Proposed wealth tax risks destroying California’s innovation engine

• September 23, 2026

California voters will soon decide whether to impose a one-time 5% tax on the wealth of the state’s billionaires. Google co-founder Sergey Brin recently contributed $82 million to oppose the measure. His critics frame this as an existential battle between self-interested billionaires and the public interest. At stake are funds unions and legislators believe could be collected from billionaires and put to better use.

Supporters of the initiative argue it would raise billions while making the wealthy pay their fair share. Critics like Brin see it as a threat to the startup culture that made California the innovation capital of the world and warn it could undermine an entrepreneurial ecosystem responsible for much of California’s prosperity.

The debate partly centers on the popular belief that billionaires pay lower effective tax rates than ordinary Americans. The two main proponents of wealth taxes, U.C. Berkeley economists Gabriel Zucman and Emmanuel Saez, claim that they do. Other economists dispute their methodology.  But the accounting debate obscures a deeper economic issue. Setting aside the risk that billionaires and their workforces would relocate to other states, and the thorny problem of taxing unrealized income and capital gains, what exactly does government tax when it taxes entrepreneurial wealth?

Many wealth tax advocates assume that a founder’s fortune represents wealth unfairly extracted from society. But economic research says the opposite. Nobel laureate William Nordhaus estimated that innovators capture only about 2.2% of the economic value they create. The other 97.8% flows to consumers. In short, a billionaire tech founder’s wealth is only a small slice of the value he or she created for society.

Google illustrates the point. Sergey Brin and Larry Page became extraordinarily wealthy by building one of California’s most valuable companies. Their combined fortunes are over $500 billion.   Yet, if Nordhaus’s estimates are even roughly right, the value that Google’s innovations create for consumers is measured not in billions but in trillions of dollars.

Much like AI companies today, Google’s technology was highly disruptive and displaced several categories of work—from print advertising to travel services. Total U.S. newspaper advertising revenue collapsed from nearly $50 billion at its peak in the mid-2000s to under $10 billion by the early 2020s. Meanwhile, as consumers increasingly booked flights and hotels online, jobs for U.S. travel agents tumbled nearly 50%, from around 124,000 in 2000 to roughly 66,000 today.

Happily, as has occurred throughout history with disruptive technologies, these highly visible losses were dwarfed by massive, but less visible gains. Google helped launch and accelerate new industries—from digital advertising and app development to search optimization and cloud services. Google’s platform helped birth a broad ecosystem where businesses can instantly reach suppliers and customers across the globe. Both consumers and businesses benefited as the cost of search and price comparisons fell, shifting bargaining power to buyers and intensifying competition among sellers to produce better products at lower prices.

According to the U.S. Bureau of Labor Statistics, since Google’s founding in 1998 employment in software publishing, internet services, digital marketing, and related information industries has grown by well over a million jobs. Google itself estimates that its Search, Ads, Play, Android, and Cloud ecosystems support more than 2 million U.S. businesses, publishers, developers, and nonprofits.

Brin and Page became billionaires by revolutionizing how billions of people find information, products and services. The fortunes they accumulated are not the result of wealth redistribution; they reflect a series of innovations that increased productivity, expanded consumer choice, reduced transaction costs, contributed to greater competition and more efficient markets, and helped create new markets and employment opportunities across the globe.

This matters for how we think about wealth taxes. Most startups fail. A handful like Google earn outsized returns that compensate investors and founders for those many failures. Meddling with the potential rewards reduces the incentive to take those risks—not just for existing billionaires, but for the next generation of entrepreneurs deciding whether and where to launch a company or pursue risky new technologies.

None of this means that California’s fiscal challenges aren’t real. But under current law the wealthy already pay a substantial share of the state’s income taxes. The top 1% of taxpayers—around 180,000 filers—pay 40% to 50% of all personal income taxes. The state’s roughly 200+ billionaires alone pay 2-3% of all personal income taxes. They and the tech companies they founded also pay high corporate, capital gains, and payroll taxes.

California’s economy is substantially built on its startup ecosystem. Voters should therefore be especially cautious about policies that target the very mechanism that produced that prosperity. A wealth tax is not the right instrument to raise revenues and reduce inequality. Fortunes targeted by wealth taxes represent a thin slice of an enormous pie that mostly went to others. In fighting this tax, Sergey Brin is benefiting not just himself but virtually all Californians.

David R. Henderson is a research fellow with the Hoover Institution at Stanford University and a senior fellow with the Independent Institute. Francois Melese is an Emeritus Professor of Economics at the Naval Postgraduate School and Vice Chair of the California Arts & Sciences Institute.

​ Orange County Register 

Afghan female cyclist wins silver at Asian Games after disguising herself as a man to train

• September 23, 2026

By STEPHEN WADE, AP Sports Writer

NAGOYA, Japan (AP) — The easy part for Fariba Hashimi was winning a silver medal in the women’s cycling road race at the Asian Games.

The nearly impossible part for the female cyclist from Afghanistan was trying to train in her country. To do that, she dressed as a man in a place where women have few rights.

“All the time when I was going to training,” she said, “I was dressing as a guy.”

She said she also hid her face when she could in order to not be recognized.

“Because sometimes when they recognized me, they were trying to throw … stone(s) or hitting me,” she said.

Hashimi, who is 23, won silver Tuesday in a time of 2 hours, 50 minutes, 5 seconds, which marked another leg in a journey that began in 2021 when she left Afghanistan.

“In 2021, when the Taliban moved into my country, I escaped my country because I wanted to follow my dream,” she said. “I want to show the Afghanistan women in the world that … we can have an opportunity.”

Hashimi talked about having many dreams for women in Afghanistan, dreams for herself and dreams that may take time to be realized.

“I’m really, really happy and I’m full of emotion. I don’t know how I can explain it for you,” she said.

“I hope one day I come back in my country and ride the streets of Kabul — and riding with the women side by side to share the same passion,” she explained.

“And I hope in the future changing some things,” she added. “I think we are really tired of the situation of our country and I hope the Taliban is watching. I know how much one woman can be powerful and that’s why Taliban is scared (of) women.”

SNTV video journalist Raj Mohan contributed to this report.

See full AP coverage of Asian sports here

​ Orange County Register 

Cafe devoted to Mexico-grown beans opening in Costa Mesa

• September 23, 2026

Mexico rarely gets top billing when talk turns to the world’s great coffee-growing regions. A new cafe at Mercado González wants to change that.

Casa Libre, a specialty cafe devoted to coffee grown in Mexico, will open Thursday, Sept. 24, inside the Costa Mesa mercado.

The new concept will roast single-origin beans onsite, allowing customers to compare coffees from growing regions like Chiapas and Veracruz.

“Casa Libre is built on a simple idea: mi casa es tu casa,” said Jeremy Creighton, Casa Libre cofounder, in a written release. “Mexico is literally our neighbor, and its coffee deserves a place in the spotlight.”

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Mexico boasts more than 500,000 coffee farmers across 15 states, with most tending plots smaller than three hectares (or 7.4 acres). At Casa Libre’s roastery and bean market, customers can learn about individual regions and producers, sample varying flavor profiles and watch beans being roasted before they’re packed.

Opening selections will include coffee from Doña Duglas Molina and her family at El Cielo farm in Villa Corzo, Chiapas, with notes of chocolate, red plum and honeydew melon. Other offerings will come from small farms near Motozintla, Chiapas, near the Guatemalan border, and Huatusco, Veracruz.

“We’re excited for guests to discover that ‘Mexican coffee’ isn’t one single flavor or experience,” said cofounder Natalie Taormina. “These coffees are shaped by completely different landscapes, climates, families and traditions.”

In addition to espresso, batch brew and other coffee-shop staples, the menu will feature the El Jaguar Latte made with a corn, cacao and chile syrup, as well as the El Colibrí tinged with cafe de olla syrup.

Pastelería González will supply such pastries as canela rolls, jamón pockets, chocolate chip galleta, almond croissants and colibrí galletas, the bakery’s gingerbread hummingbird cookies.

Hours will be Sunday through Thursday from 6 a.m. to 10 a.m. and Friday and Saturday from 6 a.m. to 11 p.m.

Find it: Mercado González, 2300 Harbor Blvd., Costa Mesa, cafecasalibre.com

​ Orange County Register 

Xi heads into Trump visit after making China into a global force since 2015

• September 23, 2026

By DIDI TANG

WASHINGTON (AP) — When Chinese leader Xi Jinping arrived in Washington for a state visit in 2015, he sought to calm the growing unease among the Americans about his country’s rapid ascent.

Xi largely succeeded, shaking hands with then-President Barack Obama to deepen economic ties and expand cooperation. In the Rose Garden, Obama declared that the U.S. “welcomes the rise of a China that is peaceful, stable, prosperous and a responsible player in global affairs.”

Those days are over.

Returning to the U.S. capital Wednesday for the first state visit in over a decade, Xi — more confident than ever — is seeking stability even as the globe’s two largest economies compete over everything from artificial intelligence to space ambitions and global influence. Xi is expected to urge cooperation with the U.S. for the sake of the world.

“In 2015, China was a rising power still, profoundly and quickly rising, but rising undeniably,” said Mira Rapp-Hooper, a visiting fellow at Brookings Institution’s Center for Asia Policy Studies. Now, “China is risen.”

Both economies have grown remarkably over the decade, and while the U.S. still maintains a strong edge, what’s important is that Beijing has gained the capabilities to check the U.S. and “the will to use those capabilities,” said Sun Yun, director of the China program at the Stimson Center, a Washington-based think tank.

That was on display last year when China matched President Donald Trump’s whopping 125% tariffs, nearly freezing trade and leveraging a near-monopoly in processing critical minerals — crucial for products from smartphones to fighter jets — to force the U.S. to stand down.

“In the past, China was disadvantaged in terms of strength, and it was not an equal to the U.S.,” Sun said. “But now it is considered a near-peer.”

US and Chinese leaders have shifted tones since the last state visit

In 2015, the U.S. raised myriad concerns: a level playing field for American companies in China, protection of intellectual property, cyberthreats, and freedom of navigation in the South and East China Seas.

Xi told Obama that “China is making all-around efforts to deepen comprehensive reform, to build law-based governance, to enforce strict party discipline.” Xi said Beijing would manage differences in the South China Sea “through dialogue” and told Obama that “China does not intend to pursue militarization” there.

Now, Xi remains in office after purging political rivals, abolishing presidential term limits and consolidating power. In the U.S., voters brought Trump back to the White House.

Most issues from 2015 either remain unresolved or have worsened: U.S. companies are still seeking market access, the Chinese have become more aggressive in cyberattacks, and the tensions in the South China Sea have only risen with the increasing Chinese military presence.

Xi made no mention of Taiwan in his Rose Garden remarks in 2015. But when hosting Trump in Beijing in May, Xi warned of “clashes and even conflicts” if the U.S. should mishandle the self-governed island that Beijing claims as its own. This week, Xi is expected to press Trump to further delay an arms sales package to Taiwan.

On the U.S. side, Trump will be welcoming Xi on Wednesday evening on the tarmac at Joint Base Andrews, a rare move that deviates from the typical protocol of waiting for leaders to drive up to the White House.

China reduces its economic reliance on the US, but the US is still dependent on China

The U.S. was China’s largest export market in 2015, accounting for nearly one-fifth of its $2.3 trillion in exports. Today, the U.S. remains China’s top export destination, but its share has slipped to 11% of China’s global exports, which rose to more than $3.7 trillion in 2025.

That’s because the U.S. is buying less from China due to higher tariffs, while the Asian country is shipping more goods to additional markets around the world to soften the blow of Trump’s trade war.

And China has moved up on the global value chain in manufacturing, widening the gap with the U.S.

In 2015, China launched a national strategy to pursue advanced manufacturing by investing in key sectors. It has helped China reduce dependency on imports in areas such as memory chips and medical devices, and it made Chinese companies competitive globally in industries from drones to electric vehicles, clean technologies and shipbuilding, according to an analysis last year by Rhodium Group, a research provider that tracks China’s economy and policy.

“There’s an undeniable sense of China’s progress on the global stage,” said Kurt Campbell, a former veteran U.S. diplomat who is now chair of The Asia Group, a strategic advisory firm. “China is not arriving. It has arrived.”

Beefing up industry has meant China’s military now poses a threat to the US

Beijing’s manufacturing clout has turned into military strength.

Its shipbuilding power has allowed China to build the world’s largest fleet by number of vessels, including a sophisticated aircraft carrier and advanced amphibious assault ships, said Matthew P. Funaiole, a senior fellow for the China Power Project at the Center for Strategic and International Studies.

But the U.S. Navy still has an advantage in overall tonnage and weapons systems, he said.

China has developed fifth-generation fighter jets and expanded the fleet to hundreds — it had none in 2015, according to a RAND report.

In 2019, China became the first country to land spacecraft on the far side of the moon, and it is operating one of the two space stations in orbit. It is the only other country besides the U.S. to have a space force.

China’s military buildup “has made the U.S. homeland increasingly vulnerable,” according to the latest Pentagon report on China’s military powers. “China maintains a large and growing arsenal of nuclear, maritime, conventional long-range strike, cyber, and space capabilities able to directly threaten Americans’ security.”

That was not the picture in 2015, when the Pentagon warned that “China’s military modernization has the potential to reduce core U.S. military technological advantages.”

Secretary of State Marco Rubio told reporters hours before Xi arrived that the two leaders must interact because the U.S. and China are “the two largest economies in the world” and “probably the two most powerful militaries in the world.”

And Trump, while he has slammed Democrats as communists in a tactic ahead of November’s midterm elections, now is looking to wow Xi, the leader of the world’s most powerful communist country, in Washington.

Trump is greeting Xi planeside because of their “great relationship,” first lady Melania Trump told Fox News Channel’s “Fox & Friends.”

“He’s coming on our soil, and we need to welcome them with the most respect,” she said.

Associated Press journalist Kevin Vineys contributed to this report.

​ Orange County Register 

Costco ditches its Kirkland beer, made by a well-known craft brewer

• September 23, 2026

Costco‘s Kirkland Signature beer has come to an end as the retailer discontinued its partnership with Deschutes Brewery.

The warehouse retailer announced in July that it would no longer sell the beers, and the remaining stock has already run out in many stores.

The two beers in the line were Kirkland Signature Helles Lager ($13.99 for a 12-pack) and Kirkland Signature Vintage Ale, a 12% ABV imperial stout ($7.99 for a 22-ounce bottle).

The partnership began at the end of 2024. Deschutes, based in Bend, Ore., produces a wide range of beers under its own name, including Mirror Pond Pale Ale and Black Butte Porter.

The Helles marketed under the Kirkland name won back-to-back medals in the Munich-Style Helles category at the World Beer Cup: silver in 2025 and bronze in 2026. Before the Costco deal, when Deschutes sold it as Prinz Crispy, it won gold at the 2023 Great American Beer Festival.

For several years, Costco sold a Kirkland Craft Beer Variety Crate, with the manufacturer varying by region; for many stores in the Western U.S., the beers were made by San Jose-based Gordon Biersch. That product was discontinued in 2018.

Costco has a reputation for selling some exceptional wines and spirits at low prices under its Kirkland label. In California, you don’t have to be a member to check out those products: The state requires Costco to allow non-members to shop in its alcoholic beverages department.

​ Orange County Register 

Son of Israel’s ambassador to US seriously injured in ramming attack in the occupied West Bank

• September 23, 2026

JERUSALEM (AP) — The son of Israel’s ambassador to the United States was gravely injured in a ramming attack in the occupied West Bank on Wednesday.

Neria Leiter, a reservist in Israel’s military, “needs a miracle,” Ambassador Yechiel Leiter said in a social media post. Leiter’s older son, Moshe Yedidya Leiter, who also served in Israel’s military, was killed in Gaza just days after the Hamas-led Oct. 7, 2023 attack, which triggered the war in Gaza.

According to the military and law enforcement, a Palestinian man rammed his car into a security checkpoint Wednesday afternoon near the settlement of Beit Horon, seriously wounding the officer.

Israeli forces at the scene then “opened fire at the terrorist as he attempted to flee” and killed him. More military forces were deployed in the area in the aftermath.

A paramedic with the Magen David Adom emergency service said the injured officer was unconscious when crews arrived at the scene and was evacuated to a hospital in Jerusalem.

The suspect was identified as Mahmoud Suleiman, according to the Palestinian Health Ministry.

Israel’s Prime Minister Benjamin Netanyahu and President Isaac Herzog both sent wishes for Leiter’s recovery, whom a social media post by Herzog described as “fighting for his life.”

Earlier this week, an Israeli man was killed in a shooting attack in the West Bank, which has experienced a surge in deadly violence since the war in Gaza began.

In the spring, Ambassador Leiter was a central figure in the first direct diplomatic talks in decades between Israel and Lebanon in Washington. Later, Leiter, Lebanon’s ambassador to the U.S., and Secretary of State Marco Rubio announced a framework agreement between Israel and Lebanon that was described as a first step toward peace following months of conflict between Israel and the Lebanese militant group Hezbollah.

​ Orange County Register 

Why nursing home beds are becoming more scarce

• September 23, 2026

By Paula Span | KFF Health News

The San Vicente de Paúl Nursing Home in the South Bronx hasn’t admitted a patient since December 2024. ArchCare, which operates the facility, has reduced its capacity from 120 available beds to 53 and plans to shrink it further.

Another ArchCare nursing home, on Staten Island, has shut down a full floor. North of the city, in Dutchess County, its Ferncliff Nursing Home has contracted from 309 available beds to 196.

The eight nursing homes owned by ArchCare, a nonprofit that provides eldercare through the Archdiocese of New York, have 269 fewer usable beds than they did 18 months ago, a nearly 12% decline, creating waiting lists for patients seeking long-term care.

Across New York state, 24 nursing homes have closed since 2020, resulting in a loss of more than 3,000 licensed beds, according to LeadingAge New York, which represents nonprofit senior living organizations.

That mirrors a national trend. In 2015, the Centers for Medicare & Medicaid Services certified 15,648 nursing facilities. A decade later, that number had fallen by more than 900.

With the oldest baby boomers turning 80 this year, an age when the need for long-term care climbs sharply, researchers are sounding alarms. Will there be enough nursing home beds for a rapidly graying nation?

“We’re seeing a serious problem and it’s heading in the wrong direction,” said David Grabowski, a health policy researcher at Harvard Medical School. He is an author of a study in JAMA Internal Medicine that found a 5% decrease in national nursing home capacity from 2019 to 2024. “As you look at the demographics, this is only going to get worse, maybe a lot worse,” he said, especially given looming Trump administration policies on immigration and Medicaid financing.

The reasons for the shrinkage?

ArchCare blames inadequate state reimbursement for Medicaid, a perennial industry complaint. The primary payer for nursing home care, Medicaid provides less than the daily cost of care, said Clif Porter, chief executive of the American Health Care Association, an industry trade group.

“Before the pandemic and inflation, the losses were sustainable,” said Jason Hutchens, ArchCare’s chief operating officer. More recently, he said, “we were running at an unsustainable loss — we had no choice.”

Nursing homes, most of them for-profit, try to compensate by attracting short-stay patients covered by Medicare, which pays higher rates than Medicaid. When they can’t, “unless you’re extremely rapacious or extremely efficient, you’re not going to make it,” said Vincent Mor, a health services researcher at the Brown University School of Public Health who is an author of an article, published in the New England Journal of Medicine, raising concerns about reduced capacity. “The numbers don’t add up.”

Staff shortages, which have plagued nursing homes for decades, have also caused contractions and closures. Nursing home aides work stressful, low-paying jobs with historically high turnover rates. Their median hourly wage last year was $20.67, according to federal data compiled by PHI, a research and advocacy group for direct care workers. Although pay has risen over the past decade, about 40% of nursing home aides rely on some form of public assistance, such as Medicaid or the Supplemental Nutrition Assistance Program, PHI reported.

The number of nursing home aides has rebounded from the covid pandemic, according to PHI, but fewer are working than in 2015. And while hiring and retention have improved, Porter said, “there’s still a significant gap between demand, especially future demand, and where the workforce currently is.”

National occupancy rates, which fell sharply during the pandemic, have returned to a more typical 80%.

That figure can be misleading; it doesn’t mean 1 bed in 5 sit empty, awaiting a patient. Occupancy counts state-licensed beds, but the more meaningful number is operating beds — how many are actually available depending on a facility’s staffing and other factors.

That number is usually lower and, in many cases, sinking. The American Health Care Association reported in 2024 that almost half of nursing homes were limiting admissions and 57% had waiting lists for new residents.

It’s possible, of course, that they also face financial losses because of lower demand. “Nursing homes close because people don’t want to go to nursing homes,” said Sam Brooks, director of public policy for the National Consumer Voice for Quality Long-Term Care, an advocacy group. “The quality is so low that people avoid them like the plague.”

Last year, Medicare inspectors found at least one quality violation serious enough to harm or jeopardize residents in 27% of nursing homes, according to an analysis by KFF, a health information nonprofit.

In recent decades alternatives emerged that diverted patients from nursing homes. About a million older adults currently live in assisted living facilities. And among Medicaid recipients, the ongoing policy shift called “rebalancing” has enabled more people to receive services at home (where most want to be) rather than in nursing homes.

In 1988, only 10% of Medicaid expenditures for long-term services went to home- or community-based services; the rest paid for institutional care. By 2020, more than 60% of expenditures funded home and community care, said Priya Chidambaram, a KFF senior policy manager specializing in Medicaid, citing a staff analysis.

How big a problem these trends pose depends partly on geography. The decline in the number of nursing homes in rural locations — about 10% from 2015 to 2025 — was much greater than the national drop of about 6%.

“It’s more difficult to staff a rural nursing home,” Chidambaram said. “Labor pools are smaller, and it’s hard to get people to take lower-paid or part-time jobs if they have to travel long distances.”

Bed shortages are also creating bottlenecks at hospitals. Where nursing home capacity declined, Grabowski’s team found, patients stayed in hospitals longer because they couldn’t locate posthospital care. They often had to travel farther to find facilities. “It gums up the entire system,” Grabowski said.

On two fronts, Trump administration policies could make matters worse, experts said. Revoking legal status for certain immigrant groups has worsened staffing shortages.

So far, “we’re not seeing significant impact across the country,” Porter said. But the effects are being felt in specific locations, including Florida, New York, and Massachusetts, he confirmed. With further revocations and deportations, “a lot fewer older adults are going to have caregivers,” Grabowski said.

The administration’s more than $900 billion in cuts to Medicaid over a decade are also expected to exact a toll. As states grapple with reduced funding, analysts expect home and community services to take a greater initial hit than institutional care. But that could increase pressure on nursing homes if patients who lose home care turn to institutions instead.

Less of these services “means more nursing home entry,” Grabowski said.

As policy ideas circulate — with calls for better data tracking, special visas for immigrant health workers, and targeted grants for nursing homes serving high-cost populations — researchers, advocates, and families are waiting to see what unfolds.

“So much of this is speculative,” Chidambaram said. “We don’t know what states will decide. We don’t know how the market will react. We’re in new territory here.”

The New Old Age is produced through a partnership with The New York Times.

KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF

​ Orange County Register 

Hayden Panettiere’s death highlights risk of overdose death after stopping and resuming drug use

• September 23, 2026

By LAURA UNGAR, AP Medical Writer

A coroner’s report notes actor Hayden Panettiere had been in rehab just weeks before her death from an accidental drug overdose.

Although details of her care are unknown, people with drug addictions face a high risk of fatal overdose immediately after a period of sobriety. Experts say they may not realize their tolerance has dropped in that time, meaning a previously tolerated dose could overwhelm the body.

Panettiere, 36, was found unresponsive in an apartment in Greenville, South Carolina, on Aug. 16. The Greenville County Coroner’s Office said several drugs were found in her system, including fentanyl and its chemical byproduct, the anti-anxiety medication alprazolam, a muscle relaxer and a drug used to treat major depression and other serious mental health disorders. The case report says a senior deputy was told she had been in rehab for two or three weeks in Malibu, California.

Last year, about 70,000 Americans died of drug overdoses, down about 14% fewer from the previous year, according to preliminary government data released in May.

How opioid addiction can be treated

For people struggling with addictions, there are various types of care, including therapy and counseling, medication and support groups.

With addictions to fentanyl, heroin, oxycodone and other opioids, treatment may include medications and behavioral therapy. The National Institute on Drug Abuse says medications are the standard of care for opioid use disorder. Treatment options include methadone, buprenorphine and naltrexone, which research shows can reduce the risk of resumed drug use and a fatal overdose. Behavioral therapy for opioid use disorder is most effective when combined with medication, the institute says.

Using drugs after stopping them can be deadly

Using opioids again after withdrawal can be especially dangerous.

According to the National Library of Medicine’s MedlinePlus, most opioid overdose deaths occur in people who have just undergone detoxification. Because withdrawal reduces the person’s tolerance, those who have just gone through withdrawal can overdose on a much smaller dose than they previously took.

This risk has long been known. A 2003 study in the British Medical Journal said “treatment reduces mortality but can sometimes increase mortality transiently,” including among people with prior opioid addiction after their release from prison.

Experts at Pennsylvania State University’s Social Science Research Institute said the risk of overdose death is higher immediately after opioid use disorder treatment, including after detox and stopping medication for the disorder.

They cited research showing that the month after completing treatment is associated with a much higher risk — five times higher for ending treatment without medications and two times higher after ending medication treatment. That’s compared to periods more than a month after ending treatment.

What friends and family can do to reduce risk of overdose death

The first thing to know is that someone who recently stopped using drugs is at higher risk for an overdose if they relapse. Be ready to respond if that happens.

Death following opioid overdose can be prevented if the person gets prompt basic life support and the medication naloxone, an antidote that rapidly reverses the effects of an opioid overdose if administered in time.

The New York State Department of Health recommends taking these steps if someone witnesses an overdose:

1. Call 911 and say, “I think someone may have overdosed.”

2. If the person isn’t breathing, begin mouth-to-mouth breathing by pinching the nose and blowing into the mouth.

3. Administer naloxone if available.

4. Place the person on their side once they have resumed breathing.

5. Stay with the person until the ambulance arrives.

The Associated Press’ health and science coverage receives financial support from the AP Fund for Journalism and private foundations. AP is solely responsible for all content. Find AP’s standards for working with philanthropies, a list of supporters and funded coverage areas at AP.org.

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