Princess Health and Survey of Cincy-area students, including some in Kenton County, finds pot and vaping more popular than cigs; drug use down. Princessiccia

Princess Health and Survey of Cincy-area students, including some in Kenton County, finds pot and vaping more popular than cigs; drug use down. Princessiccia

alcohol drug abuse electronic cigarettes heroin marijuana survey tobacco

Gusty 08:57 Add Comment

Students in Greater Cincinnati, including Northern Kentucky, are more likely to use marijuana and electronic vapor products than cigarettes, according to a drug-use survey of students in the region.

Graph from PreventionFirst report

The survey found that students in the area were most likely to use alcohol (16.3 percent) within the past 30 days, followed by marijuana (11.7 percent), electronic vapor products (13.4 percent), tobacco (8.2 percent) and non-prescribed prescription drugs (4.6 percent).

This was the first year a question was included about electronic vapor products in the biennial surveys by PreventionFirst (formerly the Coalition for a Drug-Free Greater Cincinnati), a comprehensive effort to reduce adolescent alcohol and drug use.

The good news is that most students are not using alcohol, tobacco or other drugs, says the report.

The study surveyed nearly 40,000 students in grades seven through 12 from 88 public and private schools in several counties in Greater Cincinnati and Kentucky's Kenton County. They were asked whether they'd used any of 21 drugs.

The survey found that use of alcohol, tobacco and marijuana have declined significantly since 2000: alcohol down 46 percent, tobacco down 61 percent and marijuana declining 22 percent. Since 2012, non-prescribed prescription drug use has declined 29 percent.

It found that students' perception of the harm that alcohol can do has increased, while they were less concerned about marijuana.

With marijuana, as students get older "their perception of harm decreases, and use increases," said PreventionFirst CEO Mary Haag told Terry DeMio  of the Cincinnati Enquirer.

"Marijuana has become very prevalent and it's becoming more so," Hamilton County Commissioner Dennis Deters, who chairs the Hamilton County Heroin Coalition, told DeMio. "It's dangerous to our children and it enhances their risk when they become adults for serious addiction."

The report calls age 13 a "pivotal age" because this is when first drug use often occurs in students.

The report also finds that peer and parental disapproval rates are at an all-time high.

"We know how important friends and parents are in a young person's life," Haag said in the news release. "Students whose peers and family express disapproval are more likely to make the healthy choice to not use drugs and alcohol."

Princess Health andKentucky had biggest increases in binge drinking, heavy drinking and any drinking from 2005 to 2012, first county-level study shows.Princessiccia

Princess Health andKentucky had biggest increases in binge drinking, heavy drinking and any drinking from 2005 to 2012, first county-level study shows.Princessiccia

alcohol alcohol abuse research

Gusty 04:51 Add Comment

By Melissa Patrick
Kentucky Health News

Kentucky has a relatively small percentage of drinkers compared to the rest of the nation, but it appears it is leading the nation in the increases in the percentage of people who are drinking any alcohol, drinking heavily and binge drinking, especially among women, according to a new analysis of county-level drinking patterns in the U.S.

The study took a look at any drinking, heavy drinking and binge drinking at a state and county level and found that Kentucky leads the nation in the percentage of increase in all three categories. Kentucky showed a 17.6 percent increase in any drinking, compared to no national increase; a 60.8 percent increase in heavy drinking, compared to 17.2 percent nationally; and a 29 percent increase in binge drinking, compared to 8.9 percent nationwide, between 2005 and 2012.

"It is surprising that there has been such a big increase in Kentucky in more people drinking," Ty Borders, professor of health management and policy at the University of Kentucky, said in an interview. "I'm not sure why that would be, especially because it was the only state that had this really big increase in drinking and risky drinking. ... It just really doesn't make sense."

Borders was perplexed at these outcomes, especially for the "any drinking" category, saying that because there is a greater percentage of persons who are members of religious affiliations that forbid drinking in the Southeast, people in this region tend to drink less. He expressed more confidence in the state and national estimates than the county-level estimates because of the often low response rates generated by the Behavioral Risk Factor Surveillance System on which the county estimates are based, but he said, "This is the best we have at the county level." The system is a continuous national poll by the federal Centers for Disease Control and Prevention.

Allen Brenzel, medical director for the state Department for Behavioral Health, Developmental and Intellectual Disabilities, emphasized in an interview that while Kentucky is well below the national alcohol abuse averages, this report shows an "alarming trend, regarding women particularly."

�It really does show that we need to be careful to not become so preoccupied with prescription drug abuse and opiate abuse,� he said. �We need to realize that alcohol is still a major issue when we see trends like this, we need to rebuild our education, prevention and treatment efforts.�

Borders agreed. "If you think about the overall burden on the health of the population, alcohol is still the top in terms of the effect it has on our health status and other downstream factors such as loss work productivity and also health-care costs," he said. "A lot of attention has been focused on obesity and illicit drug use, but alcohol misuse really remains a very big public health concern and it should be at the forefront of issues that we are discussing."

Brenzel said that while the BRFSS data is �more intended to be used across states and across regions of the country,� which makes it �a little bit challenging to break it down specifically� to counties, this data does show a statewide �absolute increase from the 2005 levels.�

He also said that this report conflicted slightly with a recent state report that shows a consistent decline in alcohol use and abuse in both boys and girls during the same time period. �Typically, what we see is that trends in children are usually reflected later in trends in adults,� he said.

Brenzel offered several possible reasons for the increases found in the report, but said it would take a while to �drill down� the specifics. He suggested one thing to investigate regarding the increases shown in women is whether it has become more socially acceptable in Kentucky for women to drink, especially with the increased marketing of liquor to women.

He suggested that the increased number of Kentuckians who are in the active military might have influenced the increases shown in this study, saying studies have shown that if a family has someone actively in the military, it tends to have higher drinking rates. He also noted that the socioeconomic strains that occurred between 2005 and 2012 could have also influenced these increases.

The study, "Drinking patterns in U.S. counties from 2002 to 2012," by the Institute on Health Metrics and Evaluation at the University of Washington, was published in the American Journal of Public Health and is the first study to track trends in alcohol use at the county level.

It defined "any drinking" as one drink in the past 30 days, "heavy drinking" as more than one drink a day for women and two drinks per day for men, and "binge drinking" as at least five drinks for men and four for women on a single occasion during the previous 30 days.

The data are adjusted for age, and the county figures reflect statistical modeling to compensate for small sample sizes. Click here for an interactive map of the data, which shows the possible ranges of percentages, reflecting the poll's error margin.

Drinking in Kentucky

The study found that nationwide, Kentucky showed the greatest increase in drinking, with a 17.6 percent (possible range of 10.6 to 25) increase between 2005 and 2012. No other state was even close; Tennessee ranked second at 11.3 percent and Louisiana was third at 9.8 percent. Nationally, there was no percentage increase in drinking during this time frame.

Kentucky women led the nation in increased drinking, at 21.9 percent, with Tennessee women at 17 percent. Kentucky men also led the nation in this category with an increase of 14.6 percent, followed by Louisiana at 9 percent and Tennessee at 7.3 percent.

In 2012, 43.1 percent of Kentuckians drank at least one drink per month, including 36 percent of women and 50.4 percent of men. Nationwide, 56 percent of Americans have at least one drink a month.

Heavy drinking in Kentucky

Kentucky also showed the nation's largest increase in heavy drinking, up 60.8 percent (possible range 39 to 89.5) between 2005 and 2012. Once again, no other state was close. South Dakota came in at 46.5 percent, Nebraska 45 percent, Kansas 44.5 percent and Washington, D.C., 42.2 percent. Nationally, the increase in heavy drinking was 17.2 percent.

Kentucky's increase was driven largely by women, who showed a 68.2 percent increase in heavy drinking. Nebraska (63.8 percent) and Oklahoma's (60.1 percent) women had the next largest increases in this category. Kentucky men also led the nation in this category with a 57.6 percent increase in heavy drinking, followed by Washington, D.C., at 52.1 percent. Other states were nowhere close to these numbers.

In 2012, 7.2 percent of Kentuckians self-reported as heavy drinkers, including 4.6 percent of women and 10 percent of men. Nationwide, 8.2 percent of Americans identify as a heavy drinker.

Heavy drinking is a risk factor for long-term health effects like cancers, liver damage and heart disease, according to the study.

Binge drinking in Kentucky

Kentucky also led the nation in increased binge drinking, up 29 percent (possible range 17.9 to 42.7) between 2005 and 2012, compared to 8.9 percent nationally. Washington, D.C, up 21.4 percent, and Maryland, up 20.8 percent, were next in the rankings for increased binge drinking.

This increase in Kentucky was also driven by women, with 51.4 percent more of them binge drinking between 2005 and 2012, compared to 17.5 percent nationally. This was far ahead of the next two state leading this category, Maryland women at 34.7 percent and Vermont women at 32.3 percent. Men in Kentucky increased their binge drinking by 20.7 percent, followed by Washington, D.C., at 17.9 percent and Kansas at 17.6 percent. Other states were not close.

In 2012, 15.1 percent of Kentuckians self-reported as binge drinkers, compared to 18.3 percent nationally, including 9.5 percent of Kentucky women and 21 percent of Kentucky men.

Binge drinking is commonly linked to higher risk for serious bodily harm like car crashes, injuries and alcohol poisoning and acute organ damage, says the study.

Nationwide, women showed a much faster escalation in binge drinking than men, with rates rising 17.5 percent between 2005 and 2012; men, on the other hand, saw rates of binge drinking increase 4.9 percent, according to the release.

�We are seeing some very alarming trends in alcohol overconsumption, especially among women,� Dr. Ali Mokdad, a lead author of the study and professor at the Institute for Health Metrics and Evaluation, said in a press release. �We also can�t ignore the fact that in many U.S. counties a quarter of the people, or more, are binge drinkers.�

County data

This report is the first to track trends in alcohol use at the county level, and while the confidence level for the county data are lower than the state data, the report found that every Kentucky county experienced increases in rates of drinking since 2005, with Lawrence County recording the largest increase in drinking at 43.5 percent (possible range 21.4 to 67.8).

Kenton County posted the highest levels of heavy drinking in 2012 (13.1 percent, with a possible range of 10.2 to 16.4), and Bracken County experienced the fastest rise in heavy drinking between 2005 and 2012, increasing 94 percent (possible range 42 to 188.8).

Pike County experienced the largest increase in binge drinking for women, climbing 90 percent (possible range 45.9 to 166.6), says the release.

Campbell County had the highest percentage of binge-drinking residents (27.3 percent with a possible range of 23.9 to 31.8), and Lawrence County recorded the fastest increase in rates of binge drinking, rising 52.8 from 2005 to 2012 (possible range 24 to 88.8).

Kentucky Health News is an independent news service of the Institute for Rural Journalism and Community Issues, based in the School of Journalism and Telecommunications at the University of Kentucky, with support from the Foundation for a Healthy Kentucky.

Princess Health andStudy suggests that adolescent exposure to alcohol can negatively affect learning, memory and behavior in adulthood.Princessiccia

Princess Health andStudy suggests that adolescent exposure to alcohol can negatively affect learning, memory and behavior in adulthood.Princessiccia

alcohol behavioral health children children's health learning disorders research

Gusty 11:44 Add Comment

A study at Duke University suggests that repeated exposure to alcohol during adolescence causes long-lasting changes in the part of the brain that controls learning and memory. The study, published in the journal Alcoholism: Clinical & Experimental Research, helped explain how exposure to alcohol before the brain has fully developed can cause cellular and synaptic abnormalities and negatively affect behavior. Kentucky is ranked 9th in the nation for the percentage of children who drank alcohol before age 13 (25.1 percent), according to the state Department for Public Health.

"In the eyes of the law, once people reach the age of 18, they are considered adult, but the brain continues to mature and refine all the way into the mid-20s," said lead author Mary-Louise Risher, a post-doctoral researcher in Duke's Department of Psychiatry and Behavioral Sciences. "It's important for young people to know that when they drink heavily during this period of development, there could be changes occurring that have a lasting impact on memory and other cognitive functions.

Studies had shown that animals exposed to alcohol at an early age do not perform as well in memory tasks as those not exposed to it. The new study, which involved exposing young rodents to alcohol and waiting for them to grow into adulthood, found that the exposure also affects the hippocampus, the area of the brain that controls memory and learning. The researchers measured a cellular mechanism called long-term potentiation, which involves the strengthening of brain synapses being used to learn new tasks or bring up memories. Ideally, LTP should be high, especially in young people. The researchers found that the adult rodents exposed to the alcohol during adolescence had higher levels of LTP, which may seem to be a positive outcome but is actually not.

"If you produce too much LTP in one of these circuits, there is a period of time where you can't produce any more," said senior author Scott Swartzwelder, a Duke professor. "The circuit is saturated, and the animal stops learning. For learning to be efficient, your brain needs a delicate balance of excitation and inhibition�too much in either direction, and the circuits do not work optimally."

The researchers also observed a structural change in individual nerve cells: those exposed to alcohol at a young age have brain cells that appear immature, even in adulthood. "It's quite possible that alcohol disrupts the maturation process, which can affect these cognitive functions later on," Risher said. She also noted that the immature appearance of the cells might be associated with behavioral immaturity.

Princess Health andPolling shows Kentucky ranks third in share of residents, 24.5 percent, who say they take mood-altering drugs every day.Princessiccia

Princess Health andPolling shows Kentucky ranks third in share of residents, 24.5 percent, who say they take mood-altering drugs every day.Princessiccia

alcohol alcohol abuse drug abuse drug use drugs prescription drug abuse prescription drugs tobacco

Gusty 08:59 Add Comment

Kentucky is the place to be for mood-altering drugs. The state ranked third in a Gallup Organization study that asked 450 adults in each state how often they use drugs and medications to affect their mood or relax them, Christopher Ingraham reports for The Washington Post. West Virginia led, with 28.1 percent of respondents saying they use mood-altering drugs every day, Rhode Island was second at 25.9 percent, but Kentucky was not far behind at 24.5 percent.

Nationally, 18.9 percent of respondents said they take drugs almost every day, while 62.2 percent said they never do, 13.1 percent said they rarely do and 5 percent said they sometimes do.

The way the question was worded allows for errors, Ingraham writes. The question asked about drugs and medications, but didn't specify which ones, and didn't mention alcohol or tobacco. That left interpretation of the question up to individual respondents.

A recent National Survey of Drug Use and Health said that at least 71 percent of American adults drank in the past year, and 56 percent drank in the past month, which if true, could raise the rates in most states, if respondents were to consider alcohol a mood-altering drug. (Read more) (To view this interactive Post map click here)

Princess Health and Princess Health andSafety-net hospitals, haven for the uninsured, are seeing more covered patients since the expansion of Medicaid.Princessiccia

Princess Health and Princess Health andSafety-net hospitals, haven for the uninsured, are seeing more covered patients since the expansion of Medicaid.Princessiccia

Affordable Care Act alcohol insurance coverage Medicaid

Gusty 10:19 Add Comment

By Melissa Patrick
Kentucky Health News

Hospitals that most often treat the poor and uninsured  are seeing fewer uninsured patients since the new health law's expansion of Medicaid, Phil Galewitz reports for Kaiser Health News. Kentucky's safety-net hospitals have also seen a drop in their uninsured patients.

Safety-net hospitals, which are often not paid for the billions of dollars it costs to care for the disproportionate share of poor and uninsured people they care for, will benefit most from the health law's expansion to more than 13 million people this year, Galewitz writes.

Hospitals across the country had expected this outcome, but told Galewitz in interviews that it has happened "faster and deeper" than anticipated -- "at least in the 25 states that expanded Medicaid in January."

Kentucky is one of the states that agreed to the Medicaid expansion and has expanded health coverage to some 413,000 people, with 75 percent of them reporting that they did not have coverage before signing up on Kynect, the state's health insuance exchange.

Michael Rust, president of Kentucky Hospital Association, said figures from his members won't be available until July, but "Anecdotally, I can tell you that more people do have coverage," adding later that "most are on Medicaid."

The University of Kentucky has seen a decrease in uninsured patients. �The number of uninsured patients seeking care at UK HealthCare since Medicaid expansion took effect in January has decreased,� said Mark D. Birdwhistell, UK vice president for health system administration. �Even though we have seen a double-digit increase in the number of services provided, request for financial assistance is down when compared to this period last year.�

Investor-owned hospitals are also being affected by the expansion of coverage. HCA, Tenet Healthcare Corp., Community Health Systems, some of which own safety-net hospitals, told Galewitz "they saw their rates of uninsured patients drop by as much as a third in the first quarter of 2014 in hospitals located in Medicaid-expansion states," he writes.

"An Urban Institute study published in the May edition of Health Affairs estimated the costs of uncompensated care to hospitals were as high as $45 billion in 2013, with government programs defraying an estimated 65 percent of those costs," Galewitz reports. That made the hospital industry one of the first to support the Affordable Care Act, he notes, agreeing to take funding cuts "exceeding $150 billion over a decade" in return for more paying patients.

However, because the Supreme Court ruled that states could not be forced to expand Medicaid, hospitals in the 24 states that didn't are suffering the funding cuts, without the "corresponding reduction in uncompensated care," Galewitz writes.

Hospital officials told Galewitz that the biggest impact of the expansion of Medicaid is that patients can now go to a primary-care doctor instead of the emergency room for routine care. Kentucky ERs have reported a surge in patients since the law took effect. Galewitz notes that a study in Massachusetts following its Obamacare-like expansion showed an initial surge in ER use followed by a decline over several years.

Princess Health and New study finds texting and driving kills and injures more teens than drinking and driving, and is becoming more prevalent.Princessiccia

Princess Health and New study finds texting and driving kills and injures more teens than drinking and driving, and is becoming more prevalent.Princessiccia

alcohol drunk driving highway safety injuries injury prevention motor vehicles safety

Gusty 20:29 Add Comment

A new study finds that texting while driving has become more dangerous among teenagers than drinking and driving, and it says the number of teens who are dying or being injured as a result of this habit has "skyrocketed."

Nationwide, more than 3,000 teens are killed and 300,000 are injured as a result of texting and driving, compared to 2,700 deaths and 282,000 injuries from drinking and driving, said researchers at Cohen Children's Medical Center in New Hyde Park, N.Y.

"A person who is texting can be as impaired as a driver who is legally drunk," said Dr. Andrew Adesman, chief of developmental and behavioral pediatrics at Cohen.

Adesman and his team found that the number of teens who text and drive exceed the number who drink and drive, that more boys admit to texting than girls, and that texting increases with age, writes Delthia Ricks of Newsday. While teens' texting is increasing, the CDC reports alcohol use among teen drivers has decreased by 54 percent over the past 14 years.

On Wednesday, officials from the National Highway Traffic Safety Administration described texting as among the worst of driver distractions, and Adesman says texting is as hazardous as "drinking and driving, binge drinking, drug and tobacco use, unsafe sex and tanning devices," writes Ricks.

"We have very strong taboos against drinking and driving. Kids don't drink and drive every day," Adesman said. "But some kids are out there texting and driving seven days a week -- and they admit it."

Princess Health and Bankruptcy filing by mental-health agency is a loser for Kentucky, where such services can be scarce and little used.Princessiccia

Princess Health and Bankruptcy filing by mental-health agency is a loser for Kentucky, where such services can be scarce and little used.Princessiccia

alcohol alcohol abuse depression drug abuse health care law legislature Medicaid mental health mental illness prevention state government

Gusty 14:15 Add Comment

By Molly Burchett
Kentucky Health News

The decision of Seven Counties Services Inc. to file bankruptcy to avoid paying into the Kentucky Employee Retirement System has created a "no win" situation for the state, and the issue may add yet another obstacle for Kentuckians to get the mental health care they need.

Louisville-based Seven Counties is one of the state's largest mental-health agencies, serving more than 30,000 adults and children with mental-health services, alcohol and drug-abuse treatment, developmental-disabilities services and preventive programs, according to its website.

And while Kentucky's mental-health system has received an F grade for its funding, the state pension system needs agencies like Seven Counties to pay in more because the system is just 27 percent funded. "Employers will have to ante up around 38 percent of annual payroll, compared with the 23 percent now required," Mike Wynn notes in The Courier-Journal.

Kentucky's need for mental health services is much greater than the supply, and an estimated 1.7 million Kentuckians live in areas designated as a "mental health professional shortage area," which means almost 40 percent of Kentucky residents lack proper access to such professionals, says a report by the Kaiser Family Foundation. About 24 percent of residents' mental-health care needs are under-served, and this situation could be worsened by federal health reform, which will expand mental-health and substance-abuse treatment benefits to more Kentuckians without adding to the number of providers.

Bankruptcy for Seven Counties is a lose-lose proposition: It could close its doors in 2014 and stop providing services to 30,000 Kentuckians or, if the bankruptcy goes through, the state's retirement system wouldn't get anticipated agency payments into the system, reports Ryan Alessi of cn|2, a news service of the Time Warner and Insight cable-TV companies.

�The only two paths this can go is we could stay in KERS until we have given them our last nickel, which is a year (or) year-and-a-half from now � (and) we close the doors and go out of business and KERS gets no more money because we�re out of business,� Dr. Tony Zipple, president of Seven Counties, told Alessi.

In addition to funding problems for mental-health services, many people with mental-health issues don't seek treatment because of its stigma, said Sheila Schuster, executive director of the Kentucky Mental Health Coalition, in a recent opinion piece sent to Kentucky newspapers.  Shuster calls on elected leaders to increase funding of mental health services and highlights the prevalence of mental health illness.

"At least one-fourth of us will experience a behavioral health issues (mental illness or substance use disorder) in a given year," Schuster writes. That number, and the number of people needing treatment, will continue to grow, she says.

Schuster also writes about the societal impact of not treating mental illness: "Depression is rated as the #1 cause of disability in this country, and is a leading cause of absenteeism and decreased productivity in the work force." Because some people avoid treatment due to stigma, they may self-medicate with drugs or alcohol, and "the effects of stigma and failure to treat the whole person can have catastrophic results," she writes.

In addition to calling for more mental health funding, Schuster asks all Kentuckians to get educated about mental illness so that its stigma can be erased. Click here to read more from Schuster about mental health and resources for help. For a PDF of her op-ed, click here; for a text version, here.

Princess Health and Parents should talk to children about alcohol; study shows teens do listen.Princessiccia

Princess Health and Parents should talk to children about alcohol; study shows teens do listen.Princessiccia

alcohol alcohol abuse children's health prevention teenagers teens

Gusty 15:15 Add Comment

Two recent studies highlight how important it is for parent to talk with their teens about the risks of alcohol use, which leads to more than 4,500 deaths nationwide every year.

In the first study, Mothers Against Drunk Driving found that fewer than a third of alcohol-related deaths among 15- to 20-year-olds are caused by drinking and driving. About 32 percent of the drinking-related deaths involved traffic crashes, while 68 percent involved incidents such as murder (30 percent), suicide (14 percent), alcohol poisoning (9 percent) and other causes (15 percent), MADD says in a press release.

"These data show that taking away the keys truly does not take away all of the risks when it comes to underage drinking," MADD national president Jan Withers said. "MADD hopes this information will inspire parents to have ongoing conversations with their kids about the dangers of drinking alcohol before age 21, especially since we know that a majority of kids say their parents are the biggest influence on their decisions about alcohol."

Another study says parents can help reduce children's excessive drinking in college by talking with them about the potential dangers of excessive drinking before they set foot on campus, and it turns out that children really do listen to their parents about drinking, says the study by Rob Turrisi of Penn State. Discussing drinking in any way before teens go to campus, including why some teens drink while others don't, as well as the potential dangers of excessive drinking, can help.

Having this type of conversation with teens about the reality of underage drinking and its risks, such as alcoholism and alcohol poisoning, and can reduce the odds that light drinkers will escalate into excessive drinkers, says the study. It can also increase the likelihood that already heavy-drinking teens cut down on their drinking or even stop completely.

The National Institute on Alcohol Abuse and Alcoholism also urges parents to talk with their children about alcohol. Click here for more information about doing this or to read about the risks of alcohol use and other prevention strategies.