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July 2, 2015

SENATORS PUSH FOR CONTROL AGAINST PRESCRIPTION MEDICATION ABUSE

Republican U.S. Sen. Mitch McConnell and two Massachusetts Democrats have found common ground in efforts to fight the opioid-overdose crisis and are working across the aisle to push for legislation and information to address it, Asma Khalid reports for WBUR, a Boston NPR affiliate.

Sens. Ed Markey, D-Mass., and Mitch McConnell, R-Ky., agree on fighting the opiod overdose epidemic. (AP photos)“McConnell and I are requesting that there be a surgeon general report on the opioid overdose epidemic in the United States,” Sen. Ed Markey told Khalid. Markey is also co-sponsoring a bill with Sen. Rand Paul, R-Ky., to expand the use of medication-assisted treatment, like Suboxone.

Kentucky has the third highest overdose death rate in the nation, with more than 1,000 people dying each year, according to the state attorney general's website. Massachusetts has the 32nd highest overdose death rate in the nation, according to Trust for America's Health. Most of these opioid deaths in both states are from prescription drugs.

“The reason I can do that with two senators from Kentucky, who are Republicans, is that there really is no difference between Lexington, Massachusetts, and Lexington, Kentucky,” Markey said. “We have an epidemic in both states, and we have to ensure that we put together a national plan.”

McConnell has also partnered with Rep. Katerine Clark, D-Mass,, on a bill that focuses on infants and neonatal abstinence syndrome. “Mitch McConnell and I may disagree on 98 percent of topics, but we agree on this,” Clark told Khalid.

Drug-dependent newborns in Kentucky increased by 48 percent last year, to 1,409 from 955 in 2013, which was up from only 28 in 2000, Laura Ungar reported for The Courier-Journal last week. "Research in the Journal of Perinatology shows opioid addiction in babies grew nearly five-fold between 2000 and 2012," Khalid notes.

The McConnell-Clark proposal "tries to pull the best practices from around the country to improve treatment and prevention for sick babies. The bill has 80 cosponsors so far, and they’re from both sides of the aisle," Khalid reports, with no opposition voiced at the House Committee Energy and Commerce last week.

Another Massachusetts Democrat on the committee said he supports the effort, but the key is money -- something McConnell has been stingy with, supporting automatic cuts to reduce the federal budget deficit.

“The big push that I’ve been trying to focus on in our hearings is this comes back to the lack of resources — lack of doctors, lack of treatment facilities, lack of beds, lack of continuum of care,” said Rep. Joe Kennedy III, D-Mass., “because our federal government has systematically underfunded resources for prevention and treatment.”

HALF AGAIN AS MANY KENTUCKY NEWBORNS WERE HOSPITALIZED FOR DRUG DEPENDENCY LAST YEAR AS THE YEAR BEFORE

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

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

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

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

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

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

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

JUNE 22, 2015


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.
Posted by Melissa Landon at 3:27 PM

June 23, 2015

Kentucky Homeplace has been serving the residents of Kentucky for more than 20 years.  It is operated by the University Of Kentucky Center Of Excellence in Rural Health and currently has an office located in Lawrence County, on 108 Bulldog Lane in the Lawrence County Community Building.

Although many more Kentuckians now have insurance, some individuals still find it difficult to afford their healthcare needs.  If you, or someone you know, needs assistance with getting medication, eye glasses, hearing aids, or has questions about Medicare, contact your local community health worker.  Kentucky Homeplace also offers assistance with disease self-management for clients who want to take control of their chronic disease.

For an appointment, please contact Angela McGuire at (606)638-1079.  Services are offered at no cost to clients.  Kentucky Homeplace does not access controlled substances for clients.  Funding for Kentucky Homeplace is provided in part by the Kentucky Cabinet for Health and Family Services.

Date: 06-16-2015

Kentucky is the most allergic place in the country

“It’s a very, very allergic place along the Ohio Valley. With the vegetation and types of trees, grasses and weeds, typically the spring is the worst.”

The official first day of summer is less than a week away, and with summer’s arrival spring allergy sufferers typically get something of a reprieve.

That reprieve hasn’t been as noticeable in recent years, including this one, as tree pollen is still prevalent throughout most of Kentucky. Grass pollen is also starting to cause problems for people with allergies.

Dr. Ara Makdessian, a specialist at Bluegrass Ear, Nose and Throat in Winchester, works with general otolaryngology and allergy and sinus disorders, and has seen a steady flow of patient visits in his office this spring.

It’s a trend Makdessian, who’s been in Winchester for the past 10 years, doesn’t foresee subsiding anytime soon.

“Basically, Kentucky is the most allergic place in the country,” Makdessian said. “They (Asthma and Allergy Foundation of America) rate cities across the country as the most allergic and Louisville and Lexington in the past five to 10 years are typically in the top five.

“It’s a very, very allergic place along the Ohio Valley. With the vegetation and types of trees, grasses and weeds, typically the spring is the worst.”

Long, cold and snowy winters add to allergy problems, Makdessian said.

“Whenever we have a harsh winter and it’s prolonged, what happens is trees delay in blooming and they kind of all try to pollinate or catch up. All tree species pollinate at the same time in large volumes and they call that the pollen vortex,” he said.

With large volumes of oak, ash, elm, pine, cedar and sycamore pollen in the air, the more sensitive people are to pollen and will experience stronger reactions.

“You become bombarded with various pollen types,” Makdessian said. “Your immune system becomes overwhelmed and it goes into overdrive. You start having the typical symptoms of watery eyes, scratchy eyes, sneezing, coughing and it goes into overdrive.”

Makdessian said in more severe cases, allergy sufferers may begin to break out into hives or have asthma-like symptoms, shortness of breath and wheezing.

In April and May, pollen counts in Winchester and Clark County were consistently around a 10 on a scale of 1 to 12 according to Pollen.com, with 12 being extremely high.

“We had that big storm in February and another in March and that made a big difference,” Makdessian said. “They were pretty severe and it prolonged the winter. Trees are smart and all living things ensure survival by passing on genes, so their way of passing on genes is pollen or cross-pollination. When they sense they’ve missed a week or two they increase their volume.”

Makdessian mentioned now tree pollen numbers are going down, while grass pollen is going up. Typically in Kentucky, the grass pollen season isn’t as severe as tree pollen because the summer months are usually dry and hot, which doesn’t allow grass nutrition.

That and in most urban areas, people mow their lawns which keeps grass from pollinating. However, once fall hits, the ragweed season creates more problems.

Along with ragweed, mold in the fall season becomes a large problem, Makdessian said.

“A lot of people don’t know about mold. Mold is in the atmosphere 12 months out of the year,” he said. “In the winter months that number goes down because here the rainy season is in the spring and fall. The mold count goes up in the fall especially because that season you get a lot of dead leaves on the ground. Molds like organic matter and water. In the fall, they get both.”

Many allergy sufferers can get relief from symptoms by various over-the-counter medications, but with increased symptoms associated with a bad tree pollen season, such as this spring, many visit an allergist to treat symptoms more aggressively.

“In terms of patient volume, it has increased dramatically because of the pollen season this spring,” Makdessian said.

Makdessian said in order for an allergist to properly treat allergies, first a patient’s medical history is looked at before making a proper diagnosis. The two most common ways to test and properly diagnose allergies are blood testing and skin testing. Skin testing is still considered the main standard today.

“The skin test I do is not only a diagnosis, but it’s quantitative which means it tells me the degree of sensitivities you have,” he said. “It not only tells me yes or no, but it tells me how severely you are allergic to a specific pollen.”

Treatment for allergies come threefold with avoidance, medication and immunotherapy.

“Here in Kentucky, it is the most allergic place in the country and I see a lot of patients who have multiple allergies, we call them polysensitized,” Makdessian said. “I rarely see patients who test positive to just ragweed or only to mold or only to grass. Over 90 percent of my patients are polysensitized, which means at the same time they are allergic to dust mites, dog dander, cat dander, molds, tree pollen, grass pollen and wheat pollen. That changes the dynamic of the treatment.”

Immunotherapy is also the only treatment available which will modify the disease process, while medication simply controls symptoms, Makdessian said.

“You’re genetically hard wired to develop sensitivities to your environment and medication does not modify the course of your allergic disease,” Makdessian said. “The only way to make it better is allergy shots. Shots work in the same sense as vaccines, we’re basically exposing your immune system to those allergens and making your immune system tolerant. By the time you finish the therapy, your immune system recognizes it’s nothing harmful.”

Along with shots, allergy drops are a relatively new way of immunotherapy, however the drops are not yet covered by major insurance providers or FDA approved.

Makdessian said allergy drops are more convenient to most simply because they can be administered yourself at home or work anytime.

Makdessian doesn’t see allergy symptoms improving anytime soon.

“Global warming will have a huge impact on when trees will pollinate, either prolonging the pollination period or making trees like this year pollinate in high volumes,” Makdessian said. “In the future, that may even overlap with grass pollen.”

Although allergies are not a serious or life-threatening issue, they do interfere with a person’s quality of life and are a progressive disease which could lead to a sinus infection, asthma or eczema.

By Steve Foley
The Winchester Sun