Mandy Oaklander | November 01, 2026

You might assume that doctors would be the first to know what's circulating in the illicit drug supply. After all, they're the ones treating patients with drug-related medical emergencies.

But doctors often cannot access rapid tests for emerging substances, write Dr. Shravani Durbhakula and Jeremy Kourvelas in a new essay for TIME. They have some ideas for a solution, below.

TODAY’S TOPICS

When 911 was too busy
The threat “taking out entire ecosystems”
Doctors lack rapid tests for emerging illicit drugs
How politeness has changed over time

QUICK CHAT

Streamlining 911 calls

I recently spoke with Richard Larson, a professor emeritus of data, systems, and society at MIT, for my new story on what to say when someone cuts in line in front of you. He has spent much of his career studying queuing, which sounds niche until you learn where that work has taken him.

When he was a graduate student at MIT back in the 1960s, New York City had recently introduced 911—and they definitely had a line problem. Larson decided to help. —Angela Haupt

This interview has been condensed and edited for clarity.

amenic181—Getty Images

You were still a graduate student when you decided to help New York City's 911 system?

Yes. The universal emergency number 911 had recently been introduced. Before that, New York City had all these different emergency numbers depending on where you were and whether you needed the police, fire department, or an ambulance. Imagine being a tourist and trying to figure out whom to call.

What made you realize the new system wasn't working?

I started reading letters to the editor of the New York Times. One person described calling 911 and letting it ring for 27 minutes with no answer. They hung up, called again, and waited another 24 minutes before someone finally answered, “Police emergency, may I help you?” I figured they needed some help.

What did you do?

I volunteered and went down to the police department. I lived there for about a month, studying the data. I looked at how many calls came in at different times of day. The hourly call volume varied by a factor of 10 between the quietest periods, around 3 a.m., and the busiest, like Saturday night at 8.

Did they actually use your recommendations?

They did! I came up with 10 different staffing schedules, with different numbers of operators depending on the time of day. They implemented them. And I was just a grad student!

THE QUOTE THAT STUCK

❝

The world is not prepared for a fungal pandemic.

Dr. Arturo Casadevall

Dr. Arturo Casadevall, an infectious-disease expert at the Johns Hopkins School of Medicine, told me in an interview that we shouldn’t be surprised if a future pandemic is caused by a fungal disease. Fungal infections are already “taking out entire ecosystems,” says Casadevall, decimating populations of bats, frogs, and insects. —Dominique Mosbergen

Read the full story here.

SUNDAY READ

Why doctors are last to know what’s in the drug supply

By Dr. Shravani Durbhakula and Jeremy Kourvelas

Drug tests used to detect fentanyl and xylazine in New York City on May 25, 2023.Angela Weiss—AFP via Getty Images

The illicit drug supply has changed rapidly over the last few months, with nitazenes, medetomidine, cychlorphine, and other novel synthetic substances appearing in rapid succession. Rapid tests for emerging substances are being developed and marketed with impressive speed, and these can return results within minutes. Law enforcement, medical examiners, employers, community organizations and even the general public can use them, if their states have decriminalized them. Physicians treating overdoses cannot.

The contrast is hard to ignore: A test can be used to fire someone or support a criminal case, yet it remains unavailable to the physician in an emergency room trying to save that person’s life, when minutes are essential.

The divide is largely regulatory. Many tests for emerging drugs are labeled for forensic use only, and clinical tests for living patients require approval by the Food and Drug Administration (FDA) as a diagnostic tool. As such, they cannot legally be used by medical clinics that adhere to federal law and funding policies.

Read the full story here.

TIME100 Most Influential Companies is expanding

TIME100 Most Influential Companies 2027 entries are now open.

With new Exceptional Workplaces categories, the TIME100 Companies publication is expanding to recognize businesses pioneering new approaches to how people work, from flexible and hybrid work to technology integration and career development.

Because it’s no longer just what you do, but how you do it.

Submit your company.

WHAT WE’RE READING

A new report in the Lancet argues that online misogyny should be treated as a public-health issue akin to obesity or smoking, Tobi Thomas writes for the Guardian.
You can be productive, responsible, and seemingly successful—and still feel no joy. Allison Aubrey at NPR explores anhedonia, a frequently overlooked symptom of depression, and how to recognize it.
Small words help us understand how politeness has changed over time, writes Valerie Fridland for TIME.