When his father came home with change he had taken from a payphone to pay for his sister’s prescription, Dr. Nick Kouns understood the importance of medicine and decided he would become a doctor. Earlier this week, Kouns, who now chairs the department of medicine at Clark Regional Medical Center in Winchester, became involved in a contentious discussion about his medical opinion supporting the medicinal benefits of marijuana with the Interim Joint Committee on Health and Welfare.Kouns emphasized to lawmakers that since he was a child he understood how precious medication can be to a patient and after receiving a Thomas J. Watson Fellowship, Kouns studied medicine abroad in countries including Israel, Egypt and South Africa.Citing reports and literature from the National Cancer Institute at the National Institutes of Health, Kouns said 75 percent of the world’s doctors endorse the use of cannabinoids, the active compounds found in marijuana, to be beneficial for Post Traumatic Stress Disorder, nausea, controlling loss of appetite and symptomatic treatment for cancer patients. “If physicians are lieutenants when it comes to controversial or new treatment protocols, those are the people we need to look to,” Kouns said. “I can talk about the National Institute of Health, the National Cancer Institute, the American College of Physicians, the American College of Neurology and on and on who have very similar opinions in their advocacies of medical marijuana.”Better alternativeUsing medical marijuana for relief from chronic pain, Kouns said was a better alternative to the withdrawal symptoms and abuse associated with benzodiazepines and opiates. “The fact that medical marijuana is a medicine to my mind is incontrovertible,” Kouns said. “To not move forward in a rational and meaningful way is a willful disregard of the medical literature.” Kouns encouraged lawmakers to look at the evidence and literature in support of medical marijuana and the states that have adopted or are in the process of adopting medical marijuana policies, including the District of Columbia. More doctors don’t come forward to policymakers, Kouns said, because of the stigma of marijuana and that it is a crime. Rep. Robert Benvenuti (R-Lexington) remarked that instead of Kentucky adopting any medical marijuana legislation, the state should allow the FDA to do its due diligence in researching the substance’s medicinal properties. Support not thereMoreover, Benvenuti said he had position statements from the American Cancer Institute, American Society for Addiction Medicine and the American Psychiatric Society that say the research in support of medical marijuana isn’t there. As many organizations show opposition to the legislation, Kouns said he has research supporting medical marijuana such as that from the National Cancer Institute. Sen. Joe Bowen (R-Owensboro) asked Kouns if had ever recreationally used marijuana and if it impaired his ability to drive a car. Kouns candidly answered that he had recreationally used marijuana in college, and the only casualty was eating a large portion of a sheet cake and that marijuana’s safety profile couldn’t be compared to something as dangerous as oxycontin.Co-Chair Rep. Tom Burch (D-Louisville) reined in the discussion saying the doctor was invited to the committee to give his medical opinion and that he was brought before legislators to answer their questions not debate personal beliefs. “I’m very much a believer in facts,” said Sen. Reginald Thomas. (D-Lexington) “I guess the question before us…what is it going to take to convince us of its usefulness.”
By Brad BowmanThe State Journal
Dr. Tom Friedon
Dr. Tom Frieden, director of the U.S. Centers for Disease Control and Prevention, juggled an Ebola outbreak in Africa while traveling in Eastern Kentucky last month to learn about the region's stark health disparities. Kentucky's lung cancer rate exceeds the nation's by 67 percent, and in Eastern Kentucky it's even higher. The state's ranking on heart disease has actually worsened, Frieden reported, going from 30 percent above the U.S. rate in 1999 to 54 percent in 2011. How can we fight this scourge? Frieden prescribed: Higher tobacco taxes, Public smoking bans, Aggressive advertising about how smoking and tobacco use harm human health.
By Chris KenningThe Courier-JournalWith a smoking rate that tops the nation, Kentucky is further tightening tobacco restrictions for 33,000 state workers, Gov. Steve Beshear said Thursday.A new executive order will expand a 2006 ban on smoking inside state buildings to include surrounding property such as sidewalks, lawns and parking lots, while extending it to include all forms of tobacco such as snuff, chew or e-cigarettes — and it will apply to state vehicles.State parks, rest areas, some veterans centers and the state fairgrounds will be among those areas exempted under a new policy, which is effective Nov. 20 for the state’s largest employer in 2,888 buildings.“When it comes to preventable illnesses and deaths, nothing in Kentucky is as devastating as smoking and tobacco use,” Beshear said. “Today’s policy is about improving our health.”The order, signed Thursday, comes after the General Assembly earlier this year rejected legislation that would have prohibited smoking in workplaces throughout the state, which opponents said trampled the rights of property and business owners.Amy Barkley, head of the Smoke-free Kentucky advocacy group, applauded Thursday’s action, saying in a statement that it would protect non-smokers and help others quit. The state says about 5,000 of its workers use tobacco.“We are hopeful that this policy will motivate the legislature to pass a comprehensive, statewide, smoke-free law that will protect the rest of Kentucky workers from secondhand smoke exposure in all other indoor workplaces,” she said.But the new policy did not go over well among state workers in the outdoor smoking area at Louisville’s L&N building on Broadway, which houses hundreds of employees with the Kentucky Cabinet for Health and Family Services offices.“My health is my business, not his,” said state worker Amy Frith, who sat at a wooden picnic table on a converted loading dock with a half-dozen other upset smokers, who said it would force them across the street. “Fix our economy, don’t worry about what we’re smoking.”Others said they smoked because their jobs were stressful and poorly paid, and noted they already paid a health care surcharge for smoking. Frith added, “Is he going to come and take my Hershey’s bars, too?”A recent Gallup-Healthways report found Kentucky topped states in smoking, at 30.2 percent — a rank it has held since 2008. Nearly 7,900 residents die each year of smoking related illnesses, in a state with one of the nation’s highest rates of lung cancer.Beshear said he and the General Assembly have already worked to raise taxes on cigarettes, expanding counseling services to quit and banning sale of e-cigarettes to youth.Yet with the smoking rate slowly falling nationally to 19.7 percent — and 33 states having bans on smoking in private worksites and restaurants — support for smoking bans is growing, even in Kentucky, polls show.A Bluegrass Poll earlier this year found that, for the first time, a majority, or 57 percent, supported a statewide ban. Supporters included groups such as the Kentucky Chamber, which argued that smoking costs the state billions a year and raises health care costs.Beshear said tobacco-related health care costs amount to nearly $1.9 billion a year in Kentucky.At least 39 Kentucky cities and counties have enacted or adopted some sort of smoke-free law, including Louisville and Lexington, according to the University of Kentucky’s Tobacco Policy Research Program. Some are stricter than others, advocates say.The latest move by Beshear adds to the executive order signed by Governor Ernie Fletcher in 2006. Prior to that, the state was required to provide access to indoor smoking facilities in office buildings. The L&N, for example, had a large indoor smoking room.He said he include e-cigarettes because, while they do not contain tobacco, do contain nicotine and can increase the likelihood of someone smoking.Asked how it would be enforced, he said that “we’re not going to have tobacco police” but said that “anyone who repeatedly refuses to abide by the policy would be subject to disciplinary action.”At the L&N, security guard Wesley Burton said he was going to have to stop people from smoking while he, too, would be craving a smoke.The policy doesn’t include the General Assembly or the judicial branch, but Beshear said he hoped other offices and even employers would follow suit. He said the state would continue to offer programs to help employees quit.He highlighted a state goal to reduce smoking by ten percent across the state, and said he planned to support another attempt to pass a broad state smoking ban in 2015.“We’re setting an example here,” he said.Smoking will be banned at property surrounding state buildings including:• Sidewalks• Lawns• Parking lots• State VehiclesExempt locations:• State parks• rest areas• some veterans centers• State fairgrounds
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