As the nation's attorneys general debate a legal settlement with Purdue Pharma, the opioid epidemic associated with its blockbuster painkiller OxyContin rages on in state after state, community after community, killing tens of thousands of people each year with no end in sight.
In Pennsylvania's York County, the coroner investigated eight suspected overdose deaths in a single week of August — four in 24 hours.
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As the nation's attorneys general debate a legal settlement with Purdue Pharma, the opioid epidemic associated with its blockbuster painkiller OxyContin rages on in state after state, community after community, killing tens of thousands of people each year with no end in sight.
York resident Ed Bojarsky got an oxycodone prescription to manage pain from his kidney disease and became addicted, taking "an ungodly amount" of the powerful drug as his illness progressed, his stepmother said.
"These doctors do this to people. This medication does this to people. And then what are they supposed to do?" his stepmother said.
The coroner serving the Columbus, Ohio, area reported nine overdose deaths in just 48 hours in July. Police in Norwalk, Connecticut, responded to eight overdoses — five fatal — over a six-day period in August and September.
Fenner said her 31-year-old daughter, Ashley, became addicted to Percocet so quickly after taking it at a party that she began shooting heroin within a month. Ashley has been in recovery for three years, but Fenner remains wary of the "manipulator" who once stole her valuables to support her habit.
"Where I really struggle more than anything is they realize they're a major contributor to the problem, but they're not rolling up their shirt sleeves and saying, 'Hey, let me get in here and help,'" Cannon said.
"This is a battle that's not going to end easily, and it will be something we are fighting for a while," Coroner Pam Gay said. "It's going to take a while to see a significant decline."
FILE - This July 31, 2017, file photo shows discarded syringes in an open-air heroin market that has thrived for decades, slated for cleanup along train tracks a few miles outside the heart of Philadelphia. While the nation's attorneys general debate a legal settlement with Purdue Pharma, the opioid epidemic associated with the company's blockbuster painkiller OxyContin rages on. The drugs still kill tens of thousands of people each year with no end in sight. (AP PhotoMatt Rourke, File)
York resident Ed Bojarsky got an oxycodone prescription to manage pain from his kidney disease and became addicted, taking "an ungodly amount" of the powerful drug as his illness progressed, his stepmother said.
"You don't need all that medication," Tina Bojarski would tell him. But he "didn't want to hear it," she said. "Because once you have it, you need it."
And when he couldn't get it, Tina Bojarski said, he turned to the streets. Last month, the 36-year-old died of a suspected overdose.
FILE - This Monday, June 17, 2019, file photo shows 5-mg pills of Oxycodone. While the nation's attorneys general debate a legal settlement with Purdue Pharma, the opioid epidemic associated with the company's blockbuster painkiller OxyContin rages on. The drugs still kill tens of thousands of people each year with no end in sight. (AP PhotoKeith Srakocic, File)
"These doctors do this to people. This medication does this to people. And then what are they supposed to do?" his stepmother said.
Purdue has entered a proposed settlement with about half the states and 2,000 local governments, but attorneys general in Pennsylvania and many other states have come out against the deal, calling it insufficient. They vowed to continue litigation against the company and the family that owns it. Days after reaching the tentative settlement that could be worth up to $12 billion over time, Purdue filed for bankruptcy in White Plains, New York. The chairman of the board of directors said in a statement that the company would work with the plaintiffs "to finalize and implement this agreement as quickly as possible," but several states plan to object to settlement in bankruptcy court.
In the meantime, communities are struggling with the personal toll wrought by the crisis as well as a ballooning tab for drug treatment, social services and law enforcement. Since 1999, opioids have killed about 400,000 Americans. U.S. drug overdose deaths climbed year after year for decades, topping 70,000 in 2017 before falling slightly last year.
In this Friday, Sept. 13, 2019, photo, Denise Spence shows photos of her son Timothy at her home in Elk Grove Village, Ill. Spence said Timothy died of an opioid overdose. While the nation's attorneys general debate a legal settlement with Purdue Pharma, the opioid epidemic associated with the company's blockbuster painkiller OxyContin rages on. (AP PhotoTeresa Crawfor)
The coroner serving the Columbus, Ohio, area reported nine overdose deaths in just 48 hours in July. Police in Norwalk, Connecticut, responded to eight overdoses — five fatal — over a six-day period in August and September.
In Wilson, North Carolina, where Purdue has a manufacturing plant, Jonathan Cannon took opioids before moving on to heroin. He died of an overdose at 26. At Cannon's 2015 funeral, his father, Mike Cannon, warned Jonathan's friends — who were also using — to go to rehab or risk meeting the same fate.
One of them did wind up in rehab, and she continues battling addiction, said her mother, Elizabeth Fenner.
In this Friday, Sept. 13, 2019, photo, Denise Spence poses for a photograph by the window of her home in Palatine, Ill. Spence said her son Timothy died of an opioid overdose. While the nation's attorneys general debate a legal settlement with Purdue Pharma, the opioid epidemic associated with the company's blockbuster painkiller OxyContin rages on. (AP PhotoTeresa Crawfor)
Fenner said her 31-year-old daughter, Ashley, became addicted to Percocet so quickly after taking it at a party that she began shooting heroin within a month. Ashley has been in recovery for three years, but Fenner remains wary of the "manipulator" who once stole her valuables to support her habit.
"That's just who she is," said Fenner, who had known Mike Cannon since high school. "I really accept that she has the addiction, and I accept that it's a disease. But I'm trying to work on the anger that comes out of this. I just don't understand parts of it and I never, ever, ever will because I haven't been there."
After their son's death, Cannon and his wife launched a nonprofit group aimed at helping addicted people, but he said Purdue has never stepped up.
FILE - In this Nov. 2, 2017 file photo, a medic with the Cincinnati Fire Department nasally administers Naloxone to a man while responding to a possible overdose report at a gas station in downtown Cincinnati. While the nation's attorneys general debate a legal settlement with Purdue Pharma, the opioid epidemic associated with the company's blockbuster painkiller OxyContin rages on. The drugs still kill tens of thousands of people each year with no end in sight. (AP PhotoJohn Minchillo, File)
"Where I really struggle more than anything is they realize they're a major contributor to the problem, but they're not rolling up their shirt sleeves and saying, 'Hey, let me get in here and help,'" Cannon said.
State and local governments aren't waiting on potential Purdue settlement money before taking action, promoting "warm handoff" policies that connect overdose survivors to immediate drug treatment, dramatically expanding distribution of the life-saving overdose-reversal drug naloxone and keeping better tabs on opioid prescribing.
In the wake of at least 16 fatal overdoses, Elk Grove Village, a community of 32,000 outside Chicago, launched a program in which addicted people can ask police officers and other municipal workers for help without fear of arrest, even if they have illegal drugs or paraphernalia. Drug treatment is offered regardless of ability to pay, and local employers commit to hiring graduates of the program.
In this Friday, Sept. 13, 2019, photo, Mayor Craig Johnson poses for a photograph in his office in Elk Grove Village, Ill. While the nation’s attorneys general debate a legal settlement with Purdue Pharma, the opioid epidemic associated with the company’s blockbuster painkiller OxyContin rages on. Johnson created a program in which addicted people can ask police officers and other municipal workers for help without fear of arrest, even if they have illegal drugs or paraphernalia. (AP PhotoTeresa Crawfor)
Mayor Craig Johnson, who helped create the program, said 32 people have taken part, and 21 are "still clean and sober."
One of the success stories is Tom, a 54-year-old who owned a construction company before breaking his hip and leg in a fall and becoming addicted to painkillers. He eventually lost his company and his house.
"All you do is spend your days looking for meds off the street because you don't want to detox. It was horrifying," said Tom, who has since completed Elk Grove Village's recovery program and landed work with a catering company. He did not want his last name used because he's now seeking a job in the medical field.
Gay said nearly all of the overdose deaths in York County this year involved heroin and fentanyl, a synthetic opioid that's 50 to 100 times more powerful than morphine. In almost every case, the overdose victim started with prescription painkillers like OxyContin, she said.
"You can see from their medical records how they were on prescription drugs for chronic sports injuries, pain," she said. "Which is why so many counties are going after Big Pharma."
In Virginia, Scott Zebrowski became addicted to opioids after being prescribed OxyContin for a back injury.
On Feb. 28, 2017, Zebrowski, who was young, fit and managed a gym, took a pain pill a friend had given him. He didn't know it was laced with fentanyl. Zebrowski dropped dead in the parking lot of a Starbucks.
Jill Zebrowski, Scott's twin sister, who lives in Midlothian, Virginia, said she holds Purdue and other pharmaceutical companies responsible.
"I think they knowingly did this. They've caused such pain and heartache for my family and so many others."
Associated Press writers Emery P. Dalesio in Raleigh, North Carolina; Don Babwin in Elk Grove Village, Illinois; Denise Lavoie in Richmond, Virginia; and Mike Stobbe in New York City contributed to this report.
VENICE, Italy (AP) — Under the gaze of the world’s media, the fragile lagoon city of Venice launched a pilot program Thursday to charge day-trippers a 5-euro (around $5.35) entry fee that authorities hope will discourage visitors from arriving on peak days and make the city more livable for its dwindling residents.
Visitors arriving at Venice's main train station were greeted with large signs listing the 29 dates through July of the plan's test phase, as well as new entrances separating tourists from residents, students and workers.
Stewards were on hand to politely guide anyone unaware of the new requirements through the process of downloading the QR code to pay the fee.
“We need to find a new balance between the tourists and residents,’’ said the city’s top tourism official, Simone Venturini. “We need to safeguard the spaces of the residents, of course, and we need to discourage the arrival of day-trippers on some particular days.”
Arianna Cecilia, who lives in Rome and was visiting Venice for the first time with her boyfriend, said it felt “strange" to have to buy a ticket to enter a city in her native Italy, and then pass through a tourist entrance.
The couple were staying in nearby Treviso, and had paid the fee and downloaded the QR code as required prior to arrival.
Workers in yellow vests carried out random checks at the train station, and anyone caught faces fines of 50 euros to 300 euros — though officials said “common sense” was being applied for the launch.
The requirement applies only for people arriving between 8:30 a.m. and 4 p.m. Outside of those hours, access is free and unchecked.
Venice has long suffered under the pressure of over-tourism, and officials hope the pilot project can help provide more exact figures to better manage the phenomenon.
The city can track the number of hotel visitors — which last year numbered 4.6 million, down 16% from pre-pandemic highs. But the number of day visitors, which make up the majority of the crowds in Venice, could only be estimated until recently.
A Smart Control Room set up during the pandemic has been tracking arrivals from cell phone data, roughly confirming pre-pandemic estimates of 25 million to 30 million arrivals a year, said Michele Zuin, the city’s top economic official. That includes both day-trippers and overnight guests.
But Zuin said the data is incomplete. “It’s clear we will get more reliable data from the contribution” being paid by day-trippers, he said.
Venturini said the city is strained when the number of day-trippers reaches 30,000 to 40,000. Its narrow alleyways are clogged with people and water taxis packed, making it difficult for residents to go about their business.
Not all residents, however, are persuaded of the efficacy of the new system in dissuading mass tourism. Some say more attention needs to be paid to boosting the resident population and services they need.
Venice last year passed a telling milestone when the number of tourist beds exceeded for the first time the number of official residents, which is now below 50,000 in the historic center with its picturesque canals.
“Putting a ticket to enter a city will not decrease not even by one single unit the number of visitors that are coming,’’ said Tommaso Cacciari, an activist who organized a protest Thursday against the measure.
“You pay a ticket to take the metro, to go to a museum, an amusement park; you don’t pay a ticket to enter a city. This is the last symbolic step of a project of an idea of this municipal administration to kick residents out of Venice,” he said.
Venturini said about 6,000 people had already paid to download the QR code, and officials expect paid day-tripper arrivals Thursday to reach some 10,000.
More than 70,000 others have downloaded a QR code denoting an exemption, including to work in Venice or as a resident of the Veneto region. People staying in hotels in Venice, including in mainland districts like Marghera or Mestre, should get a QR code attesting to their stay, which includes a hotel tax.
The tourist official says interest in Venice's pilot program has been keen from other places suffering from mass tourism, including other Italian art cities and cities abroad such as Barcelona and Amsterdam.
Marina Rodino, who has lived in Venice for 30 years, is opposed to the new plan. She was passing out mock EU passports for “Venice, Open City,” underlining the irony of the new system, and challenging its legal standing with citations from the Italian constitution guaranteeing its citizens the right to “move or reside freely in any part of the national territory."
Rodino has seen her local butcher close and families leave her neighborhood near the famed Rialto Bridge as short-term apartment rentals spring up. But she said the new entrance fee requirement will still allow young people to flood the city in the evening for often rowdy gatherings.
“This is not a natural oasis. This is not a museum. It is not Pompeii," she said. “It is a city, where we need to fight so the houses are inhabited by families, and stores reopen. That is what would counter this wild tourism.”
Tourists arrive in Venice, Italy, Thursday, April 25, 2024. The fragile lagoon city of Venice begins a pilot program Thursday to charge daytrippers a 5 euro entry fee that authorities hope will discourage tourists from arriving on peak days. The daytripper tax is being tested on 29 days through July, mostly weekends and holidays starting with Italy's Liberation Day holiday Thursday. Officials expect some 10,000 people will pay the fee to access the city on the first day, downloading a QR code to prove their payment, while another 70,000 will receive exceptions, for example, because they work in Venice or live in the Veneto region. (AP Photo/Luca Bruno)
Stewards check tourists QR code access outside the main train station in Venice, Italy, Thursday, April 25, 2024. The fragile lagoon city of Venice begins a pilot program Thursday to charge daytrippers a 5 euro entry fee that authorities hope will discourage tourists from arriving on peak days. The daytripper tax is being tested on 29 days through July, mostly weekends and holidays starting with Italy's Liberation Day holiday Thursday. Officials expect some 10,000 people will pay the fee to access the city on the first day, downloading a QR code to prove their payment, while another 70,000 will receive exceptions, for example, because they work in Venice or live in the Veneto region. (AP Photo/Luca Bruno)
Stewards check a tourist QR code access outside the main train station in Venice, Italy, Thursday, April 25, 2024. The fragile lagoon city of Venice begins a pilot program Thursday to charge daytrippers a 5 euro entry fee that authorities hope will discourage tourists from arriving on peak days. The daytripper tax is being tested on 29 days through July, mostly weekends and holidays starting with Italy's Liberation Day holiday Thursday. Officials expect some 10,000 people will pay the fee to access the city on the first day, downloading a QR code to prove their payment, while another 70,000 will receive exceptions, for example, because they work in Venice or live in the Veneto region. (AP Photo/Luca Bruno)
A steward shows the QR code access outside the main train station in Venice, Italy, Thursday, April 25, 2024. The fragile lagoon city of Venice begins a pilot program Thursday to charge daytrippers a 5 euro entry fee that authorities hope will discourage tourists from arriving on peak days. The daytripper tax is being tested on 29 days through July, mostly weekends and holidays starting with Italy's Liberation Day holiday Thursday. Officials expect some 10,000 people will pay the fee to access the city on the first day, downloading a QR code to prove their payment, while another 70,000 will receive exceptions, for example, because they work in Venice or live in the Veneto region. (AP Photo/Luca Bruno)
A steward checks a tourist QR code access outside the main train station in Venice, Italy, Thursday, April 25, 2024. The fragile lagoon city of Venice begins a pilot program Thursday to charge daytrippers a 5 euro entry fee that authorities hope will discourage tourists from arriving on peak days. The daytripper tax is being tested on 29 days through July, mostly weekends and holidays starting with Italy's Liberation Day holiday Thursday. Officials expect some 10,000 people will pay the fee to access the city on the first day, downloading a QR code to prove their payment, while another 70,000 will receive exceptions, for example, because they work in Venice or live in the Veneto region. (AP Photo/Luca Bruno)
Stewards check tourists QR code access outside the main train station in Venice, Italy, Thursday, April 25, 2024. The fragile lagoon city of Venice begins a pilot program Thursday to charge daytrippers a 5 euro entry fee that authorities hope will discourage tourists from arriving on peak days. The daytripper tax is being tested on 29 days through July, mostly weekends and holidays starting with Italy's Liberation Day holiday Thursday. Officials expect some 10,000 people will pay the fee to access the city on the first day, downloading a QR code to prove their payment, while another 70,000 will receive exceptions, for example, because they work in Venice or live in the Veneto region. (AP Photo/Luca Bruno)
Tourists take pictures at the St. Mark square in Venice, Italy, Wednesday, April 24, 2024. The lagoon city of Venice begins a pilot program Thursday, April 25, 2024 to charge daytrippers a 5 euro entry fee that authorities hope will discourage tourists from arriving on peak days. Officials expect some 10,000 people will pay the fee to access the city on the first day, downloading a QR code to prove their payment. (AP Photo/Luca Bruno)
Tourists ride on a ferry boat in Venice, Italy, Wednesday, April 24, 2024. The lagoon city of Venice begins a pilot program Thursday, April 25, 2024 to charge daytrippers a 5 euro entry fee that authorities hope will discourage tourists from arriving on peak days. Officials expect some 10,000 people will pay the fee to access the city on the first day, downloading a QR code to prove their payment. (AP Photo/Luca Bruno)
People stand in front of an information board explaining how to pay the tourist tax in Venice, Italy, Wednesday, April 24, 2024. The lagoon city of Venice begins a pilot program Thursday, April 25, 2024 to charge daytrippers a 5 euro entry fee that authorities hope will discourage tourists from arriving on peak days. Officials expect some 10,000 people will pay the fee to access the city on the first day, downloading a QR code to prove their payment. (AP Photo/Luca Bruno)
Marco Bettini, director of Venis Informatics System, gestures as he talks to reporters at the police Venice control room, in Venice, Italy, Wednesday, April 24, 2024. The lagoon city of Venice begins a pilot program Thursday, April 25, 2024 to charge daytrippers a 5 euro entry fee that authorities hope will discourage tourists from arriving on peak days. Officials expect some 10,000 people will pay the fee to access the city on the first day, downloading a QR code to prove their payment. (AP Photo/Luca Bruno)
Venice councillor Simone Venturini speaks with reporters in front of a tourist tax totem in Venice, Italy, Wednesday, April 24, 2024. The lagoon city of Venice begins a pilot program Thursday, April 25, 2024 to charge daytrippers a 5 euro entry fee that authorities hope will discourage tourists from arriving on peak days. Officials expect some 10,000 people will pay the fee to access the city on the first day, downloading a QR code to prove their payment. (AP Photo/Luca Bruno)
Workers prepare banner explaining how to pay the tourist tax in Venice, Italy, Wednesday, April 24, 2024. The lagoon city of Venice begins a pilot program Thursday, April 25, 2024 to charge daytrippers a 5 euro entry fee that authorities hope will discourage tourists from arriving on peak days. Officials expect some 10,000 people will pay the fee to access the city on the first day, downloading a QR code to prove their payment. (AP Photo/Luca Bruno)
Marco Bettini, director of Venis Informatics System, gestures as he explains the Venice density to reporters at the police Venice control room in Venice, Italy, Wednesday, April 24, 2024. The lagoon city of Venice begins a pilot program Thursday, April 25, 2024 to charge daytrippers a 5 euro entry fee that authorities hope will discourage tourists from arriving on peak days. Officials expect some 10,000 people will pay the fee to access the city on the first day, downloading a QR code to prove their payment. (AP Photo/Luca Bruno)
Tourists arrive at the main train station in Venice, Italy, Wednesday, April 24, 2024. The lagoon city of Venice begins a pilot program Thursday, April 25, 2024 to charge daytrippers a 5 euro entry fee that authorities hope will discourage tourists from arriving on peak days. Officials expect some 10,000 people will pay the fee to access the city on the first day, downloading a QR code to prove their payment. (AP Photo/Luca Bruno)
Workers prepare the tourist tax cashier desks outside the main train station in Venice, Italy, Wednesday, April 24, 2024. The lagoon city of Venice begins a pilot program Thursday, April 25, 2024 to charge daytrippers a 5 euro entry fee that authorities hope will discourage tourists from arriving on peak days. Officials expect some 10,000 people will pay the fee to access the city on the first day, downloading a QR code to prove their payment. (AP Photo/Luca Bruno)
Porters wait for tourists outside the main train station in Venice, Italy, Wednesday, April 24, 2024. The lagoon city of Venice begins a pilot program Thursday, April 25, 2024 to charge daytrippers a 5 euro entry fee that authorities hope will discourage tourists from arriving on peak days. Officials expect some 10,000 people will pay the fee to access the city on the first day, downloading a QR code to prove their payment. (AP Photo/Luca Bruno)
Workers prepare the tourist tax cashier desks outside the main train station in Venice, Italy, Wednesday, April 24, 2024. The lagoon city of Venice begins a pilot program Thursday, April 25, 2024 to charge daytrippers a 5 euro entry fee that authorities hope will discourage tourists from arriving on peak days. Officials expect some 10,000 people will pay the fee to access the city on the first day, downloading a QR code to prove their payment. (AP Photo/Luca Bruno)
Workers prepare the tourist tax cashier desks outside the main train station in Venice, Italy, Wednesday, April 24, 2024. The lagoon city of Venice begins a pilot program Thursday, April 25, 2024 to charge daytrippers a 5 euro entry fee that authorities hope will discourage tourists from arriving on peak days. Officials expect some 10,000 people will pay the fee to access the city on the first day, downloading a QR code to prove their payment. (AP Photo/Luca Bruno)
Porters wait for tourists outside the main train station in Venice, Italy, Wednesday, April 24, 2024. The lagoon city of Venice begins a pilot program Thursday, April 25, 2024 to charge daytrippers a 5 euro entry fee that authorities hope will discourage tourists from arriving on peak days. Officials expect some 10,000 people will pay the fee to access the city on the first day, downloading a QR code to prove their payment. (AP Photo/Luca Bruno)
Tourists arrive outside the main train station in Venice, Italy, Wednesday, April 24, 2024. The lagoon city of Venice begins a pilot program Thursday, April 25, 2024 to charge daytrippers a 5 euro entry fee that authorities hope will discourage tourists from arriving on peak days. Officials expect some 10,000 people will pay the fee to access the city on the first day, downloading a QR code to prove their payment. (AP Photo/Luca Bruno)
Tourist information boards are seen outside the main train station in Venice, Italy, Wednesday, April 24, 2024. The lagoon city of Venice begins a pilot program Thursday, April 25, 2024 to charge daytrippers a 5 euro entry fee that authorities hope will discourage tourists from arriving on peak days. Officials expect some 10,000 people will pay the fee to access the city on the first day, downloading a QR code to prove their payment. (AP Photo/Luca Bruno)
Tourists arrive outside the main train station in Venice, Italy, Wednesday, April 24, 2024. The lagoon city of Venice begins a pilot program Thursday, April 25, 2024 to charge daytrippers a 5 euro entry fee that authorities hope will discourage tourists from arriving on peak days. Officials expect some 10,000 people will pay the fee to access the city on the first day, downloading a QR code to prove their payment. (AP Photo/Luca Bruno)
