
New illicit drug containing fentanyl and powerful sedative may be behind mass overdose in Baltimore
At least 27 people were hospitalized after the mass overdose in the Penn North neighborhood on July 10.
On Thursday, scientists with the National Institute of Standards and Technology (NIST) said drug samples collected from the overdose site revealed a mix of drugs, including N-Methylclonazepam, an ingredient the NIST had not encountered before in street drugs. It can cause intense sedative and hypnotic side effects.
"Many people remained unconscious after receiving naloxone, likely as a result of the presence of N-methylclonazepam," NIST Research Chemist Edward Sisco told the Banner. Naloxone, more commonly known by its brand name Narcan, is a medication that reverses opioid overdoses by blocking the effects of the drug, according to the National Institute of Health (NIH).
Sisco said the drug samples also contained the pain medication acetaminophen, the diuretic Mannitol, the anti-malaria drug quinine and caffeine. According to Sisco, those drugs are often found in samples tested in Maryland.
Data from the Baltimore Health Department shows there were 921 fentanyl-related deaths reported in the city in 2023.
Between July 2024 and July 2025, the Maryland Department of Health reported 980 fentanyl-related deaths across the state. 487 of those incidents were in Baltimore, data shows. In 2024, overdose deaths in the city dropped by nearly 25%.
At the time of the mass overdose, witnesses told WJZ the alleged drug was called "New Jack City" and may have been laced with antifreeze, though those reports are now proven to be unfounded.
First responders in Baltimore jumped into action when the first overdose was reported at the intersection of Pennsylvania and North Avenues.
Crews initially found one person who they believed to be suffering from a drug overdose. Community members then alerted crews to additional victims in the area.
At least 27 people were taken to hospitals, seven in critical condition.
On July 13, five people were arrested for possession with intent to distribute drugs near the location where the overdose occurred, Baltimore Police said. However, it is unclear if the arrests are connected to the mass overdose, police said.
Community partners and addiction advocates swarmed the Penn North neighborhood with resources shortly after the overdoses were reported.
Officials with the city's Office of Overdose Response handed out Narcan and passed out test strips. They encouraged anyone who planned to use drugs to be extremely cautious.
"We're really just trying to engage the community to let folks know that if they are using today, that we don't know what's in the supply, and for folks to be careful," Overdose Response Executive Director Sara Whaley said.
Advocates have maintained a presence in the neighborhood, letting residents know that help is available.
Residents can connect with peer supervisors at the Enoch Pratt Library's Pennsylvania Avenue branch on weekdays during business hours. They can also call the 988 helpline to connect with a counselor or find treatment.
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Politico
9 hours ago
- Politico
How Trump's AI orders could throw states for a loop
EXAM ROOM A day after President Donald Trump unveiled plans to accelerate the adoption of artificial intelligence in health care, one expert warns that some aspects of the initiative could complicate state laws aimed at preventing discrimination in health care. Dan Silverboard, a health care attorney at Holland & Knight, says the White House AI Action Plan's requirement that the National Institute of Standards and Technology remove references to diversity, equity and inclusion could create significant challenges for state regulations. As the nation's primary technology standards body, NIST suggests standards and guidance on AI development and implementation. Within the health care sector, there's considerable concern that AI could make decisions that discriminate against certain patients. In 2022, NIST addressed the concerns by releasing recommended practices for managing bias and discrimination in AI — which Silverboard says may soon disappear. To understand the implications of the upcoming changes to NIST, Ruth sat down with Silverboard to discuss the potential impact on patient care and state regulations. This interview has been edited for length and clarity. How do states use the NIST AI framework? The NIST framework is basically a compliance plan for addressing risk posed by AI, including discrimination. The National Association of Insurance Commissioners came out with a model bulletin that will require insurance companies to have programs to mitigate risk caused by AI, things like unfair claims practices, unfair business practices and also algorithmic discrimination. And that bulletin has been adopted, I think, in 24 states, red and blue. If you have the NIST framework in place that would satisfy this requirement. And if the NIST framework no longer specifies how to mitigate discrimination risk? It bungles that. You also have specific state laws which prohibit insurance companies from using AI in such a way that results in algorithmic discrimination, Colorado, for example, California. The NIST changes complicate the enforcement of these laws. How else might removing DEI from NIST's AI framework impact how companies and developers are designing their technology? Multinational companies have to comply with more than just U.S. law. There is EU law out there. So, how the EU requirements might conflict with the requirements that come at a federal level is anybody's guess, but a multinational company would have no choice but to comply with other standards in place on the international level. MORNING MONEY: CAPITAL RISK — POLITICO's flagship financial newsletter has a new Friday edition built for the economic era we're living in: one shaped by political volatility, disruption and a wave of policy decisions with sector-wide consequences. Each week, Morning Money: Capital Risk brings sharp reporting and analysis on how political risk is moving markets and how investors are adapting. Want to know how health care regulation, tariffs or court rulings could ripple through the economy? Start here. WELCOME TO FUTURE PULSE This is where we explore the ideas and innovators shaping health care. Silverboard isn't the only one raising concerns about the AI Action Plan. Brenda Leong, director of the AI division at legal firm ZwillGen, says the call to remove references to 'misinformation' from NIST's risk frameworks is misguided. 'AI systems' tendency to generate factually inaccurate, misleading, or confidently wrong outputs — hallucinations — is a well-documented challenge,' she said. 'The plan shifts away from acknowledging this fundamental technical and safety hazard.' Share any thoughts, news, tips and feedback with Carmen Paun at cpaun@ Ruth Reader at rreader@ or Erin Schumaker at eschumaker@ Want to share a tip securely? Message us on Signal: CarmenP.82, RuthReader.02 or ErinSchumaker.01. WORLD VIEW Hackers love Europe's hospitals, our colleague in Europe, Giedrė Peseckytė, reports. The European Union's health care sector was targeted in 309 cybersecurity incidents in 2023 — more than in any other critical sector. The cost of a major incident typically reached €300,000 or approximately $350,000. For cybercriminals, targeting health data 'is a perfect business plan,' according to Christos Xenakis, professor at the department of digital systems at the University of Piraeus, Greece. 'It's easy to steal data, and what you steal, you can sell it at a high price.' Ransomware attacks — where hackers lock data and demand a ransom — dominate the sector, an EU Agency for Cybersecurity report showed. 'They achieve two targets: One is to get the data and sell [it], and the other is to encrypt the whole system, disrupt the whole system and ask for money,' Xenakis said. Stolen data can be sold on the dark web to criminals who use it to commit identity theft, insurance fraud or blackmail. To restore disrupted systems, criminals can demand millions of euros — hackers, for instance, wanted $4.5 million for the return of the stolen data after a cyberattack on Hospital Clínic in Barcelona. The hospital refused to pay. Why it matters: Beyond the financial impact, cyberattacks pose a threat to patients' lives. The stakes became clear in a recent case in the U.K., where a patient's death was linked — among other contributing factors — to a delayed blood test result caused by a cyberattack that disrupted pathology services last summer. A critical investment: Despite the risks, only 27 percent of health care organizations in the EU have a dedicated ransomware defense program, and 40 percent don't offer any security awareness training for non-IT staff, a separate EU Agency for Cybersecurity report found. Xenakis believes the health care sector sees cybersecurity as a 'luxury,' not an essential. Health care staff are unaware of the risks, he believes, resulting in poor 'cyber hygiene.' Findings from the Finnish Innovation Fund Sitra, an independent public foundation supervised by the Finnish Parliament, back this up. While many health care organizations have cybersecurity policies in place, they're often not 'clearly communicated or consistently understood by their staff.' High personnel turnover — not just among medics but also among cybersecurity officers — further 'exacerbates training gaps and the ability to enforce cybersecurity policies.' Europe mounts a response: In response to increasing cyberattacks on health care systems, the European Commission unveiled an 'action plan' for cybersecurity in hospitals and the health care sector in January. The plan proposes establishing a European Cybersecurity Support Center for the health care sector within the EU cybersecurity agency and a specific rapid-response service. The plan also introduces 'cybersecurity vouchers,' which will enable EU countries to provide financial support to smaller health care providers for enhancing their cyber resilience. 'It's good,' said Markus Kalliola, Sitra's program director. But it 'could be stronger.' Kalliola is one of the authors of the Commission's evaluation report by Sitra, which points to murky EU governance, a lack of clear targets or budgets and a missed opportunity to establish a single functioning market for cybersecurity solutions. What's next: Whether Europe's security will feature in the commission's final hospital cybersecurity plan remains to be seen; the EU executive has just concluded a consultation and promised to put forward a refined plan by the end of the year. SMALL BYTES The Food and Drug Administration is adding more AI talent to its roster. The agency has brought on radiologist Rick Abramson to help support the agency's AI efforts, according to two current FDA staffers granted anonymity to discuss sensitive personnel matters. Abramson previously served as Vanderbilt University's first vice chair for innovation in its Department of Radiology. He also briefly served as an adviser to the Office of Management and Budget under former President Bill Clinton. The Department of Health and Human Services did not return a request for comment as of press time.


Forbes
10 hours ago
- Forbes
Yes, You Should Brush Your Teeth For 2 Minutes, Twice A Day. Here's Why.
Maintaining good oral hygiene practices is key to keeping your teeth and gums healthy—and spending two minutes brushing twice a day is a crucial part of any routine. This may seem like a simple mandate, but there are several factors to keep in mind when you're brushing for optimal results: Technique, toothpaste, pacing and more will make a difference. The ultimate goal of brushing your teeth is to remove bacteria, which can otherwise build up to cause decay and disease. '[For] oral disease, whether that's cavities or whether that's gum disease, reducing the amount of bacterial load in the mouth is a critical piece of that prevention measure,' says Jennifer Cullen, clinical assistant professor at the University of Michigan School of Dentistry. We spoke to three dental experts to learn the best tips and tricks for keeping your teeth sparkling ... More clean. Illustration: Forbes / Photos: Retailers To help you make the most of your two-minute toothbrushing sessions—and learn why we should brush at this cadence in the first place—I spoke to three dental experts to get their advice: Mark S. Wolff, DDS, PhD, Morton Amsterdam dean and professor of the division of restorative dentistry at the University of Pennsylvania; Jennifer Cullen, clinical assistant professor at the University of Michigan School of Dentistry, and director of the division of dental hygiene; and Matthew Messina, DDS, associate professor, clinical and clinic director at the Ohio State University College of Dentistry, and ADA spokesperson. These experts shared their insights on how to brush most effectively, and why brushing teeth is important, to help you stay motivated. Here are the tips and techniques they recommend. Multiple clinical studies show that brushing for two minutes is key to removing plaque so you can keep your teeth and gums healthy. 'There's clinical studies that have shown two minutes of brushing to be highly effective in reducing [tooth] decay,' says Dr. Wolff. A key reason for the two-minute mandate is so you can actually reach the surface of every tooth in the mouth with your brush, and tackle all of the plaque on your teeth. Cullen explained that there are multiple layers of plaque on teeth, and that the longer you brush, the better you can get to the bottom-most, stickiest layers. The experts I spoke with maintained that thoroughly brushing the surface of every tooth takes time: You want to make sure you get the cheek and tongue surface and the back and front of each one. Wolff advises softly placing the bristles right at the gumline to start brushing. How can you ensure you're getting each tooth? 'Brush methodically, not randomly,' says Wolff. Approaching each quadrant of the mouth in 30-second intervals can help you hit all the areas of your mouth, too. Some of the best electric toothbrushes we've tested, like the Oral-B iO Deep Clean + Protect, our pick for the best smart electric toothbrush, and the Philips Sonicare 9900 Prestige, our pick for best splurge electric toothbrush, not only buzz at 30-second intervals to move you along but also have apps that track your brushing to show you any spots you're missing. Let Fluoride Do Its Job The other crucial reason to brush for two minutes twice a day is to let the fluoride in toothpaste take effect to help prevent tooth decay. Cullen notes that hygienists and dentists recommend that people use some sort of fluoridated toothpaste, and that 'there is evidence for the benefits of that increased duration with respect to fluoride delivery.' The experts I spoke to said that fluoride is key to protecting tooth enamel, and that longer exposure to fluoride makes it harder for bacteria to build back up on the tooth. 'It's actually making the enamel less soluble to acids,' says Wolff. Many of the best electric toothbrushes have timers to track your brushing. Some, like the Oral-B iO Deep Clean + Protect, display time clearly on the brush's LED interface and offer cartoon faces (ranging from a frown to starry-eyed smile) to indicate where you stand with your time goal. This brush also works with an app to help you track time, and uses a buzzer in 30-second increments to cue you to move around your mouth. Other brushes use an automatic shutoff feature, or similar buzzing notifications, to let you know when you've reached your full two minutes. Timers And Apps There are multiple ways to time your brushing. Cullen suggests a sand timer for kids or patients with special needs. Dr. Messina recommends using a timer on your phone. He also notes there are apps that are especially helpful for kids to guide them to brush around their mouth over the course of two minutes. Break It Up By Quadrant To break up the two minutes, you can also count for 30 seconds while brushing each quadrant of your mouth, if you don't have an electric toothbrush that does this automatically. This can help keep track of time while making sure you're getting to every tooth. Sing A Song Both Cullen and Messina suggest one way to track your time is to either sing or play a favorite song that lasts around two minutes. This can help gamify your brushing—and make it more enjoyable, a technique that can be especially helpful for kids. Be Gentle Though it's important to be thorough while brushing, experts advise against brushing too hard. 'You don't want to wear the teeth away by scrubbing like this is a floor,' says Wolff. Brushing too hard can actually damage your teeth and gums. To avoid that, opt for a brush with soft bristles. Many electric toothbrushes also have pressure sensors to indicate if you're brushing too aggressively, or if you're hitting the sweet spot. In our electric toothbrush tests, we preferred the easy-to-see sensor on the Oral-B iO Deep Clean + Protect, which uses a light around the neck of the toothbrush to flash green, white or red to indicate pressure. Other brushes can have pressure sensors that will buzz or light up to tell you to ease up. Don't Forget To Floss Brushing is just one key component of a great oral hygiene routine; it can't act alone. Flossing is crucial to reach every surface of the tooth to remove food and debris. 'Brushing itself only reaches 60% of your tooth surfaces,' says Cullen. 'Everywhere a tooth touches another tooth, that toothbrush can't get to.' She recommends floss or an adaptive aid to help get into those hard-to-reach spaces. We've also tested the best water flossers at Forbes Vetted, and these devices can help reach in between teeth to clear debris. The Waterpik Aquarius Water Flosser won as best water flosser overall in our tests. Water flossers may be especially useful for people with orthodontia or those who have difficulty using traditional dental floss. Consider The Swish, And The Social Brush All the experts I spoke to recommended brushing at least twice a day—but what if you want, or need, to brush more frequently? In general, that's fine, and some people may need to brush more frequently due to medical conditions or orthodontia. Wolff advises being mindful of not brushing too hard, however. 'There's nothing wrong with too much or too frequent brushing, as long as you do it gently and you don't wear away the gums [or] damage the tooth with a hard toothbrush,' he says. He also warned of compensating with frequency versus technique. 'Doing it three times a day badly does not make you less likely to get cavities or less likely to have gum disease,' he says. If you don't have access to a sink or brush after every meal, there are still easy things you can do to help keep your mouth cleaner. Cullen and Messina both advise swishing your mouth with water after eating to neutralize the pH of the mouth (when the environment of the mouth is more acidic, it becomes more hospitable to cavity-causing bacteria). Messina also recommends what he calls a 'social brush,' or a quicker brush to clear the mouth of food—for example, after eating a pungent meal like a hamburger with onions— that's less thorough than your twice-daily toothbrushing geared toward deeper cleaning and hitting every surface of the tooth. Remember That Every Patient Has Different Needs Though brushing your teeth for two minutes twice a day is the standard, every patient has different needs; some people may need to brush more frequently or require assistance with brushing. Cullen spoke to how a 10-year-old who isn't snacking frequently or drinking sweet drinks could brush just twice a day, while someone with Parkinson's disease may need to brush more frequently and with assistance. Sometimes electric toothbrushes can help people brush more effectively, but other assistive devices, like a universal cuff, can also help with holding a toothbrush independently. Cullen also said that caregivers may need to give patients breaks or adjust the location for brushing. 'If you're a caregiver, maybe you're doing it at the kitchen table,' she says. 'Maybe you're able to brush for 60 seconds and that person needs a break.' Check in with your hygienist, dentist and care team for the most relevant advice for your needs. Some Brushing Is Better Than None Building new habits like brushing your teeth for two minutes twice a day takes time, and starting a new routine can be intimidating. Messina notes that some patients can feel overwhelmed by the guilt of not brushing enough, and encourages people to do the best they can. Brushing isn't all or nothing; even if you can't reach the full two minutes, Messina says it's still helpful to brush in the first place, no matter how long the duration. 'I know if you start small, that you'll realize how much better it feels and then you'll do more and more,' he says. And remember, brushing is key to overall health. 'It seems like such a small thing to brush your teeth twice a day, but I think people should be encouraged that they're really making a big impact on their overall health when they do that small thing,' says Cullen.


Forbes
10 hours ago
- Forbes
20 Hurdles For Healthcare Tech Startups In Scaling Solutions
A healthcare startup may launch with a bold and innovative idea, but turning that idea into a scalable solution that works across hospitals and complex health systems is rarely straightforward. From integrating with legacy infrastructure to navigating strict compliance requirements and diverse stakeholder priorities, even the most agile teams can struggle to scale effectively. Left unaddressed, these challenges can stall adoption, drain internal resources and limit a product's long-term impact. Below, members of Forbes Technology Council highlight some of the most common hurdles healthcare startups must be ready for and share their expertise on breaking into and succeeding in this challenging sector. 1. Finding Client Champions To scale solutions within a health system or payer organization, you need to engage a team of internal champions who can understand, justify and prioritize your platform. Organizations evaluate dozens if not hundreds of companies each year. Champions help articulate your value, often leveraging their professional credibility to advocate for it. Finding and 'winning' them is essential to scaling. - Graham Gardner, Kyruus Health 2. Navigating Integration Requirements Across Hospital Systems One of the biggest hurdles is navigating the complexities of integration requirements across different hospital systems. Healthcare startups frequently underestimate the time and resources needed for integrations. Success requires building flexible APIs from day one and having dedicated integration specialists who understand healthcare IT infrastructure, not just general software development. - Ted Kail, Cority Forbes Technology Council is an invitation-only community for world-class CIOs, CTOs and technology executives. Do I qualify? 3. Gaining Traction In A Risk-Averse Environment Most healthcare organizations are risk-averse and don't want to be early adopters. They look for proven, well-established companies and products, making it difficult for healthcare startups to get traction, even when they have clearly better solutions. Partnering and delivering real value to that first set of clients is critical in scaling early on. - John Bou, Modio Health 4. Integrating With Insurance Systems Health insurance companies amplify the interoperability challenge by adding another layer of complex, often siloed, data and systems that healthcare tech startups must integrate with. This makes the negotiation and implementation of business associate and HIPAA agreements more complicated, given the data types, security requirements and shared liabilities that arise from integrating with both providers and payers. - Ajai Paul, Affirm Inc. 5. Understanding The Complex Stakeholder Ecosystem Healthcare startups often make the mistake of viewing the U.S. healthcare system with a 'singular' point of view. It is an integrated ecosystem where each stakeholder is affected by the others, which means multiple interests must be aligned when adopting new technologies. - Raghav Ramabadran, Intelligine Technologies 6. Building Custom Integrations For Each Customer Healthcare startups' challenges include integrating with electronic health record systems, which is not a 'plug and play' process. Each hospital or system has its own highly customized version of an EHR, with unique workflows, data fields and security protocols. This lack of standardization means startups must build a new integration for nearly every customer. - Chris Ciabarra, Athena Security Inc. 7. Developing Strong Governance From The Outset Healthcare startups often wait to build full product depth until after landing their first client, but healthcare's high-risk, structured environment demands strong governance from day one. Change control, release management and a deep understanding of current operations, especially when replacing legacy systems, are essential before customizing. Building depth late risks delays and failure! - Trisha Swift, Mula Integrative Health & Wellness 8. Maintaining HIPAA Compliance With Digital Content One challenge healthcare startups face when scaling tech is managing digital content while staying HIPAA-compliant. Hospitals need more than stock photos and shared drives—they expect secure, role-based access to branded visuals that convey authenticity and protect patient privacy. Without a digital asset management strategy, startups risk falling short on compliance, credibility and growth. - Andrew Fingerman, PhotoShelter 9. Ensuring Consistent Performance And Compliance Across Disparate Systems Healthcare startups often struggle to scale because hospital environments vary widely in terms of infrastructure, workflows and data systems. Without a unified data architecture, real-time metrics, and built-in security and governance, it's hard to ensure consistent performance—or meet privacy requirements like HIPAA and business associate agreements governing protected health information. - Dave Albano, Diliko 10. Working Within Complex Pricing And Claims Rules One of the challenges is the integration of new tech into strict hospital billing and compliance processes. Hospitals have complex pricing and claims rules, and startups must work within these rules. They can't disrupt revenue or patient data safety. Doing this right builds trust and helps a solution scale faster. - Abhishek Sinha, Accenture 11. Processing Both Structured And Unstructured Health Data Integrating structured data (EHRs; lab results) and unstructured data (clinical notes; imaging; video) can be a major challenge. Healthcare startups must ensure their tech can process both, all while adapting to varying data and privacy standards across systems, which further complicates scaling and interoperability. Fortunately, generative AI is making this easier to do. - David Talby, John Snow Labs 12. Balancing Accuracy And Transparency With Scalability The healthcare and life sciences sector faces rigorous accuracy and transparency requirements that cannot be sacrificed and must be built into products from the start. Balancing this with scalability—which is really code for 'solving problems you don't have yet'—is a constant challenge—especially for startups, which often place a key focus on agility and speed. - Martin Snyder, Certara 13. Maintaining A Consistent, Accurate Record Of Core Assets One key challenge healthcare startups face when scaling tech solutions across systems is the inability to maintain a consistent and accurate record of core assets—such as patients, providers and devices—due to the absence of a robust master data management strategy. This causes data fragmentation, which in turn hinders decision-making, innovation and seamless integration across platforms. - Somnath Banerjee 14. Keeping Up With A Range Of Regional Norms And Laws Key challenges include a wide range of compliance requirements, regulations, cultural norms, and data privacy and region-specific laws—making a one-size-fits-all solution impractical, even within a single organization. Startups often rely on business rules engines that lack user friendliness. Agentic AI offers a more adaptable and intuitive alternative. - Koushik Sundar, Citibank 15. Working Within Legacy Hospital Systems One major challenge healthcare startups face when scaling tech solutions is integration with legacy hospital systems. Many hospitals rely on outdated EHRs or siloed IT infrastructure, making interoperability difficult. Startups must ensure compliance, data security and seamless integration to gain trust and adoption at scale. - Srikanth Bellamkonda 16. Clearly Demonstrating ROI And Pathways To Reimbursement Healthcare startups often struggle to clearly demonstrate a return on investment and secure reimbursement pathways. Without established billing codes or tangible cost-savings data, hospitals hesitate to allocate budget. Startups must invest heavily in economic validation, health economics and outcomes research, ensuring payers and finance teams see sustainable revenue models before adoption. - Manav Kapoor, Amazon 17. Creating An Internal COE Establishing an internal center of excellence with deep industry experience in scaling healthcare systems is vital, but costly. A key challenge lies in selecting vendors that align with the company's DNA. Bridging the gap between emerging tech and the unique demands of healthcare requires thoughtful planning and a nuanced understanding of both innovation and patient-centric outcomes. - Hari Sonnenahalli, NTT Data Business Solutions 18. Overcoming Resistance To New Tech I've regularly observed the challenges clinical sites face when adopting new technologies. There is often reluctance or resistance to change; staffing shortages further exacerbate these issues. A more effective approach may be to 'mirror' site-level data. This would allow AI-driven platforms to build a harmonized system that enables forward progress without disrupting existing workflows. - Rachel Tam, Bristol Myers Squibb 19. Accounting For Integration Issues When Building Solutions The biggest hurdle to overcome when scaling tech solutions across hospitals or healthcare systems is not technical; rather, it is integration—into provider workflows, clinical practice guidelines, financial models and revenue cycle management programs. Unless the issues around integration are considered and covered when building the solution, scaling will not occur. The landscape is littered with misaligned HealthTech startups. - Mark Francis, Electronic Caregiver 20. Completing Vendor Risk Documentation Post-ransomware, hospitals demand extensive vendor risk audits with hundreds of security controls, SOC 2/HITRUST docs, and custom BAAs. Completing these lengthy questionnaires stretches sales cycles to 18 to 24 months, burning cash and pulling engineers from product work to compliance, blocking scale. - Mohit Menghnani, Twilio