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President Donald Trump pledged on Wednesday to put an "extremely big dent" in the scourge of drug addiction in America as he signed legislation intended to help tackle the opioid crisis, the deadliest epidemic of overdoses in the country's history. Nearly 48,000 people died last year from overdoses involving opioids. Overall, U.S. drug overdose deaths have started to level off, but Health and Human Services Secretary Alex Azar says it's too soon to declare victory. (10/24)

"Together we are going to end the scourge of drug addiction in America," Trump said at a White House event celebrating the signing. "We are going to end it or we are going to at least make an extremely big dent in this terrible, terrible problem." (Rascoe and Horsley, 10/24)

The bill addresses numerous aspects of the opioid crisis, including prevention, treatment and recovery. It knits together bills sponsored by hundreds of lawmakers, many of whom are embroiled in tough reelection battles and can now tout their support of the law in the run-up to Election Day. “Together we will defeat this epidemic — it’s a true epidemic — as one people, one family and one magnificent nation under God,” Trump said. Drug overdoses killed about 72,000 people last year, and opioids have become a major campaign issue for both Democrats and Republicans. (Zezima and Kim, 10/24)

A hallmark provision of the bill aims to stop the flow of deadly synthetic opioids into the U.S. from other countries by requiring the U.S. Postal Service to obtain electronic data on international mail shipments that can be used to target suspicious packages for inspection. (Hellmann, 10/24)

The bill “is an important step forward,” Dr. Kelly Clark, the president of the American Society of Addiction Medicine, said in a statement. “[But] there is much work ahead to ensure that all Americans living with addiction have access to treatment that is standardized and evidence-based, as well as comprehensive insurance coverage.” The legislation extended the ability of nurses to prescribe addiction-treatment medications, made it easier for Medicare beneficiaries to access the addiction treatment drug methadone, and allowed more flexibility for doctors wishing to prescribe those treatments via telemedicine. (Facher, 10/24)

Rural Americans can take a dim view of outsiders from Washington, D.C., (or even from the state capital) meddling in their communities. Ronald Reagan summed up the feeling when he was president: "I've always felt the nine most terrifying words in the English language are, 'I'm from the government, and I'm here to help.' " (Morris, 10/25)

Nora Volkow is America's top scientist on addiction. And she's worried that by focusing on the opioid crisis, we're missing a chance to fight what caused it in the first place. (10/25)

Larrecsa Cox is a paramedic, but instead of an ambulance with flashing lights and sirens, she drives around in an old, white sedan. Her first call on a recent day in Huntington, W.Va, was to a quiet, middle-class neighborhood. "He overdosed yesterday," Cox says. "And I think we've been here before. I'm almost 100 percent sure we've been to this house before." (McCammon, 10/24)

A small Pennsylvania county will pay nearly $5 million to the family of a teenager who collapsed and died after four days of heroin withdrawal in jail. The family’s lawyer said jail staff ignored her dire medical needs for days and then lied about it. (Dale, 10/24)

After drawing overwhelming bipartisan support, a bill expanding drug treatment courts to every county in Missouri was signed into law Wednesday by Gov. Mike Parson. The measure places all of Missouri’s treatment courts beneath the same umbrella, allowing a state commission to establish “best practice standards” for treatment courts. Treatment courts, which include DWI and veterans treatment courts, provide offenders with an alternative to incarceration by allowing them to remain in their communities.  (Calacal, 10/24)

CareFirst BlueCross BlueShield announced Tuesday plans to award about $2.1 million in grants to 11 community health organizations in Maryland, Virginia and the District of Columbia — a move that health care and government officials hope will boost addiction treatment efforts. CareFirst officials, along with Baltimore Mayor Catherine Pugh and U.S. Rep. Elijah Cummings, announced the grants at a news conference Wednesday, emphasizing the urgent need to address the soaring number of drug- and alcohol-related deaths in Maryland. In 2017, the state saw an all-time high of 2,282 deaths stemming from drugs and alcohol. (Reed, 10/24)