Showing posts with label heroin. Show all posts
Showing posts with label heroin. 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."

Tuesday, 7 June 2016

Princess Health and  Kentuckians agree regionally on tobacco controls; poll shows wide differences among regions in impact of drug abuse. Princessiccia

Princess Health and Kentuckians agree regionally on tobacco controls; poll shows wide differences among regions in impact of drug abuse. Princessiccia

By Al Cross
Kentucky Health News

In a state that once had more tobacco farms than any other, Kentuckians in all regions of the state support policies that discourage use of the product, according to the Kentucky Health Issues Poll.

"Such policies could greatly improve Kentucky's overall health," says the Foundation for a Healthy Kentucky, which co-sponsors the poll each fall. It issued a package of reports that broke down a wife range of previously reported poll results on a regional basis.

Kentucky has fewer than 5,000 tobacco farms, down from a high of 60,000 in 1982, but still has one of the nation's highest smoking rates, 26 percent. That leads to an estimated $2 billion in annual health-care costs.

In every region of the state, a majority (ranging from 59 to 70 percent) of people polled said it would be "difficult" or "very difficult" to make the most important change in their personal health behavior, which for most smokers would be to stop smoking.

"Kentucky adults in every region recognize that improving diet, getting more exercise and quitting smoking could help improve personal health, but the changes are difficult," said Susan Zepeda, president and CEO of the foundation. "Policies around these areas could help all Kentuckians improve their personal health."

The policy getting the strongest support in the poll was tobacco-free school campuses, favored by 85 percent statewide. Fewer than a third of Kentucky's school districts have such policies, but enough do to cover almost half the population.

A statewide ban on smoking in workplaces got 66 percent support. Such a ban is unlikely during the administration of Gov. Matt Bevin, who says the issue should be decided locally. About a third of the state's population lives in jurisdictions with comprehensive smoke-free ordinances; another 10 percent or so live in places that have ordinances with varying exceptions.

There was little difference among the five regions in polling on the two issues.

The poll found regional differences in the percentage of Kentucky adults who said they had no insurance, from 18 percent in Western Kentucky to 8 percent in Eastern Kentucky. The statewide uninsured rate reported at the time of the poll was 13 percent. Other surveys have showed the number in the single digits statewide, after expansion of the Medicaid program under federal health reform.

Health reform also provided subsidies for buying insurance, but some consumers have complained about high deductibles and co-payments. In Northern Kentucky, 34 percent of poll respondents said they had difficulties paying their medical bills in the previous 12 months. The figure was 31 percent in Appalachian Kentucky, 30 percent in Greater Louisville, 25 percent in Western Kentucky, and 22 percent in Greater Lexington.

"An increasing number of Kentuckians have health insurance, but many are still delaying or simply can't afford necessary health care," Zepeda said.

Federal health reform was most popular in the Louisville area, at 44 percent support, and least popular in Northern Kentucky, with 33 percent. Generally, the more impact people said reform had on them, the more likely they were to support it. Three of five Northern Kentuckians said they had not been affected by the reforms but only 45 percent in the Louisville area said that.

There are bigger differences in the impact of drug abuse. One-third of Eastern Kentucky residents in the poll reported reported family members or friends struggling with prescription drug abuse, but only 16 percent in Western Kentucky said so.

Heroin use has caused problems for 35 percent of respondents' families and friends in Northern Kentucky, 17 percent in Greater Louisville, 14 percent in Greater Lexington, 10 percent in Eastern Kentucky, and 8 percent in Western Kentucky.

The regional reports for Eastern KentuckyGreater LexingtonGreater LouisvilleNorthern Kentucky, and Western Kentucky, and associated news releases, are available at http://healthy-ky.org/news-events/press-releases.

The poll was conducted Sept. 17 through Oct. 7 by the Institute for Policy Research at the University of Cincinnati. A random sample of 1,608 adults from throughout Kentucky was interviewed by landlines and cell phones. The statewide poll has a margin of error of plus or minus 2.4 percentage points, but the smaller regional samples have higher error margins. The complete data file, codebook and survey instrument will be posted by June 30 at http://www.oasisdataarchive.org/ with other data files from previous polls.

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 Justice secretary, drug-policy chief and ex-health boss back needle exchanges but 'political rhetoric' can trump science. Princessiccia

By Melissa Patrick
Kentucky Health News

CORBIN, Ky. � Local officials and legislators continue to debate and sometimes reject needle exchanges, but two state officials and a former state health commissioner voiced their strong support of them at a pubic forum May 17 in Corbin.

Dr. William Hacker:
"Needle exchanges work."
"Needle exchanges work," said Dr. William Hacker, chair of Shaping Our Appalachian Region's Health and Wellness Advisory Committee and former state health commissioner. "We would, as a public health role, encourage them to be extended."

Hacker spoke at the "Cumberland River Forum on Opioid Use Disorders: A Time for Community Change," one of three public forums on the subject in Kentucky in May.

The General Assembly authorized needle exchanges in the 2015 anti-heroin bill, as a way to decrease the spread of HIV and hepatitis C, which are commonly spread by the sharing of needles among intravenous drug users. They require both local approval and funding.

Kentucky's rate of hepatitis C is the highest in the nation, and a recent federal Centers for Disease Control and Prevention report said that of the 200 counties in the nation that are most susceptible to a hepatitis C or HIV outbreak, 54 of them are in Kentucky.

So far, only 14 counties in Kentucky have either approved or are operating needle exchanges: Jefferson, Fayette, Jessamine, Franklin, Clark, Kenton, Grant, Harrison, Pendleton, Carter, Boyd, Elliott, Pike and Knox.

Justice Secretary John Tilley:
"Real facts and real science"
Justice Secretary John Tilley, who was instrumental in getting the heroin bill passed when he was a state representative from Hopkinsville, encouraged communities to look at the evidence-based research that supports needle-exchange programs and to not listen to the political rhetoric.

"We've got to push aside this political rhetoric on topics like this one and talk about real facts and real science," he said. "These programs have been validated by meta-analysis. ... Those who seek out a needle exchange are five times more likely to enter treatment. These programs continue to beat back blood-borne illnesses like hepatitis C and HIV, at rates we cannot duplicate without these programs. They are universally successful at what they do."

Tilley said after the meeting that addiction is a chronic disease and should be treated as a public-health crisis, noting that other diseases are treated based on science and medicine, not opinion.

"When you go to the doctor, you don't ask him his political view of a particular health program," he said. "Well, this is no different. And for me to substitute my judgment for the science is dangerous."

Van Ingram changed his mind
Van Ingram, executive director of the Governor's Office of Drug Control Policy, said his opinion about needle exchanges changed after he researched them and learned how effective they are at decreasing the spread of hepatitis C and HIV. He also noted that these programs provide testing and treatment referral for these infectious diseases, and also help participants get treatment.

"Eleven years ago I left law enforcement, and if you had told me that I would end up being the poster boy for syringe exchange, I would have said you were crazy," he said. "But quite honestly, they do work."

Ingram also noted the CDC study and reminded the audience of the "enormous" HIV outbreak that occurred last year in Scott County, Indiana, 30 miles north of Louisville.

"So if a syringe exchange can keep us from having a rapid HIV outbreak, I think that is probably a good trade-off," Ingram said.

But evidence-based research isn't always enough to convince policy makers that needle exchange programs don't condone or perpetuate drug use.

The Georgetown newspaper answered its
question in its story. The answer is yes.
Last week it was reported that two Kentucky counties decided against needle exchanges. Boone County's Fiscal Court silently said no to a needle exchange by refusing to call up a resolution to support one, Mark Hansel reported for NKyTribune. And the Scott County Fiscal Court voted 5-3 against one, Dan Adkins reported for the Georgetown News-Graphic. Adkins followed up with a featured front-page story about the county's heroin problem.

A point of contention among Republicans in the General Assembly is that some of the exchanges don't require a needle-for-needle exchange, which they say was their intent.

Then-Attorney General Jack Conway said Dec. 18 that needle exchanges did not have to be one-for-one. It is also widely accepted that not requiring one-for-one is considered a best practice across the country to prevent the spread of HIV and hepatitis C and to stop intravenous drug users from sharing and reusing needles, Dr. Sarah Moyer, the interim director of the Louisville Metro Department of Public Health and Wellness, told Kentucky Health News in March.

Last session, as the Senate voted to amend House Bill 160 to require one-to-one exchanges, Senate Republican Floor Leader Damon Thayer of Georgetown threatened to file a bill to eliminate them altogether next session if they don't make this change during the upcoming year.

In its original form, HB 160 was a bill to educate the public about how to safely dispose of hypodermic needles in order to keep them out of landfills. The House let the bill die without another vote.

Tilley said after the meeting, "Culture and change takes a while," and noted that while he respected his colleagues differing opinions, he said it is likely that this topic is not in their "wheelhouse."

"So, I think the more they learn the more they will come along," he said. "What we should do is all come back to the table and talk about how the programs that are now in place in Kentucky are working and how the reliance on science and evidence based policy makes them work."
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.

Friday, 6 May 2016

Princess Health and  Three more Kentucky counties get needle exchanges; several others discussing, some debating; most are in early stages. Princessiccia

Princess Health and Three more Kentucky counties get needle exchanges; several others discussing, some debating; most are in early stages. Princessiccia

By Melissa Patrick
Kentucky Health News

Harrison, Pike and Knox counties are the latest in Kentucky to approve a needle-exchange program, bringing the total number of counties to 14, and several more are getting close.

Needle exchanges were authorized by the 2015 anti-heroin bill in an effort to decrease the spread of HIV and hepatitis C, which are commonly spread by the sharing of needles among intravenous drug users. They require both local approval and funding.

The other counties that have either approved or are operating needle exchanges are Jefferson, Fayette, Pendleton, Carter, Grant, Jessamine, Franklin, Clark, Boyd, Kenton and Elliott.

Campbell County close, could have domino effect

The Campbell County Fiscal Court voted 3-1 May 4 to approve a needle exchange and now awaits the support of the City of Newport, Mark Collier of Fort Thomas Matters reports for WCPO-TV, its news partner.

If approved, the exchange will be be operated by the Northern Kentucky Health Department and paid for by a grant from the R.C. Durr Foundation. It also has a a sunset provision that would make it expire Dec. 31, 2018.

Commissioner Charlie Coleman, the only dissenter, said he opposed the exchange because Campbell County residents told him "overwhelmingly" that they didn't want one, Collier reports. He was also not comfortable with the proposed location in the Fiscal Court building.

While Kenton County has approved a mobile needle exchange and the City of Covington has also approved one, both programs are contingent on Boone or Campbell counties to join the effort.

The Fort Mitchell City Council passed a resolution April 18 supporting a needle exchange, making it the second Kenton County city to do so. Independence passed a similar resolution earlier this year, Melissa Stewart reports for The Cincinnati Enquirer.

Some counties in very early stages

The Whitley County Board of Health has unanimously voted in support of a needle exchange program, Mark White reports for the Corbin-Whitley News Journal. The county health department and the Whitley County UNITE Coalition, which works toward reversing the country's opioid epidemic, have held a public meeting to discuss the topic.

Mercer County will hold a community forum May 16 from 6 to 8 p.m. at the county Extension office to discuss a needle exchange, Kendra Peek reports for The Advocate-Messenger in Danville. Their program has been prompted by reports of two people stuck by discarded needles in public places in the county. County Judge Executive Milward Dedman told Peek he was "leaning in favor of it."

Nelson County is also considering a needle exchange, Randy Patrick reports for The Kentucky Standard in Bardstown. The public-health director for the Lincoln Trail District Health Department, Sara Jo Best, gave a presentation in support of the program April 19 at the Nelson County Fiscal Court meeting.

The Laurel County Board of Health is considering a needle exchange and will further discuss it at its June 9 meeting, Kelly McKinney reports for The Sentinel-Echo.

Ben Carlson of The Anderson News recently told what now reads like a familiar story about the exchange that occurs in an early needle exchange educational meetings. The Anderson County Health Department held such a meeting April 25.

At the meeting, health officials shared research showing that needle exchanges decrease the rates of HIV and hepatitis C caused by shared needle use; do not increase drug use; help connect users with counseling and treatment; and get dirty needles off the street.

It also included complaints from opponents who say that needle exchanges are "tacit approval of IV drug abuse." The foes included peace officers.

�The sheriff and I have over six decades of law-enforcement experience combined, and we�ve used those to teach children about the dangers of drugs,� said Chief Deputy Sheriff Joe Milam. �We�re not going to say don�t use drugs, but if you do, use this. We are not in favor of this.�

Exchanges get use, award

Lexington's needle exchange program is adding on-site referrals to rehabilitation programs to its needle exchange, which has been operating since September, reports the Lexington Herald-Leader. Since its opening, the program has received 10,297 used needles and given out 10,803 clean ones.

The Little Sandy District Health Department, which runs needle exchanges in Olive Hill and Grayson, recently received the Kentucky Public Health Association Commissioner's Award for its needle exchange. Since Feb. 4, more than 500 dirty needles have been exchanged in both Carter County locations, Joe Lewis reports for the local weekly, the Journal-Times.

Tuesday, 26 April 2016

Princess Health and More than 100 at SOAR Substance Abuse Roundtable committed to work on prevention and treatment efforts in region. Princessiccia

By Melissa Patrick
Kentucky Health News

More than 100 people attended the Shaping Our Appalachian Region Substance Abuse Roundtable April 7 to learn about current research and emerging opportunities associated with substance abuse and intravenous drug use in region, according to a SOAR news release.

SOAR is a bipartisan effort to revitalize and diversify the economy in Kentucky's 54 Appalachian counties. It has advisory councils for each of its 10 areas of focus, one of which is community health and wellness.

That council's chair, former state health commissioner Dr. William Hacker, facilitated the roundtable at Natural Bridge State Resort Park.

As part of the solutions-driven discussion, Susan Zepeda, CEO of the Foundation for a Healthy Kentucky, told the attendees that it is important to ask the right questions when gathering information about drug abuse to accurately depict what is going on in the region.

�When you ask people if they have a problem with prescription drugs they, of course, say no,� Zepeda said. �When you ask them if they know someone, like a family member or friend, that answer is very different.�

The group also discussed the importance of getting accurate data about substance abuse and overdose into the right hands to make progress on these issues.

�We want to get data into the hands of legislators and those who can do something about prescription-drug overdose,� said Dana Quesinberry, public-health-policy and program evaluator for the Kentucky Injury Prevention and Research Center at the University of Kentucky. �Sitting in a repository, it doesn�t do anything for anyone.�

The roundtable members also discussed needle-exchange programs, authorized under the state's 2015 anti-heroin law. The program is meant to slow the spread of HIV and hepatis C, which are commonly spread by sharing of needles among intravenous drug users.

�We�ve seen a switch from using pills as an opioid to using intravenous methods,� said Greg Lee, the HIV/AIDS continuing-education program director for the state Cabinet for Health and Family Services.

Clark County Health Director Scott Lockard said the federal Centers for Disease Control and Prevention issued a "wake-up call" with its report identifying 54 Kentucky counties as being among the 220 most vulnerable in the nation for the rapid spread of HIV and hepatitis C infection among intravenous drug users. Most of the counties, and eight of the top 10, were Appalachian.

"We are potentially on the leading edge of one of the biggest public health crises to hit our state," Lockard said in an e-mail to Kentucky Health News. "It will take a combined effort across sectors to prevent an HIV outbreak in the SOAR region such as the one that occurred in Scott County, Indiana," just north of Louisville.

Although many Kentucky county officials are talking about needle-exchange programs, so far only Louisville and Lexington and the counties of Boyd, Carter, Clark, Elliott, Franklin, Grant, Harrison, Jessamine, Knox, Pendleton and Pike are either operating or have approved such programs. Of these, Boyd, Carter, Clark, Elliott, Knox and Pike are part of SOAR.

The news release noted that participants left the discussion with a commitment to continue the conversation and to build a strategic plan to address substance abuse issues in the region, with a focus on clinical practices, health systems, drug screenings and other best practices.

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.

Princess Health and  Kenton County's approval of a needle exchange inches Northern Kentucky, hit the hardest by heroin, toward getting one. Princessiccia

Princess Health and Kenton County's approval of a needle exchange inches Northern Kentucky, hit the hardest by heroin, toward getting one. Princessiccia

The Kenton County Fiscal Court unanimously approved a mobile needle exchange program March 29, which moves the City of Covington's needle exchange program one step closer to fruition, Terry DeMio reports for the Cincinnati Enquirer.

The Fiscal Court's approval was one of several conditions required by the City of Covington to allow its exchange to move forward. Covington's plan also requires two other counties in the Northern Kentucky Health District to adopt exchanges (only Grant County has); limits access to only resident's of the district's four counties; and would move the exchange to St. Elizabeth Healthcare hospital.

In addition, it requires a one-for-one needle exchange and a mandate that all participants must be tested for hepatitis C, hepatitis B, HIV, and, where applicable, pregnancy. This condition is likely not legal and is being investigated by the Northern Kentucky's Health Board's legal counsel, DeMio reports.

Kenton County's plan differs from Covington's in that it mandates only the offering of these tests, DeMio reports.

Both plans will require the Kenton County Board of Health's approval.

Needle-exchange programs were authorized by the state anti-heroin law passed in 2015, and require both local approval and funding. They are meant to slow the spread of HIV and hepatitis C, which are commonly spread by the sharing of needles among intravenous drug users. Northern Kentucky has been hit the hardest in the state by heroin and its hepatitis C rates have been reported at 19 times the national rate.

The needle exchange would be funded by $250,000 from the R.C. Durr Foundation, and the health department would use its staff and already available testing to further pay for the exchange, DeMio reports.

The Fiscal Court also approved exploring the idea of building a community-wide addiction treatment center on the county jail grounds; putting $25,000 toward a heroin helpline; and approved a resolution to encourage the Northern Kentucky Board of Health to create a high-quality prevention and education program for the community.

The Northern Kentucky Area Development District has already put out proposals for the heroin helpline, DeMio notes. And County Judge-Executive Kris Knochelmann told him that Boone and Campbell counties were willing to consider putting $25,000 each toward it, and that St. Elizabeth had promised $75,000 toward its operation.

The other needle exchanges in the state that are either operating or have been approved are in Louisville and Lexington and in the counties of Pendleton, Carter, Elliott, Franklin, Grant and Jessamine.

Friday, 25 March 2016

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

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."

Tuesday, 15 March 2016

Princess Health and Kentucky ranks fourth nationally in painkiller prescriptions; CDC proposal would limit prescription strength and amount. Princessiccia

Kentucky has the nation's fourth highest rate of painkiller prescriptions, at about 130 prescriptions for every 100 people, Christine Vestal reports for Stateline. The high rate of painkiller prescriptions is being blamed on a rising rate of overdose deaths, leading health and government officials in many states to call for a limit on the number and strength of painkiller pills prescribed by doctors. (Stateline graphic)
"The U.S. Centers for Disease Control and Prevention is close to taking the unprecedented step of issuing national guidelines to curb liberal opioid prescribing practices widely blamed as the cause of the epidemic," Vestal writes. "CDC�s draft proposal urges primary care doctors to try drug-free methods to relieve chronic pain, such as exercise, weight loss and physical therapy, as well as non-opioid pain relievers such as acetaminophen and ibuprofen, before resorting to powerful opioid pills. If opioids are needed, the guidelines recommend starting with the smallest effective dose of immediate-release opioids, avoiding more dangerous time-release formulations except when needed." (Stateline graphic)
"Democratic and Republican governors unanimously support the CDC initiative and have pledged to promote the voluntary physician guidelines in their states," Vestal writes. "But the American Medical Association and pain organizations backed by drugmakers are complaining the initiative could make it difficult for chronic pain sufferers to get the pills they need."

Last week the U.S. Department of Health and Human Services announced that five Kentucky clinics�in Richmond, Louisville, Burkesville, Mount Sterling and Whitesburg�would receive $1.8 million to fight addiction to heroin and painkillers, Curtis Tate reports for McClatchy Newspapers. "According to the Kentucky Office of Drug Control Policy, 1,087 Kentucky residents died of overdoses in 2014, including 204 in Jefferson County and 112 in Fayette County. HHS estimates that overdose deaths from prescription pain medications quadrupled from 1999 to 2013 and that deaths related to heroin increased 39 percent from 2012 to 2013."

Saturday, 20 June 2015

Princess Health and Biotech firm buys UK professor's anti-overdose nasal spray.Princessiccia

Princess Health and Biotech firm buys UK professor's anti-overdose nasal spray.Princessiccia

Pharmacy Professor Daniel Wermeling at the University of Kentucky invented a nasal spray to fight heroin overdoses, and a biotech firm has bought the product, which may be on the market within six months, pending approval by the U.S. Food and Drug Administration. The device "contains a single dose of a mist form of naloxone and delivers the drug in a way similar to how Flonase is used to treat allergies," Mary Meehan reports for the Lexington Herald-Leader.

The product is on a fast track for approval because of the rising rates of heroin overdoses across the country, said UK Provost Tim Tracy, former dean of UK's pharmacy school. Wermeling doesn't know exactly when his product will be on the market, but he said the FDA approved another fast-track, anti-overdose therapy after only 14 weeks. The fast-track program speeds development of drugs to treat serious or life-threatening conditions. "Last year, 233 people [in Kentucky] died with heroin in their systems, according to the state medical examiner's office," Meehan notes.

Wermeling has been developing the project at UK since 2009 with the help of more than $5 million in federal and state tax dollars. Tracy said Indivior PLC, the spinoff pharmaceutical company that bought the nasal spray, will be able to manufacture, market and distribute the product. Right now, emergency responders and hospitals must draw naloxone, branded as Narcan, in a syringe to provide the correct dose.

Friday, 12 June 2015

Princess Health and Louisville opens first needle exchange in state; officials predict rural counties will be slow to follow.Princessiccia

Photo by Scott Utterback, The Courier-Journal
Louisville Metro Public Health & Wellness opened its mobile needle-exchange program Wednesday, June 10, making Louisville the first place in Kentucky to implement such a program.

Lexington and Northern Kentucky are expected to follow soon, but officials say that establishing needle exchanges in much of Kentucky will be "more politically complex," Mike Wynn reports for The Courier-Journal.

"We're going to see some parts of our state where this is available and others where it is not," Scott Lockard, president of the Kentucky Health Departments Association, told Wynn. "Rural areas are opting for a slow and deliberate approach, heavy on education and dialogue," he said, and some communities won't even consider a exchange because of "seemingly endless hoops to jump through."

Bullitt County, south of Louisville, is a prime example. There, officials told Wynn that they plan to do a needs assessment and host a community forum with input from law enforcement and mental health experts.

"It's a work in progress," Public Health Director Andrea Renfrow told Wynn. "We are not able to go as quickly as Louisville Metro."

One critic, Magistrate Joe Laswell, told Wynn that he had talked to many voters who are against the exchanges and want to know why police wouldn't arrest addicts when they show up to swap out dirty needles. "I believe in charging and incarcerating," he said, apparently unaware that the addicts would need to have drugs in their possession to be charged.

Lockard, who heads the Clark County Health Department, told Wynn that he won't ask his board to take a vote until August and that he can't predict the political outcome when it goes to city and county officials.

In three other Bluegrass counties, Scott, Harrison and Nicholas, the board of the Wedco District Health Department wants to start a needle exchange, reports The Cynthiana Democrat, but can't proceed in any of the counties without approval of the fiscal court.

So, despite the two-year debate that just ended in Frankfort over the law, it's not really over.

Democratic state Rep. John Tilley of Hopkinsville, the legislature's biggest proponent for needle exchanges, told Wynn that giving city councils and fiscal courts final authority over the programs was necessary to sooth critics and pass a comprehensive heroin bill this year.

Opponents of the law say the exchanges promote drug use, while proponents cite evidence that doesn't support those claims, but instead "help prevent the spread of deadly and expensive diseases and pull addicts into treatment programs while keeping dirty needles out of parks and off the streets," Wynn writes.

A Lexington Herald-Leader editorial wrote about needle exchanges: "Congressional critics rely on a gut feeling that providing needles endorses drug use, but 20 years of research argues otherwise." Listing that where there are syringe exchange programs:
  • Participants are five times more likely to get treatment.
  • HIV and hepatitis C declines among drug users.
  • Participants can get referrals to substance abuse treatment, disease prevention education, vaccinations, condoms, counseling and testing for communicable diseases.
  • Costs are more than recaptured. A 2011 European study found that $1 spent on needle-exchange programs yielded $27 in health-care cost savings, prompting an international report to call needle exchanges "one of the most cost-effective public health interventions ever funded."
The federal Centers for Disease Control and Prevention recently reported that new cases of hepatitis C more than tripled in Kentucky, Tennessee, Virginia and West Virginia between 2006 and 2012, mainly from the use of dirty needles. Officials fear an outbreak of HIV and AIDS will follow.

Thursday, 28 May 2015

Princess Health and Free overdose-reversal kits are given to Kentucky hospitals with the highest recent rates of heroin-overdose deaths.Princessiccia

Princess Health and Free overdose-reversal kits are given to Kentucky hospitals with the highest recent rates of heroin-overdose deaths.Princessiccia

Kentucky hospitals with the highest rates of heroin overdose deaths are receiving funding for heroin/opiate overdose reversal kits, which will be provided free of charge to every treated and discharged overdose victim at the pilot project hospitals, according to a state press release.

The funding for these kits is through the Substance Abuse Treatment Advisory Committee, which oversees the distribution of a $32 million pharmaceutical settlement fund that is used to expand treatment in Kentucky. The committee has allocated $105,000 to purchase these kits for the pilot hospitals: the University of Louisville Hospital, the University of Kentucky Medical Center in Lexington, and the St. Elizabeth Healthcare in Northern Kentucky.

In 2013, 230 Kentuckians died from heroin overdoses. Final numbers for heroin overdoses in 2014 are not yet available, but the Office of Drug Control Policy estimates heroin was involved in 30 percent of all drug-overdose deaths, according to the release.

Attorney General Jack Conway chairs the committee and First Lady Jane Beshear serves on it. They announced recently that about 500 of these kits will be made available to the St. Elizabeth system, which treated 545 people in 2013 and 745 people in 2014 for heroin overdoses.

�There is evidence the collaborative efforts in our community are having an effect,� St. Elizabeth interim president and CEO Garren Colvin said in the release. �A report earlier this month indicated that heroin-related overdose deaths are down in Northern Kentucky. ... To continue to battle heroin issues in our community and throughout Kentucky, it is going to take education and collaboration at the local and state levels.�

Naloxone, which is also known as Narcan, is the drug in the free Naloxone Rescue kits and "has no potential for abuse and immediately reverses the effects of heroin overdose by physiologically blocking the effects of opiates," says the release.

One of the challenges for access to these kits is that they are not covered by Medicaid or many private insurance companies and are too expensive for most people to purchase. Health experts anticipate that when the U.S. Food and Drug Administration approves the nasal mist form of the drug, most insurance companies and Medicaid will cover it.

�As Kentuckians expand access to mental health treatment, including addiction recovery, it�s more important than ever to have community access to tools like Narcan,� Jane Beshear said in the release. �Often, an overdose experience is what finally drives people suffering from addiction to seek help.�

Sunday, 24 May 2015

Princess Health and State health commissioner backs needle exchanges, most controversial part of anti-heroin legislation passed this year.Princessiccia

The Kentucky General Assembly cracked down in 2012 on "pill mills" that dispense painkillers irresponsibly, and addicts responded by going for heroin, creating a big problem in much of the state. The 2015 legislature passed laws to crack down on heroin, including local needle-exchange programs, the most controversial feature of the package.

In a column distributed to Kentucky newspapers, state Health Commissioner Stephanie Mayfield defends and promotes the local programs, which are subject to local approval.

�To some, a needle exchange may sound like a program that helps intravenous drug users feed their habit,� Mayfield writes. �To the contrary, the intent of an NEP is to protect public health and create a path for heroin users to get treatment while preventing the spread of diseases through the sharing of needles.

Needle exchanges reduce the number of HIV/AIDS and hepatitis cases in a community, Mayfield writes. "The use or even the accidental stick of a dirty needle can lead to hepatitis, HIV/AIDS infection and other dangerous diseases. . . . About 15 percent of all HIV cases that have occurred in Kentucky have been among injecting drug users."

Stephanie M. Gibson
Mayfield also says needle exchanges protecting people from accidental sticks from dirty needles discarded in public places. "Intravenous drug users submit dirty needles to the NEP for proper disposal in exchange for clean needles," she writes. "Researchers have also found that injecting drug users who participated in an exchange were more likely to reduce or stop injecting than drug users who had not participated in a needle exchange."

Research has also shown that needle exchanges "do not encourage the initiation of drug use nor do they increase the frequency of drug use among current users," Mayfield writes, noting that there are 203 such programs in 34 states.

"The presence of NEPs in communities does not expand drug-related networks nor does it increase crime rates. . . . Needle exchange programs actually create a path for injecting drug users to get help because the programs offer information on how to find available treatment options. In fact, NEP participants are more likely to enter a drug treatment program than nonparticipants."

More recent studies show that needle exchanges "provide opportunities for disease testing and education leading to a decline of at-risk behaviors, resulting in HIV incidence dropping as much as 80 percent within this population," Mayfield writes. "Many Kentucky communities are desperate for the ability to reach out to members who suffer from addiction, to help slow the spread of diseases and provide treatment referrals to people they might otherwise never have the chance to reach. This law gives them that opportunity."

Saturday, 23 May 2015

Princess Health and Congress is taking on opoid abuse and the nationwide increase in drug overdoses.Princessiccia

Princess Health and Congress is taking on opoid abuse and the nationwide increase in drug overdoses.Princessiccia

Federal officials have become increasingly concerned about the rapid increase in drug overdoses across the country. The House Energy and Commerce Committee, in a series of hearings on the topic, is looking at how states are dealing with this problem. The next meeting is scheduled Thursday, May 28.

Senate Majority Leader Mitch McConnell and Sen. Ed Markey of Massachusetts, in a bipartisian effort, wrote a letter to Department of Health and Human Services Secretary Sylvia Mathews Burwell this week, asking her to call on the surgeon general to address opoid abuse and made a request for more information regarding its recently announced initiative to reduce opoid-related deaths and addictions, according to a press release.
.
"This crisis of opioid related overdoses strikes without regard to geography, age, race, or socio-economic status and it requires an immediate and sustained response," McConnell said in a statement, calling opioid abuse a "public health crisis."

In the final hours of the last legislative session, Kentucky passed a bipartisan heroin bill that included an emergency clause for it to take effect immediately. This new law allows judicial discretion to determine if low-level traffickers should go to jail or be ordered to treatment; stronger sentencing for high-volume dealers; increased money for treatment; optional needle exchange programs; a "good Samaritan" provision; and increased access to Naloxone, a drug that can reverse the effects of an overdose.

Opoid-related overdose deaths are largely caused by prescription drug and heroin.

In Kentucky, of the 722 deaths autopsied in 2013, 230, or 32 percent, were attributed to heroin, compared to 143, or 20 percent in 2012, according to the 2013 Overdose Fatality Report.

Nationwide, the death rate from painkiller overdoses nearly quadrupled between 1999 and 2013 and heroin related deaths increased by 39 percent and the number of Americans seeking treatment for painkiller addiction has increased by 900 percent since 1997, according to the release.

Indiana's health commissioner, Jerome Adams, is scheduled to speak at Thursday's House committee meeting to discuss the state's recent HIV and hepatitis C outbreaks, which is tied to needle sharing among drug users. Adams will discuss the state's needle exchange programs, which was put in place to help combat this problem.

Saturday, 28 March 2015

Princess Health andNew health-related laws deal with heroin, dating violence, end-of-life care, prescriptions, colon-cancer and newborn screening.Princessiccia

Princess Health andNew health-related laws deal with heroin, dating violence, end-of-life care, prescriptions, colon-cancer and newborn screening.Princessiccia

By Melissa Patrick
Kentucky Health News

FRANKFORT, Ky. � The Kentucky General Assembly passed several health-related bills this session, including high-profile measures on heroin and dating violence. It did not pass many others, including one that would have a great influence on the state's health: a statewide smoking ban, which passed the House for the first time ever, but never got out of an unfavorable committee in the Senate. Here's a roundup:

Heroin: Kentucky's heroin-overdose epidemic was caused partly by a 2012 legislative crackdown on prescription painkillers, which steered users to the illegal drug. Last year's bill died because of deadlock over sentences for traffickers and needle-exchange programs for addicts, and Gov. Steve Beshear and legislators gave this year's bill top priority. It was not finally negotiated until a few hours before passage, but Beshear signed Senate Bill 192 into law less than 12 hours after it passed so that its emergency clause could put it into effect immediately.

SB 192 includes both a needle-exchange program and harsher penalties against traffickers, the main points of contention between the House and Senate, but requires local governments to approve needle exchanges and allows judges to be lenient in sentencing addicts, to help them get treatment. It allocates money for drug-treatment programs, allows increased access to Naloxone, a drug that reverses the effects of an overdose, and allows jailers to provide medically assisted treatment for inmates with opiate addiction.

Dating violence: After 10 years of lobbying and debate, the dating violence bill will allow dating partners to get interpersonal protective orders from a judge if they have been the victim of dating violence, sexual abuse or stalking. This year's bill largely dissolved social conservatives' opposition by creating a new chapter in the law for dating violence, with the same protections as the domestic-violence law. Kentucky is the last state to offer protection to dating-violence victims. House Bill 8 was sponsored by Rep. John Tilley, D-Hopkinsville, who also sponsored the House heroin bill.

Beshear has signed these bills into law:

Prescription synchronization: SB 44, sponsored by Sen. Julie Raque Adams,R -Louisville, will allow patients with multiple prescriptions, in consultation with their health-care provider and their pharmacist, to synchronize prescriptions so that they may be picked up at the same time.

Medical order scope of treatment: SB 77, sponsored by Sen. Tom Buford, R-Nicholasville. will create a medical order scope of treatment (MOST) form that specifically directs the type of treatment a patient would like to have, and how much intervention he or she would like to have, during end-of-life care.

Colorectal cancer screening: SB 61, sponsored by Sen. Ralph Alvarado, R-Winchester, will require that a fecal test to screen for colon cancer, and any follow-up colonoscopy, be considered preventive measures that health insurance is required to cover without imposing additional deductible or co-insurance cost. The governor also signed a similar measure, HB 69, sponsored by Rep. Tom Burch, D-Louisville, which contains an amendment by Sen. Julian Carroll, D-Frankfort, for a Medicaid savings study.

Newborn screenings for fatal disease: SB 75, sponsored by Sen. Alice Forgy Kerr, R-Lexington, will require all newborns to be tested for Krabbe disease, a neurological disorder that destroys the protective coating of nerve and brain cells and is fatal once symptoms occur.

Spina bifida: SB 159, sponsored by Adams, will require medical providers to supply written, up-to-date, accurate information to parents when their unborn child is diagnosed with spina bifida so they can make informed decisions on treatment.

Emergency care for strokes: SB 10, sponsored by Sens. Stan Humphries, R-Cadiz, and David Givens, R-Greensburg, requires that local emergency services have access to a list of stroke-ready hospitals, comprehensive stroke centers and primary stroke centers in Kentucky. Emergency medical providers will set their own protocols for assessment, treatment and transport of stroke patients.

Alcohol and drug counselors: HB 92, sponsored by Rep. Leslie Combs, D-Pikeville, creates an enhanced licensing program to recognize three levels of certified alcohol and drug counselors, with different levels of education. The goal is to increase the number of counselors in the state.

UK cancer research centerHB 298, sponsored by Rep. Rick Rand, D-Bedford, revises the state budget to authorize $132.5 million, half of the cost, for a new medical research center at the University of Kentucky. The university says it will raise money to cover the other half.

These health bills awaited the governor's signature Monday morning:

Physician assistants: HB 258, sponsored by Rep. Denver Butler, D-Louisville, to allow physicians to supervise up to four physicians at the same time, rather than two.

In-home care: HB 144, sponsored by Burch, to establish a 60-day, hospital-to-home transition program through an approval waiver from the Department for Medicaid Services.

Pharmacist-practitioner collaboration: HB 377, sponsored by Rep. Dean Schamore, D-Hardinsburg, to allow collaboration between pharmacist and practitioners to manage patients' drug-related health needs.

Tax refund donations: SB 82, sponsored by Sen. Max Wise, R-Campbellsville, to put an income tax check-off box on tax forms to allow people the option of donating a portion of their tax refund to support pediatric cancer research, rape crisis centers or the Special Olympics.

Health related bills that were left hanging:

The smoking ban, HB 145, sponsored by Rep. Susan Westrom, D-Lexington, never got a hearing in the Senate Veterans, Military Affairs and Public Protection Committee, and neither did the Senate companion bill, SB 189, sponsored by Adams.

Three bills challenged Medicaid managed-care companies. SB 120, sponsored by Alvarado, would have created a process for health-care providers to appeal the companies' decisions to the state passed the Senate, but not the House.  And the following two bills that never got out of the Senate: SB 88, also sponsored by Alvarado, which challenged the $50 "triage fees" MCOs pay for emergency-room visits that they conclude were not emergencies, and would have required them to pay contracted fees instead and SB 31, sponsored by Buford, which would limited the amount of co-payments. Also not getting House action was Alvarado's SB 6 would have created review panels for lawsuits seeking damages from health-care providers.

Wednesday, 25 March 2015

Princess Health andHeroin bill finally passes and is signed into law; Naloxone program put into motion; dating-violence bill sent to Beshear.Princessiccia

Princess Health andHeroin bill finally passes and is signed into law; Naloxone program put into motion; dating-violence bill sent to Beshear.Princessiccia

By Melissa Patrick
Kentucky Health News

The long-negotiated bill to tackle Kentucky's heroin-overdose epidemic passed in the final hours of the 2015 legislative session.

Almost immediately after the heroin bill passed the Senate, a bill to offer immediate civil protections to dating partners who are victims of dating violence was passed after being held in the chamber since February 13 -- likely because Democratic Rep. John Tilley of Hopkinsville, chair of the House Judiciary Committee, was the original sponsor of both bills.

Tilley told reporters that the passage of the two bills meant it had been a successful session.

Gov. Steve Beshear signed the heroin legislation, Senate Bill 192, into law Wednesday, March 25, less than 12 hours after it passed, so that its emergency clause could put it into effect immediately. The dating violence bill, House Bill 8, has been delivered for his signature.

"Senate Bill 192 is tough on traffickers who bring these deadly drugs into our communities, but compassionate toward those who report overdoses or who admit they need help for their addiction," Beshear said in a release. "I applaud our legislators for putting aside partisan interests for the greater good of all Kentuckians who have been affected by this devastating drug."

The bill passed the Democrat-controlled House 100-0 and the Republican-controlled Senate 34-4. Republican senators John Schickel of Union, Joe Bowen of Owensboro, Chris Girdler of Somerset and Paul Hornback of Shelbyville voted against it.

The stickiest issues were a needle-exchange program, which many senators opposed, and tough new penalties for drug traffickers, which Tilley and many House members said would not be effective. The new law allows needle-exchange programs of approved by local governments, and the tough penalties, but allows the judge to be lenient in sentencing if the defendant is an addict.

The bill also allocates money for drug treatment programs; includes a "good Samaritan" provision that allows a person to seek medical help for an overdose victim and stay with them without fear of being charged; access for addicts and their families to the drug Naloxone, a drug that reverses the effects of an overdose; and allows the Department of Corrections to provide an approved medication to inmates to prevent a relapse in their addiction.

"The bill includes provisions that are important to law enforcement and me: increasing penalties for large volume traffickers, expanding access to treatment, and getting heroin overdose reversal kits into the hands of our first responders. I know this legislation will save lives," Attorney General Jack Conway said in a news release.

Hornback argued that "forced rehab doesn't usually work," providing addicts with Naloxone and free needles simply enables them and the bill does not allow addicts any "consequences for their actions."

He said that while he knows there are people dying from heroin overdoses,"I didn't make that decision for them and I for one, and a lot of my constituents are tired of paying for people's bad decisions and that is what this (bill) does."

Tilley said in an interview after the vote that needle exchange programs are proven to work, will save taxpayers money and are absolutely necessary to "stem the tide of two tidal-waves that are headed Kentucky's way: HIV and Hepatitis C and Hepatitis B."

"The cost of treating someone with HIV is $350,000. The cost of treating someone with Hepatitis C is $85,000. The budget now had a $55 million hit just with the explosion of Hepatitis C last year. We can't afford that in Kentucky," he said. Advocates say the programs can be a gateway to treatment and rehabilitation.

Meanwhile, Conway and first lady Jane Beshear announced that funding for Naloxone kits would be made available to the hospitals in Kentucky with the highest rates of heroin overdose deaths. The kits will be provided free to every treated and discharged overdose victim at the pilot-project hospitals.

They made the announcement at the University of Louisville, which treated 588 people in 2013 for heroin overdoses, a news release said. In 2013, the latest data available, 230 of the 722 autopsied overdose deaths, or 32 percent, were caused by heroin, according to the Kentucky Office of Drug Control Policy.

Tilley and Republican Sen. Whitney Westerfield, also of Hopkinsville, "forged a friendship that allowed the two men to work out differences on a pair of high profile bills fraught with political pitfalls," Adam Beam reports for The Associated Press. "Westerfield, a former prosecutor, is running for attorney general against the son of Democratic Gov. Steve Beshear, giving Democrats all the reason in the world not to work with him."

The AP notes that Republican Sen. Chris McDaniel wrote the first draft of the heroin bill that passed the Senate in January, but it omits McDaniel's other role: candidate for lieutenant governor on a slate headed by Agriculture Commissioner James Comer. As the Senate prepared to give the final bill final passage, Republican Floor Leader Damon Thayer accused the House of not passing McDaniel's bill because of his candidacy.
Read more here: http://www.kentucky.com/2015/03/25/3767938_political-compromises-brokered.html?rh=1#storylink=cpy