is postmarked October 9, in Trenton, New Jersey.

November 22, 2001 – Lundgren, a 94-year-old Connecticut woman, dies of inhalation anthrax.

January 2002 – FBI agents interview former US Army bioweapons scientist Steven Hatfill as part of the anthrax investigation.

June 2002 – Bioweapons researcher Hatfill is named a “person of interest” by the FBI.

June 25, 2002 – The FBI searches Hatfill’s Maryland apartment and Florida storage locker with his consent.

June 27, 2002 The FBI says it is focusing on 30 biological weapons experts in its probe.

August 1, 2002 – The FBI uses a criminal search warrant to search Hatfill’s Maryland apartment and Florida storage locker a second time; anthrax swab tests come back negative.

August 6, 2002 Attorney General John Ashcroft refers to Hatfill as a “person of interest.”

August 11, 2002 – Hatfill holds a press conference declaring his innocence. He holds a second one on August 25, 2002.

September 11, 2002The FBI searches Hatfill’s former apartment in Maryland for the third time.

August 26, 2003 – Hatfill files a civil lawsuit against Attorney General John Ashcroft, the Justice Department and the FBI claiming his constitutional rights have been violated. The suit alleges violations of Hatfill’s Fifth Amendment rights by preventing him from earning a living, violations of his Fifth Amendment rights by retaliating against him after he sought to have his name cleared in the anthrax probe and the disclosure of information from his FBI file. The suit also seeks an undetermined amount of monetary damages.

July 11, 2004 – The former headquarters of American Media, Inc. in Boca Raton, Florida, where Stevens contracted the anthrax is pumped full of chlorine dioxide gas for decontamination. This was the last building exposed to anthrax in the fall of 2001.

June 27, 2008 – The Justice Department reaches a settlement with Hatfill. The settlement requires the Justice Department to pay Hatfill a one-time payment of $2.825 million and to buy a $3 million annuity that will pay Hatfill $150,000 a year for 20 years. In return, Hatfill drops his lawsuit, and the government admits no wrongdoing.

July 29, 2008Bruce Ivins, a former researcher at the Army’s bioweapons laboratory at Fort Detrick, Maryland, dies after overdosing during a suicide attempt on July 27.

August 6, 2008 – Judge unseals and releases hundreds of documents in the 2001 FBI Anthrax investigation that detail Ivins’ role in the attacks.

August 8, 2008The Justice Department formally exonerates Hatfill.

September 25, 2008 – The court releases more documents including emails that Ivins sent to himself.

February 19, 2010 – The Justice Department, FBI and US Postal Inspection Service announce its investigation into the 2001 anthrax mailings is at an end.

March 23, 2011 – A report, entitled The Amerithrax Case, is released through the Research Strategies Network, a non-profit think tank based in Virginia. According to the report, old mental health records suggest Ivins should have been prevented from holding a job at a US Army research facility in Maryland. The report was requested by the US Department of Justice.

October 9, 2011 – The New York Times reports indicate there are scientists questioning the FBI assertions regarding Ivins. Possibly Ivins, if he was involved, worked with a partner. Also, the scientists say the presence of tin in the dried anthrax warrants that the investigation be reopened.

November 23, 2011 – The Justice Department settles for $2.5 million with Stevens’ family. The family originally sued for $50 million in 2003, arguing that the military laboratory should have had tighter security.

December 19, 2014 – The Government Accountability Office releases a 77-page report reviewing the genetic testing used by the FBI during the investigation into the anthrax attacks.

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Getting prescription meds via telehealth might change soon. Here’s how to prepare | CNN

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CNN
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For three years now, the expansion of telehealth has made care more accessible for many people, especially those in rural areas. Patients have been able to receive prescriptions from providers without seeing them in person. But that may change come May 11 when the federal government is set to end the Covid-19 public health emergency declaration that made this convenience possible.

Before the pandemic, medical practitioners were subject to the conditions of the Ryan Haight Act, which required at least one in-person examination before prescribing a controlled medicine, said Dr. Shabana Khan, chair of the American Psychiatric Association’s Committee on Telepsychiatry.

“There are seven exceptions, and one of them is a public health emergency declared by the secretary of (health and human services), which is what we’ve had for the past three years,” Khan said. “It was immensely helpful … and allowed many Americans to get their medical care without having to come in person, so we could treat patients completely remotely.”

“The administration and HHS has put out a notice that they don’t intend to renew it any further,” Khan said, “so the federal public health emergency is going to be expiring May 11.”

Returning to pre-pandemic rules means people who were prescribed controlled medications via telehealth — such as stimulant medications for attention-deficit/hyperactivity disorder, benzodiazepines for anxiety, or medications for opioid use disorder, sleep or pain — will need one in-person medical examination to continue these prescriptions or start new ones.

The US Drug Enforcement Administration’s website has a general list of controlled substances, and an exhaustive list can be found here.

Patients will still be able to get prescriptions for non-controlled medications, such as antibiotics or birth control, via telehealth. The pre-pandemic rules also wouldn’t affect telehealth care by a practitioner who has already conducted an in-person examination of a patient.

To establish some flexibility in the telehealth framework moving forward, Khan said, the DEA has put forth proposals (PDF) that would allow telehealth practitioners to prescribe one 30-day supply of buprenorphine — a medication for opioid use disorder — or Schedule III-V non-narcotic controlled medications without doing an in-person examination first. A patient would have to do an in-person exam before the second prescription of either type of medication, according to those proposals.

But there’s no guarantee that will happen — public comment on the proposals was open through March; since then, the DEA has been considering comments before drafting final regulations.

“It is really important to start planning now,” Khan said. “For many medicines, it can be a risk to abruptly stop treatment.”

People who are on medications for opioid use disorder, ADHD or anxiety and don’t get an in-person exam between May 11 and the next time they need a prescription refill could experience withdrawal requiring a trip to the hospital, or negative effects on health, relationships, employment or academics, she added.

Here’s what else you should know about the changes and steps you should take, according to Khan.

This conversation has been lightly edited and condensed for clarity.

CNN: How should people prepare to ensure their prescription routine isn’t disrupted?

Khan: It’s important for patients who may be prescribed one of these types of medicines by a telemedicine physician or other practitioner to reach out to that practitioner to discuss this issue and make sure that they have a plan. And if it’s feasible to see that telemedicine physician in person, schedule that as soon as possible.

CNN: What if you can’t see your telehealth provider in person?

Khan: Let’s say a telemedicine physician practices completely remotely — then the patient would discuss with them what next steps would be.

In the proposed rule, the qualifying telemedicine referral may allow a patient to be seen by a local DEA-registered practitioner. So, for example, perhaps their primary care doctor or pediatrician — if they are DEA-registered — might be able to go through the qualifying telemedicine referral process so that they can see them in person and continue to be prescribed the medicine. Or patients can contact their health insurance provider to get a list of local referrals.

CNN: Are there any drawbacks to seeing general physicians or pediatricians for controlled medication prescriptions?

Khan: Some may say they aren’t going to prescribe certain medications, like psychiatric medications. Some may say they are comfortable with it, and some may say they will prescribe for a short period of time until you connect with a specialist. So there is variability.

CNN: Would the patient have to continue seeing the referral provider after that first in-person appointment?

Khan: In terms of what’s required at the federal level, if a patient has that one in-person exam with a provider through that qualifying telemedicine referral process, they wouldn’t necessarily have to see that provider again unless that’s part of their treatment plan that’s discussed.

With the qualifying telemedicine referral in the proposed rule, the way it’s written, it doesn’t necessarily have to be the referral practitioner prescribing the medicine; they just need to do the in-person exam. The referral practitioner can refer the patient back to the telemedicine doctor, who can prescribe the medicine.

The other factor that’s significant here is we discussed all the proposed rules and the status at the federal level, but there’s also the state level. States also have rules around controlled medicine prescribing, and they may not always align with federal law. Let’s say the DEA puts out their final rule, and there’s some flexibility — some states might adopt the older Ryan Haight Act language from the federal level, so they might actually be stricter than what we’ll be seeing at the federal level. When federal and state laws don’t align, providers generally have to follow whatever is stricter.

CNN: Will patients need to see their provider in person every time they need a prescription refill?

Khan: The DEA has indicated that the absolute requirement at the federal level is one in-person examination. Beyond that, it would be left to the discretion of whoever the patient is seeing.

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Biden administration declares fentanyl laced with xylazine ‘an emerging threat’ in the US | CNN



CNN
 — 

The White House has declared that the powerful synthetic opioid fentanyl combined with xylazine – an animal tranquilizer that’s increasingly being used in illicit drugs – is an “emerging threat” facing the United States due to its role in the ongoing opioid crisis.

Administration officials call the threat FAAX, for fentanyl-adulterated or -associated xylazine.

The move, announced Wednesday, marks the first time in history that any administration has declared a substance to be an emerging threat to the country, said Dr. Rahul Gupta, director of the Office of National Drug Control Policy. The SUPPORT Act of 2018 established that the office has authority to declare such “emerging threats,” and no administration has used it until now. Last year, Congress declared methamphetamine an emerging drug threat but none have been declared by an administration previously. Under other agencies or in separate circumstances, concerns such as bioterrorism, infectious diseases or climate change may be identified as “emerging threats.”

“This drug, which is an animal sedative, is being mixed with fentanyl and is being found in almost all 50 states now,” Gupta said Tuesday. “It’s become an important part for us to make sure that we’re declaring it an emerging threat.”

Now that the administration has declared fentanyl combined with xylazine an emerging threat, it has 90 days to coordinate a national response. “We are working quickly to develop and implement a whole of government nationwide plan, with real deliverable action, that will save lives and will be published within 90 days of this designation,” Gupta said.

Xylazine, also known as tranq or tranq dope, has been linked to an increasing number of overdose deaths in the United States due to its rising illicit use. Between 2020 and 2021, overdose deaths involving xylazine increased more than 1,000% in the South, 750% in the West and about 500% in the Midwest, according to an intelligence report released last year by the US Drug Enforcement Administration.

And in some cases, people might not even know that xylazine was in the drug they used.

Just last month, authorities at the DEA issued a public safety alert about the “widespread threat” of fentanyl mixed with xylazine, reporting that in 2022 approximately 23% of fentanyl powder and 7% of fentanyl pills seized by the DEA contained xylazine.

Fentanyl, which has been driving the opioid crisis, is a fast-acting opioid, and people who use it illicitly say that adding xylazine can extend the duration of the high the drug provides.

Xylazine is not an opioid. It is approved by the US Food and Drug Administration for use as a tranquilizer in veterinary medicine, typically in horses, but it is not approved for use in humans. And xylazine can do major damage to the human body, including leaving drug users with severe skin ulcers, soft-tissue wounds and necrosis – sometimes described as rotting skin – that can lead to amputation.

“Xylazine is one of the contaminants in fentanyl, but there could be others,” Gupta said. “So, I think with the declaration of an emerging threat, we’re sending a clear message to producers and traffickers of illicit xylazine and illicit fentanyl that we’re going to respond quicker, we’re going to match the challenge of evolution of these drugs supply, and that we’re going to protect lives first and foremost.”

Now that xylazine has been declared an emerging threat, some of President Biden’s $46 billion drug budget request to Congress can be used to respond.

This year, the Biden administration announced that the President has called on Congress to invest $46.1 billion for agencies overseen by the Office of National Drug Control Policy to tackle the nation’s illicit drug crisis.

If the budget request is not approved, there could be the option to reallocate money within the Office of National Drug Control Policy, but “we don’t want to be in a position where moneys that are being utilized for some other important aspect of saving lives has to be moved away for this purpose,” Gupta said Tuesday. “That is the reason we are asking Congress to act.”

Such funds could be used to test drugs on the street for xylazine, collect data on FAAX, invest in care for people exposed to FAAX and develop potential treatments for a xylazine-related overdose.

The medication naloxone, also known as Narcan, is an antidote for an opioid overdose, but people who have overdosed on a combination of opioids and xylazine may not immediately wake up after taking naloxone, as it may not reverse the effects of xylazine in the same way it does opioids.

“We need to recognize, first of all, that there is a shift that is occurring from organic compounds and substances like heroin and cocaine to more synthetics,” Gupta said of the state of the nation’s illicit drug crisis.

“Both the types of drugs have changed – from predominantly organic to predominantly synthetics – but the way drugs are bought and sold have also changed,” he said. “Now, all you need is a phone in the palm of your hand and a social media app to order and buy some of the most dangerous substances on planet Earth.”

Xylazine is just one of the many adulterants – or substances that are typically added to others – found in the nation’s illicit drug supply.

“All of a sudden, you can synthesize hundreds of compounds and kind of mix them together and see what does the best in the market,” Joseph Friedman, a researcher at the University of California, Los Angeles, told CNN in March. “People are synthesizing new benzodiazepines, new stimulants, new cannabinoids constantly and adding them into the drug supply. So people have no idea what they’re buying and what they’re consuming.”

Some of these adulterants may be as simple as sugar or artificial sweeteners added for taste or additives or fillers that bulk up the drug. Sometimes, they may be contaminants left over from the manufacturing process.

Addicted? How to get help

  • If you’re addicted to prescription drugs, help is available. You can call the Substance Abuse Mental Health Services Administration 24/7 hotline at 1-800-662-HELP(4357) or visit their website.
  • But all of these things can carry real-life health harms, says Naburan Dasgupta, an epidemiologist and senior scientist at the Gillings School of Global Public Health at the University of North Carolina, Chapel Hill.

    Like an opioid, xylazine can depress the respiratory system, so the risk of overdose multiplies when it’s combined with heroin or fentanyl.

    Also, “in the veterinary literature, we know that it causes a really bad severe form of anemia. And so when people are injecting heroin that’s contaminated with xylazine, they can end up with a near-fatal form of blood iron deficiency,” Dasgupta said in March. “We had one person here who ended up going to the hospital needing multiple blood transfusions. And it was all because of the xylazine.”

    US lawmakers are moving to classify xylazine as a controlled substance.

    In March, bipartisan legislation – the Combating Illicit Xylazine Act – was introduced in the House and Senate. It describes illicit xylazine as an “urgent threat to public health and safety” and calls for it to be a Schedule III drug under the Controlled Substances Act, a category on the five-level system for substances with moderate to low potential for physical or psychological dependence. Xylazine would be one level below opioids like fentanyl.

    “Our bipartisan bill would take important steps to combat the abuse of xylazine by giving law enforcement more authority to crack down on the illicit distribution of this drug, including by putting stiffer penalties on criminals who are spreading this drug to our communities,” Sen. Maggie Hassan, D-N.H., said in a statement in March.

    The bill would also require manufacturers to send reports on production and distribution to the DEA so the agency can ensure that the product is not being diverted to the black market.

    “This bill recognizes the dangers posed by the increasing abuse of animal tranquilizers by drug traffickers, and provides new tools to combat this deadly trend,” Sen. Chuck Grassley, R-Iowa, said in the statement.

    “It also ensures that folks like veterinarians, ranchers and cattlemen can continue to access these drugs for bona fide animal treatment.”

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    Tracking the opioid crisis: Inside the DEA’s secret lab | CNN

    Watch CNN Films’ “American Pain” at 9 p.m. ET Sunday, February 5.



    CNN
     — 

    Sitting among the warehouses of Dulles, Virginia, is one of the US Drug Enforcement Administration’s forensic labs. It’s one of eight across the country where scientists analyze illegal drugs and try to stay ahead of what’s driving deadly overdoses.

    Starting in the late 1990s with overprescribing of prescription narcotics, the opioid epidemic has continued to plague the United States for decades. What has changed is the type of drugs that have killed more than half a million people during the past 20 years.

    CNN was granted rare access to the secret lab where the DEA tests seized illicit drugs to understand what’s coming next.

    “The market is constantly changing, so we are trying to do everything we can from a science base to keep up with that,” Scott Oulton, deputy assistant administrator of the DEA’s Office of Forensic Sciences, told CNN Chief Medical Correspondent Dr. Sanjay Gupta.

    Holding a white bag of fentanyl precursor powder – one of the chemicals used to make the opioid – Oulton explained that the illicitly made painkiller continues to be a dominant presence in the drugs officials are finding.

    “This kilogram can be converted into fentanyl to make approximately 800 grams,” he said. “So it doesn’t take that much material, it’s fairly cheap, it’s inexpensive to obtain.”

    Fentanyl is the deadliest drug in the United States, and it’s often found in combination with other illicit drugs, including cocaine and heroin. But increasingly, fentanyl is showing up in illicit pills disguised as common prescription drugs like oxycodone, hydrocodone, even Adderall.

    Users buying drugs on the street that look like prescription pills may end up with a highly potent, potentially deadly drug they never intended to take.

    “Over 99% of what we see are fake. They contain fentanyl,” Oulton says of the pills that the agency is seizing.

    The 800 grams of fentanyl that Oulton held could be turned into 400,000 to 500,000 potentially lethal pills.

    As more and more of these lethal pills circulate, the opioid epidemic is reaching more of the population.

    Deena Loudon of Olney, Maryland, is among those living with its effects.

    “I truly love sharing Matthew with the world,” Loudon says as she flips through pictures of her son.

    One of her favorite memories is Matthew playing hockey – what Loudon calls his happy place.

    Matthew Loudon's mom says he turned to drugs after struggling with anxiety.

    But she also recalls his struggles with anxiety, which led him to turn to drugs. He started dabbling in them in the 10th grade. By the following year, his grades began to fall, and he couldn’t keep them high enough to stay in hockey.

    “He was using Xanax to help self-medicate himself and I think to help get rid of some of that angst so he could live somewhat of a normal life,” Loudon said.

    Matthew was always honest, almost to a fault, Loudon says. “He told me he tried everything. Like everything. Heroin, meth, crack, you name it, cocaine, whatever – until I guess he found what made him feel the best, and it was Xanax.”

    And as much as a mother can worry, Loudon says, Matthew always tried to reassure her. “I know what I’m doing,” he would tell her.

    She had heard about fentanyl showing up in pills in their area.

    “But you don’t ever think it’s going to happen to you,” Loudon said.

    She said they even had a conversation about fentanyl the day before he died. “I was sort of naive, wanting to stick my head in the sand and thinking ‘I bet he does know what he’s doing.’ ”

    On November 3, 2020, she found 21-year-old Matthew on the floor of their basement.

    Matthew’s autopsy report lists his cause of death as fentanyl and despropionyl fentanyl intoxication.

    “I don’t say he overdosed. I say he died from fentanyl poisoning. … Truthfully, like, at the end of the day, to me, he was murdered, right? Because he asked for one thing. They gave him something different. And it took his life.”

    For a parent, she said, the hardest thing is burying their child. It’s a pain she speaks out about in hopes of keeping other families safe.

    “It’s Russian roulette,” she warns them. “You never know what you’re gonna get.”

    The number of pills the DEA has seized skyrocketed in just three years, from 2.2 million in 2019 to 50.6 million in 2022.

    The sheer volume of pills has been one of the biggest challenges for the DEA’s lab, Oulton says. As the fentanyl threat continues to grow, the Virginia facility is expanding to accommodate the analysis needed.

    The lab can test for something as simple as the presence of fentanyl, but something called the purity of the pill also offers important insight. This means how much fentanyl is actually in one of these illicit pills.

    “Lately, we’ve been seeing a purity increase over the last year, where we used to say roughly four out of the 10 seizures that we were receiving would contain a lethal dose of greater than 2 milligrams. As of October last year, we started reporting that we’ve seen an uptick. Now we’re saying that six out of 10 of the seizures that we’re receiving contain over 2 milligrams,” Oulton said.

    He says they’re finding an average of 2.3 milligrams of fentanyl in each pill.

    Two milligrams may be the cutoff for what is considered lethal, but Oulton says that doesn’t necessarily mean a pill with 1.99 milligrams of fentanyl can’t be deadly.

    “One pill can kill” is his warning.

    “The message I would like to send out is, don’t take it,” he said. “Don’t take the chance. It’s not worth your life.”

    Oulton says he and his team are constantly finding new and different drugs and substances in pills – things they’ve never seen before.

    One machine in the lab is almost the equivalent of an MRI in a medical office, showing the structure and detail of a pill.

    “We will do what we call structural elucidation to determine that this is a different version of a fentanyl that’s got a new compound and molecule that’s been added to it,” Oulton said.

    They’ve seen “hundreds and hundreds of unique combinations,” he said.

    “We’ll see one that contains fentanyl, one with fentanyl and xylazine, one with fentanyl and caffeine, one with fentanyl and acetaminophen, and you don’t know what you’re getting.”

    Xylazine, a veterinary tranquilizer, poses a unique problem. It’s not an opioid, so even when it’s mixed with fentanyl, drugs designed to reverse an opioid overdose may not work.

    Narcan or naloxone, one of the more common overdose-reversing drugs, has become increasingly necessary as the prevalence and potency of illicit drugs increases. About 1.2 million doses of naloxone were dispensed by retail pharmacies in 2021, according to data published by the American Medical Association – nearly nine times more than were dispensed five years earlier.

    Oulton wants to be clear: The problem Isn’t with pills prescribed by your doctor and dispensed by a pharmacy – it’s the pills on the illicit market.

    Those, Matthew’s mother warns, are easy to get.

    “The first pills [Matthew] got was in high school. And it was just flipping out, floating around, and it was easy for him to get his hands on,” she said.

    Loudon’s message for parents now: Keep your eyes open.

    “Just be mindful of what your children are doing. You just just have to keep your eyes open. And even sometimes, when you keep your eyes open, you can miss some of the warning signs, but I think a parent knows their child best, so just keep talking.”

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