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Date: 07-15-2015

Rise in Ky. overdose deaths indicates persistent challenge of reining in substance use, abuse 

Kentucky Press News Service

FRANKFORT – Kentucky overdose deaths increased in 2014, while the number of deaths attributed to the use of heroin stayed relatively constant from 2013 to 2014, according to a report issued Wednesday by the Office of Drug Control Policy. The total rise in overdose deaths, after leveling off last year, indicates the persistent challenge of reining in substance use and abuse, officials said. The youngest overdose fatality was an infant, less than a year old, and the oldest was 80 years old.

The report indicates 1,087 overdose fatalities in 2014, compared to 1,010 identified in the 2013 report. Of the 795 deaths autopsied by the Kentucky Medical Examiner last year that were determined to be from a drug overdose, 233, or 29.5 percent, were attributed to heroin, compared to 230, or 31.9 percent, in 2013.

“I am discouraged that overdose deaths increased in 2014 over 2013 and I think this demonstrates the pervasive grip and cyclical nature of addiction,” Van Ingram, executive director of the Office of Drug Control Policy, said in a state news release. “Fortunately, we’ve recently put in place some changes that we hope will bring the number of deaths back down in 2015, including the expanded increase to naloxone and Good Samaritan provisions contained in Senate Bill 192. Meanwhile, there was not an increase in the prevalence of heroin in 2014, and I am pleased about that.”

The numbers, contained in the 2014 Overdose Fatality Report, were compiled from the Kentucky Medical Examiner’s Office, the Kentucky Injury Prevention & Research Council and the Kentucky Office of Vital Statistics. The report was mandated under a provision in House Bill 1, which was passed in 2012.

The law also mandated more stringent reporting requirements for deaths caused by overdose, which went into effect midway through 2012. Ingram noted that a heightened awareness of those requirements may have contributed to the increase in deaths reported. 

Ingram said that the report contains known overdose deaths as of mid-July 2015, and that a small number of overdose deaths for 2014 may still be reported as death certificates from county coroners are turned in to the Office of Vital Statistics.

Among other significant findings in the report:

• Jefferson County had the most overdose deaths of any county, with 204 (up 12 from 2013).

• The largest increase in overdose fatalities occurred in Fayette County, up 26 with 112 deaths in 2014, compared to 86 in 2013. Boone County reported 12 additional overdose deaths, while Campbell and Madison counties were up 11 each in 2014.

• The largest decrease occurred in Bell County, with 15 fewer fatalities in 2014 than in 2013 (11 versus 26, respectively). Other counties with significant declines in 2014 included Davies (14 fewer), Hopkins (12 fewer) and Harlan (6 fewer).

• Overdose deaths in some Kentucky counties, when compared by 100,000 population 2014 data, showed high rates. The top eight counties by overdose deaths per 100,000 people for 2014 were:

1. Floyd County 55.1 per 100,000
2. Pike County 50.8 per 100,000
3. Campbell County 47.9 per 100,000
4. Kenton County 43.3 per 100,000
5. Boone County 38.0 per 100,000
6. McCracken County 30.6 per 100,000
7. Bullitt County 28.2 per 100,000
8. Madison County 26.3 per 100,000

• The top five counties for heroin detected in overdose deaths, using data from the Kentucky Medical Examiner and coroner reports include:

1. Jefferson 105
2. Fayette 35
3. Kenton 26
4. Campbell 15
5. Boone 14

A review of cases autopsied by the Kentucky Medical Examiner’s Office indicates that in 2014:

• The vast majority of overdose deaths were the result of polysubstance toxicity, meaning victims had multiple drugs in their system.

• Morphine was the most detected controlled substance in overdose deaths, present in 40.88 percent of all autopsied cases.

• Cannabinoids was next at 35.72 percent, followed by 6 monoacetylmorphine (heroin) at 28.81 percent, Ethanol 28.18 percent, Alprazolam 26.79 percent, hydrocodone at 21.01 percent, and oxycodone at 19.12 percent. 

Dr. Tracey Corey, Kentucky’s chief medical examiner, said that many of the cases reported as morphine may in fact involve heroin, as morphine is the major pharmaceutical substance detected in the blood after injection of heroin, and the other substances present in the blood indicating heroin use may have already been eliminated at the time of death. But she also cautioned that some of those cases may involve only morphine, rather than heroin, so conclusions should be drawn with care.
Corey further cautioned that the data would need comparison to other data such as overall population numbers, to know if the changes from 2013 to 2014 are statistically significant. “With statistics and numbers, the devil is in the details. What we can definitely say is that we need to continue to devote significant resources and energy to help curb the tragic and untimely deaths of so many Kentuckians.” 

july 13, 2015

Kentucky Health News
Events, trends, issues, ideas and journalism about health care and health in Kentucky


State requirements are in place for kindergartners and rising sixth graders

(An editorial in the Bowling Green Daily News about the importance of getting your child vaccinated before school starts is applicable to all communities in Kentucky.)

State law requires children to be vaccinated upon entering kindergarten, with exemptions given only for medical or religious purposes. Fewer than 1 percent of Kentucky's kindergarteners were exempted during the 2013-14 school year, according to the federal Centers for Disease Control and Prevention.

For years, widespread misinformation about the safety of immunizations has caused some parents to think the mumps-measles-rubella (MMR) vaccine or the mercury-containing preservative thimerosal causes autism. Both of these claims have been proven untrue. The original study that linked the MMR vaccine to autism has since been scientifically discredited and is now considered "fraudulent," and extensive scientific studies have concluded that there is no causal connection between thimerosal and autism. The MMR vaccine does not contain thimerosal.

The editorial notes that this reluctance to vaccinate has shifted since the outbreak of measles earlier this year that resulted in mostly unvaccinated people becoming infected with measles at Disneyland from an infected traveler.

"A University of Michigan poll released this month shows 34 percent of parents think vaccines have more benefit than they did one year ago; 25 percent of parents believe vaccines are safer than they were a year ago; and 35 percent of parents report more support for day care and school vaccine requirements than a year ago," the editorial writes.

So far this year, nearly 200 people have contracted measles. In 2014, there were more than 600 cases, a sharp increase from the less than 200 the year before, according to the CDC.

So, with school about to start in a month, the editorial encourages all of its citizens to get their kids vaccinated.

"The beginning of school will be here before you know it,"says the editorial. "So please take your kids and get the necessary vaccinations they need for their own well being and for the well being of their classmates."

Vaccination schedule:

Before kindergarten, kids need immunizations, a school physical, a vision exam and a dental exam.

Children entering kindergarten receive the DtaP for diphtheria, tetanus and pertussis; a measles-mumps-ruebella vaccine; and a chicken pox vaccine.

Children entering sixth grade receive a booster vaccine for tetanus, diphtheria and pertussis (TDAP), a meningitis vaccine, and a second chicken-pox vaccine.

The HPV vaccine is also recommended, but not required. This vaccine protects against the many cancers caused by the human papillomavirus, including cervical cancer in girls, and anal cancer and genital warts in both girls and boys. HPV vaccines are given in a three-dose series that should be started and finished when the boy or girl is 11 and 12. Pre-teens and teens who have not gotten this vaccine series should ask their primary care provider about getting them.

Flu vaccines are recommended for school-aged children every year as soon as it is available, but not required. This vaccine is especially important for those with chronic conditions like asthma or diabetes.

Posted by Melissa Patrick at 5:01 PM

July 2, 2015


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.”


Amanda Copley has recently been selected as the Registration Coordinator with Three Rivers Medical Center, announced Chief Executive Officer Greg A. Kiser, MHA.  

Amanda CopleyCopley was hired on August 12, 2009 as a registration and admitting clerk with the hospital for over six (6) years.  Through her tenure as a clerk, Copley has developed solid working relationships with the clerks and the Emergency Department staff in working out the processes to better her department.  In her role as Registration Coordinator, Copley will be responsible for the admitting and registration department, including switchboard, inpatient and outpatient registration and emergency department registration.

“I am very pleased to welcome Amanda Copley to be an integral part of the management team and to lead our registration clerks forward.  She brings a wealth of admitting, pre-registration, central scheduling and ER registration in her role as Coordinator.   I am confident that Copley will be a team player, dependable and a great role model to follow in working with staff as well as fellow hospital employees.  She is a great asset who is dedicated and willing to complete extra assignments for the hospital,” Lucrece Carter, Director of Admitting, stated.

Copley resides in the Fort Gay area with her one son, Kristofer Braden Herald.  She attended Huntington Junior College in Huntington, West Virginia and received an associate degree in Medical Coding.  In her spare time, she enjoys reading, going to concerts and movies as well as spending time with family and friends.  She is a welcome addition to the management team of TRMC.  


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.