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August 13, 2018

PREGNANT WOMEN HAVE HIGH RATE OF OPIOID USE

Kentucky had one of the highest rates in the nation of pregnant women using opioids in recent years, providing another example of the state’s struggle with abuse of the painkilling drugs.

The finding was in a report released Friday by the Centers for Disease Control and Prevention, which analyzed data on women hospitalized to deliver babies from 1999 through 2014.

The rate of opioid use disorder per 1,000 delivery hospitalizations in Kentucky went up from 0.4 in 2000 to 19.3 in 2014, according to the CDC report.

That rate of 19.3 was the third-highest in the country, behind only Vermont at 48.6 and West Virginia at 32.1, the report said.

Information for the analysis was only available from 30 states and the District of Columbia, and some did not have data available for all years.

Kentucky also had one of the highest rates of increase in the country in the rate of opioid use disorder among pregnant women, an average of 1.55 annually.

That was fifth-highest among the 30 states and Washington, D.C. Vermont had the biggest annual average increase, at 5.37.

Nationwide, the prevalence of opioid use disorder per 1,000 delivery hospitalizations went up from 1.5 in 1999 to 6.5 in 2014, or 333 percent, according to the CDC report.

The agency said the report was the first multi-state analysis of opioid use disorder among delivery hospitalizations.

The agency said that excessive prescribing of opioids and difficulty in getting non-opioid remedies for pain contributed to the rise in abuse of opioids across the country.

Opioids include heroin and some prescription drugs, but the opioid threat growing most rapidly in Kentucky is from fentanyl, which is far more powerful than heroin.

Of the record 1,565 overdose deaths recorded in Kentucky in2017, fentanyl was involved in 52 percent, according to a report from the Kentucky Office of Drug Control Policy.

That was up from 47 percent of overdose fatalities the year before.

Deaths in which heroin was involved actually went down from 34 percent in 2016 to 22 percent in 2017, according to the report.

There are serious health concerns associated with opioid use by pregnant women, including death, premature labor and the risk that the baby will suffer from neonatal abstinence syndrome, according to the CDC.

Newborns with neonatal abstinence syndrome can have a variety of problems ranging from tremors and irritability to vomiting, fever and excessive weight loss, according to a December 2016 report in the New England Journal of Medicine.

The article said “neonatal withdrawal” is probably a more accurate description of what the newborns go through.

The average hospital stay for infants with the syndrome is 17 days, which is much longer than most babies and drives up health care costs, according to the article.

The Herald-Leader reported in 2017 that the number of babies born with neonatal abstinence syndrome in Kentucky had gone up 375 percent since 2007.

The University of Kentucky started a program called PATHways to deal with the problem, providing expectant mothers with a range of services including group therapy, counseling, education and medication-assisted treatment.

By the spring of 2017, 77 percent of the 150 women who had been through the program had no illicit drugs in their systems when they entered the hospital to give birth, and follow-ups showed the women were less likely to relapse and begin taking drugs again after their baby was born.

By Bill Estep
Lexington Herald-Leader

August 2, 2018

Cancer, MS, Alzheimers relief is reason enough

 

HENDERSON, Ky. -- Advocates for medicinal marijuana said Tuesday the time is now to push for statewide legalization.

They said research is clear that cannabis helps those suffering from a variety of painful conditions, yet, the word marijuana is still taboo for many in society.

Jaime Montalvo deals daily with multiple sclerosis. After being diagnosed, the Louisville man discovered that cannabis improved his quality of life far more than anything else he’d tried.

He didn’t like the black market, so he cultivated at his home. He was arrested and received five years of probation.

“I lost custody of my son for six months, not for cultivation, but for testing positive,” Montalvo said. “So that’s what’s motivated me for the last six years or so, to change the laws and give people safe access to cannabis.”

Montalvo is a cannabis educator and director of KY4MM (Kentuckians for Medicinal Marijuana). He and others who took part in a panel discussion at Henderson Community College were preaching to the choir; most of the 50 or so in attendance seemed sympathetic to legalization.

The challenge, speakers said, is convincing state legislators.

Lawmakers in Kentucky and Indiana have legalized hemp oil, also known as CBD oil. But speakers said the positive impact of that is very small compared to what legal medicinal marijuana could do.


“You’re just really scratching the surface” with CBD oil, said Ashly Taylor, a Lexington native who is now a cannabis industry entrepreneur living in Colorado. “We’re looking to get legalization so we can help more people.”

Taylor, who used to work in the pharmaceutical industry, explained at Tuesday’s forum what a legalized marijuana industry would look like.

She said in a regulated market, all cannabis grown comes from state-licensed, taxpaying cultivation facilities, monitored from seed to sale.

All plants are tagged and entered into a state regulated tracking system.

They are processed at a state-licensed product manufacturing facility, with OSHA guidelines enforced and a staffed human resources department.

The product would pass testing from a state-licensed facility before being distributed for legal consumption.

“All of the things you see with other big industry, you’re going to see here,” Taylor said.

Legal medicinal marijuana “is not that new of a thing,” Taylor noted. It’s been legalized or decriminalized in a long list of countries, from Canada to Australia and many European countries.

It is legal in 30 states, and Taylor cited a shift in public opinion on the subject: 64 percent favorability according to one Gallup poll. She said those who support legalization show varied political bent.

Sympathy for legalization has reached local elected officials in Henderson. The City Commission recently passed a resolution stating support for medicinal marijuana.

Henderson City Commissioner Brad Staton said he and his colleagues were moved by testimony from many city residents, including a veteran with post-traumatic stress disorder who spoke about suicidal thoughts and depression.

“I didn’t think there was any way we would even take a vote much less pass it,” Staton said. “But we said we have people in the state of Kentucky who are suffering, and we can do something about it.” The vote was 5-0.

Forum speakers said cannabis helps with appetite and sleep, in addition to pain relief. They said the addiction potency is comparable to sugar.

A pharmacist in the audience asked the panelists about studies showing negative effects of long-time marijuana usage, and concerns about children’s usage.

Panelists said marijuana already is pervasive in the culture. Montalvo cited a study showing that in Kentucky, about 40 percent of teens have used marijuana.

“We need to decrease that,” he said. “In my opinion the way to decrease it is regulate the product and keep it out of the hands of children. Right now everybody is prohibited, but it’s still everywhere.”

Taylor said Kentucky authorities in 2016 seized and destroyed more than 560,000 plants, placing the state in the nation's top five.

Kentucky that year spent $56.8 million for marijuana eradication.

“If we can take the money we save and do something better with it, it seems like a win-win to me,” Taylor said.

Grace Henderson would agree. The Henderson resident, an organizer of Tuesday's forum, suffers from a list of chronic conditions, such as Ehlers-Danlos Syndrome and Chron's disease.

She's on a list of medications which she said interact and cause other health problems.

Medical cannabis, she said, needs to be a option for people like her who, at times, struggle to simply get out of bed.

"We need a safe, viable alternative that does not kill people," Henderson said. "And this is it."


By John Martin
The Gleaner

 

 

 

July 29, 2018

Drug overdose deaths in Kentucky rose 11.5% in 2017; highest rates in Estill, Kenton, Campbell, Boyd, Mason, Jessamine

 

By Melissa Patrick
Kentucky Health News

Kentucky saw an 11.5 percent increase in drug-overdose deaths in 2017, with more than half of the them from fentanyl, a synthetic opioid that can be up to 50 times more potent than heroin. The number of heroin deaths decreased, but overdose deaths from methamphatime surged, according to to the annual Kentucky Office of Drug Control Policy report.

Chart by Chris Ware, Lexington Herald-LeaderChart by Chris Ware, Lexington Herald-Leader

The state recorded 1,565 overdose deaths in 2017, and has toxicology reports for 1,468. Among those, fentanyl was found in 763, or 52 percent, up from 47 percent in 2016. The 2016 report is available here.

"Fentanyl is the deadliest and most addictive drug our nation has ever seen,” Van Ingram, executive director of the ODCP, said in a news release. “The fact that people continue to use it – despite the obvious risk – shows just how addictive these drugs are. People have become powerless against them. That’s why we have to make every effort to intervene with a comprehensive treatment response.”

Fentanyl has been a leading factor in overdose deaths since 2015 and is often mixed with heroin or put in pills, making it difficult to determine the dosage. Ingram notes that drug cartels in China and Mexico have turned to fentanyl because it is cheap to produce and provides a higher profit margin.

Beth Warren of the Louisville Courier Journal reports that "a dose as small as two milligrams, the size of Abraham Lincoln's cheek on a penny, can be lethal." Carfentanil, a synthetic opioid that is used as an elephant tranquilizer, is even stronger.

The report also said three other drugs contributed to more overdose deaths last year than heroin: alprazolam, gabapentin and methamphetamine.

Alprazolam is an anti-anxiety medicine that is often known by its brand name Xanax. It was detected in 36 percent of the toxicology reports. Gabapentin, which is sells under the brand names Neurontin, Gralise and Horizant, and is often taken along with other illicit drugs to enhance their effects, was found in 31 percent. Methamphetamine, a stimulant that has long plagued Kentucky, was found in 29 percent, more than double last year's total.

"Autopsies and toxicology reports from coroners show that approximately 22 percent of overdose deaths involved the use of heroin in 2017, down from 34 percent in 2016," the report says.

County numbers

Estill County, with a population of 14,375, had 11 overdose deaths in 2017, giving it the state's highest rate of drug-overdose deaths, 7.7 per 10,000 residents, according to a table in the report.

Kenton and Campbell counties in Northern Kentucky had the next highest rates, 6.95 and 6.6 per 10,000. Then came Boyd, at 6.46, Mason, 5,82; Jessamine, 5.65; Montgomery, 5.37; Harrison, 5.32; Franklin, 4.95; Madison, 4.71; Jefferson, 4.56; Grayson, 4.17; Nelson, 4.16; Knox, 4.16; Greenup, 3.94; Fayette, 3.82; Harlan, 3.74; Floyd, 3.31; and Whitley, 3.31.

Other counties' rates were less than the state average of 3.3 per 10,000, or their rates were not published because they had fewer than five overdose deaths last year. The latter group included Leslie, Bell, Powell and Gallatin counties, which led last year's list with rates of 6.6 to 5.6 per 10,000.

The state's two most populous counties, Jefferson and Fayette, had the most overdose deaths in 2017, 426 and 123 respectively. The largest numerical increase in overdose fatalities occurred in Jefferson, which had 62 more than in 2016. Fayette went up by 49, Campbell by 26 and Kenton by 17. The largest decrease was in Madison County, which had nine fewer last year than in 2016.

Like last year, most of the Kentucky deaths were among people between 35 and 44, followed by those 25-34, then 45-54.

Gov. Matt Bevin said the report “underscores just how much is at stake in the ongoing battle against the nation’s opioid epidemic. This is a fight we must win for the sake of our families, our communities, and the commonwealth as a whole. We will continue to leverage every available resource to close off the funnel of addiction and to help our fellow Kentuckians who are struggling against this scourge.”

Kentucky has launched a number of initiatives to battle the epidemic, including a public awareness campaign called "Don't Let Them Die" that offers information on substance use disorder, treatment and naloxone, a drug that can reverse an overdose.

Kentucky State Police have launched the Angel Initiative, which allows those seeking treatment to visit a KSP post, where they would be directed to treatment.

The General Assembly has passed several laws in recent years, including a crackdown on pain clinics, limiting opioid prescriptions for acute pain to a three-day supply (with exemptions), tougher penalties for heroin dealers, more funding for drug treatment, and paying for increased access to naloxone. The attorney general's office has sued pharmaceutical companies.

Data for the report was compiled from the Kentucky Medical Examiner’s Office, the Kentucky Injury Prevention & Research Center and the state Office of Vital Statistics.

Posted by Melissa Patrick

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

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