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Activists on Friday delivered a parting gift to Scott Gottlieb, the outgoing Food and Drug Administration commissioner, at the entrance of a federal building here: an 800-pound, supersized heroin spoon stamped with the FDA’s logo. The group urged FDA to stop approving “dangerous” opioids and to instead encourage the development of more drugs to treat addiction. Many protesters decried the November approval of Dsuvia, a mega-potent pain drug, and urged the Trump administration to nominate an FDA commissioner who would take a different tack than Gottlieb on opioid approvals. (Facher, 4/5)

California had just weeks to get a program that used medication to treat opioid use disorder up and running after receiving $90 million in federal grants in 2017. So officials found a model that was already working in Vermont, and supersized it to fit the sprawling state. The scaling up of the "Hub and Spoke" system, particularly in rural areas, has presented challenges but also delivered results in locales like this Gold Rush-era city east of Sacramento — and dovetailed with existing efforts to expand medication-assisted treatment to give the state a two-pronged approach to confronting the opioid epidemic. (Colliver, 4/5)

Monroe County filed a lawsuit in federal court this week against several pharmaceutical companies, including Purdue Pharma, and national drug stores, including CVS, Walgreens and Walmart, over the manufacturing, marketing and selling of opioids, which have “created a public health crisis and nuisance” nationwide and in the Florida Keys, according to the complaint. The lawsuit accuses the drug makers of deceptively and massively marketing powerful pain medications like oxycodone and fentanyl as carrying low risks of addiction and being safe for the treatment of chronic ailments like back pain and arthritis. (Goodhue, 4/5)

While the country's attention has been focused on prescription opioids and heroin overdoses, methamphetamine has been making a comeback. The drug's history is rooted in California — biker gangs like the Hells Angels manufactured and distributed it up and down Interstate 5 in the 1980s. (Dembosky, 4/5)