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The next HIV epidemic in America is likely brewing in rural areas suffering under the nationwide opioid crisis, with many of the highest risk communities in deep red states that voted for President Donald Trump. Federal and state health officials say they are unprepared for such an outbreak, and don’t have the programs or the funding to deal with a surge in HIV cases. And given how little screening for HIV there is in some rural counties, they worry it may have already begun. (Ehley, 10/21)

More than 30 U.S. senators demanded information Friday on the 2016 law that stripped the Drug Enforcement Administration of its most potent weapon against companies suspected of spilling hundreds of millions of addictive painkillers onto the black market. Thirty-one Democrats and two independents noted that the same law required the DEA and the Department of Health and Human Services to compile a report for Congress on the law’s impact by April 16. Six months later, no report has been submitted. (Bernstein and Higham, 10/20)

Patrick Kennedy, it seemed, had been waiting for a public opportunity to speak directly to the nation’s health insurers. “The historic treatment of addiction and mental illness has been a separate and unequal process,” the former Rhode Island congressman and a member of the president’s opioid commission told a group of insurance executives on Friday. “All of you, as insurers and payers, have treated mental health and addiction as if it’s something other than the rest of medicine.” (Facher, 10/20)

Rep. Elijah Cummings, D-Md., the ranking member of the House Committee on Oversight and Government Reform, wrote to the companies after an article by ProPublica and The New York Times found that insurance companies sometimes favor cheaper, more addictive opioids over less addictive, but more expensive, alternatives. (Ornstein, 10/22)

The Richmond region trails only Roanoke for the highest rate of emergency room visits for opioid overdoses in Virginia over the past five months, according to figures compiled by the Virginia Department of Health. The local rate is more than two times the state average. (Ramsey and Burnell Evans, 10/21)

Some patients at Bon Secours Richmond Health System’s St. Mary’s Hospital are now going home two days earlier than they did a year ago after surgery, and are less likely to use opioids for their post-surgical pain. The changes come in light of St. Mary’s Enhanced Recovery Program, launched in August 2016, which has changed the protocols for patients receiving open and laparoscopic colorectal surgery. (O'Connor, 10/22)

In the United States, the number of NAS births grew nearly five-fold between 2000 and 2012 — reaching a total of nearly 22,000 infants. As the number of cases has grown, health care providers across Connecticut and the country have started to focus more on the syndrome, especially since no national standard of care currently exists for screening and treating NAS. (Rigg, 10/23)