Showing posts with label drug treatment. Show all posts
Showing posts with label drug treatment. Show all posts

Wednesday, 8 June 2016

Princess Health and Official praises needle exchanges and medication-assisted treatment for addiction: 'Treatment works. Recovery is possible.' . Princessiccia

Scott Hesseltine
Scott Hesseltine, the new vice-president of addiction services at Louisville's Seven Counties Services, talked on Kentucky Educational Television about needle exchanges and a new model of addiction treatment that combines medication assisted treatment with an abstinence-based model of care.

"We are in the midst of a tragic public-health crisis and it's claiming the lives of our citizens at astronomical rates," he said, noting that more than 1,000 people die from drug overdoses in Kentucky each year and that the state has the highest rate of hepatitis C in the nation.

Seven Counties Services provides behavioral-health services, primarily for people on Medicaid, in Jefferson County and six neighboring counties: Henry, Oldham, Trimble, Spencer, Shelby and Bullitt.

The interview on "Connections with Renee Shaw" was part of KET's "Inside Opioid Addiction" initiative, which is funded in part by a grant from the Foundation for a Healthy Kentucky. It aired in June.

Hesseltine, who came to Seven Counties Services from the Hazelden Betty Ford Foundation, a nationally recognized drug and alcohol treatment center, commended Kentucky's "forward thinking" in passing an anti-heroin bill last year.

Among other things, the bill allows needle exchanges to decrease the spread of infectious diseases, like hepatitis C and HIV, that are commonly spread by drug users sharing needles. They require both local approval and funding and have met with some resistance because many think they condone or perpetuate drug use.

Asked about that, Hesseltine said research shows that needle exchanges do what they are meant to do -- reduce the incidence of infectious disease among intravenous drug users.

He noted that Justice Secretary John Tilley, who was instrumental in passing the heroin bill as a state representative, said at a recent community forum in Corbin that research found that addicts who are involved in needle exchange programs are five times more likely to enter treatment.

"And we know treatment works and recovery is possible, so any avenue to slow the spread of disease and to help more people find the solution in recovery is a positive thing," he said.

Another point of contention among some lawmakers is that some of the state's needle-exchange programs don't adhere to a needle-for-needle exchange, which they say was the intent of the law,but instead provide as many needles as the addict needs for a week.

Hesseltine said the needs-based model decreases needle sharing and thus disease, so "Needs-based is more appropriate; it is more evidence based."

Hesseltine told Shaw that while working at Hazelden, he was part of an initiative that completely "altered the way we provided care." The new program, called COR-12, combines medication-assisted treatment with the 12-step abstinence model, which had been the only accepted recovery treatment program at Hazelden.

Hesseltine brought the new model with him to Seven Counties Services and said he likes to call it "medicated assisted recovery." He said "It has to be done appropriately so we are helping to stabilize someone from their biological symptoms of addiction so they can then engage in the recovery process."

Hesseltine told Shaw that addiction isn't curable, but is treatable.

"I would say it is a chronic disease that can be put into remission with structure, support, accountability and behavioral interventions," he said. "Curable? No, but like diabetes -- not curable, but certainly manageable."

Shaw asked if any addict is beyond reach. "Only someone who is not alive," Hesseltine replied. "Treatment works. Recovery is possible." He said that is why access to naloxone, the overdose-reversal drug branded as Narcan, is so important.

Asked what policy changes he would like to see, Hesseltine listed increased funding for drug treatment, "high level" models of care that shift addiction services to local communities, and repeal of the Medicaid rule that doesn't allow any reimbursement for mental-health and substance-use-disorder residential treatment facilities with more than 16 beds.

With treatment, Hesseltine said, "People can go from a pitiful and incomprehensible demoralization, a state where they have no hope to one of having hope, to being a productive member of society and to really regaining a place where they feel good about themselves and they are leading a life full of joy and freedom."

Monday, 6 June 2016

Princess Health and WellCare provides twist-on naloxone nasal atomizers for free, encourages those who know addicts to have naloxone on hand. Princessiccia

WellCare of Kentucky and the Kentucky Pharmacists Association have teamed up to provide 1000 twist-on naloxone nasal atomizers for free, in hopes of making it easier for people to administer the drug.

Dr. Paul Kensicki
"We believe this will make it easier, and less intimidating, for people with no medical background to administer it in an emergency situation," Paul Kensicki, medical director of behavioral health at WellCare of Kentucky, said in op-ed released by Wellcare.

WellCare will provide the atomizers to pharmacists, who will then distribute them to Medicaid recipients and individuals with no insurance coverage.

Kentucky's 2015 anti-heroin law allows pharmacists to dispense naloxone (brand name Narcan), a drug that can reverse the effects of a heroin overdose, without a prescription.Traditionally, the drug has been given as an injection, but the atomizer transforms the syringe to allow it to be administered as a nasal spray.

Naloxone immediately reverses the effects of an opioid overdose by physiologically blocking the effects of the drug. It has no side effects and cannot be abused. "It�s nothing short of a miracle drug," Kensicki writes. "It can absolutely save a life."

More than 1,000 Kentuckians die each year from drug overdoses, with more than 200 of these deaths from heroin. It has become a more common cause of death than car accidents in Kentucky.

"People who know someone who is using opioids, such as a spouse, parent or a roommate, should have naloxone readily available in case they discover an overdose in progress," Kensicki writes.

He notes that patients may be at the most risk of an overdose during recovery, because if they relapse their bodies aren't able to process the same amount of the drug they had been accustomed to before trying to quit.

"Making naloxone available does not mean it is �okay� to use heroin, and we are certainly not removing all the risks of addiction," Kensicki writes. "But we are giving friends and families a tool they can use to help save their loved ones in emergency situations � buying people the time they need to fight their addiction."

Sunday, 22 May 2016

Princess Health and  Nine myths about opioid drug abuse. Princessiccia

Princess Health and Nine myths about opioid drug abuse. Princessiccia

Do you think it's a good idea to save your leftover pain pills to have "just in case" you might need one, or that heroin is primarily an inner-city problem? Think again. Those are among nine common myths that were busted at a community opioid forum in Corbin May 17 in hopes of decreasing some of the stigma that surrounds addiction.

"One of the things we know is that the stigma that exist around opioid abuse is largely propelled because of the myths that exist," said Janet Jones, a representative from Hazelden Betty Ford Foundation, the nation's largest nonprofit addiction treatment provider. Jones led the group discussion about nine opioid myths:

*Myth 1: Abusing prescription painkillers to get high is safer because they are made by a pharmaceutical company and doctors prescribe them.
Fact: Prescription drugs can be just as addictive and just as dangerous as illegal ones, like heroin. The brain and body treats heroin and prescription opioids the same.

*Myth 2: I should save my extra prescription pain pills just in case I need them for something else later, like joint pain or a toothache.
Fact: Saving pain pills that you no longer need can be dangerous because young people often gain access to them. The next time you need pain medication, talk to your health-care provider about the risk, ask them to prescribe only what you need, and properly discard unused drugs when you no longer need them.

*Myth 3: Snorting or smoking heroin or prescription opioids is safer than injecting them.
Fact: There is no "safe" way to abuse a drug. And while injecting drugs with shared needles increases the risk of HIV/AIDS or hepatitis C, any method of opioid abuse can lead to overdose and death.

*Myth 4: Heroin is primarily an inner-city problem.
Fact: Heroin use is on the rise nationwide, including in suburban and rural areas.

*Myth 5: A person addicted to heroin or prescription painkillers is a lost cause.
Fact: Treatment works. Recovery is possible with appropriate treatment and adequate social support systems.

*Myth 6: Heroin and prescription pain pills are just the latest "fad" drugs and their appeal will fade.
Fact: Opium, heroin and other opioids have been used for thousands of years. Prescription opioids have a legitimate use as effective painkillers and are not going away any time soon. And while illegal drugs come and go, communities are experiencing unprecedented use of opioid drugs, and people are dying at epidemic levels

*Myth 7: Making Narcan (naloxone) available to first responders wastes resources on people who have given up, and takes away an addict's incentive to quit by making them less likely to die of an overdose.
Fact: Addiction is a chronic disease, not a moral flaw, and the only way a person can get help is if they are alive to do so. Time is critical to overdose survival rates and naloxone helps to save these lives.

*Myth 8: Heroin and prescription painkiller abuse only hurts those who use the drug.
Fact: Opioid abuse hurts everyone. Financially, the legal, healthcare and lost productivity costs total in the billions and the intangible costs to families and friends are incalculable.

*Myth 9: Hardworking everyday people don't use heroin or misuse prescription painkillers.
Fact: Any type of person can develop an opioid use disorder.

Thursday, 19 May 2016

Princess Health and At forum on opioid abuse in Corbin, people say they need more treatment services, community education and coalitions. Princessiccia

Image from Lauren Osborne, WYMT-TV Mountain News
By Melissa Patrick
Kentucky Health News

CORBIN, Ky. � After a day of learning and talking about opioid prevention, treatment and mobilization, people at a forum in Corbin agreed on three things: Access to substance abuse and mental health services remains a huge barrier in southeastern Kentucky; more community education is needed; and drug-prevention programs should form coalitions to better use their limited resources.

Substance abuse affects almost every family in Kentucky, and four Kentuckians die every day from a drug overdose. That was part of the opening message from Dr. Allen Brenzel, medical director of the state Department for Behavioral Health, Development and Intellectual Disabilities.

"This is, in my opinion, one of the most pressing health-care issues facing our commonwealth today," Brenzel said. "If 1,000 people a year were dying from measles in the state of Kentucky, think about the public response that we would have. ... We would be on red-alert, we would have a complete, public-health, massive intervention to solve that problem."

Van Ingram, executive director at the Governor's Office of Drug Control Policy, said that next year's drug overdose report, which will be released in a few weeks, will show the problem is getting worse.

About 125 people, most of them health-care providers, attended the "Cumberland River Forum on Opioid Use Disorders: A Time for Community Action" May 17 at the Corbin Technology Center. It was sponsored by The Kentucky Cabinet for Health and Family Services, the Hazelden Betty Ford Foundation, and Cumberland River Behavioral Health. Similar forums were held in Lexington May 16 and Louisville May 13.

John Tilley
John Tilley, secretary of the Kentucky Cabinet for Justice and Public Safety, said he hoped the forum would "light a fire under this community" to talk to their neighbors and friends, community leaders and legislators about the value of treatment over incarceration for substance abuse and mental health issues.

Tilley, who chaired the House Judiciary Committee when he was a state representative from Hopkinsville, acknowledged that some abusers should be in prison, but said society must distinguish between "who we are mad at and who we are afraid of. ... I promise you the way to get out of this mess is not to over-criminalize addiction and mental illness."

Tilley said "The solution is right before our eyes," using for treatment some of the billions of dollars now used to incarcerate drug users.

Tim Feeley, deputy secretary for the CHFS and a former legislator from Oldham County, agreed: "We are not going to incarcerate our way out of this." He said the state needs more treatment programs and said the cabinet was fully committed to addressing the state's addiction problems to the best of its abilities.

William Hacker
Kentucky has moved away from treating mental health and substance abuse issues criminally, said Dr. William Hacker, chair of Shaping Our Appalachian Region's Health and Wellness Advisory Committee and former state health commissioner. He said other successful anti-drug efforts include grassroots advocacy groups, the online prescription-drug tracking program, needle-exchange programs, a move toward medication assisted treatments for opioid addiction, and the SMARTS initiative, which provides addiction care for pregnant and parenting women for up to two years.

Hacker also mentioned Operation UNITE, a Kentucky non-profit created by U.S. Rep. Hal Rogers that leads education, treatment and law enforcement initiatives in 32 counties in Southern and Eastern Kentucky. UNITE has held a national drug abuse conferences for the past five years, with this year's summit in Atlanta including President Barack Obama. The acronym stands for Unlawful Narcotics Investigations, Treatment and Education.

A former pediatrician in Corbin, Hacker also noted that SOAR recently held a Substance Abuse Roundtable to discuss research and emerging opportunities associated with substance abuse and intravenous drug use in Appalachian Kentucky. He said SOAR works to create a network across the region to share best practices and money opportunities and to create community level empowerment.

"Substance abuse is not a failure of moral character, it is a disease," Hacker said. "Don't give up. Never give up."

At the end of the meeting, the attendees broke into groups that represented schools, community leaders, health-care professionals, parents and the faith community to discuss what actions they could take to address opioid abuse in their communities.

Most groups reported that lack of access to substance abuse and mental health treatment is a barrier in their communities. And while it was noted that some communities offer more services than others, several groups said they did not have enough counselors to support medication-assisted therapies or enough doctors willing to prescribe it. Lack of transportation was also mentioned as a barrier toward getting treatment in several groups.

Also, most groups said community members often aren't aware of the resources, so more community education is needed. They listed schools, churches and county Extension offices as possible sources of education, and noted that a community resource website would be helpful. They also said parents would benefit from a class to learn how to talk to their children about drugs.

The groups agreed that all sectors of the community were needed to combat substance abuse and suggested that drug prevention programs in each community should form coalitions to better use resources and information.

Monday, 18 April 2016

Princess Health and Women in small-town America aren't living as long as before; alcohol, drugs, food, housing, jobs, education, pollution to blame. Princessiccia

By Trudy Lieberman
Rural Health News Service

Those of us who grew up in small rural communities in the 1950s and '60s expected to have longer life spans than our parents.

The trends were in our favor. White women born in 1900 could expect to live, on average, just shy of 49 years; white men 46.6 years. Those were our grandparents and our neighbors. By 1950, life expectancy had climbed to 72 years for white women born that year and 66.5 for white men. By 2000, life expectancy was still increasing, with female babies expected to live to nearly 80 and males to almost 75.

America was on the rise, jobs were plentiful, antibiotics kept us from dying of strep throat, and polio vaccine kept us out of the iron lung. We thought things would only keep getting better. So I was dismayed to read a story in The Washington Post in April that blew holes in those childhood expectations.

The Post found �white women have been dying prematurely at higher rates since the turn of this century, passing away in their 30s, 40s, and 50s in a slow-motion crisis driven by decaying health in small town-America.�

That �small town America� was where I grew up. I contrasted the Post�s findings to the claims made by all those politicians who have told us we have the best health care in the world and who point to gobs of money lavished on the National Institutes of Health to find new cures and to hospitals promoting their latest imaging machines.

The Post found that since 2000, the health of all white women has declined, but the trend is most pronounced in rural areas. In 2000, for every 100,000 women in their late 40s living in rural areas, 228 died. Today it�s 296.

If the U.S. really has the best healthcare, why are women dying in their prime, reversing the gains we�ve made since I was a kid? After all, mortality rates are a key measure of the health of a nation�s population.

Post reporters found, however, that those dismal stats probably have less to do with health care � which we like to define today as the latest and greatest technology and insurance coverage albeit with high deductibles � and more to do with what health experts call �the social determinants of health,� such basics as food, housing, employment, air quality, and education.

Landmark studies examining the health of British civil servants who all had access to health insurance under Britain�s National Health Service have found over the years that those at the lowest job levels had worse health outcomes. Some of those outcomes were related to things like work climate and social influences outside work like stress and job uncertainty.

In its analysis, the Post found that the benefits of health interventions that increase longevity, things like taking drugs to lower cholesterol and the risk of heart disease, are being overwhelmed by increased opioid use, heavy drinking, smoking and obesity.

Some researchers have speculated that such destructive health behaviors may stem from people�s struggles to find jobs in small communities and the �dashed expectations� hypothesis. White people today are more pessimistic about their opportunities to advance in life than their parents and grandparents were. They are also more pessimistic than their black and Hispanic contemporaries.

A 42-year-old Bakersfield, California, woman who was addicted to painkillers for a decade explained it this way: �This can be a very stifling place. It�s culturally barren,� she said. There is no place where children can go and see what it�s like to be somewhere else, to be someone else. At first, the drugs are an escape from your problems, from this place, and then you�re trapped,� she told Post reporters.

I recently heard U.S. Surgeon General Dr. Vivek Murthy talk about his upcoming report on substance use. About 2.2 million people need help, he said, but only about one million are actually getting it. Murthy wants his report to have consequences as far reaching as the 1964 surgeon general�s report linking tobacco use to lung cancer. In 1964, Murthy noted, 42 percent of Americans smoked; today fewer than 17 percent do.

The Post story concludes that the lethal habits responsible for increasing mortality rates are cresting in small cities where the biggest manufacturer has moved overseas or in families broken by divorce or substance abuse or in the mind and body of someone doing poorly and just barely hanging on.

The Surgeon General has taken on an enormous task, but his efforts just might help the nation move its life expectancy trends back in the right direction.

What do you think is causing poor health in your community? Write to Trudy at trudy.lieberman@gmail.com.

Rural Health News Service is funded by a grant from The Commonwealth Fund and distributed by the Nebraska Press Association.

Thursday, 31 March 2016

Princess Health and Obama joins Rogers at National Rx Drug Abuse and Heroin Summit, says it's time to focus on treatment over incarceration. Princessiccia

By Melissa Patrick
Kentucky Health News

The fifth annual national summit on prescription drug abuse, started by U.S. Rep. Hal Rogers of Kentucky, was the largest, broadest and highest-profile yet.

A non-prescription drug was added to the title of the four-day event, making it the National Rx Drug Abuse and Heroin Summit. It drew more than 1,900 to Atlanta, including President Barack Obama, who joined an hour-long panel to talk about new ways to deal with a growing opioid and heroin epidemic.

U.S. Rep. Hal Rogers
"The rapid growth of this summit is truly a testament to the power of unity. Everyone here has one common goal - to save lives from the dark clenches of drug abuse," Rogers, a Republican from Somerset, said in a news release.

The summit was hosted by Operation UNITE, a Kentucky non-profit created by Rogers that leads education, treatment and law enforcement initiatives in 32 counties in Southern and Eastern Kentucky. The acronym stands for Unlawful Narcotics Investigations, Treatment and Education.

According to the federal Centers for Disease Control and Prevention, in the U.S. someone dies every 20 minutes from an opioid overdose and Kentucky has one of the nation's highest rates, with more than 1,000 deaths a year from it.

(On Monday, April 4, KET's "Kentucky Tonight" will have a report on the summit and a look back at the network's coverage of drug addiction issues. For a preview from host Bill Goodman, click here.)

The University of Kentucky and UK HealthCare, which helped sponsor the summit, sent a delegation of executive, clinical and research leaders, including President Eli Capilouto as one of the keynote presenters, according to a UK news release.

�Too many Kentucky families are too often confronted by the dark and painful scourge of prescription drug abuse and opioid addiction," Capilouto said. "It�s an epidemic that penetrates communities across the nation, both urban and rural, but has especially intractable roots in Appalachia and the regions served by the University of Kentucky.�

Obama opened his remarks on the panel by thanking Rogers,who is also co-chair of the Congressional Caucus on Prescription Drug Abuse, and UNITE, "the organization that has been carrying the laboring oar on this issue for many years now. We are very grateful to them."


Obama focused some of his comments on broadening access to medication-assisted treatments for addiction, most successfully with counseling and behavior therapy.

"What we do know is that there are steps that can be taken that will help people battle through addiction and get onto the other side, and right now that's under-resourced," the president said.

Obama's administration recently proposed doubling the number of patients a health-care provider can treat with buprenorphine, one of the drugs used to fight addiction, to 200 from 100.

He said the opioid and heroin epidemic is a public-health issue and not just a criminal-justice problem, which is the only way to reduce demand. "In this global economy of ours that the most important thing we can do is to reduce demand for drugs," he said.

Because the opioid and heroin epidemic is touching everybody and not just poor people and minorities, there is now more emphasis on treatment over incarceration, Obama said: "This is not something that's just restricted to a small set of communities. This is affecting everybody -- young, old, men, women, children, rural, urban, suburban."

The president also noted that there has been a significantly increase in opioid abuse in rural areas, which often suffer from an under-resourcing of treatment facilities and mental health services.

"And that's why, for all the good work that Congress is doing, it's not enough just to provide the architecture and the structure for more treatment. There has to be actual funding for the treatment," he said.

The president has proposed $1.1 billion in his upcoming fiscal year 2017 budget request to fund drug-treatment programs in counties all across the country.

Agriculture Secretary Tom Vilsack announced two rural initiatives at the summit: town hall meetings in rural areas hit hardest by drug abuse, including Appalachia, "to raise awareness of the issue and discuss possible solutions," and an extension of the Rural Health and Safety Education competitive grant program to include $1.4 million in grants that will now be available to rural communities to fight heroin and painkiller abuse, according to a press release.

The president also announced several other new initiatives: establishing a Mental Health and Substance Disorder Parity Task Force; implementing mental health and substance use disorder parity in Medicaid; releasing $11 million for the purchase and distribution of the opioid-overdose reversal drug, naloxone; expanding an initiative that improves local partnerships between law enforcement and public health; a $7 million investment for community policing to address heroin; and providing guidelines for the use of federal funds to implement or expand needle-exchange programs.

Friday, 26 June 2015

Princess Health and Half again as many Kentucky newborns were hospitalized for drug dependency last year as the year before.Princessiccia

Mother Samantha Adams and her newborn Leopoldo Bautista,
10 days old, spend quality time inside the Louisville Norton
Healthcare
child care center for children experiencing drug
withdrawal. (Photo by Alton Strupp, The Courier-Journal)
Increasing drug abuse drove up hospitalizations of drug-dependent newborns in Kentucky by 48 percent last year, to 1,409 from 955 in 2013. "The latest numbers represent a 50-fold increase from only 28 hospitalizations in 2000," reports Laura Ungar of The Courier-Journal.

"The seemingly never-ending increase every year is so frustrating to see," Van Ingram, executive director of the state Office of Drug Control Policy, told Ungar. "It's a horrible thing to spend the first days of your life in agony."

"These infants are born into suffering," Ungar writes. "They cry piercingly and often. They suffer vomiting, diarrhea, feeding difficulties, low-grade fevers, seizures � and even respiratory distress if they're born prematurely."

Drug-dependent newborns are becoming more common nationwide, Ungar notes, but "Vanderbilt University researchers publishing in the Journal of Perinatology [a subspecialty of obstetrics concerned with the care of the fetus and complicated, high-risk pregnancies] say rates are highest in a region encompassing Tennessee, Mississippi, Alabama and Kentucky."

While the increase is blamed mostly on illegal drug use, the Vanderbilt study found that 28 percent of pregnant Medicaid recipients in Tennessee filled at least one painkiller prescription, Ungar writes: "Legitimate use not only raises the risk of having a drug-dependent baby, it can sometimes lead to abuse and addiction."

While Medicaid now pays for behavioral-health and substance-abuse treatment, "Drug treatment for pregnant women is sorely lacking," Ungar reports. In Kentucky, only 71 of the 286 treatment facilities listed by the U.S. Substance Abuse and Mental Health Services Administration treat pregnant women.