Perhaps the BEST B1G Forum anywhere, here at College Football Fan Site, CFB51!!!

My knee is seems better, I bought a fancy brace for it and am trying not to torque it.  We have spiral stairs in the unit, two sets, and I learned how better to place my leg so I don't twist it.  My foot is ugly, the wife can't seem to understand that it will be ugly long after my knee has recovered (hamstring by the knee I think).

is the brace infused with copper?

No copper, but took me a while to figure out how to put it on.  I'm wearing it now.

We're going to the pool in a bit, maybe I'll apply some Coppertone to it.

leave it on the Big 12 board

I have some fixes in mind for this problem. I'm having (one last) lunch with my local state rep next week to present my thoughts. If there is one thing I know about him, it's that he's big on community-based solutions. He's a small-government guy, to the core.

I hate that Toni Taxwinkle had to play the race card. She just can't stop herself.

So.. FIX THIS!!

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Cook County is grappling with twice the amount of reported opioid-related deaths compared with this period last year, the medical examiner’s office announced Tuesday amid skyrocketing caseloads during the coronavirus outbreak.

In 2020, the county’s deaths ruled as opioid overdoses are on track to double last year’s total number of opioid-related cases, the chief medical examiner, Dr. Ponni Arunkumar, said at a Tuesday news conference. The fatalities, similar to those from the coronavirus and gun violence crises, are disproportionately affecting Black people, she added. The majority stem from Chicago’s West Side neighborhoods.

Cook County Board President Toni Preckwinkle said the briefing was convened “to sound the alarm” as the three overlapping epidemics devastate the county’s most vulnerable populations.

“This year continues to illuminate the dangerous consequences we face as a result of centuries — centuries — of racial inequity,” Preckwinkle said. “The victims of the opioid epidemic have been quietly dying around us. We must be their voice to prevent future, needless, preventable deaths plaguing our community.”

Between Jan. 1 and Monday, 773 opioid overdose deaths were logged in Cook County, with 580 more pending cases, Arunkumar said. Given that about 70% to 80% of pending cases are ruled as opioid-related, that means about 1,200 such deaths are expected to be tallied for that time period, Arunkumar said.

Last year, there were 605 opioid overdose deathsfrom Jan. 1 to July 13, and by the end of the year, 1,267 cases were confirmed to be opioid-related, Arunkumar said. That number was 1,148 in 2018.

Out of the confirmed 773 cases so far this year, 63% of the victims were Black and/or Latino, with 45- to 55-year-old males most likely to die from an overdose, Arunkumar said. Fentanyl, an exponentially deadlier synthetic opioid, was blamed for the majority of cases.


“The numbers tell a grim story,” Arunkumar said about the opioid overdose deaths. “We’ll never get used to the tragedy that each death represents.”

While more analysis needs to be done on the coronavirus pandemic’s effects on opioid deaths, officials worry that the isolation and health scares are keeping people experiencing overdoses from seeking help. Emergency department volumes have decreased since the pandemic started, said Dr. Steven Aks, division chair of emergency medicine and toxicology at Cook County Health.

“What we’d like to say is that it’s safe here. That’s the most important message,” Aks said. “This is extremely alarming with respect to the opioid overdoses. Because for each EMS run that a paramedic brings a patient to the hospital, if they make it to our care they will likely live.”

As Cook County Health emergency room visits related to opioid overdoses remained stagnant, Chicago reported a swell in EMS visits related to opioid overdoses, according to a department of public health alert. From the beginning of the year to the end of May, EMS responses went up about 67% compared with the same time in 2019.


Dr. Kiran Joshi, senior medical officer at the Cook County Department of Public Health, said a key solution is partnering with law enforcement to “blanket” communities with naloxone, the medication used to reverse opioid overdoses, because the current levels are not “nearly enough.”

On top of the opioid overdose cases, the medical examiner’s office has had to contend with spikes in gun violence homicides this year as well as the surge of deaths from the novel coronavirus. The three crises are pushing the office’s caseload to top 9,000 in the coming days — compared with 6,274 cases in all of 2019, Arunkumar said.

“Desperation and hopelessness” are the underlying causes behind the coinciding upswings in gun violence and opioid-related deaths in Cook County, Preckwinkle said.


“Those are similar causes,” Preckwinkle said. “If you look at opioid deaths and if you look at shootings and murders, you overlay them, right, it’s the same community.”

The medical examiner’s office at first attributed this year’s tidal wave of cases to the coronavirus outbreak, but after digging through the numbers, staffers realized opioid overdoses also were ballooning, Arunkumar said. She added that her office, which investigates certain cases out of the annual 40,000-or-so deaths in Cook County, such as unnatural deaths, are “by and large preventable.”
“While we concentrate on our mission to establish the cause and manner of death for cases that fall under our jurisdiction, we do not accept that they had to occur,” Arunkumar said.

sad

China.

Marco Werman: Fentanyl is such a dangerous and fatal piece of the opioid crisis here in the US. Right now, as of July 2019, where's it coming from, which countries?

Scott Stewart: We're seeing some fentanyl sent directly from China to the US, primarily in the flow of commerce, stuff that's coming in that's being purchased on the dark web. In this dynamic, we'll have fairly pure fentanyl sent by mail to dealers who will then cut it into either fake narcotic pills or they will cut it into fake heroin. Then also we have organized crime groups that are trafficking it into the country through Mexico and then we also see some of it coming in through Canada from Asian organized crime groups.

With fentanyl coming to the US via Mexico, what's happening to it in Mexico before it gets brought into the US?

Well, we're kind of seeing two sources there. Some of it is coming in directly from China that's already made and manufactured, but then we're also seeing the precursor chemicals come into Mexico and then the Mexican cartels are synthesizing fentanyl in their labs. It's actually an easier drug to synthesize than methamphetamine. So, these Mexican super labs are pretty well-positioned, both in terms of their supply chain to China but also their ability to synthesize the drug due to their experience in the methamphetamine trade.

Trace the route for us for fentanyl as it leaves Mexico and comes to the US. How does it get here? Who's delivering it and who's it delivered to?

What we're seeing is that they're pretty much piggy-backing onto the infrastructure that they've established and long had established for other drugs coming into the US. Especially the synthetic drug organizations, such as Sinaloa, are using a lot of the same labs and infrastructure to smuggle the drugs into the US that they've used for methamphetamine. Also, we see a lot of parallel into the Mexican cartels that have really cornered the heroin market in the United States. So, we're seeing fentanyl being also pushed in that same supply chain up into the US and then down to street distributors.

What do you think makes fentanyl the drug of interest currently from Mexican cartels?

There are really several factors that make it really an ideal drug for these organized crime groups. One is that it's cheap to produce. We're seeing estimates coming from the DEA that it costs between $1,400 to $3,000 a kilo to produce. Of course, they can then turn around and sell that retail for over a million dollars on the street.

How does that compare to heroin, for example?

It's much more lucrative. So, essentially, smuggling one kilogram of fentanyl is roughly the equivalent of smuggling 50 kilograms of heroin into the US.

What are the other reasons Mexican cartels all seem to like this?

It doesn't have a growing season like opium poppies do. You don't need a lot of land to cultivate it, like you do opium poppies. Basically, you can fabricate or synthesize it any place that you have the chemicals available. It's also compact to smuggle. It's lucrative, compact, easy to make and easy to smuggle. It really is a dream drug for Mexican organized crime.

Which country do you think is the bigger threat at this point in terms of fentanyl flooding the US, China or Mexico?

It's really a combination of all of the above. I think that, like the methamphetamine trade, everything goes back to these precursor chemicals that are predominantly coming out of China. But certainly, the Mexicans then have the ability to really crank out and then smuggle huge quantities of this drug. I don't want to downplay the mail-order dark-web model. It is resulting in deaths and certainly, just a few grams or an ounce of fentanyl that is very pure coming in from China can kill a lot of people. But we compare that to these shipments of 100 kilos or 70 kilos that we're seeing coming in from Mexico and we can see that the Mexicans are really flooding the market with fentanyl in a way that the Chinese can't do directly by mail.

Why do the precursor chemicals for fentanyl come solely, it seems, from China?

I think a lot of that just goes back to the difficulty of controlling all these factories and the number of them that there are in China. That goes back to the history of the methamphetamine trade, too. Initially, we saw a lot of the meth chemicals coming out of India. The DEA basically approached both India and China and asked them to clamp down on the trade. The Indians were able to largely do so. Unfortunately, the Chinese have not been able to. Of course, I think the problem still remains larger than that, though. There are other places that can produce fentanyl or the precursor chemicals — countries like North Korea, who see illicit drug markets as a way to raise much-needed foreign capital. Even if we were able to somehow magically shut down the flow of precursors from China, these organizations would still be able to get other chemicals or find the precursors elsewhere.

You spend a lot of your time researching and writing about drug cartels and the opioid epidemic in the US. What keeps you up at night? What are you most worried about?

As I've been looking more closely at fentanyl lately, I really believe that there's a misunderstanding out there across the world that sees fentanyl as being a North American problem. That it's basically just an issue for the Americans and Canadians to deal with. But I believe that the very same factors that make fentanyl attractive for the Mexican cartels also make it attractive for other organized crime groups across the globe that are involved in the illicit opiate trades. Balkan organized crime groups, Russian organized crime groups, and even organized crime groups that are selling things like counterfeit tramadol across the Middle East and Africa.

What is that product you just described?

Tramadol is actually an opiate pill. It's weaker but somewhat similar to our oxycodone that we've seen in the US and I believe that is going to be a similar gateway drug for illicit fentanyl pills the same way that we saw illicit fentanyl pills coming in for the oxycodone in the United States.

Is there strong evidence already that it is getting the attention of organized crime in Italy, Russia and in the Balkans?

Right now what we're seeing is, you know, in places like Australia, the UK, parts of Europe and even in Estonia, there's been an increase in fentanyl use. Right now, it seems to be mostly that dark web mail-order type trade but I believe that we're going to see these organized crime groups try to assume control of that market and then increase it. These same organizations already control the heroin trade in much the way the Mexicans have kind of cornered the heroin trade in North America. I think they're going to follow the same path that we've seen the Mexicans use in North America in these other parts of the world.

This interview has been edited and condensed for clarity. Reuters contributed to this report.

It's very appropriate breakfast food.  

Every food is an appropriate breakfast food, because it's all just food.  

I don't believe in breakfast food, lunch food or dinner food. If I want beef for breakfast, I don't care if some clown told me it's what's for dinner. I really don't want lunch meat at lunch time. WTF is lunch meat? Salt with some sort of protein added to it?

We need more of you.