Princess Health and Princess Health andStates and their congressmen battling new painkiller that is easier to crush and inject.Princessiccia

Princess Health and Princess Health andStates and their congressmen battling new painkiller that is easier to crush and inject.Princessiccia

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Gusty 20:49 Add Comment

Some states are restricting the use of the new painkiller Zohydro, "setting up a showdown with the federal government over who gets to decide the best way to protect public health," Michael Ollove reports for Stateline.

Rogers (Herald-Leader photo)

Though millions of chronic pain sufferers could benefit from the drug, some officials worry that abusers will crush and inject it for a big high, will significantly worsen the painkiller abuse crisis they have been battling. Combating prescription drug abuse has been a focus in Kentucky for the past few years. U.S. Reps. Hal Rogers of Somerset and Stephen Lynch of Massachusetts have introduced a bill to withdraw the Food and Drug Administration's approval, done though an advisory board voted 11-2 against it.

A federal judge told Massachusetts officials that they cannot ban a drug that the FDA has declared safe and effective, but Gov. Deval Patrick is restricting its use. Vermont Gov. Peter Shumlin has taken similar measures, and the Ohio legislature is debating similar action. Twenty-nine state attorneys general, including Kentucky's Jack Conway, have requested that the FDA rethink its approval of Zohydro.

"We're in the context of a very serious epidemic of opioid drug addictions and opioid deaths, and that's a public health crisis that has been growing over the last decade and half," said Michael Carome, director of the Health Research Group at the consumer organization Public Citizen. "The last thing we needed was another extended release opioid for treating chronic pain."

According to Trust for America's Health's 2013 report, "6.1 million Americans abuse or misuse prescription drugs," and "Overdose deaths involving prescription painkillers have quadrupled since 1999, and now outnumber those from heroin and cocaine combined, Ollove reports. Zohydro is an opioid, and opioids are not only easily abused but are also unfortunately gateway drugs, influencing people to use heroin, which isn't as expensive. One advantage to Zohydro is that it is a single-ingredient, long-acting product, unlike other painkillers that were combined with acetaminophen, which can be injurious to the liver.

Opponents are frustrated that the FDA not only approved the drug but also did not force the manufacturer, Zogenix, to create a version that isn't so easy to abuse. The company has said it is making such a version. "In the meantime, it said it has implemented other safeguards, such as compensating sales representatives for educating doctors, pharmacists and patients on the risks and benefits of extended-release opioids," Ollove writes.

Sherry Green, chief operating officer of The National Alliance for Model State Drug Laws, agreed withZohydro maker Zogenix "that taking action against selective prescription drugs is the wrong approach," Ollove reports. Green said, "When we focus almost solely on an individual drug, we tend not to put as much attention on the underlying problem, which is the abuse and addiction. Obstructing illicit routes to one medication only creates pathways to another one." (Read more)

Princess Health and Princess Health andHealth reform law isn't as sweeping when it comes to dental coverage, but Appalachian dentists say it should help.Princessiccia

Princess Health and Princess Health andHealth reform law isn't as sweeping when it comes to dental coverage, but Appalachian dentists say it should help.Princessiccia

dental care dental health dentists health reform Medicaid obamacare oral health Patient Protection and Affordable Care Act rural-urban disparities

Gusty 20:28 Add Comment

Dr. Heather Whitt explains costs to Anita Slone at the Eula Hall
Health Center in Floyd County. (C-J photo by Jessica Ebelhar)

In Floyd County, almost 40 percent of adults have lost six or more teeth to decay or gum disease, more than 50 percent of adults have had at least one tooth pulled, and 25 percent of people older than 65 have lost all of their teeth. But "When it comes to dental care, the Affordable Care Act's reach is limited," Laura Ungar reports for The Courier-Journal.

The Patient Protection and Affordable Care Act requires health plans to cover children's oral health, but adult coverage is optional. Kentucky's Medicaid benefits only cover certain services, such as oral exams, emergency visits, X-rays, fillings and extractions, and rural areas are dealing with a shortage of dentists who increasingly do not accept Medicaid.

Despite these obstacles, Dr. Heather Whitt, director of dental services for a network of health centers called Big Sandy Health Care, said she thinks the reform law will help people who live in Central Appalachia, a hotbed of bad oral health. She said the number of uninsured�which for a long time was almost 75 percent of her patients�is finally beginning to decrease. "Now, there are more adults having Medicaid. It's definitely improved the patients we see here. . . . We stay very busy," she said. "I'm excited more people have benefits."

"She and other dentists said Medicaid, which is covering most of the area residents newly insured through the ACA, does not cover every service they might need," Ungar writes. Whitt noted that Medicaid doesn't cover costs for dentures or root canals for patients older than 21, and some dentists said Medicaid managed-care organizations do not send reimbursements quickly enough.

Whitt said that she and her staff try to teach patients about brushing, flossing and regular checkups. They also teach those things in schools, encouraging children to visit dentists. Dentists say that if the law and Medicaid can get more people to visit the dentist, they'll learn to take better care of their teeth. "A lot of our patients just kind of fall through the cracks," said Dr. James Stambaugh, another dentist at the clinic. "Small problems just grow exponentially." (Read more)

Princess Health and Princess Health andIn Floyd County, opinions about health care reform depend on whom you ask, and in some cases they are surprising.Princessiccia

Princess Health and Princess Health andIn Floyd County, opinions about health care reform depend on whom you ask, and in some cases they are surprising.Princessiccia

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Gusty 13:33 Add Comment

At the Eula Hall Health Center in Grethel,
nurse Stephanie Clark takes vitals of Mary
Murphy, 54, whose leg blood clot wasn't
treated for 15 years because she couldn't
afford it. (C-J photo by Jessica Ebelhar)

"A team of journalists from USA Today and The Courier-Journal has found that in Floyd County, Obamacare is a neither a train wreck nor a cure-all. It's a work in progress; widely misrepresented and misunderstood, it's helped some people and hurt others, while a handful seem unaffected." So write Chris Kenning and Laura Ungar of The C-J, with Jayne O'Donnell and Rick Hampson of the national newspaper of C-J owner Gannett Co. Inc.

Newly insured people are being treated for ailments that they long ignored or tried to treat with inadequate resources, and people who couldn't get or afford insurance because of pre-existing conditions have been able to get it. "Yet, also because of Obamacare, insurance customers in this Appalachian community complain about higher deductibles and insuring those who don't work. Many say they can't afford even subsidized plans on the state's insurance exchange," the writers report. "Some small business owners say they may cut workers' hours. And hospital leaders say the law has exacerbated health-care trends, leading them to lay off workers and shut down an entire floor of Floyd County's largest hospital."

Advocates say the health-reform law will improve Kentucky's health by bringing care to those who haven't had it, but "Obamacare so far shows scant promise of being able to heal Floyd County, where generations of poor health habits and attitudes testify to poverty's victory" despite the "war" on it that President Lyndon Johnson declared in the region 50 years ago. "Real change, many say, will take decades, given the county's poor health: 35 percent of adults smoke, and the overall death rate is 42 percent above the national average. Many lack reliable transportation, have trouble taking time off from low-wage jobs for medical appointments or just don't believe in going to the doctor."

Some say the law didn't go far enough, and worry about its effect on hospitals. "It's insurance reform," said Bud Warman, president of Highlands Regional Medical Center in Prestonsburg, the Floyd County seat. "It's not health care reform.''

Princess Health and Princess Health andKy. leads U.S. in emphysema (COPD), but study shows fewer COPD hospitalizations in Ky. places with smoke-free laws.Princessiccia

Princess Health and Princess Health andKy. leads U.S. in emphysema (COPD), but study shows fewer COPD hospitalizations in Ky. places with smoke-free laws.Princessiccia

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Gusty 13:04 1 Comment

Click on image for larger version

People who live in smoke-free communities are less likely to be hospitalized for emphysema, according to a study by the University of Kentucky's College of Nursing and College of Public Health and recently published in the American Journal of Public Health.

The study found that people who live in communities with comprehensive smoke-free workplace laws are 22 percent less likely to be hospitalized for chronic obstructive pulmonary disease (COPD), or emphysema. Living in a community with an established law also resulted in a 21 percent lower likelihood of experiencing hospitalization due to emphysema.

Kentucky has the nation's highest rate of chronic obstructive pulmonary disease, 9.3 percent of the population, according to the federal Centers for Disease Control and Prevention. Tobacco use is the primary cause of emphysema, but air pollution and genetics can also play a role.

The study matched 2003 and 2001 data on hospital discharges with communities that were part of the Smoke-free Ordinance database from the Kentucky Center for Smoke-free Policy, Ann Blackford reports for UKnow.

Dr. Ellen Hahn (Herald-Leader photo by Matt Goins)

�Smoke-free public policies, particularly when they cover all workplaces with no exceptions and have been in place for at least one year, may provide protection against exacerbation of COPD that lead to hospitalizations, with potential to save lives and decrease health care costs,� said Nursing Professor Ellen J. Hahn, director of the center and lead author of the study. �Given that such a high percentage of Kentuckians live in at-risk rural areas and lack the protective factor of income or smoke-free laws, the state faces a higher risk of COPD."

Lexington was the first Kentucky city to pass a smoking ban. "Lexington's smoking ordinance, which bans smoking in most indoor public spaces, doesn't specify that smokers be caught in the act. But that has become the default standard since the ban went into effect 10 years ago," Mary Meehan reports for the Lexington Herald-Leader. "As the smoking ban in Lexington has aged, the challenges have lessened. In many cases, Hahn said, the ban has been self-enforcing. Patrons at restaurants complain to management about smokers, or bar employees take it upon themselves to keep people from lighting up. Gradually, she said, smoking just isn't accepted or expected anymore. Non-smoking in most places has become the 'new normal.' There are now only a handful of businesses that receive citations. Most are small bars and strip clubs."

Read more here: http://www.kentucky.com/2014/04/26/3214347/10-years-after-it-became-law-fayette.html#storylink=cpy

Read more here: http://www.kentucky.com/2014/04/26/3214347/10-years-after-it-became-law-fayette.html#storylink=cpy

Princess Health and Princess Health andInsurance companies will be allowed to add one more year to policies that don't comply with reforms; decisions due May 5.Princessiccia

Princess Health and Princess Health andInsurance companies will be allowed to add one more year to policies that don't comply with reforms; decisions due May 5.Princessiccia

health insurance health reform obamacare state government

Gusty 13:35 Add Comment

Kentucky�s health insurance companies may extend through Oct. 1, 2016, individual and small-group policies that don't comply with federal health reform, the state Department of Insurance announced Friday. This means some consumers can continue these policies until Oct. 1, 2017.

Insurance companies are supposed to notify the Insurance Department of their decisions by May 5.

This is the second �transitional relief� option offered to states by the federal government. The earlier one came in November 2013 and offered a one-year extension of existing policies; the most recent adds two more years. The latest relief does not affect �grandfathered� plans (those in existence prior to March 23, 2010, the date the law took effect) or newly issued policies.

The Patient Protection and Affordable Care Act requires 10 essential health benefits and includes other provisions that were not part of many old policies.

�We know that health insurance needs are personal,� Insurance Commissioner Sharon P. Clark said in a press release. �This choice would give individuals and small employers the flexibility to make the decision that best fits their needs at this time while planning for full implementation of the Affordable Care Act.�

Princess Health and Princess Health andPoll: Kentuckians still oppose Obamacare, but favor fixes, not repeal, and think state insurance exchange works well.Princessiccia

Princess Health and Princess Health andPoll: Kentuckians still oppose Obamacare, but favor fixes, not repeal, and think state insurance exchange works well.Princessiccia

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Gusty 06:47 Add Comment

Most Kentuckians still oppose the federal health-reform law, but think it should be changed rather than repealed, and most think the state health-insurance exchange created under the law is working well. So says a poll taken for The New York Times and the Kaiser Family Foundation in four Southern states with key U.S. Senate races this year: Arkansas, Kentucky, Louisiana and North Carolina.

"Debate over the law is expected to dominate the midterm elections. Attacks on the law are featuring prominently in campaigns across the country, and Republican lawmakers have continued to push for the law�s replacement," Sabrina Tavernise and Allison Kopicki write. "Questions about it may evoke associations with an unpopular president, the remoteness of Washington from ordinary Americans and extra costs in family budgets. But majorities say they do not want it taken away, even in states that lean Republican in presidential elections."

Among the four states, Kentucky is the only one that is running its own exchange, and the only one in which a majority said it is working well. In Arkansas, which has a combined state-federal exchange, a plurality said it was working well. The other two states use the federal exchange, which had a troubled rollout.

Kentucky is the only Southern state that created its own exchange and expanded Medicaid to include people in households with incomes up to 138 percent of the federal poverty level. The poll found support for Medicaid expansion in all four states, and 55 percent in Kentucky gave Gov. Steve Beshear, who made both decisions, a positive job rating.

The poll, done with landline and cellphone interviews April 8-15, has a margin of sampling error of plus or minus 4 percentage points in each state. (Read more)

Princess Health and Princess Health andAt National Prescription Drug Abuse Summit, Beshear cites Kentucky's successes.Princessiccia

Princess Health and Princess Health andAt National Prescription Drug Abuse Summit, Beshear cites Kentucky's successes.Princessiccia

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Gusty 15:17 Add Comment

Gov. Steve Beshear told attendees at the 2014 National Prescription Drug Abuse Summit in Atlanta on Wednesday about the progress Kentucky has made in the last two years in its battle to combat abuse of prescription drugs.

"Prescription drug abuse was wasting away the future of Kentucky... and collectively, as a state, we decided it was past time to take aggressive action," Beshear said.

Two years ago, Beshear attended the summit  and described a plan; what Kentucky was going to do about prescription drug abuse. Since then, not only has Kentucky implemented an aggressive, strategic plan, it has data showing significant progress.

The plan included increased monitoring of prescriptions, tighter regulations for painkillers, closing pain clinics that did not meet tougher requirements, collecting and disposing of leftover drugs and educating prescribers and the public about the dangerous, addictive nature of these drugs.

The state also set up an electronic prescription drug monitoring system, called KASPER and increased coordination among health regulators and law enforcement both inside Kentucky and with other states.

As for the progress, the evidence is in the numbers. From August 2012 to July 2013, Kentucky saw an 8.5 percent drop in the prescription of controlled substances, Beshear reported, adding that there must have been " a lot of unnecessary prescribing going on."

He also noted the closure of 36 pain clinics that did not meet the new requirements: "They packed up and left, essentially in the dark of the night."

Beshear reported the third area of improvement as less reported abuse of prescription drugs by teen-agers, based on every-other-year surveys of Kentucky 10th graders by Kentucky Incentives for Prevention.

In 2008, 19.3 percent of 10th graders said they had used prescription drugs for non-medical purposes at some point in their lives. In 2012, that number had dropped to 10.4 percent. In 2008, 14.1 percent said they had illegally used prescription drugs in the last month; in 2012, that number dropped to 7.6 percent.

Getting rid of old, unused drugs, whose presence in medicine cabinets can lead to abuse and theft, has also been a strategy of success in Kentucky, Beshear said. He said 172 permanent drop-off sites have been established, with at least one site in 110 of Kentucky's 120 counties.

Beshear also stressed the importance of educating both prescribers and the public. Kentucky's medical community has access to a free, on-line education program and students in Kentucky participate in Keep Kentucky Kids Safe program which has reached 40,000 students so far.

The governor said increased availability of substance abuse treatment is important, and mentioned his expansion of Medicaid under federal health reform. "Access to treatment is at an all-time high in Kentucky, thanks to expanded Medicaid programs and the Affordable Care Act," he said. "There are many addicts who want to get clean, and we�re helping them." For a copy of the speech, click here.